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re: Former AL, current TN doctor & family indicted for $41 Million healthcare fraud scheme

Posted on 10/1/20 at 3:29 pm to
Posted by CatfishJohn
Member since Jun 2020
13710 posts
Posted on 10/1/20 at 3:29 pm to
You have to be really dumb to not get away with over prescribing/over providing unnecessary medical services and drugs. It is almost always a case of them getting too greedy.

They likely have evidence of their plot that they emailed/texted each other as well. Or they did some dumb shite like giving 1,000 pills to one person for a month or something.

If done right, you don't get caught. It's a shame, but it's true. Always provide what you bill for and never, ever document the strategy in a way that can be used against you. And keep it relatively small time and never more than one patient can possibly have.

If you do all that, the worst they get you with is a medical board problem, not a legal one because you can argue it was what you believed medically best for the patient.

Doctors are people too and there are thousands that have no ethical code. It's pitiful.


ETA:

Also, doctors that flood the streets with opiates should be put in jail for decades.

This post was edited on 10/1/20 at 3:33 pm
Posted by LegendInMyMind
Member since Apr 2019
54888 posts
Posted on 10/1/20 at 3:40 pm to
quote:

You have to be really dumb to not get away with over prescribing/over providing unnecessary medical services and drugs. It is almost always a case of them getting too greedy.

Particularly when you know good and well that you're already being closely watched. He may be just as big of an idiot as he is a piece of shite.
Posted by Robin Masters
Birmingham
Member since Jul 2010
29996 posts
Posted on 10/1/20 at 4:07 pm to
quote:

You have to be really dumb to not get away with over prescribing/over providing unnecessary medical services and drugs. It is almost always a case of them getting too greedy.

They likely have evidence of their plot that they emailed/texted each other as well. Or they did some dumb shite like giving 1,000 pills to one person for a month or something.

If done right, you don't get caught. It's a shame, but it's true. Always provide what you bill for and never, ever document the strategy in a way that can be used against you. And keep it relatively small time and never more than one patient can possibly have.

If you do all that, the worst they get you with is a medical board problem, not a legal one because you can argue it was what you believed medically best for the patient.

Doctors are people too and there are thousands that have no ethical code. It's pitiful.


This was a kickback situation. The doctors were getting paid by the laboratory so they would send their urine samples to them for analysis. At that time, Medicare and BCBS would pay $1000 per cup and a decent clinic could send 80-100 per day, every day.
In this instance the lab was also providing employees and other illegal benefits as well as putting money into a "charity".
Posted by LegendInMyMind
Member since Apr 2019
54888 posts
Posted on 10/1/20 at 4:11 pm to
quote:

that time, Medicare and BCBS would pay $1000 per cup

Good grief.
Posted by The Spleen
Member since Dec 2010
38865 posts
Posted on 10/1/20 at 4:15 pm to
quote:

when your sales rep hick husband from Gadsden starts cashing Million dollar monthly checks maybe the light should go off the he might be up to something illegal.


I wish now I’d paid closer attention to him when we played golf. He just seemed like a guy that lucked into a good sales position. Didn’t give any airs he was living beyond his means or really an excess life. I have 5 mutual friends with him on Facebook, though all but one are just acquaintances. Has a lot of rentals on his Facebook page, so probably laundering that money through real estate. Hope he saved some cash for a good lawyer.
Posted by nvcowboyfan
James Turner Street, Birmingham,UK
Member since Nov 2007
2955 posts
Posted on 10/1/20 at 4:18 pm to
As an addiction medicine physician, I have to deal with the fallout from these type of assholes every day. while I know that the pill mill quacks and the drug companies are partly at fault the patient who drives 4 hours to pick this up and deals to his family is also to blame
Posted by Robin Masters
Birmingham
Member since Jul 2010
29996 posts
Posted on 10/1/20 at 4:30 pm to
quote:

As an addiction medicine physician, I have to deal with the fallout from these type of assholes every day. while I know that the pill mill quacks and the drug companies are partly at fault the patient who drives 4 hours to pick this up and deals to his family is also to blame



