PROVIDENCE, RI – The grimy details of a multimillion-dollar insurance fraud scheme have hit the Rhode Island streets as two co-owners of Alternative Integrated Medicine, LLC (AIM Health), are accused of bilking federal and private health care providers out of nearly $1.9 million dollars.
Brandon Nowak, 32, of Providence, and Jason Simmons, 32, of Foster, made their initial court appearances on Tuesday, charged with health care fraud conspiracy, health care fraud, and filing false claims. The duo was released on unsecured bond as they face these serious allegations.
AIM Health, a holistic health center based in Warwick with satellite offices in Pawtucket, North Kingstown, and East Providence, is alleged to have submitted fraudulent claims for services never provided, including infrared therapy, hot and cold therapy, therapeutic activity, and self-care/home management training.
According to charging documents, Nowak directed these actions, while Simmons was complicit. They also allegedly billed for acupuncture and office visits when only massages were given, claimed high complexity visits without the required service, altered codes on reimbursement forms to avoid automatic denials, and used credentialed provider numbers for uncredentialed services.
The end result of these fraudulent activities? A staggering $1,872,330 in payments from government and private insurers that AIM Health was not entitled to receive.
As a federal criminal complaint is merely an accusation, Nowak and Simmons are presumed innocent until proven guilty. Assistant United States Attorneys John P. McAdams and Rachna Vyas are prosecuting the case, which was investigated by the U.S. Department of Health and Human Services-Office of Inspector General, the FBI, and supported by the Defense Criminal Investigative Service and the Department of Veterans Affairs-Office of Inspector General.
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Key Facts
- State: Rhode Island
- Agency: DOJ USAO
- Category: Fraud & Financial Crimes
- Source: Official Source ↗
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