As young doctor, we were all told that to make a living as a doctor, the doctor had to participate in health insurance plans.

The key plan to participate in was Medicare, in the Fall of 2014 all doctors taking Medicare received a letter from Medicare that told the doctor that by the Jan. 1, 2015, the Doctor had to have an Electronic Health Record (EHR), approved by the federal government, running the doctor’s office, turning the office into a paperless office.

Failure to do so, would get the doctor kicked out of Medicare. I dropped out of all Health Insurance Plans, but the great majority of doctors paid the $80,000 fee to purchase the EHR, approved by the government. In January 2015, Medicare started its Performance Improvement Plan. 50% of the bills sent in to Medicare by the doctor, had to have four new codes included with the bill.

Codes are how the Doctor gets paid, and these four codes were for actions that never generated payments: Pulse and Blood Pressure plus the subcode; 1) meant the doctor forgot to look at the patients Pulse or Blood Pressure; 2) meant the doctor looked and the Pulse and the Blood Pressure were good; 3) meant the doctor looked and the Pulse and Blood Pressure were abnormal. Of course if the actual Pulse or Blood Pressure recorded in the EHR disagreed with what the Doctor coded, then the Doctor committed fraud.

The government knew that 80% of doctors outsourced billing, because the codes changed regularly and to trust a local employee was asking for dissatisfaction. A professional billing company was much safer to use. Of course, all professional billing companies only do what they get paid to do. What did Medicare pay for these four codes? Zero.

So no professional billing company included the four codes in any bill submitted in 2015.

This is a 5% pay cut for doctors in 2016. In 2016 Medicare demanded eight new codes be included in every bill sent into Medicare. None of the new eight codes concerned the patients at all. They covered the dimensions of the doctor’s waiting room, the kind of waiting room door etc.

Because the codes had nothing to do with the patient that meant the doctor had to enter all the eight code data on every Patient visit to get it in the HER. So, the doctor calls the professional billing company and asks them what it will cost the doctor to include the eight valueless codes on every bill sent into

Medicare. Fifteen percent is also the doctor’s income after all the bills have been paid.

The Doctor can’t afford to pay for the codes! So, the Doctor calls Medicare and asks what happens if the he fails to send in the eight codes in 2016. Medicare points out the eight codes systems will require a year to grade, meaning it won’t happen until January of 2018. Then if Medicare finds the doctor failed in 2016, Medicare goes back to payments made to the Doctor in 2016, looking at all 12 months of 2016, taking out 15% of the money paid to the doctor from each of the 12 months, adding it all up in 2018, the doctor has 5 days to pay the fees, if the doctor can’t pay the fee, then the doctor loses his license to practice medicine. The doctor can’t afford to keep 15% back, he and his family will starve.

So, the Doctor closed down his office, and went to the nearest hospital begging for a job. The hospital gobbled the doctor up. In 2017 Medicare went to 28 codes added to every bill. By the end of 2017, 95% of all the doctors in America were employees of the hospital industry.

In 2017 Medicare mandated Guidelines of Care which are harmful to the patient. If the hospital or the employee doctor doesn’t follow the Medicare guidelines then the hospital doesn’t get paid. As an employee the doctor has to do what the hospital industry tells the doctor to do. The doctor must intentionally harm the patient in order to keep their job. This has turned the doctor into a torturer, and during the pandemic, a murderer.

How do we fix this? We get the word out. But no one will ever publish this report. But I won’t stop!

Today 98% of America’s doctors are employees of the hospital industry. Only 2%of America’s doctors are in private practice, and the federal government is coming out for us. 

Dr. Councill Rudolph

Manchester