Backbreaker

It was at this point, Goroway claims, that he became apprehensive about whether his company had dipped too far into legal gray areas. He phased out the auditing part of the business. "I got scared of the lies from the chiropractors," Goroway said in his deposition. "I think it was too easy for the chiropractors to try to conjure up services that they say they were providing and not providing."

Boulis did not go away quietly. Upon leaving Practice Mechanix, he launched a competing firm called Practice Solutions. It wasn't the only imitator. By 2003, Goroway says the market was "saturated" with companies like his. Attendance at his seminars plunged, as did his company's sales. His overhead was still high, though, and those costs quickly devoured the profits.

Goroway had not given himself a fallback position. In 1998, he had abandoned four of the five clinics in which he had a stake. The one remaining clinic in Hollywood, the former Flamingo Chiropractic, which had since become United Care Medical Associates, had suffered from neglect in the years since Goroway embarked on his seminar blitz. In June 2003, he closed the office. On the same day, he was served with a lawsuit by State Farm Insurance.

The nation's largest auto insurer accused Goroway, Goldstein, and their business entities of being part of a "racketeering" scheme through which they encouraged their chiropractor clients to order tests of dubious medical value purely for the sake of collecting from insurers.

The suit alleged that the group submitted 33,000 reports to insurance providers and enrolled nearly 3,000 chiropractors nationwide. The cost to the insurance industry, State Farm attorneys estimated, was in the tens of millions. (Ross Silverman, an attorney who handled the case for State Farm, says company policy bars him from speaking about it.) Goroway and Goldstein denied the allegations and initially began a defense of the suit.

"They went after us because we were one of the largest," Goldstein says. "There were hundreds that did what we did, but not to the degree that we did it." He defended the integrity of the tests and said that chiropractor clients were required to sign forms in which they vouched for the necessity of a patient's receiving the test. The real issue, Goldstein suspects, is that mobile diagnostic units were emerging as a more convenient alternative to neurology clinics.

Thomas Drzemala, a chiropractor who had been hired to be a salesman for Practice Mechanix, gave an affidavit for the State Farm case in which he described how Goroway stressed that the "real money" is in electrodiagnostic testing. "He directed us to tell the chiropractors they should order the [electrodiagnostic] tests for every patient at their practice because every subluxation" — the term for spinal misalignment — "had a neurological component which could be evaluated," Drzemala stated. "I did not agree with this because, based upon my education and experience, nerve conduction studies have limited diagnostic value."

In Drzemala's view, the chiropractors themselves saw little value in the tests beyond the income they generated. "Because of their lack of understanding regarding the tests, I seriously doubt whether the chiropractors ever factored the interpretations of the tests into any patient's treatment plan," Drzemala asserted in his affidavit.

Shortly after Drzemala left Practice Mechanix in late 2001, he filed a report with the Florida Insurance Fraud Bureau alleging that "Practice Mechanix was improperly using financial incentives to encourage chiropractors to order unnecessary electro­diagnostic and spinal ultrasound testing and to submit new bills for services and procedures that may or may not have been performed."

Although Goroway couldn't have known it, he is fortunate that these allegations never appeared in a criminal indictment. They did for his former friend and salesman, Boulis, who was indicted in 2006 for health-care fraud and income tax evasion in connection with Boulis' Practice Solutions. The Pittsburgh Post-Gazette billed it as "one of the largest health insurance fraud cases in the United States" — and Boulis' company was smaller than Goroway's had been.

Even before that case was filed, Boulis had been arrested in Cleveland in June 2003 after buying three rocks of crack cocaine — a violation of his probation from the drug arrest in Georgia.

Goroway's legal bills were growing too. His wife, Patricia, filed for divorce in 2004.

Patricia Goroway, reached by phone, said of her ex-husband: "I can't comment on anything about him. I really don't know anything about him."

In January 2005, Goroway settled his part of the State Farm suit and was dismissed from the case. By the time he sat for an October 2005 deposition in the same case, there was little sign of the dashing entrepreneur who made millions on the seminar circuit. Asked whether he was the top salesman at Practice Mechanix, Goroway said: "I was it. I was the game. I mean, you know, I'm not looking myself today. I'm very tired right now, and I'm — I've been through a lot. OK? Since your case and a lot of other things. I lost my dad, my stepdad, my businesses, everything, in a year and a half's time. Everything in my life is gone. I'm at my lowest point in my whole life. I was at my highest point for a while there."