For comment on health care reform, WSJ looks to doctor who defrauded Medicaid

Blog ››› ››› JOCELYN FONG

Today the Wall Street Journal published an op-ed by Gilbert Ross, who asserts that "[a]s a threat to our nation's security, allowing imported drugs into our pharmacies ranks just below terrorism" because drug reimportation "is a sure path to destroying our drug industry." The Journal identified "Dr. Ross" as "medical director of the American Council on Science and Health," which certainly sounds like a credible authority on reform of our health care system.

But what the Journal didn't share with readers is that Ross previously served time in a federal prison after defrauding New York's Medicaid program by turning society's most vulnerable into drug dealers. In a 2005 Mother Jones expose, Bill Hogan reported that Dr. Ross worked with clinics that "raked in indigent patients-most of them homeless, alcoholic, or drug-addicted men-by offering them prescriptions for expensive drugs that they could resell on the street for cash," in return for bodies on which to perform "medically unnecessary examinations, procedures, and tests." You remember the doctors' oath: First, do no harm ... unless you've got an opportunity to steal millions from taxpayers, then do that first.

From Hogan's Mother Jones piece:

But Ross may not be ACSH's most prudent choice to question the credibility of other doctors, scientists, and researchers. Although the biography posted on the organization's website doesn't mention it, Ross actually had to abandon medicine on July 24, 1995, when his license to practice as a physician in New York was revoked by the unanimous vote of a state administrative review board for professional misconduct.

Instead of tending to patients, Ross spent all of 1996 at a federal prison camp in Schuylkill, Pennsylvania, having being sentenced to 46 months in prison for his participation in a scheme that ultimately defrauded New York's Medicaid program of approximately $8 million. During a three-and-a-half-week jury trial, federal prosecutors laid bare Ross' participation in an enterprise, headed by one Mohammed Sohail Khan, to operate four sham medical clinics in New York City. For his scam to work, Khan needed doctors who could qualify as Medicaid providers, and Ross responded to an ad in the New York Times promising "Very, very good $$."

The scheme was brazenly larcenous: The clinics, which were later described as "very dirty and unsanitary," raked in indigent patients-most of them homeless, alcoholic, or drug-addicted men-by offering them prescriptions for expensive drugs that they could resell on the street for cash. Word spread fast, and in streamed patients who, in exchange for the valuable scrip, would provide their Medicaid recipient numbers, give blood samples, and undergo medically unnecessary examinations, procedures, and tests. All of this brought Ross and the other doctors in the scheme money from the state's Medicaid system, a percentage of which was kicked back to Khan.

Ross testified at his trial that he had no knowledge of the ongoing fraud at the clinic where he worked. This defense only added to his troubles when, following his conviction, the judge ruled that Ross had obstructed justice by committing perjury. In addition to his prison sentence, Ross was ordered to forfeit $40,000 and, for his role in the fraud, to pay restitution of $612,855-an amount that was later reduced to $85,137 on the grounds that he didn't have the assets to pay more. In 1997 a judge sustained a decision by the U.S. Department of Health and Human Services to bar Ross for 10 years from participating in either the Medicare or Medicaid programs, holding that he was "a highly untrustworthy individual" who had, at Khan's clinics, engaged in "medically indefensible" practices.

If his appallingly unethical past isn't enough to establish that Ross is uniquely unqualified to comment on drug reimportation, it's also the case that his organization, the American Council for Science and Health, has been funded by the drug industry. Although ACSH no longer provides the names of its funders, in 1985 ACSH revealed that drug companies contributed to its budget. Whether ACSH continues to receive funds from the drug industry is one piece of information that would benefit Journal readers presented with an op-ed claiming a policy that hurts drug companies also threatens the country almost as much as terrorists do. But we probably shouldn't get ahead of ourselves with regard to whom the Journal's opinion page is supposed to benefit.

Posted In
Health Care, Health Care Reform
Wall Street Journal
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