Justice, putting bad providers out of business motivates longtime BWC fraud fighter
By Tony Gottschlich, Public Information Officer, BWC Communications Department
As a special agent in the bureau of diplomatic security for the U.S. State Department in the 1980s and early 1990s, Doug Fisher protected royal families, foreign presidents, Nelson Mandela and U.S. Secretary of State James Baker, among others.
As a police detective earlier in his career, Fisher served on the vice and narcotics unit in High Point, North Carolina, scrubbing the streets of drug dealers, prostitutes, racketeers and other nefarious sorts.
And today at the Ohio Bureau of Workers’ Compensation, as he’s done for the last 23 years, this veteran of the Special Investigations Department (SID) pursues crooks, cheats and others who try to rip off the state’s insurance fund for injured workers.
But contrary to appearances, Fisher’s long career in law enforcement isn’t rooted in “saving the world and all that,” at least in the beginning anyway.
“I was working in a factory, and I said, ‘Hey, that looks like a job where I won’t have to get dirty,’” Fisher recalled with a slight chuckle. “I didn’t want to work in a factory anymore.”
Fisher is Special Agent in Charge of SID’s largest unit, the health care provider team, which investigates allegations of fraud committed by medical providers, pharmacies and managed care organizations. He usually shuns the spotlight and deflects any credit he’s earned to his team, but after some arm twisting from his boss, he agreed to be featured in this article to promote SID and International Fraud Awareness Week.
“He hates the publicity, every minute of it,” said a smiling Jennifer Cunningham, SID’s assistant director and a 20-year colleague of Fisher’s. “He doesn’t go to work parties and he never wants recognized for anything. That’s just who he is, very humble.”
A Wisconsin native, Fisher joined BWC in 1993 and was one of SID’s founding members that year. The department has grown since then into a 118-member force that investigates hundreds of fraud cases a year involving workers, employers, medical professionals and others in the BWC system. In fiscal year 2016, the department’s work led to 127 convictions and $56.6 million in savings. Fisher’s team closed 51 cases, landed five convictions and identified $15 million in savings.
He said the job, though, is about more than prosecutions and protecting the State Insurance Fund.
“We knock a lot of bad providers out of the system,” Fisher said from his Mansfield office. “These are people who practice crappy medicine or no medicine at all – they’re just prescribing painkillers to people and it’s a shame.”
One recent case he’s proud of involves a chain of Cleveland-area medical clinics that was indicted Oct. 26 on racketeering and other charges related to scamming BWC out of $216,000.
A 170-count indictment returned by a Cuyahoga County grand jury accuses Dr. Stephen Bernie and an associate of billing for procedures never performed and inflating the percentage of disability for injured workers, making them eligible for higher payments from the state. Dr. Bernie is also accused of writing prescriptions for medications without examining or monitoring patients, and signing prescriptions for powerful opioids that were distributed while he was on vacation.
Said Fisher, “Cases like that are some of the most satisfying – agents working a hard, long case that takes several years and lots of frustration and they drive it to a conclusion.”
Cunningham calls Fisher a “visionary” who looks at the big picture, studies the latest trends and enjoys outfoxing the fraudsters he’s after.
“He’s always thinking, trying to be one step ahead of the bad guys,” she said.
Fisher, 56, and his wife, Debbie, live in Northeast Ohio and are the parents of two adult children. An avid reader and long-distance runner, he also teaches criminal science part time at Stark State College in North Canton.
He said he plans to retire from BWC within the next year.