Texas fitness trainer accused in health care scheme


He calls himself “Dr. Dave” and his website promotes personal training to “enhance your lifestyle.”

But for nearly five years, Fort Worth’s David Williams used his Kinesiology Specialists business to defraud health insurance companies out of more than $25 million, billing the companies for medical services even though he wasn’t a medical doctor, authorities said Friday.

When federal agents told him in May that they were investigating him for fraud, he continued fraudulently billing one of the companies under a different business name, a criminal complaint said.

Williams, 54, was arrested Thursday on a felony charge of healthcare fraud, punishable by up to 10 years in prison and a $250,000 fine.

A federal magistrate judge released him from custody Friday morning.

Wes Ball, Williams’ attorney, disputed the allegations that Williams intentionally violated health care regulations.

“Mr. Williams doesn’t believe he had done anything wrong,” Ball said.

The regulations, Ball said, are “extremely complex” and “in many instances, vague.”

“The claim is that he billed for services that he was not qualified to bill for,” Ball said. “But if you look at the language [of the healthcare regulations], it’s not a model of clarity. If you look at the policies and procedures, you can go blind reading this stuff. It’s extremely complicated and the average person can’t make sense of it.”

Williams’ Kinesiology Specialists offered in-home fitness training and therapy, including sports conditioning and arthritis exercises, according to his website, getfitwithdave.com.

The complaint alleged that Williams, beginning in 2012, advertised that his clients, most of whom worked for Southwest Airlines, could pay for the services with their health insurance.

Williams, who has a doctorate in kinesiology but is not a medical doctor, billed the insurance companies “as if he were a physician,” the complaint said.

But the services Williams provided to his clients were not eligible for health insurance, the complaint said.

Williams registered as a health care provider through the Centers of Medicare and Medicaid Services. He did this at least 19 times under different names “to divert attention away from his fraudulent billing,” the complaint said.

The criminal complaint detailed several instances in which health insurance companies notified Williams that he had improperly billed them.

In December 2015, he agreed to pay back $630,000 to United HealthCare Services, and then continued billing the company for more than $13 million using different tax identification numbers, the complaint said.

Source link

Texas fitness trainer accused in health care scheme

Tags: #Healthcare #Healthcare Info #Healthcare News #Healthcare Recipe #Healthcare Trick #Healthy Lifestyle