Tuesday, December 3, 2013

The Civil Complaint against Me

     Here is the government's civil complaint against me.  It is also linked to my blog:  check the margin on the front page under "Relevant Links."


     What is a "civil complaint."  It's a list of allegations against me, entered into the court system by the government.  The document referenced in the link above is not a criminal complaint--but there must be one of those, too!  After all, I'm told by my lawyer that I should expect to be indicted any day now, and that would have to be for something criminal.
     "Complaint" is always spelled with a capital "C" in legal documents, giving it an aura of terrible importance, and I mean terrible, because no one but no one wants to be indicted.  That's something else my lawyers have emphasized.  It's better to cower, or settle, or admit guilt, or crawl into a hole in the ground, than to be indicted.
     "Would it be better to die?" I asked my lawyer two years ago, to see how far he would go.
     "That would really make them feel as though they'd won," he said.
     "Would the case be over, then?"
     "No," he said irritably.  "They'd go after your estate."
     "Then I'd better live," I told him, "and fight."
     "I'll do the fighting for you," he answered, and asked to change the subject.
     A complaint is the first step in a process of legal action against a person or business.  A complaint is a type of "pleading."  The Federal Rules of Civil Procedure dictate how grievances are registered in legal form, and a complaint is the first pleading to be entered in the court system.
     Criminal complaints like the one that is supposed to be in progress against me involve authorization by a grand jury.  A grand jury is a group of people who meet in secret to hear evidence against the defendant (i.e., me), without hearing the other side of the story.  Since the case is presented in this one-sided way a grand jury almost always delivers a guilty verdict.  Once that's done the accuser (the government, here) is given authority to indict.
     If the grand jury system sounds unfair, it is.  It's worth noting that the United States is the only country in the world that still uses the grand jury system.  (The United States was one of the last western countries to abolish witch hunts, too--the Salem witch trials were declared unlawful in 1702, years after the European witch craze had waned.*)
     A civil complaint is a formal document listing all the reasons a party (the government, in my case) thinks it has a claim against someone else and deserves to be compensated, usually with money.  The compensation is called a "remedy."
     The government's civil complaint is a rewording of the qui tam complaint (http://solodocssolong.blogspot.com/2013/12/the-qui-tam-complaint-against-me.html), and the civil complaint must be connected to the criminal complaint.  Which means that if the facts and reasons for the government's civil complaint don't stand up to argument, neither will the criminal complaint.
     A grand jury has convened multiple times to hear evidence against me.  I am sure of this because patients and past employees have told me they had to testify in front of grand juries.  But these grand juries must not have issued indictments after hearing evidence, because I haven't been indicted.  Has it been difficult for the government to gather real evidence against me?  Is it because there isn't any evidence?
     See for yourself.  Read the Civil Complaint I've attached to this post.  It refers to patients by their their initials, and some of the visits it mentions were five or more years ago, therefore I don't recognize the cases.  (Hawthorne Medical Center had more than 8,000 patients, when I sold it, and Colasante Clinic had 3,000 before I closed it.)  I can only defend myself in general terms, and I can't share what I wrote in my defense because it's not yet public.
     It's impossible to defend myself against accusations when the names of the injured parties are concealed and all the charts confiscated in the raid on my clinic.  Mounting a defense under these circumstances is like beating back a bunch of ghosts that blow and howl and scare us half to death if we believe in them.  But I don't believe in them.  I don't believe in ghosts, and I don't believe in the government, not any more.

*France repealed witchcraft in 1682, England in 1736 and Poland in 1776, but witch trials were a rare occurrence in Europe after 1650.           


  1. Is this true? It sounds kinda bad.

    "Colasante average more services per Medicare patient than all but six of these 34,806 practitioners during this time period."


