Insurance Fraud – Vicky Lopes and Edward Rossi Sentenced to Prison

January 22, 2015

The owner and operator of a Brockton physical therapy company and her employee were sentenced for defrauding insurance companies in connection with physical therapy services purportedly provided to patients involved in car accidents.

Insurance FraudWalkyrie Massie, a/k/a Vicky Lopes, 39, and Edward Rossi, 65, of Rochester, were sentenced by U.S. District Court Judge Richard G. Stearns to 30 months and 18 months, respectively, two years of supervised release, and ordered to pay $174,597 in restitution to the defrauded insurance companies.  Massie and Rossi pleaded guilty to conspiracy to commit mail fraud and two counts of mail fraud in September and August 2014, respectively.

“The scam perpetrated by Massie and her employees defrauded insurance companies and deprived injured patients of proper care,” said U.S. Attorney Carmen M. Ortiz.  “Patients deserve quality care and insurance providers need honest care-givers.  This kind of fraud is corrosive to our healthcare system.”

“Westgate Physical Therapy was solely motivated by profit rather than patient care when it forged patient records and billed for medical care never provided scamming private insurance companies out of hundreds of thousands of dollars,” said Vincent B. Lisi, Special Agent in Charge of the Federal Bureau of Investigation, Boston Field Division.  “The FBI is dedicated to aggressively investigating this type of criminal activity because it has a great impact not only on private insurance companies but on the economy as a whole as well.”

Massie, the owner and operator of Westgate Physical Therapy in Brockton, and her employees submitted fraudulent medical progress notes to insurance companies, in connection with physical therapy the company purportedly provided to patients involved in car accidents.  Specifically, Rossi, a licensed physical therapy assistant, was supposed to provide physical therapy to patients several times a week until the physical therapist, Deidre Chouinard, re evaluated the patient and signed off that the treatment was complete.  Westgate would then send a bill to the responsible insurance company.  The progress notes contained in the patients’ chart would also be used to determine personal injury protection payments, as well as any bodily injury settlements with other insurance companies.

In reality, for the majority of patients, Rossi simply filled in cookie-cutter treatment notes for patients who either never showed up that day, came into the clinic for mere minutes, or were not seen at all by Rossi because he was not present.  Furthermore, Rossi signed notes for treatments that Massie performed, even though she was not licensed to do so.  Based on these fraudulent submissions, from 2009 to 2011, Westgate billed insurance companies more than $400,000 and received more than $174,000 in payments.

During the investigation into Westgate’s activities, federal law enforcement used a cooperating witness, who claimed to have been in a car accident and sought treatment at Westgate.  From March through June 2011, recordings made of this individual’s visits to Westgate captured how Massie boasted about forging the individual’s name to the sign-in sheets to falsely show that he had come in for treatment when he had not.  In one recorded conversation, Rossi can be heard demonstrating how the therapy exercise equipment worked so that the individual would be able to describe the physical therapy if he were called in to give a statement to the insurance company about his injuries and treatment at Westgate.

In December 2014, Chouinard, Westgate’s physical therapist, was sentenced to three years of probation.  A fourth defendant is awaiting trial.

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International Business Ethics Expert Chuck Gallagher featured at Medtronic meeting in Geneva, Switzerland

December 18, 2012

FOR IMMEDIATE RELEASE

Medtronic Gray and BlueChuck Gallagher, international Business Ethics expert was the featured keynote speaker at the Medtronic – Culture of Ethics and Integrity Meeting in Geneva, Switzerland on December 11th and 12th, 2012.

Medtronic, Inc. (www.medtronic.com), headquartered in Minneapolis, is the global leader in medical technology – alleviating pain, restoring health, and extending life for millions of people around the world.

Focusing attention on the “Human Side of Ethics” Rob ten Hoedt selected Chuck because of his unique background and ability to deliver a compelling ethics message – one that will be remembered long after the meeting is over.  Rob ten Hoedt is the Senior Vice-President & President, EMEA & Canada, a role he has been in since 2009 and in which he is responsible for all sales and distribution of Medtronic products and therapies across these regions. He is a member of the Company’s Executive Committee (ExCom).

“I am excited to share with the folks at Medtronic the reality of how and why we make the ethical choices we make and what we can do to stay within our ethical boundaries.  All to often we focus on the compliance and legal issues surrounding our companies, when the most important issue of understanding the human element of our choices and the consequences that follow.”

