Behind the Bastards - Part Two: The Real Bastard Was Health Insurance Companies All Along
Episode Date: March 28, 2024Robert 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.See omnystudio.com/listener f...or privacy information.
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Scarcella took me to the precinct.
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Call zone media.
Yeah, so, I mean, I don't know.
I just I don't think it's technically murder.
Like if nobody saw. Right. Right.
That's at least, you know, that if nobody saw, right? Right.
That's at least, you know,
that's always been my stance on that.
Yeah.
Are we recording?
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 2014.
Didn't happen, you know.
Nobody saw anything, right?
So we're good.
No one can prove Sophie was there.
Yeah, nobody can prove Sophie was there.
I was about to say, I would lie for you in court, Robert,
but then I got accused.
And I would throw you under the bus, Sophie.
I know you would.
You know who throws all of us under the bus
on a regular basis?
Insurance.
Our health insurance companies, yes.
That's fucking for sure.
Let me have my inhaler, you cowards.
Yeah, Sophie and I are, we're Etna, right Sophie?
Yeah, yeah, fuck these people.
They fucking suck.
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.
Stop asking me to- This isn't a con,
we're not being robbed.
No, stop asking me to contact the original prescribing doctor.
He died in 2015.
Love it all. Please.
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.
Super great. It's cool stuff.
So we talked in episode one, two different doctor,
like fake doctor scams, right?
Both of which involved the use of NPI numbers.
People basically in one case outright faking, in another 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, right?
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.
A lot of this comes down to ProPublica,
who's going to be really the source
for most of what we're talking about today.
But I'm gonna start with the story of Dr. David Williams. As best as I can tell,
he was born in Idaho around 1963. 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. And then he moved to Texas A&M where he received his PhD in kinesiology.
Now, as a Texan, when I hear somebody went to Texas A&M
to get a PhD and being a gym teacher,
I do think this guy's probably a monster.
Right?
Yeah.
I really wanted to know to torture children.
Yeah, yeah.
So again, this is a fake doctor.
He is 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 kinesthesiology, right?
Kinesiology is an actual discipline.
It's the study of movement performance and function,
and it involves a lot of real science.
Having an understanding of kinesthesiology involves everything from molecular biology to anatomy,
and of course, the study of how exercise affects the body.
What kinesiology is not is a medical discipline, and this is going to be very important soon.
When he was at Boise State, Dave, Dr. Dave, as 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 academic academic and all American wrestler or whatever.
I don't understand the wrestling things.
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 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.
It was like, I'm not doing college in Arlington.
Fuck this shit.
Arlington, Galveston, you've been throwing a lot of,
this is like a deep Texas couple of episodes
that we've been doing.
As a 20 some year resident of Texas,
there's one place in that state I'll go to bat for
and it's Marfa.
Oh, never heard of it.
Oh, it's a great town.
Once he graduated in Texas,
he got a job working as a community college professor
in Arlington, right?
And a ProPublica investigation into him
describes this job as well-paying,
which you don't hear often
in reference to 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 marries him
about the time that he starts this job, later told ProPublica that after they'd been together
a few years, he got fired suddenly, and she never found out why.
ProPublica 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, I don't know.
He's doing-
How do you not tell your wife?
That's the, I mean, that's a hard one to,
I mean, whatever, okay.
He might take that, that might be, folks,
that might be 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 bad
Probably a problem there. Yeah, if she's being honest, yeah, that's that's not right. That's probably a problem
Yeah
So whatever get 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
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 Winn-Dixie grocery store,
and he was gonna turn it into a health club called Doc's Gym.
Now, if he didn't grow up in the South,
Winn-Dixie is like, I'd call it like a second
or third tier grocery chain.
It's better than Piggly Wiggly,
but it's not as good as H-E-B, right?
It's like a Fred Meyer.
You're just fucking making up names now.
Yeah, Fred Meyer.
It seems broadly, it's a little,
it's not quite as nice as a Fred Meyer.
Oh my God.
Yeah, it's not as nice as a Fred boy.
I wouldn't say Winn-Dixie is a classy boy.
No idea what you're talking about.
No idea. That's okay.
As a Californian, I would know when no idea talking about no idea as a Californian
I'm familiar with like three and one an alpha beta baby me for four
I'd meet every now and then like a couple of times in my life other people who shopped at piggly wigglies when they were kids
And like it's it's it's like what I imagine it was like in like the 50s and 60s
Running into someone else who'd fought at bastone, where you're like, oh yeah,
we share a special secret drama together.
What a reference.
I am working on a reboot of Band of Brothers
that's just about shopping at a Piggly Wiggly
in rural Oklahoma.
So, you know, check out for that one.
