Article from The Valley Patriot Newspaper: “State Auditor’s Office Protects The Big Swamp From The Law.”

The article below by Dr. Bharani Padmanabhan was published in The Valley Patriot  in print in April.  Will update when it is available online.

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State Auditor’s Office Protects The Big Swamp From The Law

Bharani Padmanabhan MD PhD

People on food stamps are the lowest rung on the economic ladder, people who need charity just to eat. Going after poor people helps bureaucrats pretend they care about taxpayers. By targetting people on assistance, the state auditor’s office fools everyone by deflecting attention from its refusal to audit high crimes by the ‘elite’ reptiles in control of the Massachusetts swamp.

This week the state auditor’s office preened itself on identifying $10.7 million of Medicaid fraud. In absolute terms this $10.7 million is a hill of beans given that we lose $4 billion annually to healthcare fraud nationally. Given that Massachusetts’ fiscal 2018 healthcare budget is $21.7 billion, this $10.7 million is a convenient farce. Almost a rounding error at 0.049% of annual state health costs and 0.27% of the annual national fraud.

The auditor’s enabling statute, MGL ch. 11 § 12, declares: “Section 12. The department of the state auditor shall audit the accounts, programs, activities and functions directly related to the aforementioned accounts of all departments, offices, commissions, institutions and activities of the commonwealth, including those of districts and authorities created by the general court and including those of the income tax division of the department of revenue.” Note it says SHALL, not may if you feel like it.

The state auditor’s office goes after poor people to conceal the fact that the vast majority of our ‘departments, offices, commissions, institutions and activities’ go totally unaudited. As a matter of common sense, where do you think the vast majority of the money disappears? Naturally we didn’t hear about the invisible State Police salaries from the state auditor either.

For three years now Dr Michael Langan and I have been trying to get the state auditor’s office to audit the state medical board and its illegal kickback relationship with the Massachusetts Medical Society. This effort involved emails and meetings in person with Deputy Auditor Ken Woodland and with Director William Keefe, who is with the Bureau of Special Investigations and allegedly the point person to combat white collar crime. As with everything to do with state government, reality is a bummer.

Dr Langan presented Keefe with hard evidence that showed Board lawyer Robert Harvey fabricated a false document to serve as a pretext for suspending a doctor’s license as punishment for refusing to pay extortion money to the medical society. A classic protection racket with license suspension as the Board’s form of breaking the victim’s leg. At a minimum it was Keefe’s duty to report Harvey to the SJC’s Bar Overseers for violating its Rules on Professional Conduct. Keefe did not.

Dr Langan presented Keefe with hard evidence that showed Asst. AG Bryan Bertram consciously lied to the court and concealed evidence of forensic fraud and obstruction. Exactly like the state lawyers did in the Sonja Farak case. At a minimum it was Keefe’s duty to report Bertram to the SJC’s Bar Overseers for violating the Rules and obstructing justice. He did not.

Dr Langan presented Keefe with hard evidence that showed a long-running procurement fraud and kickback scheme between the medical society and Board lawyers that involved hundreds of thousands of dollars. It has been three years and the auditors have refused to audit, let alone report crime.

Two years ago I presented Deputy Auditor Woodland in person with documents showing the renting out of the Board by its lawyers to other doctors in order to ‘take out’ their competition. I also gave him documents showing the parking of tax dollars by the Board in a private foundation invisible to the public. A secret slush fund.

Here is Keefe’s response today (4/4/18): “Sir, As Ken and I have discussed with you and Michael, we will be looking into your concerns when we audit the agency. Bill Keefe.” So, when I report a crime, it is merely ‘my concern.’

It is very difficult to collect the documentary evidence but Dr Langan has done it. And the auditors are angry because now they cannot say they do not know.

Henry Morgenthau proved that everyone at the State dept. knew about the holocaust as it was unfolding and concealed the facts to avoid public pressure to save the Jews. Everyone at the state auditor’s office is no better.

The auditors know that these crimes by Board lawyers and the medical society caused numerous doctors to commit suicide in the prime of their life. These suicides occurred because the state auditor knew about the crimes and ongoing deaths of despair and did nothing. Same as the diplomats at State during the holocaust.

(Bharani Padmanabhan MD PhD is a multiple sclerosis neurologist. On July 12, 2017 the state medical board stole his license because he reported Medicaid fraud to the government. scleroplex@gmail.com)

Please sign petition for state audit of Massachusetts physician health program (PHP), Physician Health Services, Inc. (PHS)–Evidence of top-down corruption

Screen Shot 2015-08-29 at 2.37.54 PMTo sign the petition please click here.

