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Thread: My Life as a Secret Agent (sorta but not really)

  1. #1
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    My Life as a Secret Agent (sorta but not really)

    I received some good news a few days ago...news that allows me to talk about events that I've had to keep quiet about for a while now. I've shared this with a few folks privately but this is the first open post and it's one I've started and deleted a few times already. It just feels odd to "say it out loud" so to speak. Anyway, some of you may remember that I have rheumatoid arthritis for which I regularly see a rheumatologist and receive medication. I'm very mindful of how fortunate I am that this is covered by my military retirement insurance plan.

    Routine questions. I've been seeing the same civilian doctor by referral since 2011 and my treatment settled into a routine until about a year ago. Out of the blue, I received a call from an agent of the Defense Criminal Investigative Service who asked if I would meet him for an interview in regard to an investigation he was conducting. I agreed and we met at the US Attorney's office where he explained that my doctor was under investigation for insurance fraud. My answers to his questions confirmed that I did not receive all of the services that were billed to my insurer...and here's the kicker...nor had I ever received a full dose of the medication for which they billed. I only got half.

    Now, here's where things got a bit surreal. The agent asked if I would be willing to covertly record my visits to aid the investigation. It wasn't as if they would be duct-taping a recorder/transmitter to my belly but yeah, he basically asked me to "wear a wire." After giving it some thought, I agreed. I wound up recording my visits over the course of 5 or 6 months, using devices I carried with me that resembled small, everyday items that also recorded video and audio. My agent said I obtained excellent recordings. The doc never appeared suspicious about my behavior or the devices and the video showed that I wasn't receiving the full dose as stated and billed for...and here's an extra-strength kicker...nor was I always receiving the correct medication.

    Sneaky but not sneaky enough. Being more attuned to what was going on during my visits, I had noticed that after leaving to retrieve my injection, the doctor always brought a very small clipboard back into the exam room with her, on which she kept her prescription pad. This was odd because she almost always wrote my prescriptions at the reception desk. It turned out that the only use to which she seemed to put it, was to conceal the syringe from my view. The pre-prepared injections—which I received most often—come in distinctive syringes designed by OXO, the same folks who brought you Good Grips® kitchen utensils. The camera revealed that it wasn't always the OXO design she was hiding. The agent's research indicated that the appearance of some syringes was consistent with other common RA meds.

    Out with the old. After my last recorded visit, I switched to a new doc who I see every three months. I'm still on the same meds but I inject them myself at home...one syringe, twice per month...which I could've done all along. After all, I self-inject another med at home weekly. I'm doing pretty well with the new...er, corrected regimen. My flare-ups and chronic stiffness have been further reduced but that's not the good news I mentioned up front. My agent has kept in touch with me since the last visit and he recently called to let me know they executed a search warrant at her offices. I so wish I could've been there to see it.

    The pay off. One might wonder what I got out of this beyond the gratification from doing my 'civic duty' and helping karma come around to a deserving recipient a little quicker. Of course, I wasn't a paid informant but I did joke with my agent that after it was all over, I wanted a junior G-man badge and for him to vouch for me putting International Man of Mystery on my resume. Little did I know that after the last appointment he would show his appreciation by giving me a DCIS challenge coin. I have a few coins from my military career but this is by far the nicest...and in a way, I got the badge I joked about.

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  2. #2
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    That is equal parts awesome and scary.

  3. #3
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    You know, I went into it with some nerves at first but it's not like I was rolling over on an international drug cartel. The worst that would likely happen if I was discovered, would be that I got yelled at and kicked out. My anxiety was most accurately expressed by Alan Shepard's Prayer. I didn't want to foul up the investigation.
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    Outstanding !

    Well done!

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    Quote Originally Posted by PetersCreek View Post
    ... The worst that would likely happen if I was discovered, would be that I got yelled at and kicked out. ...
    Never watched a single episode of NCIS, huh?

    Seriously, good on you.
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    Definitely good work - helping keep the costs of medicine down for all and ensuring that patients, including yourself, receive the correct treatment/medicine is an admirable thing to do. Will you be required as a witness for court?

