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Dec. 12, 2007
Copyright © Las Vegas Review-Journal

ALLEGED MEDICAL SCHEME: Conspiracy cases now separated

Lawyer's speedy trial request granted; judge rips prosecutors

By ADRIENNE PACKER
REVIEW-JOURNAL

Howard Awand
Self-proclaimed medical consultant faces trial Oct. 29



Noel Gage
Attorney's trial in federal court has been moved up to Feb. 19

A visiting U.S. district judge accused federal prosecutors Tuesday of acting secretively and engaging in a fishing expedition to dig up more evidence in their widespread conspiracy case involving Las Vegas doctors and lawyers.

"The government is playing its cards close to the vest," said U.S. District Judge Justin Quackenbush, who is based in the Northern California District. "I need to know more about this case."

Attorney Noel Gage and self-proclaimed medical consultant Howard Awand were scheduled to go to trial together on charges related to what prosecutors allege was a scheme that inflated medical costs and jacked up settlements.

Despite objections from the government, Quackenbush severed the two cases and granted Gage's request for a speedy trial, setting Gage's case for Feb. 19. Awand is not scheduled to go to trial until Oct. 29.

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    • The U.S. attorney's office issued an indictment against Awand in March, charging him with recruiting a network of doctors who agreed to refer patients to him. In turn, Awand would refer patients to personal injury attorneys, including Gage.

    According to the indictment, Awand and Gage would steer the clients to doctors who would recommend the patient pay for their services on a medical lien basis rather than using their medical insurance carrier, which would have set a limit on the cost of procedures.

    The doctors then inflated the cost of the medical care, according to the government.

    What patients were not told is that Awand secretly purchased the liens at a steep discount, the indictment says. The clients would be required to pay the full value of the liens and Awand pocketed the difference and paid the co-conspirators referral fees, according to the indictment.

    The indictments revolve around two patients referred to Awand.

    The first patient outlined in the indictment sought treatment for kidney stones in 2001 and ended up in a permanently vegetative state. A physician working with the man referred him to Awand, who then suggested he hire Gage to file a medical malpractice suit.

    Between September 2001 and June 2003, Awand and Gage persuaded the patient's wife to sign medical liens, which are settled after a lawsuit is resolved.

    When the man's lawsuit was settled, Gage paid Awand $347,654 for the medical liens that covered the inflated cost of the medical treatment, the indictment states. Awand had purchased the liens for $130,000, according to the indictment.

    Gage's attorney, Tom Pitaro, told Quackenbush that medical liens were the only option after the patient's HMO refused to cover the cost of a special procedure.

    "This is a man without insurance and the hospital would take him in only if he had up-front cash and liens," Pitaro said. "We believe that the treatment aided in saving his life. There is nothing nefarious about the lien process."

    Buying medical liens is a risky but not unusual practice, he said.

    Pitaro added that Gage sued the man's health insurance company for failing to pay for the treatment. The family was awarded $200,000, but Gage didn't keep any of the settlement money, Pitaro said.

    The second case involves a schoolteacher who elected to undergo a spinal fusion in 2000. She was left paralyzed from the procedure.

    The federal government contends Gage and Awand met with the physicians involved in the surgery. Together they agreed to blame the anesthesiologist and to shape their testimony to show it was the anesthesiologist's fault, the indictment says.

    Acting U.S. Attorney Steve Myhre told Quackenbush that prosecutors have no intention to keep their case secret. Myhre said they are reluctant to disclose potential witnesses in open court because of concerns they might be threatened. The indictment against Awand accuses him of badgering a witness who testified in front of the grand jury.

    Myhre said concerns about the well-being of witnesses is a primary reason he preferred to have one trial rather than sever the cases.

    "If they are reluctant to testify once, it will be very difficult to get them to testify twice," Myhre said.

    Quackenbush also denied the prosecution's request to again search Gage's legal office. Investigators raided the office in March, two months before the indictment was issued against Gage.

    Quackenbush said he would allow the government to subpoena specific records, but going through Gage's files appeared to be a "fishing expedition" to search for additional evidence against the lawyer, Quackenbush said.

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    Robert wrote on December 12, 2007 03:27 PM: Quick, run to the restroom...your horns are peeking through. My God, your feet aren't even wet yet.

    You should have played it cool a little longer man, everyone would have been completely fooled.


    ANNA wrote on December 12, 2007 01:43 PM: HIS HONOR QUACKENBUSH SURE IS BRASH FOR A VISITING JUDGE!

    WONDER WHO ARRANGED THIS VISIT?

    WONDER IF USA MYHRE IS FEELING LIKE WE DO WHEN WE GO BEFORE OUR NON-BIASED, NON-POLITICALLY MOTIVATED, BLACK ROBED NON-DEFENDERS OF THE CONSTITUTION. OOOPS, I MEAN DEFENDERS OF THE CONSTITUTION.

    WE FEEL YOUR PAIN STEVE. WELCOME TO VEGAS. NOW WILL YOU HELP A L L OF US? ONE FELL SWOOP. ONE FELL SWOOP.

    DO YOU HEAR ME?


