Scott R. Werner, M.D., Convicted of Insurance Fraud
and Surrenders Medical Licenses

Stephen Barrett, M.D.


In 2003, a federal grand jury charged Scott Rulon Werner, MD, of Cedar City, Utah, with 54 law violations in a scheme to defraud Medicare, Medicaid, Tricare, and private insurance companies. The indictment (shown below) charged that he had falsely represented on insurance claim forms that he had provided IV services when he had actually performed chelation therapy for ailments for which chelation is not approved. Insurance plans pay in response to claim forms that contain code numbers for the patient's diagnosis and treatment. The indictment also noted that Werner not only used improper codes but also modified patient records when he thought he was being investigated.

The court docket and other records from the case contain several notable entries:

In 2005, Werner agreed to (a) plead guilty to Count 1 of the indictment (health care fraud), (b) surrender his Utah medical license, (c) surrender his narcotics license, and (d) be permanently excluded from all federal health care programs. He was sentenced to time served and three years of supervised release and ordered to pay restitution of $145,616. He also surrendered his Arizona medical license. However, the biographical sketch for his 2012 book Take Back Your Health spins his history this way:

Scott R. Werner, MD, practiced medicine, starting out as an OB/GYN, but became a medical intuitive after curing his own cancer with herbs and healing energy. He voluntarily gave up his medical practice to focus on the real causes of disease. He now lives in St. George, Utah, with his wife and children. Scott has used herbs, homeopathic, energetic remedies and chelation to help improve and heal untreatable illnesses and diseases helping thousands of patients. He does intuitive medical readings for clients, putting them on the products that will help them the most. Scott currently lectures to many groups in Nevada, California, Hawaii, Florida and Utah, teaching about herbal products, homeopathics, essential oils, energy medicine, and spiritual healing.

Werner's Web site says he charges $200 for an "initial intuitive reading" and $100 for 30-minute follow-up readings.


IN THE UNITED STATES DISTRICT COURT

DISTRICT OF UTAH, CENTRAL DIVISION


UNITED STATES OF AMERICA,

Plaintiff,

v..

SCOTT RULON WERNER, M.D.,

Defendant.

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Case No. 2:03CR00907 DAK

INDICTMENT

VIOL. 18 U.S.C. § 1347 (Health Care Fraud);
18 U.S.C. § 287 (False Claims to the United States);
18 U.S.C. § 1035(a)(2) (False Statements Related to Health Care Matter);
18 U.S.C. § 2(b) (Willfully Causing Another to Act in Violation of the Law)


The Grand Jury charges:

At all times relevant to this Indictment,

BACKGROUND

A. THE DEFENDANT AND HIS CLINIC

1. The defendant, Scott Rulon Werner, was a resident of Iron County in Cedar City, Utah.

2. The defendant was licensed to practice medicine by the Division of Occupational and Professional Licensing, Department of Commerce, State of Utah.

3. The defendant owned and operated the Total Health Center ("THC"), a medical office principally engaged in the business of providing medical services to individuals who were qualified beneficiaries of public and private health care benefit programs. THC maintained its principal place of business at 1870 North Main Street, Cedar City, Utah, which also served as its mailing address.

B. THE VICTIMS

Public Health Care Benefit Programs

The Medicare Program

4. The Social Security Act of 1965 (Pub. L. No. 89-97, codified at 42 U.S.C. §§ 1395, et seq.), including rules and regulations promulgated thereunder, were in effect and established the Medicare program, a government-sponsored health care program for the elderly. The Medicare program was administered by the Centers for Medicare and Medicaid Services (formerly, the Health Care Finance Administration; hereafter, "CMS"), an agency under the U.S. Department of Health and Human Services. Some of the individuals for whom the defendant provided chelation therapy services were beneficiaries under the Medicare program.

5. The defendant was an approved provider under Part B of the Medicare program.

6. The Medicare program was a "health care benefit program", as that term is defined under 18 U.S.C. § 24(b).

7. Claims submitted by the defendant, and clinic personnel acting at the defendant's direction and control, to Part B of the Medicare program were received, processed, and paid out of government funds by Regence Blue Cross Blue Shield of Utah ("Regence-Public"), a fiscal carrier acting for and on behalf of CMS. As a fiscal carrier for CMS, Regence-Public was a fiscal agency of the United States.

