Pain doc gets sentenced to federal prison time

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NJPAIN

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Pain doc formerly practicing in MD and out of same ASC that I use here in NJ. His partner committed suicide just days prior to anticipated indictment. This guy got $10 million in life insurance when the partner killed himself. I believe that the feds seized that money and released a few million for legal fees.

Pain Management Physician Sentenced to 8 Years in Federal Prison for Central Role in Million Dollar Kickback Scheme and Fraudulent Billing Scheme
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There are 3 other docs in the practice that were also sentenced. The fraudulant billing was for a separate doctor who billed for anesthesia for patients having procedures but was actually in another office nowhere near the patients. The kickbacks were from the urine drug testing company.
 
NJPAIN said:
Pain doc formerly practicing in MD and out of same ASC that I use here in NJ. His partner committed suicide just days prior to anticipated indictment. This guy got $10 million in life insurance when the partner killed himself. I believe that the feds seized that money and released a few million for legal fees.

Pain Management Physician Sentenced to 8 Years in Federal Prison for Central Role in Million Dollar Kickback Scheme and Fraudulent Billing Scheme
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Nice...

"However, he texted Dr. Malik that “I am using your name today as surgeon as we have 34 procedures here [in Frederick] and 20 in Waldorf,” to which Malik responded “ok.” Malik was seeing patients at his office in Hackettstown, New Jersey that day."
 
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Dr Malik was a Baylor PMR grad from my class. I think he went to Harvard for Pain.
 
These guys seem to follow a pattern. They start with the occasional ethical slip and just can't stop. In the end, they are busted on tax fraud, in addition to the other stuff. Or maybe it's just the tax fraud that make these cases a slam dunk for prosecutors...
 
drusso said:
I'm curious: Was he sketchy then? I've always wondered if sociopaths are *MADE* or *BORN*.
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we didnt hang out but he was friendly. He is a dark skinned middle eastern descent and he married a cute redhead girl that we as a class went to a party with, but that didnt last....he was a bit eccentric and i remember him bragging that a pain doc in the Houston area he knew made $1 mill a year. He wanted to go to Harvard for Pain Fellowship. And he liked Porsches. No other memories.
 
bronchospasm said:
There is. There are d bags from every cultural background and ethnicities.
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drusso said:
I wonder if there is an association between committing medical fraud and cultural background?
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Every ethnicity is guilty, but I’ve noticed certain ethnicities are guilty more often than others.
 
Doctodd said:
we didnt hang out but he was friendly. He is a dark skinned middle eastern descent and he married a cute redhead girl that we as a class went to a party with, but that didnt last....he was a bit eccentric and i remember him bragging that a pain doc in the Houston area he knew made $1 mill a year. He wanted to go to Harvard for Pain Fellowship. And he liked Porsches. No other memories.
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He was doing tons of endoscopic discs and got himself a consulting/teaching position with JoyMax and then followed the $ to MaxMore and other spinoffs I believe. I just read that he spent the last 8 months in a detention facility awaiting sentencing. If he comes out on the other end of this will depend upon where he gets sent for the next few years.Yikes!!

Sent from my iPhone using Tapatalk
 
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hogs get slaughtered. Guy could have had the same set up with his own Utox lab and a Crna for sedation, paid his taxes and would have made a couple million a year
 
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nvrsumr said:
hogs get slaughtered. Guy could have had the same set up with his own Utox lab and a Crna for sedation, paid his taxes and would have made a couple million a year
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It's really an addiction. These guys cross ethical lines and rake in cash but it's never enough. Even after they get a warning from various boards and get on the radar, they can't stop. The partner even killed himself. It's a $$/adrenaline/player addiction I guess.
 
nvrsumr said:
hogs get slaughtered. Guy could have had the same set up with his own Utox lab and a Crna for sedation, paid his taxes and would have made a couple million a year
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Pardon my ignorance here, but how are these people making a million a year? How can you ethically and conscientiously do 30 procedures a day?
 
drusso said:
I wonder if there is an association between committing medical fraud and cultural background?
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Could also ask if there is an association between committing medical fraud and gender.
 
