Third Degree: A Novel Read online

  “I’m glad we can agree on that, at least. That’s probably all I should say at this time. I just wanted you to know that we’re moving to the next phase of our investigation. We’ve sometimes been criticized in the past for conducting surprise searches. I’ve even heard the phrase ‘storm trooper tactics’ used. In your case, I want to make sure that you have every opportunity to prepare your staff for the disruption. I don’t want you to feel we’ve made our investigation unduly burdensome in any way.”

  What the hell is this guy up to?

  “In my experience, you need to take certain steps if you want to be able to continue practicing medicine during the investigative process. You’ll probably want to make copies of your business software. I would also suggest purchasing some new computers, since we almost always remove the on-site computers from the practice.”

  Auster’s head was spinning. He opened his bottom drawer and unscrewed the cap from the Diaka bottle. A hundred dollars’ worth of vodka slid down his throat as Biegler continued.

  “You should photocopy any and all documents necessary for the running of your business, since we’ll probably be taking those away as well. It could be months before you see them again.”

  “And when are you moving to this next phase?”

  “Eight a.m. tomorrow.”

  Tomorrow! “Agent Beagle, I—”

  “Biegler,” the agent cut in, his irritation plain.

  “Right, listen, I couldn’t do the things you just suggested by tomorrow if I kept the staff working overnight.”

  “You’re getting eighteen hours more notice than most people do, Dr. Auster.”

  Stay calm, be courteous and professional at all times—his lawyer’s voice in his ear. “Be that as it may, sir, tomorrow presents real problems. My partner, Dr. Warren Shields, is out due to illness, and consequently I have an especially heavy patient load tomorrow. It would be a huge help if you could delay your search until after the weekend.”

  Biegler cleared his throat. “Dr. Auster, perhaps this might be a good time to inform you that destroying medical records that are under subpoena constitutes obstruction of justice. In your case, those would be felony charges.”

  Anger began to override the fear in Auster’s pounding heart. “Are you saying my records have already been subpoenaed?”

  “That’s correct, sir. And I should inform you that digital files are no less a legal record than hard copies. If anyone attempts to erase any digital files, we will know it, and we will recover them. The penalties are quite severe.”

  “I see.” Auster took a quick slug of vodka, then wiped his chin with the sleeve of his lab coat. “You know what I think, Agent Biegler? I don’t think you called me out of courtesy. I think you called to kick my blood pressure up. You called me to gloat. This is how you get your rocks off, isn’t it? You’ve got a bug up your ass about doctors, and you spend every day trying to bankrupt them or put them in jail. Well, I’ve got news for you. You’ve picked on the wrong doctor. First of all, I’m not guilty of anything. Second, I’ve got lawyers out the wazoo, and I can afford to pay them for a long, long time. And third . . .” Auster tried to remind himself that this conversation was almost certainly being recorded. It wouldn’t be good to threaten bodily harm or death by the intervention of third parties he might know in a questionable line of work. “Never mind about third,” he ended lamely. “You get the idea.”

  “Yes, I do,” said Biegler. “You paint a vivid picture, Doctor. Now let me paint you one. You’re going to be indicted under a number of federal statutes, many of which have been newly created to deal with predatory physicians like you. You have violated the False Claims Act, the False Statements Act, several sections of the Social Security Act, and most importantly, the Kennedy-Kassebaum Health Insurance Portability Act. Also, by mailing fraudulent bills to patients in Louisiana, you’ve violated the Federal Mail and Wire Fraud Act, each instance punishable as a separate offense. Furthermore, there are civil penalties for all the above crimes. You have violated the Civil False Claims Act and the Civil Monetary Penalties Law . . .”

  Auster was having difficulty breathing. The Diaka wasn’t going to do it this time. He opened a prescription bottle in his drawer and swallowed twenty milligrams of propranolol to slow his heart.

  “Are you still there, Doctor?”

  “Of course.”

