Friday, August 17, 2012

My 100th Post: Recap

     TV-20 called my office yesterday asking if the station could put together an update on my clinic since the raid last year.   A reporter showed up with a camera at 4:30 pm, and the story was aired on the 11 o'clock news.  Here's the link:

     Three years ago a nurse from Kentucky named Pat McCullough purchased my 8,000-patient medical clinic in Hawthorne, Florida.  She and various business consultants had spent eighteen months analyzing thousands of pages of billing and patient records, and seemed enthusiastic about the purchase.  During that time Pat's lending institution went bankrupt in the economic crisis, and she told me her loan fell through--so I agreed to finance eighty percent of the purchase.
     Within weeks of the sale Pat reported me for fraud.  An employee overheard a call she made to state senator Bill Nelson, asking, "How do I report a doctor for fraud?"
     Pat made two monthly payments to me--then stopped payments most everyone, including electric, phone, and medical supply companies.  She begged the staff to keep working, even though she wasn't paying them for weeks at a time.  Meanwhile, she petitioned banks and private organizations for loans and donations to support "the poor rural clinic" where she had hoped to "help people in need."  She must have accumulated $12 million in debt (not including the loan from me) because eighteen months later she shut the clinic doors, dissolved the business, and was granted bankruptcy relief for that amount.
     With astonishing ingenuity Pat had seized the clinic assets,  convinced scores of people to extend loans to her, and made $12 million in cash "disappear."  In addition, she maneuvered the government into attacking me on charges of billing fraud, misleading them with ease because the billing and coding constructs for physicians are so complicated that federal agents would have had to rely on Pat--who happens to be gifted with powers of persuasion--and on several past employees--who knew I had never done anything fraudulent but were lured by the possibility of the high whistleblower fees Medicare promises, and who were counting on Pat's bravado to win out over evidence of my meticulousness.
     Perhaps they were right to bank on Pat, who was so successful at maximizing her own financial gain, while appearing harmed, and pointing a finger at me.  The FBI raided my office last year, and took all the money out of my bank accounts, without giving a reason.
     I am surprised that the FBI agents took up Pat's lead with such ardor, like dogs tracking the scent of dead meat laid out for them, but I forgive them because:
          a) they stood to gain financially, if they could find even minor coding errors, because the liberal statutes allowing government intrusions, indictments and fines imposed on doctors make it possible to attack any solo physician and slap a clinic with fines of millions of dollars;
          b) it was hard for them to accept that the clinic's income--which placed me above the earnings range for the average family doctor, could have been legitimate, despite the evidence that I had been industrious and devoted to my work;
          c) Pat's ill-gotten gains were well-hidden, and her motives murky;
          d) Pat was so much better than me at the art of psychological manipulation;
          e) it is difficult to grasp the concepts of medical coding without years of practice, because coding and billing have become absurdly complicated by monthly insurance "updates"--it was so much easier for FBI agents to launch an attack on a physician (me) based on gut feeling and the subliminal anger Americans feel towards the medical profession in general, than on facts.
     I opened another clinic, Colasante Clinic, in Gainesville, FL, when it became clear that Pat had no intention of taking care of the patients I had treated for eighteen years.  The employees she had fired as soon as they voiced doubts about her--or were of no further use--asked to work for me again.  But by that time the feds had gotten involved, and were questioning patients and employees.  Some of the employees may have been prevailed upon by the FBI to say things that would support a federal case against me.  After two years of investigation it wouldn't look good for the FBI to have spent so much attention and money on a suspect who turns out to be innocent, would it?
     The FBI raided my new clinic on June 16, 2011.  Since then a court hearing has failed to uncover a reason for the raid.  The 3,000 patient charts, the personnel records, boxes of medical supplies, and the money confiscated from the clinic and personnel bank accounts remain in the government's custody.
     I am confused.  What is going on?
     I wonder what happened to "due process" and "innocent until proven guilty"?  I wonder why psychopathic personalities are so successful in America?  I wonder if the FBI knows how to analyze a medical office's billing practices?  I wonder if the FBI knows how to apologize.  I wonder if I am ever going to get my life back.   

1 comment:

  1. The problem is that there is no objective way to "analyze" notes relative to billing documents. It is totally subjective unless there is no note at all. Standards vary widely between organizations and even in the same organizations from year to year. I think the federal government became aware of this when they allowed large healthcare organizations to form their own compliance units rather than subject themselves to external police action.

    All of this flows from the failed political theory that health care inflation was essentially from fraud and doctors bore a large part of the responsibility. That led to an era where the HHS secretary invited senior citizens to scrutinize their bills and turn in their doctors for fraud.

    I can recall sitting in a "coding" seminar and being threatened with incarceration in federal prison and the RICO statute if my notes did not contain enough bullet points. I have attached a post below that gives a good reference on just how subjective this is.

    I applaud your efforts in making your personal struggle public. It goes without saying that it must be at a large personal cost and wish you the best in resolving this as soon as possible.