every patient's worst nightmare: that an unscrupulous doctor
will prescribe unnecessary surgery... perform it badly or
not at all... and charge through the nose for it.
kind of misconduct is difficult to identify and nearly impossible
to prove. Why? Because medical diagnoses and procedures are
so complex that it often takes a doctor to recognize medical
fraud -- and doctors don't have the time or training to ferret
it out themselves.
Dr. Holdcraft. When she saw something wrong, she made it her
business to do something about it.
13, the Society of Former Special Agents of the FBI honored
Dr. Holdcraft for her extraordinary service in exposing medical
fraud by presenting her with the Lou Peters Award, which it
annually bestows to a person who selflessly dedicates time
and service to assist the FBI in uncovering wrongdoing.
did Dr. Holdcraft do?
She identified acts of medical fraud by another ENT specialist
in her hometown of Kansas City and, in 1996, reported him
to local U.S. Attorney. And that was just the start.
1996 to 2001, she spent hundreds of hours with investigators,
then with prosecutors. Why? To help them understand medical
terminology and procedures and also billing codes. To review
medical records, including office records, hospital records,
x-rays, and MRI scans. In one case, she spent weeks over 150
sinus and mastoid surgeries performed by the doctor in 1999,
which yielded overwhelming evidence that over 90% of the mastoid
surgeries were unnecessary and over 50% of the sinus surgeries
were unnecessary or billed incorrectly. Then Dr. Holdcraft
testified for the government in two long trials. In December
2001, the doctor on trial was convicted of 33 counts of health
care fraud, seven counts of mail fraud, and three counts of
perjury--and in May 2002, he was sentenced to 6 years of prison.
His license to practice has also been revoked.
joins the Society of Former Special Agents of the FBI in hailing
the extraordinary public service of Dr. Holdcraft. She stopped
an unscrupulous man -- and, in the end, ensured that he would
never prey on unsuspecting patients again. Congratulations,
Dr. Holdcraft -- and thank you.