  “To sum up, under the new sentencing laws, you are facing the possibility of one hundred and seventy-five years in prison, and sixty-five million dollars in penalties. That doesn’t include punitive damages, which the government is entitled to pursue, up to three times the cost of actual damages. In each instance, of course.”

  Auster felt a sharp pain radiating down his left arm. Even the hint of a heart event sent his pulse into the stratosphere.

  “Dr. Auster?”

  Auster shut his eyes and forced himself under control. All these sensations were simply a stress reaction. Paul Biegler had ambushed him, and the panic now redlining his vital signs was exactly the result Biegler had sought to produce. But he would not give the agent that victory. This was like tournament poker in Vegas. It was all about balls. Cojones. Nerves of steel. You might have bet heavy on the come and drawn a shit hand, but you couldn’t let anybody know that. Especially the guy sitting across the table from you, daring you to call. You knew he had the cards—you could read them in his eyes as surely as if his corneas were mirrors reflecting what was in his hand. But you had to call the bastard and play it out. Anybody could win with a royal flush. It was how you played the shit hands that proved your mettle.

  “Did you hear what I said, Doctor?” Biegler repeated. “Sixty-five million dollars.”

  Somehow, Auster found it within himself to chuckle. “That figure is a fantasy, Agent Biegler. None of that will ever happen. You know why? You’re rattling off all those numbers to scare me into settling out of court. You want me to pay Uncle Sam a big chunk of extortion money. Well, guess what? I have committed no crimes. None. And I already pay the government my fair share of extortion money. It’s called taxes, and I shell out close to a million dollars every year. So kiss my sanctified ass, you pencil-pushing cocksucker.”

  For a few glorious moments, Kyle Auster felt the euphoria of having done what every hardworking American wanted to do in his heart of hearts, tell the government to go to hell—and it felt good.

  Then Agent Biegler started laughing. “You’re something, aren’t you?” he said, his voice betraying something like admiration. “I heard that about you. High-stakes gambler, they tell me. Boy, this one’s gonna be fun. By noon tomorrow, you’re going to think you’re dealing with a proctologist, not a Medicaid investigator.”

  “What exactly are you, Agent Biegler? Are you really an investigator? Because I smell a lawyer. I can respect a cop, you know? But a lawyer’s something else again.”

  “I have a law degree.”

  “Couldn’t pass organic chemistry, huh?”

  Biegler’s laughter stopped. “I should also inform you that as of nine a.m. tomorrow, all Medicaid payments to the partnership of Auster-Shields Medical Services will cease. You are being excluded from the Medicaid program pending the outcome of your criminal trial. Have a nice day, Doctor.”

  Auster slammed down the phone before Biegler could hang up. “Vida!” he yelled at his door. “Vida!”

  Nothing.

  He buzzed the front. “Nell, tell Vida to come back here!”

  “Yes, Doctor.”

  Auster put away the Diaka bottle and took three deep breaths to try to calm down. A moment later, Vida stepped into his office, her face lined with worry.

  “Nell told me who it was,” she said. “You shouldn’t have taken that call, Kyle.”

  “Yeah, well, you should have been here to tell me not to take it.”

  “Let me guess. You got into a pissing contest.”

  Auster shrugged helplessly. “Do you know what he said I’m facing?”

  “Jail, I guess.”


  Auster leaned forward and looked hard into Vida’s heavily made-up eyes. “Not just jail. A hundred and seventy-five years in prison.”

  She didn’t flinch. “No way. Never happen.”

  “Then there’s the little matter of sixty-five million dollars in penalties.”

  At last her face lost some color. “Sixty-five million? Can that be true?”

  “Oh, yes. And that’s not counting punitive damages. You need to start researching the Kennedy-Kassebaum law. If you want to know what the rest of your life looks like, that is.”

  Vida walked halfway around the desk and looked down at him. “Don’t let that asshole get to you. He’s just talking tough, like all cops do.”

  “He’s pretty good at it.”

  “It doesn’t matter. I’ve been sterilizing records for the past ten days. We never did anything stupid. I’ve been working in medical offices for eighteen years. Everything we billed for can be defended on medical grounds.”

