Of all the things Dick had done to make a living in his life, his favorite, by far, was being a detective. Not the kind he had become, sitting behind a desk and moving his men around like so many chess pieces, supervising investigations, and being strategic. But a real gumshoe detective like the kind he used to watch on TV when he was a kid. The kind who got to meet clients and suspects, pressed the flesh, and looked people in the eye and asked them tough questions. The detective who solved cases that everybody else had given up on. That was the most fun of all and, unfortunately, the part that Dick got to do the least.
“You’re the victim of your own success, Dick Deaver,” Ursula would tell him when he was in any kind of mood to listen to her. “You’re good at what you do and people know it and want you to solve their cases. You couldn’t possibly work every job yourself, so you have to be a good supervisor and keep your people properly aimed at the target.”
Dick would grunt disdainfully, not wanting to acknowledge that Ursula was correct, as she usually was. But that never stopped Dick from always looking for opportunities to hit the road himself, to get his hands dirty. He had to pick his spots carefully because he had a business to run. And even Dick had to admit that his skills were no longer as honed or his reflexes as sharp as when he had started out years ago. On the other hand, he did have the advantage of years of experience to make up for at least some of the accumulated rust.
To begin the Springer/Gilbert investigation, Dick reread all of Tiffany’s articles, focusing on persons who Tiffany had identified as persons of interest. Though she didn’t always name actual names, the detail she provided did everything but post a photo of the alleged villains. Her ability to describe the medical issues that brought them to her attention convinced Dick that Ray Gilbert had been doing a lot of talking and that, without his expertise, Tiffany’s articles would have fallen as flat as a pancake. How could you finger a doctor for putting in an unnecessary pacemaker if you didn’t know what a pacemaker was, what it was expected to do, and, most of all, which patients should get one?
Dick made a list of several people he might want to talk to during his investigation and turned it over to Al Kenworthy to gather contact information, and as much dirt as he could find without making direct contact with them, be they family, friends, or colleagues.
“I put them in order of importance, Al,” Dick said when he handed over the list. “I expect that the first two or three will provide enough information to get to the bottom of what happened. But you can look up the others, just in case I hit a wall.”
Within a couple of days, Dick was armed and ready to travel north. His secretary booked a room for him for three nights at the best hotel in the Hazelton area, central to the facilities and the offices Dick would visit. After conferring with Al and other colleagues, Dick decided on a risky but effective identity: a Medicare fraud officer. As the funding agency for Medicare, CMS had broad authority over several aspects of device manufacturing and marketing, including fraud and abuse. Though a CMS officer could not pursue and arrest a person suspected of committing Medicare fraud, it was not uncommon for an agent to refer the case to a federal bureau—specifically, the FBI. This identity would fit well with the work that Al and Doug had done in Minnesota. If they had returned to their agency with any residual concerns, the next step would have been an investigation by Medicare Fraud and Abuse. If anyone at the local level had been warned about an investigation by Bobby Adair or others at the home office, Dick’s arrival would make perfect sense.
Dick’s team was able to prepare a suitable identification document for Richard Ratner, Dick’s alias. Anita, using a burner phone, called a few of the intended targets to set up appointments, and soon thereafter, Dick was on the Northeast Extension of the Pennsylvania Turnpike.
Dick was fairly certain that Sterling was the key to the controversy, and the sooner he could talk to the person in charge of the central Pennsylvania sales region, the sooner he might be able to figure out what had happened. Unfortunately, that person, Robert Helge, was attending a national sales meeting and wouldn’t be back in town for two days. Rather than waste time, Dick chose to interview a couple of chief executives of hospitals who Tiffany had fingered as profiting from an increased number of device implants. First stop, Saint Anselm Hospital, a friendly-looking, medium-sized community hospital in a rundown area of Hazelton.
Hearing that a Medicare officer was on the doorstep for an unscheduled visit got the anticipated reaction. He was quickly ushered into a finely appointed boardroom and made welcome by a senior secretary, who asked if he had a beverage preference.