Burnted_out said:
Pardon my ignorance here, but how are these people making a million a year? How can you ethically and conscientiously do 30 procedures a day?
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Make more $$ from single asc facility fee, mac/sedation or utox than the doctor’s professional fee for doing injections.
 
nvrsumr said:
Make more $$ from single asc facility fee, mac/sedation or utox than the doctor’s professional fee for doing injections.
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Someone told me standard of care for tpi and joint injections is sedation
 
he is done....stick a fork in him
 
hyperalgesia said:
Aaaaand the door closes... I would also want to flee to Pakistan, rather than spend life in prison here. How much money do you think he has stashed away?
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Did the ACGME fail Dr. Malik, Dr. Sherlekar, Dr. Grewal, et al by not having them demonstrate various ethical competencies in arranging business relationships and keeping accurate records during their training?

Did St. George University fail Dr. Malik? Baylor? Harvard? Could someone along the way help him learn right from wrong?

"I sent a united health care patient and PK told me that she did not do any anesthesia today as Malik was not there. This was a substantial loss of revenue to us today. The discogram itself would have generated more than enough on the sedation side. We need to create anesthesia records for it. I revised the report too. Can someone gently look into this please[.]"

https://www.gpo.gov/fdsys/pkg/USCOURTS-mdd-1_16-cr-00324/pdf/USCOURTS-mdd-1_16-cr-00324-2.pdf

If someone comes up to you and says, "Hey, doctor, I've got an idea to make a lot money. Give us all your urine tox and we'll bill whatever we can and kick you back x%, and then, let's set up an anesthesia business and charge for services that aren't medically necessary..." You should punch them in the face...

More interestingly, if *YOU* arranged unsound business relationships and falsified medical records, would your spouse defend you??

Malik’s wife, Megan Malik, asked [Judge] Bredar to consider alternatives to prison, such as home detention and community service, that could allow Malik to be with his family and contribute to society. Malik has a history of both donating to charity as well as traveling to Iraq and Pakistan to practice medicine, she said.

“Atif is selfless,” she said. “I’ve known his generosity to be bottomless. ... Why waste his brilliant mind in prison?”

Frederick pain management clinic at center of criminal case files for bankruptcy

...I think my wife would tell the judge to let me rot...

“The bottom line is this case is about dishonesty,” [Judge] Bredar said. “Dr. Malik, through his conduct, revealed himself to be dishonest.”
 
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drusso said:
Did the ACGME fail Dr. Malik, Dr. Sherlekar, Dr. Grewal, et al by not having them demonstrate various ethical competencies in arranging business relationships and keeping accurate records during their training?

Did St. George University fail Dr. Malik? Baylor? Harvard? Could someone along the way help him learn right from wrong?

"I sent a united health care patient and PK told me that she did not do any anesthesia today as Malik was not there. This was a substantial loss of revenue to us today. The discogram itself would have generated more than enough on the sedation side. We need to create anesthesia records for it. I revised the report too. Can someone gently look into this please[.]"

https://www.gpo.gov/fdsys/pkg/USCOURTS-mdd-1_16-cr-00324/pdf/USCOURTS-mdd-1_16-cr-00324-2.pdf

If someone comes up to you and says, "Hey, doctor, I've got an idea to make a lot money. Give us all your urine tox and we'll bill whatever we can and kick you back x%, and then, let's set up an anesthesia business and charge for services that aren't medically necessary..." You should punch them in the face...

More interestingly, if *YOU* arranged unsound business relationships and falsified medical records, would your spouse defend you??

Malik’s wife, Megan Malik, asked [Judge] Bredar to consider alternatives to prison, such as home detention and community service, that could allow Malik to be with his family and contribute to society. Malik has a history of both donating to charity as well as traveling to Iraq and Pakistan to practice medicine, she said.