Spielberg's attached to direct.
We're very excited.
So whatever is going on with this,
cause I think there's some,
I'm sure there's some sort of scam here beyond just
that this is a bad 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 wind dixie collapses,
and everyone who had invested lost everything, right?
A local newspaper published an article
on the whole affair titled, What's Up With Docs?
Because that was gonna be the name of the gym
because he called himself Doc.
Yeah, yeah, I see where they're going with that.
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 2006, after 14 years together and two children,
they started divorce proceedings.
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 ProPublica investigation.
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 autism 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 bad.
I knew autism would find its way
into one of these episodes eventually.
Sure, of course, of course.
Because again, it's one of those gray zones
where all, like, when people aren't clear
about what's going on, these grifters come in
and fucking find a way to make money off of it.
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
a 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 knows enough
about what should be going on that they'll catch this.
But they do!
In November 2008, Williams pleads guilty in Tarrant County to felony theft.
He's sentenced to 18 months in jail and he is released on bail as he appeals.
He does wind up doing some time, something like a year I think, and life goes on.
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 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 people.
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 so he starts doing that again.
He continues trying to make a living that way.
And he has a friend code him a website, Get Fit With Steve.
This friend, Steve Cozzio, 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 11-year-old son comes to school covered
in facial bruises.
His teachers obviously reported this, and an investigation revealed that Williams had
hit their son in the face quote about 20 times.
So that's real bad.
Williams pleads guilty to a felony and he goes back to jail for two years, right?
Just like, did he, I mean, you probably know the details of this, just fucking hitting
his kid, like his kid comes over and just fucking hits his kid?
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
the kid a bunch what a fucking asshole yeah it's horrible yeah I mean he's he's
he's the villain of the episode he's he's the villain of the ep
He's one of the villains of the episode
You know what?
I'm not one of these doctors that says like other people aren't doctors like PhDs, etc
I'm doctor but like when a guy like this like tries to use doctor like it's I mean
Having the experiences I had in a grade school
I'm not surprised that a guy who's got a PhD
and being a gym teacher's 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, of course. That scans.
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, right?
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 behind bars perfecting his next con.
So he still has a friend on the outside and it's Steve Cosio, the guy who had coded his
website.
Williams convinced him that the whole hitting his son in the face 20 times 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?
Number one, I'm not a big fan of spanking, but do you spank the face?
Is that where you spank?
Is the face?
What a fucking asshole.
Is that where you spank is the face? What a fucking asshole.
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 gullible than piece of shit,
but probably not none piece of shit.
So Williams and Cozzio work out a plan
for him to make a bunch of cash quick
when he gets out of jail because he's calculated,
Williams has calculated,
I need $30,000 ASAP to get an attorney
that can get me access to my kids again, right?
Which, so he can have them again.
That's the last thing, yeah, that's the last thing.
But what the fuck does he want?
Like at this point?
Yeah, what does he want?
I mean, this is this kind of guy, right?
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.
Couple of things it could be.
None of them good.
So there's no honest way for a kinesiology PhD
to make $30,000 overnight, right?
It's just not that kind of gig. There's no honest way for a kinesiology PhD to make $30,000 overnight, right?
It's just not that kind of gig.
But a medical 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.
$30,000 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 at the hospital, easy.
So while he's 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 bill himself as a doctor.
And then he would diagnose patients and prescribe them physical training and bill their insurance
both for the diagnosis and for the PT sessions.
Right?
God damn it.
Our system is so stupid.
Our fucking system is so fucking stupid.
Yeah, our system is stupid.
This is also a crime, right?
Like he's taking advantage of the system,
but you're not supposed to be able to do this, right?
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 gray,
but like your average physical personal trainer
and that's a valid profession.
There's a lot of skill that goes into that.
But it's not a medical profession, right?
It can help prevent certain medical problems,
sure, potentially, but like you're not,
but you see the gray area, right?
You're not treating medical conditions with therapy.
You're treating injury with therapy
and you're strengthening.
But there is a real thin line between that and saying,
we're gonna use this physical therapy to treat your blank,
whatever medical issue, your diabetes or something.
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 will like notice anything, right?
Yeah, they really count on that.
They really count on the fact that the 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.
It's just 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.
The problem is that 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 they're the kinds of people who are bold enough
to try this in the first place,
they're the kinds of people who get overconfident, right?
And also, one thing to always note
when we talk about these guys who get caught,
for every one of them,
who knows how many people there are who are smarter, right?
Who stay below the line, you know?
So, but that's his plan, right?
Clients are gonna get free physical training sessions,
and he will get to build the work of his trainers
as actual medical therapy, right?
