Texas man arrested for $25 million insurance fraud scheme

Authorities say the fitness trainer billed himself as a physician to scam insurance companies

Texas man arrested for $25 million insurance fraud scheme

Life & Health

By Ryan Smith

The FBI arrested a Texas man last week for allegedly scheming to bilk insurance companies for more than $25 million by posing as a physician.

According to the Department of Justice, David Williams, 54, ran the scam between November of 2012 and August of this year.
Williams allegedly advertised on his website that he offered in-home fitness training and therapy. He billed himself as “Dr. Dave” and told potential clients that he accepted most insurance plans.

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In order to bill insurance companies, Williams registered with the Centers for Medicare and Medicaid Services, falsely claiming that he was a healthcare provider, authorities said. He allegedly enrolled as a healthcare provider at least 19 times under different names or variations of his own name. The DOJ said that Williams would then bill insurance companies as if he were a medical doctor who had provided care “requiring medical decision making of high complexity.” In reality, the DOJ said, Williams was simply providing fitness and exercise training.

According to the DOJ, Williams would meet with new clients or speak with them over the phone, review their health history, and assign each a personal trainer. The trainer would generally meet with the client one to three times a week, and Williams would allegedly bill insurance companies for each training session using inaccurate codes. Authorities said that Williams occasionally billed for services that neither he nor his staff provided.

If convicted, Williams could face up to 10 years in federal prison.

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