Pain Lingers in Community After Arrests of Viet Doctors

On most days, rather than sit in his empty clinic on Bolsa Avenue in Westminster and wait for patients who might never appear, Dr. Vo Thuong slips on his sweat suit, laces his running shoes, clips a beeper to his waist and escapes to a park.

“Sometimes I have maybe three patients, five patients, all day. Sometimes I have no patients at all,” Thuong said. “I don’t like to have nothing to do. So I go to the Westminster park, jogging. It take the pressure away for one or two hours.”

It was about 1 1/2 years ago that police and state investigators raided Thuong’s office and some 35 other Vietnamese clinics and pharmacies throughout California, uncovering what they said was a widespread pattern of Medi-Cal fraud by Southeast Asian doctors and pharmacists that had drained $5 million to $7 million from the government health program.

The physicians and pharmacists were accused of paying fees to “drivers”--refugees with automobiles who allegedly collected Medi-Cal cards that were used to charge the government for prescribing drugs and treating non-existent patients.

Devastated by Experience

Thuong, 48, and his wife, Nga Thieu Du, were handcuffed and forced to stand in the parking lot of the small shopping center as investigators searched the clinic for documents. Shoppers stopped and stared. Newspaper photographers took pictures. Thuong said he and his wife were devastated by the experience.

“Crowds start coming around. They all over the shopping center,” Thuong recalled. “My wife, she beg the police officer, ‘Please, go ahead and shoot me, but I cannot stay out like this. I want to die right here.’ She really mean it. It was too much for her.”

Several weeks later, Thuong’s wife tried to kill herself with an overdose of a prescription medicine, he said. Later, she became pregnant and miscarried. One of their two daughters left home to join the Hare Krishnas, primarily, Thuong said, because of the arrests.

The Vietnamese, Laotians and Cambodians who once crowded into the small waiting room in Thuong’s clinic 10 hours a day, six days a week, have stopped coming. Most of them are Medi-Cal and welfare recipients, Thuong says, and they fear their benefits would be stopped if they went to his office.

Free on Bail

Thuong and his wife initially pleaded guilty to fraud charges. They are free on bail while waiting for a judge to rule on their appeal to withdraw their guilty plea.

With so few patients and with legal bills in excess of $100,000, Thuong doesn’t believe he can keep his office open longer than six months. If their appeal fails, the state Board of Medical Quality Assurance probably will revoke Thuong’s license, and it is almost certain that he will be scratched from the list of Medi-Cal providers.

The impact of the Southeast Asian Project, as the investigation by the state attorney general’s Bureau of Medi-Cal Fraud was called, extended far beyond Thuong and the other physicians and pharmacists arrested in the raids of February, 1984.

Although the project was intended to combat Medi-Cal fraud, members of the Vietnamese community say that the highly publicized raids not only dealt a severe blow to those arrested but humiliated and embarrassed the entire Southeast Asian refugee community as well. They say the project intensified the racist attitude some Americans have toward Southeast Asian refugees. And, more than 18 months later, the pain remains.

“It was taken as a blow to the whole community. Not just the doctors, but everybody,” said Dr. Quynh Kieu, a Fountain Valley pediatrician who was not a subject of the investigation. “It was seen as an action of the government against our people. People who were sick, really sick, were afraid to get care. We still feel a lot of resentment about what happened.”

Vietnamese pulmonary specialist Dr. Vu Dinh Minh, who also was not a subject of the investigation, was critical of the procedure of arresting the physicians on the same day. He also criticized the extensive press coverage of the operation. “Did they have to make it appear like show biz?” he asked.

Greg Baugher, senior assistant attorney general and chief of the Bureau of Medi-Cal Fraud, said the arrests were conducted simultaneously to keep physicians from destroying potentially incriminating evidence. He denied responsibility for the press coverage, although local newspaper reporters were tipped off by authorities before the raids began.