Now I know what a lot of people are saying. Well, how is this guy? Is this really I mean, he's a bachelor
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 gonna build to the explanation of why that's not,
but I wanna assure you all right at the end,
it is not fine.
He is hurting people.
He is in fact hurting you.
If you are a member of any of these,
this is not a victimless crime, right?
And it's not a crime where the only victim
is some faceless insurance company.
He is actually hurting a lot of people by doing this,
and we're going to explain why.
I just wanna 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 remove the phrase
personal training from his website.
And he starts, 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,
95% of my clients are paid for by insurance,
which does not cover personal training.
I have to bill it as therapeutic exercise.
Steve's contention, Casio, the guy who's his webmaster,
is like, well, 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 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 like Casio
could just not really understand what's happening.
It's so complicated.
It seems like it's the Wild West.
It seems like anything can go.
I get it.
I get how like people would try to get away with this.
Yeah.
On his website, this is how Doc Williams described
his services to interested clientele.
During your initial consultation,
Dr. Williams will perform a fitness appraisal
to determine your current fitness level.
This exam will help determine physiological strengths
and deficits.
Dr. 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 that you know how to do the exercises
and are performing them safely. Many of Dr. Dave's services are covered by medical insurance
policies. Inquire with Dr. Dave to see if you qualify. Dr. Dave, whenever the doctor goes by his first names,
it's weird, right?
He's just coming from a guy who goes by Dr. Covey sometimes.
It's a red flag.
No, the only doctor that I will take advice from
is Dr. 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.
No, no, no, not that.
I don't think that doctor knows much about generation sicknesses
No, that's crusher and Pulaski in season two both fine doctors
Starfleet's best really when of them a hologram. Well, that's that's in Voyager. Yeah, Voyager. Sorry
Yeah, I mean he shows up other places too. Mm-hmm. Mm-hmm
Speaking of Star Trek Voyager, you know what else is, you know...
Voyages. Yeah, voyages. Into your mind. A big part of UP in during the early aughts. I don't know, here's ads.
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And me, Simone Boyce.
Every weekday, we're bringing you conversations
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In the 1980s and 90s, New York City needed a tough cop like Detective Louis Scarcella.
Putting bad guys away, there's no feeling like it in the world.
He was the guy who made sure the worst killers were brought to justice.
That's one version.
This guy is a piece of s***.
Derek Hamilton was put away for murder by Detective Scarcella.
In prison, Derrick turned himself
into the best jailhouse lawyer of his
generation.
And the law was my girlfriend.
This is my only way to freedom.
Derrick and other convicted murderers
started a law firm behind bars.
We never knew we had the same cop in
the case.
Scarcella.
We got to show that he's a corrupt cop in the case. Scarcella.
We gotta show that he's a corrupt cop.
They can go f*** themselves.
I'm C. Fishman.
And I'm Dax Devlin Ross.
And this is The Burden.
Listen to new episodes of The Burden
on the iHeartRadio app, Apple Podcasts,
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Podcasts.
We're back. Did you watch a lot of Voyager, Kava?
I watched a little of The Next Generation and that was the only Star Trek I ever watched.
That's the best.
I recognize 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 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, Jean-Luc Picard
is one of the best characters on film or TV.
I love the guy, but yeah, I can't get into the other stuff.
Like there was a one with a black hole and-
There's several with a black hole, yes.
Yeah, I mean, and there was a one
where they went to San Francisco, I saw that one. Oh, the one where they go back in time or the one with the whale? Ah, that was one of the black hole. There was, yeah, I mean, and there was a one where they went to San Francisco, I saw that one.
Oh, the one where they go back in time
or the one with the whale?
Ah, that was one of the-
Yeah.
They do a lot of going to San Francisco.
They go, well, there's one where they go back in time
to save the whales.
There's one in DS9 where they wind up
in it's like the 2024 riots and stuff.
And then there's one where they go back in time
to the 1800s and Mark Twain
is a major character. That one's a lot of fun. Yeah.
Yeah, I bet. I could see that in the Hollow Room or whatever. Yeah, the Danger Room, whatever
they called it.
Oh no, they're in actual San Francisco in the 1880s or whatever. No, they meet real
Mark Twain and he travels into the future and gets to go to space.
Fucking actors love playing Mark Twain. They just love playing Mark Twain and he travels into the future and gets to go to space. Fucking actors love playing Mark Twain.
They just love playing Mark Twain.
The actor in those episodes playing Twain
is just absolutely chewing the scenery.
He's having a great fucking time.
God damn, they love it, yeah.
So we're back.
Now you can see how a lot of decent people
could fall for this, right?
It's great to be able to have a physical trainer
but expensive.
And if some guy's like,
hey, your insurance will pay for it, why not?
And you can even see how it would make sense to somebody.
