Ted Ventures, Trend, Enrique Stowhaus

Case 3:20-cv-03729-S Document 53 Filed 05/28/23 Page 1 of 28 PageID 288
IN THE UNITED STATES DISTRICT COURT

NORTHERN DISTRICT OF TEXAS
DALLAS DIVISION
ARLENE PEREZ-MERINO §
§
PLAINTIFF §
§
V. § C. A.NO. 3:20-CV3729-S
§
TREND CLINICS, INC., §
§
DEFENDANT §
THIRD AMENDED COMPLAINT
Plaintiff Arlene Perez-Merino (“Plaintiff”), for her Third Amended Complaint against
Defendant Trend Clinics, Inc. (“Defendant”), would show as follows:
I. PARTIES AND BACKGROUND
1. Plaintiff is an individual with substantial experience in assisting workers
compensation claimants, including federal employees with work-related injury claims under the
Federal Employee Compensation Act (“FECA”). Plaintiff has served and continues to serve
FECA claimants as an official lay representative for FECA claimants under regulations
promulgated pursuant to the FECA. Plaintiff was employed by Defendant between July 2017 and
March 2020.
2. Defendant is a corporation which may be served with summons through its
registered agent for service of process, Ted Ventures, LLC, 621 Highlander Avenue, Midlothian,
Texas 76065.
THIRD AMENDED COMPLAINT – Page 1

3. The United States (the “Government”), through its Department of Labor
(“DOL”), and specifically the Office of Workers Compensation Programs (“OWCP”) of the
DOL, administers claims under the FECA, including paying such claims on behalf of the
agencies of the Government employing FECA claimants. Under the FECA, certain claims
against the Government are not properly payable, including claims for services of unsupervised
non-licensed personnel, services other than physical therapy on a patient performed by a
chiropractor under supervision of a physician and under certain conditions, and services
performed by an unsupervised licensed professional counselor in training. Specifically, in regard
to reimbursement for services of a chiropractor, (a) services of chiropractors other than physical
therapy that may be reimbursed are limited by the FECA to treatment to correct a spinal
subluxation; the costs of physical and related laboratory tests performed by or required by a
chiropractor to diagnose such a subluxation are also reimbursable, (b) a diagnosis of spinal
“subluxation as demonstrated by X-ray to exist” must appear in the chiropractor's report before
the DOL can consider payment of a chiropractor's bill, and (c) a chiropractor may interpret his or
her x-rays to the same extent as any other physician, but to be given any weight, the medical
report must state that x-rays support the finding of spinal subluxation. DOL will not necessarily
require submittal of the x-ray, or a report of the x-ray, but the report must be available for
submittal on request. A chiropractor may also provide services in the nature of physical therapy
under the direction of, and as prescribed by, a qualified physician. Defendant or one of its
Principals or related entities referred to in paragraph 4, or one of the Providers referred to in
paragraph 5, or one of the other related individuals or entities referred to in paragraphs 6, 7 and
8, has made claims against the Government under the FECA in violation of the False Claims Act
(“FCA”), including based on violations of the Anti-Kickback Act (“AKA”)and the Travel Act.

4. On information and belief, Enrique Stowhas, Derek Gove and Trey Austin (the
“Principals”) own or control Defendant, TED Ventures, LLC, Trend Physicians Group, Inc.
Tritin Medical Distribution, LLC., Tritin Surgical Assist, LLC and TI Medical Holdings, LLC
and various other entities.
5. Certain individuals or entities constituting medical providers or pharmacies
(“Providers”) owned, controlled, or managed by Defendant, purport to offer medical care to
individuals substantially all of whom are claimants under the FECA. Individual Providers offer
medical care individually or through certain entities owned, controlled or managed by Principals
Gove and Austin, including Defendant, formerly known as WOLMED, owned by Dr. Edward
Wolski, Karen Dickerson, Patient’s Choice, owned by Dr. Ara Dayian, or managed by the
Principals, WellSpine, owned by Dr. Francisco Batlle, Regional Orthopedics and Sports Medical
Center, owned by Dr. Robert Roye, Lancaster Hospital nka Crescent Medical Center Lancaster,
owned by Raji Kumar, Blue Star, owned by Chris Green, NextGen Healthcare, owned by Hunter
Jochem, Actuhealth, owned by Dr. Lashoneria Camp and formerly owned by Trownon Thomas,
a licensed pharmacist and Allan Gonzales, 360 Clinics, PPC, owned by Dr. Naveed Clair, and
Defendant Trend Physicians Group, Inc., operated by Dr. Gregg Podleski, Dr. Brian Rogers and
Dr. James K. Kaufman.
6. Certain individuals and entities, including Tritin Medical Distribution, LLC. and
Tritin Surgical Assist, LLC, owned and controlled by Principal Austin, and ProMed, Inc., owned
by Bryan Neal, purportedly offer medical instrumentation and durable medical equipment to
Defendant and one or more related entities and Providers. Kym Grant also provides medical
instrumentation to one or more of the Providers through an entity named Doctors Guild. Her
husband is a licensed chiropractor, and she and her husband have a relationship with one or more

