Jail, reprimands, failures
In the end, everyone loses
During the summer and fall of 2003, Connecticut’s Medicaid Fraud Control Unit investigated Noah’s Ark. The jurisdiction of this agency, as described on its website, is to investigate and prosecute health care providers who defrauded the Medicaid program:
The Medicaid Fraud Control Unit employs a professional staff of criminal investigators, auditors and prosecutors experienced in financial investigations. In addition to investigating and prosecuting fraud by those who provide health care services, the unit investigates cases of abuse of patients who reside in facilities that receive Medicaid funding.
Leedom says she was told that there was some uncertainty as to whether the Medicaid Fraud Control Unit had jurisdiction in the Noah’s Ark case. But because it had opened a Medicaid fraud investigation, the agency could pursue other alleged criminal acts as well.
In the raid after Lichtenthal was arrested, police seized the records of 33 Medicaid recipients who were treated at Noah’s Ark. In four cases, the agency’s investigator, Kenneth O’Brien, found that Noah’s Ark had over-billed Medicaid. The amounts ranged from $205 to $2,644.50, and totaled $5,944.50.
O’Brien interviewed the four Medicaid patients. His report cited only one negative comment made by one of them in reference to Leedom, and she disputes what was said. The rest of the accusations were directed toward Barry Lichtenthal, or were related to Medicaid billing, which Leedom did not handle.
In regards to the corporate head of Noah’s Ark, Barry Lichtenthal’s cousin, O’Brien wrote, “The President of Noah’s Ark is listed as: Robert Lichtenthal. He is the first cousin of Barry Lichtenthal. Robert Lichtenthal actually resides in Florida. Robert Lichtenthal only spent time on occasion in the clinic. Robert’s main responsibility at Noah’s Ark was data entry and computer programming.” O’Brien made no accusations against the president of the company, a former corrections officer.
But O’Brien did apply for an arrest warrant for Leedom.
The Medicaid Fraud Control Unit filed criminal charges against Dr. Liane Leedom in January 2004. “She allowed her husband to play doctor under her license and to dispense drugs under her license,” said Supervisory Assistant State’s Attorney John DeMattia of the Medicaid Fraud Control Unit, as quoted by the Connecticut Post.
DeMattia charged Leedom with:
- Larceny in the first degree (by defrauding a public community)
- Conspiracy to commit larceny in the first degree (by defrauding a public community)
- Reckless endangerment in the first degree (four counts)
- Conspiracy to commit practicing pharmacy without a license or temporary permit
- Conspiracy to commit misuse of the title “doctor”
- Vendor fraud in the second degree
- Conspiracy to commit vendor fraud in the second degree
The larceny and vendor fraud charges were related to the accusation of Medicaid fraud. The reckless endangerment and conspiracy charges were related to the actions of Barry Lichtenthal. These charges were based on the police reports of sexual assault and the statements of George Stowe, who was identified in the report as “LPN #1.”
Liane Leedom turned herself in to the police on January 7, 2004.
That same day, Vincent Curcio, George Stowe, Dr. Chiman Patel and Claire Zang attended a public hearing in Hartford on Fresh Start’s certificate of need. On January 9, 2004, the certificate was granted.
This was not a total green light to provide methadone maintenance. Fresh Start still had to apply for federal Opioid Treatment Programs certification, and then become licensed by the Connecticut Department of Public Health. So the facility could not yet offer the profitable methadone maintenance services.
But a new treatment for addiction became available—buprenorphine, which is marketed as Suboxone. Buprenorphine was easier on patients and not as highly regulated as methadone—any doctor could attend an eight-hour class and become certified to prescribe it. Dr. Patel became certified, and Fresh Start began to offer buprenorphine treatment.
With this option available, Fresh Start became a much busier place. The clinic was open every day, but Patel was still only there on Tuesday evenings and Saturday mornings. This made it difficult for the doctor to see all the patients, which later became an issue.
Lichtenthal pleads guilty
Almost a year after he was arrested, Barry Lichtenthal pleaded guilty to three counts of fourth-degree sexual assault, three counts of practicing medicine without a license, and charges of first-degree larceny, reckless endangerment, vendor fraud and practicing pharmacy without a license. On March 26, 2004, as reported by the Connecticut Post, he was sentenced to five years in prison followed by five years probation. He was also ordered to register as a sex offender and pay $6,000 in restitution to the state of Connecticut for the Medicaid fraud.
Then he was sentenced to 18 months in federal prison for violating his probation in the 1998 fraud case, according to the Newark Star-Ledger. He would begin serving the federal prison term after he was released on the Connecticut charges.
Doctor signs consent order
Leedom’s cases dragged on for another year. Finally, on May 4, 2005, she signed a consent order with the Connecticut Department of Public Health. The consent order clearly states that it was not an admission of guilt or wrongdoing.
Leedom’s medical license was reprimanded and restricted so that she could only engage in the non-clinical practice of medicine and/or medical research. She could not provide treatment to anyone, direct any person’s medical care, or manage a medical facility.
In other words, she could not work as a doctor.
