If allegations against them prove true, a group of New York doctors, medical
staff members and billing specialists may have taken an early lead in
the bid for worst Medicaid fraud of the year. These guys promised homeless
people free shoes, but the homeless people paid a hefty price for those
boots and sneakers.
And so did you.
According to federal prosecutors in New York, the
Medicaid fraud ring sent a van out to make the rounds of shelters, soup kitchens and
welfare offices. Recruiters offered homeless people a van ride to a place
where they could get free shoes.
But wait — there was a catch!
There was a catch, though! Not every homeless person could get on the
van. Only homeless people
with valid Medicaid cardscould get in the van to be taken to the boot scootin’ bounty. The
recruiters checked Medicaid cards, and only people who had bona fide cards
were allowed on the bus.
The homeless men and women had no idea what was in store for them. The
vans took them to medical clinics located in Brooklyn and the Bronx, where
they spent hours undergoing numerous unnecessary tests, say prosecutors.
The unneeded tests were sent on to cardiologists and vein specialists
who happily billed Medicaid for reviewing the tests, although according
to the allegations these doctors never actually bothered to review the
testing (after all, they were
just homeless people who didn’t need the tests anyway, right??).
The doctors slapped fake diagnoses on the homeless, justifying yet more
unnecessary medical care. The podiatrists prescribed orthotics or leg
braces (need them or not!), which enabled yet more lucrative billing for
durable medical equipment. The podiatrists referred the patients to psychiatrists
and pain management specialists who were also in on the fraud, and who
set up regular visits for their services.
Many Healthcare Professionals Implicated
An in-depth
New York Times article details the fraud. Prosecutors have indicted 23 people they say were involved
in the healthcare fraud, including 9 doctors, including a cardiologist
who is an assistant professor of medicine at New York Medical College.
“We can use the same patients like guinea pigs for anything we want.”
The Government says it a wiretap recording of the leader of the fraud saying,
“We can use the same patients like guinea pigs for anything we want.”
Can that possibly be for real?
This guy apparently made money coming and going: he owned the medical clinics,
he supplied the orthotic devices billed to Medicaid, and he had financial
arrangements with the doctors who were getting to bill Medicaid. But apparently,
say prosecutors, that was not enough: he
even gipped Medicaid by substituting cheap, drugstore substitutes for the custom
orthotics he claimed he was giving these people.
I’m not saying it would be impossible for someone else to capture
the lead, but I think I can safely say that these guys will be in the
final few if the allegations against them prove true. Allegations like
these are exactly the reason why I became a lawyer who represents whistleblowers.