unions representing federal employees as FECA claimants and she refers such FECA claimants
to her husband without disclosing her relationship with her husband and she also refers FECA
claimants to Crescent Medical Center Lancaster under circumstances in which she is
compensated for such referrals.
7. Certain individuals and entities or purported entities, including Sonar Care
Management, owned, controlled or managed by the Principals, purportedly offer services to one
or more Providers to assist their management, or provide medical management services, or in
order to obtain medical instrumentation, durable medical equipment or pharmaceutical products
or laboratory services to be provided FECA claimants served by Providers. Plutus Health, Inc.,
owned by John Thomas, purports to provide preauthorization services for patients of Providers.
8. Certain individuals also purportedly offer billing, marketing and other services to
Defendants or one or more of the Providers, including Terri Horner, Christina Morales, Carol
Debord, Kristen Gilmore, Delilah Garcia, Lori Moya, Crystal Myers, Krystal Hamilton, Carson
Roye, Nick Kossorow, Jeff Bob, Ashley Carter, Travis Miller, Henry Velasquez, John Merritt,
Brandon Brenner, Juan Pedraza, Scott Ostrow, Gage Merritt, Scott Atwater and Sheila Bennett.
9. During her employment by Defendant, Plaintiff engaged in protected conduct in
an effort to stop one or more violations of the FCA, but was terminated and otherwise subjected
to retaliation before and after her termination on account of her doing so. Specifically, Plaintiff,
during her employment by Defendant, believed Defendant and related individuals and entities
were making false claims for payment for medical services, pharmaceuticals, medical
instrumentation and durable medical equipment purportedly provided to FECA claimants, made
by Providers to the Government and fiscal intermediaries of the Government for goods or
services purportedly provided to FECA claimants through fraudulent billing schemes, including

upcoding, false documentation in violation of the FCA and violations of the FECA, AKA, Stark
Act and Travel Act. In 2019 and early 2020, Plaintiff made known her opposition to one or more
of such false claims in violation of the FCA and was, in consequence of such opposition,
subjected to retaliation, including interference with her performance of services as a lay
representative for FECA claimants, termination of her employment and suit against her. Plaintiff
was also subjected by Defendant to discrimination on the basis of disability and to retaliation by
termination of her employment in violation of the Americans with Disabilities Act (“ADA”) and
the Texas Labor Code (“TLC”).
II. JURISDICTION AND VENUE
10. Plaintiff asserts a first claim under Section 3730(h) of the FCA and thus has this
Court accordingly has subject matter jurisdiction over this action pursuant to 28 U.S.C. § 1332
and 31 U.S.C. § 3732, as well as under 28 U.S.C. § 1345. This Court also has subject matter
jurisdiction under Plaintiff’s claims under the ADA under 28 U.S.C. § 1332 and supplemental
jurisdiction over Plaintiff’s claims under the TLC under 28 U.S.C. § 1367.
11. Venue for this action lies under 28 U.S.C. § 1291 and 31 U.S.C. § 3732.

III. FACTS
A. Providers and Employment of Plaintiff
12. On information and belief, Providers were formed or acquired by Principals or
other entities and individuals or are managed by Principals or other entities and individuals. The
individual Providers include Wolski, Dr. Andrew Garrett, a licensed chiropractor, Dr. Robert
Ippolito, Dr. Douglas Beeman, a licensed chiropractor, Dr. Robert Helsten, Rogers, Dr. Julian
Crutchfield, a licensed chiropractor, Dr. Michael Smith, a licensed chiropractor, Chad Dugas,
formerly licensed as a chiropractor and now as a licensed family nurse practitioner, David
Janaway, a licensed professional counselor, Dr. Aaron Jackson, a licensed chiropractor, Dr. Jared
Ulrich, Dr. Ara Dayian, Dr. Franciso Batlle, Evelyn Garallado, a certified medical assistant,
Chris Keaton, a certified medical assistant, Dr Quam Pham, Layten Revel, purporting to offer
medical care or pharmaceuticals in the form of chronic pain evaluation but holding only a Ph.D.
and not any license, Dr. Candace Addison, Douglas Byers, a licensed chiropractor, Dr. Kevin
James, Dr. Aaron Eubanks, Dr. Robert Niece, Dr. Jared Ulrich, a licensed chiropractor, Dr.
Quam Pham, a licensed chiropractor, Dr. Robert Roye, Dr. Pedro Laredo, Dr. Danika
Rasmussengeter, a licensed chiropractor, Dr. Corey Strunk, a licensed pharmacist, Dr. Karen
Dickerson, Dr. Lashoneria Camp, Trownon Thomas, a licensed pharmacist, Dr. Patty Cates, a
licensed chiropractor, Dr. Robert Roye and Dr. Naveed Klair. The entity Providers include
U&Me Pharmacy, LLC, a licensed pharmacy, Southern Star Pharmacy 002, LLC, Southern Star
Pharmacy 003, LLC and Southern Star Pharmacy 004, LLC, each a licensed pharmacy, and
Assurance Consolidated Pharmacy, LLC.

13. Plaintiff became employed by Defendant in March 2017 as its Director of
Business Development and contemporaneously by WOLMED as its chief operating officer.
Defendant is the successor to WOLMED.
14. During her employment between March 2017 and March 9, 2020, Plaintiff
became familiar with multiple false and fraudulent practices in violation of the FCA, the AKA,
Stark and the Travel Act carried out by the Principals and Defendant, through one or more of the
Providers or other individuals listed above, as specified in more detail in paragraphs 15 through
44.
B. False and Fraudulent Practices
15. One or more of the Providers has charged the Government for unsupervised
therapy by chiropractors, unlicensed technicians and licensed professional counselors in training.
By way of example only, Crutchfield, Dugas, Smith, Garrett, Jackson, Pham, Ulrich, Addison,
Dayian, Pham, Gilmore, Wolski, Helsten, Debord and Miller, falsified billing notes stating they
patients were not actually treated under the supervision of a physician and the physicians never
saw the patients. Also by way of example only, persons without a license named Brittany
Bowman, a so-called LPC-I, or licensed professional counselor in training, and Stacy Ogden, a
so-called LPC-I, or licensed professional counselor in training, provided counseling but were
billed by Wolski and Helsten as if they provided the services. Plaintiff has the names of patients
subject to such improper charging. The Government has paid some or all of the fraudulent
charges of the Providers identified in this paragraph and in paragraphs 15 through 44, 45 and 46
of this Third Amended Complaint.
16. One or more of the Providers has charged the Government in amounts otherwise
not legitimately charged, including chiropractors charging for two hours of physical therapy

