Man pleads to posing as chiropractor, filing $1.4M in false claims

FROM THE OUTSIDE, the Oasis Holistic Healing Village, housed in an Italianate former mansion on a leafy block near Rittenhouse Square, appeared as serene as its name suggested.

Except that behind the extravagant stone facade, the man wearing the scrubs inside the chiropractor's office was a liar, a thief and, judging by what law-enforcement sources say, a creep.

Federal prosecutors say Tahib Smith Ali had no license or medical certification when he bought the business from a chiropractor in December 2008. But that didn't stop him from examining patients and performing treatments on them, including "muscle stretching and spinal manipulation," according to court documents.

He allegedly had a particular affinity for women. One source who asked not to be identified said that after Ali hired a part-timer, he would examine the attractive patients and pawn the others off on his employee, a licensed chiropractor, when she was in the office.

Ali then filed more than $1.4 million in bogus claims from January 2009 to April 2010, the documents said. Independence Blue Cross paid out more than $280,000 during that time.

Several female patients were expected to testify at trial about Ali's interaction with them, but they never got the chance.

Just before jury selection was to begin Tuesday, Ali pleaded guilty to 50 counts of health-care fraud, 50 counts of making false statements and one count of aggravated identity theft. U.S. District Judge Mitchell Goldberg did not set a date for sentencing.

Ali, 35, of the Summerdale section of Northeast Philadelphia, could face as many as five years in a federal lockup, including a mandatory minimum two years for stealing the identity of Paul Bodhise, the licensed chiropractor from whom Ali bought the business.

Assistant U.S. Attorney Mary Beth Leahy said in a court filing that Ali had "submitted more than $1.4 million in fraudulent claims for chiropractic services to Independence Blue Cross under Bodhise's name and medical provider number even though he had moved out of state and no longer treated patients at Oasis."

This wasn't even Ali's first time manipulating the chiropractic game. When he bought Oasis, he was on probation for a state conviction in Montgomery County in July 2007, for his role in an insurance-fraud scheme in which a Philadelphia-area chiropractor submitted millions of dollars in fraudulent claims to insurance providers for services that were never rendered.

Leahy said in court papers that Ali worked for the chiropractor and met patients to have them sign phony "treatment sheets indicating they had been treated by the chiropractor when they had not received any treatment at all." The court filing said Ali was paid $49,000 for his role in the scheme. He was sentenced to two years' probation.

At Oasis, Ali operated without any chiropractor on staff from January to late August 2009, when he hired the licensed chiropractor, Valda Dawson, to work about eight hours a week. "Dawson saw four patients at most, but usually less, on days she worked, and was paid $40 for each patient she treated," Leahy said in a court document.

Had the case gone to trial, Dawson was expected to testify for the government. She did not submit any claims to IBC or any other insurance provider for her services while working for Ali.

Prosecutors said Ali submitted claims to IBC for Dawson's patients, also using Dr. Bodhise's identity, that included procedures Dawson did not perform.

Dawson could not be reached for comment.

IBC investigators were tipped off to Ali, Leahy said, when the number of claims submitted under Bodhise's provider information "spiked dramatically to $1.4 million for 2009 compared to approximately $316,000 for 2008."

In 2009, claims submitted for Bodhise were among the highest for all IBC participating chiropractors nationwide, court papers said.

By late 2009, IBC began to investigate complaints from insured patients who reported that Oasis had submitted claims on their behalf for office visits that never occurred and for services that were not performed.

Ali, who was released on $50,000 unsecured bond after his arrest in July 2011, remains free pending sentencing.