Speaking and consulting with companies worldwide, you may have seen Chuck on television, or heard him on CNN, CBS or NPR radio programs.  His business insights are sought after for his strong position on ethics and sales leadership.  Chuck Gallagher’s focus is business – but his passion is empowering others.  His unique presentations, from Expert Sales Training to Effective Business Ethics clearly demonstrate he brings something to the platform that isn’t often found in typical business speakers.  Chuck’s personal experience in building businesses and sales teams while leading companies provides a practical and powerful framework for success.

Currently COO of a National Company and former Sr. VP of Sales and Marketing for a Public Company, Chuck may have found a sales niche early on in life selling potholders door to door, or convincing folks to fund a record album of his musical performance at age 16 (and yes those were the days when an album was made of vinyl), but it was the school of hard knocks that provided a fertile training ground for Chuck’s lessons in Success.  Described as Creative, Insightful, Captivating, and a person that “Connects the Dots” between behavior, choices and success, Chuck Gallagher gives his clients what they need to turn concepts into actions and actions into results.

It has been said that with Chuck you have an industry professional sharing practical tested and time proven methods that can enhance personal and professional performance with a clear focus on Ethics.  What Chuck shares in his presentations – whether training, keynotes or consulting – are understandings of not only “How To”, but also “what motivates behavior” – behavior of individuals which create personal and professional success.

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Chuck Gallagher is the founder of the Ethics Resource Group and for information about Chuck’s Ethics presentations, he can be contacted via http://chuckgallagher.com, email at chuck@chuckgallagher.com or phone 828.244.1400.

Chuck Gallagher is represented by Eclectic Media Productions a national PR firm.

http://www.mediaproductions.tv

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Bottom Line or Business Ethics – Which is more Important? Judith Samuelson’s article discusses – Chuck Gallagher Business Ethics Speaker comments…

July 21, 2012

There have been a flurry of articles lately about what and how business schools teach business ethics.  The most recent, an article written by Judith Samuelson on the HUFF Post Business section states the following:  “Research conducted by the Aspen Institute suggests that ethics IS taught in business schools, and, increasingly, with an eye to making it stick by embedding it in orientation programs, “learning journeys,” core course work and hands-on experience.”

It is in the first part of her article that I take exception.  As a business ethics speaker and author I see first hand what seems to be the norm for business ethics offerings in b-schools and it’s pathetic – at least that’s my opinion.  Samuelson goes on to say, “Business ethics goes by many names and the vast majority of schools in the Institute’s ranking of business schools require ethics or something that goes by the name of “social responsibility,” “social enterprise,” “social impact” or “leadership and values.””

REALLY?  Social responsibility?  Social enterprise?  Leadership and values?  Come on…you can call it what you want, but if you don’t teach beyond the theory of what is socially acceptable or how leadership intersects moral norms, you effectively have little more than just fluff!  Theoretical fluff…I would call it and that has little impact in the real world when faced with split second decisions that have an impact far beyond the moment.

One clue comes from the inside. Luigi Zingales, a titan of the academy of finance who teaches at the University of Chicago, argues that business education across the disciplines needs to move from a stance of “values neutrality” to one where students are exposed to the moral decisions that permeate the core of business. Zingales suggests we deliver “ethics” in accounting and finance rather than a course labeled Ethics, which is bound to turn off motivated students looking to get ahead.

Interesting paragraph by Samuelson.  Intriguing that Zingales wants to hide ethics in some other course because it turns off motivated students who want to get ahead.  I have an alternate suggestion…  Educate students with the course – “How to avoid an orange jumpsuit and handcuffs” – in other words make ethics real and alive.  What do the professors know about the real world of federal prison, how one turns to the dark side and what happens when that happens.  Pardon the bluntness, but perhaps students should be scared sh*tless and know the real world implications of their (sometimes misguided) desire to get ahead.

Samuelson shares: To the contrary — research also suggests that the big take away from b-school is the same one that permeates board rooms. Ethics are important, but earnings-per-share is the guiding principle. Remember the ethics handbook distributed to each employee at Enron? The more compelling and well compensated message went something like this: We exist to make money. “Profits,” aka “shareholder value,” is the most important metric. We all benefit when the stock price goes up — and employees who make it happen will receive the most. Damn the torpedoes; full speed ahead. EPS is the main meal. “Ethics” is desert.

Samuelson’s article approaches the education of business ethics in a focuses thought provoking way.  Nice article.  I, on the other hand, would love to share a good dose of reality into the minds of the students helping them connect the dots between choices and consequences.  Perhaps a semester of real world example where the students choose among a set of choices giving them an opportunity to see which one’s result in career destruction and arrest would have far more impact.  Maybe we should call it:  Career Destruction and Prison – the Ethics Course YOU Won’t Forget!

What do you think Judith?

