by Mark Friedman on Monday, May. 5, 2014 12:00 am
Drs. Robert and Angela Barrow practice at this office in west Little Rock. | (Photo by Jason Burt)
The Conway massage therapist who allegedly helped perpetuate a health care fraud has taken a plea deal and will testify for the prosecution of Drs. Robert Barrow and Angela Barrow.
The therapist, Billy Marc Young, 35, pleaded guilty in U.S. District Court in Little Rock on April 10 to making a false statement related to a health care matter. He agreed to pay $267,871 in restitution and forfeit $311,130.
A sentencing date has not been set for Young, who faces up to five years in federal prison, a fine of up to $250,000 and up to three years of probation.
Just over a week before Young took his plea, the Barrows, who are married, were indicted by a federal grand jury on one count of conspiracy to commit health care fraud and six counts of health care fraud that exceeds $1.2 million. Robert Barrow also faces four counts related to billing Arkansas Blue Cross & Blue Shield for ultrasounds that weren’t performed.
Robert Barrow, 60, and Angela Barrow, 50, have entered not guilty pleas in U.S. District Court in Little Rock and are currently practicing at Renaissance Health & Wellness in west Little Rock, which was the site of their previous practice, Your Doctor’s Office. The Barrows closed Your Doctor’s Office and sold the 7,600-SF medical office building on Nov. 13 for $1.2 million. The buyer was South Central Management Services LLC of Fort Smith.
“We plan to fight the charges,” Angela Barrow’s attorney, Jeff Rosenzweig of Little Rock, told Arkansas Business last week. “She didn’t defraud anyone. She didn’t attempt to defraud anyone, and we believe a jury will agree with us.”
Robert Barrow’s attorney, Jack Lassiter of Little Rock, didn’t return a call for comment, nor did Robert or Angela Barrow.
Meanwhile, the Barrows are facing more questions from the Arkansas State Medical Board. Kevin O’Dwyer, the attorney for the Medical Board, told Arkansas Business last week that he expects the Barrows’ indictment will be discussed at the board’s next scheduled meeting on June 5-6.
He said the board has a number of options to deal with the Barrows, including issuing an emergency order of suspension against the doctors if board members feel the health and welfare of the citizens of Arkansas are in danger. Or it could wait until the criminal case is completed to take action.
In the meantime, a lawsuit filed by a patient of the Barrows that led to a question of overtreatment was put on hold pending the resolution of the criminal charges against the two physicians.
A 30-year-old North Little Rock kindergarten teacher, Micah Kaye Haupt, was in a car accident in December 2010. Haupt sued the driver who caused the accident, Joshua Clouse of Little Rock. The only issue in dispute in the lawsuit is Haupt’s damages, according to court filings by Clouse’s attorney, T.J. Fowler of Friday Eldredge & Clark LLP of Little Rock.
That case has been wending its way through Pulaski County Circuit Court since 2011.
The damages that Haupt is seeking include payment for 244 physical therapy sessions that totaled nearly $26,000, according to a summary of medical expenses that was filed in the case.
“Throughout this litigation it has been [Clouse’s] position that the physical therapy the Barrows prescribed was excessive and medically unnecessary,” Fowler said in the filings. “The therapy records at issue contain anomalies that, when viewed in the light of the Barrows’ recent indictment, cast additional doubt on the validity of the medical treatment in this case.”
According to the court records filed in the case, Angela Barrow was the first practitioner to examine Haupt after the accident in December 2010. She referred Haupt for treatment by physical therapist Derek Lagemann at Ortho Rehab & Specialty Centers in Little Rock.
Lagemann told Arkansas Business last week that he “didn’t have any affiliation with Dr. [Robert] Barrow.” Lagemann said he occasionally saw Barrow’s patients, but that was the extent of the relationship.
According to the legal filings, Lagemann released Haupt from treatment in June 2011, about six months after the accident, and reported that Haupt “reports no pain.”
That was the end of the physical therapy sessions — for several months. The sessions restarted in April 2012, thanks to a referral from Robert Barrow.
He became involved in the treatment of Haupt after he and his wife were deposed in March 2012 to prepare for Haupt’s trial, which was scheduled for April 2012.
Robert Barrow said during the March 2012 deposition that he didn’t examine Haupt after the accident, but said she had a permanent ligament injury.
Within days after the deposition, he became Haupt’s treating physician and said a back injury she received related to cheerleading in 2011 was also tied to the December 2010 car wreck, according to a defense filing.
Robert Barrow ordered more physical therapy. Haupt returned to Ortho Rehab for treatment by physical therapist Robert Tillman on April 5, 2012. “Over the next year and a half, therapist Rob Tillman conducted roughly 100 physical therapy sessions with [Haupt],” Fowler said in the filing.