“Atif is selfless,” she said. “I’ve known his generosity to be bottomless. ... Why waste his brilliant mind in prison?”

Frederick pain management clinic at center of criminal case files for bankruptcy

...I think my wife would tell the judge to let me rot...

“The bottom line is this case is about dishonesty,” [Judge] Bredar said. “Dr. Malik, through his conduct, revealed himself to be dishonest.”
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Jesus, what a mess...

He may have a code of ethics centered around his family, where everyone else is the "mark", from St. George to Harvard to his patients. His wife may have the same code, like Bonnie and Clyde. I think some of the responsibility is with the parents, the culture, the early schools. By the time you get to med school, I'm not sure people change that much.

Medicare also to blame for spending our tax dollars to pay this guy to do unnecessary stuff. WE paid him to do this. They got him in the end but how many are they missing? It's a travesty on many levels.
 
blaming medicare?

im sorry, lack of moral ethics and willingness to follow rules is not a fault of the system.

and if you truly believe that, then why would you hope and pray for a free market economy, in which there are fewer rules and increasing likelihood of devious actions?
 
Ducttape said:
blaming medicare?

im sorry, lack of moral ethics and willingness to follow rules is not a fault of the system.

and if you truly believe that, then why would you hope and pray for a free market economy, in which there are fewer rules and increasing likelihood of devious actions?
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I think fraud is MUCH less likely to occur in a true free market, where service providers are held directly accountable to consumers.

But TBH, for some people, deferring to the state for protection, guidance, and wisdom is probably a safer choice than the other option.
 
hyperalgesia said:
It's really an addiction. These guys cross ethical lines and rake in cash but it's never enough. Even after they get a warning from various boards and get on the radar, they can't stop. The partner even killed himself. It's a $$/adrenaline/player addiction I guess.
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So true
 
bronchospasm said:
So true
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@hyperalgesia @bronchospasm @Ducttape Do you think that there is a way to identify practitioners who are vulnerable to this kind of behavior and intervene earlier in their career? Why don't fellowships have a formal business ethics component to them? Doctors learn medical ethics, but no one sits down and teaches us business ethics. It's sort of "assumed" that we know how to stay out trouble, conduct our business, plan for taxes, manage professional relationships, etc.

Would it have made a difference if someone sat down with your fellowship program and said, "Look, here are all the ways you can lose your reputation and livelihood by doing stupid $hit. Don't do stupid $hit..."

Alternatively, what if Dr. Malik got his sentence reduced for "good behavior" on the condition that he give talks and presentations to residents and fellows about health fraud, Ponzi schemes, Kick-back's and Stark violations. Would that be effective at "scaring straight" hungry, indebted residents/fellows who think that they can make some quick money by scamming the system?
 
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drusso said:
@hyperalgesia @bronchospasm @Ducttape Do you think that there is a way to identify practitioners who are vulnerable to this kind of behavior and intervene earlier in their career? Why don't fellowships have a formal business ethics component to them? Doctors learn medical ethics, but no one sits down and teaches us business ethics. It's sort of "assumed" that we know how to stay out trouble business, taxes, professional relationships, etc.

Would it have made a difference if someone sat down with your fellowship program and said, "Look, here are all the ways you can lose your reputation and livelihood by doing stupid $hit. Don't do stupid $hit..."

Alternatively, what if Dr. Malik got his sentence reduced for "good behavior" on the condition that he give talks and presentations to residents and fellows about health fraud, Ponzi schemes, Kick-back's and Stark violations. Would that be effective at "scaring straight" hungry, indebted residents/fellows who think that they can make some quick money by scamming the system?
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i dont think you need to be taught to not be a crook.
 
SSdoc33 said:
i dont think you need to be taught to not be a crook.
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Bingo.

I would love to make more money than I do now, and I could if I ran one of those BS "wellness clinics" where everyone gets put on testosterone and special diets and what not with monthly followups that are over billed.

