By JEN McCAFFERY
THE ROANOKE TIMES

   The lead health care fraud agent admitted on the stand Tuesday that 12 of the allegations against one of the defendants in the federal case against a Roanoke pain specialist and three of his associates did not square with records in patient charts.

    The testimony of special agent Robert Wardlow of the U.S. Department of Health and Human Services marks another time in the trial that the testimony of a witness for the prosecution has undermined charges against defendants.

    Under cross-examination by Roanoke attorney Randy Cargill, Wardlow acknowledged that the charts of several patients contained notes about their treatment that did not agree with some of the allegations federal prosecutors Rusty Fitzgerald and Pat Hogeboom have leveled at Kathleen O'Gee of Pulaski.

    O'Gee, 55, has been charged in connection with the billing of an alternative treatment she practiced from 1997 to 2002 at the Roanoke practice of Dr. Cecil Byron Knox. Federal prosecutors have argued that craniosacral therapy, a treatment of gentle massage that targets the central nervous system, has no recognized medical utility and that federal health care and insurance programs will not provide reimbursement for the treatment.

    Federal prosecutors have also used patients' medical files extensively in the case as evidence that Knox, 54, routinely prescribed painkillers such as OxyContin and methadone outside the scope of legitimate medical practice.

    O'Gee, along with Knox, and his practice's office manager, Beverly Gale Boone, 44, and the practice itself - Southwest Virginia Physical Medicine and Rehabilitation - face charges of defrauding Medicaid, Medicare, and Trigon Blue Cross/Blue Shield. Federal prosecutors argue they illegally billed the programs for craniosacral therapy.

    The charges include specific occasions on which federal prosecutors argue that the group defrauded the health care and insurance programs. Federal prosecutors have alleged that the group defrauded the programs 43 times.

    But Wardlow acknowledged that on 12 of the instances O'Gee has been charged with fraud, patient files say another practitioner performed the craniosacral therapy.

    The revelation also shows that at least four other people - Kimball Egge, Greg Shaller, Diane Caldwell and Tim Rowe - also practiced craniosacral therapy at Southwest Physical Medicine and Rehabilitation, but they have not been charged in the case.

    In addition to six health care fraud charges, O'Gee faces counts of racketeering, conspiracy to commit racketeering, conspiracy to violate general criminal statutes, three counts of mail fraud, and three counts of mail fraud involving a kickback scheme.

    Wardlow also acknowledged that Southwest Virginia Physical Medicine and Rehabilitation was audited by Medicaid in 1997 and that the auditor approved payment for craniosacral therapy, based on the information the auditor was supplied by the practice. Hogeboom later pointed out that Trigon has said it will not reimburse for craniosacral therapy.

    Wardlow also acknowledged on cross-examination by David Damico, who is representing counselor Willard Newbill "Bill" James in the case, that some health care publications say it is appropriate to bill for all physical therapies provided under one code.

    The prosecution hit its first roadblock in the first week of the case, when the first witness Fitzgerald called, Edwin Shomaker, could not identify Knox either in the courtroom or in a photograph. One of the charges against Knox is that he traded Shomaker OxyContin for marijuana.

    The trial continues today and is expected to last another four and a half weeks.

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