Why this is important

State Physician Health Programs (PHPs) were originally developed by competent and caring physicians to help colleagues who developed problems with addiction or substance abuse.

As an alternative to disciplinary action by state Medical Boards they provided a safe haven for sick doctors while also protecting the public from impaired physicians.This image as a humanitarian agency with virtuous organizational purpose has created an absence of the need to guard.   Any system can be subverted, but as self-governing organizations with no meaningful transparency, oversight, regulation or accountability these organizations were particularly vulnerable to exploitation.

State PHPs have been gradually taken over by the Federation of State Physician Health Programs (FSPHP). The FSPHP is an offshoot of  the American Society of Addiction Medicine (ASAM), the self-proclaimed “voice of addiction medicine.”

A “self-designated” medical specialty, American Board of Addiction Medicine (ABAM) “board certification” is not recognized by the American Board of Medical Specialties (ABMS).

Through a torrent of propaganda and misinformation, however, combined with strategic and successful lobbying efforts they have gained tremendous sway in the field of addiction medicine. Advancing the 12-step rehab drug testing agenda they have modified and monopolized the field. By cozying up to regulatory boards and politicians they have altered the rules, statutes, and regulations to provide immunity, impunity, and confidentiality. All of this was done without difficulty or any meaningful opposition. They have swayed legal opinion and successfully tinkered with the system to amend rules and policies.

Many consider the ASAM and FSPHP to be corporate front groups, organizations whose agendas match those of corporate interests but who claim no formal relationship. In this case the agenda is 12-step rehabilitation industry and the drug testing industry. Over the past 10 years the ASAM has grown to over 3000 physicians. Within this group there is a subset of recovery fundamentalists who have populated the PHPs. Many have also become medical directors of the rehabilitation facilities to which they refer. By removing dissenting physician who do not agree with the groupthink they have successfully taken over the State PHP system. The evidentiary standard is low. They encourage confidential referral from colleagues and provide immunity to those who refer. If the PHP believes a physician “could benefit” form their services there is no choice. The FSPHP political apparatus exerts a monopoly of force. It selects who will be monitored and dictates every aspect of the evaluation and monitoring process. Conflicts of interest abound.

Control has replaced conduct and ideology has trumped science and reason. It is a system that fosters corruption and impunity. There have been reports of gross misconduct and breaches of standards of care, ethical violations, and civil rights violations. Basic human rights violations and criminal activity has been reported.

In Massachusetts caring and competent physicians such as J. Wesley Boyd and John R. Knight were removed from the State PHP, Physician Health Services, Inc. (PHS). In an article written for the Journal of Addiction Medicine in 2012 they address some of these concerns and suggest the “broader medical community begin to reassess PHPs as a whole.” They recommend independent oversight, transparency, national standards, periodic auditing, and an appeals process. They state:

“Because PHP practices are unknown to most physicians before becoming a client of the PHP, many PHPs operate outside the scrutiny of the medical community at large. Physicians referred to PHPs are often compromised to some degree, have very little power, and are therefore, not in a position to voice what might be legitimate objections to PHP’s practices.”

The FSPHP has introduced junk science such as Ethyl Glucuronide, Ethyl Sulfate, and Phosphatidylethanol as long term alcohol biomarkers with no evidence base. They did this by getting them approved as “Laboratory Developed Tests” (LDTs) to bypass FDA scrutiny. There is no evidence-based support for these tests but the FSPHP convinced Regulatory Agencies (medical boards) that they were valid tests. This “medical sanctification” of these bogus tests resulted in other monitoring programs utilizing them and, unregulated by the FDA, the labs doing the tests could claim they were accurate and reliable with no repercussion. they are claiming the PHP programs as the “new paradigm in addiction treatment” claiming an 80% success rate. They have also created a myth that medical mistakes are the result of a hidden cadre of drug addicted doctors and are behind the recent call to randomly drug test all physicians. Of course who will run such a program? They will. They also want to expand to other organizations such as the DOT.

There is a lot of anecdotal evidence that the marked suicide rate in physicians is because of this.

The propaganda and misinformation is based on a study that is misleading and full of methodological flaws.

In “Ethical and Managerial Considerations Regarding State Physician Health Programs,” published in the Journal of Addiction Medicine in 2012, John Knight, M.D. and J. Wesley Boyd, M.D., PhD recommend ”the broader medical community begin to reassess PHP’s as a whole” and that “consideration be given toward the implementation of independent ethical oversight and establish and appeals process for PHP clients who feel they are being treated unfairly.”

