Undercover: How I Went from Company Man to FBI Spy -- and Exposed the Worst Healthcare Fraud in U.S. History

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Overview

When John Schilling, an unassuming mid-level accountant, went to work for the Columbia Hospital Corporation, he never expected to become the catalyst for the series of “whistleblower” cases that ripped through the healthcare industry in the late 1990s. But when he unwittingly discovered that the company was siphoning billions of dollars away from Medicare and stealing from American taxpayers, he was faced with a choice: Speak up for what he believed to be right, or remain silent.

Undercover tells the story of Schilling’s harrowing journey from ordinary citizen to federal informant. The book recounts how Schilling allied himself with the FBI and the ...

See more details below

More About This Book

Overview

When John Schilling, an unassuming mid-level accountant, went to work for the Columbia Hospital Corporation, he never expected to become the catalyst for the series of “whistleblower” cases that ripped through the healthcare industry in the late 1990s. But when he unwittingly discovered that the company was siphoning billions of dollars away from Medicare and stealing from American taxpayers, he was faced with a choice: Speak up for what he believed to be right, or remain silent.

Undercover tells the story of Schilling’s harrowing journey from ordinary citizen to federal informant. The book recounts how Schilling allied himself with the FBI and the Justice Department and—unable to confide in friends or family—journeyed into an undercover world in which he carried a wire and mapped out offices for secret government raids. Suspenseful and provocative, Undercover chronicles Schilling’s nine-year ordeal that eventually led to the resignation of high-level executives and forced Columbia to return $1.7 billion dollars to the federal government.

A compelling account of one man’s decision to risk everything for the greater good, this book reveals the personal side of a thankless role that resulted, ultimately, in justice.

Editorial Reviews

Library Journal

Schilling (JWS Group), a former accountant with Columbia Hospital Corporation/HCA, here writes about his experience as a whistleblower in an immense Medicare fraud case. While the criminal convictions of company participants were reversed on appeal, Schilling's efforts resulted in $1.7 billion being returned to the federal government in a settlement. Schilling writes chronologically, ranging from his own CPA certification to his work with Columbia/HCA and his discovery of internal fraud. After filing his secret action under the federal False Claims Act, he left the company, then returned in an undercover capacity, monitored by the FBI. The author recounts the fear, stress on his family, and doubts that plagued him while he dealt with his company superiors, federal agents, prosecutors, and his private attorneys. The best parts of the book are Schilling's tart comments on the eventual civil settlement of the claims and the "Postscript: 10 years later," in which another writer interviews the participants on both sides and discusses the case and Schilling's role. While not as extensive as Henry Scammell's Giantkillers: The Team and the Law That Help Whistle-Blowers Recover America's Stolen Billions, Schilling's memoir is a worthwhile addition to this subject area in general collections.
—Harry Charles

Product Details

  • ISBN-13: 9780814474501
  • Publisher: AMACOM
  • Publication date: 4/28/2008
  • Pages: 256
  • Product dimensions: 9.42 (w) x 9.62 (h) x 1.11 (d)

Meet the Author

John W. Schilling (Naples, FL) is a licensed CPA with 16 years of healthcare financial experience. He was instrumental in the FBI probe of Columbia/HCA as a confidential undercover informant and served as a key witness in the successful criminal prosecution of the company, resulting in a civil settlement of more than $1.7 billion. Schilling currently runs JWS Group, a forensic accounting and consulting firm that assists law firms and the federal government with both civil and criminal healthcare fraud cases.

Read an Excerpt

Prologue

Tuesday, May 8, 1997

Fort Myers, Florida

He drove a dark, nondescript Chevy, its interior strewn with coffee

cups and gum wrappers. The four-door sedan badly needed a wash, but I

recognized it right away and slid into the front passenger seat. There on

the floor lay a 10-millimeter Glock, snug in its brown leather holster. I

grimaced and gingerly shifted my feet to avoid touching it. I adjusted the

air-conditioning vent to find relief from the stifling tropical heat. The

driver flashed me a reassuring grin and stepped on the accelerator as we

sped out of the Wal-Mart parking lot. We were in Fort Myers, Florida, and

today’s mission was to tour each Southwest Florida site that would be

targeted. I wondered why this was necessary, but my handler explained

that in his experience, guessing only leads to mistakes. He obviously had

a lot of experience.

Although the tourist season was over, the traffic was unusually slow

for a Tuesday afternoon. The familiar flickering of red emergency lights

indicated an accident scene ahead. After we maneuvered past the sheriff ’s

squad cars at the crash site, we arrived at Gulf Coast Hospital, located at

a busy intersection. Ford pulled the car into an empty space in the parking

lot and produced a yellow legal notepad.

Then he said, ‘‘Tell me everything you know about these offices, John.

Where are the executive offices and the financial documents?’’

As I spoke, he drew small diagrams, mapping the layout of the admin-

istrative suites. When he was satisfied that he’d gleaned all the information

he needed, he tossed the notepad into the backseat, restarted the car,

and headed northeast toward East Pointe Hospital in nearby Lehigh

Acres. After briefly discussing the administrative office layout, we returned

to Fort Myers.

‘‘Any idea when you’ll execute the raid?’’ I asked on our way back.

‘‘Might be another two or three weeks,’’ Ford replied, vowing to warn me

beforehand.

Then he cautioned, ‘‘After the raids, you might get a few phone calls

asking if you know anything.’’ He advised me to say that I was paranoid

about talking on the telephone and to arrange a meeting.