But a) I don't want to risk my license/freedom and b) I'm not a bad doctor or person.
 
drusso said:
@hyperalgesia @bronchospasm @Ducttape Do you think that there is a way to identify practitioners who are vulnerable to this kind of behavior and intervene earlier in their career? Why don't fellowships have a formal business ethics component to them? Doctors learn medical ethics, but no one sits down and teaches us business ethics. It's sort of "assumed" that we know how to stay out trouble, conduct our business, plan for taxes, manage professional relationships, etc.

Would it have made a difference if someone sat down with your fellowship program and said, "Look, here are all the ways you can lose your reputation and livelihood by doing stupid $hit. Don't do stupid $hit..."

Alternatively, what if Dr. Malik got his sentence reduced for "good behavior" on the condition that he give talks and presentations to residents and fellows about health fraud, Ponzi schemes, Kick-back's and Stark violations. Would that be effective at "scaring straight" hungry, indebted residents/fellows who think that they can make some quick money by scamming the system?
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It's an interesting point... The concept of civics is not really formally taught in our education system, at least I haven't seen much of it. I guess everyone assumes you learn at home, through trial and error, or that's just "the kind of person you are".

But who is qualified to dictate ethics - the govt? The program director? When does it become fascism?
 
hyperalgesia said:
It's an interesting point... The concept of civics is not really formally taught in our education system, at least I haven't seen much of it. I guess everyone assumes you learn at home, through trial and error, or that's just "the kind of person you are".

But who is qualified to dictate ethics - the govt? The program director? When does it become fascism?
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Maybe I'm old fashioned, but I think Hippocrates did a good job...

"I will keep pure and holy both my life and my art ... I will abstain from all intentional wrong-doing and harm"
 
There is so much graft and criminal activity occurring in pain medicine that I did a poster presentation on the subject at the IARS this year. I agree there should be education about the nuances of the laws that sometimes entrap doctors and business behaviors that may culminate in criminal charges. Doctors are woefully untrained in the business of medicine during medical school and residency.
 
the problem is a societal one where we focus so much on who has the biggest toys.

id guess that there will be those individuals who naturally gravitate towards medicine as a way of making money, instead of the primary focus of taking care of people. theres no way of weeding out these individuals.

in addition, id hazard that medical students will have very little interest in this type of course.
"you going to that ethics course?"
"nah man, stupid and I gotta cram for gross anatomy"
 
drusso said:
@hyperalgesia @bronchospasm @Ducttape Do you think that there is a way to identify practitioners who are vulnerable to this kind of behavior and intervene earlier in their career? Why don't fellowships have a formal business ethics component to them? Doctors learn medical ethics, but no one sits down and teaches us business ethics. It's sort of "assumed" that we know how to stay out trouble, conduct our business, plan for taxes, manage professional relationships, etc.

Would it have made a difference if someone sat down with your fellowship program and said, "Look, here are all the ways you can lose your reputation and livelihood by doing stupid $hit. Don't do stupid $hit..."

Alternatively, what if Dr. Malik got his sentence reduced for "good behavior" on the condition that he give talks and presentations to residents and fellows about health fraud, Ponzi schemes, Kick-back's and Stark violations. Would that be effective at "scaring straight" hungry, indebted residents/fellows who think that they can make some quick money by scamming the system?
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2 biggest scams run in pain medicine are pills for injections and UDS.

If they kill the reimbursement for UDS/ GC/MS and make it difficult to profit from it. I think that this would stop billions being wasted on UDS.

I think that most pain physicians are ethical. Handful of them are greedy. Just like every other speciallty. Majority in the mainstream want to do the right thing.

