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March 28, 2024 66 mins

Robert and Kaveh continue with another wacky fake doctor story that snowballs into a vast conspiracy by health insurance companies to make everyone else's life much worse.

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Speaker 1 (00:01):
Also media.

Speaker 2 (00:06):
Yeah, so I mean, I don't know.

Speaker 1 (00:08):
I just I don't think it's technically murder like if
nobody saw right, that's at least you know, That's always
been my stance on that.

Speaker 2 (00:17):
Yeah, are we recording?

Speaker 1 (00:18):
Oh shit, welcome back to Behind the Pastards a podcast
where no one involved with making this episode killed anybody
in a bar fight in twenty fourteen. Didn't happened. You know,
nobody saw anything right, So we're good.

Speaker 2 (00:35):
No one can prove Sophia is there.

Speaker 1 (00:38):
Yeah, nobody can prove Sophia about it.

Speaker 2 (00:40):
I would lie for you in court, Robert.

Speaker 1 (00:42):
I know you, and I would throw you under the
bus Sophie speaking, you know who throws all of us
under the bus on a regular basis. Insurance our health
insurance companies.

Speaker 2 (00:55):
Yes, for sure, let me have min Inhaler, you coward. Yeah,
Sophie and I are.

Speaker 1 (01:01):
We're ETNA, right, Sophie, Yeah, yeah, fuck these people, we're
both having our Our health insurance did a thing that
I'm sure a lot of people have experienced where one
year suddenly it works completely differently and you have to
pay for stuff you never had to pay for, even
though everyone on the phone says nothing has changed and
your insurance is still the same as it is.

Speaker 2 (01:22):
This isn't a con. We're not being robbed. Yeah, you
mean to contact the original prescribing doctor. He died in
twenty fifteen.

Speaker 1 (01:32):
Love it all, Love all of this stuff. Love that
what they're doing is legal. But like somebody who steals
a fucking I don't know, detergent from a CBS should
be shot. It's cool stuff. So we talked in episode
one two different doctor scal like fake doctor scams, right,

(01:52):
both of which involved the use of NPI numbers people
basically in one case fake outright faking and case a
woman who was not a doctor stealing her husband who
was a doctor's NPI for the purpose of doing fraudulent
medical stuff.

Speaker 2 (02:07):
Right.

Speaker 1 (02:08):
As I told you, when I started looking at what
I thought were kind of disparate cases, I kind of
uncovered through my research a through line between them and
I should to be specific, I uncovered other reporting that
revealed the through line. Right. I did not do this
on my own air. A lot of this comes down
to Pro Publica, who's going to be really the source
for most of what we're talking about today. But I'm

(02:29):
going to start with the story of doctor David Williams.
As best as I can tell, he was born in
Idaho around nineteen sixty three. So we're off to a
bad start already, folks. His early life was promising so
far as I can tell. He got a bachelor's and
then a master's degree in physical education from Boise State,

(02:50):
and then he moved to Texas A and M, where
he received his PhD in kinesesiology. Now, as a Texan,
when I hear somebody went to Texas A and M
to get a PhD, and being a gym teacher, I
do think this guy's probably a monster.

Speaker 2 (03:08):
I really wanted to children. Yeah.

Speaker 1 (03:10):
Yeah, So again, this is a fake doctor. He has
an actual doctor in that he's a PhD. But this
is not a medical degree. You are not a physician
because you have a PhD in kinestesiology, right. Kinnesesiology is
an actual discipline. It's the study of movement performance and function,
and it involves a lot of real science. Having an

(03:32):
understanding of kinnesstesiology involves everything from molecular biology to anatomy,
and of course the study of how exercise affects the body.
What kinistesiology is not is a medical discipline, and this
is going to be very important soon. When he was
at Boise State, Dave, doctor Dave, He's going to have
everybody call him. Had been a wrestler, and a pretty
good one at that. He was an All American and

(03:54):
academic and All American wrestler or whatever. I don't understand
the wrestling things he was. He was a good wrestler.
He claims to have held a state record in powerlifting.
I can't actually verify this, but the stuff about being
a pretty good wrestler seems to be verified, So why not.
Once he graduated in Texas, he got a job working
as a community college professor in Arlington, and again another

(04:15):
black mark against him. I don't know if you people
have ever been to Arlington, but stay away. I nearly
went to college there. I showed up on campus one day.
I did that commute from Dallas one day and was like,
I'm not doing college in Arlington.

Speaker 2 (04:27):
Fuck this shit, Arlington, Glenston. Even throwing a lot of
this is like a deep Texas couple of episodes that
we've been doing.

Speaker 1 (04:36):
As a twenty some year resident of Texas, there's one
place in that state. I'll go to bat four and
it's Marfa, so never heard of it. Oh, it's great town.
Once he graduates in Texas, he got a job working
as a community college professor in Iarlton right, and the
a Pro Publica investigation into him describes this job as
well paying, which you don't hear often in reference to

(04:56):
community college gigs. I don't know what exactly he's doing there,
but I believe he gets up to a con and
that may be why he was making a lot of
money as a community college professor. We don't really have
any details about this, but his wife, Amy Lankford, who
married him about the time that he starts this job,

(05:19):
later told Pro Publica that after they've been together a
few years, he got fired suddenly and she never found
out why. Republica just notes that he was fired for
reasons hidden by a confidential settlement and by Williams himself,
who refused to reveal them even to his wife. So
my guess is some sort of scam with like admissions
money or something faking students.

Speaker 2 (05:41):
I don't know he does tell your wife's I mean,
that's a hard one to you.

Speaker 1 (05:48):
You might take that that might be folks, that might
be a read a warning sign. If you get married
to somebody and they get fired and there's some sort
of weird legal case and they refuse to ever tell you,
probably that.

Speaker 2 (05:58):
Probably a problem there. If she's been honest. Yeah, that's
that's not right. That's probably a problem. Yeah.

Speaker 1 (06:04):
So whatever got him canned from this first gig was
very likely fraud, because his next pivot was to start
begging friends and family to invest money into a new
business venture. Once they donated, he would pressure them to
get their friends to invest in what he described as
a sure thing. And the gist of this business was
that he had bought an old Win Dixie grocery store

(06:24):
and he was going to turn it into a health
club called Docs gymab.

Speaker 2 (06:28):
He didn't grow up in the South.

Speaker 1 (06:29):
Win Dixie is, like i'd call it, like a second
or third tier grocery chain. It's better than Pigley Wiggley,
but it's not as good as agb Right, fred Meyer.

Speaker 2 (06:39):
You're just fucking making up names now, yeah, fred Meyer.

Speaker 1 (06:43):
Yeah, it's broadly, it's a little it's it's not quite
as nice as a fred Meyer. Oh my god, yeah,
it's not as nice as a fred Wi.

Speaker 2 (06:50):
I would say, no idea it's a California I'm familiar with,
like three and one of an alpha beta baby.

Speaker 1 (06:58):
Four I'd meet every now and then, like a couple
of times in my life, other people who shopped at
Pigley Wiggley's when they were kids, and like, it's like
what I imagine it was like in like the fifties
and sixties, running into someone else who'd fought at Bestone
where you're like, oh, yeah, we share a special secret
trauma together.

Speaker 2 (07:18):
What a reference.

Speaker 1 (07:22):
I am working on a reboot of Band of Brothers
that's just about shopping at a Pigley Wiggly in rural Oklahoma,
So check out for that one. Spielberg's attached to direct.
We're very excited, ye, So whatever is going on with this?
Because I think there's some I'm sure there's some sort
of scam here beyond just that this is a bad

(07:43):
idea for a business because a lot of you know,
like kind of midway through the deal, after he's taken
a bunch of people's money, the deal he had set
up to buy this, when Dixie collapses and everyone who
had invested lost everything, right, a local newspaper published an
article on the whole titled what's up with Docs, because
that was going to be the name of the gym,

(08:04):
because he called himself Doc.

Speaker 2 (08:06):
I see where they're going with that.

Speaker 1 (08:07):
Yeah, yeah, yeah, yeah, you can put together those pieces.
I've seen it referenced, but I have not found the article,
so I didn't come across more information there. But the
fact that he has just taken a bunch of investments
from their close friends and family and then made all
that money go away put some strain on the marriage,
as you might imagine, and by two thousand and six,
after fourteen years together and two children, they started divorce proceedings.

