February 2003

See no evil, see no mercy

Closing your eyes to the possibility of Medicare fraud in your office not only won't make the problem go away – it also won't save you from conviction if the feds uncover the wrongdoing.

Put another way, pleading ignorance won't get you off the hook if the misconduct is staring you in the face, as the co-owner of a Jonesboro, AR ambulance service recently learned the hard way. In a Jan. 14 ruling, the 8th U.S. Circuit Court of Appeals affirmed the conviction of Clarence Woodard for conspiring to submit false claims to Medicare for the transportation of dialysis patients.

Woodard, a certified public accountant, handled personnel and payroll for Keller Medical Services Inc., a Medicare ambulance services provider. An FBI probe of the company revealed that it had collected more than $1 million for medically unnecessary trips, and the feds ultimately brought fraud charges against Woodard and KMS co-owner Mark Keller.

At trial, Woodard maintained that he didn't know about the improper billings, and thus couldn't be held responsible. Prosecutors, however, presented evidence at trial that Woodard ignored concerns raised by other company employees and cut short a meeting when talk turned to potential medical necessity problems.

That allowed prosecutors to present instructions to the jury on how Woodard could be found guilty if he "deliberately avoided learning the truth." Woodard objected, but in United States v. Woodard (No. 02-1244), the 8th Circuit shot him down. Pointing out that Woodard "repeatedly denied any knowledge or involvement in the scheme" while trial testimony suggested he "remained deliberately ignorant," the appellate panel ruled that the court was right to allow the jury to consider whether the exec deliberately blinded himself to misdeeds that should have been obvious.

Source: Medical Newswire

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