Federal Jury Finds Chiropractor Guilty of $3 Million Health Care Fraud Scam

A jury in federal district court has returned a guilty verdict against DR. WILLIAM STEARNS, DC, 47, of Marietta, Georgia, on 18 charges of health care fraud and five charges of money laundering.

United States Attorney David E. Nahmias said, “Today’s verdict sends the message that health care providers who fraudulently bill for their services will be held accountable for their crimes. The Defendant and his partners received millions of dollars to which they were not entitled, by lying to insurers about the services they were providing patients. These lies contribute to the problem of soaring health costs for all, and will be vigorously prosecuted.”

According to United States Attorney Nahmias and the information presented in court:

In 2004, STEARNS and two partners, fellow chiropractors STEVEN LEVINE and CHRISTOPHER TOPEL, operated three clinics around the Atlanta area under the name Comprehensive Care Medical Group (“CCMG”). CCMG, under the Defendant’s direction, fraudulently billed Blue Cross/Blue Shield of Georgia for two separate back pain procedures, costing that insurer alone approximately $3 million. Both LEVINE and TOPEL previously pleaded guilty to the charges.

First, the Defendant and his partners fraudulently billed for a procedure known as Vertebral Axial Decompression (“VAX-D”) – a non-invasive back pain procedure that uses a mechanical table to stretch a patient’s spine. Blue Cross/Blue Shield of Georgia considers VAX-D to be investigational and not medically necessary, and made clear to health care providers that it did not cover the procedure. Thus, the Defendant, along with LEVINE and TOPEL, were convicted of having lied to Blue Cross about what procedures they were performing in order to get paid for this non-covered procedure. Specifically, instead of using the specific billing code assigned to VAX-D, CCMG used a different code that pertained to surgical nerve decompression procedures. The Indictment charged that the Defendant used that code because he and the others knew Blue Cross would pay for it, and would not pay for VAX-D. The proof at trial included testimony from the Defendant’s former employees, several of whom were explicitly instructed to not refer to the procedure as “VAX-D” in patient files.

Second, the Defendant also fraudulently billed for an electrical stimulation procedure using a device known as “Hako-Med.” Instead of billing for a relatively low-paying electrical stimulation procedure, the Defendant instead claimed to be performing surgical procedures known as nerve block injections. This was false, but allowed the Defendant to bill for rates 5-10 times as high as if he had correctly billed for electrical stimulation.

STEARNS could receive a maximum sentence of 230 years in prison and a fine of up to $5,750,000. Sentencing is scheduled for February 12, 2009 at 4:00 pm before United States District Judge Clarence Cooper.

This case was investigated by Special Agents of the Federal Bureau of Investigation along with the U.S. Office of Personnel Management.

Assistant United States Attorneys Teresa D. Hoyt and Justin S. Anand are prosecuting the case.

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Third Atlanta Police Officer Pleads Guilty In Fatal Shooting of Elderly Woman

PRNewswire-USNewswire/ -- The Justice Department announced October 30, 2008, that former Atlanta Police Department (APD) Officer Arthur Bruce Tesler pleaded guilty in federal district court to conspiring to violate the civil rights of Kathryn Johnston, 92, in connection with her fatal shooting during the execution of an illegal search warrant at her Atlanta home on Nov.21, 2006.

Tesler, of Ackworth, Ga., joins two other former APD officers who pleaded guilty last year to state and federal charges in the case. Gregg Junnier, of Woodstock, Ga., and Jason R. Smith, of Oxford, Ga., pleaded guilty in state court to voluntary manslaughter, violation of oath by a public officer, criminal solicitation and false statements, and in federal court to a civil rights conspiracy violation that resulted in the death of Ms. Johnston. Smith also pleaded guilty in state court to one count of perjury. Junnier and Smith also agreed to cooperate in a broader investigation of APD officer misconduct, which has since been completed.

"When law enforcement officers do not live up to the high ideals they typically uphold, we will not hesitate to take action," said Grace Chung Becker, Acting Assistant Attorney General for the Justice Department's Civil Rights Division. "The Department of Justice will continue to vigorously prosecute those who cross the line and commit such violent criminal acts."

According to the information presented in court, Junnier and Smith, on several occasions while working as APD narcotics officers, made false statements in sworn affidavits to state magistrate judges in order to obtain "no knock" search warrants for residences and other locations where the officers believed illegal drugs would be found.

On the afternoon of Nov. 21, 2006, Smith, Junnier and Tesler executed such a warrant at Johnston's home, knowing that the warrant had been obtained on the basis of false information that Smith had presented to a magistrate judge. The victim, who was the only occupant of the house, fired through the door a single .38 caliber shot, which hit no one. Junnier, Smith and four other officers returned fire, hitting the victim with five or six shots, one of which was fatal.