“I’m fine, thanks,” Dick answered. “I’ll just wait until Mr. Beamon can join me.”
“He’ll be right in, Mr. Ratner. He’s just wrapping up another meeting.”
Or calling the hospital attorneys to find out what he should do when he comes in here, Dick thought. Which was spot on, as Mr. Beamon entered the boardroom accompanied by two younger people. Lawyers, Dick thought. How unique!
“Mr. Ratner, it’s a pleasure to meet you. I’m Dave Beamon. I’ve asked a couple of my colleagues to join us. This is Debra Friedman and Dan Blasingame from our legal office.”
Dick stood to greet them, shook hands with each, offered a bogus business card prepared just for this occasion, and sat down, trying not to smile at the predictability of it all. All three looked fit and well dressed, and they smiled hard to hide their anxiety.
“Mr. Beamon, I’m sure you’re wondering why I’m here,” Dick began. “First, I want to reassure you that we have no reason to suspect wrongdoing by anyone on your hospital staff. And we don’t want to launch a full investigation. We have limited resources, and there are better places to spend our time. However, we believe that the Tiffany Springer articles about cardiac implants are a potential problem, so we’re interviewing key individuals at institutions that she named in her series to see if we can figure out what led to her suspicions of wrongdoing.”
Beamon took a deep breath, relieved to hear that the hospital was not in hot water but still concerned that a fraud officer had popped in for a chat. “Let me say we were as surprised as anyone that we were named. At the time of Ms. Springer’s death, we were trying to understand what had happened ourselves. We couldn’t find evidence that anyone had done anything wrong.”
“So you went back and looked at your pacemaker and defibrillator numbers and didn’t see a blip?” Dick said.
“Yes. Our total implant numbers did go up over the period that Ms. Springer reported on. But everybody saw an increase in this area, as best we can tell. There was also a shift in volume for a few months to Sterling that was easy to see, but that movement was evening out over time.”
“Do you know why?”
“We heard rumors that doctors were being treated well by Sterling, but we didn’t have any details. We talked informally to a few of the physicians and couldn’t come up with anything definitive.”
“Was pricing comparable?”
“Pretty much. Sterling had a few bargains on bulk purchases that we were happy to take advantage of, but there was no windfall for us. We’d be happy to show you the financials, if you wish.”
Dick had no intention of taking Beamon up on his offer. He wouldn’t know how to examine those records, and he didn’t want to look foolish. There was only so much he was willing to do for Philip, and embarrassing himself and risking his cover wasn’t one of them.
“Did you notice any other device purchase or use trends over the same period?”
“Not really. There’s always a small amount of flux from month to month, but volumes, compared to the same period a year ago, looked about the same.”
Dick knew that he had gotten what he needed. He asked a few more perfunctory questions to make his appointment look legitimate. “Mr. Beamon, this has been most helpful. Chances are, I won’t have to bother you again, but I may be back to you with a few more questions.”
“We’re happy to cooperate, Mr. Ratner. We have nothing to hide. Our hospital takes great pride in our integrity and service to our community. If you do come up with something that looks suspicious, we’d sure like to know about it.”
Dick left with the distinct feeling that Beamon was telling the truth. He might have to circle back to look at the actual financials with help, but for now, he was satisfied. He called Anita on his way to the parking lot. She had three more hospitals lined up over the next day and a half, but after Dick finished with the second and heard a nearly identical story, he decided to postpone the others. There was no reason to risk exposure when all he was going to hear was something about a temporary shift in volume that clueless Tiffany had apparently escalated into a scandal of Watergate proportions for the purpose of selling newspapers and becoming famous.
Dick used his afternoon off to drive through the mountains of central Pennsylvania, enjoying the lush scenery and the spectacular vistas. No, the Poconos weren’t the Rockies, but they had their own brand of natural beauty that Dick appreciated, especially since it was so close to home. Dick finished off his leisurely drive at an all-you-can-eat family-style restaurant that had the best fried chicken Dick had ever tasted. He arrived back at his hotel room, pleasantly tired and ready for a good night’s sleep.
