Undercover Agents

Doctors are not the only healthcare providers that are investigated by the FBI.

By Michael L. Smith, JD, RRT

The FBI and other law enforcement agencies routinely use undercover agents to ferret out all sorts of illegal conduct. Doctors and other healthcare providers are regularly visited by phony patients that are actually undercover agents.  Not surprisingly, a large number of the doctors visited by undercover law enforcement officers are pain management physicians.   

In New York, undercover agents repeatedly obtained prescriptions for narcotics from a doctor in exchange for cash.  According to the New York Attorney General, the physician was paid $1.4 million for prescription drugs between 2011 and 2012.  According to the allegations, the doctor charged between $250 and $300 for each office visit where he wrote prescriptions for painkillers.  The doctor and his wife were also charged with failing to pay taxes on the cash they collected from patients for prescriptions.

In May, a California physician was arrested after selling narcotics to an undercover agent.  The physician was out on bail when he was arrested again in August for selling other controlled substances.  At the time of his second arrest, the physician was under a court order to not sell any controlled substances. 

In California, an undercover agent obtained prescriptions for narcotics from a physician claiming she was injured in a car accident.  The undercover agent even brought x-rays showing her back injury, which the doctor reviewed.  The doctor failed to notice that the x-ray was that of a dog and clearly showed the dog's tail.  The name on the x-ray was the dog's name and the name of the animal hospital that took the x-ray.  The doctor was subsequently convicted of a felony and surrendered his medical license.

Doctors are not the only healthcare providers that are investigated by undercover agents.  The FBI uses undercover agents to investigate all types of fraudulent practices in health care.  Numerous individuals have been criminally charged in fraudulent home health schemes and bogus clinics for the treatment of HIV.  The Department of Health and Human Services (HHS) and the Department of Justice (DOJ) are actively investigating health care fraud in Florida, Louisiana, Texas, California, Michigan, New York, and Illinois.  Undercover agents are actively involved in all those areas.

Undercover agents do not limit their activity to health care.  Political corruption is also aggressively investigated by undercover agents.  A judge in Philadelphia recently pleaded guilty in federal court to charges of mail and wire fraud.  The charges were based upon the judge accepting campaign contributions in exchange for influencing a criminal trial.  The defendant in the criminal trial was actually an undercover FBI agent that staged his arrest on a felony weapon charge.  The judge accepted a campaign contribution and then told the donor he would assist the donor with any of his people according to the allegations.  The judge then contacted a second  judge who was set to consider the felony case against the undercover agent.  The second judge reduced the felony charge to a misdemeanor according to the court documents.  Two other judges were also suspended while their conduct in the matter is investigated.

Greed can lead otherwise intelligent people to do amazingly bad things.  Unfortunately, some very intelligent and skilled individuals still lose their judgment and common sense due to greed. 

Michael L. Smith is board certified in health law by The Florida Bar and practices at The Health Law Firm in Altamonte Springs, Fla.  This article is for general information only and is not a substitute for formal legal advice.

This article was originally published in: Advance for Respiratory Care and Sleep Medicine.