Grifty Scientologist Chiropractors Charged With $80 Million In Medicare Fraud, And Oh, Hi Rick Scott!
A pair of Orange County, New York, chiropractors were indicted last week for some truly impressive Medicare fraud; US Attorney for the Southern District of New York Geoffrey Berman unsealed an indictment accusing them and two members of their office staff of defrauding Medicare of more than $80 million dollars. Not only are the chiropractors brothers -- they're big-time Scientologists, and, in perhaps a sign that names are destiny, they're named Jeffrey and James "Jay" Spina. What a couple of grifty crackers!
The story comes via journalist and former newsweekly editor (Village Voice, Broward-Palm Beach New Times) Tony Ortega, who now blogs about the Church of Scientology and some of the weirdass shit it gets up to. But these birds would be amazingly sleazy crimers even with no connections at all to the Old Hubbard Mother Ship. When we saw the headline "Feds Charge Scientologists in New York for $80 Million Medicare Scam" we thought maybe the church itself was involved, but nah -- at most, the only connection there is that the Spina brothers channeled their Medicaid fraud proceeds into lots and lots of pricey high-level Scientologyizing:
According to Scientology's own publications, Jay Spina went "Clear" in 1990, did the expensive L10-L12 Rundowns at the Flag Land Base in 1990-91, finished OT 7 in 2003, and completed the "Havingness Rundown" just last year. His brother Jeffrey went Clear in 1990, did the L's in 1990-91, OT 3 in 1994, and the Purification Rundown (again) last year.
So, just to be clear, there weren't any Thetans at all involved in this crime. The spine boys did it all on their perfect, ready-for-Xenu selves. With some help from their sister, Kim Spina, and their bookkeeper Andrea Grossman. All four were charged with a single count each of health care fraud and of conspiring to commit health care fraud; the brothers were also charged with a count each of obstructing a federal audit, which was conducted by accountants with computers, not charlatans with an E-meter. (If you want more on just how deeply involved in Scientology the Spina lads were, Ortega goes into way more detail -- they've even won a very prestigious award!)
And just what kind of scam were the running on Medicare? More like, were there any scams for Medicare dollars they weren't running? The indictment is a doozy, and makes for pretty amazing reading. They were into a little of everything! In addition to their own chiropractic clinic, the two also owned a bunch of other medical businesses, although they hid their ownership of the entire complex of companies to help hide their scamming. They had straw owners in place who pretended to run them, and even gave their stand-ins scripts, so they could answer questions from insurance companies that might get nosy.
The indictment emphasizes over and over that maximum reimbursement, not medical necessity, was behind most orders for medical tests, treatments, or equipment, which many times were never actually provided, but billed for all the same. Lots of back braces for people who didn't need them, and lots of unnecessary testing like MRIs or treatments given by other providers -- and when patients were referred outside the Spinas' own clinic, the providers they were sent to paid kickbacks to the grift brothers. The Spinas also specialized in double-billing: charging both Medicare and a private insurer for the same procedure and faking paperwork to make it appear the service had been done for different reasons. We guess the lucky "patients" were the undercover law enforcement officers whose complaints were as bogus as the treatments the brothers billed for, but never actually provided -- one of the cops spent only "four minutes at the clinic (in the bathroom) and received no treatments or services," but the Spinas billed both Medicare and a private insurer for two different nonexistent treatments.
And speaking of Medicare fraud, let us never forget who ran what was, at its time, the biggest Medicare scam ever: Florida Governor Rick Scott, who's now running for the US Senate. As CEO of of Columbia/HCA, Scott made assloads of money while the hospital chain did all sorts of fraud, as Politifact summarizes from a 2000 settlement in the case:
• Columbia billed Medicare, Medicaid, and other federal programs for tests that were not necessary or had not been ordered by physicians;
• The company attached false diagnosis codes to patient records to increase reimbursement to the hospitals;
• The company illegally claimed non-reimbursable marketing and advertising costs as community education;
• Columbia billed the government for home health care visits for patients who did not qualify to receive them.
Gee, that sounds kind of familiar, though on a much grander scale than what just two guys managed to pull off in New York. Still, they dreamed big. Scott resigned as CEO of Columbia/HCA in 1997, a few months after the federal investigation was made public; he got a $10 million severance package. The company later settled with the feds and paid fines totaling $1.7 billion. Politico has a good overview of the whole wretched mess.
Not surprisingly, now that Scott is trying to defeat Democratic incumbent Bill Nelson, Democrats have been focusing on just how awful Scott has been for healthcare in Florida -- not just in his background as a frauder, but also his constant opposition to Medicaid expansion, his privatization of Florida's Medicaid program, and then his attempts to slash a billion dollars in funding for Medicaid. There's just something about this guy and healthcare, we don't know. And let's not forget the 11 nursing home residents who died after Hurricane Irma last year while the nursing home frantically left messages on Gov. Scott's private phone -- or the fact that those messages got deleted, somehow.
Scott, of course, insists this is all old news, because no matter how grifty he was, Floridians elected him governor twice, didn't they? But this year, let's hope they're paying closer attention.
For your edification, here's the indictment against the Spina brothers in New York, be advised that if your jaw drops in amazement while reading, that's not really covered by Medicare. We wish the fellas luck in their inevitable career in Florida politics.
Doktor Zoom's real name is Marty Kelley, and he lives in the wilds of Boise, Idaho. He is not a medical doctor, but does have a real PhD in Rhetoric. You should definitely donate some money to this little mommyblog where he has finally found acceptance and cat pictures. He is on maternity leave until 2033. Here is his Twitter, also. His quest to avoid prolixity is not going so great.