when patients received no more than 1½ hours of therapy or the physical therapy was
unsupervised while the attending Provider was asleep. By way of example only, Jackson and
Byers did so. Plaintiff has the names of patients subject to such improper charging.
17. One or more of the Providers has charged for medical office visits with physicians
when care was actually provided by chiropractors, licensed professional counselors in training,
technicians and medical assistants. By way of example only, Crutchfield, Garrett and Dugas saw
patients and referred them to surgeons. Plaintiff has the names of patients subject to such
improper charging.
18. One or more of the Providers charged for office visits under CPT code 97110, for
active physical therapy, when the CPT code should have been 97140, for manual hyperbolt
massage. Also, one or more of the Providers charged for office visits under code, for active
physical therapy, when the CPT code should have been 97530, for therapeutic therapy. Also, one
or more of the Providers charged for physician office visits under code 97213 and 97214 when
the code should have been one for physical therapy not by a physician, 97110, 97140, 97530 or
other physical therapy codes. By way of example only, Crutchfield, Dugas, Smith, Garrett,
Jackson, Pham and Ulrich did so. Plaintiff has the names of patients subject to such improper
charging.
19. One or more of the Providers has charged for EMG diagnostic services by an
unlicensed technician signed off by Wolski and Helsten without them ever seeing the patient.
Plaintiff has the names of patients subject to such improper charging.
20. One or more of the Providers did not sign CA-17 and CA-20 and OWCP-5 forms
required by the DOL but the forms were stamped as signed by medical assistants, chiropractors,
nurse practitioners, front office staff and administrative staff without the physicians seeing the

patients. The use of the stamps by persons other than physicians was contrary to limitations on
FECA claims. These forms improperly stamped included pharmacy scripts, office visit scripts,
narrative reports, office dictation, federal government status reports (CA17’s), referral scrips,
FMLA documentation, government assistance documentation and responses to letters from the
DOL to the treating physician. The physicians knowingly instructed their staff to use these
stamps on items not prepared or reviewed by a medical physician after a visit with the patient. As
a consequence, the Government was charged when it should not have been. By way of example
only, Wolski, Dugas, Dickerson, Jannaway, Addison, Ippolitio, Helsten and Dan did so. Plaintiff
has the names of patients subject to such improper charging.
21. One or more of the Providers was charging for office visits under CPT code
99211 when the only event which occurred was medical assistants providing necessary
paperwork to patients. By way of example only, Wolski, Helsten and Dugas did so. Plaintiff has
the names of patients subject to such improper charging.
22. One or more of the Providers opened up false claims, or induced patients to give
false statements to open up such claims, with the DOL when the patient/claimant had not worked
for five years or more and billed charges to the DOL notwithstanding. By way of example only,
Wolski, Rogers, Garrett, Ippolito and Addison did so. This included opening new injury claims
as either traumatic or repetitive for FECA claimants to maximize payment of wage substitution
benefits for FECA claimants when there was not a basis to do so. Plaintiff has the names of
patients subject to such improper charging.
23. One or more of the Providers who were chiropractors prepared medical necessity
letters for physicians recommending surgery when the chiropractors never saw the patients. As a
consequence, the Government paid for surgery related to such letters when it should not have. By

way of example only, Beeman, Garrett and Cates did so. Plaintiff has the names of patients
subject to such improper charging.
24. One or more of the Providers refused to provide medical necessity letters
recommending surgery unless the surgery would involve use of medical instrumentation supplied
by one or more of Defendants or an individual or entity associated with them, specifically
including Tritin Medical Distribution, LLC or Tritin Surgical Assist, LLC but not limited to such
entities. Also, one or more Providers provided medical necessity letters recommending surgery
when use of medical instrumentation supplied by Defendant or an individual or entity associated
with Defendant would be used, and charged for a medical narrative under CPT codes 99203,
99204, 99213, 99214 without disclosing the reason why such letters were being provided. By
way of example only, Beeman, Kaufman, Cates, Podleski, Eubanks, Ippolito, Batlle and Niece
did so. Plaintiff has the names of patients subject to such improper charging.
25. One or more of the Providers provided disability narratives for Social Security
disability benefit purposes for FECA claimants when the claimants were not actually entitled to
Social Security disability benefits. By way of example only, Wolski, Garrett, Beeman, Cates,
Podleski, Eubanks, Ippolito, Batlle and Niece, Addison, Dan, Pham and Dugas did so. Plaintiff
26. One or more of the Providers constituting pharmacies consistently provided
medication for which it would receive most reimbursement without regard to clinical necessity,
facilitated by a practice of Defendant and one or more related entities providing to Providers
substitution scripts authorizing pharmacies to substitute medications if they did not have the
medications originally prescribed. Plaintiff has the names of patients subject to such improper
charging.

27. One or more of the Providers constituting pharmacies provided medication to
patients even without physicians reevaluating those patients after as long as five months. Plaintiff
28. One or more of the Providers constituting pharmacies forged medical necessity
letters to justify prescription of certain medications. By way of example only, Sydia Ahmed, a
licensed pharmacist employee of one of the Southern Star Pharmacy, and other employees of
Southern Star, and Trownon Thomas of Assurance Consolidated Pharmacy, LLC and Scott
Ostrow, a pharmaceutical representative, engaged in forging of such medical necessity letters.
29. One or more of the Providers constituting chiropractors forged medical necessity
letters to justify prescription of certain medications and one or more Providers constituting
pharmacies provided such medications and charged for them. By way of example only, Cates
and Beeman engaged in forging of such medical necessity letters. Plaintiff has the names of
30. On one or more of the occasions, marketers would get a 5% commission, and then
later a 2% commission, of any pharmaceuticals ordered through certain Providers constituting
pharmacies. The marketers included Crystal Meyer, Krystal Hamilton, Carson Roye, Gage
Merritt, Juan Pedraza and Brandon Brenner. As a consequence, the marketers were inducing
Providers to use only pharmacies associated with Defendant. Plaintiff has the names of patients
subject to such improper charging.
31. On one or more of the occasions, marketers would get a 5% commission of any
medical instrumentation and durable medical equipment ordered through certain physicians. The
marketers included Crystal Meyer, Krystal Hamilton, Carson Roye and Brandon Brenner. As a