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    Quote Originally Posted by Jim View Post
    Never watched a single episode of NCIS, huh?
    Well, I did qualify it with "likely" but I suppose she could've given me a nefarious injection to keep me quiet.

    Quote Originally Posted by ozduck View Post
    Will you be required as a witness for court?
    Most likely, if it goes to trial. My impression was that I may have been the only patient recording visits, I may have been the most prolific, or I may have obtained the clearest, most damning recordings. My agent did say that the evidence I provided would probably be a key component of their case.

    Actually testifying in court would certainly take things to a whole other level of surreality. However, I think it's more likely that a plea deal will be offered at some point and that she'll agree after she and her attorney are confronted with the evidence.
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    Quote Originally Posted by PetersCreek View Post
    Well, I did qualify it with "likely" but I suppose she could've given me a nefarious injection to keep me quiet.



    Most likely, if it goes to trial. My impression was that I may have been the only patient recording visits, I may have been the most prolific, or I may have obtained the clearest, most damning recordings. My agent did say that the evidence I provided would probably be a key component of their case.

    Actually testifying in court would certainly take things to a whole other level of surreality. However, I think it's more likely that a plea deal will be offered at some point and that she'll agree after she and her attorney are confronted with the evidence.
    Good point.

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    Quote Originally Posted by DaveC426913 View Post
    That is equal parts awesome and scary.
    Ageeed! Well done.


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  11. #11
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    I also also add that, while inappropriate billing is bad, not delivering proper care takes it to a whole new level.



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  12. #12
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    I wish my local hospital had been investigated. My Dad kept going there for years. "Doc, you back isn't supposed to hurt--like THIS!"

    The doctor told him he was on too many pils to use medications for arthritis.

    After threatening to take my Dad to another hospital, he assigned my father to go to another Doctor.

    The MRI results showed he had a tumor in his spine--oh, and he had a swelling on his Aorta.

    The bad news? We got the results the day we put him in the ground.

  13. #13
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    In Belgium, generally speaking hidden recordings aren't valid as evidence. That does not make life easier.

  14. #14
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    Quote Originally Posted by Nicolas View Post
    In Belgium, generally speaking hidden recordings aren't valid as evidence. That does not make life easier.
    Interesting. Here, such video evidence of a private interaction can be excluded if prior consent or a warrant was not obtained but in general it is otherwise admissible, subject to state as well as Federal laws. In this case, it wasn't necessary to obtain a warrant for the surveillance. Alaska is a 'one party consent' state. That is, only one participant in a conversation need give consent to recording and that person may be the one making the recording...as I was.
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  15. #15
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    Quote Originally Posted by PetersCreek View Post
    Interesting. Here, such video evidence of a private interaction can be excluded if prior consent or a warrant was not obtained but in general it is otherwise admissible, subject to state as well as Federal laws. In this case, it wasn't necessary to obtain a warrant for the surveillance. Alaska is a 'one party consent' state. That is, only one participant in a conversation need give consent to recording and that person may be the one making the recording...as I was.
    Thought it worthwhile to bold that and second it for anyone who might stumble across this thread. Wiretapping* laws (which is what these generally fall in to, even if not recording via wire) vary widely from state to state in the United States. And if the communication is happening across state lines (e.g. by phone or internet) then both state's laws can come in to play. There's other factors to consider, too. For instance, Ohio is a one-party state as well, but there's also an expectation of privacy which means you can't capture audio or video beyond what a "regular person" could gather with their natural senses. In other words, no telephoto/zoom lenses, or audio-boosting equipment.

    I'd have assumed that had they needed one for it to be admissible, the DCIS would have secured a warrant first.

    *I think I'm remembering that section correctly, though I could be rusty since I've spent the last 15 years selling insurance and not using my criminal justice degree or police academy training

    Anyway, I thought that was a really interesting read, PetersCreek! Also glad you got to help bring the doctor to justice, if for no other reason that so you and the other patients can receive the proper care that you should have been getting all along!

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