Fraud Fishing Part 4: If you find one bad apple, keep climbing that tree

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August 16, 2010

When you find a doctor who you suspect of insurance fraud, tax violations or some other financial misdeed, it's a good idea to check his neighbors, business partners and family members.

Fraudsters often work together, and they also have a habit of using legitimate businesses as fronts. Regular readers of Antidote might recall how Dr. Harrell Robinson in Santa Ana, Calif., "worked" at a clinic owned by a different doctor and used the licenses of two other doctors as part of an operation that the U.S. Drug Enforcement Agency found was a painkiller prescription mill.

After reading about San Diego-based Dr. Mohammed Tarek Kady's fraud charges, I found another alternative medicine business that raised a forest of red flags.

For one, the business makes extensive use of the old Hippocrates-style, staff-and-serpents symbol in its materials. You know the one. Made famous by the U.S. Army Corps, stylized by the American Medical Association, and parodied by Snakes on a Plane.

I have learned from many years of health reporting that when businesses scream, "Look at us! We're legitimate!" they often are far from it.

And what do you know? Despite the über-medical logo, this operation has exactly zero MDs, DOs or RNs on staff.

Yet another alternative medicine business I encountered has a similar name. Looking them up online reveals an even sketchier profile. This business does not list a single staff person's name, despite claiming to have the "most experienced" doctors on staff.

Like the begging-for-legitimacy logo, another sign of a medical operation with something to hide is a sales pitch better suited to a used car lot. When was the last time you went to a clinic and were told that the clinic had "lowered our prices while still maintaining the highest standards of care"?

Or how about this pitch? "Call us and ask for the prices now through Christmas -- We will not be beaten!"

Both of the businesses mentioned above (but deliberately not named) are behind on their taxes to the tune of about $8,000. People usually pay their taxes first and then everything else, so there is a good chance they owe other creditors money, too.

If you check the courts, you will find lawsuits that reveal more details.

And don't forget federal court, especially bankruptcy court. All kinds of skeletons can come tumbling out of the closet there.

Throughout, never forget that you aren't just checking one doctor's name or one business name. You are looking for a network of names, aliases, family connections and business connections. For Kady's case alone, Antidote drew up a list of 25 names that could be run through local, state and federal agencies looking for interesting material.

Chances are good you'll catch a bad actor before Medicare does. If Congress is to be believed, you have at least 178 days before the private investigators the agency hires to root out fraud actually make a case.

Related Posts:

Fraud Fishing, Part 1: Why that corner health clinic might be flush with ill-gotten gains

Fraud Fishing, Part 2: Health scammers are hiding in plain sight

Fraud Fishing, Part 3: Following the health fraud paper trail