Same Model, Same Fraud

Why is this case so important?  Because this is the exact fraud scheme that is used in child welfare, particularly in the area of Targeted Case Management (TCM) in dealing with psychological services.  

The complexity of the TCM scheme incorporates all the components of the False Claims Act and RICO but will incorporate another layer of fraud in the use, or rather improper use of psychotropic medication in children and egregious violations of antitrust law.

The only difference is, in child welfare, you never get busted due to the propaganda machines, FOIA protections and the moritoria on Medicaid regulation.

Iowa physician involved in Florida Medicaid fraud surrenders license

A 55-year-old Iowa physician who formerly practiced in Fairfield has voluntarily surrendered his state medical license in the wake of a Florida-based criminal conviction on grand theft and racketeering charges related to treatment of individuals with HIV and AIDS.

Robert David was arrested and charged in September 2004 with criminal racketeering, 1st degree grand theft and 2nd degree grand theft for engaging in Medicaid fraud in Miami-Dade County, Fla. Charges brought against the physician indicated that he had entered into a financial agreement with an HIV/AIDS treatment center that allowed use of his Medicaid provider number in Florida to bill for services he did not provide.

Last February, David pleaded guilty in federal court to one count of each of the charges he faced, and was placed on probation for four years. He was also ordered to pay $100,000 in restitution and roughly $45,000 in court costs.

The Iowa Board of Medicine, which has filed formal disciplinary charges against David in 2006, accepted his surrendered medical license on Dec. 31, 2010, as part of a settlement agreement to resolve any further state disciplinary action.

The Florida scheme, which prosecutors estimate bilked the government out of $4.7 million, involved a south Florida treatment center for infectious diseases. Four people — two co-owners of the facility, a nurse and David — were arrested for their individual roles in billing for prescriptions for medications that were never dispensed and the creation of false medical records to conceal David’s absence from patient treatment and office supervision.

From 1999 to 2001, according to court records, the treatment center employed David as a physician. According to the clinic’s Medicaid billing records, David was present to administer professional treatment to HIV and Hepatitis-C patients and to oversee staff procedures. In fact, the physician was in Iowa and other locations when patients received whatever treatment was provided. David allegedly ordered a physician’s assistant to initial and mark hundreds of patient records with a rubber “Robert David, MD” stamp in his absence. These records contained high-cost medication orders for injections and infusions of Neupogen and WinRho that were never administered to the clinic’s patients. The pharmacy would then submit bills to Medicaid for drugs that were never actually dispensed, resulting in a total of $4.7 million in improper billings.

During the course of the investigation, the Attorney General’s Medicaid investigators seized over $1.6 million in illegally purchased assets, including a 40-foot motor vessel, an ocean-view condominium, a Cadillac Escalade and funds in a money market account.