I remember this case from many years ago. Dr. Leonard Morse of Brooklyn, NY was wrongfully accused of Medicaid fraud by then Attorney General (and now disgraced on multiple levels) Elliot Spitzer. It took nearly seven years for Dr. Morse to vindicate himself. He won his lawsuit and was awarded $7.7M, but he lost his practice and his reputation. $7.7 million isn’t enough in my opinion. But, I’m glad that Dr. Morse feels vindicated. He was offered $100,000 to drop his lawsuit against the state. $100k in exchange for losing his practice, his name, and his honor??? Good on Dr. Morse for standing up for what’s right!
But, That’s Not All! There’s More!
I’m familiar with a couple of similar cases involving dentists who posted their stories on Dentaltown. Dr. Roy Shelbourne laid out his story on Dentaltown. There’s another story by another dentist on DT, but I can’t seem to find it at the moment. I’ll keep looking and add it here. Found it! It’s the story of Dr. Anthony Sanchez in Wisconsin.
Government Help Lines Give Wrong Advice
According to a study by the Government Accountability Office (GAO), the Medicare help lines gave the WRONG answer to doctors’ questions 96% of the time! NINETY-SIX PERCENT!
Dr. Sanchez reported in his account that he was told by the Medicaid help line that he was doing the right thing. Do you think the Medicaid help line is any more accurate than the Medicare help line? “Prolly not!”
Editing to add (4/8/17):
New Hampshire orthodontist ,Dr. Nicholas Marshall, faced a possible 1,300 year sentence for 160 counts of fraud, totaling $781. NONE of those numbers are typos. Read it again. A two-day trial exonerated him. How much did it cost the state to pursue this arguably FRIVOLOUS witch hunt? How much did it cost the good doctor to prove his innocence?
I dare say any dentist who agrees to expose him or herself to these kinds of risks are out of their fucking minds. Or, at least, woefully ignorant of the minefield they are tap-dancing through.
Strange and Dangerous Bedfellows
Getting in bed with the federal (or state) government is extremely risky. When you sign on as a “provider,” you effectively waive your Constitutional Rights. If you are a Medicaid provider and are even SUSPECTED (or accused by a bitter ex-employee) of improprieties, the feds can padlock your front door, seize your files, and even seize your personal assets… BEFORE due process. Read that again! BEFORE DUE PROCESS! How much are your rights worth? Considering that I put my life on the line to support and defend the Constitution, mine are priceless.
How Much Would You Pay Now?
Are you willing to risk being the victim of an ambitious state attorney’s witch-hunt?
If the day ever comes that my license to practice is predicated on participation in any socialized program (like Medicaid), I will leave the keys on the counter of my office and walk away. Such a condition of licensure HAS been suggested by some states’ legislatures!
The Problem Is the System
While I won’t defend fraud in any manner, I contend that the dismally low fees paid by Medicaid are part of the problem. Those dentists who accept Medicaid struggle to provide care without LOSING money at those fees. So, many find a way to make it profitable. Again, there’s no excuse for fraud. If you can’t make it work, then GET OUT of it.
The bleeding hearts cry about “access to care.” They even accuse non-participating dentists of being “greedy” and being heartless or not caring about the “poor.” It’s the dentists’ fault. They claim a delusional moral high ground and pretend they’re “helping the poor.” Anyone who would dare disagree (or point out the pitfalls of participation) are labeled as “uncaring” and even “prejudiced.”
Where is the ADA (American Dental Association) on this?? Missing in action!
Rock on, Dr. Morse!
Comments? Anyone have experience with accusations of fraud?
PS… Here’s a MUST READ eye-opening interview of Dr. Morse (since his victory in court): Texas Dentists for Medicaid Reform Interview with Dr. Leonard Morse.