A Doctor's Challenge
From One Chiropractor's Perspective Part II
As printed in the December issue, Dr. Anthony Calandro continues to give his side of his story about what happened after the FBI raided his office on suspicion of fraud.
By Dr. Anthony Calandro Why Indicted
On July 24, 2012, a call came in from my attorney at 7:38 p.m. He said, “The government is not accepting our explanations and solutions to the coding. They are targeting you to make an example for others in your profession and will be indicting a staff member, you, and the practice corporation tomorrow. And be ready—it will be in the papers!”
A feeling of fear washed over me, and I then had the realization, “Is this really happening?” Even after my attorney and I had met over and over again? We explained our points of views and gave explanations to the government about our documentation, and showed them that ah services were rendered, even by patient signatures on files. We felt this was a direct targeting because these were common coding errors seen in many offices, and it was not criminal at ah. The federal government was so strong to prove that the use of these general codes repeatedly, while tracking them for a period of four years, was fraudulent and considered a scheme. When your services are being rendered and recorded in your patient’s billing file, be absolutely sure that the description of the codes matches exactly what you are doing and document it. I know some doctors don’t think this is important, but it’s the most important lesson learned in our practice and in my life.
On July 25, the indictment was posted in the paper and it was made public record. Friends, colleagues, and family were texting and calling me all day and wondering what was going on. I am sure they were thinking, “This can’t be the doctor we all know! He’s from a good Catholic family, has so much credibility, and is looked up to by other professionals.” The reality was, though, that it happened.
It felt as if ah that you professionally worked for in your practice for more than 30 years, for you and your family, was challenged in one day, and now you had to face the challenges of the press, friends, and family members with explanations to uphold your credibility. The press, as we know, tries to make things sound horrible, and they did.
Since I knew we were targeted, I was prepared to prove the innocence of my staff members and me. I met with my attorney and informed him upfront that I would refuse any plea bargains that the federal government would offer, unless it was for community service. I told him to take them to trial because we felt this was no scheme at ah, but a set up for me, the practice, and a staff member who did our coding for more than 30 years.
The Trial (Four grueling days)
Many factors came out at the trial that were interesting to know and learn. It was interesting to know, that on my meeting with my attorney, for preparing for trial, it was a long and tedious procedure. My attorney would say, “This is not for the faint of heart,” when referring to taking the federal government to trial. The FBI’s documentation was reviewed, as well as the FBI’s hours of undercover agents’ videos and recordings, which took weeks to complete.
My attorney needed to prove that ah of the services were rendered, and that this represented honest coding errors that occur with computer software systems, as well as additional errors with insurance companies. We did provide the government with examples of errors over the past four years that were uncovered with our own research, and we again proved that this was a targeted effort to stand up for my patients and my profession, specifically by one insurance company and one specific person heading it up.
So we began to get ah of the information together. Just two days after the indictment, the trial was scheduled for November 5, 2012, so we had approximately three months to prepare for the trial. Again, this was very
time consuming, expensive, and grueling. By that time, my attorney’s fees were off the chart with the time involved already, and we had not yet gone to trial !
Two weeks before the trial, during a meeting with my attorney, he started out by saying, “We have some bad news.” The codefendant who had also been indicted (a female employee who was 62 and had worked with me for 30 years) was taking a plea bargain of five years probation to testify against me and the practice. We decided to continue and go to trial anyway with what we had—a good defense, or so we thought.
On Monday, November 5, the trial began by choosing the jury, which took a whole day. I was feeling tense but assured of my credibility and full of self-confidence, as always. The defense we had planned was to prove that all services were performed on our patients, including the undercover FBI agents who had posed as patients. We were to present all of the sign-in sheets from the past four years, providing proof that all patients were there and treated. We also were going to use the FBI’s video and audio as proof as well. As for the misrepresenting of the codes, the undercover agents presented these as described (by the way, we found out the agents used a USPS office address as their address in St. Louis, Missouri).
The second and third days of the trial were, as my attorney stated earlier, “not for the faint of heart.” The federal government tried to bring up facts—that I was a criminal monster, an alcoholic, and had a gambling habit—and destroyed my credibility with the jury. They said that was the reason we put this fraud scheme together. The government brought in a so-called consultant from a different state and from professional college that was different from the one where I had received my degree. When he testified, he said that he looked at my records and the services were not done as described or were not necessary at all.
They then put the three FBI agents on the stand to testify that the coding did not match the services as demonstrated by the videos, but contrary to what they showed, the videos demonstrated that the services were provided and rendered. Then the government tried to prove the coding did not match the actual service descriptions of the AMA coding book. They provided the X-ray codes and showed that many of the X-rays were missing. We explained that we received the X-ray codes from a professional software company when the computer system was originally set up. We always kept the X-rays that were of diagnostic value and discarded the others to be recycled for silver. We even provided actual charts and dates of when the professional recycling company had taken the X-ray barrels for silver recycling.
On the fourth day, my staff member and codefendant testified. Because of her plea agreement of probation, she testified against our practice and me. She knew quite well that a professional software company set up the codes that we used years ago, and we had been using these codes since they were installed. Since she had been my trusted employee for more than 30 years, her testimony had an emotional impact on me. I could not believe it, and as I listened to her, I could only look at her with a blank stare of disbelief.
We continued to the last day of trial and had our CPA testify to confirm all of the income that the government said we had received from the socalled fraud scheme, which had no truth to it at all. The actual tax returns that were presented proved to be in our favor.
I wanted to take the stand—to defend myself and my practice. With the advice of my attorney, I did not testify because we believed that we had a good defense already. Now, after much thought, I believe that my testimony would have proved a stronger defense for our case. At the advice of the government, the hired consultant did not testify, but was present. My attorney was prepared to bring up many things found in our research about this consultant that would have helped our case, but we never did get him to take the stand. Finally, the trial was over, but we still had to wait for the verdict.
Look for part III in our next issue!
