Dr. Janet Johnson Hunter Pleads Guilty to Medicare Fraud…what was she thinking?

For more than three years, Janet Johnson-Hunter, a licensed medical doctor and former owner/manager of a private ambulance transportation company, committed fraud.  Johnson-Hunter, late this past year, pled guilty to conspiring to conceal material facts in connection with the delivery of payment for health care benefit, items and services according to a news release from the US Attorney’s office.

Johnson-Hunter changed medical records and ordered employees to change records to indicate patients’ needs to ride in an ambulance, when they did not, in order to be reimbursed by Medicare or Medicaid, according to a federal criminal information complaint was filed Nov. 30.   According to numerous EMT’s and billing staff, Johnson-Hunter, directly and through subordinates, directed employees to re-write medical records which indicated that patient-beneficiaries could sit upright, stand, walk or ride in a wheelchair.  The loss to Medicare/Medicaid = $400,000.

WHAT WAS SHE THINKING?

First I should say, it is not for me to point the finger.  I am not here to pass judgment, that is not mine to pass.  Rather, I’d like to explore the WHY this would or did happen.  As a business ethics speaker, I know that EVERY CHOICE HAS A CONSEQUENCE!  I have lived those words and spent time in federal prison as a result of my past misdeeds.  While I am not proud of that fact, it is a fact nonetheless.  The one thing I am able to do, as a result, is look at choices from a unique perspective.

NEED:  I can’t identify the need directly.  One would assume that to change records in order to increase billing or reimbursement from Medicare would driven by a need for money.  Seems obvious, but Bernie Madoff surely did not need the money, yet he effected one of the largest frauds in US history.  So what’s the need here?  Perhaps those who know Dr. Johnson-Hunter could help with that piece of the puzzle.  FEEL FREE TO COMMENT.

OPPORTUNITY:  It is of little doubt that any system can be manipulated.  If one person can take advantage of a system, one might say that there is a material weakness.  In this case, Janet Johnson-Hunter did not do this alone.  Rather, she used her power and influence to cause others to change records and thus deceive Medicare.  Now…a fair question is: will the Federal Government go after those who admitted to changing records or have they been given immunity from prosecution.

RATIONALIZATION:  This area is most troublesome.  Here’s a reality check…a 50 year old female medical doctor knows better.  You can’t live for half a century and earn a medical degree without having some clue that choices have consequences.  This is especially true when you involve others in the fraud.  You have to know that someone somewhere is going to reveal the truth.

Why would Dr. Janet do this..?  Perhaps that will come out as people comment.  For now, let me restate the obvious:  EVERY CHOICE HAS A CONSEQUENCE.  When you hear the words, “You will reap what you sow” let me state from experience – THEY ARE VERY TRUE.

Likely, Dr. Janet will spend time in federal prison (as did I some 15 years ago for a similar crime).  Prison is no fun as Dr. Janet will soon find out.  But, the question she has to face now, especially now since her misdeeds are brought to light, is what choices will she make now that prove redemptive in the future.

A wise man once said to me:  “You’ve made a big mistake, BUT YOU ARE NOT A MISTAKE!  The choices you make today will define your life in the future and the legacy you leave for your two sons.  MAKE THOSE CHOICES WISELY!”

Comments are welcome

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