Officers searched the home after the shooting, but found no drugs. Smith then planted in the basement of the house three bags of marijuana that the officers had seized elsewhere earlier that day. Tesler then filed a false APD incident report stating that a purchase of crack had been made at Johnston's home earlier that day and Smith submitted two bags containing crack that falsely indicated the drugs were bought by an informant at 933 Neal Street, the home of the victim. The defendants also met to fabricate a story, which they later recounted to APD homicide investigators, falsely justifying the events leading to the shooting of Kathryn Johnston.

Under Tesler's plea agreement, the parties agreed that the appropriate sentence under the advisory federal sentencing guidelines is 121 months. The federal sentence will run concurrently with Tesler's 54 month state sentence arising from the same criminal conduct. Junnier also faces a guidelines sentence of 121 months, and Smith faces a guidelines sentence of 151 months; those two defendants may, however, receive reductions based on their cooperation with the Government's investigation.

Assistant U.S. Attorney Jon-Peter Kelly, U.S. Attorney David E. Nahmias, and Department of Justice Civil Rights Division Special Litigation Counsel Paige M. Fitzgerald are prosecuting the case.


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Two Men Sentenced for Making False Bomb Threat to CDC

QUANTAVIOUS GREENE, 28, of Jackson, Georgia, and ELIJAH CHANDLER, 21, of College Park, were sentenced today (July 16, 2008) by United States District Judge Orinda D. Evans on charges of aiding and abetting one another in using the telephone to call in a false bomb threat to the Atlanta-based Centers for Disease Control (CDC) and later making false statements to FBI agents regarding the call.

United States Attorney David E. Nahmias said of the case, “Bomb threats, whether real or false, cause untold costs to the community in terms of law enforcement response, lost working hours, and fear. Anyone who may be inclined to make a bomb threat on a whim should understand that we take those threats very seriously no matter the motivation. One of these defendants wanted to get off work early. Now he and his codefendant are going to federal prison.”

GREENE was sentenced to 4 months in federal prison to be followed by 3 years of supervised release. GREENE pleaded guilty to the charges on November 15, 2007. CHANDLER was sentenced to 6 months in federal prison to be followed by 3 years of supervised release. CHANDLER pleaded guilty to the charges on January 25, 2008.

According to United States Attorney Nahmias and the information presented in court: On April 14, 2006, the CDC Office in Atlanta received a telephone call from a blocked telephone number. The caller stated that a bomb had been placed in the building and identified himself using the name of a former employee of the CDC who had been fired. DeKalb County Police responded and searched the building, but did not find any explosive devices. On the date the call was made, ELIJAH CHANDLER was employed by the CDC as a contract worker. Through a lengthy investigation, FBI agents determined that the former employee whose name was given by the caller did not make the call. Ultimately, the investigation led to GREENE and CHANDLER, both of whom at first gave false statements to the agents about their knowledge of the telephone call and telephone number used. The false statements further impeded the investigation. GREENE later confessed to making the call, stating that CHANDLER urged him to do so so that CHANDLER could leave work early.

This case was investigated by Special Agents of the Federal Bureau of Investigation.

Assistant United States Attorney Katherine Monahan Hoffer prosecuted the case.

Former State Representative Ron Sailor Jr Pleads Guilty to Additional Federal Charges

WALTER RONNIE ("RON") SAILOR, JR., 33, of Norcross, pleaded guilty June 17, 2008, in federal district court to a superseding information charging him with wire fraud in connection with a fraudulently obtained loan, as well as laundering and attempting to launder what he believed to be $375,000 in drug proceeds. After SAILOR's initial guilty plea to the drug money laundering charges on March 18, 2008, the government learned that SAILOR had secretly obtained a $250,000 loan utilizing as collateral property belonging to the church that he pastored. SAILOR served as the Representative of District 93 (parts of DeKalb and Rockdale Counties) in the Georgia General Assembly until he resigned after his initial guilty plea.

"Former Representative Sailor's actions are both disturbing and reprehensible," said
United States Attorney David E. Nahmias. "After his efforts to launder drug money were
thwarted by the FBI and he agreed to assist the government in an unrelated investigation,
Sailor made the decision to commit a serious new crime by concocting a scheme to defraud
the church where he pastored and a bank. As a result of his continued criminal conduct,
Sailor now faces a much longer prison sentence than originally anticipated."

FBI Atlanta Special Agent in Charge Greg Jones said, "The decision of Mr. Sailor to
continue in engaging in criminal conduct and to victimize those that trusted him was an
unfortunate one to say the least. The FBI, along with the U.S. Attorney's Office, responded
to these new developments accordingly. The plea today of Mr. Sailor reaffirms our priority
to matters such as this that impact the public trust."

According to United States Attorney Nahmias and the information presented in court:
On March 18, 2008, SAILOR entered a guilty plea in federal court to one count of drug
money laundering. This guilty plea was the result of a series of meetings between SAILOR
and an undercover law enforcement officer posing as a drug dealer who was seeking to
launder proceeds generated from the sale and distribution of cocaine. Prior to the meetings,
SAILOR had indicated that he was looking for a drug dealer who had the ability to provide
him with $300,000 in drug proceeds to launder in return for a fee. As a result of his interest
in laundering money, the FBI arranged an introduction to an undercover law enforcement
officer posing as a drug dealer with drug proceeds that he was seeking to have laundered.

