Dr. David Williams, a fraudster who billed over $175,000 to Cigna and millions to United Healthcare by exploiting Medicare's unvetted NPI loophole, exposed how insurers like Aetna and Cigna ignored his crimes despite ProPublica's findings. While regulators pursued only 22 criminal charges for private insurance fraud compared to hundreds for Medicaid cases, companies prioritized raising premiums over investigations to recoup losses. Ultimately, this systemic negligence allows organized fraud to thrive unchecked, proving that health insurers are the true culprits harming consumers through inflated costs rather than stopping dishonest providers. [Automatically generated summary]
Transcriber: nvidia/parakeet-tdt-0.6b-v2, sat-12l-sm, and large-v3-turbo
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Fake Doctor Gym Teacher00:15:36
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Cool zone media.
Yeah, so I mean, I don't know.
I just, I don't think it's technically murder, like if nobody saw, right?
Right.
That's at least, you know, that's always been my stance on that.
Yeah.
Are we recording?
Oh, shit.
Welcome back to Behind the Bastards, a podcast where no one involved with making this episode killed anybody in a bar fight in 2014.
Didn't happen.
You know, nobody saw anything, right?
So we're good.
No one can prove Sophie was there.
Yeah, nobody can prove Sophie about there.
I would lie for you in court, Robert, but then I know.
And I would throw you under the bus, Sophie.
You know who throws all of us under the bus on a regular basis?
Insurance.
Our health insurance companies, yes.
That's fucking for sure.
Let me have my inhaler, you cowards.
Yeah, Sophie and I are, we're Aetna, right, Sophie?
Yeah, yeah, fuck these people.
We're both having our health insurance did a thing that I'm sure a lot of people have experienced where one year, suddenly it works completely differently and you have to pay for stuff you never had to pay for, even though everyone on the phone says nothing has changed and your insurance is still the same as it is.
This isn't a con.
We're not being robbed.
No.
Stop asking me to contact the original prescribing doctor.
He died in 2015.
Love it all.
Love all of this stuff.
Love that what they're doing is legal, but like somebody who steals a fucking, I don't know, detergent from a CBS should be shot.
Super great.
It's cool stuff.
So we talked in episode one, two different doctor scams, like fake doctor scams, right?
Both of which involved the use of NPI numbers.
People basically, in one case, outright faking.
In another case, a woman who was not a doctor stealing her husband, who was a doctor's NPI for the purpose of doing fraudulent medical stuff, right?
As I told you, when I started looking at what I thought were kind of disparate cases, I kind of uncovered through my research a through line between them.
And I should, to be specific, I uncovered other reporting that revealed the through line, right?
I did not do this on my own here.
A lot of this comes down to ProPublica, who's going to be really the source for most of what we're talking about today.
But I'm going to start with the story of Dr. David Williams.
As best as I can tell, he was born in Idaho around 1963.
So we're off to a bad start already, folks.
His early life was promising, so far as I can tell.
He got a bachelor's and then a master's degree in physical education from Boise State, and then he moved to Texas A ⁇ M, where he received his PhD in kinesthiology.
Now, as a Texan, when I hear somebody went to Texas A ⁇ M to get a PhD in being a gym teacher, I do think this guy's probably a monster.
I really wanted to know how to torture children.
Yeah.
So again, this is a fake doctor.
He is an actual doctor in that he's a PhD, but this is not a medical degree.
You are not a physician because you have a PhD in kinesthesiology, right?
Kinesthesiology is an actual discipline.
It's the study of movement, performance, and function, and it involves a lot of real science.
Having an understanding of kinesthesiology involves everything from molecular biology to anatomy, and of course, the study of how exercise affects the body.
What kinesthesiology is not is a medical discipline, and this is going to be very important soon.
When he was at Boise State, Dave, Dr. Dave, as he's going to have everybody call him, had been a wrestler and a pretty good one at that.
He was an all-American and academic and all-American wrestler or whatever.
I don't understand the wrestling things.
He was a good wrestler.
He claims to have held a state record in powerlifting.
I can't actually verify this, but the stuff about being a pretty good wrestler seems to be verified.
So why not?
Once he graduated in Texas, he got a job working as a community college professor in Arlington.
And again, another black mark against him.
I don't know if you people have ever been to Arlington, but stay away.
I nearly went to college there.
I showed up on campus one day.
I did that commute from Dallas one day and was like, I'm not doing college in Arlington.
Fuck this shit.
Arlington, Galliston, you've been throwing a lot of, this is like a deep Texas couple of episodes that we've been doing.
As a 20-some-year resident of Texas, there's one place in that state I'll go to bat for, and it's Marfa.
So never heard of it.
Oh, it's a great town.
Once he graduates in Texas, he got a job working as a community college professor in Arlington, right?
And a ProPublica investigation into him describes this job as well-paying, which you don't hear often in reference to community college gigs.
I don't know what exactly he's doing there, but I believe he gets up to a con, and that may be why he was making a lot of money as a community college professor.
We don't really have any details about this, but his wife, Amy Lankford, who married him about the time that he starts this job, later told ProPublica that after they'd been together a few years, he got fired suddenly and she never found out why.
ProPublica just notes that he was fired for reasons hidden by a confidential settlement and by Williams himself, who refused to reveal them even to his wife.
So my guess is some sort of scam with like admissions money or something faking students.
I don't know.
He's doing tell your wife.
That's the, I mean, that's a hard one to take that.
That might be, folks, that might be a red, a warning sign.
If you get married to somebody and they get fired and there's some sort of weird legal case and they refuse to ever tell you, probably bad.
Probably a problem there.
Yeah, if she's being honest, yeah, that's that's not right.
That's probably a problem.
Yeah.
So whatever got him canned from this first gig was very likely fraud because his next pivot was to start begging friends and family to invest money into a new business venture.
Once they donated, he would pressure them to get their friends to invest in what he described as a sure thing.
And the gist of this business was that he had bought an old Winn-Dixie grocery store and he was going to turn it into a health club called Docs Gym.
Now, if he didn't grow up in the South, Winn-Dixie is like, I'd call it like a second or third tier grocery chain.
It's better than Piggly Wiggly, but it's not as good as HEB, right?
It's like a Fred Meyer.
You're just fucking making up names now.
Yeah, Fred Meyer.
Yeah, it's broadly.
It's a little, it's not quite as nice as a Fred Meyer.
Oh my God.
Yeah, it's not as nice as a Fred White.
I wouldn't say Winn Dixie.
It's no idea.
No idea.
That's okay.
It's a California.
I'm familiar with like three and one and alpha beta, baby.
Maybe four, four.
I'd meet every now and then, like a couple of times in my life, other people who shopped at Piggly Wiggly's when they were kids.
And like, it's, it's, it's like what I imagine it was like in like the 50s and 60s, running into someone else who'd fought at Bastogne, where you're like, oh yeah, we, we share a special secret drama together.
What a reference.
I am working on a reboot of Band of Brothers that's just about shopping at a Piggly Wiggly in rural Oklahoma.
So check out for that one.
Spielberg's attached to Direct.
We're very excited.
So whatever is going on with this, because I think there's some, I'm sure there's some sort of scam here beyond just that this is a bad idea for a business, because a lot of, you know, like kind of midway through the deal, after he's taken a bunch of people's money, the deal he had set up to buy this Winn-Dixie collapses and everyone who had invested lost everything, right?