They also recommend the relationship of PHP’s between the evaluation and treatment centers and licensing boards be transparent and that national organizations review PHP practices and recommend national standards “that can be debated by all physicians, not just those who work within PHPs.”

In evaluating a physician this group is not gathering data to form a hypothesis but making data fit a hypothesis that arrived well before the physician did. And this may be part of the explanation for the recent marked increase in physician suicide. With guilt assumed from the start, no due process, no appeal, and no way out physicians are being bullied, demoralized, and dehumanized to the point of hopelessness. This needs to end now.

Medicine is predicated on competence, good-faith, and integrity. Medical ethics necessitates beneficence, respect, and autonomy. The scaffold erected here is designed for coercion and control. Exposure, transparency, and accountability are urgent. An evidence based Cochrane type assessment of their “research” and an Institute of Medicine Conflict of Interest review are long overdue.

In addition it is a “rigged game” as the ASAM makes the public policy and the FSPHP enforces it. Furthermore the FSPHP mandates that physicians be evaluated at a “PHP-approved” facility. All of the medical directors of these facilities (which number around 20) are ASAM physicians “in recovery.” It is essentially self-referral.

A State Audit done in North Carolina found no oversight or regulation of the State PHP from either the state Medical Board or the Medical Society. In addition they found lack of due process for physicians and exposed the conflicts of interest between the PHP and the out of state treatment programs. They concluded abuse could occur but not be detected.  It is the same scaffold present in Massachusetts.

The Medical Director and CEO of the North Carolina Physicians Health Program (NCPHP) Dr. Warren J. Pendergast, M.D. is the immediate past President of the Federation of State Physician Health Programs (FSPHP)  and the audit findings of the NCPHP are standard operational procedure for other state programs fully infiltrated by the FSPHP.

The same infrastructure that exists in North Carolina and Massachusetts exists in other states.   In this system there is absolutely no oversight from the medical board, the medical society, department of health or anyone else for that matter.  They truly have removed all aspects of accountability.

PHS, inc. has been given cart blanche power in the assessment, treatment, monitoring, and disposition of all physicians referred to them.

The previous Medical Director of the Massachusetts PHP, Physicians Health Services, Inc. (PHS) for fourteen years (prior to Dr. Steve Adelman) , Dr. Luis Sanchez, is also a past President of the FSPHP.

And although  PHS did not enter into formal partnership with the FSPHP until 2013, Sanchez and PHS Director of Operations Linda Bresnahan (who was interviewed for the recent Medscape article critical of PHPs) have both had long term involvement in the political hierarchy of the FSPHP and, in fact, helped develop the prototype for other states.

PHS, inc. exclusive use of out of state treatment programs has been challenged. In the past PHS, Inc. has adamantly refused to allow physicians to be evaluated in State despite it being one of the medical hubs of the country. Physicians in Massachusetts who are referred for evaluation in Kansas, Georgia, Alabama, and West Virginia as PHS has convinced the Board that only these facilities are ‘experienced in the assessment and treatment of health care professionals.”

In actual fact the medical directors of all of these preferred facilities are also ASAM physicians with the vast majority being in 12-step “recovery” themselves and close colleagues,  if not friends of the medical directors of other state PHPs.

There is also documentary evidence that PHS, inc. is colluding with third parties (labs and treatment centers) to misrepresent test results and diagnoses in conspiracy to commit fraud.  Documentation shows purposeful and intentional act to commit “confirmatory distortion” which is the deliberate misinterpretation or misrepresentation of facts to support a predetermined hypothesis.

Knight and Boyd note in “Ethical and Managerial Considerations Regarding State Physician Health Programs” “To further complicate matters, many evaluation/ treatment centers depend on state PHP referrals for their financial viability. Because of this, if, in its referral of a physician, the PHP highlights a physician as particularly problematic, the evaluation center might—whether consciously or otherwise— tailor its diagnoses and recommendations in a way that will support the PHP’s impression of that physician.

To consciously “tailor” a diagnosis or recommendation based on the PHPs impression of a physician is fraud.

Documentary evidence shows how PHS, inc. is engaging in fraud by colluding with a “PHP-approved” assessment center to fabricate and falsify neuropsychological tests to show “denial” and “relapse” with normal objective raw data being interpreted as abnormal. (again verified by a third-party oversight agency which resulted in the colluding party being forced to correct the results under threat of disciplinary action).

