Two officials with Team Work Ready (TWR), with chiropractic and physical therapy clinics in Texas and Louisiana, have been sentenced for defrauding the federal Office of Workers’ Compensation Programs and United States Postal Service, the U.S. Attorney’s Office for the Southern District of Texas announced.
TWR chief financial officer (CFO) Pamela Annette Rose, 55, CEO Jeffrey Eugene Rose Sr., 54, were sentenced to 120 months and 300 months, respectively, and ordered to pay millions in restitution.
Pamela Rose and Jeffrey Rose, along with VP of Operations Frankie Lee Sanders, 55, were convicted on Oct. 17, 2016, for submitting more than $9 million in false claims to the DOL – Office of Workers’ Compensation Programs (OWCP) for healthcare services that were never provided to federal workers suffering from work related injuries, according to the U.S. Attorney’s office.
Sanders is to be sentenced at a later date.
TWR had clinics in five states including Federal Work Ready in Houston, Alamo Work Ready in San Antonio and Bayou Work Ready in New Orleans, Louisiana. During the criminal trial, the jury heard testimony from 38 witnesses including former patients of TWR clinics, former employees of TWR clinics, various experts and special agents from the USPS-OIG and IRS-CI.
According to testimony, TWR submitted approximately $9.6 million in false and fraudulent claims from four of its clinics for physical therapy services that were not provided. The claims were submitted under the Federal Employees Compensation Act (FECA) health care benefit program which is administered by the DOL – OWCP.
DOL-OWCP’s chief fiscal officer said at trial that FECA does not pay for professional services performed by unlicensed aides which is why DOL-OWCP requires the enrollment of all licensed professionals providing services to injured federal employees, including copies of professional licenses.
He testified that the FECA program only considers chiropractors as physicians when they treat spinal subluxation. Otherwise, chiropractors are considered equivalent to physical therapists and may provide physical therapy under the direction of, and as prescribed by, a medical doctor.
Specifically, in relation to this case, the DOL-OWCP would not have paid millions of dollars for the physical therapy services billed by TWR if they had known that the services were not provided as described in the claims submitted to DOL-OWCP.
The claims TWR submitted falsely and fraudulently described skilled one-on-one physical therapy services provided by a licensed chiropractor. Patients from four TWR clinics testified that they did not receive the one-on-one physical therapy services paid for by DOL-OWCP under FECA.
Former employees testified that they did not perform all the one-on-one services documented on patient treatment notes and admitted they frequently completed the patient treatment notes at the end of the day by following a “cheat sheet” and asking each other and the patients what activities had been done.
Assistant United States Attorneys Julie Redlinger and Daniel Rodriguez prosecuted the case. Assistant U.S. Attorney Kristine Rollinson handled the forfeiture matters.
Source: U.S. Attorney’s Office for the Southern District of Texas
Topics USA Texas Fraud Claims Workers' Compensation
Was this article valuable?
Here are more articles you may enjoy.
Deere Retreats From Diversity Measures After Online Attacks 
Wall Street Pushes Back After Activists Escalate Protests 
Progressive Q2 Net Income Skyrockets Over 320% 
Hurricane Beryl Triggers Record Payout for Caribbean Insurer 
