For more than two decades Jill Jaynes operated the most popular and successful acupuncture clinic in Indian River County. Every year hundreds of patients came frequently for treatment at her beautifully decorated, state-of-the-art facility in the Bridgewater Building on Indian River Boulevard, which employed five acupuncturists and featured soft music, herbal tea and sterling self-help literature in the waiting room.
Now it turns out that soothing environment may have been funded by a variety of illegal activities, if fraud and racketeering charges brought last week are proven.
Jaynes, a licensed acupuncture physician and owner of Absolute Integrated Medicine was arrested at her office last Wednesday and faces allegations that she conspired with others to defraud an insurance company by submitting false or incomplete information, illegally waived patient copayments and deductibles, and unlawfully paid others who referred patients for treatment.
“Inflated and exaggerated,” is what Attorney Brooke Butler calls the charges against her client. “You bet we’re going to fight this.”
Butler said she plans to enter a not-guilty plea. Jaynes, who is out of jail on bond, is scheduled to be arraigned Sept. 26.
If convicted, she could face a maximum of 135 years in prison and millions in fines, officials said.
The alleged crimes occurred between September 1, 2013 and December 31, 2016, according to the arrest warrant, but Butler, who appeared in court with Jaynes on Friday, Aug. 24 for a bail hearing, vigorously denies the charges against her client.
After the hearing, at which Jayne’s bail was reduced by half a million dollars, from $955,000 to $455,000, Butler pointedly accused the county of trumping up charges against Jaynes because her client embarrassed the county by finding a since-closed loophole in its employee insurance plan.
Butler was also upset that one of the bail terms set by Judge Robert Pegg required Jaynes to immediately close her business.
“These are simply allegations at this point,” Butler said. “Nobody has said that the place needed to be shut down. That’s not a finding from the Department of Health about licensing.
“It’s almost like they’re taking away any chance she has of making money so that she can’t defend herself.”
County Attorney Dylan Reingold could not be reached for comment.
State investigators raided Jaynes’ clinic in October 10, 2017, seizing computers, patient files, bank records and billing information.
The arrest warrant alleges that she defrauded Florida Blue Cross Blue Shield of about $1.5 million, about $1.2 million of which was for county employees.
Investigators say Jaynes enticed patients covered by the insurance company plans to use acupuncture by waiving deductibles and coinsurance payments and providing free vitamins, supplements and weight-loss programs.
A typed guide found in Jaynes’ office included a handwritten note about the plan covering county employees. It read: “Only insurance – carte blanche,” seeming to indicate that no co-pays would be charged.
Another of the charges against Jaynes arose from bank records obtained via subpoena that show she was paying Relentless Dietetics $300 per patient that they referred to Absolute Integrated Medicine, a violation of state law. Investigators discovered that Jill Jaynes’ daughter, Jessica Jaynes, and Jonathan Montgomery were associated with Relentless Dietetics, a company that claims to “help high-performing men and women lose weight, remove stress, build confidence and take control of their lives.”
According to the warrant, weight-loss programs are specifically excluded from coverage under all Blue Cross Blue Shield Plans. Investigators say Jill Jaynes got around that restriction by requiring weight-loss customers to receive acupuncture treatments so that she could bill their insurance.
Montgomery and Nicholas Peterson, who are co-owners of Relentless, admitted to investigators that they are not familiar with “any benefits of acupuncture on weight loss, nor are their clients ever required to receive acupuncture treatments to be successful with their programs.” In addition, both Peterson and Montgomery stated the Relentless Program is not covered by insurance and that, in most cases, their clients not involved with Absolute Integrated Medicine pay cash for their weight-loss program.
None of the claims Jaynes submitted in connection with the Relentless Dietetics program were coded as being treatments for “weight loss” but rather for different types of pain.
According to investigators, Jaynes, who taught several acupuncture billing classes and seminars, including one titled “ethical insurance billing,” had devised more than one way of bilking insurance companies.
