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Coding Issues Land Life-Saving Doc Behind Bars



An Illinois physician, convicted of making false statements in connection with surgical codes, is serving a 10-month prison term. The Association of American Physicians and Surgeons says the federal case against him is having a "chilling effect" on doctors nationwide.



17 comments on "Coding Issues Land Life-Saving Doc Behind Bars"
Sarah (11/20/2013 at 10:06 PM)

Ann I was a nurse for Dr. Natale I assisted himb on many surgeries. I find your comment disqusting and everything that is wrong with medicine. Dr. Natale life was his patient's, he was one of the best surgeon's in practice, and many of us medical practitioner's sent our family to him including my mom. I think your confused! This doctor was the best in the business more will fall just like him.
Ann (10/22/2013 at 5:46 PM)

My family member is a victim of this mans unnecessary surgery and fraudulent behavior Her leg was sliced up and down when a simple incision would have repaired her problem Her choice to not pursue this due to the further duress it would cause is lucky for Dr Natale
Ann (2/26/2013 at 8:28 PM)

Dr. Thomas Painter was the doc that went to the prosecutors to report Dr. Natale in an effort to remove the doc he considered his "economic competitor" (as the prosecution stated). Unfortunatesly, over time too many that came to see Dr. Painter at Northwest Hospital...heard of Dr. Natale and his amazingly positive surgical record (never loosing even One patient on the operating table)... And as a result moved from Painter to Natale. Now Painter had been sued, and often, while Natale never, not once, had been sued. That is extremely unusual...and Painter was twisted with jealousy and resentment.... Painter went to the US Attorney's hoping to sell them the prosecution ...the GOvernment wanting to prove awful doctors were thieves stealing from Medicare in light of the publics outrage over Obamacare...wanted the show trial ..and the prosecution...WHen not one Doc approached would agree to testify ageing Natale as the Exoert Witness....Painter went out and got an old med School chum..who by the grace of the US government was given a lofty promotion...and Painters buddy agreed to testify.... Don't you just feel slimed reading about this? What the heck has happened to our government? Are they willing to intimidate and incarcerate so other Docs and all patients comply??? Such an incredible injustice ...Free Doctor Natale...Free a good decent, competent surgeon...He did no wrong!! If there was no exact code for what they called a "coding error"...If MEDICARE HAS TO CREATE 1500 NEW CODES EVERY YEAR....WHY ARE THERE NOT 1500 Other Docs in Prison every year! This is political...and a disgrace...Patrick Fitzgerald himself should be in prison for this twisted prosecution ...Shameful Free Dr. Natale
Rick Zajac (2/25/2013 at 1:47 PM)

How much money are we talking about? Too bad he wasn't a Wall Street gangster and ripped off billions. Then he would have been alright. What is wrong with our "justice" system? The US has the best justice money can buy.
Sue Roehl (2/25/2013 at 10:12 AM)

I have my doubts he went to prison if he only made "a mistake" on two of 2,400 records. What were the real statistics?
lnatale (2/20/2013 at 10:24 PM)

Being the oldest daughter of Dr. John Natale I know first hand how many long hours he has put into saving lives. He has missed countless of birthday parties, graduations, and other family events through out my entire life in order to save numerous of lives. I have countless stories of friends and friends of friends who tell me how my Dad saved their grandparent, parent, or dear friends life. They would always address him as their HERO. I'm SO PROUD to have him as a role model in my life and love him very much. I feel sorry for individuals like "ALMARIE and ETHICAL DR.." who read an article like this and can t read behind the lines to see the TRUTH. The government has not only destroyed my father's career/life for more than 10 months but complete devastated anyone who loves and cares for my father. I cry every single night thinking about my father. But individuals like "ALMAIRE AND ETHICAL DR" feel there is more to the story. Well let me re-cap for you....the government doesn't care who or how they get a sentence. As long as they get one. They want a conviction and will go to any lengths to get one. My father's economical competitor brought this case to the prosecution. This was a weak case that should have NEVER been brought to the courts. Furthermore TONS of tax payer dollars were wasted that could and should have gone to schools and other programs that help better our society. In my opinion that is where the fraud lies. He was wrongly accused and wrongly sentenced. Shame on anyone who has been a part of creating a mountain out of a mole hill. I hope you all fall below that 1% of human error. I know my father fell way under that line but still received an unfair sentence.
Bill (2/20/2013 at 4:26 PM)

Another reason to get out of Medicare any way you can. sell vitamins, Botox, spa medicine; anything but treat sick people. Sanctimonious lazy judge, arrogant power mad prosecutor. Everyone will be a patient someday. Everyone is affected by this type of criminal arrogance by in judicial system. Thank god we're all safe from that dangerous, thieving doctor. Thanks Judge. One less talented, caring life saving surgeon in our midst. Add insult to injury, tax payers are footing the bill to keep this poor soul incarcerated. Wake up people!
meredith (2/20/2013 at 9:46 AM)

