Hyperbaric Oxygen Clinic Operator Convicted

Stephen Barrett, M.D.


In December 2008, Chauncey Beckwith, who owned and operated International Alternative Medicine, Inc., in Tucker, Georgia, was charged with 35 counts of health care fraud in connection with her clinic's operation. The indictment, shown below, states:

In April 2008, Beckwith pleaded guilty to one count of health care fraud.

IN THE UNITED STATES DISTRICT COURT
FOR THE NORTHERN DISTRICT OF GEORGIA
ATLANTA DIVISION

UNITED STATES OF AMERICA

v.

CHAUNSAY BECKWITH

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:
:
:
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CRIMINAL INDICTMENT

NO. : 1 08-CR-490

THE GRAND JURY CHARGES THAT:

COUNTS 1 THROUGH 35

(Scheme to Commit Health Care Fraud)
(18 U .S .C. $$ 1347 and 2)

1. Beginning in or about September 2003 and continuing until in or about December 2007, in the Northern District of Georgia and elsewhere, defendant, CHAUNSAY BECKWITH, aided and abetted by others known and unknown to the grand jury, knowingly and willfully executed and attempted to execute a scheme and artifice to defraud certain medical insurance companies and Medicare, which were health care benefit programs as defined in Title 18, United States Code, Section 24(b), and to obtain, by means of materially false and fraudulent pretenses and representations, monies and property owned by and under the custody and control such health care benefit programs, in connection with the delivery of and payment for health care benefits, items and services, as set forth below.

Background of the Scheme

2. At all times relevant to this Indictment:

a. Defendant CHAUNSAY BECKWITH was the owner and operator of  International Alternative Medicine, Inc. (hereinafter "IAM"), a Georgia corporation, which operated an alternative medicine clinic at 4450 Hugh Howell Road, Tucker, Georgia.

b. Defendant CHAUNSAY BECKWITH, while operating IAM, employed several physicians ostensibly to provide medical treatment and to supervise medical treatment delivered to patients of the SAM clinic.

c. A medical treatment frequently provided to patients of IAM was Hyperbaric Oxygen Therapy.

d. Hyperbaric Oxygen Therapy (hereinafter "Hyperbaric") was a non-invasive, non-surgical procedure used in the treatment of arterial embolism and thrombosis of lower extremities, chronic osteomyelitis and venous embolism and thrombosis of deep vessel of distal lower extremity, administered to the patient in a Hyperbaric Chamber.

e. Certain health care benefit programs provided health insurance benefits or medical services to individuals (commonly referred to as "beneficiaries") pursuant to the terms of a contract or plan of insurance.

f. It was common practice for certain medical services providers, including the physicians employed by IAM, to request payment for medical services rendered to a particular patient by submitting a claim, bearing the name of the treating physician, for payment directly to the patient's health care benefit program.

g. Every medical services provider who submitted claims for payment directly to a health care benefit program was required to provide the health care benefit program with a standard form known as a "Health Care Financing Administration Form 1500" ("HCFA 1500").

h. A medical services provider requesting payment directly from a health care benefit program was required to identify the treatment provided to the beneficiary and to identify the beneficiary's diagnosis by including on the HCFA 1500 the appropriate "Physician's Current Procedural Terminology" ("CPT Codes") and "International Classification of Diseases, 9th Revision ("ICD9 Codes").

i. CPT and ICD9 Codes are published by the American Medical Association as a uniform numerical classification of the most common treatments performed by and diagnoses submitted by physicians and other medical service providers.

j. The CPT code for the Hyperbaric Oxygen Therapy procedure was 99183. The CPT specified that code 99183 must be administered under physician attendance and supervision in order to qualify for reimbursement.

k. It is the responsibility of the medical services provider submitting a HCFA 1500 to select the CPT code and the Diagnosis code that describes the procedure performed and the patient's medical condition to the highest level of specificity.

1. In most situations, the health care benefit program received these claims and paid the medical claims based on the CPT and ICD9 codes submitted. Typically, the health care benefit program processed these claims through a computer, and based on the codes submitted, payment was electronically computed.

m. The health care benefit programs would reimburse medical services providers for a particular CPT code procedure only if that procedure was approved for the treatment of the medical condition of the patient as specified by the ICD9 code.

Description of the Scheme

3. It was part of the scheme and artifice to defraud and to obtain money and property that defendant CHAUNSAY BECKWITH would cause patients at IAM to be treated with the Hyperbaric Oxygen Therapy medical procedure, CPT code 99183, for a multitude of medical conditions, well knowing at the time that health care benefits programs were unlikely to approve payment for such treatment for the actual diagnoses of the patients.

4. It was further part of the scheme that defendant CHAUNSAY BECKWITH would, despite the fact that the CPT required physician attendance and supervision for Hyperbaric therapy, cause patients to be treated with Hyperbaric therapy without physician attendance or supervision.

5. It was further part of the scheme that defendant CHAUNSAY BECKWITH would cause HCFA 1500 forms to be submitted to health care benefit programs requesting payment for Hyperbaric procedures for payment, well knowing at the time that such HCFA 1500 forms bore false ICD9 codes, falsely specifying the patients' medical conditions to be Chronic Osteomyelitis, ICD9 code 730.18, and Arterial Embolism, Thrombosis of Lower Extremity, ICD9 code 44 .22 and Venous Embolism and Thrombosis of Deep Vessels of Distal Lower Extremity, ICD9 code 453.42, and further knowing that health care benefit programs were likely to approve payment in reliance on the accuracy of such diagnoses.