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, right?
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 identifier number, right?
And now it's time to talk about how you can scam
an NPI number, right?
Because what Malachi in episode one and now what Dr. Williams did is actually really fucking
easy.
NPIs are handed out by the federal government through Medicare.
Both individual doctors and organizations like clinics have NPIs so they can bill Medicare
or a health insurer.
And now I'm going to turn you back over to that ProPublica investigation and read a quote.
One would think obtaining an NPI with its stamp of legitimacy would entail at least
some basic vetting, but Williams discovered 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 own name as far back as 2008.
But it wasn't until 2014 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, Kinesiology Specialists.
The following year, he picked up another under Mansfield Therapy Associates.
In 2016, he obtained at least 11 more.
Often for entities he created in the areas where he found fitness clients.
Dallas, Nevada, North Texas, and more.
By 2017, he had 20 NPIs each
allowing him a new stream of billings. 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 guide you fill out this application I don't know if it's changed
but it doesn't seem that hard.
I'm not recommending people do this, by the way.
I'm not saying do this.
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 EIN
or employer 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 each application.
Wow.
Yeah.
And no one caught that.
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
He just did it. Yeah, nobody looked
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
that's like in the day.
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?
No, so Williams began taking on clients and 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 and he's set to work using some of his newfound 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 2013.
Now, because the 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 that's- And 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.
Right.
But she's like, yeah, 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,
I don't know, this is a debatable thing,
but like she keeps, she looks at her son's new iPad
and she notices an app on it called iMessage,
which is, you know what iMessage is,
I don't know if you explain this,
and it's got a bunch of new messages in it.
And she's like, well, why would my like,
I don't know, teenage, little teenage kid
have a bunch of iMessages on this brand new iPad?
That seems kind of weird.
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.
That's a damn iCloud.
It'll get us all.
These are his 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.
He hands it to his ex-wife.
Oh my God.
Oh my God.
He's the worst.
He's so successful at this point.
Yeah, it's funny.
Like it shows you how easy the NPI con is
that like this is not a genius.
That this dummy could do it.
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 a scammer.
And her dad, having 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,
you're talking like 10 minutes
to throw together a fucking indictment, you know?
It would not take a lot of time, 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, Cave?
How?
I'm assuming she said,
did she say something at this point
or is she kind of keeping it under wraps?
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 gets him on the phone.
He's like, I should probably report this.
And he tells Etna, I wanna 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.
Bye.
Hang up the fucking phone.
Now, thankfully, or maybe not thankfully,
cause Etna's dog shit, but his daughter
is insured by Etna, right?
What kind of rule is that?
That's the dumbest thing.
I know, only members can report that we're being defrauded.
That seems insane.
What do you do with the FBI call?
Sorry, you gotta get an agent who's on our healthcare plan.
Find someone who's married to somebody with Etna.
Right.
That's the stupidest thing.
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.
Oh, we trust you.
Yeah.
Her we trust, because she's one of us.
They take the info from her at least,
and then nothing happens, ever.
One of their, again, when all of this blows up,
because this guy does get arrested,
this becomes a big case,
and ProPublica reaches out to Aetna,
and is 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.
Liars, lying liars.
So funny.
So Pratt and Amy, next, he's like,
well, I don't know if Aetna's going anywhere,
but he is defrauding all of the insurance companies.
So let's call Cigna next, right?
And they provide the same information to Cigna
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 violets.
Maybe he has something.
Say he has multiple, multiple identities.
The least should be a doctor
of anyone who shouldn't have been a doctor,
whoever pretended to be a doctor, yes.
So next he reaches out, 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 healthcare benefits
and thus they pay directly for employee care.
And Southwest is like, well, we pay directly for it,
but we run it through United Healthcare,
which is this massive $226 billion company.
They administer our benefits, so talk to them.
So he calls 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 2014.
And I'm gonna quote again from ProPublica,
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.
"'Prat continued calling United over the following two years,
"'making about a dozen calls in total,' he said.
"'He is not a doctor!'
"'Prat's told whoever picked up the phone.
"'So I don't see how he could be filing claims.
Frustrated, Pratt made one final call to United in 2016,
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 complaint.
Wow.
What a maddening situation.
One guy, one family is trying to do right.
Trying really hard to do the right thing.
And the company is that they're trying to help ostensibly
or wanting no part of it.
Because at this point, by the way, this guy makes millions.
He is defrauding them from what do a regular,
again, it's nothing to these companies.
I just said United is due to $26 billion company,
but this isn't pocket change, right?
Yeah, but it's so funny.
Like they focus so much about small amounts of money
to them in every other case.
