Something didn't seem right to Dr. Barbara Petkovic.
“I didn't like it,” the Northeast Ohio podiatrist recalled. “It made me feel very uncomfortable.”
Patient after patient passed through.
"I feel like it was an assembly line," she said.
It soon became apparent: she was working amid an assembly line of false claims and illegal kickbacks.
“I just felt it was wrong. I felt I was involved in it. The whole thing scared me," she said.
Instead of continuing, she blew the whistle against her employer, Mobile Medical. After years of litigation, the company eventually paid a $4.5 million settlement to the federal government and Petkovic.
The case symbolizes the breadth of taxpayer-funded healthcare fraud that is rapidly growing, right along with the aging baby boomers.
From podiatry to optometry to dental work. From hospitals and medical facilities to general practices, Medicare and Medicaid fraud runs rampant, into the billions of dollars.
Locally, a mother-son medical team, Delores and Isaac Knight, scammed Medicare out of $8 million. Westlake cardiologist Harold Persuad billed the government for $29 million in unnecessary procedures and inflated invoices. Dr. Persuad was sentenced to 20 years in prison.
“You’re talking billions of dollars worth of fraud and that is something we've seen nationwide," said Justin Herdman, the U.S. Attorney for the Northern District of Ohio.
Overall, Ohio ranks 11th in Medicare fraud with nearly $2 billion. In Medicaid, the health benefit for the poor, there’s been $350 million of fraud uncovered just from 2,800 cases uncovered since 2012.
“Ultimately, we're all paying for it as U.S. taxpayers," Herdman said.
The fraud is so widespread, federal law enforcement consider it a priority, ranking it alongside national security and violent crime.
But healthcare fraud generally targets one specific group: the elderly.
“This is a population that is vulnerable to these types of scams," Herdman said.
And those were the very patients Dr. Petkovic saw as a podiatrist for Mobile Medical, a division of Onsight Health Care based in Troy Mich.
Petkovic recalls the filing of false claims, including unnecessary diabetic shoes for patients she met at facilities that contracted with Mobile Medical.
"I just didn’t think it was right. You're getting shoes for people that I don't think they qualify for them," she said.
The company contracted with 60 facilities owned by Provider Services Inc. to obtain exclusive access. For its part, Mobile Medical offered free eyeglasses, dentures and hearing aids for patients, an often costly burden normally absorbed by the facilities.
Mobile Medical also offered to provide transportation services to the patients, another costly perk.
Anti-kickback laws bar companies from providing anything of value to obtain Medicare or Medicaid business.
“It’s a kickback," said Petkovic, who also has a law degree.
The arrangement ended with Petkovic's whistleblower lawsuit that the U.S. Attorney joined.
Mobile Medical paid $4.5 million in 2015. The case, however, was only unsealed this year by a federal judge.
Despite an FBI raid, Provider Services has so far walked away unscathed.
Federal prosecutors won't say why they've dropped the case. The company, which denies any wrongdoing, won't comment.
But Dr. Petkovic refuses to drop her end of the suit and intends to pursue the case without the help of the federal government.
"It cost her her job. It really damaged her career but she came forward anyway and tried to make things right,” said her attorney Warner Mendenhall of Akron.
Provider Services, now known as Foundations Health Solutions, and its CEO Brian Colleran, were part of a separate $19 million whistleblower settlement earlier this year in southern Ohio.
The allegations were the same: false Medicare claims and kickbacks.