consequence, the marketers were inducing Providers to use only providers of medical
instrumentation and durable medical equipment associated with Defendant or related entities.
32. One or more of the Providers constituting chiropractors prepared maximum
medical improvement reports for physicians without physicians seeing the patients themselves.
By way of example only, Andrew Garrett did so. Plaintiff has the names of patients subject to
such improper charging.
33. One or more of the Providers has charged for therapy by patient technicians
outside the scope of their licensed practice. By way of example only, Wolski, Helsten, Dayian,
and Rodges billed for services that were provided by technicians but should have
been provided by physical therapists or chiropractors. Plaintiff has the names of patients subject
to such improper charging.
34. One or more of the Providers has charged for the services of a nurse visit, under
CPT code 99211, but without providing the proper standard of care. By way of example only,
medical assistants were not taking vitals. By way of example only, Dugas, Wolski, Addison,
Crutchfield, Garrett and Helsten did so. Plaintiff has the names of patients subject to such
improper charging.
35. One or more of the Providers has charged for visits nearly every time FECA
claimants are retrieving medical records or other documentation even when the documentation
was not provided. By way of example only, when an FECA claimant came to retrieve records, it
was billed under CPT code 99808 even though no new documentation was provided. By way of
example only, Dugas, Wolski, Addison, Crutchfield, Garrett, Helsten, Kaufman, Ippolito and
Podleski did so. Plaintiff has the names of patients subject to such improper charging.

36. One or more of the Providers has overcharged chiropractor time by billing as new
patient physician visits, CPT codes 99202, 99203, 99204, or 99205, and follow up office visits,
under CPT codes 99212, 99213, 99214 or 99215. The result of this was that the amounts charged
were significantly higher because the codes used were proper only for physicians, not
chiropractors. By way of example only, Crutchfield, Garrett, Helsten, Kaufman, Dan and
Podleski did so. Plaintiff has the names of patients subject to such improper charging.
37. One or more of the Providers has provided blank medical preauthorization scripts
to Plutus Health and given signature stamps to its owner, John Thomas, when the scripts should
have been reviewed and signed by the treating physician. As a consequence, the Government
was charged for preauthorization services resulting in more necessary therapy to FECA
claimants by Plutus Health. The result of this was that the amounts billed were significantly
higher than they should have been. By way of example only, Dugas, Wolski, Addison,
Crutchfield, Garrett and Helsten did so. Plaintiff has the names of patients subject to such
improper charging.
38. One or more of the Providers has opened accelerated claims for FECA claimants
in which the circumstances did not justify doing so. By way of example, Providers would open
traumatic injury cases by CA-1 forms and occupational injuries by CA-2 forms when the patients
did not have work-related traumatic injuries or were not working on the claimed injury date to
get surgeries or other medical treatment or disability benefits covered that would otherwise not
have been covered by the FECA. By way of example only, Wolski, Rogers, Beeman, Kaufman,
Podleski, Niece, Ippolito, Cates, Garrett, Dugas and Helsten engaged in this practice. Plaintiff

39. One or more of the Providers made referrals to individuals or entities constituting
medical specialists, hospitals, and/or imaging center(s) conditional on exclusive mutual referrals
or payment of money by such entities or individuals to them. By way of example, Kaufman,
Podleski, Niece, Batlle, Rove, Eubanks and James exclusively perform surgeries at hospitals
with medical instrumentation provided by individuals or entities associated with Defendants and
is compensated by such individuals or entities for such use. The Government has been charged
for such medical instrumentation without disclosure of such facts. Plaintiff has the names of
40. One or more of the Providers made referrals of FECA claimants for surgery to a
physician providing the same diagnosis for every such claimant topic even when circumstances
did not justify the same diagnosis. By way of example only, Kaufman, Beeman, Podleski, Niece
and Ippolito engaged in this improper practice. Plaintiff has the names of patients subject to such
improper charging.
41. One or more of the Providers made referrals of FECA claimants for surgery to a
physician even if the injury the subject of the surgery was not properly covered by the FECA
because not work-related. By way of example only, Wolski, Helsten, Dan, Garrett, Addison,
Beeman and Rogers engaged in this improper practice. As a consequence, the Government paid
certain claims it was not required to pay. Plaintiff has the names of patients subject to such
improper charging.
42. One or more of the Providers directed pharmaceutical scripts to be filled by one of
the Southern Star Pharmacy entities for 90% of prescriptions. Wolski, Kaufman and Podleski,
Helsten, Dayian, Garrett, Rogers and Rove engaged in this improper practice. Plaintiff has the
names of patients subject to such improper charging.