The Medicaid Program

8. The Social Security Act of 1965 (Pub. L. No. 89-97, codified at 42 U.S.C. §§ I 395, et seq.), including rules and regulations promulgated thereunder, were in effect and established the Medicaid program, a government-sponsored health care program for indigent individuals who are aged, blind, disabled, or members of families with dependent children. The Medicaid program was administered by the United States Department of Health and Human Services and the Division of Health Care Financing ("DHCF"), Department of Health, State of Utah. The United States government contributed approximately 75% of the costs of the Medicaid program, with the remaining costs contributed by the State of Utah. Some of the individuals for whom the defendant provided chelation therapy services were beneficiaries under the Medicaid program.

9. The defendant was an approved provider under the Medicaid program.

10. The Medicaid program was a "health care benefit program", as that term is defined under 18 U.S.C. § 24(b).

11. Claims submitted by the defendant, and clinic personnel acting at the defendant's direction and control, to the Medicaid program were received, processed, and paid by the DHCF. By virtue of the federal funding it received and disbursed as a fiscal carrier, the DHCF was a fiscal agency of the United States.

The Tricare Program

12. The 1956 Military Dependent's Medical Care Act was in effect and established the Civilian Health and Medical Program of the Uniformed Services, otherwise known as the "CHAMPUS" program. The CHAMPUS program, now known as the Tricare program, was a federal program which provided health care benefits to eligible retired employees of the uniformed services of the United States, and their dependents. The Tricare program also provided health care benefits to dependents of active duty employees. The United States government contributed 100% for the costs of the Tricare program. Some of the individuals for whom the defendant provided chelation therapy services were beneficiaries under the Tricare program.

13. The defendant was an approved provider under the Tricare program.

14. The Tricare program was a "health care benefit program", as that term is defined under 18 U.S.C. § 24(b).

15. Claims submitted by the defendant, and clinic personnel acting at the defendant's direction and control, to the Tricare program were received, processed, and paid by Palmetto Government Benefits Administrators ("Palmetto"), a fiscal carrier acting for and on behalf of the Tricare program. As a fiscal carrier for the Tricare program, Palmetto was a fiscal agency of the United States.

Private Health Care Benefit Programs

16. Some of the individuals for whom the defendant provided chelation therapy services were beneficiaries of various private health insurance companies, including but not limited to, Regence Blue Cross Blue Shield of Utah ("Regence-Private"), Educator's Mutual Insurance Association ("EMIA"), and Public Employees Health Plan ("PEHP"). The defendant was an approved provider for each of the foregoing companies.

17. Each of the above private health insurance companies was a "health care benefit program", as that term is defined under 18 U.S.C. § 24(b).

18. Claims submitted by the defendant, and clinic personnel acting at the defendant's direction, to the above private health care benefit programs were received, processed, and paid directly by each respective program.

C. THE CLAIMS SUBMISSION PROCESS

19. For each chelation therapy service provided by the defendant to a beneficiary, the defendant, or clinic personnel acting at the defendant's direction and control, prepared and completed a "Health Insurance Claim Form", commonly known as a "HCFA 1500", requesting reimbursement from a beneficiary's public or private health care benefit program. Each claim required the preparer to provide, among other things, the following information:

    1. diagnosis - a patient's diagnosis is identified using a code from the International Classification of Diseases, Clinical Modification, commonly referred to as the "ICD-9" code.

    2. procedure code - a medical service or procedure is identified using a code obtained from the Current Procedural Terminology ("CPT") codebook, a publication of the American Medical Association which assigns codes for use in the medical profession to indicate specific types of medical tests and procedures; at times, procedure codes may also be found in the billing regulations, policies, and/or rules prepared and implemented by public and private health care benefit programs.

    3. provider certification - each claim requires the provider's signed certification that the services and procedures for which reimbursement is requested were medically indicated and necessary for the health of the patient; providers often authorize and direct clinic personnel to use a signature stamp on paper claims prepared and submitted under his or her direction; electronic claims typically refer to the provider's signature on file with the respective public or private health care benefit program.