  2. Hawthorne Medical Center was open 365 days a year, from 6 am to 10 pm. Most solo practitioners--the ones being used for comparison in the civil complaint, have office hours 4 days a week, 7 or 8 hrs a day, and take vacations of 2 to 4 weeks, thereby serving the public 1,344 hours per year. Hawthorne Medical Center--and Colasante Clinic after that--served the public 5,824 hours per year, which was nearly equivalent to 4 1/2 typical clinics. Moreover, Hawthorne Medical Center and Colasante Clinic offered many more services in-house than the comparison practitioners, services like ultrasound, stress testing, spirometry, overnight heart and blood-pressure monitoring, overnight oximetry, walk-in emergency care, house calls, x-ray, casting, bone densitometry, labs, IV antibiotics, allergy skin testing and allergy shots, colposcopy, cryosurgery, flexible sigmoidoscopy, hemorrhoid surgery, skin cancer surgery with complicated repairs, abscess draining, IUD insertion, Norplant, endometrial biopsies, walkers and other assistive devices, Hako-Med pain machine treatments, and vestibular testing and training to prevent falls. It is grossly misleading to compare the full-service clinics I operated, and at which patients repeatedly expressed their gratitude for not being "referred" here, there and everywhere for medical care, to "other family practitioners."

  3. Complaint #2 – Colasante ‘submitted millions of dollars in false claims to the Medicare program’.

    Complaint #5 – ‘Medicare program paid Colasante and her clinics millions of dollars for false and fraudulent claims’.

    Complaints 50-57 – Patient A - Payment $626.67
    Complaints 68-63 – Patient B - Payment $517.93
    Complaints 66 – Patient C – Payment $38.27
    Complaints 67-69 – Patient D – Payment $22.63
    Complaints 70-72 – Patient E – Payment $28.49
    Complaint 73 – Patient E – Payment $22.63
    Complaint 74 – Patient F – Payment $22.15
    Complaint 75 –Patient F – Payments around $650.00
    Complaint 76 – Patient G – Payment(s) Unspecified

    Total dollar amount claimed in Complaints provided in this post: $1,928.77

    ***This agency has had your patient’s files in their possession since 2009 and this is what the prosecutors took to the Grand Jury? Are we, the taxpayers, supposed to now foot a bill of millions of dollars to prosecute for $1,928.77 for alleged wrongful claims over several years and two clinics?

    Where are the millions of dollars in claims and payments? (see Complaint #2 and #5 above)

    FYI on Complaint #86 - ‘Colasante hired and fired employees’ - I’m assuming this Compliant was made by fired employees. Florida has Right-to-Work laws. Employees can be fired without cause.

  4. Thank you for your rational and thoughtful response to the civil complaint, which is more useful than ranting seat-of-the-pants censoriousness.

  5. On complaint # 86. Sure you can fire employees without cause in Florida. When using the Right-to-Work law most employers are tactful about firing. I was never fired by Dr Colasante. Threatened everyday basically. Told how worthless I was one moment while in the next breath being praised. Basically everyday we walked into work not knowing if I would have a job within the next five minutes. It all depended on her mood. After reading the civil suit, knowing now what I know, years ago she should have had these charges filed against her. I am sure that this is just the tip of the iceberg for what charges she will be facing. Her charts were handwritten and barely legible for the most part. It has probably taken all this time for them to correctly decipher them. Maybe that's why they cannot find the Medical Necessity.

    Dr C maybe you can use the whole, "I wasn't sure what I was doing" or "you did not know it was wrong" or maybe even "really you cannot due that". I am sure your going to want to argue chart by chart. By all means please, tell the OIG that they have no clue what they are talking about and that "you can find better employees at Wal-mart cause all you have to do is push buttons". Unless someone has worked for you they will never fully grasp the hell that was in your office. Thank goodness for the coworkers. Without them I would probably be in a straight jackert now. I however feel bad for Carmine. He's such a good kid. Remember, always Karma will get you. Intimidation is no longer a factor.