A local newspaper published an article on the whole affair titled, What's Up with Docs?
Because that was going to be the name of the gym because he called himself Doc.
Yeah, yeah, I see where they're going with that.
Yeah, yeah, yeah, yeah.
You can put together those pieces.
I've seen it referenced, but I have not found the article.
So I didn't come across more information there.
But the fact that he has just taken a bunch of investments from their close friends and family and then made all that money go away puts some strain on the marriage, as you might imagine.
And by 2006, after 14 years together and two children, they started divorce proceedings.
Amy's father, Jim Pratt, was a finance MBA, and she had him over to help her with the complex nightmarish process of divorcing.
She asked him to help her recover a file on her computer, which was acting up.
And while they were doing that, he came across a shady file folder named Invoices from a ProPublica investigation.
Quote, Pratt found about a dozen bills that appeared to be from a Fort Worth nonprofit organization where his daughter and Williams took their son Jake for autism treatment.
As Pratt suspected, the invoices turned out to be fake.
Williams had pretended to take Jake for therapy, then created the false bills so he could pocket a cash reimbursement from the county agency.
So wow.
Yeah, that's autism would find its way into one of these episodes eventually.
Of course, of course.
Because again, it's one of those gray zones where all like when people aren't clear about what's going on, these grifters come in and fucking find a way to make money off of it.
This is about when I'm teaching special ed and dealing with a lot of like how the healthcare system and whatnot was treating autism at that point in time.
And it is like, especially compared to now, a significantly more primitive period of time.
So it makes sense to me that he would think like, well, I can like fake some invoices for this and probably won't run into anybody who knows enough about what should be going on that they'll catch this.
Right.
But they do, right?
In November 2008, Williams pleads guilty in Tarrant County to felony theft.
He's sentenced to 18 months in jail, and he is released on bail as he appeals.
He does wind up doing some time, something like a year, I think, and life goes on, right?
Amy eventually allows him to take partial custody of their children because his crime, while fucked up, had not involved the abuse of a child, just the abuse of the system itself.
It is kind of on the edge of abuse of a child.
And spoiler, that's where this is heading, but she doesn't really have grounds to separate him from his kids at this stage, right?
So he moves on to working as a personal trainer.
He had been doing that for some people.
That was part of why their marriage broke up.
He'd been working as a personal trainer for a bit during that period, and he wasn't really able to bring in much money.
And, you know, so he starts doing that again.
He continues trying to make a living that way.
And he has a friend code him a website, Get FitWithSteve.
This friend, Steve Cosio, receives free physical training sessions in exchange for his work.
And for a while, things seem good.
This changes a year or so later as he and Amy's 11-year-old son comes to school covered in facial bruises.
His teachers obviously reported this, and an investigation revealed that Williams had hit their son in the face, quote, about 20 times.
So that's real bad.
Williams pleads guilty to a felony and he goes back to jail for two years, right?
Just like, did he?
I mean, you probably know the details of this.
Just fucking hitting his kid.
Like he just fucking hits his kid.
Yeah, I'm guessing the kid, you know, I think he's like, not, he's not neurotypical.
So I'm guessing the kid was engaged in some sort of behavior that Doc did not know how to like either just didn't like or didn't know how to deal with.
And he just decided to punch the kid a bunch.
What did fucking do this hole?
Yeah, it's horrible.
Yeah, I mean, he's, he's, he's, he's the villain of the episode.
He's one of the villains of the episode.
You know what?
I'm not one of these doctors that says like other people aren't doctors, like PhDs, et cetera, aren't doctor.
But like when a guy like this, like tries to use doctor, like it's, I mean, I will say, having the experiences I had in grade school, I'm not surprised that a guy who's got a PhD in being a gym teacher's like default reaction is just to hit a kid when they have a medical issue.
Yeah.
That absolutely scams.
Texas gym teacher uses punches to treat some sort of neurological situation.
Yeah, of course.
That scans.
This kid is different.
I'm going to punch him.
So at this point, Doc has crossed the line from con artist and scammer, which is a mixed bag from a moral standpoint, but not inherently evil.
Plenty of lovable con artists out there to outright monster shit, right?
Amy spends the next like two years while he's in jail, focusing on her kids, trying to move on in life, trying to help them heal from what the fuck this guy has done to them, while Williams spends his time behind bars perfecting his next con.
So he still has a friend on the outside, and it's Steve Cosio, the guy who had coded his website.
Williams convinced him that the whole hitting his son in the face 20 times thing was overblown.
He claimed he'd just been disciplining the boy normally, and he wrote in one email, I can honestly say that I am the only one in here for spanking their child.
In the face.
In the face.
Do you spank a child in the face?
Number one, I'm not a big fan of spanking, but do you spank the face?
Is that why you spank the face?
What a fucking asshole.
His father-in-law, he wrote, was an evil, evil man who'd engineered the charges against him in some nefarious manner.
Now, I'm not sure if Cazio himself is a huge piece of shit or just very gullible.
My gut says probably a little bit of column A, a little bit of column B, probably more gullible than piece of shit, but probably not none piece of shit.
So Williams and Cosio work out a plan for him to make a bunch of cash quick when he gets out of jail because he's calculated, Williams has calculated, I need $30,000 ASAP to get an attorney that can get me access to my kids again, right?
Which does he want this guy?
Yeah, what does he want?
I mean, this is this kind of guy, right?
They think they have a right to their children.
They possess them.
They have a right to discipline them or whatever.
Maybe it's just as simple as he hates his ex-wife and he wants to take them away from her.
I don't know.
A couple of things it could be.
None of them good.
So there's no honest way for a kinesiology PhD to make $30,000 overnight, right?
It's just not that kind of gig.
But a medical practitioner taking advantage of the hysterically fucked up state of our healthcare industry absolutely can bill insurers for that kind of money in a very short period of time if they are diagnosing and treating a handful of patients.
$30,000 is not a lot of money in the world of billing health insurance, right?
One person can rack that up in a night or two at the hospital.
Easy, you know?
So while he's inside, they sketch out a plan.
When he gets out, he's going to go back to doing personal training, but he wouldn't work as a personal trainer.
Instead, he'd recruit other trainers and have them train people.
And he'd remove personal training from his website.
Instead, he would use his legitimate status as a PhD to bill himself as a doctor.
Billing Therapeutic Exercise00:05:04
And then he would diagnose patients and prescribe them physical training and bill their insurance both for the diagnosis and for the PT sessions, right?
Damn.
Our system is so stupid.
Our fucking system is so fucking stupid.
Yeah.
Our system is stupid.
This is also a crime, right?
Like he's taking advantage of the system, but it's not, you're not supposed to be able to do this, right?
Obviously, there's a gray area in that sometimes, like I said, like I've had a back injury and I got some physical therapy for it, right?
Like there's a gray, but like your average physical personal trainer, and that's a valid, you know, profession.
There's a lot of skill that goes into that.
But it's not a medical profession, right?
It can, it can help prevent certain medical problems, sure, potentially, but like you're not, but you see the gray area.
Yeah.
You're not treating medical conditions with therapy.
Yeah.
You're treating injury with therapy and you're strengthening.