43. Klair administered neurostimulator treatment to FECA claimants, and to Medicare
and Medicaid patients, even when such claimants and patients did not need such treatment.
44. Roye refers all patients to one or more of the Providers because his son works for
one or more of the entities associated with Defendant and his son becomes entitled to
commissions with respect to pharmaceutical scripts or medical instrumentation with respect to
such patients. Batlle refers all patients to his own neuromonitoring provider, owned by him, and
charges the Government even where there is no clinical need for them to obtain services of that
provider. Further, medical instrumentation manufactured or sold by Defendant, or individuals or
entities owned or controlled by Defendant, or otherwise associated with Defendant, are only used
in certain hospitals in which Providers have an ownership interest, and Defendant and related
entities and one or more Providers are both paid for referring patients to such hospitals for
surgeries. Kaufman engaged in this practice. Plaintiff has the names of patients subject to such
improper charging.
C. Violation of the FCA
45. Under the circumstances described in paragraphs 15 through 44, Plaintiff, while
employed by Defendant, believed and understood that one or more of the Providers, with the
knowledge of Defendant, submitted claims, or caused to be submitted claims, that were requests
for payment or approval to the Government, or made, used, or caused to be made or used, claims
to get money or property from the Government, which were false due to improper charges,
upcoding, unbundling and providing for medically unnecessary treatment or other unlawful
reason, with knowledge of their falsity. Also under the circumstances described in paragraphs 15
through 44, Plaintiff, while employed by Defendant, believed and understood that one or more of

such the false claims were submitted by the Providers for payment approval to fiscal
intermediaries of the Government, with knowledge of their falsity. Also under the circumstances
described in paragraphs 15 through 44, Plaintiff, while employed by Defendant, believed and
understood that the Providers’ false submissions, and requests for payment had a natural
tendency to influence, or be capable of influencing, the payment of funds to the Providers. Each
submission to the Government by the Providers, with the knowledge of Defendant, for payment
or approval, constituted a false representation and certification, both express and implied, and
thereby represented a false or fraudulent record or statement and a false or fraudulent claim for
payment, and that the falsity of these claims submitted by the Providers was material to the
Government’s decision to pay these claims and the false claims, knowingly submitted by the
Providers, with the knowledge of Defendant or one or more related entities, to the Government,
were paid by the Government. Among the false claims of which Plaintiff became aware were the
following:
(a) Beeman, a chiropractor, despite being limited to the performance of physical
therapy services under the FECA, purported to perform orthopedic physician services, including
opinion letters for the purpose of surgery. Services of chiropractors under rules applicable
pursuant to the FECA are limited to treatment to correct a spinal subluxation.
(b) Beeman, in medical opinions, routinely misrepresented disc herniations as being
part of original work-related injuries in patients who had not worked in three to five years in
order to justify treatment of such herniations by use of pharmaceutical, instrumentation, durable
medical equipment, physical therapy, physician and, in particular, surgery services of one or
more Providers or other entities or individuals associated with Defendant, the charges for which
would be submitted to the Government under the FECA. By way of example, a patient who was

injured in 2012 and diagnosed with a sprain/strain of the back would otherwise not be a surgical
candidate. However, upgrading the diagnosis to a disk herniation, stenosis, retrolisthesis and/or
disk displacement would allow the patient to get surgery paid for by the Government. In opinion
letters, Beeman would omit that a patient had not worked in several years or that the patient fell
at home. Such medical opinions were, moreover, not within the scope of his chiropractic
knowledge, but were prepared for surgeons to be signed by such surgeons and to be billed by
such surgeons to the government without Beeman’s involvement being disclosed, and without
examination by Beeman of the claimants to whom the opinions related.
(c) Garrett and Crutchfield also provided treatment of claimants for conditions other
than spinal subluxation not authorized to be charged to the government by them as chiropractors,
without necessary preauthorization, including new patient exam encompassing knees, neck and
back charged through Wolski and Helsten as if they had provided the services. The total charges
for such services amounted to as much as $300,000 for the period between 2004 and 2019.
Additional services that Garrett provided outside his limited authority under the FECA were
Schedule of Awards ratings amounting to $300 per evaluation and report. The reports were
signed by Wolski or Helsten and billed as if Wolski and Helsten had performed the evaluations
and the reports and signed them.
(d) Wolski allowed medical assistants to fraudulently use prescription stamps when
he was not in the office and had not seen a claimant for whom the prescription was provided but
charged the Government for services related to the prescription as if he had seen the claimant.
(e) Wolski’s preauthorization representative, Kristen Gilmore, falsified pre-
authorizations for therapy by changing diagnosis codes to codes that she knew would get

accepted and used Wolski’s signature in the name of Wolski. Ms. Gilmore was disciplined after
Plaintiff became aware of her doing so.
(f) Evelyn Gallardo, medical assistant at WOLMED, falsified a return to work
limited duty opinion by changing the date and otherwise. Plaintiff was not allowed to discipline
Gallardo.
46. Prior to the termination of her employment by Defendant on March 9, 2020,
between June 2019 and November 2019, Plaintiff complained verbally or in writing to Stowhas,
Gove, Wolski, Lori Moya, WOLMED office manager, Carol Dubois, WOLMED billing
manager and Damassia Ferria, WOLMED human resources manager, and attorneys for
Defendant, Tom Dickerson and Matt Lawhon, of the illegal fraudulent of charges of Providers
and entities owned, controlled or managed by Defendant or otherwise associated with Defendant,
with respect to FECA claimants. Her complaints included the false claims referred to in
subparagraphs a through f of paragraph 45 and the other false claims referred to below:
(a) on August 3, 2018, in a conference call with Stowhas and Gove, Plaintiff
summarized an audit of billings from Wolski and physicians associated with him, Helsten and
Rogers, in which she identified that charges were being made to the Government for FECA
claimants involving medically unnecessary services, claims for services not rendered, double
billing for services, fabricated medical records and false claims of new injuries to FECA
claimants;
(b) on August 20, 2018, Plaintiff emailed Wolski and other Providers, including
Dugas, Crutchfield, Garrett and other employees of WOLMED, that services were being charged
by Garrett, a chiropractor, beyond his authority to charge patients;

