Podiatry Malpractice Blog : Podiatry Malpractice Lawyer & Attorney : Michael A. Quinn Law Firm : Surgery, Amputation, Podiatric Medicine : New Jersey

Dr. Dave Dai Quang Pham, a St. Louis podiatrist, is accused of trying to exchange prescription drugs for sex.

The St. Francois County Prosecutor charged 49-year-old Dr. Pham with possession of a controlled substance with intent to distribute, distribution of a controlled substance, and a misdemeanor, patronizing prostitution.

Source: Associated Press (April 2, 2009)
 

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A St. Louis, Missouri podiatrist has plead guilty to obstructing a federal audit when she provided the Medicare program with a false and backdated treatment record, U.S.  said Thursday.

Bic Chau Stafford, D.P.M., 59, who practices at the Family Foot and Ankle Care Center in Maryland Heights, as well as assorted assisted living facilities in St. Louis County and St. Louis City, plead guilty to one felony count of obstruction of a federal audit.  When sentenced Dr. Stafford faces fines of up to $250,000 and  maximum penalty of five years in prison. 

Prosecutors said that Dr. Stafford allegedly billed Medicare for complex foot surgeries provided to 39  Medicare beneficiaries when she was really providing these patients with only routine foot care, such as toenail clippings

Prosecutors said, in response to a Medicare audit, Dr. Stafford created new treatment records for the 39 patients in 2007 and backdated them to 2004, and claimed that she had provided these patients with podiatric surgery.
 

Source: St. Louis Business Journal (April 2, 2009)

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Larry Cruel, D.P.M., a Mississippi podiatrist,  has been arrested following an insurance fraud investigation, announced Attorney General.

Larry Cruel, D.P.M. (age 44), is a podiatrist at Advanced Foot Care in Jackson, MS.  He was recently arrested  by investigators with the Attorney General's Office and charged with one count of insurance fraud and one count of wire fraud for allegedly submitting false claims to Blue Cross Blue Shield. Dr. Cruel faces up to three years for the insurance fraud charge and up to five years for the wire fraud charge .

As with all cases, the defendant is presumed innocent until proven guilty in a court of law.

Source: Compnewsnetwork, March 27, 2009 (workerscompensation.com)

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A St. Louis County podiatrist, Dr. Denise Hardy, 45,  recently plead guilty to a health care fraud charge in federal court in St. Louis and has admitted to over billing Medicaid and Medicare for unnecessary treatments.

Prosecutors said that Denise Hardy, D.P.M.,  lied on treatment notes from 2000 through 2005 so that Medicaid and Medicare would pay for foot care that would not otherwise have been reimbursed.

Dr. Hardy worked for South St. Louis Orthopedic Group between 1998  and 2005 and provided podiatric services at their office as well as at nursing homes, such as Lafayette Habilitation and at senior service centers at St. Anthonys Medical Center and  St. Alexius Hospital.

Denise Hardy was paid a salary of  $55,000  plus between 50 to 60 percent of the revenue she had billed each month over $12,000.
 

Source: St. Louis Post Dispatch 3-13-2009

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Generally the standards of medical care will be the same from specialty to specialty, however there may be distinct differences within each sub-specialty. In addition, training and procedures will vary between the sub specialties. It is important to establish that a particular provider is trained and qualified to perform the particular surgery that may be at issue. Board Qualification and Board Certification does not guarantee that a provider is qualified or trained to perform a particular surgery.

Tip: Make sure that you request the privileges  granted to the provider by a particular hospital or surgical center in order to confirm that the facility has granted privileges to the doctor to perform surgery. Absence of privileges may help confirm that the provider received inadequate training or perhaps no training in the procedure(s) at issue.

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Foot surgery and foot care can be provided by a variety of providers, as there is overlap amongst many different medical and surgical specialties. They include podiatrists, orthopedic surgeons (with or without fellowship training in foot and ankle disease).   Dermatologists provide skin and nail treatment. Ulcer and bedsore care may   be provided by vascular surgeons and implemented by wound care nurses and physician assitants. Neurologists commonly provide treatment for neuropathy and neurosurgeons will perform nerve surgery in the foot.   Lastly, general practitioners may provide minor treatment modalities or alternatively refer to anyone of the above.

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Ohio  podiatrist, Dr. Harold M. Jones, DPM,   has been found guilty in a scheme to defraud Medicare and Medicaid. Dr. Jones, 45, recently went on trial in Cleveland on 22 counts of healthcare fraud, six counts of aggravated identity theft and 26 counts of mail fraud. The jury found him guilty on three of the counts, after three days of deliberations and not guilty on the remainder of the charges.

According to Assistant U.S. Attorney Justin Roberts, Dr. Jones had used improper billing codes, billed for services that were not rendered and also billed under a false provider number. The doctor was also accused of using another medicare provider number and person’s name in order to submit false claims for reimbursement.

Source: The News-Herald (2-24-09)

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A Long Island podiatrist was arrested and charged with writing and filling fraudulent prescriptions for painkillers and other drugs for personal use and resale for profit, Nassau County prosecutors said.

Prosecutors said, Dr. William Levine, 42, was carrying a loaded .380-caliber handgun when he was arrested  in a Port Washington school parking lot where he was about to exchange illicit prescription drugs with another man.

Disticty Attorney Kathleen Rice said "Dr. Levine has violated the community's trust by abusing his position as a doctor,".   "His actions are no different from a drug dealer on the street corner looking to poison our children, feed addictions, and ruin lives."

William Levine, DPM obtained large quantities of oxycodone,  hydrocodone, Xanax, Klonopin Vicodin, and by writing out prescription slips in the names of non patients and his family members, authorities said. Dr. Levine then filled the prescriptions at nine pharmacies in Nassau County, Queens and Brooklyn, Rice's office said.

Rice's statemetn said "He would then either use the pills himself, or sell them,"
"Family members and non patients told investigators that they were unaware of prescriptions written in their names and that they had never received the medication."

Dr. Levine,  practices  podiatry in Brooklyn.  Prosecutors said that Levine had gone to the Port Washington lot to provide the other man with five Klonopin pills in trade for 100 pills each of methadone and hydrocodone. Authorities said Dr. Levine's handgun was found in a search by Drug Enforcement Agency investigators who arrested both men.

Newsday- February 26, 2009

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A Wisconsin state review committee recommended Tuesday that  Wisconsin podiatrist, John Lanham, DPM,  be investigated for potential fraud and for possibly violating a state order meant to regulate his billing practices and other professional behavior.

The Public Investigator first wrote about  Dr. John S. Lanham in November 2007 after discovering that he billed his patients much more than the average doctor. In one case, he billed $1,700 for medicine that costs $15 or less. A former patient reported receiving a $4,500 bill for treatment that most podiatrists say costs a few hundred dollars.

Over the past year, the complaints about  Dr. Lanham have continued to be sent in to the Public Investigator Team. The State Department of Regulation and Licensing has also received complaints about the podiatrist.  The state declined to specify how many complaints have been received because some are currently being investigated.

Lanham had his license to practice podiatry suspended in 2006 after state investigators said he submitted false bills and  false claims to insurance companies. According to a final decision and order filed by the state, the state also found that the podiatrist billed for procedures he did not perform.

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