The $40 Billion Scam (page 7 of 7)

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I had no medical relationship with the patient, and N&M owned the x-ray, owned the report

So Where's the Crackdown?

The evidence of mass fraud may be piling up, but that hasn't lit a fire under the feds. Rep. Ed Whitfield of Kentucky recently chaired a Congressional investigation that has gone nowhere. The only concrete results: Two screening company owners and four doctors used their Fifth Amendment rights to avoid testifying.

A 30-month probe by a federal grand jury in New York appears more promising. In addition to the FBI and the U.S. Attorney's Office, U.S. Postal Inspectors are now working the case, searching for mail fraud. In response to a subpoena issued by the grand jury at the request of the Postal Inspectors, Dr. Martindale was required to provide reams of documents ranging from tax returns and canceled checks to medical records and invoices from subcontractors. The grand jury is investigating "conspiracy to defraud the United States."

For its part, the American Medical Association tried to force state licensing boards to take action against the doctors whose diagnoses were rejected by Judge Jack. Almost none of the boards even bothered to reply to the AMA's letters.

The biggest hurdle, perhaps, is the sheer complexity of the litigation. In a system run amok, it's not easy to distinguish the scrupulous professionals from the shady ones and the ones who simply didn't dig deep enough. It will take government investigators to sort that out. And until they do, it will remain unclear just who should be held accountable. In the meantime, no lawyers have been disbarred, and no doctors or screening companies have had their licenses yanked.

Legal analysts like Lester Brickman are impatient with the snail's pace of government action and are ready with suggested reforms. Among his ideas:
  • There should be a "national data bank" of asbestos claims that identifies retreads, suspect doctors, and those shopping for extra money from multiple bankruptcy trusts.
  • Courts need to permit the kind of intense pretrial evidence review allowed by Judge Jack, to catch and toss out phony cases early in the process and identify the wrongdoers.
  • Alternatives like arbitration are needed to weed out bad cases, reduce attorney fees and get money more quickly to the truly injured.
  • New laws should establish uniform medical criteria for patients who don't have cancer, and set compensation thresholds.
The longer it takes to clean up this mess, the more it will cost all Americans -- not only company shareholders and employees, but also genuine victims who get that much less money when big bucks go to settle meritless claims. No one is more disgusted by the ongoing racket than Judge Jack, who said in a statement dripping with sarcasm, "The law says if you're going to sue for a disease, you've got to have it."

Adopting that simple standard would finally derail the gravy train.
From Reader's Digest - January 2007
 
Additional reporting by Lora J. Hines.
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