Have You Had Pelvic Muscle Rehabilitation?
Roger Beyer, M.D. and his wife, Susan Wright, a nurse practitioner, are facing the consequences of long-term medical fraud. He has entered a guilty plea after years of denial in regard to two medical practices: Women’s Health Care Specialists and Urological Solutions of Michigan.
The case is insidious on several levels.
Along with the husband and wife team, their office manager was also involved in the scam. He is already serving two years in jail and must pay $150,000 towards a $1.26 million civil settlement. The office manager received such a severe penalty because the practice was warned back in 2007, they were committing fraud. The practice circumvented the warning and kept going.
This case is much more than just being about fraud, of course. However, in terms of fraud, the office manager, under Beyer’s direction improperly billed Medicare for lucrative treatments known as pelvic muscle rehabilitation (PMR), billing for services that did not take place, and adding in billing of an unlicensed nursing assistant.
In addition, they were allegedly modifying medical devices for use in their “pelvic muscle rehabilitation therapy.” The charges state: “This adulteration may have exposed those patients to certain infections and diseases.” So, not only was the equipment improperly used, but at times an unlicensed nursing assistant was using it.
Elderly Patients and High Risk
The specialty of the clinics (and the claim is that many patients didn’t need it in any case) involved treatment for problems involving incontinence and rectal problems.
The elderly patients, who were by virtue of the ages, immune-compromised, were evaluated for muscle strength of the rectal muscles by using rectal pressure sensors. The sensors are mandated to be disposable by FDA protocol.
According to legal documents: “A nurse at Women’s Health Care Specialist estimated that the rectal pressure sensor was used more than 100 times before being replaced.”
The FDA mandates the equipment for single patient use. They were in violation of Michigan State health codes. On June 11, 2020, The Michigan Department of Health and Human Services encouraged any patient who underwent diagnostic testing to get tested for HIV and hepatitis.
Why would they do such a heinous thing? To make the operation more profitable, of course. Rather than purchasing new probes, they re-used the old probe. Naturally, when former patients heard of the investigation, they began to react. They claimed infections and on-going health problems.
When the walls began to close in on Beyer and Wright, the practice was quickly put up for sale at close to $1 million. The couple will be sentenced in September 2020 where they face years of jail time and hefty fines.
Greed at all Costs
In 2007, the practice was specifically warned about improper billing for pelvic muscle rehabilitation that was not given, yet they persisted scamming the system for years after. In addition, they re-used mandated disposable equipment up to 100 times, to save money and employed an unlicensed practitioner for the same reason.
In the absence of oversite, they took advantage of an opportunity in order to commit Medicare fraud.
The need to squeeze every cent of profit they could from the practice, even at the expense of the patients they treated, is yet another reason to have mandated ethics training in order for a practice to maintain its license.
The major question here is one of rationalization. How does a wealthy physician, his wife (an R.N.), and an office manager rationalize their unethical behavior? Was it burnout? A complete disregard for the patients? Or feeling that they were all above the law?
When the government and ex-patients began to close the noose around the practice, not surprisingly, the husband and wife team put the practice up for sale. It was undoubtedly their escape hatch and retirement plan: to go for as long as they could, until they got caught.
We normally believe that rationalization at least requires an attempt to construct a logical excuse. What would the excuse be in this case? That it was permissible to cheat the government? That the patients were old and if they developed an infection from non-sterile equipment it didn’t matter?
We can’t always get inside the mind of an unethical person, but we can certainly see unethical behavior when it presents itself.
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