But there's a real thin line between that and saying, we're going to use this physical therapy to treat your, you know, blank, whatever medical issue, your diabetes or something.
Yeah.
And I think what he's reliant upon is that both to the people who are going to make use of his services and to like the people who might casually scan this stuff, the insurance company, you know, well, some people get prescribed like a physical therapist.
He says these guys are doing physical therapy.
Maybe this is like fine.
Right.
And it's, there's so much stuff going on.
Maybe nobody will like notice anything.
Right.
Yeah.
They really count on that.
They really count on the fact that the system is so Byzantine and like complicated that like people will just sign off on things.
And like, and maybe it's working, but it seems like in a lot of these cases, you're telling me it just, they always get caught.
It's just like people think they're going to get away with it because it's so complicated, but eventually someone's money is missing and they get mad about it.
The problem is that it all, it does work for a while and it, you can make a lot of money off of it.
One of the issues these guys have, because they're the kinds of people who are bold enough to try this in the first place, they're the kinds of people who get overconfident, right?
And also, you know, one thing to always note when we talk about these guys who get caught, for every one of them, who knows how many people there are who are smarter, right?
Who stay below the line, you know?
Right.
So, but that's his plan, right?
Clients are going to get free physical training sessions and he will get to bill the work of his trainers as actual medical therapy.
Right.
Now, I know what a lot of people are saying.
Well, how is this guy?
Is this really, I mean, he's a bastard because he ate his kid, but like, this doesn't sound that bad, right?
No one really cares if you just scam insurance.
And if clients are able to get free workout sessions, you know, maybe that's overall good.
We're going to build to the explanation of why that's not, but I want to assure you while we're at the end, it is not fine.
He is hurting people.
He is, in fact, hurting you.
If you are a member of any of these, like, this is not a victimless crime, right?
And it's not a crime where the only victim is some like faceless insurance company.
He is actually hurting a lot of people by doing this.
And we're going to explain why.
I just want to state that so you're not asking the whole time, why do we care about people getting free physical personal training, right?
So, Doc Williams has Kozio remove the phrase personal training from his website and he starts claiming he claims to his friend in one of their jail emails.
I don't know why he's allowed to do this.
From, I mean, I don't know, whatever.
He says in one of their emails, 95% of my clients are paid for by insurance, which does not cover personal training.
I have to bill it as therapeutic exercise.
Steve's contention, Casio, the guy who's his webmaster, is like, well, I didn't know any of this was illegal.
And I don't trust him because of things like that, because that's a guy saying I'm committing a crime, right?
Yeah.
But, you know, I must note that the legality of anything that involves health insurance is convoluted enough that a lot of stuff that seems like it should be a crime is legal, like Sophie and I are dealing with right now.
So I could also get how a guy like Casio could just not really understand what's happening.
It's so complicated.
It seems like it's the Wild West.
It seems like anything can go.
I get it.
I get how people would try to get away with this.
Yeah.
On his website, this is how Doc Williams described his services to interested clientele.
During your initial consultation, Dr. Williams will perform a fitness appraisal to determine your current fitness level.
This exam will help determine physiological strength and deficits.
Dr. Williams will then work with you to set up an exercise program that will help you meet your goals and take you through the exercise program to make sure that you know how to do the exercises and are performing them safely.
Many of Dr. Dave's services are covered by medical insurance policies.
Inquire with Dr. Dave to see if you qualify.
Dr. Dave.
Whenever the doctor goes by his first name, it's weird, right?
You know, this is coming from a guy who goes by Dr. Cave sometimes.
It's a red flag.
No, the only doctor that I will take advice from is Dr. Bones, you know?
Star Trek Black Hole00:04:58
From which from the show?
From the show, from Star Trek, yes.
Oh, I thought you meant Bones, the TV show.
I don't know.
I don't know.
No, I don't think that doctor knows much about sicknesses.
No, that's Crusher and Pulaski in season two, both fine doctors.
Starfleet's best, really.
One of them, a hologram?
Well, that's in Voyager.
Yeah.
Voyager.
Sorry.
Yeah.
I mean, he shows up other places too.
Speaking of Star Trek Voyager, you know what else is, you know, Voyages.
Yeah, Voyagers a big part of VPN during the early aughts.
I don't know.
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I went and sat on the little ottoman in front of him.
Hi, Dad.
And just when I said that, my mom comes out of the kitchen and she says, I have some cookies and milk.
This is badass convict.
Right.
Just finished five years.
I'm going to have cookies and milk.
Yeah, mom.
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We're back.
Did you watch a lot of Voyager, Kava?
I watched a little of the next generation, and that was the only Star Trek I ever watched.
That's the best star.
I recognize inherently the difference in how Star Trek is probably intrinsically a better product than Star Wars, but I am so simple-minded that I could only handle one fandom at a time.
So I was a Star Wars guy, and I could only do Next Generation, which I loved, by the way.
I thought it's fantastic.
I think, you know, Jean-Luc Picard is one of the best characters on film or TV.
I love the guy.
But yeah, I can't get into the other stuff.
Like, there was a one with a black hole and there's several with a black hole.
Yeah, I mean, and there was a one where they went to San Francisco.
I saw that one.
Oh, the one where they go back in time or the one with a whale?
Ah, that was one of the San Francisco.
Yeah.
They go, well, there's one where they go back in time to save the whales.
There's one in DS9 where they wind up in this like 2024 riots and stuff.
And then there's one where they go back in time to the 1800s and Mark Twain is a major character.
That one's a lot of fun.
ProPublica Fraud Complaints00:15:43
Yeah.
I bet.
I can see that in the hollow room or whatever.
Yeah.
Their danger room, whatever they called it.
Oh, no.
They're in actual San Francisco in the 1880s or whatever.
No, they meet real Mark Twain and he travels into the future and gets to go to space.
Fucking actors love playing Mark Twain.
They just love playing Mark Twain.
Oh, the actor in those episodes playing Twain is just absolutely chewing the scenery.
He's having a great fucking time.
They love it.
Yeah.
So we're back.
Now, you can see how a lot of decent people could fall for this, right?
It's great to be able to have a physical trainer, but expensive.
And if some guy's like, hey, your insurance will pay for it, why not?
And you can even see how it would make sense to somebody, right?
Obviously, it's good to work out.
That can prevent certain health problems.
Maybe my insurance is cool with this because they understand it's cheaper for them in the long run, right?
You can see how a smart person could talk themselves into thinking this is legit, right?
The only thing Williams was missing then to like make this plan a reality is the one thing that he jumped to getting as soon as he got out of jail, a national provider identifier number, right?
And now it's time to talk about how you can scam an NPI number, right?
Because what Malachi in episode one and now what Dr. Williams did is actually really fucking easy.
NPIs are handed out by the federal government through Medicare.
Both individual doctors and organizations like clinics have NPIs so they can bill Medicare or a health insurer.
And now I'm going to turn you back over to that ProPublica investigation and read a quote.
One would think obtaining an NPI with its stamp of legitimacy would entail at least some basic vetting.
But Williams discovered and exploited an astonishing loophole.
Medicare doesn't check NPI applications for accuracy, a process that should take mere minutes or if automated, a millisecond.
Instead, as one federal prosecutor later noted in court, Medicare relies on the honesty of applicants.
