Doctor Update: Slow wheels of justice finally turn up insurance fraud

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June 13, 2016

After archeologist Howard Carter opened up King Tutankhamun’s tomb in 1923, he uncovered many clues to the way the ancient world worked. One of the most interesting and ultimately enduring symbols he discovered was what came to be known as the ouroboros: a snake eating its own tail. It has been described as representing “the formless disorder that surrounds the orderly world” and “the cyclical nature of time.”

Both of these descriptions came to mind when I read about Charles Orlando Lewis finally losing his license to practice medicine.

First the disorder. I wrote about Lewis in July 2010. He had been sued by Allstate Insurance and the state of California for being part of an insurance scam. Chiropractors can’t prescribe drugs and bill insurance companies for the drugs and services. So Lewis and other doctors were allegedly creating a false front to allow chiropractors to prescribe drugs and bill insurance companies through the doctors.

That was six years ago, and for that entire time, Lewis continued to maintain a license to practice medicine in the state of California. On May 25, 2016, the Medical Board of California revoked Lewis’ license. What finally triggered the revocation?

Back in November 2014 — a year and a half prior — Lewis was convicted of insurance fraud and sentenced to five years of felony probation. He did not notify the board of his conviction, and that apparently worked for some time because he continued to practice unfettered. That the state attorney general’s office bringing the fraud case against Lewis did not tell the medical board about the conviction should not be surprising. State agencies often do not communicate effectively. It’s unfortunately the natural disorder of things.

What makes the case strange, though, is that the Medical Board opened a case against Lewis in 2013, presumably because it knew something about the insurance fraud case against him. Why it did not find out about the subsequent conviction is unclear. The board does not make complaints against physicians or its initial case documentation public. All we have to go on is the date embedded in the case number of the formal accusation against Lewis: 08-2013-229706.

And now the cyclical nature of time. When Lewis was first sued by Allstate and the state of California in 2010, he oddly built part of his defense on the Medical Board of California. As Barbara Anderson wrote in the Fresno Bee:

The allegations against the chiropractors and doctors are untrue, said James H. Wilkins, a Fresno lawyer representing Pierce, Arakelian and Lewis, who operate the San Joaquin Accident & Medical Group Inc. in Fresno. They were recently investigated by the California Medical Board, which 'determined they are operating a legal medical corporation,' he said.

So the Medical Board investigated and cleared Lewis, allowing him to continue on with business as usual and use the board in his defense against charges from the state? And then the state convicted Lewis, forcing the Medical Board to take action against him? Talk about a snake eating its tail.

And the ourborous lives on, too, in the case of Lewis’ co-conspirator, Dr. Tomas Ballesteros Rios. I’ll write about him in a later post.

[Photo by John Mosbaugh via Flickr.]