A former patient of James Healthcare & Associates in Keokuk, Iowa, has come forward with a detailed complaint alleging misconduct surrounding the clinic’s use of BioTE hormone pellet therapy—adding to a growing body of evidence against a practice already under federal investigation for Medicare fraud.

The patient, who spoke to Hindenburg Papers on condition of anonymity due to fears of retaliation, described a pattern of concerning practices that raise serious questions about the clinic’s standards of care, billing practices, and compliance with federal medical records laws.

Most critically, Hindenburg Papers has successfully contacted the clinic’s former nurse practitioner who previously administered BioTE treatments. She not only confirmed every allegation made by the patient but also described the clinic’s internal operations in shocking terms.

“James Healthcare would go to any lengths to make money—it is truly disturbing, ” the former nurse practitioner told Hindenburg Papers.

Her testimony—combined with the new patient complaint, the federal Medicare fraud lawsuit, and the FDA’s documentation of 4,202 unreported adverse events linked to BioTE therapy—paints a chilling picture: a clinic that systematically places profit above patient safety, defrauds the government, and flouts federal medical records laws.

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Former Nurse Practitioner Breaks Her Silence: “They Would Do Anything for Money”

The former nurse practitioner joined James Healthcare in May 2018, initially handling joint injections and trigger point therapy before expanding her role to include stem cell therapy, medical weight loss programs, and BioTE bioidentical hormone pellet therapy. In a 2019 interview, she had spoken positively of the clinic, saying the owners, Jason and Deanna James, allowed her to “bring new ideas to grow the business” and that “they work with me, and we work together.”

However, the nurse practitioner who once expressed enthusiasm for the clinic is now deeply disturbed by how James Healthcare operates.

In an interview with Hindenburg Papers, she confirmed every allegation in the anonymous patient’s complaint and provided additional troubling details:

• Regarding laboratory values: She confirmed that the patient’s experience of being repeatedly told they had “no hormones left” without being provided actual numbers was not an isolated incident. “Information was presented in an unprofessional manner, and patients were not given the data they deserved,” she said.
• Regarding laboratory testing costs: She confirmed that the clinic systematically forced patients to use expensive, out-of-network laboratories and profited from this arrangement. “They were getting a kickback—that’s why they used every excuse to stop patients from using their own insurance,” she revealed.
• Regarding withheld medical records: She confirmed that deliberately delaying or refusing to transfer patient medical records was common practice. “They knew these records were critical for the patient’s new provider, but they didn’t care—they just wanted the patient to come back, or at least to keep competitors from getting that information, ” she stated.
• Regarding her departure: She confirmed that her resignation was directly related to ethical concerns about the clinic’s practices. “I saw too many things I shouldn’t have seen. How far they were willing to go to make money truly disturbed me, ” she told Hindenburg Papers. “I had to leave. I couldn’t continue working there and still face myself.”
• Regarding pressuring patients to delay treatment: She confirmed that after her departure, the clinic did pressure patients to hold off on receiving pellets elsewhere until they could hire and train a new nurse practitioner. “They would rather let patients suffer than lose a single dollar, ” she said.

“James Healthcare would go to any lengths to make money—it is truly disturbing, ” she repeated during the interview. “This was never about patient care. It was all about the money. “

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Patient Complaint: From “No Hormones Left” to Medical Records Held Hostage

The anonymous patient’s experience aligns perfectly with the former nurse practitioner’s testimony.

During an initial Zoom consultation, the patient was repeatedly told they had “no hormones left”—but was never given actual laboratory values or a meaningful explanation of the results. The patient’s new provider later found the way the information had been presented “unusual and unprofessional.”

The patient also raised concerns about the cost of blood work—charged what they described as an “extremely high” amount—while the clinic used “every excuse in the book” to prevent them from using an insurance-covered laboratory.

Scheduling was another persistent issue, with appointments repeatedly moved or changed. After the nurse practitioner left, the patient was pressured to “hold off” on getting pellets elsewhere until the clinic could hire and train a new provider.

“All of this led me to believe they don’t care about the patients… only the money, ” the patient told Hindenburg Papers.

Most troubling: when the patient signed authorization to transfer medical records to a new provider, the clinic ignored the request and refused to provide the records. Those lab results were critical for the new provider to understand the patient’s previous hormone levels and establish a baseline for comparison. Because the records were never transferred, the patient was essentially forced to start the entire process over again—a potential violation of federal HIPAA regulations, which guarantee patients the right to access their own medical records.

