Fraud hunter Keating came in hard on double-dealing docs

by Dan Rodicks

If the computer-punchers at Social Security can pay $60 million to dead Americans, then a doctor can bill Medicaid for visits with non-existent patients. Non-existent and dead are pretty close, and in this day of bulky bureaucracy and mechanized billing, who's counting?

The broad shouldered Anton Keating did some counting.

Keating is a lawyer who pumps iron when he's not heading the state's Medicaid Fraud Control Unit. Last yet another doctor crossed his desk Keating studied the invoices and aimed his investigators at paper evidence in a over-stuffed state warehouse. This led to the biggest recorded cheat in the two-year history of the fraud unit.

The good doctor, a trusted man of the stethoscope, was found to have over-billed the state. For every $8 visit, he merely tacked on an extra fee for services unrendered.

Keating came in hard. He wanted the doctor to admit half of his earnings were fraudulent. He wnated the doctor to pay the state more than $80,000 in restitution, along with interest - making a neat sum of $112,318 - within 30 days. "And of course," says Keating, in that soft British brogue, "we had to recommend a prison term."

The docotor pleaded guilty. He paid full resitution and received a five-year jail term, which was suspended. He was ordered to word 52 weekends at Crownsville State Hospital. And he's been allowed to continue practicing, with conditions.

A softy perhaps, but a victory no less for Keating, a beefy-armed former Food-A-Rama store dick , and his staff of fraud hunters. In fact, the double-billing doc was just one of 10 physiciams the attorney general's fraud unit successfully prosecuted. Only one got away.

That was the gentleman who had billed the state for 221 visits in one day. (And, testimony showed, he didn't even wash his hands between patients).

"It became a quality-of-care case." Keating says, "I can't argue with the verdict. We couldn't prove an intent to steal largely because, at the time, there were no written regulations as to what was required to constitute [an office] visit."

During Keating's tenure as chief counsel of the fruad unit, the state has recouped nearly $700,000 from 27 doctors, pharmacies and nursing homes. (Annual cost of the fraud unit to the state: $120,000 - not a bad deal). Courts have ordered docs and dentists to serve some 7,500 hours of community service - free of charge, which also is not a bad deal.

"The inmates in the Maryland Pen are going to have great teeth," Keating says.

In August, Dr. Fungpit Boon (formerly known as Sungpit Boliang) was found guilty of having submitted false bills, including a fee for a baby delivery he never performed.

Just Wednesday, Dr. David Spott of Montgomery County was fined $15,000, ordered to pay back $8,000 (for consultations never performed), and perform 450 hours of community service. The day before, the former chief radiological technican at an Eastern Shore hospital was charged with embazzling more than $40,000.

Getting caught is all new to the bad-apple providers of health care who try to fatten their wallets the easy, sleazy way. It is the type of white-collar crime no local prosecutor - most notably, Keating's once and possibly future opponent for Baltimore state's attorney - shows any interest in investigating.

In the 15 years before Keating went to work, only two Maryland physicians had been prosecuted on Mediciad fraud. Now, word's out that docs are just as capable of cheating as the old stereotypes are - the food stamp fence, the welfare mother.

"I'm beginning to develop a new stereotype," says Keating, stretching big arms across the table at Gino's. "He's very, very bright. Very good at what he does. He has very good attorneys andvery good investigators and very good character witnesses." One doctor/defendant, in fact, brought a blind man and a nun to the witness stand in an attempt to shore up his veracity.

The Medicaid abusers tend to have no problem paying their subsciptions to Today's Health either. They are the type of crooks Ronald Reagan referred to the other day in his speech about crime. "The truth is that today's criminals... are making as much money or a great deal more than you or I."

Keating says his targets often earn up to $100,000 a year. They get greedy. "We had a dentist who billed the state for full-mouth X-rays when he didn't have the equipment to do it." Keating says.

Keating resigns from his post today, leaving the job with Ed Barnes, a 25-year Justice Department veteran who worked the McDonnell-Douglas corruption case. There are two Maryland doctors and one dentist under outstanding indictment and, says Keating, a lot of fraud left to investigate.

"The budget of Medicaid and Medicare nationally is $66 billion," he says. "The estimated fraud is 10 percent. That's six-point-six billion dollars."

That's a lot of non-existent patients, too.

Reprinted from ___________ Friday, October 2, 1981.