In Part I - \"What is the True Cost of Healthcare Fraud,\" we discussed only one component of this
looming crisis. In Part II, we will examine its impact on one provider.
As you read this letter, dated 01-20-09, ask yourself this question, \"With all of the very serious
instances of healthcare fraud and abuse, why is the Government, in consort with quasi-governmental
entities such as the National Insurance Crime Bureau (\"NICB\"), wasting resources on this?\"
Dear Sir:
I just read your article \"Health Care Fraud: The Costly Deception\" in Dynamic Chiropractic
(1/1/09), and an old wound was exacerbated that I fear will never heal. I am a convicted felon
(expunged one year post conviction). Convicted of one count of capping in 1995 in XXXXXXX,
California in a \"sting\" called \"What's Up Doc\".
This sting was an illegal prosecution because it was selective - only chiropractors were the
medical targets. It was also funded by the National Insurance Crime Bureau (N.I.C.B.). The
goal was to expose white collar worker's compensation fraud.
I am trying to keep this brief. An undercover police officer came into my practice pretending to
be a sales rep for Oak Tree Medical Marketing. He was \"selling\" patients that were injured on
the job. I said I wasn't interested four times (all secretly recorded by him) but he was
persistent and it turns out I was stupid and naive. I said \"OK, I'll try one\". He was sent to my
office by the Chiropractor across the street who treated a lot of worker's comp - whereas I did
not. Dr. XXXXXXXXX had the sense to say he wasn't interested but maybe the chiropractor
across the street (me) was.
Six months later (12/1/1994) ten people burst into my house with guns drawn (pointed at me
while I was holding my daughter) and another ten burst into my office. They took all my files
and computers, records from home and office and found no crime whatsoever. Later I heard
that the detectives would telephone my patients implying I was a criminal and wanted to know
if I offered them money for referrals. The few patients that returned to me stated that they
felt intimidated and scared to continue being treated by me. I still do not understand how the
N.I.C.B. expected to find criminal activity on my part when they themselves created \"the
crime\". I imagine they were trying to justify their actions, and destroying my life and my
family's was O.K. with them. After all the N.I.C.B. spent $3,000,000 on this sting and they had
to justify their behavior. I apologize for the venom that seeps into my narrative. My name was
on every T.V. news show and newspaper in Southern California. My four year old daughter
asked my wife: \"are they going to kill my daddy?\"
I'm sure you get the picture. The whole experience was terrible and expensive. My lawyer was
a friend and incompetent. During my trial the jury heard me say \"no\" thirty one times on
concealed tape to the \"medical marketing rep\" who was pushing to send me a second patient.
The first patient , (an undercover cop) pretended to be in great pain. I treated him 4 times
and released him.
The trial went to a hung jury but my attorney and I foolishly allowed a substitute juror to
replace my advocate and convict me of one count (not 2 or more) of capping. Sentence - 20
days work release. The judge's assistant (tearfully) and the bailiff came up to me and
expressed how sorry they were. At sentencing, I was supposed to receive 3 years probation,
but the prosecutor (who acted embarrassed) said that one year was enough. I was given one
year probation and my probation officer said not to bother keeping my appointments.
I was clearly entrapped in a crime that I never would have committed, in an illegal prosecution
(selective prosecution is not legal in California), that was paid for by the insurance industry. I
remain angry, frustrated, and bitter even after going through therapy and 14 years after
\"Operation What's Up Doc\" - 12/1/1994. The wealthy, or anyone for that matter, should not
be able to pay for prosecutions to promote their agenda.
I realize I am not the only little person to suffer at the hands of the rich and powerful in this
country and I am trying to forgive. I would write a book if I thought anyone cared. The irony is

I've been honest to a fault with insurers and patients my whole career. I'm now 62 and am a
very good chiropractor but I know as long as I am working the sore remains open.
As you were a former special agent for the National Insurance Crime Bureau I am interested
on your \"take\" on my experience, and the role the N.I.C.B. played.
Thank you in advance,
Sincerely,
XXXXXXXXXXXXXXXXX, D.C.
P.S. the monies I \"gained\" from this crime of treating that one patient : $345.
About the Author:
Dr. Tom Rhudy is licensed as both an Attorney and Doctor of Chiropractic in the states of Texas and
Missouri. While serving as both an Attorney and Doctor of Chiropractic, he has worked closely with law
enforcement, insurance carriers, administrative agencies, the FBI, US Attorney's Office, the US Postal
Inspector's Office, and healthcare providers in the prevention, investigation, and prosecution of
healthcare fraud.
For the past 20+ years he has devoted most of his efforts toward educating and assisting providers in
the development of healthcare treatment and compliance programs and prevention of healthcare fraud
and abuse, making every effort to improve the quality of care and representation provided to patients.
Now you can get his FREE 10-Step Quick-Start HealthCare Compliance Guide, created to minimize
healthcare fraud and abuse at http://healthcarecompliancerx.blogspot.com/