The Department of Justice’s giant health care fraud bust has resulted in 412 medical professionals being charged—including Dr. John Eastham Clark and Charlene Anita Severio of Louisiana Spine & Sports, a pain management clinic located in Baton Rouge, Louisiana.
Clark was the co-owner of Louisiana Spine & Sports and Severio was the billing supervisor. Together, they allegedly ran a Medicare-defrauding scheme that cheated taxpayers out of $4.4 million dollars over the course of a decade.
The pair purportedly began conspiring in June 2005, when they started billing Medicare and other insurers for office visits that never happened.
Allegedly, Clark and Severio would falsely claim that every patient who had minor office surgery came in for a checkup the day before their procedure and, therefore, were able to bill for two separate visits. According to The Advocate, they ran this scheme undetected for 10 years, collecting $515,880 in fraudulent reimbursements.
Clark and Severio’s conspiracy seemingly became much more lucrative when they started billing Medicare for expensive urinalysis tests. In 2013, they finalized plans to open an in-house urine testing lab and allegedly began collecting and storing patient urine samples in preparation, before the lab even opened.
According to investigators, they billed Medicare for the unnecessary urine tests and collected $3.9 million over a year and a half, until the clinic was raided in March 2015.
Investigators had been keeping an eye on Louisiana Spine & Sports for years, and Clark and Severio are not the first clinic employees to get into trouble with the law. According to WBRZ, the clinic has a history of shady dealings related to prescription pain medications.
A physician’s assistant named Christopher Armstrong was arrested in 2014 for allegedly prescribing drugs to people who had never visited the clinic. Another physician’s assistant, Abigail Peneguy, had her ability to write prescriptions temporarily revoked by the Louisiana State Board of Medical Examiners.
In addition, WBRZ discovered that Clark was one of Louisiana’s top oxycodone prescribers in 2015. At the time, he had supposedly billed Medicaid for almost 500 claims for oxycodone.
Clark and Severio are scheduled to appear in federal court in August. Each defendant has been charged with two counts each of health care fraud and conspiracy to commit wire fraud. Clark has also been charged with two additional counts of health care fraud.
Louisiana Spine & Sports is one of two health care companies to be investigated by the Baton Rouge Medicare Fraud Strike Force as part of the Justice Department’s largest-ever health care fraud takedown.
Investigators also claim that Florida-based insurance broker Express ACA committed fraud by submitting fake applications for bronze insurance plans, which are fully subsidized through the Affordable Care Act, to insurers like Blue Cross/Blue Shield of Louisiana.
Cumulatively in this nationwide takedown, health care scammers across the country have stolen $1.3 billion from taxpayers and insurance companies, according to the Department of Justice. Louisiana Spine & Sports is just one example of the lengths scammers will go to profit off their patients at taxpayer expense. Do you know of someone cheating Medicare, Medicaid or TRICARE? You might be eligible for a substantial reward. Submit our easy online form to see if your information qualifies for an award.