Records show Williams first applied for an NPI under his own name as far back as 2008, but it wasn't until 2014 that Williams began to ramp up his scheme.
Even though now he wasn't just unlicensed, he was a two-time felon.
He got a second NPI under the company name, kinesthiology specialists.
The following year, he picked up another under Mansfield Therapy Associates.
In 2016, he obtained at least 11 more, often for entities he created in the areas where he found fitness clients, Dallas, Nevada, North Texas, and more.
By 2017, he had 20 NPIs, each allowing him a new stream of billings.
Oh my God.
It's funny.
I just Googled how to get an NPI number.
And it's like you get like this national provider step-by-step guide.
You fill out this application.
I don't know if it's changed, but it doesn't seem that hard.
It's not recommending people do this, by the way.
I'm not going to do that.
Yeah, don't do this, but it's apparently quite easy.
So this is an involved con.
That's a lot of paperwork for a con, but it's not a hard one.
In order to do this, Williams had to set up an EIN or employer ID number for each NPI.
Now, this is all fraud, but he used his real name, his real address, real, the same set of real information for each application.
Wow.
Yeah.
And no one caught that.
No one's looking.
Like, it's not that like to say no one caught it would mean that like he snuck through like a dragnet of some sort.
Like there's nothing.
He just did it.
Yeah.
And nobody looked.
So he described himself as a doctor, but listed that he had a PhD, claiming his specialty was in sports medicine.
Now, the actual fraud that he had to do here is that he had to provide a fake medical license number, right?
So like that is a thing that you think would be easy to check because you can't fake it easily.
I've never heard of anyone faking a medical license number that's like in the day.
I'm sure you could like, if you're a hacker, maybe, but he didn't do that.
He just gave them a fake number and nobody checked.
This would not be hard to catch, right?
If there's like a database, here are all the medical license numbers.
You check it against it.
It's not a real one.
You know, I assume there's probably more to it than that, but they're not even doing that, right?
No.
So Williams began taking on clients and billing insurers like a son of a bitch.
And soon he was raking in millions of dollars a year.
He bought himself a McMansion in cash, several cars and motorcycles, and he set to work using some of his newfound riches trying to bribe his children's love.
And that's where he made his first fatal error.
He gave his kids iPad minis for Christmas 2013.
Now, because the last time Amy had known anything about her former husband's finances before he went to jail again, he had been struggling to make ends meet as a personal trainer.
So she was surprised to see he could suddenly afford several very expensive electronic toys, right?
And a house and a house.
I don't think maybe she doesn't know about the house, right?
She's not living with the guy.
But she's like, yeah, maybe that's sketchy.
That's her first sign that something's weird.
And her second sign is like, you know, a lot of parents, I don't know, this is a debatable thing, but like she keeps, she looks at her son's new iPad and she notices an app on it called iMessage, which is, you know, you know what iMessage is.
I don't know if you explain this.
And it's, it's got a bunch of new messages in it.
And she's like, well, why would my like, I don't know, teenage, little teenage kid have a bunch of iMessages on this brand new iPad.
That seems kind of weird.
So I'm not sure how this happened, but I think dad had activated these iPads and had like accidentally connected them to his shit.
That's iCloud.
He'll get us all.
His messages.
And it's specifically stored on this iPad is every communication he had with his friend Kozio to set up this fraudulent medical business.
He hands it to his ex-wife.
Oh my God.
Oh my God.
He's the worst.
And he's so successful at this point.
Yeah, it's funny.
Like it shows you how easy the NPI con is that like this is not a genius dummy you could do.
Yeah, but he's able to figure this shit out.
So Amy, you know, she's not a big fan of her ex-husband, what with the beating and stuff, goes back to her dad, right?
Who also knows this guy's a scammer.
And her dad, having some kind of forensic accounting experience, is able to look through this.
And it takes them a couple of hours to unravel the whole plot because it's all there in messages, right?
And including messages from new clients where he is like going back and forth.
She can see him like setting up to bill fraudulently.
Like the whole case is here.
If you hand this to like an FBI agent or whatever, you're talking like 10 minutes to throw together a fucking indictment, you know?
It would not take a lot of time, right?
Oh my God.
Here's the thing.
His fraudulent business will keep going for like four years after this point.
Now, how's that possible, Kave?
I'm assuming she said she, did she say something at this point or is she kind of keeping it under wraps?
She absolutely does not keep it under wraps.
She and her dad know this guy is dangerous and do not want him to be doing whatever the fuck con he's doing.
So her dad, once he has, again, a complete, exceptional, very clear list of all the crimes this guy, all the fraud this guy is committing, calls Aetna, right?
He gets him on the phone.
He's like, should probably report this.
And he tells Aetna, I want to report a fraud worth at this point, probably several hundred thousand dollars.
And Aetna says, what's your member number?
And he's like, well, I don't really have a number.
I just, and they're like, sorry, only members can report criminal activity.
Holy shit.
Hang on the fucking phone.
Now, thankfully, or maybe not thankfully, because Aetna's dog shit, but his daughter is insured by Aetna, right?
What kind of rule is that?
That's the problem.
Only members can report that we're being defrauded.
It seems insane.
What do you do with the FBI call?
Sorry, you got to get an agent who's on our healthcare plan.
Find someone who's married to somebody with Aetna.
Right.
It's the stupidest thing.
It's so fucking stupid.
They're clearly just trying to get him off the phone.
So he gets his daughter because she's insured by Aetna's and he has her called to make the complaint.
Oh, we trust you.
Yeah.
Her, we trust because she's one of us.
They take the info from her, at least, and then nothing happens ever.
One of their, again, when all this blows up, because this guy does get arrested, this becomes a big case, and ProPublica reaches out to Aetna is like, why didn't you do anything about this fraud tip?
And they're like, oh, no one ever called us.
Never happened.
No record of it.
Liars.
Lying liars.
So funny.
So Pratt and Amy, next, he's like, well, I don't know if Aetna's going anywhere, but he is defrauding all of the insurance companies.
So let's call Cigna next, right?
And they provide the same information to Cigna and they're like, hey, one of your providers has no medical license, is saying he does, was in prison twice for different felonies, one of them violent.
Saying he has multiple.
Yeah, multiple identities.
The least should be a doctor of anyone who shouldn't have been a doctor, whoever pretended to be a doctor.
Yes.
So next he reaches out to, so he does this.
He makes a report there.
Nothing's going to happen.
And he also reaches out to Southwest Airlines because Southwest, they self-fund their healthcare benefits and thus they pay directly for employee care.
And Southwest is like, well, we pay directly for it, but we run it through United Healthcare, which is this massive $226 billion company.
They administer our benefits.
So talk to them.
So he calls, you know, United Healthcare and he talks to HR reps from both Southwest and from United Healthcare.
And he first starts talking to someone from United in the fall of 2014.
And I'm going to quote again from ProPublica.
This is what happened.
He spoke to a fraud investigator who took the information with interest, he said.
But within a couple of weeks, he was told she moved to a different position.
Pratt continued calling United over the following two years, making about a dozen calls in total.
He said, he is not a doctor.
Pratt's told whoever picked up the phone.
So I don't see how he could be filing claims.
Frustrated.
Pratt made one final call to United in 2016, but he was told the case was closed.
United said he'd have to call the Texas Department of Insurance for any additional details.
