Tuesday, January 25, 2005

 

Medicare Testimony Highlights Prosecutions Misdeeds and Misleads



Today's testimony by Medicare supervisor Ms. Carosella (spelling?) highlighted the prosecution's case of--innuendo, misrepresentations, hyperbole, Enron like accounting skills/claims and pure bull !!!!!

The above chart is a representation of one presented by the prosecution today to show how Dr. Dhafir overcharged his peer group when it came to Medicare billings. On the surface the information seems pretty convincing…But??

In cross examination we learned that the Medicare person did not know what the make-up of the peer group was--In other words she did not know whether the peer group contained doctors with similar practices, or were they from similar locations. Meaning that a general practitioner or cardiologist could have been part of the peer group and would have had no where near the same medication billings as an oncologist such as Dr. Dhafir would have. She did not know how many patients there was in the peer group. She did not know what type of patients were used, etc….etc.. Basically the table was a bunch of numbers that proved nothing, whose only objective was to make Dr. Dhafir look bad.

The chart is another example of the prosecution's Enron like accounting efforts to fabricate statistics and numbers to make its case.

Government's attempts to inflate Dr. Dhafir's Medicare over-charges was further exposed. As we noted previously, Dr. Dhafir is accused of over charging Medicare for services done when he was not present--he gets 15% less if he is not present. The government presented the gross amount of the total billed rather than the 15% of $274,000.

We learned that even 15% of that amount is too much because the doctor can charge the full value for medication, lab work, etc…Because much of the cost of chemotherapy is medicine the 15% number is radically reduced.

In court the defense had Ms. Carosella calculate one overcharge:
$1,244.41 Total bill
$186.66 %15 of the amount ($1,244.41)

Overcharge less meds and lab work
$1,244.41 Total bill
$914.91 Cost of medicine
$329.50 ($1,244.41 less $914.91) Total bill less medicine

$10.83 Cost of lab work
$318.83 ($1,244.41 less $914.91 - $10.83) Total bill less medicine

$47.83 Revised Overcharge ($318.83 X 15%)

Last week the prosecution was caught in its own web of deceit regarding Medicare and was forced to compile a revised schedule to show the actual over-charges, that it today presented to the defense team. The defense was going to mull over the numbers.

The idea that the prosecution had to create an accurate and revised schedule of supposed Medicare overcharges after the fact raises several issues.
--The government is operating way beyond its experience base. I noted earlier that lead FBI agent Kolbe had a woefully deficient accounting background.
--It shows how bogus the Medicare overcharge is. Yes it appears Dr. Dhafir overcharged Medicare, but lets put the amount in its proper context. Secondly, as Ms. Carosella testified that in 1992 Dr. Dhafir was audited and was found to have over charged Medicare by $800. The case such as this one should have been settled out of court as is the usual way.
--It reinforces previous inconsistencies exposed in the prosecution's case. For example, FBI agent Kolbe admitted that some of the money he said Dr. Dhafir took from the charity was actually his own money.

All of this goes to show how desperate and malicious the government has been to convict Dr. Dhafir. As Ms. Carosella noted the government asked her to "GET DR. DHAFIR"; that is in essence what she said before break.

Note Closing arguments will be heard beginning Monday January 31, 2005

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