Photo by Clay Bennett – see claybennett.com


Whatever Happened to the Criminal Justice System in the USA? Dan Frishberg’s Biz Radio Folly goes Unpunished and Dan’s still on the Radio… Go Figure!

July 20, 2012

It’s been a while…a long while since I turned my attention to Daniel ( Dan ) Frishberg – the radio personality who, with his partner Al Kaleta, caused many an investor to lose substantial funds in the failed Biz Radio debacle.  I received an email today from a defrocked investor in Dan Frishberg’s failed scheme asking “Whatever happened to the criminal justice system in the USA?  Dandy question, cause it seems that Dan Frishberg has effectively walked away with no criminal consequence to his very public investor fraud.   If you want to see background go to these wordpress posts on “The Money Man“.

In Dan Frishberg’s most recent report he states the following:

The key is to hold the right assets for enough time so that the investment can reap its full reward. It takes a lot confidence for an investor to believe that the company will not only be in business years from now but will continue to create an increasing amount of value several business cycles into the future. Successful investors are only able to hold on to stocks for the long term if they are able to create conviction with the proper due diligence, generate income, and protect their capital during uncertain times.

Hum…I read the words written and wonder!  You state, “It takes a lot confidence for an investor to believe that the company will not only be in business years from now but will continue to create an increasing amount of value several business cycles into the future.”  Yet, I wonder how the folks feel that listened to your advice on Biz Radio and your podcasts and YouTube and believed that you had a sustainable business model that would create an increasing amount of value to sustain them into the future.  Seems from all accounts that you and your cronies led folks into investing into nothing more than a Ponzi scheme and today they have lost.  But have you?

“Successful investors are only able to hold on to stocks for the long term if they are able to create conviction with the proper due diligence, generate income, and protect their capital during uncertain times.”  Dan those are your words.  Yet, you solicited investments that did not protect capital, generate income and were void of due diligence.  Shame on you…!  You survived, but what about those who trusted you?

I believe in Second Chances – in fact I wrote a book about it!  I know with every fiber of my being how you operate as (sadly) I was you at one time.  But there is one BIG DIFFERENCE.  I acknowledged my unethical actions, made restitution and changed my choices.  Seems accepting responsibility – which is the first step to recovery – is something that continues to allude you.  Isn’t it time – Dan Frishberg – to face the truth of your lies and deceptions – take responsibility – make restitution and then move forward with your life in an honest and ethical way.

You – Dan Frishberg – could be a leader in ethical business practice, sharing the truth of your folly and how unethical practice can be turned into societal good.  Sadly, Dan, it seems that you only know one thing – how to be a talking head on the radio.  Every choice has a consequence and the consequences of your choices are not over…cause karma’s a bitch.

If you have been defrauded by Dan Frishberg and Al Kaleta – feel free to share your experience so others can at least be warned!


Business Ethics education – moving beyond what’s illegal…how about focusing on choices and consequences!

July 19, 2012

For the past several days I’ve been noticing a series of articles about Business Ethics education and what should be taught.  Today I see Felix Salmon’s article: Business ethics need to move beyond what’s illegal where he says we should be more worried about unethical behavior in general rather than just teaching how to avoid criminal behavior.  I agree.  However, I would challenge Salmon in his belief that Business Ethics education even teaches about unethical criminal behavior.  From my experience speaking to a number of business schools as a business ethics speaker, I have found in polling students that the level of education related to business ethics centers around ethical theories rather than practical real life application – whether criminal or not.

Salmon shares the following: There are interesting ethical debates to be had as to where to draw the line: for instance, all those “free offers” which require you to hand over your credit-card details and then bill you regularly unless you cancel. They prey on cognitive limitations, I’d say, and are less ethical than companies which don’t do that. Should business-school professors tell their students that they should avoid implementing such schemes? I don’t know. But I do think that acting ethically, even if such actions are legal and don’t maximize profits, is something that many more business-school students should be encouraged to consider.

I find it interesting that Salmon’s example implies a certain judgment regarding the rightness or wrongness of certain actions.  For example, if I ask a group of people is it ethical to kill someone, the majority would say a resounding NO.  But, if your child were being attacked and in imminent life threatening danger, would it then be ethical to kill the perpetrator – I find the answer becomes a resounding YES.  So…ethics are based on the rightness or wrongness is certain situations.  Back to Salmon’s example.  Is it ethical to offer your free credit report with hidden language that you’ll be updated monthly automatically with a charge to your credit card?  Salmon seems to judge NO.  I say it is a function of the business you’re in.  If that is your business model and that of your competitor, then it would be challenging to find a lack of ethics in a model that works.  Sure…there are those who think such a model should be banned, but until it is…it is legal and ethical.  No different than selling spirits or cigarettes.  Both are bad for you and thereby potentially unethical to sell, but unethical – NO!