  “But the special patients . . . they can blow us out of the water. The stuff we did on them was based on total fiction.”

  “Wrong. They said the words to you, Kyle. They made the complaints. You did what any conscientious physician would do, even if you thought the complaints might be psychosomatic.”

  “Jesus, Vi.”

  She reached out and brushed some hair from his eyes. “You’ve got to hold your nerve, baby.”

  “We paid them to say that stuff!”

  Vida shook her head. “Never happened. Untraceable cash, and long gone now, I promise you.”

  “But if they testify—”

  “They won’t. Where’s the upside for them? From us they get cash and free medical care. From the government they get jack shit. Anybody makes trouble, we’ll buy them off.”

  “What if somebody has an attack of conscience?”

  “They won’t. I didn’t pick a bunch of Holy Rollers to do this, I picked good, compromised Christians. The only thing we have to worry about is somebody you pissed off. Somebody testifying out of revenge. Like a woman, say.”

  Auster’s mind flew back to a couple of attractive female patients, one of whom Biegler had called by name. In the natural course of things, they had offered him certain sexual favors in exchange for certain prescriptions, and he had not resisted as he should have. When their requests got out of hand, he’d had to cut them off, no matter what they offered. One or both of those women might present problems, particularly if the government had leverage over them based on drug-related charges.

  “I see we’ve got a problem,” Vida said harshly. “Who is she?”

  “Nobody. I was just going over it all in my mind.”

  “Bullshit. Spill it, Kyle.”

  Paul Biegler needed Vida working for him. She was relentless. Auster sighed heavily. “Quinesha Washington.”

  Vida went pale. “That crackhead? You went with that skank?”

  “Just a blow job—I never touched her otherwise.”

  Vida shuddered in disgust. “Well, I hope it was a good one. She’s going to cost us plenty.”

  A good one? More like a dozen good ones. “Sorry.”

  “You go tell JaNel to draw blood for an HIV test.”

  “Come on, Vi—”

  “Now, damn it! You don’t have the sense God gave a tomcat.”

  Auster held up his hands in surrender. “I’ll do it when we’re done.”

  “We’re done until you get that test back. I’m going back up front to try to save you from yourself.” She turned on her heel and stormed out.

  Auster leaned back in his chair and waited for his heart to slow. A few blistering images of Quinesha Washington on her knees before him arced through his brain, but they vanished as Paul Biegler’s threats came rushing back. The funny thing was, the patients and the records weren’t what really worried Auster. What worried him was his partner.

  Taking on Warren Shields had been a mistake. Auster had assumed that Shields, like all the young docs, was hungry for money. And Warren certainly had nothing against making money. But he was constantly checking himself against a code of ethics that belonged to an older generation of doctors—hell, the generation behind Auster, even. It was maddening. On the other hand, the affluent patients in town loved the guy, so he was still good for business.

  Then, like a gift from heaven, Shields had suddenly come around on the money issue. About a year ago, he’d walked into Auster’s private office after work and said point-blank that he needed to make more money. Auster told him it was no problem, that the money had always been there for the taking, had Warren been ready to earn it. Warren had just nodded and said he was, and that was that. Auster didn’t know what had precipitated Warren’s sudden venality—a mistress, a drug habit, an expensive hobby—nor did he care. In short order he’d put Vida in charge of Shields on a day-to-day basis. Before Warren checked the billing code after seeing a patient, Vida would ask him a few questions, then check the appropriate box herself. A busy physician like Shields didn’t have time to be bothered with trying to figure out the finer shades of what constituted a Level 5 exam.

  Within a month, Shields’s income almost doubled.