Between November 10, 2007 and December 19, 2007, SAILOR met three times with
"Jay," the undercover officer. On each occasion, Jay provided SAILOR with what was
represented to be drug proceeds. On November 10, 2007, and November 30, 2007, SAILOR
met with Jay and was provided with $25,000 and $50,000 in cash, respectively. Several days
after each of these transactions, SAILOR returned the purported drug proceeds to Jay, less
his fee for laundering the funds, in the form of either a cashier's check or checks drawn on
business accounts and signed by a third-party. These checks falsely purported to be payment
for contracting work done at a church or for business loans.

On December 19, 2007, Jay and SAILOR met again, and Jay provided SAILOR with
$300,000 cash in purported drug proceeds to be laundered. After receiving the $300,000,
SAILOR was detained by the FBI. SAILOR admitted to the agents that he had laundered the
$25,000 and the $50,000 in what he believed was drug proceeds, and that he had intended
to launder the $300,000 that was given to him by Jay.

SAILOR soon agreed to cooperate with the government in an unrelated investigation.
However, unbeknownst to the government, in January 2008, while cooperating with the
government, SAILOR devised a scheme to obtain a $250,000 loan for his personal use,
offering as collateral property belonging to the church he pastored, the Greater New Light
Missionary Baptist Church, on Campbellton Road in Southwest Atlanta. At that time, there
were no encumbrances on the property, and SAILOR did not have permission from the
church to use the property as collateral. Nevertheless, sometime in January or February 2008,
he began the process of obtaining a $250,000 loan from the Georgia Business Capital Bank,
using the church's property as collateral.

SAILOR took a number of steps to make it appear as if he were authorized to encumber the church's property and to obtain the loan. On February 1, 2008, SAILOR caused the Church's Corporation Annual Registration to be changed to reflect that he was the church's Chief Executive Officer. He then caused the Corporation Annual Registration to be registered with the Georgia Secretary of State. On February 6, 2008, SAILOR signed a document entitled "Resolution of the Board of Directors," which purported to be a duly enacted resolution by the church authorizing the church to borrow money against the property and authorizing SAILOR to bind the church to such a loan. In addition to signing his own name, SAILOR also forged the signature of the church's secretary on the document.

That same day, SAILOR caused false church bylaws to be created, forged the signature of the church's secretary on those false bylaws, and caused the bylaws to be embossed with a
fraudulent church seal. The next day, SAILOR caused the fraudulent bylaws and the
fraudulent resolution to be presented to Georgia Business Capital Bank in order to obtain the
loan.

On March 11, 2008, the bank lent SAILOR $250,000 using the church's property as
collateral. After closing costs of $32,415.52 were deducted, SAILOR received $217,584.48
in proceeds from the loan. That same day, he opened an account at the Capitol City Bank
& Trust, in the name of Greater New Light Baptist Church, in order to access the loan
proceeds and distribute them to pay personal expenses. After the account was opened,
$217,584.48 in loan proceeds were wired into the Capitol City account. Between March 12,
2008, and March 27, 2008, SAILOR used $141,386.72 from this account to pay various
personal expenses. The remaining funds, $76,197.76, went unspent and were ultimately
returned to the lender by SAILOR after his scheme was uncovered.

The government learned of the fraudulent loan shortly after SAILOR pleaded guilty
to the drug money laundering charge on March 18, 2008. He had not disclosed this conduct
to the government, despite his pre-plea proffer agreement to cooperate fully and truthfully.
SAILOR was charged today in a superseding Criminal Information with the original
charge--one felony count of knowingly conducting and attempting to conduct a financial
transaction involving $370,000 in United States Currency represented by a law enforcement
officer to be the proceeds of the sale and distribution of a controlled substance, with the
intent to conceal and disguise the source of those funds--and two new counts of wire fraud
based upon his knowingly and willfully devising a scheme to defraud the Greater New Light
Missionary Baptist Church and the Georgia Business Capital. SAILOR pleaded guilty to all
three charges on June 17, 2008.

SAILOR could receive a maximum sentence of 80 years in prison and a fine of up to
$2,250,000. In determining the actual sentence, the Court will consider the United States
Sentencing Guidelines, which are not binding but provide appropriate sentencing ranges for
most offenders. SAILOR has also agreed to forfeit all of the property involved and traceable
to his crimes, at least $181,802.24, and to make restitution to the victims of his crimes.

Sentencing is scheduled for September 16, 2008, at 2 p.m., before United States
District Judge Camp. This case is being investigated by Special Agents of the Federal Bureau of
Investigation. Assistant United States Attorneys Bill Thomas and Elizabeth M. Hathaway are
prosecuting the case.