(08:32):
Amy's father, Jim Pratt, was a finance MBA, and she
had him over to help her with the complex, nightmarish
process of divorcing. She asked him to help her recover
a file on her computer which was acting up, and
while they were doing that, he came across a shady
file folder named invoices from a pro publica investigation quote.

(08:53):
Pratt found about a dozen bills that appeared to be
from a Fort Worth nonprofit organization where his daughter and
Williams took their son Jake for all treatment. As Pratt suspected,
the invoices turned out to be fake. Williams had pretended
to take Jake for therapy, then created the false bills
so he could pocket a cash reimbursement from the county agency.
So wow, Yeah, that's.

Speaker 2 (09:16):
I knew autism would find its way into one of
these shares eventual course, because again it's one of those
gray zones where all like, when people are unclear about
what's going on, these grifters come in and fucking find
a way to make money off of it.

Speaker 1 (09:31):
This is about when I'm teaching special ed and dealing
with a lot of like how the healthcare system and
whatnot was treating autism at that point in time, and
it is like especially compared to now significantly more primitive
period of time. So it makes sense to me that
he would think, like, well, I can like fake some
invoices for this and probably won't run into anybody who

(09:51):
knows enough about what should be going on that they'll
catch this, right, But they do right. In November two
thousand and eight, Williams pleads guilty and tearing County to
felony theft. He's sentenced to eighteen months in jail, and
he is released on bail as he appeals.

Speaker 2 (10:07):
He does wind up.

Speaker 1 (10:07):
Doing some time something like a year, I think, and
life goes on, right. Amy eventually allows him to take
partial custody of their children because his crime, while fucked up,
had not involved the abuse of a child, just the
abuse of the system itself. It is kind of on
the edge of abuse of a child and spoiler, that's
where this is heading. But she doesn't really have grounds

(10:28):
to separate him from his kids at this stage, right,
So he moves on to working as a personal trainer.
He had been doing that for some That was part
of why their marriage broke up. He'd been working as
a personal trainer for a bit during that period, and
he wasn't really able to bring in much money, and
you know, so he starts doing that again. He continues

(10:48):
trying to make a living that way, and he has
a friend cod him a website, get Fit with Steve.
This friend, Steve Causio, receives free physical training sessions in
exchange for his work, and for a while things seem good.
This changes a year or so later, as he and
Amy's eleven year old son comes to school covered in
facial bruises. His teachers obviously reported this, and an investigation

(11:11):
revealed that Williams had hit their son in the face
quote about twenty times. So that's real bad. Williams pleads
guilty to a felony and he goes back to jail
for two years, right.

Speaker 2 (11:24):
Just just like did he I mean you probably know
the details of this, just fucking hitting his kid. He
hits his kid.

Speaker 1 (11:31):
Yeah, sounds like I'm guessing the kid, you know, I
think he's like not he's not neurotypical, So I'm guessing
the kid was engaged in some sort of behavior that
the doc did not know how to like, either just
didn't like or didn't know how to deal with, and
he just decided to punch.

Speaker 2 (11:48):
The kid a bunch fucking dance whole. Yeah. It's horrible.

Speaker 1 (11:51):
Yeah, I mean he's he's the villain of the He's
one of the villains of the episode.

Speaker 2 (11:55):
Yeah, you know what, I'm not one of these doctors
that says like other people are in DOC like PhDs, etcetera.
On doctor. But like when a guy like this like
tries to use doctor like it's.

Speaker 1 (12:07):
I mean, I was saying, having the experiences I had
in a grade school, I'm not surprised that a guy
who's got a PhD in being a gym teachers, like
his default reaction is just to hit a kid when
they have a medical issue. Yeah, that absolutely scams. Texas
gym teacher uses punches to treat some sort of neurological situation. Yeah,

(12:32):
of course that's scance. This kid is different, I'm gonna
punch him. So at this point Doc has crossed the
line from con artist and scammer, which is a mixed
bag from a moral standpoint, but not inherently evil. Plenty
of lovable con artists out there to outright monster shit.

Speaker 2 (12:49):
Right.

Speaker 1 (12:50):
Amy spends the next like two years while he's in jail,
focusing on her kids, trying to move on in life,
trying to help them heal from what the fuck this
guy has done to them, while William spends his time
hind bars perfecting his next con. So he still has
a friend on the outside, and it's Steve Cossio, the
guy who had codd his website. Williams convinced him that
the whole hitting his son in the face twenty times

(13:12):
thing was overblown. He claimed he'd just been disciplining the
boy normally, and he wrote in one email, I can
honestly say that I am the only one in here
for spanking their child in the face. In the face.
Do you spank a child in the face?

Speaker 2 (13:26):
Number one? I'm not a big fan of spanking, but
do you spank the face? Is that why you spank?
Is the face? What a fucking asshole? Uh?

Speaker 1 (13:34):
His father in law, he wrote, was an evil, evil
man who'd engineered the charges against him in some nefarious manner.
Now I'm not sure if Casio himself is a huge
piece of shit or just very gullible. My gut says,
probably a little bit of column A, a little bit
of column B. Probably more gollible than piece of shit,
but probably not none piece of shit. So Williams and

(13:55):
Casio work out a plan for him to make a
bunch of cash quick when he gets out of jail,
because he's calculated. William is calculated, I need thirty thousand
dollars asap to get an attorney that can get me
access to my kids again, right, which.

Speaker 2 (14:08):
So he can the last that gets the last? They
want this? Yeah, what does he want? I mean? This
is this is this kind of guy. Right?

Speaker 1 (14:16):
They think they have a right to their children, they
possess them, they have a right to discipline them or whatever.
Maybe it's just as simple as he hates his ex
wife and he wants to take them away from her.
I don't know a couple of things. It could be
none of them good. So there's no honest way for
a kinnesesiology PhD to make thirty thousand dollars overnight, right,
It's just not that kind of gig. But a medical

(14:37):
practitioner taking advantage of the hysterically fucked up state of
our healthcare industry absolutely can bill insurers for that kind
of money in a very short period of time if
they are diagnosing and treating a handful of patients. Thirty
thousand dollars is not a lot of money in the
world of billing health insurance, right, one person can rack
that up in a night or two. A thos easy,

(14:58):
you know. So while he's in inside, they sketch out
a plan. When he gets out, he's going to go
back to doing personal training, but he wouldn't work as
a personal trainer. Instead, he'd recruit other trainers and have
them train people, and he'd remove personal training from his website. Instead,
he would use his legitimate status as a PhD to

(15:18):
build himself as a doctor, and then he would diagnose
patients and prescribe them physical training and build their insurance
both for the diagnosis and for the PT sessions.

Speaker 2 (15:31):
Right now, our system is so stupid. Fucking system is
so stupid.

Speaker 1 (15:37):
Yeah, our system is stupid. This is also a crime, right,
Like he's taking advantage of the system, but it's not
You're not supposed to be able to do this, right, Yeah,
Obviously there's a gray area in that sometimes, Like I said,
like I've had a back injury and I got some
physical therapy for it, right, Like, there's a great but
like your average physical personal trainer, and that's a valid,

(15:57):
you know, profession.

Speaker 2 (15:58):
There's a lot of skill that goes into that.

Speaker 1 (16:00):
But it's not a medical profession, right. It can it
can help prevent certain medical problems, sure potentially, but like
you're not but you see, they're not treating.

Speaker 2 (16:11):
You're not treating medical conditions. Yea, with with therapy, you're yeah,
you're treating injury with therapy and you're strengthening. But there's
a real thin line between that and saying we're going
to use this physical therapy to treat your you know blank,
whatever medical issue, your diabetes or something.

Speaker 1 (16:32):
Yeah, and I think what he's reliant upon is that
both to the people who are going to make use
of his services and to like the people who might
casually scan this stuff the insurance company. You know, well,
some people get prescribed like a physical therapist, he says,
These guys are doing physical therapy. Maybe this is like fine, right,
and it's there's so much stuff going on, maybe nobody

(16:52):
will like notice anything, right, Yeah, they.