  That abrupt uptick in billing might have been what attracted the attention of the Medicaid Fraud Unit. But Auster knew why he’d pushed it. Warren Shields’s reputation was spotless; he was the last doctor anyone would suspect of padding his charges. And Shields truly resented government intervention in medicine. Auster had no doubt that, confronted by an accusing government lawyer, Warren would experience a primal burst of outrage. If that pencil pusher Biegler went after Shields, he would get a blast of righteous anger that would set him back on his heels. Then Shields would use his considerable medical knowledge to defend every bill for every patient he’d ever examined. Auster would do the same. And if Vida could really keep the special patients quiet . . . then everything would be all right.

  CHAPTER

  9

  Laurel lay bound on the sofa, trying to keep her mind from going as numb as her extremities. She felt the minutes draining away like blood from a wound. All thoughts of marriage, adultery, and even pregnancy had fled. She lived only to discover the time. Only when she knew how long she had before the children got home could she plan her next move, which might be something she would have thought abhorrent an hour ago. Escape had been her first priority, but given Warren’s crazed emotional state, she could not limit her goal to breaking out of the house. The heavy glass vase he had urinated into—and then dropped during her race for the safe room—had come to rest against the wall that separated the great room from the kitchen. The hand-blown vessel, heavy and round at the bottom with a long, tapered neck, had the makings of an ideal club. A blow from that might crush Warren’s skull, but anything was preferable to letting her children walk into this nightmare.

  “I told you, I’m about to pee on myself!” Laurel cried for the fifth time.

  Warren didn’t even look up from her computer.

  “Why don’t you take a break from that thing and search the house some more? I told you, there’s something else waiting for you to find it.”

  He chuckled softly. “What I want to find is buried in the circuits of this machine.”

  “What you need to find is what Kyle Auster planted in here, so you can start taking out your anger on the person who’s your real problem.”

  Warren ignored her.

  She tried another tack. “Do you really want our children to see me taped up like a hostage? With urine-soaked pants? How are you going to explain that?”

  “You don’t have to use the bathroom. You just want to get loose.”

  “I’m about to burst! Can’t you see the sweat on my face?”

  He gave her a brief glance. “If you have to go that bad, go in your pants. I’ll throw them in the washer before the kids get here.”

  New anxiety awakened within her. “How are they supposed to get here if I don’t pick them up? Are you going to get them?
”

  “Maybe I e-mailed one of the girls at the office to get them.”

  She hadn’t considered the idea that Warren might be e-mailing people while he was carrying out his exercise in paranoia. “Who?”

  “Nell Roberts.”

  Laurel pictured a pretty, dark-haired Louisiana girl, the younger sister of the bleached-blond receptionist people said Auster was sleeping with. What would Diane Rivers do when Nell Roberts showed up at school to pick up the children Diane had been asked to drop off? She’d call Laurel’s cell phone, which was now tucked into Warren’s back pocket, and he’d give some smooth explanation to allay any suspicion. End of story.

  “How long till they get out of school?” Laurel asked casually.

  Warren shrugged. “They’ll get here when they get here. But Nell’s not bringing them. I didn’t e-mail her. You’re such a perfect mother that I realized you would already have arranged to get them here. Right?”

  His sarcasm angered Laurel, but at least she had learned that the possibility to intervene with Diane remained.

  “Warren, I’m begging you to let me go to the bathroom. Don’t you have enough simple human decency left to allow that?”

  At last he looked over at her. “Tell me the password to your Hotmail account. Then you can go. “

  Okay, Laurel thought angrily. You asked for it. She closed her eyes and relaxed her urinary sphincter. Within seconds her crotch was soaked, then her inner thighs and bottom. The smell would hit Warren in a minute, and he was unlikely to maintain a stoic front. The sofa beneath Laurel’s behind was a leather Roche-Bobois imported from France, $17,000 and change through a boutique store in West Palm Beach. She was still peeing when Warren sat up straight on the ottoman.

  “Fuck!” he cried. “You didn’t pee on that couch?”

  “I told you I had to go.”

  “Get off the damn sofa!”

  “Screw you. Cut this tape off me and I’ll get up.”

  He glared as though he wanted to hit her, but Laurel sat as calmly as a Buddha, almost blissful in the relief of her empty bladder.