By Camilo Smith
By Craig Malisow
By Jeff Balke
By Angelica Leicht
By Jeff Balke
By Sean Pendergast
By Sean Pendergast
By Jeff Balke
Acupuncturist Jimmy Pennington says that alternative medicine has grown into a multibillion-dollar business, but most practitioners "usually don't mess" with insurance companies. Patients have to be referred by a medical doctor, and even then insurers have been particularly slow to accept the holistic treatment of substance abuse and other mental health problems.
"The insurance companies would come out much better if they worked this kind of preventative medicine," Pennington says. "It's gonna change; it's gotta change. It's like physics a long time ago. When Einstein laid down his theory, everybody went, 'Whoa, okay, Newton may have been right, but he wasn't totally right.' "
But in November 1994, several of Mandel's therapists sued her, her former husband, Eric Orzeck, and the River Oaks Health Alliance, alleging conspiracy and fraud. The therapists say they never received thousands of dollars in fees they earned, and they maintain that Mandel and Orzeck, a Houston endocrinologist and the alliance's former medical director, failed to get proper authorization from patients' insurance companies before treatment was performed, as promised. The therapists also accused Orzeck of phony diagnostics and of charging patients "substantial sums" without performing proper examinations.
The most serious allegations were that, in some instances, Mandel and Orzeck told therapists that insurers had denied coverage or had paid lesser amounts, and then pocketed the actual reimbursements when they came in. Mandel and Orzeck denied the accusations. The lawsuit was set for trial in the spring of 1996, but was settled out of court that January. Both parties have agreed not to discuss the allegations or the settlement.
But in a written response to an interrogatory taken during discovery for the suit, Orzeck admitted that he never treated a ROHA patient named Judy Rose, even though her insurance company was billed for repeated visits to his office in November and December 1993.
When contacted by the Press, Rose provided a copy of her statement for that period, which indeed indicated that she saw Orzeck 14 times in November and six times during the first ten days of December.
Orzeck acknowledged in a phone interview that "it would not be my usual approach" to see a patient that often. He also confirmed that there was talk at the time of the lawsuit that Mandel may have used the physician's signature stamp without his permission, though Orzeck said he believed his ex-wife when she denied doing so.
Still, he admitted, if Rose "says she was never a patient of mine, then I guess [her statement] has to be looked at for what it says. It's a statement that is there that I just can't respond to."
Jimmy Pennington, who worked on that initial ROHA program, says he lost about $2,000 in fees. But he declined to join the litigation, choosing instead to accept the loss as his "karma." But Pennington says the feud that developed between Mandel and her employees sullied an exciting opportunity.
"What I thought was good was her idea of working with them and giving them more choices than just regular psychology and drugs," Pennington says. "She tried to work in acupuncture, hypnosis, less invasive-type things to help them emotionally get through it."
"I like Joanne. She had a good idea and her heart was in the right place. But something happened."
For a long time, Ty O'Malley was inclined to give his boss the benefit of the doubt. A former resident of the Transitional Living Center, a housing project for men with AIDS opened by Mandel in 1993, O'Malley was kicked out for a minor violation of program rules. Nevertheless, Mandel hired him "to work around the office and help her promote her business." It proved to be a positive experience: As ROHA's community outreach coordinator, O'Malley helped produce Getting Well Again and later designed Mandel's InnerWisdom Web site.
But, last fall, O'Malley and a few of his co-workers started to question some of Mandel's policies, particularly the requirement that H.E.L.P. House residents must attend the Wellness Program in order to keep their apartments.
"JoAnne always told me that the reason they got the HOPWA grant was because she was providing the services, too," O'Malley says. "But this is a place for homeless men who are HIV-positive. Nowhere in the city's contract does it say they have to attend her program."
But each morning, H.E.L.P. House residents board a van for the trip to the Paraclete Foundation at 9611 Marlive, off of Stella Link. The Wellness Program begins in the clubhouse at 9 a.m. and ends at 3 p.m., except for Friday, when the day ends at 1 p.m. According to a written schedule, there are five sessions a day, everything from relationship building and relapse prevention to yoga and gestalt therapy. Most patients also receive at least one individual consultation a week. They get a half-hour for lunch.
The only excuse is a doctor's note prescribing bed rest. As might be expected of a group of HIV-positive individuals, daily attendance is not always possible.
"Patches," a 41-year-old Houstonian with full-blown AIDS, is so ill he should probably be in a nursing home or hospice. He moved into the H.E.L.P. House in March from the hospital, where he was treated for tuberculosis. For the first week or two of his residency, he took oxygen therapy twice a day. His legs hurt so much that most of the time he had to be accompanied by a home-health nurse, in case he fell. On his worst days, Patches was in a wheelchair.