(c) on August 30, 2018, Plaintiff met with Wolski concerning therapy services being
provided by an unlicensed technician not authorized to perform therapy on FECA claimants or
generate a charge to the Government for such services, but he continued to perform such services
even after being warned he could not do so, without Wolski terminating him for doing so;
(d) on September 14, 2018, Plaintiff advised Stowhas, Gove and Lawhon in a
conference call that Crutchfield was performing services with respect to FECA claimants beyond
his authority to do so;
(e) on January 14, 2019, Plaintiff advised Moya, Dubois, Ferria, Gove and Stowhas
of the illegal pre-authorizations and alteration of documents by Ms. Gilmore;
(f) on April 28, 2019, Plaintiff complained to Gove, Stowhas, Lawhon and Moya of
services being performed by unlicensed providers but being falsely billed by licensed providers
as if they had performed the services, impairment ratings being assigned by Garrett to FECA
claimants when he never saw the claimants and billed as if Wolski or Helstein made the
impairment rating, billing of the Government for pharmaceuticals at unreasonable prices and
Wolski accepting cash payments from pharmaceutical representatives in a total amount estimated
to be as much as $216,000 between 2016 and 2019, EMG testing being performed by technicians
but billed as if performed by Wolski and Helsten though they never saw the claimants, charging
for nurse visits for merely giving FECA claimants copies of work status forms to which they
were entitled without a charge being made;
(g) on August 28, 2019, Plaintiff complained to Wolski, Stowhas, Gove, Dickerson
and Lawhon of signature stamps for Wolski continuing to be used by medical assistants, failure
to maintain prescription pads securely and continuing impairment rating services being

performed by contractors outside their authority to perform services to FECA claimants contrary
to advice from Lawhon that doing so was improper;
(h) on September 26, 2019, Plaintiff complained to Wolski, Stowhas, Gove and
Dickerson of the continuing use of signature stamps for Helsten by medical assistants, continuing
failure to maintain prescription pads securely and improper provision of prescription samples and
related advice by medical assistants;
(i) on September 26, 2019, Plaintiff complained to Wolski and Stowhas of
continuing problems with fraudulent use of signature stamps by medical assistants at WOLMED
continuing charging for medically unnecessary services, double billed services, fabricated
medical records and submission of false new injury claims for FECA claimants; Plaintiff also
complained about a standing order that all prescriptions would be filled by Southern Star
Pharmacy, an affiliate of Defendant, and that all FECA claimants would be referred for an EMG
at a facility owned by Wolski and Helsten and that EMGs were being charged for as if performed
by physicians when they were performed by technicians. She also continued to complain about
charging for physician visits for providing FECA claimants copies of forms to which they were
entitled without regard to a charge.
(j) on October 22, 2019, Plaintiff complained to Stowhas, Gove and Lawhon about
being required by Wolski to prepare a false injury form, and refusing to do so (the claim of
injury was properly denied on December 2, 2019 on the ground on which Plaintiff objected);
(k) on November 9, 2019, Plaintiff complained to Lawhon about falsification of
medical records by WOLMED reflecting that claimants met criteria for a given service when
they did not, or that they were provided to service when the physician had not ordered it or was

even aware it had been provided, including after remuneration by a pharmaceutical
representative to one or more of the physicians at WOLMED for prescriptions.
(l) on November 13, 2019, Plaintiff complained to Stowhas, Gove, Wolski,
Dickerson and Lawhon about coding visits as nurse visits using code 99211, which were actually
with medical assistants, involving only giving patients a copy of their CA17 duty status reports.
These reports were given on the day of patients’ office visits in general and charged as a 99080
for special forms, but if the patient lost a report, forgot it, or WOLMED forgot to give the patient
one, when they left the office and would request a copy at a later date, the patient would be
walked into the exam room, the medical assistant, specifically Gallardo, would hand the patient a
copy and this “visit” would be charged as a nurse visit using code 99211. Plaintiff also
complained of unbundling charges which were not allowed to be charged to FECA claimants
separately after Wolski had expressed anger at Plaintiff bringing such issues to his attention.
(m) on November 18, 2019, Plaintiff complained to Stowhas, Gove, Wolski,
Dickerson and Lawhon about arrangements between surgery and pharmaceutical Providers,
through Sonar Care Management, potentially in violation of the Anti-Kickback Act.
(n) on November 20, 2019, Plaintiff further complained to Stowhas, Gove and
Lawhon additional potential violations of the Anti-Kickback Act associated with the payment by
Defendant or one of its affiliates to surgeons James Kaufman and Niece, requiring such
physicians to use pharmaceutical instrumentation or other services of one of Defendant’s
affiliates.
(o) on November 26, 2019, Plaintiff further complained to Wolski and Lawhon and
another employee of Defendant, Vice President of Clinical Development, Henry Velasquez, and
to Nick Kosarow, Director of Clinical Operation, during a face to face meeting, further potential

violations of the Anti-Kickback Act by Wolski including offering free transportation to FECA
claimants, especially since claims were able to get reimbursed for mileage for any provider visits
for their accepted claim.
(p) on December 2, 2019, Plaintiff further complained to Stowhas, Gove and Austin
of potential violations of the Anti-Kickback Act related to the use of Southern Star Pharmacy
and relationships between Wolski and representatives of the union representing FECA claimants.
(q) on January 4, 2019, Plaintiff complained to Stowhas, Gove and Austin about
fraudulent practices of Wolski relating to FECA claimants involving identification of injuries to
as many body parts as possible, as many treatments as possible, whether necessary or not, and
signature by Wolski of treatment plans even without seeing claimants, uniform unnecessary
referrals for psychological counseling and use of a mental health provider who overcharged for
his services.
(r) on February 26, 2020, Plaintiff complained to Stowhas that a Southern Star
Pharmacy claimant, Mary Mancha, continued to receive medication when the last time she saw
Rogers was December 2019 and therefore asked how Southern Star Pharmacy could have a
prescription refill when she did not see a provider to be able to give her a refill. Southern Star
Pharmacy continued to provide medication refills to claimants that had not been seen by the
provider.
47. After Plaintiff made the complaints referred to in subparagraphs (a) through (o) of
paragraph 46, she was subjected to a number of escalating adverse actions:
(a) Plaintiff was subjected to irate threats by Wolski;
(b) Plaintiff was isolated by prohibited from working in the Denton office of
WOLMED although she was the chief operating officer of WOLMED;