Pratt had already filed a complaint with the regulator, but reached out again.
The department told him that because he hadn't personally been defrauded, it wouldn't be able to act on his complaint.
Wow.
What a maddening situation.
One guy, one family's trying to do right.
Trying really hard to do the right thing.
And the companies that they're trying to help ostensibly are wanting no part of it.
Because at this point, by the way, this guy makes millions.
He is defrauding them for what do a regular, again, it's nothing to these companies.
I just said United's a $226 billion company, but this isn't pocket change, right?
Yeah.
But it's so funny.
Like they focus so much about small amounts of money to them.
Yeah.
In every other case, if you're trying to get an inhaler that costs $150 as opposed to $120, for example, they'll fight you to the ends of the earth.
They will send you to prison if they have to.
Yes.
Like in this company, this one guy who's making millions off of them, they don't do anything about it.
That is maddening.
No, it's maddening.
So I bet you're all wondering at this point, what the fuck, right?
Because, you know, it doesn't make sense because we expect these companies to be greedy and this guy's stealing from them, right?
Like, why aren't they doing anything, right?
Well, you're not the only person wondering what the fuck is going on at this point.
The good people at ProPublica are wondering that too.
And the journalist who reported on the Williams case, and again, we'll conclude his case.
He does eventually get arrested.
But the journalist who reported on this several years ago was a guy named Marshall Allen, right?
Published in late 2019.
But he carries out a different investigation, kind of inspired by, he sees what's happening with Williams and he's like, why the fuck do none of these companies want to do anything to stop this?
Why is it so easy to commit fraud and have an insurance company let you get away with it?
And the conclusion of this further, the second investigation he publishes is that insurance companies have no interest in stopping or even being aware of most of the fraud that happens on their networks, right?
They do not care and they do not want to be told about it.
This may seem counterintuitive to you.
Again, these are very greedy or famously greedy organizations.
And medical fraud is estimated to make up at least 10% of the $1.2 trillion in health insurance spending this year, right?
That's not an insignificant amount of money.
We want to stop that, right?
Well, Marshall reaches out to United as well as part of this later investigation.
And here's what he writes: A United spokesperson said I couldn't speak to a fraud investigator because we do not want to make that information public that would make it easier for those intent on engaging in fraud to commit these crimes.
She said the insurer uses analytics to flag potentially fraudulent billing and, in some cases, physically verifies that medical offices exist.
With that scant response, I plunged into the daunting thicket of agencies that are supposed to oversee the fight against healthcare fraud, each divided by region and responsibility.
I contacted insurance regulators in every state and interviewed more than 50 other experts, including prosecutors, claims analysts, and a dozen former investigators for the internal fraud units of private insurers.
Far from being fierce guardians of your healthcare dollars, experts told me, the big name insurers who sell their own plans or are paid to manage employers pick and choose their battles.
And for a variety of reasons, fraud is not a top responsibility.
You know, what's weird is they'll cite fraud as one of the reasons that like costs are so high.
So, like, you know, to not choose it as something to focus on is strange, you know?
It seems strange.
It's all going to make sense.
Evil sense.
And I do want to shout out again, Marshall Allen, the ProPublica investigator.
The article he wrote on Doc Williams is very good.
The article he writes on why fraud doesn't get investigated is one of the best pieces of medical journalism I've ever read.
It's a really, really good article.
Infuriating, but it's very good.
Now, I want to look at the numbers here, Kave, right?
Because that really helps tell the story of how little these companies care about fraud.
So, California obviously is the most populous state in the Union.
There are about 14.4 million Californians on private insurance, which is something like 10% of the nation's total.
So, Mitchell asked a simple question, calling DA's offices in the counties that all of the, basically, he calls every DA's office in California for the counties that cover about 80% of the state's population, which is a representative sample, we can say, right?
And he asks each of these DAs: how often did fraud cases referred by commercial insurers lead to criminal charges in 2017 and 18?
You have a guess?
Because of this, I'm going to say, like, I don't know, 20%.
The number is 22.
22 total times.
I'm only saying that because I knew where we were headed with this.
I wouldn't before this thought much higher.
Yeah.
Now, obviously, something is fucked up here, right?
Last episode, we discussed a story of nightmarish Medicaid fraud.
About 13 million Californians are on Medicaid.
Medicaid Fraud Patterns00:04:30
During the same period of time, 2017 to 2018, the state fraud unit filed criminal charges against 321 people for defrauding Medicaid and recovered nearly $100 million.
So 321 people are charged for medical fraud through Medicaid.
About the same number of people are under private insurance, and the number of people charged is 22.
Wow.
That gives you an idea of how not on the ball the private insurance companies are, right?
There is no reason to believe Medicaid fraud is less common than corporate insurance fraud or more common either.
They seem to be probably pretty similar levels.
Mitchell looks at other states and he finds similar discrepancies.
In Minnesota, private insurers referred two cases of fraud to regulators in 2017 and five in 2018.
Meanwhile, state Medicaid fraud investigators carried out 600 investigations and got 134 indictments.
In Georgia, only three of the top 10 insurers reported any fraud at all in 2017 and 2018.
They're better there.
They're better.
They're so good.
Everyone's very honest in Georgia.
It's all the peaches.
What the fuck is going on?
Well, investigations cost money and so does pursuing court cases.
From the insurance company's perspective, that's all wasted money because the money that they're being defrauded for, they're not actually out because they can just increase your rates and co-pays to make more money.
So that makes more sense than investigating and stopping fraud.
We'll just charge our customers more.
They have to pay.
They don't have a choice.
This isn't something where they can shop around.
We'll just fuck them more and then we don't have to worry about stopping fraud.
Holy shit.
Holy shit.
Doesn't that make you want to burn down a building?
And this is.
I mean, I'm sure this is only 1% of why insurance companies are awful when we look at it.
This is certainly not the main reason.
But this is so bad and infuriating.
Infuriating.
So that's what I meant when I said, like, there's a real harm to what Doc Williams is doing because when he brags that these, these physical training sessions are free to the consumer.
That's not really true.
Everybody in the state is paying more because Aetna is going to raise their rates to compensate for this kind of shit.
It's not a, yeah, not a victimless crime.
It's not a victimless crime.
The insurance companies will find a way to make their money.
No way they're going to miss it.
There are, in fact, some victimless crimes out there, but defrauding insurance is not one of them.
Being a fake doctor is a victimful crime.
Now, it is very fucked up.
And while Williams is a bastard for a number of reasons, I hope I've made it clear that the insurers are the real bastards here.
In the state of Washington, the office of the insurance commissioner who investigates these things got only one report of fraud in 2017 from Primera Blue Cross, a major insurer.
Primera told Mitchell, the ProPublica guy, when he investigated that they don't report fraud unless there's criminal intent, which is weird because it's fraud.
They say it's criminal.
Yeah.
They say they try to educate perpetrators instead.
So we do have the enlightened Star Trek future justice system somewhere in this country.
It's only in health insurance.
Oh my God.
Isn't that nice?
Oh my God.
They're trying to reform.
Yeah.
I get it.
Yeah.
And they will try.
One thing they'll try to do is put people on repayment plans.
And this, there's a degree of sense this makes.
If it's a case where you've got a real doctor who just tries to get over something and he scams him out of a couple of grand because he's in a tight spot, instead of trying to go after that guy criminally, they'll, you know, just try to have him repay what he took, right?
