There is a great Medicare story making the rounds on Columbus Day weekend but talk about a reporter only getting half of a story. Supposedly a 450-pound, 6-foot-three "personal trainer" in Pennsylvania claimed to be a dwarf to bilk Medicare out of a half a million dollars woth of anti-dwarfism medicine. Actually that is probably not what he was being treated for1 .
It looks to me like the "trainer" is the least criminally culpable person in the story. He is probably mentally ill given the openness by which he went about his scam and other information about him in the indictment. Here are the real questions to ask:
- Is the guy really a "trainer?" Then, at 45, how is the fake dwarf on Social Security? Find the corrupt lawyer that put in a Social Security Disability (SSDI) claim for him
- The significance of a monthly $900 Social Security amount being his only income means that not only is the fake dwarf on SSDI (and therefore Medicare after two years) but he is on what is known as Social Security Extra Help, which provides free or almost free drugs. (Extra Help is the most expensive part of the Medicare Part D drug program; accounting for over half the budget but covering only 20% of the beneficiaries.) Find the corrupt and/or inept Social Security bureaucrats that processed both the disability and Extra Help paperwork.
- Prosecute the corrupt doctor that wrote the prescription for "40 times the recommended dosage."
- Name the corrupt pharmacy that filled the script. The indictment tells us it is Walgreen's mail order pharmacy
- Name the corrupt private insurer that paid Walgreen's $500,000. The indictment tells us it's Highmark.
- Prosecute Craig's List and the fake dwarf's customers as well
- Given the indictment's description of the fake dwarf, it seems highly likely some real crooks are behind this scam
And while we're at it, what took the U.S. Attorney two years to bring the case to the Grand Jury? I guess the reporter just wanted to write a dwarf-joke story.
1Apparently it was only the guy's family jewels that were dwarves. Testicular hypofunction is a legitimate disease and the drug prescribed a legitimate treatment. It is even possibly legitimate that a guy that big needs a very strong dose for that condition, which might let the doctor off the hook.
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