One woman had filed 259 claims billed to insurance before she filled out new patient paperwork, according to the warrant, a violation of insurance company terms. More than 800 appointments that were deleted from the system were billed anyway.
Investigators also allege the insurance company was billed for 185 claims totaling more than $22,000 that supposedly were incurred during a five-day period when the office was closed in November 2013.
In addition, Jaynes is accused of directing employees to file multiple claims for services provided during a single visit to help cover the costs of “free” supplements, a spreadsheet indicated.
According to the warrant, patients received more than $200,000 in herbs and supplements at no cost. Blue Cross Blue Shield paid more than $300,000 for the claims submitted, leaving Jaynes with a profit of nearly $100,000, investigators say.
A review of patient files revealed that less than half of Jaynes’ claims between 2012 and 2016 had documentation.
Jaynes troubles began in December 2016 when Suzanne Boyll, the county’s human resources director, noticed the county’s health-insurance plan paid out more than $1.1 million to one local acupuncture practice – Jaynes’ Absolute Integrated Medicine – from October 2015 through September 2016. The money paid to Absolute was far more than to any other non-hospital healthcare provider during that same period.
That amount covered 34,340 visits for 253 members who sought treatment at Absolute. County officials say Jaynes was attracting so many customers because she was waiving patient co-pays – essentially offering them free services – and billing the county and insurance companies.
To put that $1.1 million number in perspective, The Indian River Medical Center billed the county only $1.6 million for treating county employees and their dependents during the same period; and the Sebastion River Medical Center was paid only $560,000 by county.
County commissioners responded to Boyll’s revelation by placing a cap on the acupuncture benefit in the health-insurance plan offered to county employees. Previously, county employees were allowed unlimited visits for acupuncture treatment.
County officials initially asked both Florida Blue and the Florida Office of Insurance Regulation to investigate Jaynes’ billing practices and the claims filed by her patients. The OIR than forwarded the case to the Florida Department of Financial Services Bureau of Insurance Fraud, which requested the warrant.
After law enforcement officials raided Jaynes clinic, she waited nervously for more than 10 months to see if any charges would be filed against her.
In recent weeks she began to privately express optimism to friends that perhaps she wouldn’t face any charges. “It’s been 8 months since the raid and we haven’t heard from them,” she noted in a text message to a friend. “Maybe, we can put this nightmare behind us and move on with our life.”
Less than a week after she sent that that text, County Court Judge David C. Morgan signed an arrest warrant for Jaynes and within hours she was arrested at her busy office.
Jaynes sat in jail for three days while Butler worked to get her bail reduced. Morgan initially set bail at $955,000. After Butler appealed, Pegg agreed to reduce the bail, but added several stipulations, including that Jaynes must shut down her business.
Pegg also required Jaynes to give up her passport and wear a GPS monitor.
A handcuffed Jaynes, dressed in a bright orange jail jumpsuit, slowly nodded her head affirmatively, and whispered “yes” when Pegg asked if she agreed to the bail conditions.
Butler noted that the judge’s terms weren’t negotiable during the hearing, but there is an appeal process.
“We’ll probably request that the court reconsider that decision,” Butler said.
When the billing controversy first came to light, Jaynes defended her billing practices and disputed the county’s numbers, contending that they’re misleading and have been twisted to make her a scapegoat for the county’s failure to properly regulate and monitor its health plan.
“The $1.4 million she’s being accused of is inflated and exaggerated,” Butler said. “That number is the total billing of all acupuncture charges.”
Prior to her arrest, Jaynes previously said that she often waived the co-pay for patients experiencing financial hardship.
After the county’s cap was put in place, many county employees started choosing treatment in a group setting in Absolute’s less-costly community room, rather than a more expensive private room.
“What the county doesn’t want to admit is Jill has been saving them money,” Butler said. “Many people with opioid addictions seek acupuncture treatment, which is much less expensive than a traditional treatment facility.”
Prosecutors for the 19th Judicial Circuit of Florida, could not be reached for comment.