Ethics should be taught in residency to reinforce what our parents were telling us all along. The key is “ Right from Wrong”. If you can not differentiate. It would be hard to do the right thing.
 
there are medical ethics courses. my med school had one. but it was more hypothetical and exstential. physician assisted suicide, end of life care, different medical scenarios. not really financially focused at all
 
It's not smart to bill for procedures at two different locations on the same day.
Under the same name. Smh

It reminds me of a guy near me that had his own urgent care center. Busy place, doing well, making lots of money. He got caught billing the full amount ("incident-to") on patients seen by PA's when he wasn't in the office that day. At the same time, he was seeing patients on his own, at his other location. It doesn't take Medicare long to realize they're processing a crap-ton of bills by this guy on the same dates that he (or someone working for him) is billing the full amount on PAs he could be supervising physically. If he could prove he was at least physically in the office at the same time, they probably would not have pursued it. He didn't get jail time, but he got dinged for a $300K fine.

When you hand the such an easy slam-dunk case that's impossible for them to lose (billing for procedures you literally didn't do or for procedures you weren't in the building for while submitting proof to them that you were elsewhere) they'd be stupid not to pursue it.
 
bronchospasm said:
2 biggest scams run in pain medicine are pills for injections and UDS.

If they kill the reimbursement for UDS/ GC/MS and make it difficult to profit from it. I think that this would stop billions being wasted on UDS.

I think that most pain physicians are ethical. Handful of them are greedy. Just like every other speciallty. Majority in the mainstream want to do the right thing.

Ethics should be taught in residency to reinforce what our parents were telling us all along. The key is “ Right from Wrong”. If you can not differentiate. It would be hard to do the right thing.
Click to expand...

The point is: If I were wake up one day with a "brilliant" plan to make a lot money...let's just phony up a bunch of lab reqs for u-tox and anesthesia records, submit fake claims, and not pay taxes on the revenue here is a short & incomplete list of the people who I would have to involve in the scam explicitly:

1) My back office RN ("Gee, why are there sedation/anesthesia records for cases that I didn't do?")
2) My billing specialist ("Hmm, these claims don't match up to the service reqs?")
3) My lab director ("Uh, why are there reqs for specimens that don't exist?")
4) My practice manager ("I can't seem to get the numbers work in the practice management software, what's going on?")
5) My business partner ("WTF is the matter with you?")
6) My practice accountant ("What do you mean you're not going to pay your estimated taxes this quarter??")
7) My practice attorney ("Do you want to go to jail?")
8) My wife ("If you go to jail, I'm going to divorce you, sell all your $hit, and re-marry the new hot Dermatologist in town..)

So, in a sense it is not ONLY Dr. Malik who is culpable in the fraud--he's got to have some version of the same list and "collaborators." Maybe I'm just not smart nor charismatic enough to be a successful criminal...
 
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you could be smart and charismatic enough, but you aren't devious enough.

they woke up, and decided that they would be their own billing specialist, lab director, practice manager, practice accountant and practice attorney, all in one.

or they hired people to do their bidding....

(I would like to see you be your own "wife wife". otoh, strike that.)
 
bronchospasm said:
2 biggest scams run in pain medicine are pills for injections and UDS.

If they kill the reimbursement for UDS/ GC/MS and make it difficult to profit from it. I think that this would stop billions being wasted on UDS.

I think that most pain physicians are ethical. Handful of them are greedy. Just like every other speciallty. Majority in the mainstream want to do the right thing.

Ethics should be taught in residency to reinforce what our parents were telling us all along. The key is “ Right from Wrong”. If you can not differentiate. It would be hard to do the right thing.
Click to expand...

I honestly think most pain docs in 2018 are unscrupulous and I think the problem is worse in this specialty than most. Those of us who want to make a living and make a difference in patient’s lives have difficulty competing against the crooks who have deep pockets for marketing, fancy offices, bogus credentials, etc. Furthermore, in the eyes of the law and the insurance companies pain docs are ALL unscrupulous. It wasn’t like this early on in this field. People with $$$ in their eyes flooded the specialty. We made it way way way too easy to get training and have yourself rubber stamped as a pain specialist. Look at sleep medicine and “cosmetic” surgery- similar sh-t storm.


