Saturday, April 09, 2005

Jurors Freed

HEADLINE 1:

Six-Week Case of Medicare Fraud – Jurors Fried.

HEADLINE 2:

Judge Offers Free Seat Cushions to Weary 12.

HEADLINE 3:

Baron Duty Done: “What – No Gift Basket?”

REAL STORY:

I have been one of 12 jurors (13, with an alternate who had to listen for six weeks, but did not get to deliberate with us) in the United States versus a collection of persons accused of conspiracy and fraudulent billing in one of the biggest Medicare/Medicaid fraud cases in US history. We were selected on 15 February.

There is no way to recap six weeks of detailed information and testimony here. Below are the basics.

I hesitate to tell you just how much money was involved – alright, it was in excess of US $20 million. Most of this money seems to have ended up in Nigeria. There were/are a large number of co-conspirators, including a number of doctors; plus a raft of Nigerians who started medical equipment companies. The doctors were used to (or participated in) issue false Certificates of Medical Necessity (CMNs) for motorized wheelchairs and other equipment, for which the companies then billed Medicare.

Medicare/Medicaid were billed and paid for motorized wheelchairs, but delivered “scooters,” which in most cases the patients could not use. The cost difference between motorized wheelchairs (known as K11s) and the scooters is somewhere between $2,000 and $3,000 – which the owners of the medical equipment companies pockets.

We’re not talking about dozens of K11s; not hundreds of K11s; but thousands of K11 motorized wheelchairs billed to the US government. The doctors, in addition, may or may not have (1) billed falsely for medical examinations for all these Medicare patients; (2) paid recruiters to bring hundreds of non-qualifying patients into their practices, so that they could write CMNs for the equipment companies; (3) received kickbacks from the recruiters and/or the medical equipment companies.

The mainspring of the fraud/conspiracy, one Jimmie Eking, skipped back to Nigeria. Many other participants have been indicted; and either copped a plea, are awaiting sentencing, or are awaiting trial.

Our portion of the case involved a Houston doctor and his office manager. The jury hung on the former, for which the judge announced a mistrial; and acquitted the latter on all pertaining counts. (The look on this person’s face when the “Not Guilty” verdicts were read on these counts was enough to make the jury feel very, very good about the ending of this very long trial.)

Several things to note:

1. The US Medicare establishment doesn’t really get the concept of “Due Diligence.”
2. If you want to start your own medical equipment company, bill Medicare and/or Medicaid, and make an immense amount of money, you don’t need much more than a broom closet and a telephone.
3. If called to Federal jury duty, don’t get caught in the shallow end of the prospective jurors’ pool.

Thank you – thank you very much – for your patience and your understanding while I was undertaking this very long service. I must say it was a privilege to serve my country in this matter; my fellow jurors could not have represented a more diverse cross-section of the American population; and they were all bright, cheerful, and dedicated to doing their duty, too.

More blogging soon - now that I am free, free, free!

No comments: