Date: 12 June 2017
Source: The Sydney Morning Herald
The certificate that Phillip Spain copied off the internet and doctored to include his own name looked so amateurish that he thought authorities would reject it immediately.
But they didn’t and Medicare promptly issued a provider number to allow him to treat patients as an exercise physiologist.
Over five years, the 43-year-old personal trainer known as “Doc” and “Captain” to his clients, used the provider number to submit 627 claims to Medicare, to the value of almost half a million dollars.
However, his fraud unravelled in the Downing Centre Local Court last week when magistrate Jennifer Atkinson sent him to jail for two years, the maximum sentence a Local Court can impose.
Spain had no formal qualifications and instead forged a certificate from Exercise and Sports Science Australia that he found online.
The holes were obvious: the president who signed the certificate had resigned years earlier and it still bore the association’s old name.
However, he was issued with five Medicare provider numbers for five practices he worked at, allowing him to collect $486,215.45 in claims.
While working as an instructor at the NuYu Health Retreat in Windsor in 2010, Spain submitted 128 claims on behalf of three clients whom he never saw.
He offered services across Sydney, treating patients with chronic disease and illness at Philosophy Health in the city, Pitt Street Merrylands Medical Centre, Campsie Medical and Dental Centre, Wentworthville Medical Centre and Revive Health Centre in Brighton-le-Sands.
More recently, he advertised his services as an accredited exercise physiologist and dietitian at Anytime Fitness Campbelltown and Hoxton Park.
“I’m not your average trainer nor do I want to be,” he said in an online profile that spruiked his 18 years in the health industry.
He said he was “exclusively contracted” to four professional athletes ranked in the top 10 worldwide in their sport and assisted an NFL club “to continue its domination year in, year out”.
Ms Atkinson said Spain’s five-year long medical fraud was one of the worst she had seen.
After pleading guilty, he told probation officers that he only ever provided general exercise advice and would have had “minimal” impact on his patients.
“How does he know?” Ms Atkinson asked when sentencing him. “That doesn’t show remorse or contrition. He has no idea. The fact people need to see an exercise physiologist would suggest there’s something in their medical condition that requires attention.”
Spain wanted to represent himself at the sentencing but Ms Atkinson recommended he seek legal advice, saying she was “seriously considering” sending him to jail.
The matter was adjourned for a few hours to allow him to speak to a volunteer duty barrister.
Duty barrister Tiffany Davy told the court that, at the time of his offending, Spain was depressed, suicidal and had been under the influence of his emotionally abusive ex-wife, who pressured him to make more money.
Medicare cancelled his provider number on January 30, 2015, four years after one of his supposed clients complained to Medicare about a false claim.
The next day, he tried to put through a claim but it was rejected. When he didn’t show up for a interview with the Department of Health months later, he was charged.
“You had no entitlement to that money,” Ms Atkinson said.
She ordered him to repay the full $486,215.45.