(c) Plaintiff was assigned personal duties for Stowhas not consistent with her role as
chief operating officer of WOLMED;
(d) Plaintiff was advised by Lawhon that Defendant’s principals desired to terminate
her employment.
48. On November 26, 2019, Lawhon raped Plaintiff. After Plaintiff was raped by
Lawhon, Plaintiff told Stowhas and Gove about it on November 28, 2019, and Gove asked
Plaintiff she wanted to meet with Defendant’s attorney to obtain advice about how to proceed
while suggesting that she not file criminal charges against Lawhon. On November 30, 2019,
Gove and Plaintiff met with Defendant’s counsel, and arranged for the termination of Lawhon as
attorney for Defendant. On December 10, 2019, Plaintiff was diagnosed with posttraumatic
stress disorder, depression and anxiety and advised Stowhas and Gove and a human resources
representative of Defendant. Based on the symptoms associated with such diagnoses, Plaintiff
was limited in her ability to perform the major life activities of caring for herself, sleeping,
concentrating, thinking, communicating and working. These symptoms rendered Plaintiff
disabled or as having a record of disability and caused Defendant to regard Plaintiff as disabled.
49. After Plaintiff made the complaints referred to in paragraph 46 and disclosed to
Defendant’s principals and a human resources representative her psychiatric diagnoses as
reflected in paragraph 48, Plaintiff, on December 20, 2019, was told not to return to work and to
not communicate with any staff members of Defendant or FECA claimants, an automobile
previously provided to her by Defendant was taken back, and she was replaced in her role as
chief operating officer of WOLMED by another individual. On March 5, 2020, when Plaintiff
came back to work, she suffered a panic attack and Gove required her to take a drug test. As
result of her panic attack, Plaintiff was required by her psychiatrist to remain out of work. On

March 6, 2020, Plaintiff advised Stowhas that she needed information to provide to her
psychiatrist to recommend any accommodations necessary for her to return to work. In response,
Plaintiff was advised that she had been demoted from chief operating officer of WOLMED and
director of business development for Defendant and its affiliates to director of authorization. On
March 9, 2020, Defendant then terminated the employment of Plaintiff at a meeting with
Defendant’s attorney. On March 11, 2020, after Plaintiff refused to execute a separation
agreement tendered to her at the time of her termination, she was contacted by Stowhas and
offered additional terms of separation if she would sign a revised agreement. When Stowhas told
her he wanted to help her, she replied “help me? You fired me and now only going to get
medical help to get better from the rape and trauma of being fired because I tried to explain the
fraud that was going on?”
50. After Plaintiff was terminated, Defendant sued Plaintiff for alleged violation of a
non-disclosure provision in her employment agreement, and then subsequently alleged violation
of a non-competition provision in her employment agreement. Defendant’s attorney also
contacted an FECA claimant, Bobby Norman, represented by Plaintiff as a lay representative
under the FECA and refused to give medical records to other FECA claimants, Mary Mancha,
King Cross and Andre Armour, represented by Plaintiff as a lay representative, resulting in loss
of the claimants as clients of Plaintiff.

D. Discrimination and Retaliation in Violation of the Americans with Disabilities Act

(“ADA”) and the Texas Labor Code (“TLC”)
51. After Plaintiff was suspended from work between December 2019 and March
2020, upon returning from work, Plaintiff suffered a panic attack, and sought a reasonable
accommodation to be able to return to work but Defendant refused to engage in an interactive
dialogue concerning such an accommodation and to provide any accommodation and instead
terminated Plaintiff and subsequently engaged in other retaliation referred to in paragraph 50.
Prior to the filing of Plaintiff’s First Amended Complaint asserting claims of discrimination and
retaliation against Defendant under the ADA and TLC, Plaintiff, on September 24, 2020, filed a
timely charge of discrimination with the Equal Employment Opportunity Commission for joint
filing with the Texas Workforce Commission and obtained a notice of right to sue dated April 1,
2022 from the Equal Employment Opportunity Commission and asserted its rumination and
retaliation claims under the ADA within the 90 days permitted by the notice of right to sue and
asserted discrimination and retaliation claims under the TLC, as permitted without the issuance
of a notice of right to file civil action, after 180 days from the filing of Defendant’s charge of
discrimination but within two years of its filing.

IV. CAUSES OF ACTION
A. COUNT ONE
THE FCA: 31 U.S.C. § 3730(h)
52. All of the allegations set forth herein are incorporated herein by reference as if
fully set forth at length.
53. The FCA, 31 U.S.C. § 3730(h)(1) and (2), state in pertinent part:
In General --
Any employee, contractor, or agent shall be entitled to all relief necessary to make that
employee, contractor, or agent whole, if that employee, contractor, or agent is discharged,
demoted, suspended, threatened, harassed, or in any other manner discriminated against
in the terms and conditions of employment because of lawful acts done by the employee,
contractor, agent or associated others in furtherance of an action under this section or
other efforts to stop 1 or more violations of this subchapter.
(2) Relief --
Relief under paragraph (1) shall include reinstatement with the same seniority status that
employee, contractor, or agent would have had but for the discrimination, 2 times the
amount of back pay, interest on the back pay, and compensation for any special damages
sustained as a result of the discrimination, including litigation costs and reasonable
attorneys’ fees. An action under this subsection may be brought in the appropriate district
court of the Government for the relief provided in this subsection.
54. Plaintiff was subjected to one or more violations of § 3730(h) by Defendant and
is accordingly entitled to relief to include back pay, two times the amount of back pay, interest
on the back pay, front pay, and compensation for any special damages sustained as a result of the
discrimination, including litigation costs and reasonable attorney’s fees.
B. COUNTS TWO AND THREE
AMERICANS WITH DISABILITIES ACT
56. Plaintiff was subjected by Defendant to one or more violations of the ADA