    UNBELIEVABLE wrote on December 12, 2007 11:55 AM: “Federal Poobah Attempts to Intimidate Jury into Silence"

    The courtroom belongs to the people.
    Criminal prosecutions are still nominally brought not for offending the bureaucracy, but on behalf of the public order--"the people versus" whoever stands in the dock….
    On May 12, after a Las Vegas citizen jury unanimously acquitted former hotel executives Edward and Fred Doumani of all charges in a complex, 19-year-old bankruptcy fraud case stemming from the 1979 sale of the Tropicana Hotel to Ramada, Senior U.S. District Court Judge Justin Quackenbush of Spokane, Wash. (brought in to preside over the Las Vegas trial) presented another example of such arrogance.
    Judge Quackenbush told the courtroom that he planned to talk to members of the jury about whether they should discuss their deliberations.
    "I have a strong feeling that what goes on in that jury room should stay in that jury room," the judge said in front of the jury panel.
    Subsequently, members of the six-man, six-woman jury declined to comment on their verdicts as they left the courtroom.
    One juror said he was declining to answer questions, because he was afraid he would get in trouble. "We were instructed not to," he said.
    Judge Quackenbush later denied that he ever ordered jurors to remain silent. "That's a decision for them to make," he said.
    Well, of course he would say that. It would violate the First Amendment for him to issue any such order or instruction--and possibly the Sixth, as well. For if no one can interview willing jurors after a trial--or even learn who they were (as has been the case in several recent high-profile prosecutions)--how are we to know these so-called "juries" aren't merely trumped-up panels of government stooges?..."

    Continued below...


    UNBELIEVABLE wrote on December 12, 2007 11:52 AM: The judge may have a "strong feeling" that jurors should not subsequently discuss their deliberations, just as he may have a "strong feeling" that strawberry sundaes should be banned from our ice cream parlors, and only chocolate sundaes henceforth allowed. Either of these "strong feelings" has the same weight in law.
    The judge cannot have been ignorant of the likelihood that jurors might mistake his off-hand expression of personal opinion for a statement of law. By so speaking from the bench, while wearing his robes (and instead of telling jurors the plain truth--that they are free to speak as they please), it would appear he fully intended to intimidate the jurors into silence.
    These judges would love to turn our courts into their own, private estates, where they wield all power and admit mere commoners as seldom as possible, and only upon a promise that they will bow low, speak in soft tones, and follow orders.
    That may be the legal system in other nations, but not here.
    If he can't limit himself to stating the law as it exists, when it comes to expressing his stupid personal opinions from the bench, the Honorable Senior U.S. District Court Judge Justin Quackenbush should shut up.
    Vin Suprynowicz is the assistant editorial page editor of the Las Vegas Review-Journal. Readers may contact him via e-mail at vin@lvrj.com.” JRP Vin Suprynowicz Article 5/20/98

    Read ENTIRE article:
    http://www.levellers.org/jrp/orig/jrp.vs8.htm


    oldlawdawg wrote on December 12, 2007 10:23 AM: Quackenbush is the WORST possible judge the prosecution could have drawn, and many lawyers share in the opinion that he is amongst the most crooked federal judges money can buy. This case should NEVER be assigned to a temporarily appointed judge from out of state, especially given Awand's national operations and connections. No matter what one thinks of the indictments, no serious argument can be made that Quackenbush clearly has an agenda to act as aggressively as possible against the prosecution's interests when any other temporary appointment to the bench of a forgeign state would act far more conservatively until he was at least more familiar with the case. If Quackenbush's temporary appointmemnt is not already scheduled to be a short one, in which case he may be meddling in Nevada for quite some time more than what one would normally consider "temporary" because the judicial appointment process has become so slowed by political burdens, then Nevadans should try to get at least SOMETHING out of Harry Reid's rabid ultra liberalisms and partisanship by prevailing upon him to make an issue out of Quakenbush and the need for him to be replaced immediately with a perminent Judge approved by the Senate.


    GIVE ME A BREAK wrote on December 12, 2007 09:20 AM: Here we go again. Seriously guys. Show me where it is illegal to take a risk and a buy a lien. Shocking how the article omits how much the total of the lien was when the lien was bought. How much you wanna bet the medical treatment totalled $347k? Of course the article also doesnt mention that the person did not have health insurance and wouldn't have been treated any other way if they didnt get a lien!

    People lets wait to see all the evidence and then pass judgment. I have a feeling a lot of people on these boards will be eating crow!


    UNBELIEVABLE wrote on December 12, 2007 08:32 AM: undr covr US wrote on November 24, 2007 12:05 PM: Here is a start

    http://www.fbi.gov/hq/cid/pubcorrupt/pubcorrupt.htm

    https://tips.fbi.gov/

    FBI Las Vegas
    John Lawrence Bailey Building
    1787 West Lake Mead Boulevard
    Las Vegas, Nevada 89106-2135

    lasvegas.fbi.gov

    (702) 385-1281

    Seth, I believe they will leave the LIGHT ON FOR YOU!


    UNBELIEVABLE wrote on December 12, 2007 08:18 AM: I am soooo happy to see that the SAFETY OF THE WITNESSES is finally a PRIORITY. Too bad the visiting Judge doesn't see it that way.

    Anytime a witness is contacted just after leaving the Federal Courthouse, that should be a CLUE that the Federal Courthouse here HAS EYES in EVERY CORNER!!! However, if a WITNESS were to have predicted or raised the concern that he or she would be stalked, threatened, coerced and extorted I don't know that ANYONE would have believed it.

    GET A CLUE PEOPLE. The MEDICAL Mafia and similar, concurrent criminal enterprises will stop at nothing to protect their investments. They are ALL simply ONE BIG HAPPY FAMILY. When a case has various legs, the other SPECIALISTS are called in to assist...for a cut of course!


    seth wrote on December 12, 2007 08:01 AM: This behavior is practiced daily at personal injury law offices in Las Vegas to this day - Take it from an insider.


    Jo wrote on December 12, 2007 07:48 AM: Why did so many judges not want to sit this case? Whats the connection? Why does Quackenbush seem to favor this guy?


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