Five Defendants Sentenced In Health Care Fraud Case Involving A Metroplex Chiropractor And Former Union Representative
FORT WORTH, Texas — Five defendants who were convicted for their respective roles in a health care fraud case involving a chiropractor and a former union representative from the Dallas – Fort Worth (DFW) metroplex, were sentenced today, announced U.S. Attorney Sarah R. Saldaña of the Northern District of Texas.
Reginald Guy, 44, of Arlington, Texas, was sentenced this morning by U.S. District Judge Reed C. O’Connor to 156 months in federal prison and ordered to pay approximately $2.4 million in restitution. Guy was convicted at trial in June 2014 on all counts of a superseding indictment charging one count of conspiracy to commit health care fraud, five counts of health care fraud and four counts of aggravated identity theft.
Guy was a factory worker in Arlington, and from approximately 2003 until November 2009, when his employment was terminated, he served as a union representative. He used that union representative position to recruit and refer his co-workers to DFW Rehab & Diagnostics, which was operated from the office of Metroplex DFW Sports Rehab Center in Arlington, and then later from a stand-alone location in Grand Prairie, Texas. In exchange for monthly kickbacks, work excuse notes, and a variety of prizes, the workers agreed to allow their insurance companies to be billed for services they did not receive.
Dr. Abbas Zahedi, 49, of Carrolton, Texas, was convicted on the same offenses at that trial. A chiropractor, Dr. Zahedi owned and operated DFW Rehab & Diagnostics. Dr. Zahedi, who is in custody, is scheduled to be sentenced by Judge O’Connor on January 5, 2015.
From 2009 to 2012, Dr. Zahedi, Reginald Guy, and four convicted codefendants conspired to submit health insurance claims to Blue Cross Blue Shield of Texas (BCBS) and other insurers for services not rendered. These four coconspirators, James Sterns, Tina Perkins, Donna Harris and Gregory Wattron, who cooperated with the government in the investigation and testified against Zahedi and Guy at their trial, were also sentenced today.
Sterns, 50, of DeSoto, Texas, was sentenced to 10 months in federal prison and ordered to pay approximately $2.2 million in restitution. Sterns owned and operated Metroplex. In early 2010, Sterns hired Guy to be the office manager of Metroplex, where he worked in that position to mid-2011, shortly before the clinic closed. In March or April 2011, Dr. Zahedi hired Guy to work as a consultant at the clinic’s Grand Prairie location. After Guy began working for Dr. Zahedi, Guy helped transfer patients and patient information to Dr. Zahedi, and the fraudulent referral and billing scheme continued.
Perkins, 43, of Dallas, was sentenced to 10 months in federal prison and was ordered to pay approximately $2.4 million in restitution. Perkins worked as the biller and office consultant for Dr. Zahedi and was responsible for submitting claims to insurance companies.
Perkins’ sister-in-law, Donna Harris, 43 of Haltom City, Texas, was sentenced to eight months in federal prison and was ordered to pay approximately $2 million in restitution. Harris permitted the clinic, in exchange for cash payments, to submit claims to BCBS for services purportedly performed by Dr. Zahedi and Wattron, when in fact she received no treatment. Then, in early 2011, Dr. Zahedi hired Harris to be the office manager at the Grand Prairie location. There, she continued to allow Dr. Zahedi to submit claims under her name to BCBS for services that were not performed. Harris also permitted Dr. Zahedi to submit claims to BCBS for Harris’ immediate and extended family members for services they did not receive.
Wattron, 56, of Grapevine, Texas, was sentenced to six months in federal prison and was ordered to pay approximately $1.3 million in restitution. He worked as an occupational therapist at the clinic from approximately 2008 until August 2011. Wattron agreed to allow Sterns and Dr. Zahedi bill insurance companies for occupational therapy that he did not perform.
The FBI and the Office of Personnel Management - Office of Inspector General investigated. Assistant U.S. Attorney Nancy Larson and Special Assistant U.S. Attorney Douglas Brasher prosecuted the case.