20. Defendant controlled and directed all information used in the preparation of claims submitted to public and private health care benefit programs.

D. CHELATION THERAPY

21. Chelation therapy was a series of intravenous infusions containing EDTA (Ethylenediamine Tetra-acetic Acid). The chelating ingredient was EDTA, but several additional ingredients such as procaine, magnesium, vitamin B, vitamin B-12, vitamin C, and heparin, among others, were added to the chelation solution depending upon the needs of the patient.

22. The American Medical Association recognized chelation therapy as an appropriate treatment only for heavy metal toxicity such as lead poisoning. The Utah Medical Association also took a similar position.

23. The U. S. Food and Drug Administration ("FDA") determined that chelation therapy was an unproven and experimental procedure, except when used for the treatment of heavy metal toxicity.

24. During or around 1997, at the defendant's request, Dennis Harper, M.D., a physician from St. George, Utah, taught the defendant how to perform chelation therapy. As part his efforts to teach chelation therapy to the defendant, Dr. Harper:

    1. Advised the defendant that the Medicare and Medicaid programs did not cover chelation therapy except when used for the treatment of heavy metal toxicity.

    2. Advised the defendant to opt out of the Medicare program and have the patient enter into a private contract. Otherwise, the Medicare program required the defendant to bill for any services (whether or not they were covered services) provided to a beneficiary.

    3. Provided the defendant with a copy of a written waiver that Dr. Harper had his patients read and sign before they received chelation therapy. The waiver, entitled, "PATIENT REQUEST FOR CHELATION THERAPY", contained the following statements, among others:

(1) "I am hereby requesting to become your patient in a program of treatment involving the controversial use of EDTA (Ethylenediamine Tetra-acetic Acid) as a chelation agent in the treatment or prevention of Occlusive Arterial Disease, for other related conditions, or for heavy metal toxicity."

(2) "E.D.T.A.: I understand that EDTA is a well accepted chelating agent which is commonly used as a food additive and for lead poisoning, but which is controversial when used intravenously for occlusive arterial disease, hypertension or any other bodily condition.

(3) "LITERATURE: I have or intend to read the literature and books concerning chelation therapy made available to me by my physician. This has given me an understanding of the controversy that surrounds the use of EDTA chelation therapy."

(4) "I have been made fully aware of certain risks and consequences that are associated with the procedures described in prior pages of this consent form. I further understand that the use of EDTA has been approved by the food and drug administration of the U.S. government but not for the intended purposes of this course of treatment. I also understand that the Utah Medical Association does not approve of this medical treatment. The manufacturer specifically states that EDTA is not indicated for the intended use in this course of treatment."

(5) "I have been informed that medicare and most other medical insurance companies will not reimburse me for the cost of EDTA chelation therapy."

During the above period, the defendant also attended a three-day training in chelation therapy offered by the American College for the Advancement of Medicine ("ACAM"). As a result of this training, the defendant received a "diplomate candidate" certificate from the ACAM.

25. Prior to providing any chelation therapy services, the defendant typically had beneficiaries read and sign the "PATIENT REQUEST FOR CHELATION THERAPY".

E. CHELATION THERAPY - INSURANCE COVERAGE

26. The billing regulations, policies, and rules of the Medicare program authorized the defendant to bill for chelation therapy only when used for the treatment of heavy metal toxicity.

27. The billing regulations, policies, and rules of the Medicaid program authorized the defendant to bill for chelation therapy only when used for the treatment of heavy metal toxicity. The Medicaid program specifically excluded experimental medical practices from its covered benefits.

28. The billing regulations, policies, and rules of the Tricare program authorized the defendant to bill for chelation therapy only when using FDA-approved chelators for FDA-approved indications. Tricare identified the use of chelation therapy as an unproven therapeutic modality for the treatment of multiple sclerosis, arthritis, hypoglycemia, diabetes, arteriosclerosis, malaria, cancer, and alzheimers disease.

