Coeur d'Alene Chiropractor Charged in $9 Million Dockworker Health Plan Fraud

A Coeur d'Alene chiropractor with more than 26 years of licensed practice was arrested Thursday on federal fraud charges alleging he submitted more than $9 million in fabricated chiropractic claims to a unionized dockworkers' health plan and, after being booted from its network, continued collecting payments under a stolen colleague's name and provider number.

Gregory Cartmell, 62, faces a four-count federal indictment charging two counts of health care fraud and two counts of aggravated identity theft. The charges stem from Operation Never Say Die, a coordinated federal takedown announced by the Justice Department's Central District of California in connection with Vice President JD Vance's Task Force to Eliminate Fraud. Fifteen people were charged total; eight, including Cartmell, were arrested April 2.

The target of Cartmell's alleged scheme was the ILWU-PMA health plan, the benefit program for dockworkers covered by the International Longshore and Warehouse Union and the Pacific Maritime Association. From December 2018 to November 2022, prosecutors say Cartmell submitted approximately $9.14 million in fraudulent claims for chiropractic services, including for treatments never provided, and collected approximately $6.43 million in payments.

The scheme took a sharper turn in December 2020, when the ILWU-PMA plan terminated Cartmell from its provider network. Rather than stopping, he allegedly arranged with co-conspirator Vincent Surace, 87, of McKinney, Texas, to keep billing the plan using Surace's name and provider identification number. That arrangement underpins the two aggravated identity theft counts, which each carry a mandatory two-year consecutive prison sentence on top of any other penalties. Surace is charged separately with one count of conspiracy to commit health care fraud.

The fraudulent claims moved through a web of front companies, including Ohana Wellness Center, Ohana Management, and R3New Wellness in Carson, California, and One Life Acupuncture APC in Huntington Beach. Those same Ohana entities had already been exposed in civil court: in August 2022, a California state court found them liable for fraud following sworn testimony that they falsified patient chart notes and billed claims under chiropractors' names and insurance numbers without those providers' knowledge.

Cartmell holds California chiropractic license DC28214 and lists a registered practice address in Irvine, California, alongside his Coeur d'Alene residence. He appeared in U.S. District Court for the District of Idaho on April 2 and is expected to be arraigned in Los Angeles federal court in the coming weeks. He faces up to 10 years in prison on each health care fraud count, plus the mandatory consecutive terms for the identity theft charges.

The broader Operation Never Say Die charged 15 defendants in connection with schemes prosecutors say cost the health care system more than $50 million, including allegations of sham hospice facilities that billed Medicare using patients who were not terminally ill. First Assistant U.S. Attorney Bill Essayli declared at the morning press conference: "We are enforcing a zero-tolerance policy for criminals who defraud American taxpayers."

The Cartmell case illustrates a billing red flag that union members and other health plan participants can watch for: claims submitted under a provider's name for services at locations they do not staff, or charges appearing from a provider after the patient has stopped treatment. Anyone who suspects a chiropractor or other licensed provider in Idaho may be billing insurance without their knowledge, or billing for services not rendered, can file a complaint with the Idaho Division of Occupational and Professional Licenses Board of Chiropractic Physicians at chi@dopl.idaho.gov or by calling (208) 334-3233. The case is being investigated by the FBI, IRS Criminal Investigation, Homeland Security Investigations, the U.S. Secret Service, and the Department of Labor's Office of Inspector General.