If you're trying to get an inhaler that costs 150 bucks
as opposed to $120, for example,
they'll fight you to the ends of the earth.
They will send you to prison if they have to.
Like in this company,
this one guy who's making millions off of them,
they don't do anything about it, that is maddening.
No, no. It's maddening.
So I bet you're all wondering at this point,
what the fuck, right?
Because 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, right?
Well, you're not the only person wondering
what the fuck is going on at this point.
The good people at ProPublica are wondering that too.
And the journalist who reported on the Williams case,
and again, we'll conclude his case,
he does eventually get arrested,
but the journalist who reported on this several years ago
was a guy named Marshall Allen, right?
Published in late 2019.
But he carries 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
wanna do anything to stop this?
Why is it so easy to commit fraud
and 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, right?
They do not care and they do not wanna 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 10%
of the $1.2 trillion in health insurance spending
this year, right?
That's not an insignificant amount of money.
Wouldn't they want to stop that, right?
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 wanna make that information public
that would make it easier for those intent
on engaging in fraud to commit these crimes.
She said 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 healthcare fraud, each divided by region and responsibility.
I contacted insurance regulators in every state and interviewed more than 50 other experts,
including prosecutors, claims 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.
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, you know?
It seems strange.
It's all gonna make sense, evil sense.
And I do wanna 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
is 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, I wanna look at the numbers here, Kaveh, 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 14.4 million Californians
on private insurance,
which is something like 10% of the nation's total.
So Mitchell asked a simple question,
calling DA's offices in the counties that,
basically he calls every DA's office in California
for the counties that cover about 80%
of the state's population,
which is a representative sample, we can say, right?
And he asks each of these DA's,
how often did fraud cases referred by commercial insurers
lead to criminal charges in 2017 and 18?
You have a guess? commercial insurers lead to criminal charges in 2017 and 18.
You have a guess?
Because of this, I'm gonna say like, I don't know, 20%. The number is 22.
22 total times.
I won't say that because I knew
where we were heading with this.
I wasn't before this thought much higher.
Yeah, now obviously something is fucked up here, right last episode
We discussed a story of nightmarish Medicaid fraud about 13 million Californians are on Medicaid
During the same period of time 2017 to 2018 the state fraud unit filed criminal charges against
321 people for defrauding Medicaid and recovered nearly a hundred million dollars
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 22.
Wow.
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 referred two cases
of fraud to regulators in 2017 and five in 2018.
Meanwhile, state Medicaid fraud investigators
carried out 600 investigations and got 134 indictments.
In Georgia, only three of the top 10 insurers
reported any fraud at all in 2017 and 2018.
They're better there.
They're better in Georgia.
They're so good.
Everyone's very honest in Georgia.
They're very good.
It's all the peaches.
So what the fuck is going on?
Well, investigations cost money,
and so does 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 can just increase your rates and copays
to make more money.
So that makes more sense than investigating
and stopping fraud.
We'll 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.
Holy shit.
Holy shit.
Doesn't that make you want to burn down a building?
And this is, I mean,
I'm sure this is only 1% of why insurance companies
are awful when we look at the whole thing.
Oh yeah, this is certainly not the main reason.
But this is so bad and infuriating.
It's so infuriating, 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 physical training sessions are free to the consumer, 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 physical training sessions
are free to the consumer, that's not really true.
Everybody in the state is paying more
because Aetna is gonna raise their rates
to compensate for this kind of shit.
It's not a victimless crime.
Because the insurance companies will find a way
to make their money.
No way they're gonna miss it.
There are in fact some victimless crimes out there,
but defrauding insurance is not one of them.
Being a fake doctor is a victimful crime.
Now it is very fucked up.
And while 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 2017 from Primera Blue Cross, a major insurer. Primera told Mitchell, the
ProPublica guy, when he investigated that they don't report fraud unless there's
criminal intent, which is weird because it's fraud. They say instead...
Right, it is criminal.
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 in health insurance.
Oh my God.
Isn't that nice?
Oh my God.
They're trying to reform.
Yeah. I get it.
That's- Yeah.
And they will try.
One thing they'll try to do is put people on repayment plans.
And there's a degree of sense this makes,
if it's a case where you've got a real doctor
who just tries to get over something
and he scams them out of a couple of grand
because he's in a tight spot,
instead of trying to go after that guy criminally,
they'll just try to have 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, law 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,
yeah, maybe this doctor who's 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 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, his ex-father-in-law,
just goes to prove how much more is probably being done
by smart people.
Oh God. By smart crime.
Smart people who don't wind up pissing off.
Her father or her dad sounds like he's fucking cool.
And leaving a track record on 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?
Oh my God, the people who promote who I said they don't do it.
Yeah, they're too smart.