Speaker 2 (16:55):
Really count on that. They really count on the fact
that this system is so byzantine and like complicated that
like people will just sign off on things and like
and maybe it's working. But it seems like in a
lot of these cases you're telling me, it just they
always get caught. Is it's like people think they're gonna
get away with it because it's so complicated, but eventually
someone's money is missing and they get mad about it.

Speaker 1 (17:17):
The problem is that it all it does work for
a while, and you can make a lot of money
off of it. One of the issues these guys have
because of the kinds of people who are bold enough
to try this in the first place. They're the kinds
of people who get over confident, right, And also, you know,
one thing to always know, when we talk about these
guys who get caught for every one of them, who

(17:37):
knows how many people there are who are smarter, right right,
who stay below the line, you know. So, But that's
his plan, right, clients are going to get free physical
training sessions and he will get to build the work
of his trainers is actual medical therapy. Right now, I
know what a lot of people are saying, well, how

(17:59):
is this guy?

Speaker 2 (17:59):
Is this?

Speaker 1 (18:00):
I mean, he's a bastard because he had his kid,
But like this doesn't sound that bad, right, No one
really cares if you just scam insurance and if clients
are able to get free workout sessions, you know, maybe
that's overall good. We're going to build to the explanation
of why that's not. But I want to assure you
all what I have said, it is not fine. He
is hurting people. He is in fact hurting you if

(18:21):
you are a member of any of these like this
is not a victimless crime, right, and it's not a
crime where the only victim is some like faceless insurance company.
He is actually hurting a lot of people by doing this,
and we're going to explain why. I just want to
state that so you're not asking the whole time, why
do we care about people getting free physical personal training? Right? So,
Doc Williams has Cozio removed the phrase personal training from

(18:43):
his website and he starts claim. He claims to his
friend in one of their jail emails, I don't know
why he's allowed to do this from I mean, I
don't know whatever he says in one of their emails.
Ninety five percent of my clients are paid for by insurance,
which does not cover personal training. I have to build
as therapeutic exercise. Steve's contention Cossio, the guy who's his webmasters, like, well,

(19:06):
I didn't know any of this was illegal, and I
don't trust him because of things like that, because that's
a guy saying I'm committing a crime, right, yeah, right,
But you know, I must note that the legality of
anything that involves health insurance is convoluted enough that a
lot of stuff that seems like it should be a
crime is legal, like Sophie and I are dealing with
right now. So I could also get how a guy

(19:27):
like Casio could just not really understand what's happening.

Speaker 2 (19:30):
It's so complicated, it seems like it's a wild West.
It seems like anything can go I get it. I
get how like people would try to get away with this? Yeah.

Speaker 1 (19:39):
On his website, this is how Doc Williams described his
services to interest In clientele. During your initial consultation, Doctor
Williams will perform a fitness appraisal to determine your current
fitness level. This exam will help determine physiological strength and deficits.
Doctor Williams will then work with you to set up
an exercise program that will help you meet your goals
and take you through the exercise program to make sure

(20:00):
that you know how to do the exercises and are
performing them safely. Many of doctor Dave's services are covered
by medical insurance policies. In choir with Doctor Dave to
see if you qualify Doctor Dave.

Speaker 2 (20:12):
Whenever the doctor goes by his first name, it's from
the guy who goes by doctor Coff. Sometimes it's a
it's a red flag. No.

Speaker 1 (20:20):
The only doctor that I will take advice from is
doctor Bones. You know from which from the show from
the show from Star Trek. Yes, Oh, I thought you
meant Bones, the TV show. I don't know, I don't know. No, No,
not knows much about generation sicknesses. No, that's that's Crusher
and Pulaski in season two both find doctors Starfleet's best.

(20:43):
Really one of them a hologram. Well, that's that's a Voyager, Yeah, Voyager. Sorry, yeah,
I mean he shows up other places too. Speaking of
Star Trek, Voyager, you know what else is? You know? Yeah?
You during the earlyats, I don't know, here's ads, We're back,

(21:12):
did you watch a lot of Voyager Taba?

Speaker 2 (21:14):
I watched a little of the Next Generation, and that
was the only Star Trek I ever watched. I recognized
inherently the difference in how Star Trek is probably intrinsically
a better product than Star Wars. But I am so
simple minded that I could only handle one fandom at

(21:34):
a time. So I was a Star Wars guy, and
I could only do the Next Generation, which I loved,
by the way, that was fantastic. I think, you know, John, Look,
McCarter is one of the best characters you know on
film or TV. I love the guy, but yeah, I
can't get into the other stuff, Like there was one
with a black hole and yeah, I mean that was

(21:55):
and there was a one where they went to San Francisco,
I saw that one.

Speaker 1 (21:58):
And there was the one where they go back in time,
the one with a whale. Ah, that was one of
the Yeah, go into San Francisco. Yeah, they go. Well,
there's one where they go back in time to save
the whales. There's one in DS nine where they wind
up and it's like twenty twenty four riots and stuff.
And then there's one where they go back in time
to the eighteen hundreds and Mark Twain is a major character.

Speaker 2 (22:20):
That one's a lot of fun. Yeah, yeah, yeah, yeah,
I could see them in the hall room or whatever. Yeah,
they're danger room whatever they called it.

Speaker 1 (22:28):
Oh, no, they're in actual San Francisco in the eighteen
eighties or whatever. No, they they meet real Mark Twain
and he travels into the future and gets to go
to space.

Speaker 2 (22:37):
Fucking actors love playing Mark Twain. They just love playing
Mark Twain. Oh.

Speaker 1 (22:41):
The actor in those episodes playing Twain is just absolutely
chewing the scenery.

Speaker 2 (22:46):
He's having a great fucking tea. They love it.

Speaker 1 (22:48):
Yeah, so we're back now. You can see how a
lot of decent people could fall for this.

Speaker 2 (22:55):
Right.

Speaker 1 (22:55):
It's great to be able to have a physical trainer,
but expensive. You know, some guys like, Hey, your insurance
will pay for it?

Speaker 2 (23:02):
Why not?

Speaker 1 (23:03):
And you can even see how it would make sense
to somebody, right, Obviously it's good to work out that
can prevent certain health problems. Maybe my insurance is cool
with this because they understand it's cheaper for them in
the long run. Right, you can see how a smart
person could talk themselves into thinking this is legit.

Speaker 2 (23:20):
Right.

Speaker 1 (23:21):
The only thing Williams was missing then to like make
this plan a reality is the one thing that he
jumped to getting as soon as he got out of jail,
a national provider. Identify your number, right, And now it's
time to talk about how you can scam an NPI number, right,
because what Malachi and episode one and now what doctor
Williams did is actually really fucking easy. NPIs are handed

(23:45):
out by the federal government through Medicare. Both individual doctors
and organizations like clinics have NPIs so they can build
Medicare or a health insurer. And now I'm going to
turn you back over that pro publica investigation and re quote.
One would thinking an NPI, with its stamp of legitimacy
would entail at least some basic vetting. But Williams discovered

(24:05):
and exploited an astonishing loophole. Medicare doesn't check NPI applications
for accuracy, a process that should take mere minutes or
if automated, a millisecond, instead, as one federal prosecutor later
noted in court, Medicare relies on the honesty of applicants.
Records show Williams first applied for an NPI under his

(24:26):
own name as far back as two thousand and eight,
but it wasn't until twenty fourteen that Williams began to
ramp up his scheme. Even though now he wasn't just unlicensed,
he was a two time felon. He got a second
NPI under the company name Kinistesiology Specialists. The following year,
he picked up another under Mansfield Therapy Associates. In twenty sixteen,

(24:47):
he obtained at least to Leffen Moore, often for entities
he created in the areas where he found fitness clients Dallas, Nevada,
North Texas, and Moore. By twenty seventeen, he had twenty NPISA,
allowing him a new stream of billis.

Speaker 2 (25:02):
Oh my god, it's funny. I just googled how to
get an NPI number and it's like you get like
this like National Provider step by step guy, and you
fill out this application. I don't know if it's changed,
but it doesn't seem that hard. By the way, I'm
going to do this.