These guys weren’t a strip mall “pill mill” trading cash for scripts under the table. They made all their money on ancillary services and kick backs. In fact what got them in trouble was over policing their patients.
Posted by Robin Masters
Birmingham
Member since Jul 2010
29996 posts
Posted on 10/1/20 at 4:51 pm to
quote:

I wish now I’d paid closer attention to him when we played golf. He just seemed like a guy that lucked into a good sales position. Didn’t give any airs he was living beyond his means or really an excess life. I have 5 mutual friends with him on Facebook, though all but one are just acquaintances. Has a lot of rentals on his Facebook page, so probably laundering that money through real estate. Hope he saved some cash for a good lawyer.


You should have gotten him drunk and picked his brain. You could have been a whistleblower and gotten 10%!

The Feds are going to frick his shite up. He's been under investigation for probably 4 or 5 years now. His mistake was getting involved with a doctor in N Al that was the most prolific prescriber of opiates in the country who ultimately went to jail. Dr. Murphey who is the doc in the article took much of that doctors patients and then assumed the shady kickback schemes of Bowman as well.

So you have $41MM in fraudulent payments and several years of man hours by the feds...they will get their pound of flesh.


Posted by Palmetto08
Member since Sep 2012
4052 posts
Posted on 10/1/20 at 8:16 pm to
quote:

The Feds are going to frick his shite up.


What kind of punishment gets handed down for this kind of stuff?
Posted by Robin Masters
Birmingham
Member since Jul 2010
29996 posts
Posted on 10/1/20 at 8:46 pm to
quote:


What kind of punishment gets handed down for this kind of stuff


Mostly I think they want the money back, but if it appears you are not forthcoming with its whereabouts then you can enjoy several years in pound me in the arse prison.

These Mobile docs got quite a few years.
LINK
Posted by LegendInMyMind
Member since Apr 2019
54888 posts
Posted on 10/1/20 at 8:50 pm to
quote:

Mostly I think they want the money back, but if it appears you are not forthcoming with its whereabouts then you can enjoy several years in pound me in the arse prison.

I think they all need to go to prison anyway. This type stuff is not okay, and others need to know it will be taken seriously.
Posted by Robin Masters
Birmingham
Member since Jul 2010
29996 posts
Posted on 10/1/20 at 8:53 pm to
quote:


I think they all need to go to prison anyway. This type stuff is not okay, and others need to know it will be taken seriously.




True. And the all likely will. Just depends on for how long.

For the record: I’m not a lawyer or law enforcement so take what I say with a grain of salt.
This post was edited on 10/1/20 at 8:55 pm
Posted by The Spleen
Member since Dec 2010
38865 posts
Posted on 10/1/20 at 9:09 pm to
quote:

you can enjoy several years in pound me in the arse prison.


He’ll go to a minimum security country club prison.
Posted by Cracker
in a box
Member since Nov 2009
17763 posts
Posted on 10/1/20 at 9:26 pm to
Federal prison probably in Talladega
I agree the guy was is a menace BUT the pharmacy did not have to fill the prescriptions flags should have been flying years ago but noooo did they stop him? Nope the pharmacies were culpable also
Posted by LegendInMyMind
Member since Apr 2019
54888 posts
Posted on 10/1/20 at 9:34 pm to
quote:

Federal prison probably in Talladega
I agree the guy was is a menace BUT the pharmacy did not have to fill the prescriptions flags should have been flying years ago but noooo did they stop him? Nope the pharmacies were culpable also

They did stop him years ago. He closed his Alabama practices and moved to Tennessee. Alabama was in the process of pulling his license before he closed shop. There was no need to go through with it once he left the state, they could always do it if he tried to come back to the state.

Besides, this goes so much deeper than just a "pill pushing" doctor.
Posted by Damone
FoCo
Member since Aug 2016
32966 posts
Posted on 10/1/20 at 9:35 pm to
So many scumbag doctors out there taking advantage of people.
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