Dr. Tran Minh Tung, former minister of health for the Republic of Vietnam who now resides in Falls Church, Va., said physicians are among the elite in their homeland, a country where malpractice lawsuits and license suspensions are rare. Tung says the realization that the doctors could be handcuffed and arrested en masse had a profound effect on their fellow refugees.

Many refugees forced to resettle in the United States after the fall of Saigon regard themselves as “uninvited guests in somebody’s home,” Tung said. “They feel unwanted. When they see doctors being arrested, they feel even more powerless. They think that if this can happen to the doctors, what could happen to them?”

Shops Nearly Deserted

The immediate fallout from the Southeast Asian Project raids was particularly acute in Orange County, which has one of the largest Vietnamese communities in the United States and is home to about 85,000 Southeast Asian immigrants. The normally crowded Indochinese shopping centers of “Little Saigon,” a stretch of Bolsa Avenue in Westminster, were nearly deserted for several days after the arrests. Shopkeepers said that their business was off 40% to 60% for several weeks.

Despite the embarrassment created by the arrests, authorities say that at least two Vietnamese physicians in Orange County and a Westminster pharmacy are still using drivers to defraud the Medi-Cal program. Medi-Cal fraud investigator Doug Fischer said criminal complaints may be filed before the end of the year.

In addition, investigators say they believe that Vietnamese physicians in other states are pulling off the same type of fraud as those arrested in California.

U.S. Atty. Howard Pankratz said a Vietnamese physician and two associates were sentenced to jail earlier this year in Denver for defrauding the Medicaid program, Colorado’s version of Medi-Cal.

A prosecutor with the Illinois attorney general’s Medicaid fraud unit said two Vietnamese physicians in Chicago are currently under investigation for the same type of activity. The prosecutor, who requested that his name not be disclosed, said drivers are delivering Medicaid cards to the physicians from as far as Danville, Ill., about 100 miles south of The Windy City.

Methods Serve as Model

Law enforcement officials in Texas, Washington, Oregon and Louisiana said they either plan or have already begun investigations into the possibility of health fraud among Vietnamese physicians. Baugher said investigative techniques used in the Orange County’s Southeast Asian Project investigation are serving as a model for investigations throughout the country.

“We are aware of what took place in California, and we’ve talked to investigators assigned to the case,” Charles Yett, director of the Texas attorney general’s Medicaid fraud control unit, said. “We have a large enclave of Vietnamese refugees in Houston. It’s reasonable to assume that if they’re doing it out there, they know how to do it here.”

Sixty-two Indochinese were arrested in the Orange County raids and follow-up investigations. As of last month, 30 had pleaded guilty. Some received sentences ranging from probation to three years in prison. Others are awaiting sentencing. Twenty-nine cases are pending, charges against two defendants were dismissed and one person remains a fugitive.

Most of the 35 arrested physicians still have their licenses and are practicing medicine, although Kenneth Wagstaff, executive director of the state Board of Medical Quality Assurance, said his office has filed accusations against “six or seven” of the doctors, the first step toward revocation or suspension of their licenses. Such action is not normally taken until physicians have been convicted or completed criminal sentences.

Medi-Cal payments to the 35 physicians arrested in the crackdown dropped by $4.3 million in 1984, a 54% decline from the previous year, according to figures provided by Baugher’s office. It is not clear whether the drop in payments indicates that the doctors were engaging in fraud before their arrests. Some of the physicians began serving jail or prison sentences in 1984 and others lost most of their patients when they were arrested.

Top Providers Arrested

Four of the top six Medi-Cal providers in 1982 were Vietnamese, and three of them were arrested in the Southeast Asian Project case.

Medi-Cal payments to 89 Indochinese physicians not involved in the project investigation dropped $1.4 million in 1984, a 15% decline from the previous year. State investigators believe that the decline shows that some Indochinese may have been engaging in fraud and stopped the illegal practice because of the publicity surrounding the Southeast Asian Project probe. But leaders in the Vietnamese community say that there are several explanations for the decline, such as the ability of refugees to find jobs and take themselves off the Medi-Cal rolls.