Rhonda Marshall, the visiting nurse, says many of Leedom’s former psychiatric patients were so devastated that Leedom couldn’t treat them that they ended up in the hospital. Marshall says she still works with some of those patients, and they still ask about Dr. Leedom.
In the criminal case against Leedom, all of the charges related to Medicaid fraud were dropped. What remained were the charges of conspiracy to commit misuse the title doctor and two counts of reckless endangerment.
Leedom’s close friend—a former law enforcement official—wanted her to fight the charges. He thought they were bogus. But Leedom’s attorney advised her that fighting the charges would be a crapshoot.
Leedom did not have the money to for a huge legal battle. And her baby, at that point, was a year and a half old.
“The state thought I was operating a fraudulent clinic,” Leedom says. “If they tried to prosecute me for that and won, it would have put me in prison. I agreed with the attorney. To stake my children, and my son’s future, on a crapshoot wasn’t a good idea.”
She pleaded no contest and was sentenced to two years of probation.
Leedom continued to try to get back her computers and records that had been taken by the police. Eventually she was told that they were destroyed.
Fresh Start closes
Despite two years of trying, and two extensions for its certificate of need, Fresh Start never qualified for a license as a methadone maintenance facility. The Connecticut Office of Health Care Access refused a third extension, and Fresh Start’s certificate of need expired on January 9, 2006.
Claire Zang had stopped working for Fresh Start in November 2004. She stayed in the Curcio Bail Bonds building, renting her office in order to establish her own private practice.
Zang says Chiman Patel stopped working for Fresh Start in March 2006, and they both moved out of the Curcio Bail Bonds building. At that point, Fresh Start ceased to function.
Then the Connecticut Department of Public Health investigated Fresh Start. Chiman Patel was charged with failing to properly supervise George Stowe in the treatment of patients while he was not in the office. Patel signed a consent order on September 12, 2006. His license was reprimanded and permanently restricted—he could no longer work in a private freestanding facility for the treatment of substance abusers. Patel was also fined and ordered to take courses on proper prescribing and ethics.
Most of the charges against Patel were related to the actions of George Stowe. But Stowe did not sign a consent order in the Department of Health investigation of Fresh Start. He wanted a hearing.
On November 30, 2006, after Fresh Start closed down, Stowe initiated foreclosure proceedings against Leedom’s house. Unable to work, Leedom’s financial circumstances had deteriorated. Her credit was ruined, and several parties, in addition to Stowe and the eight former Noah’s Ark patients, had filed liens against her house.
Stowe’s attorney served notice on Leedom and all other parties who had liens. To settle the foreclosure and save her home, Leedom paid Stowe her last $10,000.
License on probation
After another year of investigation, the Connecticut Department of Health compiled a statement of charges against Stowe, dated October 16, 2007. It includes the following. (“Stowe” has been substituted for the word “respondent” that appears in the original document.)
- George Stowe is, and has been at all times referenced in this Statement of Charges, the holder of a Connecticut licensed practical nurse license.
- At all relevant times, Stowe was working as a licensed practical nurse for Dr. Chiman Patel in an office located at 285 Congress Street in Bridgeport, Connecticut and/or Stowe was working as a licensed practical nurse at Fresh Start Substance Abuse Services, LLC located at 285 Congress Street in Bridgeport, Connecticut.
- During 2004 and/or 2005, while working as a licensed practical nurse at 285 Congress Street in Bridgeport, Stowe practiced nursing without being under the direction and/or supervision of a registered nurse.
- During 2004 and/or 2005, while working as a licensed practical nurse at 285 Congress Street in Bridgeport, Connecticut, Stowe engaged in illegal conduct, incompetence and/or negligence when he, without being under the direction and/or supervision of a registered nurse:
- a. performed physical assessments of substance abuse patients and/or performed other nursing duties with regard to substance abuse patients;
- b. initiated and administered Suboxone treatments for one or more substance abuse patients, including patients who Stowe knew had never seen the prescribing physician in person prior to such treatment;
- c. assessed and/or monitored patients to determine whether patients were having adverse reactions to Suboxone treatments while Dr. Patel was not in the office; and/or
- d. packaged medication for patients with Dr. Patel and combined 2 mg and 8 mg pills in the same bottle using handwritten labels.
The Board of Examiners of Nursing held a hearing on the matter on March 19, 2008. The draft minutes of the hearing indicated that Stowe was “found on all charges except 4D and the second part of 2 – not at Fresh Start.”
The Board of Examiners then moved and seconded that, “Mr. Stowe’s license be placed on probation for one year with the following restrictions: quarterly reports from all employers with employer emphasis on scope of practice monitoring. There will be no substance abuse work for one year although Mr. Stowe will be allowed to continue employment at agency taking care of present child only. Mr. Stowe can only work in a facility which has RN/APRN on-site supervision. All employer reports need to include RN monitoring and exactly who is doing the monitoring. Mr. Stowe must complete coursework on legislation, legality and scope of practice. Coursework must be completed by the end of the probationary period.” The motion passed with all in favor.