Speaker 1 (25:21):
Yeah, don't do this, but it's apparently quite easy. So
this is an involved con. That's a lot of paperwork
for a con, but it's not a hard one. In
order to do this, Williams had to set up an
ei in or employ your ID number for each NPI.
Now this is all fraud. But he used his real name,
his real address, the same set of real information for

(25:45):
each application.

Speaker 2 (25:47):
Wow. Yeah, and no one caught that.

Speaker 1 (25:49):
No one's looking Like it's not that like to say
no one caught it would mean that like he snuck
through like a dragnet of some sort, Like there's nothing.

Speaker 2 (25:58):
He just did it. Yeah, and nobody looked.

Speaker 1 (26:02):
So he described himself as a doctor, but listed that
he had a PhD, claiming his specialty was in sports medicine. Now,
the actual fraud that he had to do here is
that he had to provide a fake medical license number. Right, So,
like that is a thing that you think would be
easy to check because you can't fake it easily. I've
never heard of anyone faking a medical license number.

Speaker 2 (26:24):
That's like in the day.

Speaker 1 (26:24):
I'm sure you could, like if you're a hacker, maybe,
but he didn't do that. He just gave them a
fake number and nobody checked. This would not be hard
to catch, right if there's like a database, here are
all the medical license numbers. You check it against it
it's not a real one, you know. I assume there's
probably more to it than that, but they're not even
doing that, right. So Williams began taking on clients and

(26:46):
billing insurers like a son of a bitch, and soon
he was raking in millions of dollars a year. He
bought himself a McMansion in cash, several cars and motorcycles,
and he set to work using some of his new
founder riches trying to bribe his children's love. And that's
where he made his first fatal error. He gave his
kids iPad minis for Christmas twenty thirteen. Now, because the

(27:10):
last time Amy had known anything about her former husband's
finances before he went to jail again, he had been
struggling to make ends meet as a personal trainer, so
she was surprised to see he can suddenly afford several
very expensive electronic toys, right, like a house and a house.
I don't think maybe she doesn't know about the house,
right she's not living with the guy. But she's like, yeah,

(27:30):
maybe that's sketchy. That's her first sign that something's weird.
And her second sign is like, a you know a
lot of parents.

Speaker 2 (27:36):
I don't know.

Speaker 1 (27:36):
This is a debatable thing, but like, she looks at
her son's new iPad and she notices an app on
it called I Message, which is you know, you know
what I messages. I don't have to explain this, and
it's it's got a bunch of new messages in it.
And she's like, well, why would I, like, I don't know,
teenage little teenage kid, I have a bunch of iye
messages on this brand new iPad that seems kind of weird.

(27:57):
So I'm not sure how this happened, but I think
Dad had activated these iPads and had like accidentally connected
them to his shit all messages and it's specifically stored
on this iPad is every communication he had with his
friend Cozio to set up this fraudulent medical business.

Speaker 2 (28:20):
He hands it to his ex wife. Oh my god,
Oh my god, she's the worst and he's so successful
at this point.

Speaker 1 (28:29):
Yeah, it's funny, like it shows you how easy the
npicon is, that like, this is not a dummy told. Yeah,
but he's able to figure this shit out so amy.
You know, she's not a big fan of her ex husband,
what with the beating and stuff. Goes back to her dad, right,
who also knows this guy's scammer, and her dad, having

(28:50):
some kind of forensic accounting experiences, is able to look
through this and it takes them a couple of hours
to unravel the whole plot because it's all there in messages, right,
and including messages from new clients where he is like
going back and forth. She can see him like setting
up to bill fraudulently. Like the whole case is here.
If you hand this to like an FBI agent or whatever,

(29:11):
you're not gonna like ten minutes to throw together a
fucking indictment.

Speaker 2 (29:15):
You know, it would not take a lot of time.

Speaker 1 (29:17):
Right, Oh my god, here's the thing. His fraudulent business
will keep going for like four years after this point. Now,
how's that possible?

Speaker 2 (29:25):
Cave I'm assume, I'm assuming she said, she does she
say something at this point or is she kind of
keeping it under wraps.

Speaker 1 (29:32):
She absolutely does not keep it under wraps. She and
her dad know this guy is dangerous and do not
want him to be doing whatever the fuck con he's doing.
So her dad, once he has again a complete, exceptional,
very clear list of all the crimes this guy, all
the fraud this guy is committing, calls Etna. Right, he

(29:53):
gets him on the phone, He's like, should probably report this,
and he tells EDNA, I want a report a fraud
worth at this point, probably several hundred thousand dollars. And
ETNA says, what's your member number? And he's like, well,
I don't really have a number. I just and they're like, sorry,
only members can report criminal activity.

Speaker 2 (30:10):
Hang on the fucking.

Speaker 1 (30:11):
Phone now, thankfully, Maybe not thankfully because Etna's dog shit.
But his daughter is insured by ETNA. Right, what kind
of rule is that the only members can report that
we're being defrauded? Because it seems insane.

Speaker 2 (30:28):
What do you do with the FBI? Call?

Speaker 1 (30:29):
Sorry, you got to get an agent who's on our
healthcare plan, find someone who's married to somebody with Etna.

Speaker 2 (30:35):
Right, that's the stupidest thing.

Speaker 1 (30:38):
It's so fucking stupid. They're clearly just trying to get
him off the phone. So he gets his daughter because
she's insured by etna's and he has her called to
make the complaint.

Speaker 2 (30:46):
Oh we trust you, yeah, her, we trust she's one
of us.

Speaker 1 (30:51):
They take the info from her at least, and then
nothing happens ever one of theirs again. When all this
blows up because this guy does get arrested, this becomes
a big case and pro publicer reaches out to EDNA.
It's like, why didn't you do anything about this fraud tip?
And they're like, oh, no one ever called us, never happened,
no record of it.

Speaker 2 (31:10):
Liars lying, liars.

Speaker 1 (31:13):
Funny, So Pratt and Amy next he's like, well, I
don't know if Ventna's going anywhere, but he is defrauding
all of the insurance companies. So let's call SIGNA next, right,
And they provide the same information to SIGNA and they're like, hey,
one of your providers has no medical license, is saying
he does. Was in prison twice for different felonies, one
of them.

Speaker 2 (31:33):
Violence, multiple multiple identities.

Speaker 1 (31:38):
The least should be a doctor of anyone who shouldn't
have been a doctor. Who ever pretended to be a doctor. Yes,
So next he reaches out to So he does this,
he makes a report there, nothing's going to happen. And
he also reaches out to Southwest Airlines because Southwest they
self fund their health care benefits and thus they pay
directly for employee care. And Southwest is like, well, we

(31:59):
we paid directly for but we run it through United Healthcare,
which is this massive two hundred twenty six billion dollar company.
They administer our benefits. So talk to them. So he
calls you United Healthcare, and he talks to HR reps
from both Southwest and from United Healthcare. And he first
starts talking to someone from United in the fall of
twenty fourteen, and I'm going to quote again from Pro Publica,

(32:21):
this is what happened. He spoke to a fraud investigator
who took the information with interest, he said, but within
a couple of weeks he was told she moved to
a different position. Pratt continued calling United over the following
two years, making about a dozen calls in total. He said,
he is not a doctor. Pratt's told who ever picked
up the phone, So I don't see how he can
be filing claims. Frustrated, Pratt made one final call to

(32:43):
United in twenty sixteen, but he was told the case
was closed. United said he'd have to call the Texas
Department of Insurance for any additional details. Pratt had already
filed a complaint with the regulator, but reached out again.
The department told him that because he hadn't personally been defrauded,
it wouldn't be able to act on his com point.

Speaker 2 (33:00):
Wow, what a maddening situation. One guy, one family's trying
to do right, trying.

Speaker 1 (33:08):
To really hard to do the right thing.

Speaker 2 (33:10):
And the company is that they're trying to help ostensibly
are wanting no part.

Speaker 1 (33:15):
Of it because at this point, but by the way,
this this guy makes millions, he is defrauding them for
what do a regular Again, it's nothing to these companies.
I just said, United do It a twenty six billion
dollar company. But this isn't pocket change, right, Yeah, but.

Speaker 2 (33:29):
It's so funny like they focus so much about small
amounts of money to them. Yeah, in every other case,
if you're trying.