Dr. Natale is an extraordinary man, doctor and person. Sometimes bad things happen to good to people- or in this case- one of the best. Don't rush to judgement on this one- it really is as chilling as it reads. Thank you Joe Cantulpe and Health Leaders Media for bringing light to his story.
WesR (2/19/2013 at 10:32 PM)

I assume that the criminal charge related to incorrect billing, [INVALID]d because the physician's coding was used to [INVALID] the bill. What is difference between an honest error and fraud? In my state a crab fisherman gets to sell a catch with up to 1% undersized crabs to allow for honest errors. Should surgeons get the same level of allowance when submitting bills? OTOH, if my mechanic was overbilling me and his excuse was "I did the bill from memory a month after the repair" I wouldn't feel like writing this off as an honest mistake. I am not comparing CV surgery to replacing piston rods. But it does seem there has to be some threshold rather than allowing the surgeon to say whatever she wants and get paid based on what they claim is there best memory of a month-old procedure.
Edward Murrow (2/19/2013 at 7:48 PM)

The Department of Justice has clearly decided to [INVALID] War among all medical professionals especially those that help save elderly patients lives. These Federal prosecutors pursued this doctor even after Dr. John Natale was cleared in 2005 of all charges by the State of Illinois. This nationally recognized Cardio Thoracic-Vascular Surgeon and was cleared by an ethics board consisting of three doctors who found him innocent of any malfeasance. I am sure some of you have read "Three Felonies a Day: How the Feds Target the Innocent," by Harvey A. Silverglate but if you haven't all Doctors will need to read Chapter 2 (pages 63-73) if they want to know whats happening within the Justice Department right now. Please see Harvey's story in the Wall Street Journal about psychiatrist Peter Gleason who committed suicide as his life was also destroyed by the US DOJ (just like they did too Aaron Swartz). These stories are extremely sad and must be presented to the PUBLIC for future awareness. This psychiatrist Peter Gleason recently won his appeal, he would have been thrilled to learn that on Dec. 3 in New York, a three-judge panel of the U.S. Court of Appeals for the Second Circuit issued a ringing opinion that vindicated the conduct for which he was indicted and arrested in 2006 but unfortunately he already took his life due to his career and his life being destroyed by the United States Justice Department. What Federal Prosecutor, Judge is going to sit in a FEDERAL PRISON for these unfortunate errors and or will even apologize to this Doctors family for 2nd degree murder of this man. : http://online.wsj.com/article/ SB1000142412788732398150457817 4973015235686.html Medical peers consider Dr. John Natale to be one of the top Cardio-thoracic and Vascular surgeons within the entire State of Illinois, some would even argue within the entire United States of America. Dr. John Natale graduated from Northwestern Feinberg School of Medicine, completed his Masters at University of Illinois Chicago while completing his residency at Rush Presbyterian Hospital in the late 70's studying under the pioneers at the time for cardiovascular and thoracic surgery. These highly famous and accredited doctors were Dr. Sam Dye, Dr. Cryus Serry, Dr. Marshal Golden, Dr. Hussan Najafi, Dr. Ormand Julian, Dr. Hushang Javid, and Dr. James Hunter. Dr. Cryus Serry testified on behalf of Dr. Natale's incredible skill and the specifics regarding the procedures performed during the six operations reviewed in this trial. Dr. Cyrus Serry also credited Dr. Natale as being one of the few surgeons within the country who could have saved the lives of these six patients. If any doctor or physician thinks they're immune to peer sham review within this new age Health Care System they have been sleeping underneath a rock for the past 10-15years. Please read the following articles written by Dr. Lawrence Huntoon, editor of the AAPS on Peer Sham Review. This is a nationally known expert on sham peer review. Tactics Characteristic of Sham Peer Review: http://www.jpands.org/vol14no3/huntoon.pdf * Dr. John Natale Has performed over 7,500 elective – cardiac-thoracic and vascular procedures with no deaths reported at the operating table to this date. All of his patients went back to their family's healthy with improved health. * Dr. John Natale has never been sued by any of his patients – unusual in a litigious society (Especially the State of Illinois) * Dr. John Natale has never been audited by Medicare, nor reprimanded by any state medical society or professional medical society. *Dr. John Natale had saved all six patient lives of the governments investigation was originally accused of performing ghost surgery and making these operations more complex than he actually needed too. It was brought to light during the trial that four of the patients experienced ruptured aneurisms and two of them had significant co-morbidities. * Dr. John Natale in 32 years of private Practice never turned one patient over to a collection agency. * Dr. John Natale has won three national awards of excellence in cardio-thoracic and vascular surgery. * Dr. John Natale has traveled to Diamonhead, Mississsippi to assist and aid the victims of KATRINA and also traveled to Port-au-Prince, Haitia to help Project Medishare vision of providing medical needs to one of the poorest country's within the free world.
Judy510 (2/19/2013 at 3:38 PM)

