Man charged with fraudulent chiropractor billing

Tahib Smith Ali had the patients and delivered at least some health-care services, but he wasn't the chiropractor he claimed to be, according to a federal indictment.

Ali, 34, was charged Wednesday with posing as a chiropractor and physical therapist, and submitting more than $1.1 million in fraudulent claims to Independence Blue Cross in 2009 and 2010.

It was his second arrest on health-care-fraud charges. In 2004, state police arrested him and 41 others accused of participating in a $2.8 million insurance scam. For his small role in that incident, Ali was placed on probation.

This time, Ali was in U.S. District Court, where a magistrate judge ordered him to appear with an attorney next week. He was released on a $50,000 bond.

"He presented himself to patients as a chiropractor and as a physical therapist," the government alleges in court documents.

Sometimes, the government claims, Ali employed a chiropractor on a limited basis. Ali has no chiropractic license, according to the Pennsylvania Department of State.

His business, which treated about 100 people, according to prosecutors, was called the Oasis Holistic Healing Village and was in an elegant stone building on the 300 block of South 17th Street. The office is closed, Assistant U.S. Attorney Mary Beth Leahy said.

Ali allegedly used the name and provider number of a licensed chiropractor to file claims with Blue Cross. The indictment says Ali purchased the chiropractic business from a licensed practitioner in 2008, and in 2009 started filing illegal claims.

In court, Ali told U.S. Magistrate Timothy Rice that he was now working in sales.

Ali was charged with 50 counts each of health-care fraud, false statements in health-care matters, and aggravated identity theft.

In the office, he wore scrubs and performed muscle stretching and spinal manipulation, the indictment says. He hired a licensed chiropractor to help him in August 2009, but continued to send bills under the name of the chiropractor who initially owned the practice. He also allegedly billed Blue Cross for services that were not provided.

The illegal billings were discovered by fraud investigators from Blue Cross, spokeswoman Karen Godlewski said. "This was unusual in that he used a fake ID from a credentialed person to submit the claims," she said.

In the 2004 case, state police arrested Ali and 41 others accused of participating in a $2.8 million insurance scam based at the All-Care Chiropractic Clinic in Northeast Philadelphia, run by Dr. Richard J. Walinsky and his mother, Dr. Eileen Nelson Means.

Prosecutors alleged that between 2000 and 2002, Walinsky submitted more than $2.8 million in fraudulent claims to insurance companies such as Progressive, State Farm, and Nationwide.

At the time, Ali told state investigators that he worked as a therapist at Walinsky's clinic even though he did not have the proper certification for the job. The doctors paid him nearly $50,000 during the two-year period for referring five to 10 patients, who later filed bogus claims for staged car accidents or falls.

A Montgomery County Court judge sentenced Ali to probation after he pleaded guilty in 2007 to one misdemeanor count of receiving unlawful compensation for a patient referral. Walinsky and Means also pleaded guilty to conspiracy, insurance fraud, and theft.