They're too smart for it because they're smart, inherently good.
They're inherently moral actors, just like everyone who is legally or
medically involved with this podcast.
Anyway.
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Ah, we're back.
So I just was talking about Washington, how like Primera's justification for not reporting
fraud is we only do it if there's criminal intent.
We try to educate perpetrators, you know, get them 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 all the documented fraud on that iPad, but instead a client of his personal training service,
a Southwest flight attendant named Nanette Bishop.
Bishop got referred to Doc by a coworker
and she does a couple of sessions,
but she stops working out with them, right?
Maybe they don't click or maybe she just,
she gets too busy,
she's 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 crap shoot
that like somebody checked on that.
Cause I don't know that I've ever looked into mine, 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 gotta be some fuck up.
Maybe his computer fucked up, right?
And it just kept auto billing or something.
And she's like, hey, 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 Cigna sends Williams a letter saying,
"'A', we just realized you're not a doctor
and you have billed us for $175,000.
Please give it back.'"
I would love to see that letter.
I would love to see like his response to that letter too.
Contra to what insurers like Primera 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 200 grand in care
without committing a felony.
That's felonies.
But Cigna just sends Williams a bill.
So he starts making payments,
but he also switches over to a fresh NPI number
under the same name and keeps billing Cigna.
And they keep paying.
For the same patient?
Yes, yes.
Oh my God.
They give him more than $100,000.
A year later, he owes them 310 grand, right?
He's like, sure, I'll pay it,
but I'm gonna outsmart them by changing this.
I'm gonna have her pay for her own thing.
It's fantastic.
My God.
So funny.
So stories like this are far from unheard of.
ProPublica spoke to a former fraud prosecutor,
a guy named Elliot, who claims that a big part
of the problem is that private insurers
don't just ignore fraud, they fight the government
when the feds try to investigate it. Quote, when private insurers pitched't just ignore fraud, they fight the government when the feds try to investigate
it.
Quote, 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 the case, which could create more work for the insurer or
solely its reputation.
Or prosecutors might find out the insurer
was not doing its job. Certain things they wanted you to know about and certain things
they didn't want you to know about," he said.
The private insurers, Elliott said, seemed 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 they're,
we don't care if they're faking,
if they're like tricking people into thinking
they have Alzheimer's and those people killed themselves.
As long as we cut them off from billing us, we're good.
You know?
Yeah, they've done the math.
The math works out for them.
They don't fucking care.
It's fucking amazing.
They don't give a shit.
Just math.
Yeah, it's so infuriating, right?
The worst people are in charge of the most important shit
in this country. 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?
Are they good with numbers?
Put them in, that's who we want.
Yeah, and honestly, I think skinning animals for fun
is probably like less harmful than this.
Less harmful to the, yeah.
Less damage than what these people are doing.
There's more of a sickness at play here.
Yeah, we don't recommend doing that either,
by the way,
people will not like saying go skin animals.
Don't skin animal,
but maybe skin health insurance executives for fun.
Ooh.
Yeah.
Set a couple bear traps around, see what happens.
Yeah, see what happens.
Yeah, that could be,
we could rehabilitate the skinning animals for fun people
by sticking them on health insurance executives.
I want like one of those like Iraq war deck of cards
and it's just the C suites
for all of the fucking big insurers.
So obviously there's a tremendous degree
of societal harm here.
By holding off on reporting this stuff
and actively obfuscating investigations,
private insurers make it harder for regulators
to spot patterns and effectively identify scams
or bust people who 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 Jenkinses 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 threshold
of money under which an insurer will ignore them and avoid billing too egregiously.
Williams got caught because he was sloppy.
He was billing people who had stopped going to him, right?
He lied about having a medical license, right?
But if he'd had a real MD
and still had 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 Jenkinses,
rather than just the husband, had been MDs,
she might've gotten away with it.
Oh yeah.
There's not a 0% chance, you know?
Yeah.
There are other calculations at play here too.
Per that second ProPublica 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 may be
forgiven. Wow. Great. Oh my God. Oh my God. That is amazing. Yeah. That's cool. I mean,
there's job 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 to prove 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.
And you know, if you want to do a little bit
of defrauding health insurance
and a little bit of writing me prescriptions for Dilaudid,
who's to know?
You know, it could be between the two of us.
You're not getting my MPI, Robert.
Hypothetical listeners.
Yeah, Cave won't do it, but one of you will.
Hit us up on the subreddit, it feels prescribed me to laud it.
That's a joke, legally speaking.
So Williams keeps getting in trouble with insurers, right?
Aetna next, finally, and then United Healthcare.
And this is where the story gets baffling.
United had sent more than $600,000 in payments
to Williams over the years.
