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Old 11-05-2009, 09:04 PM
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Default Unlicensed Employees Pose as Doctors

Lawsuit alleges Medicare fraud

By Darren Meritz / El Paso Times
Posted: 11/05/2009 12:00:00 AM MST


EL PASO -- A chain of clinics and a kidney specialist defrauded Medicare by having unlicensed employees pose as doctors for dialysis treatments, according to a whistleblower lawsuit that moved closer to trial Wednesday. But lawyers for the clinics said there was no fraud and no patient complained.

Rebecca Gonzalez, a former secretary for an El Paso clinic owned by Fresenius Medical Care of North America, claims the company allowed two unlicensed employees to pose as doctors and administer kidney dialysis treatment for years without the presence of a licensed physician.
Fresenius North America, which operates more than 1,500 dialysis clinics in the United States, owns the Cliffview and Gateway clinics in El Paso.
Gonzalez's lawsuit also accuses Dr. Alfonso Chavez, medical director of the two clinics, and Larry Ramirez, the clinic manager at Cliff view, of devising a fraudulent scheme to bill Medicare for those dialysis treatments.
Gonzalez said Ramirez told her to obtain signatures from Chavez for Medicare claim forms, even though the work actually was performed by the two unlicensed employees. Gonzalez refused, according to her lawsuit.

The lawsuit stated that the two unlicensed employees, Ramiro Devora and Arturo Orozco, wore white lab coats, were addressed as doctors and conducted physical exams on patients. Devora would write prescriptions; Orozco would announce to the nurses that he was "ready to initiate my rounds," the lawsuit stated.

Gonzalez filed the suit in 2006, and the FBI launched an investigation after she provided agents with details about the alleged fraudulent billing practices.

No arrests have been made, FBI officials said. According to the lawsuit, the FBI in 2007 searched the Cliffview cli nic. Gonzalez claims Chavez then retaliated, telling employees he wanted to identify whoever spoke with the FBI and fire her. Gonzalez said she resigned from her job when the situation became hostile.
In court Wednesday, Gonzalez's lawyer, Thomas Stanton, urged U.S. District Court Judge Philip Martinez to award Gonzalez damages and to find the defendants liable for making false claims and engaging in a kickback scheme.
"This is a case grounded in clinical fraud. There is the creation of a medical record that just isn't there," Stanton said.
Defense lawyers said Fresenius Medical Care and Chavez did nothing wrong. James Bennett, a lawyer for Fresenius, said dialysis treatment did not require a physician to be present.
What's more, because the Fresenius clinics are open daily from as early as 4 a.m. to as late as 7 p.m., one doctor could not practically attend to each case himself, Bennett said.
The judge did not make any ruling Wednesday
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Old 11-06-2009, 01:00 AM
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Kinda scary. They run ads for nurses around here all the time.

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Old 11-06-2009, 03:38 AM
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That's downright frightening! I cannot fathom anyone doing that--conducting rounds/performing exams.......I would think the patients themselves could sue as well. It scares me to think about. Maybe we should ask for ID everytime we get something done...is that what it will come down to?
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Old 11-06-2009, 11:10 AM
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God forbid I ever need dialysis, I know of at least one company to avoid.
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