Trust No One

The Binge Cases: Doctor Billions

The episode follows Mark Sersancy's journey from a new marketing hire to an undercover mole in a massive medical fraud ring. After discoveri

Key takeaways

• Derica Moses discovered that 12 of the 23 pieces of spinal hardware implanted in her were counterfeit.
• The fraud operation involved over $1 billion in fraudulent billings and medical deceptions.

Main topics

• Medical Fraud
• Undercover Investigation

Notable quotes

The patient is an ATM card.

Conclusion

A harrowing look at how the exploitation of patient trust for profit c

Transcript preview

Speaker 3 (0:00) One summer evening when she was 20 years old, something terrible happened to Vienna Luke. I can't figure it out, but I do know that it was a violation. Then people started asking questions. Speaker 8 (0:12) What a creep. Who else knows about this? From Speaker 3 (0:15) CBC's Personally, this is Agent Layla. The story of how a victim went undercover. So bring it on. Let's go. Let's get a confession. Available now on CBC Listen. or wherever you get your podcasts. Speaker 8 (0:30) Listen to every episode of Dr. Billion's ad-free right now when you subscribe to The Binge. You'll hear the entire series before anyone else, get exclusive bonus episodes, and unlock more than 60 other true crime podcasts. Just head to The Binge channel on Apple Podcasts and tap subscribe. Or visit GetTheBinge.com to listen wherever you are. The Binge. Feed your true crime obsession. Speaker 8 (1:00) The Bench. Speaker 4 (1:07) So when you had the surgery, you were just shy of your 32nd birthday? Yes. Speaker 8 (1:13) This is a woman named Derica Moses. She's testifying in court. Speaker 5 (1:17) I was working at Pepsi Bottle Company, and I would stock the store shelves. I'd bring in pallets to the store to stock. Speaker 8 (1:26) Derica is telling the courtroom a story. It's a story about how she got injured on the job, and according to her and her lawyers, unwittingly became the victim of a bad doctor. What she didn't know then, what she only found out about much later, is that she wasn't the only victim. She was one of thousands. Speaker 8 (1:48) In high school and college, Derek had been an athlete. She went to the University of Utah on a softball scholarship. Full ride. After, she started working for Pepsi. Speaker 5 (1:57) Each pallet would be 1,200 pounds, and he'd use a manual pallet jack, and then he'd move it over to a... Speaker 8 (2:03) One day, right before one of the biggest soda weekends in the country, Labor Day weekend, she was moving a mountain of cans and bottles from the truck to the store, and she felt a little... I Speaker 5 (2:14) just heard and felt a pop in my back. Speaker 8 (2:18) Pop. Happened to me once. I wasn't even lifting anything. Just bent over, twisted, changing the headlight on my wife's car. And suddenly, oh, I was laid out for weeks. I got better, eventually. Derica did not. And because she was injured on the job, Derica saw a doctor through her employer's workers' compensation insurance. This is the parallel medical insurance program that companies pay for so that people injured on the job get care fast and free. Derica found a doctor from workers' comp. She went to see him, and he said her back injury was very serious and that she needed surgery. But... He Speaker 5 (3:02) told me that I would get between 90 and 95 % better. And that's what gave me the hope to have the surgery done. Speaker 8 (3:09) Her doctor also testified at this trial, and he denied telling Derricka this. But this is an important moment for Derricka. This is the moment she put her trust in this doctor. And given the story I'm about to tell you, it's worth probing this a little bit. Why do we trust doctors? We know they've been to school for a very long time to do the things they do. We know about the Hippocratic Oath, which has actually changed a lot over time, but the ethical framework is real. Physicians are supposed to prioritize the patient and patient care over all other concerns. We know that lots of people go to doctors. Probably a lot of people had been to this doctor, standing right in front of Derricka. And if something was wrong with this guy, wouldn't something have happened? Missed license revoked or something? Speaker 8 (4:01) This bond of trust can be seen another way. To the bad actor, it's a moment of opportunity. An opportunity for more than you and I can imagine. Speaker 8 (4:16) Derica was hopeful going in. It was her first surgery ever, and a serious one. She would get 23 pieces of hardware implanted in her back, screws and rods to stabilize her spine. She went through with it, and you know what? It seemed good. Speaker 5 (4:36) The more time Speaker 8 (4:43) went on... the more pain she was in. Speaker 5 (4:46) I realized the pain hadn't gone anywhere. It just got worse. Speaker 8 (4:49) Eventually, Derica realized the surgery had failed. She was 37 years old. Once, she was athletic. Now she struggled to get out of bed in the morning. Her mother moved in to help her with basic day-to-day tasks. She went back to her same doctor, and he found that some of the hardware around her spine had failed. Broken loose. and she needed a new surgery to remove all the hardware he had put in. Derrick had trusted him. Why wouldn't she? He's a doctor. And her trust created another big opportunity. Speaker 8 (5:29) But then, just as she's going into that surgery, she makes one small request to the nurse. Speaker 4 (5:36) And so, when you went in for that removal surgery, you specifically asked somebody, I'd like the hardware that's getting removed out of my back. Speaker 5 (5:47) Yes. Speaker 4 (5:48) Why did you do that? Speaker 5 (5:49) Because I thought I wanted to make a necklace out of some real titanium that came out of me. It's like souvenir type, too. Speaker 8 (5:56) When Derricka woke up from the operation, there was a little baggie under her pillow. And that little baggie was one very small part of a massive web of lies, deceit, and misplaced patient trust. It involved dozens and dozens of doctors, lawyers, and medical professionals all over Southern California. Overlapping frauds and deceptions worth over $1 billion. Speaker 4 (6:24) Now you've seen that the testimony here that out of the 23 pieces of metal that were planted surgically into your back that 12 of those were counterfeit. When was the first time you learned about that? Speaker 5 (6:40) In about March 2014. Speaker 4 (6:44) Okay. And how did you learn of that? Speaker 5 (6:48) A letter in the mail that said, You have been a victim of counterfeit hardware. Speaker 8 (6:56) Twelve out of 23 pieces of hardware implanted in Derricka Moses' body were fake. They were a ticking time bomb because nobody knew how long they would last, what they were made of, and whether they were poisoning her from the inside out. And she was just one of hundreds of potential victims. I'm Ben Adair. From Sony Music Entertainment and Western Sound, you're listening to Dr. Billions. Speaker 8 (7:34) This is episode one. Trust no one. Speaker 8 (7:42) In 2007, a guy named Mark Sersancy was living in southern Washington state, close to Portland. But he was California dreamin'. Speaker 6 (7:51) Well, originally, we were from, I'm from Southern California. We wanted to move back anyway, but it was just such a slim job opportunities at the time. Speaker 8 (8:00) Through his wife's friend, he met a guy named Paul Randall, who was up from Orange County, California. Mark didn't think much of him at first. Speaker 6 (8:08) He's kind of a mousy kind of guy. I know this sounds horrible, but he just looked like a car salesman. Like the ultimate used car salesman. Dude, with the worst toupee I've ever seen in my life. I mean, he would look better if he just didn't have the toupee. Because half the time was even halfway on. Speaker 8 (8:24) But they kept talking. And Mark kind of caught on. There was something about this guy. Speaker 6 (8:30) What's that addict who can sell ice to Eskimos? He can sell ice to Eskimos all day long. He is just that dude. Speaker 8 (8:36) Paul said he owned a medical company in the OC. Very successful. Speaker 6 (8:41) He said it was a medical company that he had multiple... divisions of the medical company, which is DME, toxicology, implants, various things. He had a bunch of doctors that were working for him. Speaker 8 (8:54) And during their conversation, Paul kind of mentioned, hey, he was looking to hire. He asked Mark if he'd be open to relocate. Now, this was the heart of the Great Recession. Not a lot of opportunities floating around. Speaker 6 (9:05) He agreed to pay for all our moving expenses, housing in the meantime until we found something, and a very hefty salary. Speaker 8 (9:14) It might have seemed too good to be true, but like I said, there was something about this guy. Mark trusted him. Speaker 8