The next morning, Dick called Robert Helge while sipping a coffee in his hotel room. He was sent to voicemail, but his call was returned within a few minutes. Helge sounded anxious.
“This is Bob Helge.”
“Hi, Mr. Helge. This is Richard Ratner. I believe my office called you a few days ago to set up a time to meet?”
“Uh … yeah. They did. I just got back from Orlando. Sales meeting.”
“Yes, I heard. Is today still OK for you?”
“I think so. What do you want to talk about?”
“This has to with pacemaker and defibrillator implants in your region over the last several months.”
“Really? What about them?”
“I would prefer that we have this conversation in person. I’m staying at the Hazelton Inn on Broad Street. Can you meet me here, say, around 10:00 a.m.?
“Uh … that should be OK.”
“Great. I’ll meet you at the registration desk, and we can have breakfast in the lobby restaurant.”
“Fine. Do I need to have a lawyer with me?”
“I doubt it. You’re not under any kind of investigation, and I couldn’t charge you with anything, even if I wanted to—which I don’t.”
“OK, Mr. Ratner. See you at ten.”
Dick had found a photograph of Helge on the company website, so he thought he knew what to expect at the registration desk. What he didn’t anticipate was Helge’s size. He was well over six feet tall and weighed at least 250 pounds. He walked with the kind of limp ex-football players have after years of knee trauma, but he was well dressed in a blue serge suit, white shirt, red power tie, and black loafers. And a face that let you know he had downed his share of beer over the years.
Dick met Helge in the lobby, flashed his bogus ID, and shook his beefy hand. They walked to the nearly empty restaurant, where they were escorted to a table by a window. The waiter offered the buffet that Dick figured had been sitting out for at least four hours. Instead, they ordered from the menu, Dick deciding on coffee, juice, and a pastry, while Helge ordered the belly-filler breakfast, his anxiety somehow fueling his appetite. Dick started the conversation as soon as the orders were taken.
“Mr. Helge, I know you’re busy, so let’s just get to it. Do you mind if I tape our conversation? It’s only so I don’t have to take notes. Nothing you say here will be on the record.”
Helge hesitated and then shrugged. “Got nothing to hide, Mr. Ratner.”
Dick took out a cheap tape recorder and put it on the table between them and turned it on. He had no real use for the tape; he used it as a ploy to get people to pay attention and answer questions carefully and truthfully. If the target refused, that was helpful too.
“As I said on the phone, I work for Medicare. We’re carrying out an investigation as a follow-up to Tiffany Springer’s articles. I’m sure you’re familiar with them.”
“Oh yeah. I know all about them.”
“Then you understand that, without using your name, she implicated you in the scandal.”
“She did.”
“Have you had a chance to read the articles in their entirety?”
“Almost all of them. They made me want to puke, so I had to stop.”
“So you had a negative reaction to what she had to say.”
“I told you; they made me physically ill.”
“Because they were untrue?”
“Look, Mr. Ratner—”
“Call me Dick, please.”
“If you call me Bob. Dick, this is complicated. Let me give you some background so you know where I’m coming from. I was a poor kid, growing up around here. Coal mining dried up, and a lot of our families had to scratch around to make a living. My parents wanted me to go to college, and it never would have happened without football. Fortunately, I was a pretty good offensive lineman in high school and got a full boat to go to Penn State. I made second team All-America my senior year and tried to play pro ball but eventually found out that I just wasn’t good enough. After 9/11, I got all worked up about terrorism and enlisted in the army. I lasted all of two years before I realized what a friggin’ mistake I had made, so I got out.
“Problem was that I had no idea what I was going to do with my sociology degree after the army. Medtronic was hiring sales reps at the time, and they thought I was perfect for the job—and not because of my education. I was a local celebrity from my football days, which meant that docs would let me into their offices to meet me, and then I could convince them to use the latest product. And it worked. Except as the years went by, people forgot who I had been, so I no longer had that edge, and my sales fell off. Medtronic didn’t fire me, but they started talking about a transfer to who knows where. My wife couldn’t have that. Her parents are from around here, and her mom and she are, shall we say, joined at the hip.