‘‘Then, we can fit you with a wire and record the meeting,’’ he said,

halting to gauge my reaction. ‘‘Are you OK with that?’’ I nodded. This is

getting interesting, I thought.

Ahead I could see our next stop: Southwest Florida Regional Medical

Center. Southwest is a sprawling, four-story, white and blue stucco building,

one of the 350 hospitals then owned and operated by the U.S. healthcare

giant Columbia/HCA Healthcare Corp., the world’s largest for-profit

hospital chain. Ford turned into the hospital’s parking lot and stopped

near several cars parked at the side of the building. I pointed out a red

Buick Regal I recognized, and Ford promptly grabbed the two-way radio

wedged into the car’s console.

He began relaying the license plate numbers of cars I recognized to a

dispatcher. The red car was registered to Jay Jarrell, the chief executive

officer for Columbia/HCA’s Fort Myers division. Another was owned by

the division’s office secretary, who was just entering the building. I sat

there quietly, observing Ford.

My God, they don’t take any chances, do they? I thought to myself. After

noting the plate numbers, Ford asked me the locations of the administrative

offices in the building. He was particularly interested in the location

of the offices of the hospital’s chief executive and chief financial officers.

Did I know which computer files should be downloaded? Did Columbia/

HCA store contracts and other documents in obscure or remote sites

around the hospital? I told him what I knew, and he rapidly filled the

pages of his notepad. Only a few minutes later, the office secretary reappeared,

entered her car, and drove slowly toward us. As she passed our

vehicle, I ducked, hoping she hadn’t noticed me. I did, however, find

myself enjoying my new role as spy.

Heading north a few hundred yards to Swamp Cabbage Court, we

veered into the lot at the Central Billing Office at the end of the cul-desac.

We spent a few minutes there while Ford recorded some additional

notes, then proceeded to an offsite record storage facility located not far

from Southwest Florida Regional Medical Center. Once he completed his

detailed note taking, he swung back into traffic and deposited me back at

the Wal-Mart parking lot.

Once there, FBI Special Agent Joe Ford, my handler and the man the

U.S. Justice Department assigned to lead the investigation into my case,

reached into the backseat, fumbled with a few papers, and finally produced

an envelope with my name on it. Inside, he said, was an application.

‘‘You’re a natural, John. I think the FBI could really use a guy like

you. Think about it, OK?’’ The idea was thrilling and I was tempted to

pinch myself: The FBI wanted to recruit an ordinary accountant like me.

Table of Contents

Contents

Foreword by Kevin McDonough vii

Acknowledgments xi

Prologue 1

CHAPTER ONE Hornet’s Nest 4

CHAPTER TWO Morals and Values 11

CHAPTER THREE Chokehold 19

CHAPTER FOUR The False Claims Act 28

CHAPTER FIVE The Final Straw 33

CHAPTER SIX An Olympic Event 43

CHAPTER SEVEN Disaster or Opportunity? 53

CHAPTER EIGHT Undercover 57

CHAPTER NINE Covert Missions 67

CHAPTER TEN FBI Raid and Aftermath 89

CHAPTER ELEVEN Escape to Wisconsin 101

CHAPTER TWELVE Big Money or Bust 105

CHAPTER THIRTEEN Case Unsealed 113

CHAPTER FOURTEEN The Health Care Financing Administration 124

CHAPTER FIFTEEN Co-Conspirator 129

CHAPTER SIXTEEN Trial Opening 138

CHAPTER SEVENTEEN Anticipation 148

CHAPTER EIGHTEEN Testifying 154

CHAPTER NINETEEN Defense and Closing Arguments 170

CHAPTER TWENTY Convictions 187

CHAPTER TWENTY-ONE Partner in Crime 194

CHAPTER TWENTY-TWO Partial Settlement 199

CHAPTER TWENTY-THREE The Slaying of KPMG 211

CHAPTER TWENTY-FOUR Battling the Justice Department 217

CHAPTER TWENTY-FIVE Poker, Anyone? 225

CHAPTER TWENTY-SIX Clash of Giants 230

CHAPTER TWENTY-SEVEN Millions of Dollars or a Lump of Coal 241

Epilogue 248

POSTSCRIPT Ten Years Later by Mark Taylor 254

APPENDIX A The Fawcett Interest Issue 283

APPENDIX B United States v. Whiteside: Granting a License to Steal? by Peter Chatfield, Phillips & Cohen LLP 287

Index 309

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Sort by: Showing all of 5 Customer Reviews

  • Anonymous

    Posted August 21, 2008

    The Real White-Collar Crime stopper

    We don't need a bunch of additional regulations or government involvement in health care. What we need are more people like John Schilling. This book provides the story of how John helped to improve the efficiency of the market and how the government provides the incentive without needing a further regulation and bureaucracy.

    2 out of 3 people found this review helpful.

    Was this review helpful? Yes  NoThank you for your feedback.   Report this reviewThank you, this review has been flagged.

  • Anonymous

    Posted April 17, 2012

    Recommended reading, especially for those in health care.

    Good read. Alot of interesting information.

    Was this review helpful? Yes  NoThank you for your feedback.   Report this reviewThank you, this review has been flagged.

  • Anonymous

    Posted January 9, 2009

    No text was provided for this review.

  • Anonymous

    Posted July 26, 2009

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  • Anonymous

    Posted February 16, 2009

    No text was provided for this review.

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