constituting unlawful discrimination and retaliation. On account of such violations, Plaintiff is
entitled to recover from Defendant her backpay, front pay, compensatory damages, punitive
damages, attorney’s fees, prejudgment interest and costs of court.
C. COUNTS FOUR AND FIVE
TEXAS LABOR CODE
58. Plaintiff was subjected by Defendant to one or more violations of the TLC
constituting unlawful discrimination and retaliation. On account of such violations, Plaintiff is
entitled to recover from Defendant her backpay, front pay, compensatory damages, punitive
damages, attorney’s fees, prejudgment interest and costs of court.
V. RELIEF REQUESTED
Plaintiff requests the following relief be imposed against Defendant:
(a) That this Court award all relief against Defendant to which Plaintiff is entitled
under §3730(h) of the FCA;
(b) That this Court award all relief against Defendant to which Plaintiff is entitled
under the Americans with Disabilities Act and Texas Labor Code; and
(c) That this Court award such other relief as it deems just, necessary and fair.
Plaintiff requests a trial by jury of all issues so triable.

Respectfully submitted,
/s/ Robert E. Goodman, Jr.

Robert E. Goodman, Jr.
Texas Bar No. 08158100
Kilgore & Kilgore, PLLC
3141 Hood Street, Suite 500
Dallas, Texas 75219
(214) 379-0823
Email: reg@kilgorelaw.com
ATTORNEY FOR PLAINTIFF
CERTIFICATE OF SERVICE
This is to certify that a copy of the foregoing was served by this Court’s electronic filing
system and/or by email to all counsel of record this 28th day of May 2023:
William “Bill” Camp

William W. Camp, PC
billcamp@camplaw.com
8445 Freeport Parkway, Suite 150
Irving, Texas 65063
214-638-8400 (Telephone)
214-638-8884 (Facsimile)
/s/ Robert E. Goodman, Jr.

Robert E. Goodman, Jr.

Ted Ventures, Trend, Enrique Stowhaus

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Case 3:20-cv-03729-S Document 53 Filed 05/28/23 Page 1 of 28 PageID 288

IN THE UNITED STATES DISTRICT COURT

THIRD AMENDED COMPLAINT

Defendant Trend Clinics, Inc. (“Defendant”), would show as follows:

I. PARTIES AND BACKGROUND

1. Plaintiff is an individual with substantial experience in assisting workers

2. Defendant is a corporation which may be served with summons through its

THIRD AMENDED COMPLAINT – Page 1

3. The United States (the “Government”), through its Department of Labor

non-licensed personnel, services other than physical therapy on a patient performed by a

performed by an unsupervised licensed professional counselor in training. Specifically, in regard

Principals or related entities referred to in paragraph 4, or one of the Providers referred to in

THIRD AMENDED COMPLAINT – Page 2

and various other entities.

5. Certain individuals or entities constituting medical providers or pharmacies

(“Providers”) owned, controlled, or managed by Defendant, purport to offer medical care to

Dr. James K. Kaufman.

THIRD AMENDED COMPLAINT – Page 3

claimants to Crescent Medical Center Lancaster under circumstances in which she is

compensated for such referrals.

7. Certain individuals and entities or purported entities, including Sonar Care

or more Providers to assist their management, or provide medical management services, or in

order to obtain medical instrumentation, durable medical equipment or pharmaceutical products

9. During her employment by Defendant, Plaintiff engaged in protected conduct in

THIRD AMENDED COMPLAINT – Page 4

subjected to retaliation, including interference with her performance of services as a lay

the Texas Labor Code (“TLC”).

II. JURISDICTION AND VENUE

THIRD AMENDED COMPLAINT – Page 5

A. Providers and Employment of Plaintiff

12. On information and belief, Providers were formed or acquired by Principals or

Assurance Consolidated Pharmacy, LLC.

THIRD AMENDED COMPLAINT – Page 6

13. Plaintiff became employed by Defendant in March 2017 as its Director of

Business Development and contemporaneously by WOLMED as its chief operating officer.

Defendant is the successor to WOLMED.

B. False and Fraudulent Practices

therapy by chiropractors, unlicensed technicians and licensed professional counselors in training.

of this Third Amended Complaint.

THIRD AMENDED COMPLAINT – Page 7

Plaintiff has the names of patients subject to such improper charging.

THIRD AMENDED COMPLAINT – Page 8

has the names of patients subject to such improper charging.

the names of patients subject to such improper charging.

patients subject to such improper charging.

THIRD AMENDED COMPLAINT – Page 9

subject to such improper charging.

by one or more of Defendants or an individual or entity associated with them, specifically

when use of medical instrumentation supplied by Defendant or an individual or entity associated

has the names of patients subject to such improper charging.

26. One or more of the Providers constituting pharmacies consistently provided

THIRD AMENDED COMPLAINT – Page 10

27. One or more of the Providers constituting pharmacies provided medication to

has the names of patients subject to such improper charging.

Ostrow, a pharmaceutical representative, engaged in forging of such medical necessity letters.

Plaintiff has the names of patients subject to such improper charging.

patients subject to such improper charging.

later a 2% commission, of any pharmaceuticals ordered through certain Providers constituting

subject to such improper charging.

THIRD AMENDED COMPLAINT – Page 11

Plaintiff has the names of patients subject to such improper charging.

32. One or more of the Providers constituting chiropractors prepared maximum

such improper charging.

to such improper charging.