Twitter Thread About A Personal Trainer Who Posed As A Doctor For Years And Scammed Millions

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mattstaff
Aug 6, 2019 11:00 PM EDT

Reporter Marshall Allen shared a recent viral Twitter thread about a story he covered that makes for one true emotional rollercoaster. This story involves a shady personal trainer/terrible dad who spent years posing as a doctor and billing the nation's top insurers, while scamming millions in the process. It's being referenced as a case study in how health insurers make it easy to scam millions off of people. All around a deeply unsettling story. 

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  • 01
    Text - Marshall Allen @marshall_allen 1/ A woman discovered her ex husband was defrauding health insurance companies for millions. She tried bringing him to justice. It didn't go as expected. (This story is one of the wildest I've reported.) Here's what happened: 11:27 AM Jul 19, 2019 TweetDeck 7.4K Likes 3.5K Retweets
    via @marshall_allen
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    Text - Marshall Allen @marshall_allen Jul 19 Replying to @marshall_allen 2/ Amy Lankford was suspicious when her ex, David Williams, who had a checkered history, gave their 3 children iPad Minis for Christmas in 2013. Where'd he get that kind of money? Then, one day she noticed something on her son's iPad... 2 592 ti 66 Marshall Allen O @marshall_allen Jul 19 3/The device was stll hooked up to her ex's Apple account, and showed al the messages he was sending+ receiving. The discovery maade her h
    via @marshall_allen
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    Text - Marshall Allen 5/When Lankford read her ex's iPad messages, she saw that most were from people setting up workouts through his personal training business, Get Fit @marshall allen Jul 19 With Dave. But that's not al.. ti 52 522 Marshall Allen @marshall_allen Jul 19 6/ Oddly, people were also providing their birthdates and the group number of their health insurance plans. We're talking industry giants: -@Aetna -@Cigna -@UHC Not something that you usually share w/ a personal traine.. 1 ti59
    via @marshall_allen
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    Text - Marshall Allen @marshall_allen - Jul 19 7/ But, the people messaging with her ex husband were very pleased to hear that their health insurance would cover the costs of their fitness workouts. That's because: they usually don't pay personal trainers. So how did "Dr. Dave" pull it off? I'l explain in a minute. O 3 2i 59 575 Marshall Allen @marshall_allen Jul 19 8/ Lankford called her father, Jim Pratte, who has a finance MBA and already had strong feelings about his daughter's ex. (When I s
    via @marshall_allen
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    Text - Marshall Allen @marshall_allen - Jul 19 10/ When they were going through their divorce in 2006, Pratte had found a folder of fake invoices on his son-in-law and daughter's computer. In November 2008, Williams pleaded guilty in Tarrant County District Court to felony theft. O 1 ti 51 529 Marshall Allen @marshall_allen - Jul 19 11/Two years later, their 11-year-old son showed up to school with bruising on his face. Investigators determined that Williams had hit the boy 20 times. Williams pl
    via @marshall_allen
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    Text - @marshall_allen Jul 19 13/To set his plan in motion, Williams needed what is essentially the key that unlocks access to health care dollars: a National Provider Identifier, or NPI Marshall Allen number. Without an NPI, providers can't bill insurers for their services. 2i54 530 Marshall Allen @marshall_allen - Jul 19 14/ How'd he get around the fact that he wasn't a doctor? Williams discovered and exploited an astonishing loophole: Medicare doesn't check NPI applications for accuracy (a pr
    via @marshall_allen
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    Text - Marshall Allen @marshall_allen Jul 19 16/ He kept getting new NPls. For every application, Williams also obtained a new employer identification number, used for tax purposes. But he never hid who he was, using his real name, address and phone number on the applications. Medicare gave him 20 NPI!! 4 ti102 804
