I never intended to break the law. But I didn’t ask the right questions. I didn’t demand the right documentation. And in a business like healthcare, silence—when something feels off—is its own kind of lie.
The first time I sat across from one of the telemedicine marketers, I remember it now with an unease I couldn’t quite place. They were polished, persuasive, confident. They had a model that seemed to move fast, and they claimed it was all compliant. But I didn’t verify. I didn’t pause. I didn’t ask for their contracts with the doctors, or for the credentialing paperwork, or for documentation of their advertising practices. I just moved forward.
They weren’t hiding what they were doing. I just didn’t press for the truth.
When I think back now, I can see all the warning signs. First it was a marketer from Florida, then another one from Louisiana. They brought promises of referrals through telemedicine scripts. The paperwork arrived fast. The orders were signed. The prescriptions flowed. All of it looked efficient on the surface. But beneath that efficiency was a critical flaw: I hadn’t built a process to ensure that what I was receiving met the legal standards for Medicare reimbursement.
We passed audits. That became my excuse.
I leaned on that for a long time. Medicare paid the claims. We passed the pre-pay reviews. So I told myself it must be fine. I assumed legitimacy based on outcomes, not process. And I let their confidence displace my own responsibility.
I didn’t ask how patients were being sourced. I didn’t ask how the doctors were evaluating them. I didn’t ask how the advertising was being run. I didn’t ask, because I didn’t want to stop. I didn’t want to lose the volume. And the truth is, I didn’t want to look too hard. Because looking might have meant ending it.
At the time, I told myself it was just marketing. Not manipulation. I told myself everyone was doing something like this. I told myself it wasn’t fraud—because I wasn’t forging anything. But I was wrong. I was avoiding loss, not chasing profit, but the law doesn’t distinguish that way. And neither does conscience.
The marketers didn’t submit the claims. I did. The marketers didn’t hold the Medicare contract. I did. The marketers didn’t sign the provider agreement. I did.
That’s why I pled guilty. That’s why I said, under oath, that I was responsible.
And I say it again now: The first thing I did wrong wasn’t a scheme. It wasn’t a wire transfer. It wasn’t a forged order. It was a shrug.
If you’re in private practice, and someone offers you an arrangement that moves too fast, sounds too good, or feels just a little off—say something. That moment may be the most important decision you make.
I wish I had. Because what followed was years of compounding silence. The orders kept coming. So did the payments. And I fell deeper into the lie that everything was fine because nothing was being flagged. I ignored the complaints from patients. I ignored the returns. I ignored the unease.
Eventually, it wasn’t just silence. It became rationalization. I told myself I was helping patients get what they needed. I told myself the government wouldn’t be paying if it were truly wrong. I told myself I had too many responsibilities to start over or shut it down. I told myself that my family, my staff, and my patients needed me to keep going.
But none of that made it right. None of it made it legal. None of it made it ethical.
And now I live with the reality that I harmed a program I once trusted. I harmed my profession. I harmed my name. I harmed my family. And none of those outcomes were caused by a single bad actor waving red flags. They were caused by my failure to speak up early, when I still could have done something about it.
Today, I use that failure to teach others. Through the Prison Professors Charitable Corporation, I help deliver an entrepreneurship course to other incarcerated individuals. I don’t lecture about law. I talk about choices. I talk about the moment you feel something might be wrong, and the pressure to stay quiet. I talk about the cost of shrugging.
This isn’t a story about getting caught. It’s a story about what happens when you ignore your gut, your values, and your obligations.
If you’re in healthcare, especially in private practice, you can’t delegate integrity. You can’t assume audits will catch what you won’t confront. You can’t outsource your conscience.
Say something.
Because I didn’t. And that silence is what brought me here.
