Healthcare Fraud: Auditing and Detection Guide, 2nd Edition

Chapter 11

Accounts Receivable Pipelines

If money be not thy servant, it will be thy master.

–Francis Bacon (1561–1626)

Greed has the infamous ability to degrade the soul and corrupt every established value of an individual. In this, it is little different than the toxic effect of a drug like heroin on the brain and body. It can cause a complete personality change, along with the burial of the “conscious” attributes of right and wrong. As auditors and investigators, we need to follow the paths and respect the complexities of those we audit or investigate. Take Dr. Ronald Mikos, a podiatrist from Chicago. A father of five, he lived a $350,000 lifestyle off Medicare by billing surgeries he never performed. On January 27, 2002, Joyce Brannon, a disabled former nurse and patient of Dr. Mikos, was killed gang-style in her home. She refused to lie about the alleged 72 surgeries he billed to Medicare on her behalf and was going to testify against him.

Dr. Mikos was not accustomed to patients who refused to lie on his behalf. The consequence for Brannon was a gang-style shooting of six bullets, two in the back of the head—a strong lesson learned on how a dysfunctional mind responds to the fear of being indicted for Medicare fraud. Mikos’s fear was suffering the consequence of a five-year prison term and Medicare fraud fines. His solution was murder. As sound logic would dictate, instead of the five-year prison term he feared, Mikos was indicted and then convicted for first-degree murder, ...