Fowler said Robert Barrow didn’t monitor or modify the treatments during that time.
“The records contain essentially the same exercises for months at a time, and often repeat the same subjective observations by the therapist,” Fowler wrote.
Fowler said his medical expert will testify that he has never seen that many physical therapy sessions with a patient who was never diagnosed with any anatomical injury, never received an X-ray or MRI and was never referred to an orthopedic specialist.
Tillman didn’t return a call seeking comment, nor did David Hodges of Little Rock, Haupt’s attorney.
In a court filing, however, Hodges wrote: “There is a substantial injury in this case that has not been healed.”
The trial of Haupt’s case against Clouse was scheduled to begin April 15, but after the Barrows were indicted early last month, Pulaski Circuit Judge Collins Kilgore postponed it until further notice even though Haupt’s treatment doesn’t appear to be directly related to the criminal case.
The Barrows have been under investigation since at least June 2013, according to their files at the Medical Board.
FBI Special Agent Jill Hudson sent a subpoena to the board on June 5 and sought the Barrows’ records related to their continuing medical education credits earned from 2003 through 2013.
The board said in its response that it doesn’t routinely keep those records, but it did have them for Angela Barrow because she had been selected for a random audit and submitted her documents for the past year. Those records were handed over to the U.S. Attorney’s Office.
The indictment, however, doesn’t raise the issue of continuing education credits.
Robert Barrow had been an attorney before he graduated from the University of Arkansas for Medical Sciences in 1988, according to the March 2012 deposition he gave for the Haupt case. He began practicing medicine in Virginia while he was serving in the Navy.
He returned to Arkansas in November 1993 and began practicing medicine as a general practice doctor in Little Rock
Angela Barrow graduated from UAMS in 1989. She completed her residency in family practice at the University of Richmond in Virginia in 1992, according to her deposition taken March 30, 2012. She began practicing medicine in Arkansas in 1994.
In 1997, the Barrows incorporated the name Your Doctor’s Office in Little Rock, according to a filing at the Arkansas Secretary of State’s Office.
Neither of the Barrows has had any action taken against them by the Arkansas State Medical Board. But federal prosecutors allege that, starting in September 2005, the Barrows planned a scheme to defraud Medicare and Arkansas Blue Cross & Blue Shield.
To set the alleged scheme in motion, on Sept. 30, 2005, Robert Barrow signed a contract with the massage therapist, Billy Marc Young, who owned Life-Letics Sports Therapy.
The contract between Life-Letics and Your Doctor’s Office called for Young to lease a small office in the Barrows’ building at 600 Autumn Road.
Life-Letics then would provide “therapy services” on site, according to the indictment. Robert Barrow would refer patients to Life-Letics and the two businesses would share the proceeds, the indictment said.
Soon, Angela Barrow was referring patients to Life-Letics, the indictment alleges.
But before being seen by the therapist, Your Doctor’s Office and Life-Letics employees were told to verify that a prospective patient had insurance coverage and to determine the remaining extent of the benefits.
Young’s services were then billed to insurers using codes for physical therapy even though the Barrows knew that the massage therapist “was neither trained in nor licensed to perform physical therapy,” the indictment said.
To boost business, “the massage therapist was told to waive or reduce patient copayments and deductibles,” the indictment said.
In 2006, Life-Letics launched a website that promoted its acceptance of health insurance and Medicare, the federal health care insurance program for people 65 and older and for the disabled, but not Medicaid, the government health-insurance program that is for low-income families with children. “Your benefits will fall under your therapy benefits,” the indictment quoted the company’s website.
After each patient visit, Young handed over patient information to Your Doctor’s Office employees to bill insurance companies, the indictment said.
Young’s name “did not appear on health insurance claim forms,” the indictment said.
Neither Medicare nor Arkansas Blue Cross & Blue Shield cover physical therapy services when the treatment is done by a massage therapist.
The proceeds of bills were split between Your Doctor’s Office and Young, whose revenue under the arrangement reached nearly $250,000 annually, the indictment said. The indictment also said that the Barrows “fraudulently caused the submission of over $1.2 million in physical therapy claims to Medicare and [ABCBS].”
Young agreed to repay Medicare $18,510 and Health Advantage $249,361, which is a subsidiary of ABCBS.
Four of the criminal charges against Robert Barrow allege that he billed ABCBS for ultrasounds when “no ultrasound had been performed.” The four questionable ultrasounds all appear to have involved the same patient during a period of less than a month in the summer of 2011.
The Barrows’ jury trial is set for Jan. 12 in front of U.S. District Judge J. Leon Holmes.
If convicted, the Barrows each face up to 10 years in federal prison on each of the six counts of health care fraud as well as 10 years for the overarching conspiracy.
Robert Barrow also faces up to five years in prison on each count of making false statements in relation to health care matters.
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