Borrego Health: Still Padding for Profits
Last updated 11/9/2023 at 1:10pm
Meet Terry (Not his real name, but he is a real person). He recently told the following story to the Borrego Sun. When reviewing his medical records, Terry alleges, he discovered that Medicaid had been charged for services he did not receive.
Persons illegally padding the government invoice on behalf of Borrego Health’s (now DAP’s) Cathedral City clinic was Borrego Health insider – Dr. Edgar Barbour, and his Physician’s Assistant, Gennady Nosovitisky.
Dr. Barbour runs the Borrego Health AIDs clinic; and has been criticized for taking over $300,000 plus of promotional money for publicly pushing a specific HIV medicine, he enthusiastically offers at the Borrego Health AIDs clinic.
Also, of interest is the fact that the Cathedral City clinic is highly praised by Borrego Health as one of the most successful clinics – operating in the black. Actually, it’s one of the few clinics making any profit. Perhaps, thanks to Terry, we now know why and how.
Terry also claims he was terminated as a client after criticizing Dr. Barbour and seeking a new doctor. His new doctor was PA Nosovitsky, who actually had to go through Dr. Barbour for approvals; so, to Terry’s dismay, he didn’t really get a new doctor.
This was not the first time a client had a problem with Nosovitsky. Most recently, he was before the Physician Assistant Board, Department of Consumer Affairs, State of California, in 2019, facing disciplinary action for client negligence.
Terry was terminated by Borrego Health for supposedly “intimidating and harassing” clinic employees. Frustrated people can get to that point. Borrego Health also refused his critical HIV medicine, during the gap between the time he was forced to leave Borrego Health and schedule an appointment with a new provider.
According to Terry, he has notified the Riverside District Attorney and the state Department of Health Care Services of Borrego Health’s alleged fraud and patient neglect by written letter. The Borrego Sun has copies.
Additionally, he notified Borrego Health of the discoveries on his medical records, and what he perceived to be patient abuse by denying him the critical medicine he needed.
Borrego Health’s Patients Relations Department claims to investigate all patient claims and grievances and return to the claimant within 30 days. Terry sent them a reminder by email, warning in advance of the 30-day deadline. However, there was no response in 30 days or ever.
Terry’s encounter with Borrego Health’s Patients Relations Department is not unique to him. Over the years, the Borrego Sun has been contacted by many people, who had warned Borrego Health about doctors and illegal activities without ever receiving a whimper from the department. The conclusion we have drawn is the department is an answering machine with a robo tape.
The other conclusion is that, had Borrego Health Board of Trustees taken an interest in the complaints, they might have caught many of the illegal practices before the FBI and Department of Justice.
Another tragic victim is Thom. His mother died of heart failure as a result of neglect at the Borrego Springs Clinic. Thom went to Bruce Hebets – Borrego Health’s CEO at the time –to confront him. Hebets, in response, offered Thom a job as compensation for his mother’s loss, and because Thom had the medical documents proving malpractice.
Thom turned down the job offer. Eventually, Thom and Hebets settled for a $50,000 settlement/bribe; and a 20-year confidentiality agreement. Thom, being an honorable person, did not break that private contract even when Hebets died and news of Borrego Health’s many malfeasances were being exposed by the Borrego Sun.
However, the day when the gag order was up, Thom began making public disclosures about Hebets’ silencing of the serious malpractice at the clinic with a personal arrangement to avoid losing a costly lawsuit and censure by the medical board, or worse.
These individuals represent a sample of the grievances that patients of Borrego Health have shared with the Sun. Some have sought exposure, retribution; compensation; and help dealing with medical problems or getting medical attention. Most want Borrego Health held accountable; others want to punish medical providers that they claimed caused serious harm. Sometimes it’s lawyers.
The most recent was an attorney wanting information for his client – an elderly woman whose dentist coerced her to have six implants she didn’t need. The result; the dentist fractured her jaw.
Guess who the dentist was? None other than Husam Aldairi. It seems, his bad deeds keep adding up; yet he continues to practice without guilt or punishment. You may remember him as the dentist who made $18 million in one year, as a Borrego Health contract dentist, managed by Premier Healthcare Management – another alleged fraudulent organization.
In case you don’t remember, Premier Healthcare Management is the company created by Bruce Hebets and his friend, building contractor, and real estate entrepreneur, Daryl Priest, to take advantage of California’s large Medicaid and Denti-Cal markets. Both having no experience in health care or management, they were bound to make a mess of it. However, it served its purpose: with $25 million of taxpayer, health care money siphoned off by Priest; and an uncalculated amount going to Borrego Health.
Fifteen dentists have been named as personally and illegally profiting from the alleged scheme for Premier Healthcare to facilitate solicitation of dentists willing to contract with Borrego Health and expand the non-profit’s reach into the state’s 18 million Medicaid subscribers.
The purpose was not better dental care, but more profits and opportunity for personal profiteering by Hebets and cohorts. The dentists who allegedly also saw it as a way to make money illegally, were named in the Borrego Health Civil Suit, charging 40 of its own employees and contracting dentists with fraud.
So, now there are questions that DAP must answer as the new owners of the Cathedral City Clinic and employers of Dr. Edgar Barbour and Gennady Nosovitsky.
Do they intend to investigate the alleged Medicaid fraud by two of their employees? Will they share the results of that investigation with Terry?
The larger question is does DAP intend to have a patient complaint and grievance department that is more than an empty title?
Do they intend to take responsibility for these two employees and other Borrego Health employees for which complaints exist by letting go any personnel found to be negligent or involved in padding Medicaid bills? And any other illegal activities?
What level of resources will DAP commit to a real working grievance and complaint department?
DAP may have the will, but do they have the capacity to clean up a culture of fraud that was accepted as the norm by many employees for 20 years? How do they intend to identify and remove the bad apples? Or can they?
Have they retained any of the individuals who are defendants in Borrego Health’s civil suit?
DAP, a single clinic, purchased Borrego Health’s 18 clinics, six mobile clinics and two pharmacies. Many of which do not pay for themselves; have been ignored for two years as the Board of Trustees’ attention has been elsewhere; attempting to deal with the alleged fraud and other criminal activities the organization has allegedly been committing. In the meantime, also filing for bankruptcy and an auction of its assets.
Borrego Health has been working now, as in the past, despite so called leadership, as a headless, separate group of unconnected islands of medical practices. Islands, that offered opportunity for theft, given the absence of central controls, sound, experienced management, plus a Board of Trustees not asleep at the wheel.
Only the devious and greedy employees saw ways to profit illegally. The majority of Borrego Health’s hard working and caring employees are looking forward to positive, progressive and honest leadership that is truly concerned with the welfare of its patients.
Can DAP fill the bill? We certainly hope so; and believe the community will rally behind them. However, before the community learns to trust again, DAP is going to have to introduce itself and share their vision with Borrego Springs, not to mention exhibit examples of changes.
Examples, like investigating criminal and malpractice charges of employees made by patients with corrective actions and discipline when called for.