09/13/2013    Michael M. Rosenblatt, DPM

CT Podiatrist Receives 3 Year Sentence and $134K Restitution

Again, we have seen a recent publication of a
podiatrist who will serve prison time due to a
fraud conviction. His life and family are
devastated. Healthcare auditors and prosecutors
now regard podiatrists as one of their most
accessible and easy sources for personal career
advancement. All they have to do is generate
computer printouts on repetitive Medicare claims
for ingrown nail surgeries, especially in nursing
homes. They concentrate on those who have the
greatest numbers.

Then, they ask for your chart notes. Sometimes
they just go right to the NHs and start
interviewing patients. Incredibly, their patient
interviews serve as an excellent source of
testimony. This is surprising considering the
fact that many patients in NHs are not good
communicators. But it works. They also look at
the time you spent there and rapidly determine
that you don't have time to do 30 of these in 3
hours.

Incredibly, many NH podiatrists think they go
unnoticed in the enormous influx of Medicare
claims. Not so. You are obvious and they are
looking for you now. I am soon publishing an
article in Podiatry Management on documentation
of nail surgeries with your own smart-phone
camera. Most of you have smart phones and they
have quite reliable cameras. But before you can
bill for nail excision surgeries, you must do
three things:

1. Administer a local anesthetic by injection
2. Remove a section of nail that includes
eponychium
3. Prove that you did steps 1 and 2

These convictions have allowed investigators and
their associated prosecutors to climb to better
paid administrative and executive positions. For
them, this is simply a business. If you think you
are getting away with it, think again. Quit now
while you still have a chance.

Michael M. Rosenblatt, DPM, San Jose, CA,
Rosey1@prodigy.net

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