But without any regulation or meaningful oversight of PHS and no appeal process or avenue for the reporting or investigation for the physician, PHS has been able to get away with this misconduct with impunity and immunity. Complaints are either ignored, dismissed, or justified by sympathizers, apologists and a great deal of “willful ignorance.”

There should be zero tolerance for forensic fraud at all levels but when a person’s career, life and liberty are at stake and the perpetrator is in a position of power this conduct is particularly egregious. The damage done by a positive drug or alcohol test can be severe, far-reaching, and permanent. Intentionally and purposefully misrepresenting drug or alcohol tests by manipulation and fraud is unethical and needs to be addressed in real time. Those who engage in such behavior need to be held accountable for their actions.

For these reasons I petition Suzanne Bump to initiate a performance audit on PHS, inc. to detect fraud and abuse. There is currently no meaningful way to report, investigate, and hold accountable abuse of power in PHS, inc. Transparency, oversight, regulation, and accountability are essential.

The Physicians of the Commonwealth of Massachusetts deserve better than this.

Please Sign Petition and Call (617-727-6200) MA State Auditor Suzanne Bump to Demand Audit of Corrupt Physician Health Services and the MA BORM Physician Health and Compliance Unit

Please Sign Petition and Call (617-727-6200) MA State Auditor Suzanne Bump to Demand Audit of Corrupt Physician Health Services and the MA BORM Physician Health and Compliance UnitThe Petition can be found here.  Or better yet, sign the petition and call her.  The evidence that Physician Health Services, Inc. (PHS) is committing crimes has been free-floating for the past two years.   It has been posted on Reddit, Twitter, Facebook, Linkedin, blogged, faxed, and phoned.  The response?  Absolute silence.

The procedural, ethical and criminal violations are clear and many.     The incontrovertible evidence has been directly delivered to individuals who should address this but for some reason do not.  This is not a matter of opinion folks but a matter of fact.    Time and time again we hear of  egregious misconduct hidden for decades because of  cognitive dissonance and blinkered apathy.

What evidentiary standard is required for action?   Over the past three years and under a lot of duress I have obtained indefensible documentary prima facie  proof of  crimes committed by individuals that should elicit immediate action but produced nothing but silence.

The crimes are many and they are of significance.  Accountability necessitates both the provision of information and justification for one’s actions.   This group has effectively blocked both of these. With much effort and under threat I have obtained proof of criminal activity with the expectation that the provision of this information would  result in those who should and could do something about it would.   They have not.

The documentary evidence of crimes is self-evident.  It is indefensible.    It is inexcusable that criminal activity is taking place within the walls of the Massachusetts Medical Society.   The fact that PHS is unregulated and without any meaningful accountability is irrelevant.  They are engaging in criminal activity within the walls of an institution whose very foundation is the antithesis of this groups actions and it must be addressed. Either support what the documents show or do something about it.

So please sign this petition and call  Massachusetts State Auditor Suzanne Bump at 617-727-6200

Institutional injustice just like that being committed by Luis Sanchez, Linda Bresnahan and the corrupt MRO Wayne Gavryck is killing doctors across the country.  They need to be held accountable.  Help me hold them accountable.

You do not need to be from Massachusetts to sign this petition. It is to raise public awareness–hopefully enough to elicit more exposure of this problem to prompt audits not only in Massachusetts but in other states as was recently done in North Carolina. The N.C. state auditor conducted an investigation and found poor oversight of the state PHP by both the state Medical Society and the state Medical Board, a lack of due process for physician’s who disputed the PHP’s evaluations and requirements, and multiple instances of potential conflicts-of-interest.

Dr. J. Wesley Boyd, who was previously an Associate Director at Physician Health Services, inc., the Massachusetts PHP is recommending that state government agencies audit their PHPs as well to “ensure that their vast power is wielded judiciously and with oversight.”  He adds that “doctors who are unsafe to practice medicine ought to be prevented from doing so. But every doctor who enters any kind of treatment or monitoring program should be treated respectfully and fairly, monitored appropriately, and have legitimate avenues of appealing decisions about their care.”

The Massachusetts PHP is engaging in unconscionable conduct including forensic fraud and self-evident criminal activity that is indefensible from within the walls of the Massachusetts Medical Society. Most are not aware of this. They need to be. This rigged game is a national problem and how the racket works in Massachusetts can be seen here.

 Please help me expose this and put a stop to it!

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