29. The billing policies and rules of Regence authorized the defendant to bill for chelation therapy only when medically necessary for the treatment of extreme conditions of heavy metal toxicity (including lead poisoning), control of ventricular arrythmias or heart block associated with digitalis toxicity, emergency treatment of hypercalcemia, and Wilson's disease (hepatolenticular degeneration). Regence excluded from coverage as investigational any other use of chelation therapy for the treatment of other conditions, including arteriosclerosis, arthritis, coronary or peripheral vascular disease, diabetes, hypercholesteremia, hypoglycemia, multiple sclerosis, porphyria, and scleroderma.

30. The billing policies and rules of EMIA authorized the defendant to bill for chelation therapy only when medically necessary for the treatment of heavy metal toxicity. EMIA specifically excluded from coverage treatments that are experimental or investigative medical practices. Even for those treatments approved by the FDA, EMIA established a 12- month waiting period.

31. The billing policies and rules of PEHP did not authorize the defendant to bill for chelation therapy under any circumstances.

THE SCHEME AND ARTIFICE TO DEFRAUD

32. From in or around December 1997 to in or around March 2002,

SCOTT RULON WERNER, M.D.,

defendant herein, knowingly and willfully devised and intended to devise a scheme and artifice to defraud public and private health care benefit programs and to obtain money from such programs by means of false and fraudulent pretenses, representations, and omissions, in that the defendant submitted false claims representing that he had rendered IV therapy services for beneficiaries, when in truth and fact the defendant had rendered chelation therapy services for beneficiaries, resulting in payments from health care benefit programs to which the defendant was not entitled.

33. It was part of the artifice and scheme to defraud that the defendant recommended and performed chelation therapy services for beneficiaries who presented with various illnesses and symptoms other than those associated with heavy metal toxicity.

34. It was further part of the artifice and scheme to defraud that the defendant authorized and directed clinic personnel, through the use of a superbill form, verbal instructions, or other related documents, to prepare a HCFA 1500 claim requesting reimbursement for services using the following CPT codes, among others, or combinations thereof, for the reasons indicated below:

    1. CPT 99213 - Defendant's use of this code indicated an established patient, level 3 office visit.
    2. CPT 90780 - Defendant's use of this code indicated the patient received one hour of IV therapy.
    3. CPT 90780 - Defendant's use of this code indicated the patient received additional hours of IV therapy.
    4. 17042 - Defendant's use of this code indicated the patient received a saline solution as part of his IV therapy.
    5. 13420 - Defendant's use of this code indicated the patient received a vitamin B-12 solution as part of his IV therapy.
    6. 12000 - Defendant's use of this code indicated the patient received a xylocaine solution as part of his IV therapy.
    7. 13475 - Defendant's use of this code indicated the patient received a magnesium sulfate solution as part of his IV therapy.

35. It was further part of the artifice and scheme to defraud that the above claims were submitted to reflect falsely that a beneficiary had received IV therapy services when in truth and fact the beneficiary had received chelation therapy services. The information contained in the HCFA 1500 claims prepared at the defendant's direction and control failed to disclose any information which would have put the public and private health care benefit programs on notice that the defendant had performed chelation therapy services for their respective beneficiaries.

36. It was further part of the artifice and scheme to defraud that the above claims were submitted to public and private health care benefit programs by U.S. mail or electronically.

ACTS IN FURTHERANCE OF THE ARTIFICE AND SCHEME TO DEFRAUD

In furtherance of and to effect the objectives of the artifice and scheme to defraud, the following acts, among others, were committed in the Central Division of the District of Utah:

37. During or around 1999, the defendant, or clinic personnel acting at the defendant's direction and control, began altering patient chart entries from "chelation therapy" to "IV therapy". The changes were made in different ways, including among others: (a) placing a sticker containing a false chart entry for "IV" therapy over a chart entry for "chelation" therapy; and (b) revising the chart entry template on the clinic's computer from "chelation" therapy services to "IV" therapy services. The foregoing protocol was either in effect or implemented shortly after the clinic was served on or around September 20, 1999 with a Medicaid subpoena for records relating to specific beneficiaries.

38. During or around October and November 1999, and at other times, the defendant provided incomplete and inaccurate information to the Medicare program when requested to provide copies of records relating to specific beneficiaries.