Speaker 1 (33:38):
To get an inhaler that costs one hundred and fifty
bucks as opposed to one hundred and twenty dollars for example,
They'll fight you to the ends of the earth.

Speaker 2 (33:45):
They will send you to prison if they have to. Yes,
like in this company that this one guy who's making
millions off of them, they don't do anything. But that is maddening. No,
it's not maddening.

Speaker 1 (33:55):
So I bet you're all wondering at this point what
the fuck right because you know it doesn't make sense,
because we expect these companies to be greedy and this
guy's stealing from them, right, Like, why aren't they doing anything?

Speaker 2 (34:08):
Right?

Speaker 1 (34:09):
Well, you're not the only person wondering what the fuck
is going on at this point. The good people at
Pro Publica are wondering that too, and the journalists who
reported on the Williams case, and again we'll conclude his case.
He does eventually get arrested. But the journalists who reported
on this several years ago was a guy named Marshall
Allen Right published in late twenty nineteen, but he carries

(34:30):
out a different investigation kind of inspired by he sees
what's happening with Williams, and he's like, why the fuck
do none of these companies want to do anything.

Speaker 2 (34:39):
To stop this?

Speaker 1 (34:40):
Why is it so easy to commit fraud and let
have an insurance company, let you get away with it.
And the conclusion of this further the second investigation he
publishes is that insurance companies have no interest in stopping
or even being aware of most of the fraud that
happens on their networks.

Speaker 2 (34:57):
Right.

Speaker 1 (34:58):
They do not care and they do not want to
be told about it. This may seem counterintuitive to you. Again,
these are very greedy or famously greedy organizations, and medical
fraud is estimated to make up at least ten percent
of the one point two trillion dollars in health insurance
spending this year. Right, that's not an insignificant amount of money.
Wouldn't they want to stop that?

Speaker 2 (35:19):
Right?

Speaker 1 (35:20):
Well, Marshall reaches out to United as well as part
of this later investigation, and here's what he writes. A
United spokesperson said, I couldn't speak to a fraud investigator
because we do not want to make that information public
that would make it easier for those intent on engaging
in fraud to commit these crimes.

Speaker 2 (35:37):
She said.

Speaker 1 (35:37):
The insurer uses analytics to flag potentially fraudulent billing and
in some cases physically verifies that medical offices exist with
that scant response. I plunged into the daunting thicket of
agencies that are supposed to oversee the fight against health
care fraud, each divided by region and responsibility. I contacted
insurance regulators in every state and interviewed more than fifty

(35:57):
other experts, including prosecutors, sames, analysts, and a dozen former
investigators for the internal fraud units of private insurers. Far
from being fierce guardians of your healthcare dollars, experts told me,
the big name insurers who sell their own plans or
are paid to manage employers, pick and choose their battles,
and for a variety of reasons, fraud is not a
top responsibility.

Speaker 2 (36:18):
You know what's weird is they'll cite fraud as one
of the reasons that, like costs are so high, so like,
you know, to not choose it as something to focus
on is strange.

Speaker 1 (36:31):
You know, it seems strange. It's all gonna make sense,
evil sense. And I do want to shout out again
Marshall Allen, the pro public investigator. The article he wrote
on Doc Williams is very good. The article he writes
on why fraud doesn't get investigated, It's one of the
best pieces of medical journalism i've ever read. It's a
really really good article. Infuriating, but it's very good. Now,

(36:54):
I want to look at the numbers here, kavem right,
because that really helps tell the story of how little
these companies care about fraud. So, California, obviously is the
most populous state in the Union. There are about fourteen
point four million Californians on private insurance, which is something
like ten percent of the nation's total. So Mitchell asked

(37:14):
a simple question, calling DA's offices in the counties that
cut all of the Basicsly, he calls every DA's office
in California for the counties that cover about eighty percent
of the state's population, which is a representative sample, we
can say, right, and he asks eats of these das,
how often did fraud cases referred by commercial insurers lead

(37:34):
to criminal charges in twenty seventeen and eighteen.

Speaker 2 (37:38):
You have a guess because of this, I'm gonna say, like,
I don't know, twenty percent.

Speaker 1 (37:45):
The number is twenty two, twenty two total times.

Speaker 2 (37:50):
I won't say that because I knew where we were
heading with this. Yeah, I wouldn't before this thought much higher.

Speaker 1 (37:55):
Yeah. Now, obviously something is fucked up here right. Last episode,
we discussed a story of nightmarish medicaid fraud. About thirteen
million Californians are on Medicaid. During the same period of
time twenty seventeen to twenty eighteen, the state fraud unit
filed criminal charges against three hundred and twenty one people
for defrauding Medicaid and recovered nearly one hundred million dollars.

(38:16):
So three hundred and twenty one people are charged for
medical fraud through Medicaid. About the same number of people
are under private insurance, and the number of people charged
is twenty two.

Speaker 2 (38:26):
Wow.

Speaker 1 (38:26):
That gives you an idea of how not on the
ball the private insurance companies are right. There is no
reason to believe medicaid fraud is less common than corporate
insurance fraud or more common either. They seem to be
probably pretty similar levels. Mitchell looks at other states and
he finds similar discrepancies. In Minnesota, private insurers preferred two

(38:47):
cases of fraud de regulators in twenty seventeen and five
and twenty eighteen. Meanwhile, state medicaid fraud investigators carried out
six hundred investigations and got one hundred and thirty four
indictments in Georgia. Only three of the top ten insurers
reported any fraud at all in twenty seventeen and twenty eighteen.

Speaker 2 (39:06):
Yeah, they're better there, They're so good.

Speaker 1 (39:09):
Everyone's very honest in charging good. It's all the peaches.
So what the fuck is going on? Well, investigations cost money,
and soda is pursuing court cases. From the insurance company's perspective,
that's all wasted money because the money that they're being
defrauded for, they're not actually out because they could just

(39:31):
increase your rates and copays to make more money. So
that makes more sense than investigating and stopping fraud. Will
just charge our customers more. They have to pay. They
don't have a choice. This isn't something where they can
shop around. We'll just fuck them more and then we
don't have to worry about stopping fraud.

Speaker 2 (39:52):
Holy shit, Holy shit, doesn't that make you? It a
burned down a building, and this is I'm sure this
is only one percent of why insurance companies are awful.
Will we look at the whole thing, not the main reason.
But this is so bad infuriating.

Speaker 1 (40:12):
Yes, So that's what I meant when I said, like
there's a real harm to what Doc Williams is doing
because when he brags that these these physical training sessions
are free to the consumer, that's not really true. Everybody
in the state is paying more because it is going
to raise their rates to compensate for this kind of shit.

Speaker 2 (40:27):
It's honest. Yeah, not a victimless crime because not the
insurance companies will find a way to make their money.
No way they're going to miss it.

Speaker 1 (40:34):
There are, in fact, some victimless crimes out there, but
defrauding insurance is not one of them. Being a fake
doctor is a victim full crime right now. It is
very fucked up, and well Williams is a bastard for
a number of reasons. I hope I've made it clear
that the insurers are the real bastards. Here in the
state of Washington. The Office of the Insurance Commissioner, who
investigates these things, got only one report of fraud in

(40:57):
twenty seventeen from Primira blue Cross US, a major insurer
from Era, told Mitchell the Pro public A guy when
he investigated that they don't report fraud unless there's criminal intent,
which is weird because it's fraud.

Speaker 2 (41:10):
They say it's criminal.

Speaker 1 (41:12):
Yeah, they say, they try to educate perpetrators instead. So
we do have the enlightened Star Trek future justice system
somewhere in this country. It's only an health insurance. Oh
my god, isn't that nice?

Speaker 2 (41:27):
Oh my god. They're trying to reform.

Speaker 1 (41:29):
Yeah, you get it, that's yeah, And they will try.
One thing they'll try to do is put people on
repayment plans. And this there's a degree of since this
makes if it's a case where you've got a real
doctor who just tries to get over something and he
scams him in of a couple of grand because he's
in a tight spot. Instead of trying to go after
that guy criminally, they'll, you know, just try to have

(41:49):
him repay what he took, right, which in that case
makes a degree of sense. But there's two things happening here.
One is that they don't report this at all to
the government, so the government cannot see none of these
regulators enforcement cannot see are there broader patterns of fraud
that are maybe evidence of organized crime. And number two,
they don't really discriminate between him. Maybe this doctor who's

(42:11):
a real doctor slipped up once and did a bad
thing versus this guy's not a doctor at all, because
they just don't actually care the.

