Sunday, August 24, 1986

Medicaid fraud doesn't stop these docs

Many Medicaid Violators Continue To Practice Medicine
By Edward Colimore and Howard Goodman, Inquirer Staff Writers

Dr. Arnold Lincow and his clinic did hundreds of thousands of dollars in business with Medicaid patients in Philadelphia - and then state officials said they wouldn't pay him any more.

He broke Medicaid regulations, they said, by performing 145 unnecessary treatments on welfare clients.

But that didn't stop Lincow from billing for thousands more dollars, the attorney general's office said. After Lincow got word of his expulsion, the state said, he submitted 961 more invoices to Medicaid by fraudulently using the names of other physicians - including one doctor who was in his last, dying month, hospitalized with a heart attack.

Lincow was indicted in 1982. The following year, he pleaded guilty to 10 counts of Medicaid fraud, and was placed on probation and fined. In 1985, his license was suspended - for 90 days.

Today, Dr. Lincow is again practicing in Philadelphia, and the federal government is still seeking $418,402 from him in fines and restitution.

He is not the only Pennsylvania doctor who continues to practice on an unwitting public despite being convicted of crimes against Medicaid. An examination of records reveals that there are scores of such doctors.

And there are scores of others who continue to practice despite being barred from Medicaid because their medical practices and techniques have violated state regulations.

The state Department of Public Welfare is dropping such doctors in record numbers from Medicaid, the mammoth state and federal health-care program for the poor. Tighter regulations and stepped-up enforcement have created a dramatic increase in doctors cited for Medicaid abuses.

Overall, according to state records and interviews with medical investigators, doctors, through improper billing, stole about $13 million from Pennsylvania taxpayers last year alone.

But only rarely do the state's licensing boards, which are supposed to protect the public from violations of medical and ethical standards, follow up by significantly limiting those doctors' right to practice.