When I read an article about a Marietta, Georgia, lab owner who faked allergy
tests, the
healthcare fraud hit home for me on a personal level.
From the time she was little, my daughter was terrified of shots. She needed
allergy shots, but it took me six years to get her calm enough to even
consider doing what her doctor and I knew she needed to do. She finally
had had enough of Atlanta’s double-barreled spring and fall allergy
seasons. She was old enough to see that if the shots worked, the benefit
would be worth the injections.
Our allergy doctor wanted to be sure he was giving my daughter a serum
that was calibrated for what she was allergic to, so she underwent a battery
of pricks and blood draws that left her arms and back swollen and painful.
Based on the test results, a serum was designed for my daughter. Then,
for more than a year, the two of us trudged to the doctor twice a week,
where she got shots in both arms. As the shots got stronger, they hurt
more and more. One time she had a serious asthma reaction. But we soldiered
on, committed to the process because we thought it would work.
Faked Allergy Test Results
But according to a
press release from the United States Attorney for the Northern District of Georgia,
Sally Quillian Yates, some allergy test results were tainted as a result
of healthcare fraud.
Rahsaan Jackson Garth ran Polaris Allergy Labs, Inc., of East Point, Georgia.
Doctors sent patient’s blood samples to Polaris for testing to determine
whether the patients had various food and environmental allergies.
Garth was paid for the tests, of course. However, prosecutors say that
the 39-year-old lab owner wasn’t satisfied with getting paid for
doing the tests. Casting about for a way to up his take, it occurred to
him that using allergan reagents to actually test the blood was costing
him money (horrors!). Why, Garth concluded, it would be far easier and
cheaper to just make up fake test results!
Bizarre though it may seem, Yates says that from September 2012 to February
2014, Garth told his lab technician to stop actually testing the blood
samples. Instead, the Government explains, Dr. Garth just arbitrarily
“decided” whether the patients were or were not allergic to
the various things they had been tested for. He even varied the test results
in order to escape detection. Of course, he billed the patients and their
insurance companies as if his lab had actually done the tests.
In January 2015,
Garth was sentenced to three years and ten months in prison and three years of supervised
release. He was ordered to pay restitution of $246,536.50 and to perform
100 hours of community service
How Did the Government Find Out About the Fraud?
The press release from the Department of Justice talked about the criminal
prosecution of Garth. (He pleaded guilty to a charge of healthcare fraud.)
I wondered how the Government found out about the fraud. I am an attorney
who represents whistleblowers, so I know that when a whistleblower files
a civil case under the False Claims Act, the Government sometimes decides
that it needs to prosecute the case criminally before it turns to the
civil FCA suit.
One of the most troubling aspects of healthcare fraud is that it shakes
a patient’s faith in the entire healthcare system. My daughter was
tested during the exact period that Garth was faking test results. What
if her results were faked? She’s seen some improvement, but I’m
left wondering – was it enough?
I don’t know whether there was a whistleblower here, but I do know
this – my daughter and I are grateful to whoever it is who let the
Government in on this scheme.