Speaker 2 (42:20):
Fact that these dummies got away with it for so
long and were finally stopped at some point, probably because
of the relentless nature of his father in law. Is
ex father in law just goes to prove how much
more is probably being done by smart people.

Speaker 1 (42:36):
Oh god, by smart huge crime, smart people who like
don't wind up pissing off like this her father or
her dad sounds like he's fucking cool and the track
record on the an iPad and leaving a huge track record.
But you know who never records their crimes on an
iPad that they didn't give to the children that they hit.

Speaker 2 (42:57):
Oh my god.

Speaker 1 (42:58):
The people who I said they don't do it.

Speaker 2 (43:00):
Yeah, they're too smart. They're too smart for it because
they're smart and inherently good.

Speaker 1 (43:05):
And they're inherently moral actors, just like everyone who is
legally or medically involved with this podcast. Anyway, Ah, we're back.
So I just was talking about Washington. How like Premire's
justification for not reporting frauds, We only do it if

(43:27):
there's criminal intent. We try to educate perpetrators, you get
him to repay. And this is what's going to happen
to Doc Williams right when he finally gets caught for
the first time. It has nothing to do with his
ex wife and her father and alth the documented fraud
on that iPad, But instead a client of his personal
training service, a Southwest flight attendant named Nannette Bishop. Bishop,

(43:48):
got referred to Doc by a coworker, and she, you know,
does a couple of sessions, but she stops working out
with them, right, Maybe they don't click, or maybe she just,
you know, she gets too busy. She's, you know, a
flight attendant, busy job, right, So she goes a couple
of times and then stops. And then one day she's
checking her insurance records and again it's just a crapshoot
that like somebody checked on that, because I don't know

(44:09):
that I've ever looked into mind, right, And she sees
that Williams has continued billing her company for dozens of sessions,
even during periods where she had been out of the country,
like working. So she reaches out to Williams. First, I
think her assumption is like, there's maybe there's got to
be some fuck up, maybe his computer fucked up, right,
and it just kept auto billing or something, and she's like, hey,

(44:30):
you know I didn't do these sessions. You should probably
return this money to my insurer so they don't raise
my rates. And you know, when he doesn't do anything,
she eventually reports it to her insurer and Signa sends
Williams a letter saying, hey, we just realized you're not
a doctor and you have built us for one hundred
and seventy five thousand dollars.

Speaker 2 (44:52):
Please get it back. I would love to see that letter.
I would love to see his response to that letter too.

Speaker 1 (44:58):
Contra to what insurres like Primara like to claim, there's
no way this could have been anything but criminal fraud.
There's not a chance that this is in good faith
because he doesn't have a medical license. You can't lie
about having a medical license and bill for almost two
hundred grand and care. So that's committing a felony, right,
that's felonies.

Speaker 2 (45:15):
Yeah.

Speaker 1 (45:16):
So, but Signa just sends Williams a bill, so we
starts making payments. But he also switches over to a
fresh NPI number under the same name and keeps billing
Signa and paying. Yes, yes, my god, they give him
more than one hundred thousand dollars. A year later, he
owes them three hundred and ten grand.

Speaker 2 (45:36):
Right. He's like, sure, I'll pay it, but I'm out
them by changing this. I'm gonna have her paid for
her own thing. It's fantastic, my god, uh huh so funny.

Speaker 1 (45:48):
So stories like this are far from unheard of. Pro
Publica spoke to a former fraud prosecutor, a guy named Elliott,
who claims that a big part of the problem is
that private insurers don't just ignore fraud, they fight the
govern when the Feds try to investigate it.

Speaker 2 (46:02):
Quote.

Speaker 1 (46:03):
When private insurers pitched the occasional case, Elliott said, prosecutors
had to weigh whether the insurer would fully cooperate with
the investigation. Federal prosecutors dig into the details when they
get referrals, he said, they might want to broaden a case,
which would create more work for the insurer or sully
its reputation, or prosecutors might find out the insurer was
not doing its job certain things they wanted you to

(46:25):
know about, and certain things they didn't want you to
know about, he said. The private insurers, Elliott said, seem
to prefer to close cases quietly, cutting off the fraudster
and pursuing repayment, But he said that allows the scammer
to go on cheating others. That's not fraud enforcement, he said,
it's an accounting mechanism. Again, we don't give a shit
who else this person hurts. If they're prescribing, if we

(46:47):
don't care if they're faking, if they're like tricking people
into thinking they have Alzheimer's, those people kill themselves. As
long as we cut.

Speaker 2 (46:54):
Them off from billing us, we're good.

Speaker 1 (46:56):
You know, they've done the math. The math works out
for them. Care ship just this. Yeah, so it's.

Speaker 2 (47:06):
The worst people are in charge of the most important ship.

Speaker 1 (47:09):
And absolutely this should be like a central concern of
our entire society. And instead we're like, who's the biggest psychopaths?
Who's someone who's like just on this edge of like
skinning animals for fun, Like, let's put them in charge
of it, right?

Speaker 2 (47:25):
Are they good numbers? Put them? That's what we were Yeah.

Speaker 1 (47:28):
Yeah, And honestly, I think skinning animals for fun is
probably like less harmful than this. Yeah, let's less damage
than what these people are doing. There's more of a
sickness at play here.

Speaker 2 (47:39):
Yeah, we don't recommend doing that either. By the way,
people were not.

Speaker 1 (47:42):
Like saying skin don't skin animal, but maybe skin health
insurance executives for fun A couples around that. See what happens, Yes,
see what happens. Yeah, that could be we could we
could rehabilitate the skinning animals for fun people by sticking
them on health insurance executives. I want like one of

(48:04):
those like Iraq War deck of cards, and it's just
the c suites for all of the fucking big insurance.
So obviously there's a tremendous degree of societal harm here.
By holding off on reporting this stuff and actively obvius
skating investigations, private insurers make it harder for regulators to
spot patterns and effectively identify scams or bust people who

(48:26):
are conning Americans. Right, Remember, Williams is just scanning money
for PT, so the harm he's doing to people here
is less than like what the Jenkinses are doing. But like,
there's other people doing what the jenkins is are doing,
and they're allowed to hide for years and harm people
because insurers are helping them hide. The most difficult cases
to catch are the folks who carefully figure out the

(48:48):
threshold of money under which an insurer will ignore them
and avoid billing to Egregiously, Williams got caught because he
was sloppy. He was billing people who had stopped going
to him.

Speaker 2 (48:58):
Right.

Speaker 1 (49:00):
Lie it about having a medical license.

Speaker 2 (49:01):
Right.

Speaker 1 (49:02):
But if he'd had a real MD and still have
been doing this fraud, and if he hadn't been quite
so dumb about it, he probably could have kept doing
it forever. Likewise, if both Jenkins's rather than just the
husband had been MD's, she might have gotten away with it.
Oh yeah, there's not a zero percent chance. You know.
There are other calculations at play here too. Per that

(49:23):
second Pro Publica investigation quote, other investigators say targeting suspect
medical providers and facilities puts the insurers in the dilemma.
They need a certain number of doctors and hospitals and
their networks to make plans attractive to employers. They also
must ensure patients have access to the care they need.
So apparently I learned there's a calculation that goes on if,
for instance, you're the only neurologist in town, your fraud

(49:46):
may be forgiven.

Speaker 2 (49:48):
Wow, great, oh my god, oh my, that is amazing. Yeah,
that's mean. I mean there's jobs, security and medicine, folks.
For any young people out there considering lifestyle and considering
what they'll do with their lives. I mean, it goes approve.

(50:10):
You can make a good money being a doctor, and
if you're really sort of a go getter, you can
defraud health insurance for millions of dollars. Yeah.

Speaker 1 (50:23):
And you know, if you want to do a little
bit of defrauding health insurance and a little bit of
writing me prescriptions for delatted, who's to know, you know,
it could be between between the two of us.

