Tuesday, December 24, 2013

The Government's Response: Notes, Part 1, Bare Bones of Its Attack

     There are four main claims against me in the government's Complaint.

     1.  I provided medical services to patients and billed for them, but the services weren't "necessary."
     2.  I provided medical services to patients, but the written documentation in the charts wasn't "adequate" to justify those services.
     3.  I did not "order" the tests and procedures provided in my clinics.
     4.  I administered, as part of patient care, medications that came from Northwest Pharmacy, which is located in Canada and therefore has "non-FDA-approved" products that may be acceptable, from the U.S. Government's standpoint (in its desire to protect all of us) for personal use, or for self-paying patients, or even for non-government insurance-covered patients--but for which it is illegal to bill costs to Medicare.

     The government makes liberal use, in its Complaint and its Response to my Motion to Dismiss, of terms that have a denunciatory timbre and, in the absence of conditioning facts, have been chosen to make the reader wince.
     For example, on page 3 of the Response:  "…defendants engaged in numerous fraudulent schemes to systematically bill Medicare…"  Schemes?  What schemes?  The word implies diabolical activities, and casts me as a modern-day Machiavelli employing devices both brutish and destructive to civilization.  Schemes suggests that I had an elaborate blueprint for profiting from an unwitting boss, without working, without patients, with evil intent, even in my absence.
     And on page 17:  "Defendant engaged in these fraudulent practices in order to make more money--millions of dollars--from Medicare."  Millions of dollars, as though the generic figure alone constituted a crime.  Millions of dollars were, in fact, earned over the course of the ten years Hawthorne Medical Center was open for business, and the three years Colasante Clinic served patients.  Any bookkeeper can do the calculations.  When twenty or thirty employees are earning between $12 and $30 per hour, and providers are paid $85,00 to $200,000 per year, payroll expenses alone for a clinic running full-sail run about $1 million.   Add to that the cost of medical supplies, specialized equipment, maintenance plans, utilities, liability insurance and employee benefits and the clinic had better make "millions of dollars" if it has any hope of surviving as a business.
     And on page 9:  "…the United States vigorously disputes defendants' self-serving characterization of their own actions as 'objectively reasonable' or 'patient specific.'"  (If you're confused by the plural "defendants," remember that the prosecutor has accused me, a human being, as well as Hawthorne Medical Center, a corporation, and Colasante Clinic, another corporation, as though we were all in cahoots together, like a pack of bandits.)   I wonder about the use of the term "self-serving," which insinuates, again, selfishness, a decidedly non-Protestant trait in an overwhelmingly Protestant--even puritanical, in its self-characterization as selfless--country.  Is it "self-serving" to act in one's own defense against government attack?  Is there something wrong with a defendant defending herself?  It's true that my Motion to Dismiss claims that my process of billing for each patient's care was "objectively reasonable" and "patient specific."  What's so "self-serving" about that?  A defendant like me, in defending against attack by a monster of an attacker like the American government, is supposed to serve herself, i.e., be "self-serving."  But the prosecutor chose this term with deliberateness, to expand on the implication of self-profitting, even "profiteering," and to persuade the reader, i.e., the judge, that self-serving profit, an abomination against our shared Protestant ethic, is the crime we law-abiders have to halt.  (Never mind the hypocrisy of our living in the most self-serving nation in the world.)
     I won't censure the prosecutor for using, over and over, terms like "unjust enrichment, "reckless disregard," "deliberate ignorance," and "false claims" because they now belong to the staggering junk pile of legal jargon and, like all cliches, have lost any kernel of nuance or meaning.
     In the next few posts I'll take the four general sets of claims the government has posited and answer them.  It is unfortunate that I can't reproduce the document I wrote for my lawyers, since it's full of details both medical and procedural, but I have been told to keep these secret in case I should need them for "the trial," that august event that looms like a mirage far into the future, is supposed to petrify me, and will cost practically every penny I can scrounge up, if I hope to secure my freedom.


  1. I just bought a house and had it inspected by a professional home inspector. When he saw my water heater he beamed. He had just won the prize his local professional group has for finding the oldest appliance. He immediately took a photograph of the unit. My water heater is a Ruud Monel. It is was made in the 1940s and it still going strong. Ruud no longer makes it for precisely this reason. It was made with a very strong kind of metal. Another piece of evidence for planned obsolescence.

    My inspector told me a lot of people immediately replace these old units when they buy a house, to buy a new one. People sometimes do this with cell phones that still work, in order to buy a newer 'better' phone. So the first step we can take is not to throw things out before they even break.

  2. This comment was intended to go with the earlier "Everything Breaks" post, but somehow ended up here. I've had a little trouble lately commenting on this blog.

    I think you are right to call them on using these words as their use here is clearly rhetorical: the words are being used to make an argument that is implicit, hidden, and therefore more insidious, less open to reasoned refutation.

    The word "scheme" is perfect example. The word is in fact ambiguous. It can be neutral, as in 'color scheme.' But it also can carry a connotation of cunning dishonesty. Ironically, that is precisely what the government is doing by using the word "scheme." This whole letter is a 'scheme.' It is a cunning and dishonest way to attack a person by using words that insinuate themselves into our minds without our realizing what is going on. And the government knows this.

    As for this prosecution, are we tax-payers allowed to know how much the government has spent (should I say wasted?) on the this silly prosecution?

    I'll bet it was "millions."