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    Text - Marshall Allen @marshall_allen Jul 19 17/Time to drum up business: "Now accepting most health insurance plans," his Get Fit With Dave website announced. He added a drop-down menu to his site, allowing potential dients to select their health insurance provider: -Aetna -Blue Cross Blue Shield -United OCT APR SEP htpigetfiwithdave.com Go INTERNET AacIvE 30 2016 2017 2018 56.cantares ntceugachtien Feb 2007-Aug 201 Kinesiology Specialists 817-648-6999 weTH IN-HOME PERSONAL FITNESS TRAINING GET
    via @marshall_allen
  • 09
    Text - Marshall Allen @marshall_allen Jul 19 18/ He began building a team, soliciting trainers from the strength and conditioning department at Texas Christian University. He met with new recruits at local fast food joints or coffee shops to set them up. To the trainers, the business appeared legit. 1 536 ti 49 Marshall Allen @marshall_allen Jul 19 19/ He told clients their health plan would cover their fees, but didn't tell them he was billing for medical services. For example: one client recei
    via @marshall_allen
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    Text - Marshall Allen @marshall_allen - Jul 19 20/ "Dr. Dave's" business expanded to a dozen trainers and 1,000 patients. He bought a couple pick-up trucks, a new Harley and a fany house. The checks from insurance companies kept rolling in. Look at this whopper from United! Business was good. Ihs. Seces POEOK 74000 ATLANTA GA 30at-ce0 PHONE 1477-642-3210 PH 915557 16 DATE: 11/25/15 JP Morgan Chase Bank NA PLEASE PRESENT PROMPTLY FOR PAYMENT Syracuse, NY 13200 11-790 PM-151-10 PAY: $121,028.05" O
    via @marshall_allen
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    Text - Marshall Allen @marshall_allen Jul 19 21/With all their evidence, Amy Lankford and her father thought that they had an open-and-shut case. It wasn't the case: 2 1 ti 58 547 @marshall_allen - Jul 19 Marshall Allen 22/ an @Aetna customer service rep told them non-members couldn't report any criminal activity. Lankford and Pratte never heard back from them. -a @Cigna investigator called asking for more info, which they shared. Then crickets. -calls to @UHC were similarly ineffective. 16 O787
    via @marshall_allen
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    Text - Marshall Allen @marshall_allen - Jul 19 23/ Even after the insurers caught him, Dr. Dave continued his scheme. Mostly, they asked him to pay them back. He just reached into his bag of NPls to keep billing them. They kept paying! In 2017, @UHC finally contacted the FBI. O 1 O673 tl73 Marshall Allen @marshall_allen - Jul 19 24/ In all, from the time Lankford found the texts, it took authorities *3 years* to finally stop "Dr. Dave." In total, he ran the scheme for more than 4 years, billing
    via @marshall_allen
  • 13
    Text - Marshall Allen @marshall_allen Jul 19 25/That's a small piece of the overall tally of health care fraud. The truth is no one keeps track of how much is lost to health care fraud. Experts told me it could be 10% of what we spend. Those losses get passed on to all of us. ti196 10 1.1K Marshall Allen @marshall_allen Jul 19 26/ The insurance companies wouldn't do an interview with me about the Williams case. They said in emails that they care about fraud and take the problem seriously. 11 ti6
    via @marshall_allen
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    Text - Marshall Allen @marshall_allen Jul 19 28/Medicare warns NPI applicants that submitting false information could lead to a $250,000 fine and five years in prison. But since they started issuing NPls in 2006, officials said they could not identify *anyone* who had been sanctioned. 2 860 ti 108 Marshall Allen @marshall_allen Jul 19 29/ So, for those bent on fraud, the first step is easy: The online approval for an NPI takes mere minutes. ti 62 4 692
    via @marshall_allen
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    Text - Marshall Allen @marshall_allen Jul 19 30/ Thanks for reading all this. For more astonishing details, check out the full story, co-published with @voxdotcom, on @ProPublica here: Health Insurers Make It Easy for Scammers to Steal Millions. Who Pays? Y... Health insurers are regarded as fierce defenders of health care dollars. But the case of David Williams shows one reason America's health care costs... &propublica.org 2i 416 16 1.9K ilii
    via @marshall_allen

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