Sent from my iPhone using Tapatalk
 
hyperalgesia said:
These guys seem to follow a pattern. They start with the occasional ethical slip and just can't stop. In the end, they are busted on tax fraud, in addition to the other stuff. Or maybe it's just the tax fraud that make these cases a slam dunk for prosecutors...
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This is totally un-PC and anti-liberal of me, but.... I feel like there's a trend toward foreign-born among medical fraudsters. Often they come from countries where life is very cheap. It's not hard not to imagine that the culture you grow up in might influence how you treat others one day.

I have a little inside information on what happened in this case. Not the fraud per se, but the behavior of one of the docs involved, may he rest in peace. Secondhand information from someone who was a witness, but your eyes would pop out if you heard the stories of what this guy was doing. Truly an impaired doc.
 
powermd said:
This is totally un-PC and anti-liberal of me, but.... I feel like there's a trend toward foreign-born among medical fraudsters. Often they come from countries where life is very cheap. It's not hard not to imagine that the culture you grow up in might influence how you treat others one day.

I have a little inside information on what happened in this case. Not the fraud per se, but the behavior of one of the docs involved, may he rest in peace. Secondhand information from someone who was a witness, but your eyes would pop out if you heard the stories of what this guy was doing. Truly an impaired doc.
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Come to Florida. If you look at the culprits of scumbaggery it's like the United Nations!
 
powermd said:
This is totally un-PC and anti-liberal of me, but.... I feel like there's a trend toward foreign-born among medical fraudsters. Often they come from countries where life is very cheap. It's not hard not to imagine that the culture you grow up in might influence how you treat others one day.

I have a little inside information on what happened in this case. Not the fraud per se, but the behavior of one of the docs involved, may he rest in peace. Secondhand information from someone who was a witness, but your eyes would pop out if you heard the stories of what this guy was doing. Truly an impaired doc.
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Can you elaborate? I was thinking that perhaps if you've gone through US schools, native-trained, and inculcated in Western values and ethics then you might be less vulnerable to committing certain kinds of fraud.
 
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drusso said:
Can you elaborate? I was thinking that perhaps if you've gone through US schools, native-trained, and inculcated in "WASP-ish" Judeo-Christian values and ethics then you might be less vulnerable to committing certain kinds of fraud.
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Tough to elaborate without sounding like a stereotyping jerk.

A quick google search for "doctor accused of medical fraud" turns up quite a few foreign-sounding names. But a number of Americans too.
 
NJPAIN said:
I honestly think most pain docs in 2018 are unscrupulous and I think the problem is worse in this specialty than most. Those of us who want to make a living and make a difference in patient’s lives have difficulty competing against the crooks who have deep pockets for marketing, fancy offices, bogus credentials, etc. Furthermore, in the eyes of the law and the insurance companies pain docs are ALL unscrupulous. It wasn’t like this early on in this field. People with $$$ in their eyes flooded the specialty. We made it way way way too easy to get training and have yourself rubber stamped as a pain specialist. Look at sleep medicine and “cosmetic” surgery- similar sh-t storm.


Sent from my iPhone using Tapatalk
Click to expand...

There are bad apples in every bunch. FWIW as a doc in a different field I don't reflexively associate "unscrupulous" with fellowship-trained pain docs (whereas I can usually tell if my patient is seen at a pill mill). I'm an ER doc and with the variety of souls that wash up on my shores I get to see a wide "variation of practice" between specialists.

Cardiologists who troll for empty real estate in Coronary Land to place another stent in the stable CADer. No evidence it leads to better outcomes but it does incur risk to the patient. I'd guess there's also a trend toward increased lambo and mclaren ownership.

Stroke docs who recommend TPA for tingling as long as the patient also has a pulse.

Orthopods who replace joints on demented geriatrics who they know won't be able to meaningfully participate in rehab.

The list could go on....

If the public momentum against opiates keeps up and more pill mills are closed down, the wheat in your field will be separated from the chaff. It may take some time but it can happen.
 
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