Speaker 2 (50:33):
I'm not getting my.

Speaker 1 (50:35):
Medical listeners. Yeah, Cave won't do it, but one of
you will hit us up on the subreddit if you'll
prescribe me to lauded. That's a joke legally speaking. So
Williams keeps getting in trouble with insurers right at the
next Finally, and then United Healthcare, and this is where

(50:56):
the story gets baffling. United it sent more than six
hundred house and dollars in payments to Williams over the years,
and then they realize he doesn't have a medical license,
they demand he pay them back, which makes a degree
of sense. But this demand includes an offer. They're like,
if you don't reply, we will pay ourselves back out
of future billings that you file. In other words, we

(51:19):
know you're not a we know you're not a doctor.
You know who you are a doctor, but if you
keep pretending to be one, we'll take it out of
your future billing.

Speaker 2 (51:29):
My god, you know us.

Speaker 1 (51:34):
You just absolutely you can't even parody the evil here.
So this even is rather academic because again he just
keeps switching in pis. He's got a bunch of them right,
whenever he gets caught, he's like the borg.

Speaker 2 (51:50):
Right, you shoot him.

Speaker 1 (51:51):
Once and they get hit, and then you shoot him again,
and there's shields of remodulated.

Speaker 2 (51:56):
That's what he's doing. All of every thought.

Speaker 1 (52:00):
I have is filtered through the lens of Star Trek,
the next generation Kava.

Speaker 2 (52:04):
That's just the way it is. That's cool, that makes sense.

Speaker 1 (52:08):
Quote in all, United paid Williams more than three point
two million dollars, most of it after the insurer had
caught him in the act, but in reality the losses
weren't all Uniteds. Most of the fraud was funded by
its clients Southwest. It's just not worth it to them.
Said doctor Eric bricker An in turn, is who spent
years running a company that advised employers who self funded

(52:29):
their insurance, and perhaps Kenner. Intuitively, insurance companies are loath
to offend physicians and hospitals, and they're all important networks,
even those accused of wrongdoing. Many experts have said, so,
the reasons for this are complicated, and it's more than
purely bastardy on behalf of insurers, but that is at
the center of it.

Speaker 2 (52:47):
Now.

Speaker 1 (52:48):
Doctor Williams is eventually fully caught, not by an insurer
but by the FBI, in part because of the tireless
reporting of his ex wife and her father, all of
these different insurers who keep catching him and like this
keep they don't give up, and eventually, somewhat at the
FBI puts two and two together and it's like, oh, hey,
freak conviction.

Speaker 2 (53:07):
They've got everything on the iPad. Great. I wonder if
at this point he was still just doing it because
he felt like he was sort of stuck and he
had to pay the insurance companies and he was like
he felt like he had to just keep doing it,
or if he thought he was really gonna get away
with it.

Speaker 1 (53:22):
He's just kind of dumb because like a smart guy,
you got four million dollars at that age you're kind
of middle aged. You move to Ecuador somewhere that doesn't
extra out. You can live off that. You know, that
didn't go into prison. But like the Dwarves of Moria,
he delved too deeply and too greedily. The star Trek
are we talking, No, that's a Lord of the Rings reference.

Speaker 2 (53:45):
I'm a specific type of nerd, Robert, I'm a very
specific type of nerd.

Speaker 1 (53:49):
Okay, yeah, So he gets sentenced. He goes to prison
for a while, more than nine years, so good, he
gets punished. None of the guys at any of the
insurance cups get punished.

Speaker 2 (54:00):
But he does.

Speaker 1 (54:01):
And uh that's good now, Covet. This whole story is
a real bummer to contemplate, right, kind of sad, kind
of depressing. So I want to end the story of
one more fake doctor. This does not really tie into
the NPI stuff, but maybe it'll leave everybody in a
better mood because it's kind of like a good story
of a fake doctor.

Speaker 2 (54:20):
It's a redemption arc. I'm listening doctor. Yeah.

Speaker 1 (54:24):
So his name is Adam Litwin and he is now
a real MD too, But as a boy, Adam grew
up in all of his grandfather, a pediatrist, and he
wanted desperately to be a doctor himself. As a teenager,
he would wear a beeper and pretend to be getting
texts from patience, which was maybe a warning sign weird.

Speaker 2 (54:44):
I'm sorry, weird. Yeah, that is weird. Should not become
a doctor. That is a red flag if I've ever
heard one. You don't. Nobody wants to have a pager.
They're the worst thing. It's an electronic leash that gets
hugged around your neck. In love with the worst thing
about being a doctor. Oh my god, oh god.

Speaker 1 (55:04):
Yeah, that's like joining the army and being like, yeah,
finally I'm in the army. I'm going to get to
file paperwork.

Speaker 2 (55:11):
God, I get to run through luod Yes. Well no,
then people do like yeah that.

Speaker 1 (55:18):
So after high school he goes to San Jose State
and then he transfers to Saint Louis to get into
the pre med program, which included clinical rotations, and he
does some actual clinical rotations, and he describes this as
the happiest moment of his life. Right he is he
feels like this is exactly where I meant to be.
It's what I want to do. And then that portion
of schooling ends and he gets depressed. Right the way

(55:40):
he describes it, he just wanted to I think there
may be a little bit of mental illness going on here.
He wanted to be a doctor so bad that he
couldn't focus on actually finishing school to become one.

Speaker 2 (55:51):
It's weird.

Speaker 1 (55:52):
His actions don't make a lot of if if he's
purely acting logically, I don't know why you wouldn't go
through medical school.

Speaker 2 (55:58):
But he doesn't.

Speaker 1 (55:59):
He just drops out and he moves to California, and
he starts spending all of us time in the UCLA
Medical Library reading medical textbooks. Here's how the La Times
describes what happens next. At some point, someone mistook him
for a resident, and he didn't correct them, he said, instead,
he made up a backstory that he began to widely share.
He was a surgery resident who had recently transferred from

(56:21):
a nearby hospital. Litwin was twenty six, about the same
age as most doctors in training. For months he fooled them.
He ate lunch in the cafeteria at UCLA Medical Center
and he watched doctors perform complicated surgeries allowed because senior
doctors thought he was a physician. Litwyn claims now that
he never treated anyone doing this and he was never

(56:42):
caught treating a patient.

Speaker 2 (56:44):
Again.

Speaker 1 (56:44):
I've run into a couple of cases. It's one of
those things where like Malachi makes the same claim. I
wonder if the hospitals are kind of just protecting their
asses and they don't really want anyone to know I have.
I didn't include them because we're talking about the US here,
but I ran into some fake doctors who scammed the
NA over in the UK, who noted that like a
really good way to be a fake doctor is to

(57:05):
be part of like a team of doctors consulting on
it case because you don't actually have to get in
there and physically do anything. You can just kind of
like provide like talk, right, and that that's easy to get,
easier to get away with, right, And that does kind
of make sense to me that like maybe that's all
he was doing, whether or not when actually treated anyone.
He did other stuff. He used the doctor's parking lot

(57:25):
with a borrowed pass, He stole a key to get
into the residence lounge. He slept in the on call rooms,
and he seems to have really loved all this stuff around,
actually practicing medicine along with the medicine.

Speaker 2 (57:37):
Which is like davish. He's like, I love the cafeteria food,
I love sleeping in the shitty call rooms.

Speaker 1 (57:44):
It's like someone being like, God, one day, I'm going
to be a professional podcaster and I'll finally get to
put an SD card into an SD slot, the dream
that I've had in my whole life transferring files from
one machine to the other.

Speaker 2 (58:00):
So weird, So weird. Man doctor, Yeah, doing rounds and helping.

Speaker 1 (58:06):
Patients is awesome to sleep at work sometimes.

Speaker 2 (58:09):
Yeah, that's the part that we like live with because
of all the other stuff that we do. You know,
we don't very strange. You don't go into it for that.
The page the.

