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Show : II BiTFH CONTINUED Dr. John H. Budd, a Cleveland family of the practitioner and president-elec- t doctor AMA, says any responsible should expose any colleagues not acting ethically, "as any good citizen would." Dr. Budd admits that is nice theory. "There may be reluctance on the part . i of doctors to bring charges against colleagues and to testify against them because of the risk of lawsuits. I would like to encourage local medical societies to act against people behaving badly. It brings discredit on all of us, and that's one of our problems." The ABA has a suggested model code of professional ethics and responsibility, but individual states adopt and police their own codes. rt. - After the accident, can an ambulance chaser be far behind? He gets a lawyer and doctor, and that's how thriving fraud rings are born. Russell Twist, director of the Department of Professional Standards for the ABA, says, "We believe that lawyers should follow the law, and it's clear that those who don't are unethical. State supreme courts, which admit and can disbar lawyers, actually set the standards of professional conduct. "The standards are generally the same, but there may be a difference in enforcement." Would insurance premiums be reduced if most fraud were eliminated? "At least 10 percent, according to insurance experts," says Ahern. How many of the big rings has the ICPI been able to bring down? Scores of them. Some recent examples: Sixteen doctors and lawyers indicted in Baltimore; 20 persons indicted in two Los Angeles rings on nearly 250 counts of conspiracy, insurance fraud and grand theft; more than 100 persons indicted in a Detroit operation, one of whom was the lawyer son of a late mob boss; two Bronx chiropractors indicted on 242 criminal counts. Why do doctors and lawyers get into the business of faking insurance claims? "Creed and easy money," says Ahern. "Take a young lawyer. He's just out of law school, rents an office and sits there looking at the walls. It takes time to get established Sometimes he takes a partner, another young lawyer, and they sit together looking at the walls. Offer of a deal "So one day some guy walks in and says, can get you a couple of accident cases for a price.' This guy can be a cop, a tow truck operator, a guy who runs an auto body shop, emergency room help, anyone. "So the lawyer thinks it over and its a very tempting thing. All he has to learn is how to joust with an insurance adjuster. He really doesn't have to know very much 'I mi 120s. Long, lean, delicious. They take longer to smoke so you dont light up as often. i, Regular. 17 mg. tar," 1.2 mg nicotine Menthol: 17 mg. "tar. 1.3 mg. nicotine av per cigarette by FTC Report Apnl 1976. Warning: The Surgeon General Has Determined That Cigarette Smoking Is Dangerous to Your Health. about the law. "But to be really successful, he has to get a doctor to work with. The doctor is the key. He's the one who has to work up the medical expenses, to recommend needless treatments, to inflate costs past the lt insurance threshold. "It's sure money that is going to be paid by the insurance companies. And the doctor does practically nothing for it. Maybe he'll prescribe 20 visits for heat treatments given by a nurse. Sometimes he just makes up fake bills. "There's just a lot of money in it. We nabbed one kid, two years out of law school, who was making a quarter of a million a year on insurance frauds." no-fau- |