And then they realized 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 know you're not a doctor.
We know you aren't a doctor,
but if you keep pretending to be one,
we'll take it out of your future billings.
Oh my God.
You now work for us.
Yeah, that's so fucked up.
Holy crap.
Just absolutely, you can't even parody the evil here.
So this even is rather academic
because again, he just keeps switching NPIs.
He's got a bunch of them, right?
Whenever he gets caught, he's like the Borg, right?
You shoot them once and they get hit
and then you shoot them again
and their shields have remodulated.
That's what he's doing with his NPIs.
So much Star Trek in this episode.
So much Star Trek.
All of every thought I have is filtered
through the lens of Star Trek, The Next Generation, much Star Trek. All of every thought I have is filtered through the lens
of Star Trek, the next generation, Kava.
That's just the way it is.
That's cool, that makes sense.
Quote, in all, United paid Williams
more than $3.2 million.
Most of it after the insurer had caught him in the act.
But in reality, the losses weren't all United's.
Most of the fraud was funded by its client, Southwest.
It's just not worth it to them, said Dr. Eric Bricker, an internist who spent years
running a company that advised employers who self-funded their insurance.
And perhaps counterintuitively, insurance companies are loath to offend physicians and
hospitals in their 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 bastardry on behalf of insurers,
but that is at the center of it.
Now, Dr. 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 they keep, they don't give up
and eventually someone at the FBI puts two and two together
and is like, oh, hey, free conviction.
They've got everything on the iPad, great.
Yeah.
That's right.
I wonder if at this point he was still just doing it
cause 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.
Eventually he's just kind of dumb.
Cause like a smart guy, you got $4 million at that age.
You're kind of middle aged.
You, you moved to Ecuador somewhere that does an extra night.
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.
Is this Star Trek? Are we talking?
No, that's a Lord of the Rings reference.
God damn it.
My God. My God.
I'm a very specific type of nerd, Robert.
I'm a very specific type of nerd.
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 companies get punished.
But he does. And that's good.
Now, Kavett, 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.
It's a redemption arc for a fake doctor.
I'm listening.
Yeah.
So his name is Adam Litwin, and he is now a real MD too.
But as a boy, Adam grew up in awe of his grandfather,
a podiatrist, and he wanted desperately
to be a doctor himself.
As a teenager, he would wear a beeper
and pretend to be getting texts from patients,
which was maybe a warning sign.
Yeah, that's fucking weird.
That is kind of weird.
I'm sorry. That is fucking weird.
You should not become a doctor. That is a red flag if I've ever heard one.
Nobody wants to have a pager. They're the worst thing.
It's an electronic leash that gets tugged around your neck.
He's in love with the worst thing about being a doctor.
Oh my God.
Oh God.
Yeah, that's like joining the army and being like,
yeah, finally I'm in the army.
I'm gonna get to file paperwork.
God.
I get to run through mud.
Yes.
Well, no, that people do like.
Yeah, yeah, sure right.
The people who pay for that, yeah, that's right.
So after high school, he goes to San Jose State
and then he transfers to St. 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.
He feels like this is exactly where I'm meant to be,
it's what I wanna do.
And then that portion of schooling ends
and he gets depressed, right?
The way 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 like couldn't focus on actually
finishing school to become one.
It's weird.
His actions don't make a lot of,
if he's purely acting logically,
I don't know why you wouldn't go through medical school,
but he doesn't.
He just drops out and he moves to California and he starts spending all of his 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 a nearby hospital.
Litwin was 26, 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.
Litwin claims now that he never treated anyone doing this
and he was never caught treating a patient.
Again, 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 NHS
over in the UK who noted that like a really good way to be a fake doctor
is to be part of a team of doctors consulting on a case,
because you don't actually have to get in there
and physically do anything.
You can just kind of provide talk, right?
And that that's easier to get away with, right?
And that does kind of make sense to me
that 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 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 the stuff around
actually practicing medicine along with the medicine.
Which is like unhinged.
He's like, I love the cafeteria food.
I love sleeping in the shitty call rooms.
It's like someone being like, God, one day,
I'm gonna be a professional podcaster
and I'll finally get to put an SD card into an SD slot.
The dream that I've had my whole life,
transferring files from one machine to the other.
It's so weird.
It's fucking so weird, man.
There's a lot of good parts to being a doctor.
Yeah, doing rounds and helping patients is awesome.
Is that having to sleep at work sometimes?
Yeah, that's the part that we like live with
because of all the other stuff that we do, you know?
It's very strange.
You don't go into it for that.
I love the pager in the call room.
And the pager thing is so unhinged.
So eventually he gets caught.
Litwood claims it takes nine months, prosecutors say six.
