In 2014, an internist pled guilty to violating anti-kickback laws for illegal referrals. She accepted monthly cash payments of $5,000 to refer patients to a New Jersey lab, Biodiagnostic Laboratory Services. Apparently a total of 30 doctors have been snagged in the roundup. Biodiagnostic Laboratory Services is now out of business. 

Dr. Martinho accepted a total of $155,000 in payments.  

She took an ethics training course and thought she should speak to medical students about lessons learned. She emailed 350 medical schools, health groups, and other institutions. She’s given 25 lectures.  

Dr. Martinho is a single mother with two small children. She is scheduled to be sentenced shortly. She is facing a five year prison term and $250,000 fine. Future employment prospects as a physician are not rosy.  

An article detailing her odyssey can be found at the Washington Post.

What puzzles me is the following quote from the article: 

She blames only herself for her situation, acknowledging that she knew when she started taking the cash in 2010 that she was evading tax laws. But she said she didn’t understand that the referral itself was considered a kickback. The idea had been suggested by a friend who helped set up her office and subsequently a rep from the laboratory itself. 

I understand the impulse to educate others about what not to do. And I am sympathetic to a single mother with two young children at risk of going to prison. I cannot understand how accepting unreported envelopes of cash to the tune of six figures did not trigger a red flag to this physician. While many nuances of Stark and Anti-kickback can be difficult to understand, this is not the story of a doctor allowing a pharmaceutical rep to bring in lunch to feed staff while going over the risks of a new drug.  

What’s irritating about her dilemma is that most doctors will correctly say their advice cannot be bought for the price of a donut or a pen. But, Dr. Martinho is arguing the donut and pen create a slippery slope which leads to $155,000 in unreported cash payments. Call me old fashioned. I still do not believe that doctors can be bought for a pen or donut. But, Dr. Martinho’s rehabilitation tour makes her Exhibit A in the argument against. 

What do you think? 



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