6. As a result of multiple executions of the health care fraud scheme set forth in this Indictment, defendant CHAUNSAY BECKWITH caused fraudulent claims in amounts totaling approximately $1,577,827 .00 to be submitted from IAM to various health care benefit programs, including insurance companies and Medicare, causing in said programs to send payment checks to IAM in amounts totaling approximately $1,035,144 .00

Execution of the Scheme

7. On or about the dates listed in each count below, in the Northern District of Georgia and elsewhere, defendant CHAUNSAY BECKWITH knowingly and willfully executed the aforesaid health care fraud scheme by causing to be submitted to the health care benefit programs named below fraudulent claims for reimbursement for Hyperbaric procedures, CPT code 99183, which procedures were administered without the attendance or supervision of a physician, below:

COUNT SERVICE
DATE

PATIENT
INITIALS

FALSE ICD9
CODE
AMOUNT
BILLED
AMOUNT
PAID
1 1-9-05 L.K. 730.18 $1,184 $947.20
2 7-8-05 L.K. 730.18 $1,184 $947.20
3 10-1-05 L.K. 730.18 $1,184 $947.20
4 1-15-06 L.K. 730.18 $1,184 $947.20
5 6-16-06 L.K. 730.18 $1,184 $947.20
6 10-15-05 S.K 444.22 $1,184 $947.20
7 12-11-05 S.K. 444.22 $1,184 $947.20
8 1-21-06 S.K. 444.22 $1,184 $947.20
9 4-3-06 S.K. 444.22 $1,184 $947.20
10 7-21-06 S.K. 444.22 $1,184 $947.20
11 12-29-05 C.B. 730.18 $1,184 $1,170.64
12 2-10-06 C.B 730.13 $1,184 $1,170.64
13 3-7-06 C.B 730.18 $1,184 $1,170.64
14 4-13-06 C.B 730.18 $1,184 $1,170.64
15 5-26-06 C.B 730.18 $1,184 $1,170.64
16 7-19-06 W.S. 444.22 $1,184 $1,164.00
17 8-10-06 W.S. 444.22 $1,184 $1,164.00
18 8-25-06 W.S. 444.22 $1,184 $1,164.00
19 9-15-06 W.S. 444.22 $1,184 $1,164.00
20 10-16-06 W.S. 444.22 $1,184 $1,164.00
21 10-7-06 R.L. 444.22 $1,184 $1,170.64
22 11-3-06 R.L. 444.22 $1,184 $1,170.64
23 11-17-06 R.L. 444.22 $1,184 $1,170.64
24 12-9-06 R.L. 444.22 $1,184 $1,170.64
25 12-30-06 R.L. 444.22 $1,184 $1,170.64
26 3-07-07 N.R. 453.42 $1,184 $1,170.64
27 3-21-07 N.R. 453.42 $1,185 $1,170.64
28 4-3-07 N.R. 453.42 $1,184 $1,170.64
29 4-19-07 N.R. 453.42 $1,184 $1,170.64
30 4-26-07 N.R. 444.22 $1,184 $1,170.64
31 10-26-07 M.T. 444.22 $1,184 $678.8
32 10-29-07 M.T. 444.22 $1,184 $449.10
33 11-3-07 M.T. 444.22 $1,184 434.00
34 11-8-07 M.T. 444.22 592.01 582.01
35 11-14-07 M.T. 444.22 507.44 $497.44

All in violation of Title 18, United States Code, Sections 1347 and 2.

Forfeiture Provision
(18 U .S .C. 5 981(a)(1)(0)

1. All of the allegations set forth in the preceding paragraphs are incorporated herein by reference, as if fully restated.

2. Upon conviction of one or more of the offenses alleged in Counts 1 through 35 of this Indictment, defendants, defendant, CHAUNSAY BECKWITH, shall forfeit to the United States pursuant to 18 U .S .C. § 981(a) (1) ( C) and 28 U .S .C. § 2451(c) any property constituting or derived from proceeds obtained directly or indirectly as a result of the said violations.

3. If any of the above-described forfeitable property, as a result of any act or omission of the defendant(s):

a. cannot be located upon the exercise of due diligence;

b. has been transferred or sold to, or deposited with, a third party;

c. has been placed beyond the jurisdiction of the court;

d. has been substantially diminished in value; or

e. has been commingled with other property which cannot be divided without difficulty ; it is the intent of the United States, pursuant to 21 U .S .C. § 853 (p) as incorporated by 18 U. S. C. S 982 (b) , to seek forfeiture of any other property of said defendant (s) up to the value of the forfeitable property described above.

A TRUE BILL

 

_________________
Billy A. Horne
FOREMAN

DAVID NAMIAS
UNITED STATES ATTORNEY
DAVI E. MCCLERNAN
ASSISTANT UNITED STATES ATTORNEY
600 United States Courthouse
75 Spring Street, S .W.
Atlanta, Georgia 30303
404/581-6000
FAX (404) 581-6181
Georgia Bar No. 483555

This page was posted on April 13, 2009.

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