COUNTS 1 THROUGH 36
18 U.S.C. §§ 1347, 2(b)
(Health Care Fraud)

39. The Grand Jury incorporates and realleges the allegations contained in paragraphs 1 through 38, above.

40. On or about each of the dates identified below, in the Central Division of the District of Utah,

SCOTT RULON WERNER, M.D.,

defendant herein, and clinic personnel acting at the defendant's direction and control, knowingly and willfully, for the purpose of executing a scheme and artifice to defraud and to obtain money by means of false and fraudulent pretenses, representations, and omissions of material fact from public and private health care benefit programs, knowingly submitted and caused to be submitted, the following representative false claims, among others, to such programs:

Count Beneficiary Date of Service (on or about) Health Care Benefit Program
Date Claim Received (on or about)
False Statements
in Claim
1 Beneficiary 1
06/22/98
Medicare
06/29/98
CPT 90780, 90781 representing
IV therapy services
2 Beneficiary 1
07/27/98
Medicare
09/09/98
CPT 90780, 90781 representing
IV therapy services
3 Beneficiary 2
07/30/98
EMIA
08/04/98
CPT 90780, 90781 representing
IV therapy services
4 Beneficiary 3
08/19/98
Medicaid
08/20/98
CPT 90780, 90781 representing
IV therapy services
5 Beneficiary 4
09/21/98
Medicare
09/28/98
CPT 90780, 90781 representing
IV therapy services
6 Beneficiary 4
10/15/98
Medicare
10/26/98
CPT 90780, 90781 representing
IV therapy services
7 Beneficiary 5
12/29/98
Medicaid
01/03/99
CPT 90780, 90781 representing
IV therapy services
8 Beneficiary 5
01/21/99
Medicaid
01/26/99
CPT 90780, 90781 representing
IV therapy services
9 Beneficiary 6
02/18/99
Regence
02/24/99
CPT 90780, 90781 representing
IV therapy services
10 Beneficiary 6
03/11/99
Regence-Private
03/19/99
CPT 90780, 90781 representing
IV therapy services
11 Beneficiary 7
04/07/99
EMIA
04/12/99
CPT 90780, 90781 representing
IV therapy services
12 Beneficiary 8
06/28i/99
PEHP
07/23/99
CPT 90780, 90781 representing
IV therapy services
13 Beneficiary 9
07/16/99
EMIA
07/21/99
CPT 90780, 90781 representing
IV therapy services
14 Beneficiary 10
08/17/99
Regence-Private
08/18/99
CPT 90780, 90781 representing
IV therapy services
15 Beneficiary 10
09/07/99
Regence-Private
09/10/99
CPT 90780, 90781 representing
IV therapy services
16 Beneficiary 11
11/18/99
Medicaid
02/10/00
CPT 90780, 90781 representing
IV therapy services
17 Beneficiary 11
12/02/99
Medicaid
02/10/00
CPT 90780, 90781 representing
IV therapy services
18 Beneficiary 11
01/21/00
Medicaid
02/10/00
CPT 90780, 90781 representing
IV therapy services
19 Beneficiary 12
02/16/00
Tricare
03/01/00
CPT 90780, 90781 representing
IV therapy services
20 Beneficiary 11
03/31/00
Medicaid
04/12/00
CPT 90780, 90781 representing
IV therapy services
21 Beneficiary 13
04/18/00
PEHP
07/11/00
CPT 90780, 90781 representing
IV therapy services
22 Beneficiary 12
05/08/00
Tricare
05/30/00
CPT 90780, 90781 representing
IV therapy services
23 Beneficiary 11
06/29/00
Medicaid
07/05/00
CPT 90780, 90781 representing
IV therapy services
24 Beneficiary 11
07/05/00
Medicaid
07/12/00
CPT 90780, 90781 representing
IV therapy services
25 Beneficiary 14
08/31/00
PEHP
01/27/01
CPT 90780, 90781 representing
IV therapy services
26 Beneficiary 14
09/07/00
PEHP
01/27/01
CPT 90780, 90781 representing
IV therapy services
27 Beneficiary 11
10/30/00
Medicaid
11/03/00
CPT 90780, 90781 representing
IV therapy services
28 Beneficiary 11
11/20/00
Medicaid
12/01/00
CPT 90780, 90781 representing
IV therapy services
29 Beneficiary 11
12/14/00
Medicaid
12/26/00
CPT 90780, 90781 representing
IV therapy services
30 Beneficiary 12
01/27/01
Tricare
04/11/01
CPT 90780, 90781 representing
IV therapy services
31 Beneficiary 12
04/16/01
Tricare
04/23/01
CPT 90780, 90781 representing
IV therapy services
32 Beneficiary 12
03/30/01
Tricare
04/11/01
CPT 90780, 90781 representing
IV therapy services
33 Beneficiary 12
07/26/01
Tricare
09/04/01
CPT 90780, 90781 representing
IV therapy services
34 Beneficiary 12
02/14/02
Tricare
02/26/02
CPT 90780, 90781 representing
IV therapy services
35 Beneficiary 15
02/14/02
Tricare
02/26/02
CPT 90780, 90781 representing
IV therapy services
36 Beneficiary 15
02/19/02
Tricare
03/05/02
CPT 90780, 90781 representing
IV therapy services

