CEO of 5 years ago One of the biggest pain clinic companies In the southeast, he was sentenced to more than three years in prison after being convicted of a $4 million illegal kickback scheme.
But just four months after the bar, John Estin Davis walked freely. President Donald Trump notified Davis’ sentence on the last day of his first term. In a statement describing the decision, The White House said “No one is suffering financially” from Davis’ crime.
But in the court, the Trump administration said something very different. When the president let him go, the Justice Department alleged in a civil lawsuit that Davis and his company had fraudulent taxpayers from tens of millions of dollars with excessive urinary drug testing. The DOJ claimed that a comprehensive pain expert had done such a “amazing” summed from a cup of pee, just as employees gave the test the profit-oriented nickname “Liquid Gold.”
Davis and the company denied all claims relating to the court’s application and settled the DOJ fraud case without determining liability. Davis declined to comment on this article.
Since returning to the White House, Trump has said he will target Medicare, Medicaid and Social Security fraud, and his Republican allies in Congress have scamned key arguments in his plans to cut spending on Medicaid, which provides healthcare to millions of low-income and Americans with disabilities. In a speech to Congress last month, Trump said his administration had discovered “.Thousand-Billion Dollar Scams“Without quoting specific examples of fraud.
“We’ve gotten a lot of that money back,” Trump said. “I made it just in time.”
But Trump’s history showing generosity to convicted con artists is in contrast to his current crackdown. To at least 68 people convicted of obstructing the KFF Health News Review of Court and Court and Court, Trump has granted amnesty or dispute on his first and second terms. A tolerant recordDOJ press releases, and news reports. At least 13 of these fraudsters were found guilty if they included more than $1.6 billion in fraudulent claims filed with Medicare and Medicaid, according to the Department of Justice.
And as one of his first actions in the second season, Trump 17 independent inspectors have been fired They are responsible for eradicating government fraud and waste.
“We’ve seen a lot of people living in the world,” said Jacob Elberg, a former U.S. lawyer and law professor at Seton Hall University in New Jersey. “To reduce medical fraud, it’s not only necessary for people to be afraid of getting into trouble, but also for people to believe in the legitimacy of the system.”
Elberg said there is a considerable number of scams in Medicare and Medicaid. This is because the program’s “pay-chase model” prioritizes patient care payments first and tracks stolen dollars second. To prevent more fraud, the program likely needs to be redesigned in a slower, more cumbersome way for all patients, Elberg said.
Anyway, Elberg said that claiming that he focuses on the president’s alleged fraud appears to be an excuse to significantly reduce spending legally allocated by Congress. Trump has empowered the efficiency of the Elon Musk-led government. Deep cuts in federal budgetsin addition to reducing spending on climate change, transgender health, diversity, equity and inclusion programs, it also suspends several medical research and aid programs.
“The administration’s focus to this day is not what anyone has called medical fraud before,” Elberg said. “There’s a real blur between what’s actually fraudulent and what they’re spending on what they don’t support.”
Jerry Martin, a US lawyer for the Central Tennessee region under President Barack Obama and now represents a whistleblower of healthcare fraud, also said Trump’s focus on fraud is “a platform that doesn’t attack what they disagree with.”
Still, Martin said some of his whistleblower clients were encouraged.
“We’ve had our clients come back repeatedly,” Trump says fraud is a priority,” Martin said. “People are hearing that, but I don’t know what he’s saying leads to what they believe.”
The White House did not respond to requests for comment for this article.
1 Billion Fraud Cases and Unnecessary Eye Injection
The president enjoys the unique power to erase federal convictions and prison sentences through pardons and conflict. In theory, power is intended to be the ultimate breakwater against injustice or overly harsh punishment. However, many presidents have been accused of being close friends when they leave the White House, using their pardon power to reward their powerful allies.
Trump issued about 190 pardons and commutes in the last two months of his first term.
For example, Trump allowed Philip Esforms, a Florida healthcare executive convicted in 2019 in the $1.3 billion Medicare and Medicaid fraud scheme, to commute. After he was sentenced, DOJ announced in a press release that “the man behind one of the biggest medical scams in history will spend 20 years in prison.” Trump released him 14 months later.
Trump also gave Medicare a commute to work for Salomon Mergen, a Florida ophthalmologist who had sentenced Medicare to 17 years in prison for a $42 million fraud. Mergen was mistakenly diagnosed as a patient with eye disease and was given unnecessary care, including laser treatment and painful eye injections, according to DOJ and court documents.
“Salomon Mergen calmly took advantage of the patient who came to him for fear of blindness,” he said. DOJ News Release After Mergen was declared in 2018.
DOJ: $70 million spent on “excessive” urine tests
The generosity he showed Davis was unique despite the gusts of pardon and commuting at the end of Trump’s first term. Davis was the only convicted medical con artist who received leniency while the Trump administration simultaneously accused him of more fraud.
As CEO of comprehensive pain experts from 2011 to 2017, Davis quickly expanded to more than 60 locations in 12 states. Federal Court Documents.
He was charged in 2018 using his CEO position to refer Medicare patients who need medical devices to co-conspirators in exchange for kickbacks paid through the Shell Company, according to court documents. He was found guilty in April 2019 for fraudulent Medicare.
Three months later, DOJ filed a fraud lawsuit against Davis and CPS, who hit a piggy bank with the allegations of seven whistleblowers. The lawsuit alleges that CPS has raised more than $70 million from the federal insurance program for urinary drug testing, most of which are “excessive,” and at least 93% of test sampling audits admitted that they “lack of medical necessity.”
Government insurance programs usually pay for urine tests, so pain clinics can ensure that patients are taking their prescriptions properly and are not abusering other drugs that may contribute to overdose. Patients can be tested once a year or monthly depending on the level of their risk, according to the DOJ lawsuit.
However, comprehensive pain experts have conducted “at least 16 tests on almost every visit, almost every CPS patient, and almost every CPS patient,” and sometimes as many as 51 people, according to the lawsuit.
Trump notified Davis’ sentence in January 2021 for his criminal conviction as DOJ had finalized a civil lawsuit settlement. According to a White House statement, the commute was supported by country music star Luke Brian.
A few months later, with President Joe Biden taking office, CPS and its owners agreed to repay less than 10% of the damage sought in the lawsuit, and the case was shut down.
In the settlement, Davis agreed not to do the job of reclaiming Medicare or other federal health programs. He personally didn’t have to pay anything back.
Martin, who represented one of the whistleblowers who first filed the allegations against Davis and CPS, said the generosity Trump has shown to him and the other healthcare scammers may discourage DOJ employees from pursuing similar investigations in his second term.
“There are a lot of rank and file people who are active at the lowest points of their professional careers, where I have seen many of their work essentially being water under the bridge,” Martin said. “It really has to be moraleless.”
KFF Health News is a national newsroom that produces detailed journalism on health issues, one of KFF’s core operating programs and an independent source of health policy research, voting and journalism. Please see more KFF.
Subscribe For a free morning briefing at KFF Health News.
this article It appeared first KFF Health News It is reissued here under a Creative Commons license.