“Along comes Sterling, a new device company. They’re looking for people with my experience. They offer me a district manager position. I jump at it and sign up before reading the fine print. It says that my district will have a sales quota, and if we don’t make target, our pay will be pretty much shit. Now, Dick, I grew up disadvantaged, scrapping for anything I could get, so I was not going to let those assholes screw me out of my earnings. So I went to work. I came up with, like, a million ideas of ways to convince the docs up here to use Sterling. Let me emphasize—they were all legal. I didn’t give kickbacks or anything like that. I’m talking about making friends with the docs and their office staffs and hanging out. Most of the time, we’d go to a ballgame or a show. They would pay their own way, but they depended on me to get good tickets and line up a place to eat afterward.”
“So you just befriended them?”
“Pretty much. Me and the sales guys and gals. Now remember, Dick, these docs up here are not the smoothest people in the world. They’re almost all immigrants, they don’t dress too well, they don’t speak English well, and this is Hazelton, for Christ’s sake. They feel isolated. All I did was treat them like human beings, and they responded like I figured they would.”
“And they used your devices.”
“Hey, Dick, don’t make it sound like we were implanting crap. Sterling has some good devices. All we did was make friends. So if you had a choice of four devices, and your good friend was selling one of them, and it was just as good as the others, what would you do?”
“Did they put in more devices than were necessary because you and your salespeople were their friends?”
“I ain’t a doc. No way could I answer that question. But for sure, we never asked them to do anything like that. We did go into the operating room and helped out with unpacking the devices and making sure they had the leads and other stuff they needed. From what I could see, it looked like most of the patients had a good reason to get a device.”
“How long did this go on, Bob?”
“It’s still going on. The damn thing is that these people ended up being likeable. They’re funny, family-oriented, hard-working, good people, Dick. I have to say that I learned a valuable lesson in all of this. Don’t judge a book by its cover and all that.”
“So have the other companies caught up with Sterling?”
“Hell, yeah. They did the same thing we did. They made friends and treated the docs and their families well. Now, there’s no reason to pick Sterling all the time. And to tell you the truth, I feel better about it. The community up here is much happier, and I think the patients are getting better care. I’m not saying it’s perfect. There are still a few cases where you look at them and go, ‘Shit, why did he or she do that?’ But it’s a process that will need to go on for a long time before we get it perfect, especially in places like this. These docs are isolated from mainstream medicine, and there aren’t a lot of people looking over each other’s shoulders like there are in academic programs.”
“Bob, I hate to ask you this question because it’s probably out of line and really none of my business. Call it idle curiosity, but some other people may get around to it. Do you have an alibi for the night that Tiffany Springer and Ray Gilbert died?”
“You’re right, Dick. Your question is out of line, and I shouldn’t need to answer it. But I will. My wife and I hosted a dinner party that evening for some of the implanting docs and their spouses at our house. Paid for by me, and we did it because we enjoy their company.”
“So a lot of people up here who might have had a motive to hurt Tiffany and Ray were in the same place at the same time?”
“Yes, and, ironically, you’re the first person to ask me that question.”
“Tiffany didn’t bother to ask you anything?”
“As far as I know, Springer never showed her face up here or talked to anyone she crapped on in her articles. Don’t you think she should have taken the time to find out what we were about before throwing bombs?”
Dick dropped his head, abashed by how poorly Tiffany had done her job. She had fallen upon a few cases of apparent abuse and then tried to indict an entire community of physicians, hospitals, and companies. And she had used a clueless, horny doctor to help her make it look authentic.
After saying goodbye to Helge and checking out of his hotel, Dick made his way south to his Philly home. He marveled at how much he had learned in a few interviews, including a half-hour breakfast at a hotel in the middle of God’s country, talking to an ex-jock who had lived the story. If only Tiffany had spent a little time doing the same damn thing, maybe she would still be above ground.