I would like to know how many chests "An Ethical Doctor" and "Almarie" have opened lately that resulted in saving another human beings life? The surgeries Dr. Natale performed were complex ruptured Abdominal Aortic Aneurysms - some as large as 9cm. The government cherry-picked these 5 surgeries because they were exactly that: Complex. There was no exact CPT code for what the doctor did and so he chose the closest one. Furthermore, let me remind you: Each one of these patients went home to see another day with their families because of this man. If you read the article- or any material on this case for that matter- you would know there was no monetary difference for what he billed for. This case was not about money or "fraud" this was about a government prosecutor who got far too deep into an investigation of an honest doctor that resulted in millions of tax payer dollars spent and several years of time- only to come up short. At the end of the day this prosecutor needed to win- at any cost. Judges do not apologize to a defendant's family at sentencing and commend the doctor for being "upstanding" when truth and justice are involved. Unfortunately for Dr. Natale, this was the perfect storm of an ego-driven, blatantly competitive colleague who went to great lengths to get him off staff at a hospital where Dr. Natale saw far more business, a prosecutor who was not man enough to back down when he knew the case he was pursuing was fruitless and a judge who operated with absolutely zero conviction; displaying minimal interest in the facts and having little respect for medicine. This was a chess game for all involved. God bless Dr. Natale, a man who spent a career that spanned nearly 35 years dedicating himself to the well-being of others and sits in prison for saving people's lives. A man that had no prior record, accepted public aid, routinely wrote off thousands of dollars each year and put his patient's on five dollar a month payment plans if needed. Dr. Natale will be fine. It is the other individuals involved in this heinous prosecution we should be worried about.
Pat (2/19/2013 at 1:01 PM)

I have a question for ¨An Ethical Doctor¨. How are coding and dictation errors putting a patient's life in danger? Doctors don't diagnosis based on coding ever, and dictations are merely a procedural step used to describe what has been done in surgery. 99.9% of a time a doctor never reviews this to treat a patient. A doctor does what is called a work up. They run tests take x-rays, and CT-scans to see what is happening to a patients. Many time doctors and surgeons speak or talk directly with the previous doctor and surgeon to understand what is done. They would never perform surgery based on operative reports!
William Natale (2/19/2013 at 10:57 AM)

Judge Rebecca Pallmeyer had the opportunity to merely give the surgeon a fine and/or a sanction. At the behest of the prosecutor, the judge sentenced this surgeon to 10 months of incarceration. This was after she solicited letters regarding the doctor's character - one of which was written by the venerable Congressman Danny Davis in support of the surgeon. The prosecutor demanded that the Judge make an example of the surgeon. What's disturbing is that even after being found not guilty of any of the three major fraud charges the Judge still used the word fraud in the sentencing hearing - "FRAUD" should have been off the table completely. If we're going to sentence doctors regarding clerical and dictation errors, then just about every doctor could risk the loss of their liberty.
Dr. Rick (2/19/2013 at 9:10 AM)

Almarie and An Ethical Doctor you two dont have a clue about medicine. Coding is not straight forward in fact hundreds of new CPT codes come out each year. The AMA tells doctors that if there is not a code for the procedure they are doing then to use a code that is closet to their procedure. An Ethical Doctor, there is a back story, the back story I have read about in other comments on other articles seems to be a peer shame review. It seems there was another doctor after Dr. Natale. Billing and operative reports is not something that is done for all surgeons right away most have other cases, sometimes operative reports are not done for days after work. This has all doctors asking what comes first, patient care or patient paper work. Dr. Natale´s story is what is happening to what was the greatest medical system in the world. I feel terrible for Dr. Natale, and regardless of any errors he may have made, 10 months in Prison! What is wrong with our system when we put life saving surgeons in prison because of there operative report! Scary...maybe I should look into another profession!
Almarie (2/15/2013 at 10:30 AM)

There must be more to this story as the previous poster stated. Coding is very straight forward and waiting long periods of time before dictating is crazy in itself for any physician. He is only one of thousands that do this and needs to be made an example of. Hire an assistant to take care of these issues before they become a problem. Ten years is a long time to get away with this and I'm sure his bank account shows this. Too bad that honest physicians will have to be lumped into this.
An ethical doctor (2/15/2013 at 10:30 AM)

Check Wikipedia for the Association of American Physicians and Surgeons. They are an activist organization that does not represent mainstream medicine at all. This doctor put patient's lives at stake by dictating and coding the wrong procedure. It was not fatigue; it was fraud. An accurate medical record is crucial to good care and his greed could have had dire consequences. He deserves to be imprisoned.
Tyco Brahe (2/14/2013 at 3:27 PM)

On face value, this seems crazy. But with all such cases, I know there must be a back story that we're not hearing but the judge did. What's the whole story? This article only gives the doctor's side.