Articles Posted in Medical Fraud

Perhaps you or your husband recently got arrested for medical fraud in Los Angeles or Southern California. If so, let’s address a large “elephant in the room” issue — something not often talked about. Namely this: how do otherwise caring and well intention doctors, chiropractors, dentists and other caregivers get “sucked into” perpetrating Southern California white collar crimes, like insurance fraud, credit card fraud, etc?

Now, most people out there assume that doctors or others who engage in fraudulent behavior started with a “master plan” of some sort. They have a cartoonish image of an “evil mastermind” criminal – a la Dr. Evil.

In the real world, however, fraud and other crimes often happen spontaneously, accidentally, unintentionally, etc! This isn’t to say that planning is not involved. Indeed, many people who get into the “Medicare fraud business” (if you will) spend a great deal of time strategizing and executing on their plans. Some of the systems used are extremely complicated, after all.

Last Friday, 50-year-old David James Garrison was found guilty of perpetrating a Los Angeles Medicare fraud scam that bilked the federal program out of almost $19 million.

As a result of his convictions — fraud, conspiracy, and other Los Angeles white collar criminal charges — Garrison could face more than seven decades behind bars and a fine of up to $2 million. If he ends up having to serve that entire prison sentence, he would have to become the 2nd oldest person in the history of the world to ever see freedom again.

Garrison worked as a physician’s assistant at various bogus medical clinics. He pilfered the identities of patients and used those IDs to create false prescriptions and to place orders for (Medicare funded) equipment. He also stole the identities of doctors to write these fake scripts.

If you are a physician who has recently been arrested for Los Angeles Medicare fraud due to double billing or overbilling — or as an accomplice to a larger and more sophisticated scheme that spanned several years — you’re probably terrified. How will the arrest (and potential conviction) impact your career, your freedom (jail time or not?), your finances, your relationships with the people closest to you, and your professional reputation (or what’s left of it)?

Odds are, in fact, that you are overwhelmingly focused on the potential negatives of the situation. In some ways, this makes sense. Now is a good time for reflection and sober strategic thinking, particularly if you did commit criminal activity. A Southern California Medicare or Medi-Cal fraud lawyer can help you devise and execute an intelligent response to the charges against you. And you should certainly introspect and analyze how you got into the situation in the first place. But you might also find it extremely resourceful to focus on potential positive outcomes.

The brain works in mysterious ways. Since the 1950s, neurologists have studied an activity center in the brain called the reticular activating system (RAS). This is a region of our brain that helps to manage and process attention and focus. Obviously, the neurology of the RAS is too complicated for this blog to address, but the takeaway is pretty profound. Science suggests that how and when and where we hold our focus can color not only our perceptions of our experiences but also our strategies for dealing with crises.

If you, a spouse, or a close family member was recently arrested and charged with Medicare fraud in Los Angeles—or some other Southern California white-collar crime—you’re probably very frightened right now. You might fear the prospect of going to jail, losing your dental, medical, or chiropractic license, getting kicked out of a professional association, paying massive fines, and seeing your reputation and character besmirched. These are very legitimate concerns. Depending what you did or did not do, you can certainly suffer all those penalties—and more.

The federal government is getting extremely serious about cracking down on Medicare fraud. Three weeks ago, federal officials busted an alleged scam in Dallas, Texas. Observers are calling it the biggest case of Medicare fraud in US history. Allegedly, a 54-year old Dr. Jacques Roy masterminded a $375 million scam, by certifying Medicare reimbursement claims fraudulently and then keeping payments without providing services.

Prosecutors allege that Roy created a sophisticated “boiler room” to run his scam. He found homeless people to pose as patients and created thousands of fraudulent Medicare claims. Assistant Attorney General Lanny Breuer said that the Medicare Fraud Strike Force found that “Dr. Roy and his co-conspirators, for years, ran a well-oiled fraudulent enterprise . . . making millions by recruiting thousands of patients for unnecessary services and billing Medicare for those services.” During the six years of his scam, according to ABC News, “Dr. Roy . . . had more patients than any other medical practice in the United States.” The 13-count indictment is loaded with serious charges. If convicted, Dr. Roy faces life imprisonment.