    1. I worked for Dr. Colasante for 10 years, I no trouble reading her handwriting, and her charts looked complete. her thoughtful, thorough care for patients was a rare thing in medicine, and people loved her. She ran a tight ship, and didn't tolerate sloppiness, laziness, or excuses for not doing the job, and if she expressed irritation with an employee it was because she could see how something that employee did was going to put a patient in jeopardy, or cause problems for the clinic. The patients always came before everything. I will always regard the time I spent working for Dr. Colasante as the most productive and best years of my career.
      As for Carmine, he has the best life a person, with or without his disability, could have. It is because of the care he receives from Dr. Colasante that he has progressed to the point he is.

  6. Are these remarks a basis for civil or criminal charges, even if this was your experience? I don't think so.

  7. The tone and style of writing in the second-to-last employee grievance makes the identity of this past employee obvious to me, but I will respect her apparent wish for anonymity. It bears saying, however, that this is an employee who was extremely valuable to the clinic, though she had been hired with little experience and virtually none of the skills required for performance of her job. She benefited from her position in many ways, among them the acquisition of high-tech skills for a family practice clinic, all of which were taught to her on the job. Her pay rate was twice what she could have earned at another clinic, and she accepted the substantial month-end bonuses given to her, by way of thanks for hard work, as did other employees who met the requirements of their jobs and showed up for work every day. Nevertheless, she quit her job on several occasions, leaving the clinic in the lurch and never clearly articulating her dissatisfaction, returning to the job each time when I offered to rehire her, which I did because she was an excellent and reliable member of our staff, and I said so. If the office was "hell" to work in, why keep returning? Quitting one final time days before the FBI raid, this employee is likely to have been one of the few who had advance notice that the clinic was going to be raided, and she may have hoped to be on the winning--i.e., the weightiest, not necessarily the most principled--side.

  8. Is it legal for a PA or NP to perform services and have those services billed by the doctor, even if the doctor was not present, or proximate to the clinic? Is it legal for nurses to perform testing before being seen by a provider?

  9. Yes, it is legal, and special exceptions are also made for rural health clinics, of which Hawthorne Medical Center, when run by me (but not when owned by Ms. McCullough), was one. Look for more information in an upcoming post on "Incident-to" billing. Thank you for the suggestion.
    As for "performing testing before being seen," this is also "legal," given the requirement by Medicare that a physician simply sign an order (or otherwise indicate necessity for the test) within a reasonable period of time. Consider the following scenario. Your husband has chest pain. He presents to the clinic. A nurse summons the doctor. Meanwhile, another nurse obtains an EKG, administers oxygen, and--obtaining a history that your husband usually has nitroglycerine with him, but forgot it today--gives sublingual nitroglycerine. The doctor's office has a protocol for people like your husband. When the doctor arrives moments later, no time is wasted "giving an order for" an EKG. The doctor reads the abnormalities on the EKG, examines your husband and summons the ambulance. Was it illegal for the nurse to obtain the EKG, especially given a pre-established office protocol for situations like this? Had the EKG been unnecessary, the doctor could have refrained from billing for it, and no harm would have been done. Had the EKG not been obtained in advance, valuable time would have been lost--and every second is crucial when a heart attack is imminent.

    1. I'm curious about your Rural Health Clinic. Was it a separate facility? Did it have separate hours? Did it have hours concurrent with your other operations? Do you get to choose when you are seeing patients as a Rural Health Clinic? Can you use Rural Health Clinic status to circumvent "incident to" requirements that called for a physician to be on-site? How much of your billing was part of the RHC program?

  10. I was devastastated when Dr. C made the decision to close her practice. I was hoping that Colasante Clinic would be my last job. I learned so much in that practice and was challenged daily to be the best I could be. Some days were more difficult than others but I never felt anything was a personal attack on me. I guess you can say I am not afraid to take constructive criticism and learn to improve in areas in which I do not excel.

    I know that the bottom line is doing what is best for the patient while protecting the physician's license so they may continue to serve their patients and I feel most of the staff did just that.

    I have been a supporter of Dr. C since I accepted the position in her Gainesville practice March 2010 and would love to see the day when she is able to start over. I for one will be there in any capacity I am able to be.

    Kathryn L. Chaky