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"Once they got the chest X-rays, they might say, `Hey, this guy's got a spot on his lung - we better lose his application,'" Weinstein explains. "They never bothered to tell them they might be dying. These people were walking time bombs." Not only did the clinics save money by secretly using the exam to target sick patients for rejection, but they also made money by billing the exams and tests to Medicare. Both practices are blatantly illegal.
Miguel Recarey, Jr., was eventually indicted by a Miami federal grand jury, which found sufficient evidence that he had bribed union officials to sign up IMC patients from the ranks of organized labor, and had run an illegal wiretapping operation against his own employees. Shortly before he was to go to trial in Miami in 1987, Recarey fled to South America with his family. Today he is said to travel widely in Europe and Latin America, returning to a home base in a posh suburb of Caracas, Venezuela. But while the chief of IMC was on his way to becoming a high-profile target for a host of federal investigative agencies, Leon Weinstein was immersed in the separate and far less glamorous matter of decoding the shadowy finances of the individual IMC clinics.
Though anonymous tips from patients and clinic workers had been filtering into Weinstein's office for years, he had been unable to prove any wrongdoing. But in February 1986, the manager of an IMC clinic came to Weinstein in tears. "She said, `I can't take it. I have to tell you what's really going on,'" Weinstein recalls. "And she did, for about three hours. I got a search warrant. We went out, we grabbed the records. And we saw that they had torn up all the applications of people they had determined were sick. But they did something stupid. They photocopied each application and left a copy of it in their files."
Weinstein says the owner and operator of the clinic, Dr. Cristino Enriquez, had kept the photocopies to safeguard against possible complaints. If a rejected patient ever complained to federal authorities, Enriquez could simply say the application had been misplaced. But the plan backfired. "That was the break," Weinstein recalls. "That was how we opened the whole can of worms. We went out and we started hitting other clinics. I developed a computer audit that showed exactly what Enriquez was up to. It showed that immediately before a particular patient joined the IMC program, he had a series of tests by a doctor he had never seen before. Then there were others who never went on IMC, but who did have the tests. Those are the ones who we contacted, and those are the ones who were sick.
"And that's when they started wanting to take me off the case."
By late spring of 1986, slow afternoons in the tiny South Florida satellite office of the HHS inspector general were a thing of the past. Weinstein and his four colleagues opened several new investigations of IMC doctors. Weinstein also believed doctors at a Miami-based IMC competitor, Comprehensive American Care Inc., were engaging in a similar pattern of Medicare fraud. He urged his superiors to establish a task force to deal with the burgeoning IMC investigation.
The task force, dubbed Project Minicare by Weinstein, was born in late summer. Several out-of-town HHS investigators were brought in, along with two special agents from the FBI. Extra office space was leased. But Weinstein quickly noticed that his reinforcements were oddly lacking in Medicare expertise. Several of the HHS agents were Social Security experts. Others were recent transfers from the Navy and the Secret Service. Jack Petersen, the FBI man put in charge of the operation, was known as an intelligent, hard-charging agent, but had little interest in or knowledge of Medicare fraud, according to Weinstein. Petersen would not comment about the composition of the task force or his recollection of Project Minicare.
"When the agents went out to conduct interviews, a lot of times they didn't know which questions to ask," Weinstein says of the Enriquez investigation. "In the end, the reports were so bad we almost botched the case." When Weinstein suggested that certain task force members receive special training, Regional Inspector General Robert A. Simon vetoed the idea from his office in Atlanta. Weinstein says Simon also ordered Project Minicare members to conduct operations on a need-to-know basis, meaning agents assigned to a particular investigation were prohibited from discussing details of their sleuthing even with other agents working along similar lines. A certain amount of secrecy was always observed in federal fraud cases, but the new tinge of espionage struck Weinstein as bizarre and counterproductive.
Two months after the project commenced, Weinstein's immediate supervisor, Assistant Regional Inspector General Harry Kinsella, handed him a transfer notice signed by Simon. More than a year earlier, records show, Weinstein had refused to attend a three-month training session in Georgia on the grounds that he could not leave his sick mother. Simon had at first threatened to fire him, then said he would demote Weinstein from investigator to analyst. But the demotion never took place, and the issue seemed to have been dropped - or so Weinstein thought. Now, as he prepared the Enriquez case for trial by the Miami U.S. Attorney's Office, Simon threatened to strip him of his "special agent" title, a designation that carried cachet within the department and held the promise of postretirement consulting work. Weinstein was shocked and outraged.