Which in that case makes a degree of sense.
But there's two things happening here.
One is that they don't report this at all to the government.
So the government cannot see.
None of these regulators, law enforcement cannot see.
Are there broader patterns of fraud that are maybe evidence of organized crime?
And number two, they don't really discriminate between, yeah, maybe this doctor who's a real doctor slipped up once and did a bad thing versus this guy's not a doctor at all because they just don't actually care.
The fact that these dummies got away with it for so long and were finally stopped at some point, probably because of the relentless nature of his father-in-law, his ex-father-in-law, just goes to prove how much more is probably being done by smart people.
Organized Crime Evidence00:03:43
Oh, God.
By smart crime.
Smart people who like don't wind up pissing off like this.
Her father or her dad sounds like he's fucking cool.
And leaving a track record on an iPad.
And leaving a huge track record.
But you know who never records their crimes on an iPad that they didn't give to the children that they hit?
Oh my God.
People who I said they don't do it.
Yeah.
They're too smart.
They're too smart for it because they're smart and inherently good.
And they're inherently moral actors, just like everyone who is legally or medically involved with this podcast.
Anyway, I went and sat on the little ottoman in front of him.
I was hi, dad.
And just when I said that, my mom comes out of the kitchen and she says, I have some cookies and milk.
This is this badass convict.
Right.
Just finished five years.
I'm going to have cookies and milk.
Come on.
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Redemption Arc Fake Doctor00:15:17
Ah, we're back.
So I just was talking about Washington, how like Primera's justification for not reporting fraud is we only do it if there's criminal intent.
We try to educate perpetrators, you know, get them to repay.
And this is what's going to happen to Doc Williams, right?
he finally gets caught for the first time.
It has nothing to do with his ex-wife and her father and all the documented fraud on that iPad, but instead a client of his personal training service, a Southwest flight attendant named Nanette Bishop.
Bishop got referred to doc by a co-worker and she, you know, does a couple of sessions, but she stops working out with him, right?
Maybe they don't click or maybe she just, you know, she gets too busy.
She's, you know, it's a flight attendant, busy job, right?
So she goes a couple of times and then stops.
And then one day she's checking her insurance records.
And again, it's just a crapshoot that like somebody checked on that because I don't know that I've ever looked into mine, right?
And she sees that Williams has continued billing her company for dozens of sessions, even during periods where she had been out of the country, like working.
So she reaches out to Williams first.
I think her assumption is like there's maybe there's got to be some fuck up.
Maybe his computer fucked up, right?
And it just kept auto-billing or something.
And she's like, hey, you know, I didn't do these sessions.
You should probably return this money to my insurer so they don't raise my rates.
And, you know, when he doesn't do anything, she eventually reports it to her insurer.
And Cigna sends Williams a letter saying, hey, we just realized you're not a doctor and you have billed us for $175,000.
Please give it back.
I would love to see that letter.
I would love to see like his response to that letter too.
Contrary to what insurers like Primera like to claim, there's no way this could have been anything but criminal fraud.
There's not a chance that this is in good faith because he doesn't have a medical license.
You can't lie about having a medical license and bill for almost 200 grand in care without committing a felony, right?
That's felonies.
Yeah.
So, but Cigna just sends Williams a bill.
So he starts making payments, but he also switches over to a fresh NPI number under the same name and keeps billing Cigna.
And he's paying.
Yes.
Oh my God.
They give him more than $100,000.
A year later, he owes them $310,000, right?
He's like, sure, I'll pay it, but I'm going to hurt them by changing the, I'm going to have her pay for her own thing.
It's fantastic.
My God.
Uh-huh.
So funny.
So stories like this are far from unheard of.
ProPublica spoke to a former fraud prosecutor, a guy named Elliot, who claims that a big part of the problem is that private insurers don't just ignore fraud.
They fight the government when the feds try to investigate it.
Quote, when private insurers pitched the occasional case, Elliot said, prosecutors had to weigh whether the insurer would fully cooperate with the investigation.
Federal prosecutors dig into the details when they get referrals, he said.
They might want to broaden a case, which could create more work for the insurer or solely its reputation.
Or prosecutors might find out the insurer was not doing its job.
Certain things they wanted you to know about and certain things they didn't want you to know about, he said.
The private insurers, Elliot said, seem to prefer to close cases quietly, cutting off the fraudster and pursuing repayment.
But he said, that allows the scammer to go on cheating others.
That's not fraud enforcement, he said.
It's an accounting mechanism.
Again, we don't give a shit who else this person hurts.
If they're prescribing, if they're, we don't care if they're faking, if they're like tricking people into thinking they have Alzheimer's and those people kill themselves, as long as we cut them off from billing us, we're good.
You know?
They've done the math.
The math works out for them.
They don't fucking care.
It's fucking good.
And they don't give a shit.
Yeah, it's so infuriating, right?
The worst people are in charge of the most important shit.
Yeah, absolutely.
This should be like a central concern of our entire society.
And instead, we're like, who's the biggest psychopaths?
Who's someone who's like just on this edge of like skinning animals for fun?
Like, let's put them in charge of it, right?
Are they good with numbers?
Put them.
Yeah.
That's what we want.
Yeah.
Yeah.
And honestly, I think skinning animals for fun is probably like less harmful than this.
Yeah, less damage than what these people are doing.
There's more of a sickness at play here.
Yeah.
We don't recommend doing that either.
By the way, people, we're not like saying go skin.
Don't skin animals, but maybe skin health insurance executives for fun.
Send a couple bear traps around Aetna.
See what happens.
Yeah, see what happens.
Yeah, that could be we could we could rehabilitate the skinning animals for fun people by sicking them on health insurance executives.
I want like one of those like Iraq war deck of cards and it's just the C-suites for all of the fucking big insurers.
So obviously there's a tremendous degree of societal harm here.
By holding off on reporting this stuff and actively obfuscating investigations, private insurers make it harder for regulators to spot patterns and effectively identify scams or bust people who are conning Americans, right?
Remember, Williams is just scanning money for PT.
So the harm he's doing to people here is less than like what the Jenkinses are doing, but like there's other people doing what the Jenkinses are doing.
And they're allowed to hide for years and harm people because insurers are helping them hide.
The most difficult cases to catch are the folks who carefully figure out the threshold of money under which an insurer will ignore them and avoid billing too egregiously.
Williams got caught because he was sloppy.
He was billing people who had stopped going to him, right?
He lied about having a medical license, right?
But if he'd had a real MD and still have been doing this fraud, and if he hadn't been quite so dumb about it, he probably could have kept doing it forever.
Likewise, if both Jenkins's, rather than just the husband, had been MDs, she might have gotten away with it.
Oh, yeah.
There's not a 0% chance, you know?
Yeah.
There are other calculations at play here, too.
Per that second ProPublica investigation, quote, other investigators say targeting suspect medical providers and facilities puts the insurers in the dilemma.
They need a certain number of doctors and hospitals and their networks to make plans attractive to employers.
They also must ensure patients have access to the care they need.
So apparently, I learned there's a calculation that goes on.
If, for instance, you're the only neurologist in town, your fraud may be forgiven.
Wow.
Great.
Oh, my God.
Oh, my, that is amazing.