Along with the $5.7-million drop in Medi-Cal payments that is at least partly attributable to the Southeast Asian Project investigation, prosecutors hope to gain another $2.5 million for the state in fines.

Investigators say that of the 35 Vietnamese physicians arrested statewide in the Southeast Asian Project, Thuong was one of the most flagrant abusers of Medi-Cal. Court documents list numerous instances in which Vietnamese drivers delivered to Thuong’s office Medi-Cal cards that he allegedly used to bill Medi-Cal for treatments that never happened.

In 1982, Thuong billed Medi-Cal for $869,345 and was paid $416,102, ranking him second statewide in both the amount of billings and income received, according to figures provided by Assistant Atty. Gen. Baugher.

Thuong Discusses Case

For the first 11 months of 1983, Medi-Cal paid Thuong another $466,594, according to an audit after his arrest. Investigators say they suspect that at least 75% of billing was fraudulent.

Thuong spoke barely above a whisper when he discussed his case earlier this month in his office. He expressed no anger or resentment and at times smiled at his misfortune. He said he did not intend to defraud Medi-Cal.

“When I try to review all of my acts here, there is not one second that I get the impression that I intend to do it (commit fraud),” Thuong said. “I really review hard. I think many times. ‘What did I do? What was wrong?’ I feel like my conscience is clear. And I can look you right in the eye and tell you that.”

Perhaps, Thuong said, he accepted too many patients, at times up to 50 or 60 a day. “At one time I was known as the most busiest doctor in Orange County,” he said. Burdened by the caseload, Thuong said, he left the billing and record keeping to a staff that included his wife, a receptionist and an X-ray technician.

Thuong acknowledges using as many as 30 to 40 drivers a month and writing checks for their services, paying $5 for each new patient and $4 for returning patients. But he denies knowingly billing Medi-Cal for treatment that was not given. Thuong said some patients might have brought him their Medi-Cal cards sometime after their treatment, which could appear fraudulent.

‘Not Going to Blame System’

“Quite a few patients, they are newcomers,” Thuong said. “They apply for Medi-Cal, but they don’t have it yet. It may take one month or two months or three months later, they still no have cards. They say they don’t have money. I say that’s fine. And any time they have something to pay back, with the Medi-Cal card or a little bit money, or whatever they have, we take it.

“I’m not going to blame the (Medi-Cal) system, but nobody give us (Vietnamese physicians) training, or guidelines whatsoever. Practically when I come here I know nothing about this billing system. I know just a tiny bit, and I go and tell my staff to do this, and I know a little bit of English, and they know much less than I do. There must be something wrong with the business, and we don’t know.”

Thuong also acknowledges that he sometimes prescribed drugs for patients whom he suspected would send them to relatives in Vietnam. Antibiotics are particularly scarce in Vietnam and are a valuable commodity on the black market. Thuong also says he knows that many of the drugs he prescribed probably were taken to Vietnamese pharmacies and sold or traded for other items, such as fabric or cigarettes.

Thuong is not critical of the legal system. “It seems to be quite fair,” he said. “Like, you give us time looking for some lawyer for the defense.”

But he does not understand why he and his wife were handcuffed and forced to stand humiliated before crowds who gathered in the shopping center in the predominantly Vietnamese section of Westminster. He says American doctors arrested for a similar crime would not be treated that way.

‘Seem to Be Not Fair’

“The handcuffs, making us stand outside, if it be done for everybody, that be OK,” Thuong said. “But for Vietnamese white-collar crime, it seem to be not fair. Why do we have to suffer a little bit more than anybody else? Somebody, somehow, I feel took advantage of the Vietnamese people.”

“From my own personal philosophy, somehow I believe in astrology,” Thuong said, smiling. “This is from the Oriental culture. We feel like your life is somehow like a good period, then a bad period, then another good period. And no matter how hard you work, nothing can change this type of way. So whatever you have, try to be happy with.”