However, at the risk of getting off track from Salmon’s fine article…it would seem that the point of teaching more than just legal and illegal makes sense.  The question for me is – are we teaching legal and illegal and exposing the choices made have consequences that follow?  I don’t think so…at least not nearly enough.  Theories are fine, but practical application teaching is far more effective in my opinion.  For example, I was consulting with a fellow just a week ago who was convicted of conspiracy.  Here’s the simple truth, if a company (or people within the company) conduct unethical illegal acts and you don’t report it then you may be found guilty of conspiracy.  Seems to me to be more of a deterrent to unethical behavior if folks know the dire consequences that follow unethical and illegal behavior.

What are your thoughts?


Business Ethics as a Core Course in Business Schools? What a novel idea…or do you prefer an Orange Jumpsuit and Handcuffs?

July 18, 2012

What a novel idea is right…  It seems that what is OBVIOUS sometimes is missed by the masses.  Honesty, integrity, and ethics are – or should be – the core foundation for which we operate in life.  Yet, as Luigi Zingales points out in his article: “Business School should count ethics as a core course” it appears that all to often those who are at the top of the business food chain seem to forget the core of business fundamentals.

Zingales, in his article, states: “Recent scandals at Barclays, JPMorgan Chase, Goldman Sachs and other banks might give the impression that the financial sector has some serious morality problems. Unfortunately, it’s worse than that: We are dealing with a drop in ethical standards throughout the business world, and our graduate schools are partly to blame.”

The problem – at one level – is academics seem to be more concerned with theory than practical application.  Again, Zingales shares the following:

Most business schools do offer ethics classes. Yet these classes are generally divided into two categories. Some simply illustrate ethical dilemmas without taking a position on how people are expected to act. It is as if students were presented with the pros and cons of racial segregation, leaving them to decide which side they wanted to take.

Others hide behind the concept of corporate social responsibility, suggesting that social obligations rest on firms, not on individuals. I say “hide” because a firm is nothing but an organized group of individuals. So before we talk about corporate social responsibility, we need to talk about individual social responsibility. If we do not recognize the latter, we cannot talk about the former.

I agree!  Ethics theory – while valuable – doesn’t go far enough to teach those who will face practical application what to do and when to do it when faced with pressure and temptation.  Theories are wonderful, but how many of us think about theory when faced with real life challenges in real time.

As a business ethics speaker, I was set up as the keynote speaker at a university in Canada.  My background was hidden from the faculty as the Dean of the Business School…wanted my presentation to impact both the student attendees as well as the faculty guests.  To that end, as we prepared to share dinner together before the presentation, one of the professors asked me a simple question – “What theory of ethics do you follow?”

That question caught me a bit off guard as my mind raced to formulate an appropriate answer.  Then it hit me…  The answer just flowed from my mouth – “The theory that keeps you out of federal prison!”

“Oh” responded the professor, and quickly he found company somewhere else.  Discomfort created by my response is just what needs to take place when teaching ethics.  We, all too often, make ethics some luke warm course to fill a curriculum and fail to teach the real world application of what happens when ethics fail.  Zingales says:

The way to teach these ethics is not to set up a separate class in which a typically low-ranking professor preaches to students who would rather be somewhere else. This approach, common at business schools, serves only to perpetuate the idea that ethics are only for those students who aren’t smart enough to avoid getting caught.

Rather, ethics should become an integral part of the so-called core classes – such as accounting, corporate finance, macroeconomics and microeconomics – that tend to be taught by the most respected professors. These teachers should make their students aware of the reputational (and often legal) costs of violating ethical norms in real business settings, as well as the broader social downsides of acting solely in one’s individual best interest.

So here’s the deal…if your business school isn’t committed to teaching practical ethics then you can’t expect graduates to apply ethics in practical day-to-day applications.  What is practical ethics – perhaps it’s ethics applied in such a manner that it keeps you out of an orange jumpsuit and handcuffs.

Your comments are welcome


BUSINESS ETHICS: From a Corporate Secretary’s perspective! An interesting new book by Nan DeMars

August 18, 2011

FEATURED IN CANADIAN BUSINESS – NEW BOOK NEWS RELEASE reprinted from CANADIAN BUSINESS

One December day in 2008, Eleanor Squillari’s boss was arrested for securities fraud. The next day, the secretary arrived at her office to find it a scene of utter chaos: phones ringing, faxes spewing paper, FBI agents strutting around and a couple of dozen red-faced investors in the lobby demanding blood, or at least an explanation.