All in violation of 18 U.S.C. §§ 1347, 2(b).

COUNTS 37THROUGH 49
18 U.S.C. §§ 287, 2(b)
(False Claims to the United States)

41. The Grand Jury incorporates and realleges the allegations contained in paragraphs 1 through 15, and 19 through 28 above.

42. Defendant recommended and performed chelation therapy services for beneficiaries who presented with various illnesses and symptoms other than those associated with heavy metal toxicity.

43. Defendant authorized and directed clinic personnel, through the use of a superbill form, verbal instructions, and other related documents, to prepare a HCFA 1500 claim requesting reimbursement for services using the following CPT codes, among others, or combinations thereof, for the reasons indicated below:

    1. CPT 99213 - Defendant's use of this code indicated an established patient, level 3 office visit.
    2. CPT 90780 - Defendant's use of this code indicated the patient received one hour of IV therapy.
    3. CPT 90780 - Defendant's use of this code indicated the patient received additional hours of IV therapy.
    4. 17042 - Defendant's use of this code indicated the patient received a saline solution as part of his IV therapy.
    5. 13420 - Defendant's use of this code indicated the patient received a vitamin B-12 solution as part of his IV therapy.
    6. 12000 - Defendant's use of this code indicated the patient received a xylocaine solution as part of his IV therapy.
    7. 13475 - Defendant's use of this code indicated the patient received a magnesium sulfate solution as part of his IV therapy.

44. The above claims were submitted to reflect falsely that a beneficiary had received IV therapy services when in truth and fact the beneficiary had received chelation therapy services. The information contained in the HCFA 1500 claims prepared at the defendant's direction and control failed to disclose any information which would have put the public and private health care benefit programs on notice that the defendant had performed chelation therapy services for their respective beneficiaries.

45. The above claims were submitted to public and private health care benefit programs by U.S. mail or electronically.

46. During or around 1999, the defendant, and clinic personnel acting at the defendant's direction and control, began altering patient chart entries from "chelation therapy" to "IV therapy". The changes were made in different ways, including among others: (a) placing a sticker containing a false chart entry for "IV" therapy over a false chart entry for "chelation" therapy; and (b) revising the chart entry template on the clinic's computer from "chelation" therapy services to "IV" therapy services. The foregoing protocol was either in effect or implemented shortly after the clinic was served on or around September 20, 1999 with a Medicaid subpoena for records relating to specific beneficiaries.

47. During or around October and November 1999, and at other times, the defendant provided incomplete or inaccurate information to the Medicare program when requested to provide copies of records relating to specific beneficiaries.

