AMARILLO, Texas - A 49-year-old man from Bushland, Texas, Thomas Roy Clark, who pleaded guilty in August 2017 to one count of health care fraud, was sentenced today by U.S. District Judge Sidney A. Fitzwater to 41 months in federal prison and ordered to pay $514,576.29 in restitution, joint and severally with his codefendant. The announcement was made today by U.S. Attorney Erin Nealy Cox of the Northern District of Texas.
As part of the plea agreement Clark agreed to forfeit a total of $84,750.23. Judge Fitzwater ordered Clark to surrender to the Bureau of Prisons on January 9, 2018.
According to the plea agreement factual resume, from July 2012 through July 2015, Clark operated Panhandle Chiropractic Clinic (PCC) in Amarillo, Texas, without a license issued by the Texas Board of Chiropractic Examiners. Co-defendant Karen Denise Jones, 56, assisted Clark in billing insurance companies on PCC’s behalf for services properly billable only by a licensed chiropractor. They also billed for services not rendered and for services rendered in lesser quantities billed.
Clark and Jones would omit Clark’s name or national provider identifier on PCC’s itemized billing statements, which prevented insurance companies from knowing they were being billed for services provided by a chiropractor without a license. Clark and Jones also listed the specific type of procedure or service PCC provided by misrepresenting to insurance companies that the procedures being billed were performed by a licensed health care provider in good standing with their state board.
Health care providers issued approximately $524,547.89 in payments to PCC from 12 insurance companies.
The case was investigated by the Federal Bureau of Investigation and the Randall County Sheriff’s Office.
Assistant U.S. Attorney Joshua Frausto was in charge of the prosecution.
Source: U.S. Department of Justice, Office of the United States Attorneys