Yeah, that's cool.
I mean, there's job security and medicine, folks, for any young people out there considering lifestyle and considering what they'll do with their lives.
I mean, it goes to prove you can make a good money being a doctor.
And if you're really sort of a go-getter, you can defraud health insurance for millions of dollars.
Yeah.
And, you know, if you want to do a little bit of defrauding health insurance and a little bit of writing me prescriptions for Dilaudit, who's who's to know?
You know, it could be between the two of us.
I'm not getting my insurance.
Hypothetical listeners.
Yeah, Kave won't do it, but one of you will.
Hit us up on the subreddit if you'll prescribe me to laud it.
That's a joke, legally speaking.
So Williams keeps getting in trouble with insurers, right?
Aetna next, finally, and then United Healthcare.
And this is where the story gets baffling.
United had sent more than $600,000 in payments to Williams over the years, and then they realize he doesn't have a medical license.
They demand he pay them back, which makes a degree of sense.
But this demand includes an offer.
They're like, if you don't reply, we will pay ourselves back out of future billings that you file.
In other words, we know you're not a doctor.
You're going to know who you are to doctor.
But if you keep pretending to be one, we'll take it out of your future building.
Oh my God.
You now work for us.
Yeah.
You're so fucked up.
Holy shit.
Just absolutely, you can't even parody the evil here.
So this even is rather academic because again, he just keeps switching NPIs.
He's got a bunch of them, right?
Whenever he gets caught, he's like the Borg, right?
You shoot them once and they get hit and then you shoot them again and their shields have remodulated.
That's what he's doing with his NPIs episodes.
All of every thought I have is filtered through the lens of Star Trek the Next Generation, Kava.
That's just the way it is.
That's cool.
That makes sense.
Quote, in all, United paid Williams more than $3.2 million, most of it after the insurer had caught him in the act.
But in reality, the losses weren't all United's.
Most of the fraud was funded by its client Southwest.
It's just not worth it to them, said Dr. Eric Bricker, an internist who spent years running a company that advised employers who self-funded their insurance.
And perhaps counterintuitively, insurance companies are loath to offend physicians and hospitals, and they're all important networks, even those accused of wrongdoing, many experts have said.
So the reasons for this are complicated and it's more than purely bastardry on behalf of insurers, but that is at the center of it.
Now, Dr. Williams is eventually fully caught, not by an insurer, but by the FBI, in part because of the tireless reporting of his ex-wife and her father, all of these different insurers who keep catching him and like they keep, they don't give up.
And eventually someone at the FBI puts two and two together and is like, oh, hey, free conviction.
They've got everything on the iPad.
Great.
Yeah.
Right.
I wonder if at this point he was still just doing it because he felt like he was sort of stuck and he had to pay the insurance companies.
And he was like, he felt like he had to just keep doing it or if he thought he was really going to get away with it eventually.
He's just kind of dumb because like a smart guy, you got $4 million at that age.
You're kind of middle-aged.
You move to Ecuador, somewhere that does an extra diet.
You can live off that, you know?
Better than going to prison.
But like the dwarves of Moria, he delved too deeply and too greedily.
Is this Star Trek?
Are we talking?
No, that's a Lord of the Rings reference.
God, my God.
I'm a very specific type of nerd, Robert.
I'm a very specific type of nerd.
Okay.
Yeah.
So he gets sentenced.
He goes to prison for a while, more than nine years.
So good.
He gets punished.
None of the guys at any of the insurance companies get punished, but he does.
And that's good.
Now, Kavit, this whole story is a real bummer to contemplate, right?
Kind of sad, kind of depressing.
So I want to end the story of one more fake doctor.
This does not really tie into the NPI stuff, but maybe it'll leave everybody in a better mood because it's kind of like a good story of a fake doctor.
It's a redemption arc for a fake doctor.
Yeah.
So his name is Adam Litwin, and he is now a real MD, too.
But as a boy, Adam grew up in awe of his grandfather, a podiatrist, and he wanted desperately to be a doctor himself.
As a teenager, he would wear a beeper and pretend to be getting texts from patients, which was maybe a warning sign.
Yeah, that's fucking weird.
That is kind of weird.
That is fucking weird.
You should not become a doctor.
That is a red flag, if I've ever heard one.
Nobody wants to have a pager.
They're the worst thing.
It's electronic leash that gets tugged around your neck.
He's in love with the worst thing about being a doctor.
Oh, my God.
Oh, God.
Yeah, that's like joining the army and being like, yeah, finally, I'm in the army.
I'm going to get to file paperwork.
God.
I get to run through mud.
Well, no, then people do like.
Yeah, yeah, sure, right.
The people who pay for that.
Yeah, that's right.
After high school, he goes to San Jose State and then he transfers to St. Louis to get into the pre-med program, which included clinical rotations.
And he does some actual clinical rotations.
And he describes this as the happiest moment of his life, right?
He is, he feels like this is exactly where I'm meant to be.
It's what I want to do.
And then that portion of schooling ends and he gets depressed, right?
The way he describes it, he just wanted to, I think there may be a little bit of mental illness going on here.
He wanted to be a doctor so bad that he like couldn't focus on actually finishing school to become one.
It's weird.
His actions don't make a lot of, if he's purely acting logically, I don't know why you wouldn't go through medical school, but he doesn't.
He just drops out and he moves to California and he starts spending all of his time in the UCLA medical library reading medical textbooks.
Here's how the LA Times describes what happens next.
At some point, someone mistook him for a resident and he didn't correct them, he said.
Instead, he made up a backstory that he began to widely share.
He was a surgery resident who had recently transferred from a nearby hospital.
Litwin was 26, about the same age as most doctors in training.
For months, he fooled them.
He ate lunch in the cafeteria at UCLA Medical Center and he watched doctors perform complicated surgeries allowed because senior doctors thought he was a physician.
Litwin claims now that he never treated anyone doing this and he was never caught treating a patient.
Again, I've run into a couple of cases.
It's one of those things where like Malachi makes the same claim.
I wonder if the hospitals are kind of just protecting their asses and they don't really want anyone to know.
I have, I didn't include them because we're talking about the U.S. here, but I ran into some fake doctors who scammed the NHS over in the UK who noted that like a really good way to be a fake doctor is to be part of like a team of doctors consulting on a case because you don't actually have to get in there and physically do anything.
You can just kind of like provide talk, right?
And that that's easy to get easier to get away with, right?
And that does kind of make sense to me that like maybe that's all he was doing.
Whether or not Litwin actually treated anyone, he did other stuff.
He used the doctor's parking lot with a borrowed pass.
He stole a key to get into the residence lounge.
He slept in the on-call rooms.
And he seems to have really loved all the stuff around actually practicing medicine along with the medicine, which is like David.
He's like, I love the cafeteria food.
I love sleeping in the shitty call rooms.
It's like someone being like, God, one day I'm going to be a professional podcaster and I'll finally get to put an SD card into an SD slot.
The dream that I've had my whole life.
Transferring files from one machine to the other.
So weird.
It's so weird, man.
There's a lot of good parts to being a doctor.
Yeah, doing rounds and helping patients.
Not having to sleep at work sometimes.
Yeah, that's the part that we like live with because of all the other stuff that we do.
You know, we don't.
It's very strange.
You don't go into it for that.
I love the pager.
