Wednesday, July 25, 2012

Why Did the FBI Contact Me Five Times?

     Right before I sold my Hawthorne Clinic in 2009 the FBI contacted me twice.  Within nine months of the sale it happened three more times.  On all five occasions someone named "Special Agent So-and-So" telephoned me at home and asked for my help on a case.  The agents told me that lots of charges had been paid by Medicare for supplies never issued to patients in South Florida (300 miles from my clinic) and never needed.  In all five cases my medical license and clinic information had been entered as the referring physician.  Did I know anything about this?
     The FBI agents sent me names of patients in the Miami area, and next to the names were the amounts of money Medicare had paid on their behalf--millions of dollars--for nothing.  The federal agents acknowledged that Medicare had been scammed.  "All we want you to do is sign at the bottom of the list, confirming that you don't recognize the names of any of the patients," they instructed me.
     Medicare had made electronic deposits to invisible people's accounts for hospital beds, home ventilators, wound vacs, and the like--very expensive items.   Each time I was asked to review another list it showed that someone had received several millions of dollars in payments over the course of a few weeks.
     "What are you going to do about this?" I asked, as though I myself had been robbed--and hadn't I, really--and you, too--as taxpayers of our shared Medicare fund?  Isn't that why we have public servants and protectors like the FBI?
     "Oh, we'll never catch them," the FBI agents replied.
     "This is a huge problem!"  I exclaimed.  Then, in my medical problem-solving way, I made a series of what must have seemed like amateur suggestions about how the perpetrators of these scams might be found and brought to justice.
     "By the time we get the news from Medicare that there have been bills for services that weren't provided, the scam-artists are paid and gone, probably out of the country," they said each time they needed my help.  "We're just trying to close out the case."
     Were  the agents pretending to be apathetic?  Did they have another agenda altogether?  Was I "helping" them, or was I their real target?  The possibility that the feds were hiding another purpose, or that I might have been exploited, or framed, didn't occur to me.  At that point I still had faith in our justice system.  I knew I was a good citizen.  It didn't cross my mind that someone else might not think so.
     Pat McCullough, the buyer of my clinic, had been given access to my office records--patient ID numbers, and provider license information--for more than a year before the sale was finalized.  It is customary for business records to be reviewed by a buyer during the due diligence period--which means Pat had the same information that con artists use to send fake claims to Medicare.  It's possible that Pat had been selling my patient and provider information through subterranean networks, to be used by other scammers.
     Sending fake charges to Medicare is big business, and easy money.  The payments are far in excess of what actual doctors receive for their work.  A lot of Medicare fraud losses could likely be explained by such well-executed insurance heists.  My conversations with the FBI agents didn't give me confidence in their ambition to track down these criminals--but of course they may have been covering up their real intentions.
     Attacking doctors, who are visible--and fairly puny when it comes to fighting--is easier than unraveling high-caliber fraud--and maybe it's better publicity.  Besides, doctors usually end up settling with the government before a case gets expensive to defend--so it's easy money.
     I told the FBI agents in 2009 that I suspected a scam, with Pat as a peripheral participant.  They weren't interested.  They took down my information, as agents are required to do when a citizen reports a suspicion, and they said they'd contact me again--but I never heard from them.
     Do government agents have any respect for doctors and ordinary citizens?
     "They consider you vermin," said an ex-police chief who entered a comment on my blog.  When I read what he wrote I found myself feeling hopeless.
     What has happened to honor and justice?  If you and I are vermin, what does that make the friendly,  peacemaking "men in blue," our policemen?
     Animal trappers?  Zookeepers?  Exterminators?


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