15 October 2004
It's fraud, says the AG
Oklahoma Attorney General Drew Edmondson has told the Associated Press that the filing of the Medicaid reimbursement form for Dr Tom Coburn's 1990 operations on Angela Plummer constituted "fraud," though no charges will be filed as the statute of limitations has expired.
Coburn treated Plummer's ectopic pregnancy by removing both her Fallopian tubes, even though only one was affected, leaving her sterile. Since Medicaid did not pay for sterilization procedures for patients under twenty-one years of age Plummer was twenty Coburn reported only the removal of the tube containing the embryo.
Edmondson says that had Coburn described his actions in full, he would have received no reimbursement from Medicaid, and that his omission was intended to make sure he "got paid for something that he would not have been paid for had he submitted the claim accurately."
Plummer eventually filed suit against Coburn, claiming she had never consented to the sterilization, but did not pursue the matter.
Meanwhile, Coburn's rival for a hotly-contested Senate seat, Brad Carson, is already running ads waving the "fraud" description around.
Persuaded as I am that wording treatment descriptions in the way that pries the most money out of insurance companies is a true 21st-century art form, I'm inclined to dismiss Edmondson's claims as so much white noise. On the other hand, Coburn's deposition, in which he states that he had asked Plummer not to discuss the sterilization with Medicaid, is more troubling, at least to me.
(If you'd just as soon not go through NewsOK.com, the Carson campaign has posted the entire AP story here.)