Either way, he gets away with this for a while.
I think because he does know a lot, right?
He's legitimately well-educated.
He's read and reread 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, 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 mistake.
What a dumb mistake. What a dumb mistake.
If he had written like, you know,
mitoprolol or some blood pressure medicine
or some like diabetes medicine,
probably he would have done.
A gabapentin script or some shit.
But like fucking going for anything that's controlled,
what a stupid mistake.
Yeah, it is a dumb mistake.
They catch him and at age 28,
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 that's actually not what he does.
He stays in therapy after the six months of counseling that he was mandated to do and
keeps working on himself.
He moves back home.
He said in interviews that he realized afterwards that he had narcissistic tendencies, which
is probably part of why he didn't actually go through with medical school, why he felt
like he could fake it.
And he accepts this about himself and works on it.
He gets into business with his grandfather who was a doctor
and he's running the books for their healthcare 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 think a cardiologist. Oh my Godologist and she divorces him, right?
But two years-
How did it get that far?
How do you marry him and not know?
I mean, that's on her, that's on him.
He's gotta be good.
I mean, I assume he's probably good at it, right?
Yeah, right.
So, but you know, he apparently like comes to terms
with the fact that that was fucked up
and two years after the divorce,
a now middle-aged Litwin enrolls himself
in the St. James School of Medicine.
Now, St. James is a for-profit medical school.
It is very expensive,
but nowhere else is gonna take him, right?
Is that Caribbean?
I think it's in the Caribbean.
From what I can tell, it's a real medical school.
They do teach you to be, their degrees are recognized,
but it's the kind of place where like,
if you can't get in anywhere else,
all they care about is that you have money, right?
And that's, for him, that's the only option, right?
He's not gonna get into a regular medical school.
And I looked at some like, I found like a doctor on Quora
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 Litwin gonna go? Right? 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 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, we'll 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 was going to take him knows it.
And at this point, I think the last story I ran into him
was in like 2021, 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?
Yeah, I mean, it sounds like there's some legitimate,
like he must've had some legitimate issue
that prevented him from finishing.
I don't know what it was, you know?
Yeah, neither do I.
But yeah, that is actually,
it does seem like he's trying to do the thing.
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 gonna 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.
Like- That is interesting.
Yeah, I'm curious to know where he is now.
I'm fascinated to know what he's doing.
Yeah, so am I.
Like if he is just like,
he's like some small town somewhere. Yeah, I he's just like, he's like some small town somewhere.
Yeah, I hope so.
Like, put his knee for it.
Yeah, there's certainly not enough doctors.
So my hope is that like, he figures it out
and is able to like, help people.
But the thing is, you need to do a residency.
I mean, medical school, you learn a lot.
Of course.
But you don't learn really how to take care of patients.
No, no, no.
Until you do like, your residency. That's when you're't learn really how to take care of patients until you do like your residency.
That's when you're like really in charge of it.
So I mean, I'd be really fascinated to see how he does that.
I mean, he's better than the Malachi kid, the Malachi kid.
You kind of expect him to have like on his white coat, like FBI 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 good. Yeah. And he wants to be a doctor, which I can always respect.
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 opposed to the health insurance industry,
which only has the capacity to grow
in the same sense that a tumor grows.
Some listener out there is like,
my doctor's name is Adam Litwin, wait a minute.
Yeah, maybe.
Ah, Kawe.
How you doing?
Thank you so much for having me.
It's like every time I get to come on your 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 20s and 30s to
can provide you so much horrible, horrible content.
Oh yeah, yeah.
No, we have feasted off of the wealth of bastardry
that surrounds this.
You know, it's the same, 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
It's the same reason why there's all sorts of like scams and unethical shit with like the ag big ag and all like the way
Subsidies and shit work, right? Everybody needs needs food most people don't understand how to make it
Yeah, right great place for a con artists to live right someone to fit that's that void. Yeah, you're absolutely right
It's the one thing that's like the most important thing that we're terrible at and yeah
And it's on so many ways on so many levels
But thank you for continuing to be the good part of that thing and thank you listeners
For continuing to be good good part of that thing. And thank you listeners for continuing to be good people.
And again, we'll put a PO box,
we'll plug that in after the episode
if you do get a Dilaudid script
and you just wanna help out your boy.
What, Sophie, Sophie, it's not illegal
to receive Dilaudid in the mail, I assume.
Wait, yeah, we should check that.
We should probably check that.
Don't send Robert things.
Listen to my podcast instead, The House of Pod, do that.
Do that instead.
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, one of our listeners is the hospital
from the show House.
So I hope they take that to heart.
Anyways.
I forget the name of that hospital.
Robert, this podcast is so over.
Yeah, just like House.
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