John Thomas Terrence, 75, of Marina del Rey, pleaded guilty to health care fraud involving a scheme to defraud the California workers’ compensation insurance system.
According to court documents, Terrence, a clinical psychologist, saw patients in Bakersfield by “Skype,” generated reports for each patient that were virtually word-for-word identical, and then submitted identical bills to the insurance companies.
Co-defendants Bhahar Gharib-Danesh, 41, of Woodland Hills, and Na Young Eoh, 44, of Bakersfield, were chiropractors working at the same company. They previously pleaded guilty to health care fraud charges in this case.
According to a federal indictment Gharib-Danesh was a chiropractor and the manager of Pain Relief Health Centers (PRHC). PRHC was headquartered in Los Angeles, and had clinics in Bakersfield, Visalia and Fresno, as well as in Los Angeles County.
Na Young Eoh was also a chiropractor, and was the treating physician for PRHC’s Kern County workers’ compensation claims..
PRHC recruited patients who were workers claiming to have an injury. In treating the patients, Gharib instructed her staff to add as many injured body parts for treatment as possible to generate higher billings. The treatment plan generally included shock wave therapy, electro stimulation therapy, myo-facial release/massage, physical therapy, chiropractic manipulation, compound creams, and psychological evaluation.
Nearly every patient was scheduled for the same treatments, and the maximum amount of treatments allowed by law was generally billed to the insurance company.
Eoh operated out of the Bakersfield Clinic, the Visalia Clinic, and the Fresno Clinic and would sign the treatment plans and referral forms. The indictment further alleges that Gharib directed Eoh to refer all patients who came into the clinic to Terrence for a psychological evaluation, regardless of the injury the patient reported. Terrence submitted bills and reports for each patient that were virtually identical. He also allegedly fraudulently billed for patients at a rate higher than legally allowed. According to the indictment,
Terrence provided each patient with approximately 20.8 hours of psychological evaluations in a single day. On one day, Terrence billed a total of 291.2 hours for treating 14 patients. In one period of two weeks, Terrence billed over a thousand hours treating patients and writing reports. Between 2005 and 2012, Terrence submitted claims for psychological services in workers’ compensation cases totaling in excess of $5.6 million.
Pain Free Diagnostics Inc. (dba Pain Free Management) pleaded guilty on July 9, 2018, to conspiracy to commit health care fraud and agreed to pay restitution to the defrauded worker’s compensation insurers in the amount of $1.2 million.