Speaker 1 (58:18):
Patriot thing is so unhinged. So eventually he gets caught.
What claims it takes nine months, prosecutors say six. Either way,
he gets away with us for a while, and because
he does know a lot right, he's legitimately well educated.
He's read and re read tons of medical textbooks, so
he's able to fake. And he's like the right age too,
So you can't just look at him and be like, well,

(58:39):
that's obviously a small child in a costume. His downfall
comes when a pharmacist realizes that he's forged prescriptions for
cough medicine and tranquilizers using the name of a real
doctor who shared his last name. Litwin claims the prescriptions
were for a friend, which, sure, buddy, all of our
illegal drugs are for a friend. What a dumb mistakes

(59:02):
A dumb mistake.

Speaker 2 (59:03):
If he had written, like you know, with toopralol or
some some blood pressure medicine or some like diabetes medicine,
probably he gab a penton script or some shit well
like fucking going for anything that's controlled. What a stupid mistake.

Speaker 1 (59:18):
Yeah, it is a dumb mistake. They catch him, and
at age twenty eight, he pled guilty to three misdemeanors
forging a prescription, chief among them. He was sentenced to
six months of counseling and two months in jail, which
he served. And normally this would either be the start
of an arc of a bunch of other cons or
maybe he would sheepishly go back to regular life, but

(59:39):
that's actually not what he does. He stays in therapy
after the six months of counseling that he was mandated
to do, and like keeps working on himself. He moves
back home. He said in interviews that like he realized
afterwards that he had narcissistic tendencies, which is probably part
of why he didn't actually go through with medical school.
While he felt like he could fake it, and he

(59:59):
like ex about himself and works on it. He gets
into business with his grandfather who is a doctor, and
he's running the books for their health care company. But
he doesn't do anything about Like, he's not treating patients.
He's just handling like finance and stuff. Occasionally he would
keep lying about being a doctor. In his personal life,
he like lies to his first wife about being I

(01:00:20):
think a chi cardiologist, and she divorces him. Right, but
you get that far.

Speaker 2 (01:00:26):
How do you marry him and not know he's got
to be good? I mean, I assume he's.

Speaker 1 (01:00:31):
Probably good at it, right, He's probably so, but you know,
he apparently like comes to terms with the fact that
that was fucked up. And two years after the divorce
and now middle aged, Litwin enrolls himself in the Saint
James School of medicine.

Speaker 2 (01:00:44):
Now.

Speaker 1 (01:00:45):
Saint James is a for profit medical school. It is
very expensive, but nowhere else is going to take him, right,
I think it's in the Caribbean. It is a from
what I can tell, it's a real medical school. They
do teach you to be at their degrees or recognized,
but it's the kind of place where like, if you
can't get in anywhere else, all they care about is

(01:01:05):
that you have money, right, And that's for him, that's
the only option, right.

Speaker 2 (01:01:09):
He's not going to get into a regular medical school.

Speaker 1 (01:01:12):
And I looked at some like I found like a
doctor in Quorra who was like, yeah, it's like an
okay school, but the only reason you'd go there is
if you can't get in anywhere else. And it makes
sense to me, like, yeah, where else is it when
gonna go?

Speaker 2 (01:01:23):
Right?

Speaker 1 (01:01:24):
But he goes to medical school and he graduates, right,
he has an MD. He now lives in Chicago. He
does medical school, he does his rotations at least in Chicago,
but he can't finish right, And as far as I know,
I don't think he has finished it because he can't
do his residency. Because to do a residency you have
to get accepted somewhere as a resident and anyone one

(01:01:46):
of the things. When he goes to Chicago to do
his medical school rotations, there's like this whatever board handles that.
There's this big debate about it, and what they decide
is like, well, let him do his rotations, but we're
going to put a note on his record about what
he did in the past so that anyone who is
going to take him knows it. And at this point,
I think the last story I ran into him was

(01:02:06):
in like twenty twenty one, a couple of years after graduation,
he still had not gotten his residency. I don't know
if he's gotten it yet. I don't know if he
ever will, but like it is at least a story
of growth. This is the one fake doctor who did
He did get an MD, you know.

Speaker 2 (01:02:21):
Yeah, it sounds like there's some legitimate like he must
have had some legitimate issue that prevented him from finishing.
I don't know what it was, you know, Yeah, No,
but yeah, that is Actually it does seem like he's
trying to do the thing.

Speaker 1 (01:02:35):
Yeah, and he's trying to do the right thing, yeah,
in his own way. Yeah, it's what I can't blame
any hospital for being like, no, we're not going to
take this guy as a resident. But I just because
of my belief in like the fact that people can
be better and like be redeemed, I do hope he
gets a chance.

Speaker 2 (01:02:53):
Like that's interesting. Yeah, I'm curious to know where he
is now. I'm fascinated, Like, yeah, if he is, just
like he's like some small town somewhere.

Speaker 1 (01:03:04):
For it, there's certainly not enough doctors. So my hope
is that like he figures it out and is able
to like help people.

Speaker 2 (01:03:13):
The thing is, you need to do a residency. I
mean medical school you learn a lot, but you don't
learn really how to take care of patience until you do,
like your residency. That's when you're like really in charge
of it. So I I mean, I'd really fascinated to
see how he does that. I mean, he's better than
the Malachi kid. The Malachi kid, like you can't expect
him to have like on his white coat like FBI

(01:03:35):
Female Body Inspector or something like that on it. Like
that guy was a creep. This guy, at least I
get the sense that his intentions are are good. Yeah,
and he wants to be a doctor, which I can
always respect.

Speaker 1 (01:03:48):
It seems like he's also like accepted his mistakes and
like why he made them, Like, oh, that was like narcissism,
That's why I did that. That's not a reasonable or
an okay thing to do. So yeah, I hope, I
hope things go well with that. It's at least a
nice story to end on, Like it's a story of
somebody who's shown some capacity for growth and change, as

(01:04:10):
opposed to the health insurance industry, which only has the
capacity to grow in the same sense that a tumor grows.

Speaker 2 (01:04:19):
Some listener out there is like, my doctor's name is
Adam Littwin Mine.

Speaker 1 (01:04:27):
Yeah maybe, ah cave, how you doing?

Speaker 2 (01:04:32):
Thank you so much for having me. It's like every
time I get the coming show, I feel like I'm
like a listener who won a contest, and it's very
nice to be here. It's very nice to talk to you.
I'm so glad that the field that I've dedicated my
whole life to and lost my twenties and thirties to
can provide you so much horrible, horrible content.

Speaker 1 (01:04:51):
Oh yeah, yeah, No, we have feasted off of the
off of the wealth of bastardrey that surrounds this. Yeah,
it's it's it's like anything that is absolutely crucial to
survival and also complicated and hard to understand will be
targeted by real pieces of shit. Ye, it's the same

(01:05:13):
reason why there's all sorts of like scams and unethical
shit with like the big ag and all like the
way subsidies and shit work. Right, everybody needs food, most
people don't understand how to make it. Yeah, right, great
place for a con artists to live that void.

Speaker 2 (01:05:27):
Yeah, you're absolutely right. It's the one thing that's the
most important thing that we're terrible at. And yeah, and
it's in so many ways, on so many levels.

Speaker 1 (01:05:35):
But thank you for continuing to be the good part
of that thing, and thank you listeners for continuing to
be good people. And again, well, well we'll put a
po box. We'll plug that in after the episode. If
you do get a delauded script and you just want
to help out your boy, what Sophie, Sophie, it's not

(01:05:55):
illegal to receive delauded in the mail, I assume bo.

Speaker 2 (01:06:00):
Wait, yeah, we should check that.

Speaker 1 (01:06:02):
We should probably check that.

Speaker 2 (01:06:03):
Don't send Robert things. Listen to my podcast instead, the
House of pod do that.

Speaker 1 (01:06:10):
Do that?

Speaker 2 (01:06:11):
Don't send. Don't send fentanyl or drugs via the mail.
If you are not a large hospital, prescribing pharmacy, or
anything along those lines. Listen to my podcast The House
of Pod instead. Yeah.

Speaker 1 (01:06:23):
One of our listeners is the hospital from the show House,
so I hope they take that to heart. Anyway, I
forget the name of that Robert. This podcast is so
over yeah, just like House.

Speaker 2 (01:06:41):
Behind the Bastards is a production of cool Zone Media.
For more from cool Zone Media, visit our website cool
Zonemedia dot com, or check us out on the iHeartRadio app,
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