Squillari didn’t know what to tell the clients of the man for whom she’d worked for 25 years. She also didn’t know if she’d been unintentionally complicit. Even if she’d never once felt that something might have been amiss, in clients’ eyes she was at least guilty by association. So the following year, when the secretary decided to go public in a Vanity Fair article with her account of a quarter-century spent working for Bernie Madoff, it was hard to begrudge her a voice. As one G-man told her, “You need to take care of yourself, because nobody else will.”

No doubt Nan DeMars feels some empathy for Squillari. DeMars spent 20 years as a corporate secretary in Minnesota, and through her leadership role with the International Association of Administrative Professionals, she was responsible for authoring her profession’s first ever code of ethics. Now president of her own consulting firm, DeMars has become a popular media expert on the subject of ethics in the workplace. In You’ve Got to Be Kidding: How to Keep Your Job without Losing Your Integrity (Wiley), DeMars offers a comprehensive guide to navigating the ethical traps found in every workplace.

Of course, the subject of business ethics now sees much more attention than it once did (not least from Saint Mary’s prof Chris MacDonald, whose thoughtful blog on business ethics is published on canadianbusiness.com). DeMars observes that in the U.S. alone more than 300 colleges and universities now offer ethics curricula, whereas a decade ago it was fewer than 10. She recognizes that, unlike her first book on this topic in 1998, this one arrives in “a ‘we get it’ climate.” But however widely businesses have adopted codes of ethics to govern behaviour in the workplace, the ideal “ethical office” that DeMars describes isn’t attainable through the enforcement of rules. Not only is it impossible to anticipate in such a code every possible variable or potential dilemma, but always “it is possible to satisfy the letter of the law while still committing an act that most reasonable people would consider unethical or immoral.” Even if accepting a gift from a potential client isn’t explicitly proscribed, does that make it right?

Before this starts to sound like the annual lecture from management—perhaps you’re one of those corporate employees forced to sleepwalk through an intranet quiz once in a while to prove to your higher-ups that you’re familiar with the company’s code of conduct—consider DeMars’s argument for the value of the ethical office from a personal standpoint: “In order to live happily and at peace with ourselves, we have to live in ways that are congruent with our morals,” she argues. (Morals, as DeMars defines them, are the principles of a person’s character, while ethics is a system of moral values, the set of rules or expectations publicly accepted by a group.) “For us to work happily and productively, we need to share common ethical standards with our coworkers,” she writes. If the ethics in your office are at odds with your personal values, it invariably makes you unhappy. “And the larger the gap, the greater your level of stress.” That’s why the onus for ethical behaviour lies so firmly with each employee. A code of conduct is just ink on paper; it’s how the group brings it to life that ultimately matters.

So what to do about it? The bulk of You’ve Got to Be Kidding is a subject-by-subject manual for dealing with the most common office dilemmas. There are chapters on workplace gossip, on the vagaries of loyalty, on expense accounts, whistleblowing, vendor relationships and even pornography. But as DeMars says, a written set of rules will never anticipate every situation—and not every ethical quandary will offer choices in black and white. So the most valuable tool DeMars provides is what she calls an “Ethical Priority Compass.”

The tool’s goal is to provide “a hierarchical approach to resolving ethical dilemmas,” and it’s an incredibly simple one: First, take care of yourself. In every situation that arises, DeMars writes, “you must protect your professional reputation and your financial security—and do so in a way that is aligned with your personal morals and values.” Second, take care of your company and its customers. Worry about your supervisors last.

It’s the relationship with our supervisors that often leads us onto the most treacherous terrain, and DeMars devotes plenty of words to the subject. By her reckoning, your boss is the first person you should go to if confronted with an ethical dilemma—even if your boss is the source of the problem. You should be careful not to “immediately leap to the conclusion that he or she is the enemy.” It’s always worth making the effort to preserve that relationship, even if you’re uncomfortable with some of the person’s behaviour. Despite its unequal power dynamic, the relationship, DeMars argues, can be more elastic than is apparent, and she offers a 20-step method to ethically manage up. “You have more power than you think you do to affect your boss’s ethical (or unethical) decisions,” she says.

Those decisions may draw you in actively—“Do me a favour and shred everything in that cabinet, would you?”—or passively, in the expectation that you’ll turn a blind eye if you see something amiss. DeMars’s ethical priority compass will help you audit your decisions about how to respond to situations that seem ethically questionable, whether with a co-worker or a manager. If your boss is a Madoff—or just misguided—no code of conduct will steer you right except your own.