48. On or about each of the dates identified below, in the Central Division of the District of Utah,

SCOTT RULON WERNER, M.D.,

defendant herein, and clinic personnel acting at the defendant's direction and control, knowingly made and caused to be made, false, fictitious, and fraudulent claims identified below to RegenceĀ­-Public, the DHCF, and Palmetto, each a fiscal agency of the United States, in that the defendant misrepresented, and caused to be misrepresented, that IV therapy services were rendered to beneficiaries, knowing full well that such beneficiaries actually received chelation therapy services. Such representative claims included, among others, the following:

Count Beneficiary, Date of Service (on or about)

Government Program
Fiscal Agency
Date Claim Received (on or about

False Statements in Claim
37 Beneficiary 1
06/22/98
Medicare
06/29/98
CPT 90780, 90781 representing
IV therapy services
38 Beneficiary 1
07/27/98
Medicare
09/09/98
CPT 90780, 90781 representing
IV therapy services
39 Beneficiary 2
07/30/98
EMIA
08/04/98
CPT 90780, 90781 representing
IV therapy services
40 Beneficiary 3
08/19/98
Medicaid
08/20/98
CPT 90780, 90781 representing
IV therapy services
41 Beneficiary 4
09/21/98
Medicare
09/28/98
CPT 90780, 90781 representing
IV therapy services
42 Beneficiary 4
10/15/98
Medicare
10/26/98
CPT 90780, 90781 representing
IV therapy services
43 Beneficiary 5
12/29/98
Medicaid
01/03/99
CPT 90780, 90781 representing
IV therapy services
44 Beneficiary 5
01/21/99
Medicaid
01/26/99
CPT 90780, 90781 representing
IV therapy services
45 Beneficiary 6
02/18/99
Regence
02/24/99
CPT 90780, 90781 representing
IV therapy services
46 Beneficiary 6
03/11/99
Regence-Private
03/19/99
CPT 90780, 90781 representing
IV therapy services
47 Beneficiary 7
04/07/99
EMIA
04/12/99
CPT 90780, 90781 representing
IV therapy services
48 Beneficiary 8
06/28i/99
PEHP
07/23/99
CPT 90780, 90781 representing
IV therapy services
49 Beneficiary 9
07/16/99
EMIA
07/21/99
CPT 90780, 90781 representing
IV therapy services

All in violation of 18 U.S.C. §§ 287, 2(b).

COUNTS 50 THR0UGH 54
18 U.S.C. § 1035(a)(2)
(False Statements Related to Health Care Matter)

49. The United States Attorney incorporates and realleges the allegations contained in paragraphs 1 through 3, 16 through 25, and 42 through 47 above.

50. On or about each of the dates identified below, in the Central Division of the District of Utah,

SCOTT RULON WERNER, M.D.,

defendant herein, and clinic personnel acting at the defendant's instruction and direction, in a matter involving a health care benefit program, knowingly and willfully made and used, and caused to be made and used, a materially false document, knowing said document contained a materially false, fictitious, and fraudulent statement or entry, in connection with the delivery of and payment for health care benefits, items and services, in that the defendant misrepresented, and caused to be misrepresented, on a claim that IV therapy services had been rendered for a beneficiary, knowing full well that such beneficiary actually received chelation therapy services. Such representative claims included, among others, the following:

Count Beneficiary Date of Service (on or about) Health Care Benefit Program
Date Claim Received (on or about)
False Statements
in Claim
50 Beneficiary 17
10/22/98
EMIA
10/28/98
CPT 90780, 90781 representing
IV therapy services
51 Beneficiary 17
11/17/98
EMIA
11/20/98
CPT 90780, 90781 representing
IV therapy services
52 Beneficiary 9
08/13/99
EMIA
08/17/99
CPT 90780, 90781 representing
IV therapy services
53 Beneficiary 8
0701/99
PEHP
07/23/99
CPT 90780, 90781 representing
IV therapy services
54 Beneficiary 13
04/03/00
PEHP
04/26/00
CPT 90780, 90781 representing
IV therapy services

All in violation of 18 U.S.C. §§ 1035(a)(2), 2(b).

A TRUE BILL:

_______________________
Gail Ellison
FOREPERSON OF THE GRAND JURY

PAUL M. WARNER
United States Attorney

__________________________
MARK Y. HIRATA
Assistant United States Attorney

WADE FARRAWAY
Special Assistant United States Attorney

This page was revised on December 26, 2016.

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