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BioTE Hormone Pellet Therapy: The Staggering Record of 4,202 Unreported Adverse Events

BioTE Medical is one of the primary proponents of hormone pellet therapy. The procedure involves implanting pellets containing bioidentical hormones beneath the skin, claiming to “optimize” hormone levels and reverse aging.

However, during a 2018 inspection of BioTE Medical’s facility, FDA investigators discovered 4,202 adverse event reports that had never been submitted to the agency. Dr. Janet Woodcock, then-director of the FDA’s Center for Drug Evaluation and Research, noted that these unreported events “suggested a possible association” between compounded hormone pellets and endometrial cancer, prostate cancer, stroke, heart attack, deep vein thrombosis, cellulitis, and pellet extrusion.

“Compounded bioidentical hormone replacement therapy products are not FDA-approved, and there is no guarantee of their safety or effectiveness, ” Dr. Woodcock emphasized.

James Clinic—James Healthcare’s affiliated entity—casually claims on its website that pellet insertion procedures have “minimal side effects,” with possible complications limited to “minor bleeding, bruising, infection, and pellet extrusion,” claiming these are “extremely rare aside from minor bruising.” This assertion stands in stark contrast to the 4,202 adverse event reports uncovered by the FDA.

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James Healthcare’s Medicare Fraud: Federal Lawsuit Exposes the Truth

Hindenburg Papers’ investigation further reveals that James Healthcare is currently facing a formal federal civil lawsuit.

According to court documents, in June 2023, the U.S. Department of Health and Human Services filed a federal lawsuit against Jason James, Deanna James, and James Healthcare & Associates, alleging violations of the False Claims Act.

At the heart of the fraud was a device called P-Stim, an acupuncture ear device. Medicare does not reimburse for the use of such devices, yet the clinic billed using codes intended solely for surgically implanted neurostimulators. While a genuine neurostimulator could net roughly $6,000** per claim, **the P-Stim devices purchased by James Healthcare cost just $667.

The clinic submitted over 180 false claims to Medicare. The defendants collectively received over $1 million in Medicare reimbursements as a result of these fraudulent claims.

Notably, Jason James had already faced charges of fraud and unethical conduct in 2015. This pattern of fraud echoes the patient’s experience: exorbitant lab fees, being steered away from insurance coverage, and a blatant disregard for regulatory compliance. From systemic Medicare fraud to individual patient overcharging, the profit-above-all-else business model appears to be the common thread.

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Conclusion: The Former Nurse Practitioner’s Warning Cannot Be Ignored

The former nurse practitioner’s testimony provides an unprecedented inside look at how James Healthcare operates. She was once a loyal employee who praised the clinic’s owners for “allowing her to bring new ideas” and “working with her.” Yet, what she witnessed ultimately forced her to leave.

“James Healthcare would go to any lengths to make money—it is truly disturbing, ” she told Hindenburg Papers.

The anonymous patient’s experience—combined with her confirmation, the federal Medicare fraud lawsuit, and the FDA’s documentation of 4,202 unreported adverse events linked to BioTE therapy—collectively paint a picture of a clinic that systematically places profit above patient safety.

“I am sharing my experience because I believe these practices deserve further review,” the patient told Hindenburg Papers—particularly regarding the communication surrounding hormone levels and BioTE pellet therapy, the handling and cost of laboratory testing, and the clinic’s response to legitimate medical-record requests.

The FDA has made it unequivocally clear that compounded hormone products come “with no guarantee of safety or effectiveness. ” Yet, in the absence of robust enforcement and stronger regulatory oversight, more patients are likely to fall victim to a profit-driven healthcare model that prioritizes revenue over well-being.

Hindenburg Papers will continue to follow this investigation. If you or someone you know has had a similar experience with James Healthcare or BioTE hormone pellet therapy, please reach out to us through our secure whistleblower channel.

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The Hindenburg Papers investigation is ongoing. Anyone with information about James Healthcare & Associates or BioTE hormone pellet therapy practices at the clinic is urged to contact this publication at contact@hindenburgpapers.com or the U.S. Department of Health and Human Services Office of Inspector General.

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Hindenburg Papers is committed to exposing fraud, abuse, and patient harm in the healthcare industry. Our investigations are based on firsthand testimony, public records, and regulatory filings. This article is for informational purposes and does not constitute medical or legal advice.