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Harold,

I have to tell you I find this all very interesting.  I can agree 100% with you about Mr. Francis, and having a taste of what good prosthetic care is like.  I know him, to the point the at my daughter is partly named after him.  You see, he was, and still is very much a mentor of mine.  I had the great pleasure of working with Mr. Francis as a staff research prosthetist in the patient care division of Ohio Willow Wood's  R&D department . Whats funny is that I can easily recall Dr. Davidson's first Ertl reciepient, and looking at your age I would have thought for sure I would remember your case.  I worked with him for years up until I left to open my own private pratice in December of 2005.  I have to ask, knowing the great care he surley gave you, how is it that you are not still going to him for your care?

I would suspect you are getting sub-standard care, not because of your insurance, because that is guaranteed, but because your prostehist is not very good. Like any profession in life, some people go into to it with good intentions, but little talent, or for the money, instead of the area of expertize. I don't know how many people I met that went into certain professions for the money and literally hated what they did for a living. You will find the right one if you look hard enough...

He's on the front page on the local news paper today... looks like he's getting what he deserves.

 

http://www.mansfieldnewsjournal.com/apps/pbcs.dll/article?AID=/20080607/BUSINESS/806070309

 

MANSFIELD -- Federal investigators seeking evidence of Medicare fraud have served a search warrant on a Mansfield-based business that makes prosthetic legs. U.S. District Court documents indicate a federal contractor conducting an audit of Mansfield Orthotic and Prosthetic Centers Inc., 240 Marion Ave., discovered the local business was billing the highest amount per Medicare beneficiary across seven states for lower limb prosthetics.

 

TriCenturion, a contractor for the Centers for Medicare and Medicaid Services, said MOPC was reimbursed $1.67 million for prosthetic services for 19 months ending July 31, 2006. TriCenturion estimated $1 million in Medicare overpayments for that period, according to court documents.

 

Eric S. Howe, special agent for the U.S. Department of Health and Human Services, Office of the Inspector General, obtained a search warrant from a U.S. District Court magistrate in Akron. Billing records, sign-in sheets, patient files and computer data were seized in a search of the business last month.

 

Don White, a spokesman for the Department of Human Services-OIG, said he could not comment on whether the agency plans to file criminal charges as a result of the search.

 

"It's the Office of Inspector General's mission to look for waste, fraud and abuse," he said.

 

As of Friday, no criminal charges had been filed in federal court. Mansfield Orthotic's owners could not be reached for comment.

 

David Hoy is majority owner of the business, and Hans Georg owns 33 percent, according to court records. The business, which specializes in lower-limb prosthetics, dates to 1956.

 

In his affidavit, Howe told the court TriCenturion contacted Health and Human Services in January alleging Mansfield Orthotic submitted false claims to Medicare.

 

After TriCenturion requested 10 complete patient files, the contractor found invoices that didn't coincide with services provided, or had some patient or employee names covered with correction fluid, the affidavit said.

 

When TriCenturion conducted an on-site inspection June 17, 2007, reviewing 20 additional patient files, Hoy reportedly could not produce invoices.

 

Court papers said TriCenturion talked with several Medicaid beneficiaries, and turned up several discrepancies:

# Billings to Medicare for five prosthetic legs for one patient who reported receiving only one prosthetic leg after an amputation in 2005.

# Medicare billings for six prosthetic legs for another patient who reported receiving two.

# Billings for four prosthetic limbs for a patient in a nursing facility who was unable to walk independently and reported receiving only one prosthetic limb.

 

The affidavit said Ronald Kidd, a former president of the Ohio Orthotics and Prosethetics Association, was shown Medicare spreadsheets documenting services Mansfield Orthotics billed for five patients, and told investigators he saw "blatant fraud." Kidd said the business appeared to be billing for totally new parts and systems while the old systems were still on warranty.

 

Howe told the court, in seeking the search warrant, that Mansfield Orthotic appeared to be shutting down its business.

 

Bryan Seamour, of the FBI's Mansfield office, assisted in the investigation, according to court filings.

 

Mark B. Levy, director of the State Board of Orthotics, Prosthetics and Pedorthics, said Hoy and Georg have state licenses in good standing.

 

"Nothing has been reported to us, either by federal authorities or anyone else, about this pending matter," he said.

Wonderful! What goes around, comes around eh? Good luck to you.

 

Becky

As a wearer of a pair of prosthesis I deeply commiserate with you. Too many prosthetist still get away with playing God with our devices and by default our lives. Document your concerns and see what avenues are available to resolving your situation. Prosthesis challenges will always exist because we all have different needs and differently shaped stumps.I've repeatedly told prosthetist that though they have basic knowledge its the wearer who is the expert. I get the impression that they listen but don't understand. Its as tough I'm paying them to torture me. unfortunately the battle will continue unless power-sharing becomes the norm at clinics.