And the pager thing is so unhinged.
So eventually he gets caught.
Litwood claims it takes nine months.
Prosecutors say six.
Either way, he gets away with this for a while.
I mean, because he does know a lot, right?
He's legitimately well-educated.
He's read and reread tons of medical textbooks.
So he's able to fake.
Residency vs Finance00:10:08
And he's like the right age, too.
So you can't just look at him and be like, well, that's obviously a small child in a costume.
His downfall comes when a pharmacist realizes that he's forged prescriptions for cough medicine and tranquilizers using the name of a real doctor who shared his last name.
Litwin claims the prescriptions were for a friend, which, sure, buddy, all of our illegal drugs are for a friend.
What a dumb mistake.
That's a dumb, dumb mistake.
If he had written like, you know, metoprolol or some blood pressure medicine or some like diabetes medicine, probably he wrote a Pinton script or some shit.
But like fucking going for anything that's controlled, what a stupid mistake.
Yeah, it is a dumb mistake.
They catch him.
And at age 28, he pled guilty to three misdemeanors, forging a prescription chief among them.
He was sentenced to six months of counseling and two months in jail, which he served.
And normally this would either be the start of an arc of a bunch of other cons, or maybe he would sheepishly go back to regular life, but that's actually not what he does.
He stays in therapy after the six months of counseling that he was mandated to do and like. keeps working on himself.
He moves back home.
He said in interviews that like he realized afterwards that he had narcissistic tendencies, which is probably part of why he didn't actually go through with medical school, why he felt like he could fake it.
And he like accepts this about himself and works on it.
He gets into business with his grandfather, who is a doctor, and he's running the books for their healthcare company, but he doesn't do anything about like, he's not treating patients.
He's just handling like finance and stuff.
Occasionally, he would keep lying about being a doctor in his personal life.
He like lies to his first wife about being, I think, a cardiologist and she divorces him, right?
How did he get that far?
How do you marry him and not know?
I mean, that's not her.
That's not her.
He's got to be good.
I mean, I assume he's probably good at it, right?
He's probably like, so, but, you know, he apparently like comes to terms with the fact that that was fucked up.
And two years after the divorce, a now middle-aged Litwin enrolls himself in the St. James School of Medicine.
Now, St. James is a for-profit medical school.
It is very expensive, but nowhere else is going to take him, right?
Is that like Caribbean?
I think it's in the Caribbean.
It is a, from what I can tell, it's a real medical school.
They do teach you to be at, their degrees are recognized, but it's the kind of place where like, if you can't get in anywhere else, all they care about is that you have money, right?
And that's, you know, for him, that's the only option, right?
He's not going to get into a regular medical school.
And I looked at some like, I found like a doctor on Quora who was like, yeah, it's like an okay school, but the only reason you'd go there is if you can't get in anywhere else.
And it makes sense to me, like, yeah, where else is Litwin going to go, right?
But he goes to medical school and he graduates, right?
He has an MD.
He now lives in Chicago.
He does medical school.
He does his rotations, at least, in Chicago, but he can't finish, right?
And as far as I know, I don't think he has finished it because he can't do his residency because to do a residency, you have to get accepted somewhere as a resident.
And anyone, one of the things when he goes to Chicago to do his medical school rotations, there's like this, whatever board handles that, there's this big debate about it.
And what they decide is like, we'll let him do his rotations, but we're going to put a note on his record about what he did in the past so that anyone who was going to take him knows it.
And at this point, I think the last story I ran into him was in like 2021, a couple of years after graduation.
He still had not gotten his residency.
I don't know if he's gotten it yet.
I don't know if he ever will, but like, it is at least a story of growth.
This is the one fake doctor who did.
He did get an MD, you know?
Yeah.
I mean, it sounds like there's some legitimate, like he must have had some legitimate issue that prevented him from finishing.
I don't know what it was, you know?
Yeah, neither do I.
But yeah, that is actually, it does seem like he's trying to do the thing.
Yeah, and he's trying to do the right thing.
Yeah.
In his own way.
Yeah.
It's what I can't blame any hospital for being like, no, we're not going to take this guy as a resident.
But I, just because of my belief in like the fact that people can be better and like be redeemed, I do hope he gets a chance.
Like that is interesting.
Yeah.
I'm curious to know where he is now.
I'm fascinated to know what he's doing.
Like, if he is just like, he's like some small town somewhere.
Yeah, I hope so.
He's in need for it.
Yeah, there's certainly not enough doctors.
So my hope is that like he figures it out and is able to like help people.
But the thing is, you need to do a residency.
I mean, in medical school, you learn a lot.
Of course.
But you don't learn really how to take care of patients until you do like your residency.
That's when you're really in charge of it.
So I, I mean, I'd be really fascinated to see how he does that.
I mean, he's better than the Malachi kid.
The Malachi kid.
You can't expect him to have on his white coat, like FBI female body inspector or something like that on it.
Like that guy was a creep.
This guy, at least I get the sense that his intentions are good.
Yeah.
And he wants to be a doctor, which I can always respect.
It seems like he's also accepted his mistakes and like why he made them.
Like, oh, that was like narcissism.
That's why I did that.
That's not a reasonable or an okay thing to do.
So yeah, I hope things go well with that.
It's at least a nice story to end on.
Like it's a story of somebody who's shown some capacity for growth and change as opposed to the health insurance industry, which only has the capacity to grow in the same sense that a tumor grows.
Some listener out there is like, my doctor's name is Adam Litwin.
Wait a minute.
Yeah, maybe.
Ah, Jave.
How you doing?
Thank you so much for having me.
It's like every time I get to come on your show, I feel like I'm like a listener who won a contest.
And it's very nice to be here.
It's very nice to talk to you.
I'm so glad that the field that I've dedicated my whole life to and lost my 20s and 30s to can provide you so much horrible, horrible content.
Oh, yeah, yeah.
No, we have feasted off of the wealth of bastardry that surrounds this.
You know, it's the same.
It's like anything that is absolutely crucial to survival and also complicated and hard to understand will be targeted by real pieces of shit.
It's the same reason why there's all sorts of like scams and unethical shit with like the big ag and all like the way subsidies and shit work, right?
Everybody needs food.
Most people don't understand how to make it.
Yep.
Right.
Great place for a con artist to live.
Right.
Someone to fit that void.
Yeah.
You're absolutely right.
It's the one thing that's like the most important thing that we're terrible at.
And it's in so many ways, on so many levels.
But thank you for continuing to be the good part of that thing.
And thank you, listeners, for continuing to be good people.
And again, we'll put a P.O. box.
We'll plug that in after the episode if you do get a delotted script and you just want to help out your boy.
What?
Sophie!
Sophie!
It's not illegal to receive delotted in the mail, I assume.
Wait, yeah, we should check that.
We should probably check that.
Don't send Robert things.
Listen to my podcast instead, The House of Pod.
Do that.
Do that.
Don't send fentanyl or drugs via the mail if you are not a large hospital prescribing pharmacy or anything along those lines.
Listen to my podcast, The House of Pod, instead.
Yeah.
One of our listeners is the hospital from the show, House.
So I hope they take that to heart.
Anyway, I forget the name of that house.
Robert, this podcast is so over.
Yeah, just like House.
Behind the Bastards is a production of CoolZone Media.
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