In Wisconsin - The "Narrative" Says It All...
Opinion by Consumer Advocate Tim Bolen
Friday March 26, 2004
Finding the Suster case (Wisconsin DRL v. Suster) was like
finding gold. For in it, are all the elements wherein health
insurance companies are involved in the suppression of new
things in health care. Below is a "Narrative" recently filed
in that DRL v. Suster case. It says a lot about the
corruption in our Administrative Law system.
The "Narrative" also points out how sleazy health
insurance companies really are, and how far they'll go to
NOT pay claims.
I've always said that those people who have to rely on
Medicare suffer, because they are restricted, due to an
antiquated approval process, to health offerings that are,
at their newest, fifteen (15) years old. Health insurance
companies, in my opinion, are not much better in their
offerings for similar reasons - and offer nothing newer than
seven (7) to ten (10) years old.
In response to this vacuum in health care offerings, what's
known as "Alternative Medicine" has taken over 50% of the
total US health care dollar away from the medical complex -
and Americans are paying for these services out-of-pocket.
Health Insurance companies are slow to wake up to reality,
and instead of embracing health paradigms Americans are
buying, they pull stunts like the one described in the
"Narrative."
Stuart Suster MD is a man, who at great risk to himself (he
is now getting DEATH THREATS), tried to get health insurance
companies to recognize the benefits of, and pay for, new
health paradigms. Look what's happened - so far...
I doubt we'll see any change, in the near future, in the way
health insurance companies operate.
The Suster case is, in my opinion, a landmark. It brings up
legal issues, involving the Administrative Law process
itself, rules regarding the conduct of prosecutors, and it
spotlights health insurance companies' improper use of the
Administrative licensing hearing to simply NOT PAY CLAIMS by
threatening the health professional's very existence. If you
are interested in reading these legal issues, read the
"RESPONDENT'S POST-HEARING CLOSING ARGUMENT BRIEF FOR
PROPOSED DECISION BY ALJ" by going to www.quackpotwatch.org,
and clicking on the new newsletter.
Here is the "Narrative..."
STUART M. SUSTER, M.D., Respondent Case No.: 00MED272,
LS-0210291-MED
NARRATIVE ATTACHED TO RESPONDENT'S POST- HEARING CLOSING
ARGUMENT BRIEF FOR PROPOSED DECISION BY ALJ
I am Stuart Suster MD, a pain management expert practicing
in the greater Milwaukee, WI area. My advertisements state
"When you've been everywhere else and nothing worked – come
here…" I offer newer, and comprehensive, methods towards
pain management. I have significant training in this area
(see exhibit A – Curriculum Vitae Stuart Suster
MD), have completed significant research in this area, and
follow the best of Federal and the University of
Wisconsin Guidelines (see exhibit B – UW Pain Management
Guidelines) in pain management.
I, Stuart Suster MD, operate on the "cutting edge" of pain
management – and that is the problem. As a colleague of mine
once said "It's bloody on the cutting edge…"
I am under assault because I exercised my legal rights,
insisting that health insurance companies pay, and pay
reasonable amounts, for my services to my patients. Indeed I
hired the best experts I could find to assist me in properly
billing for my services. I followed their advice, and the
guidelines of the American Medical Association, in all of my
billing practices. One of my experts has since been
appointed by Wisconsin Governor James Doyle as the Insurance
Commissioner for the State of Wisconsin. He was not allowed
to testify at my hearing – since I was allowed NO DEFENSE
witnesses.
I am under assault by an unscrupulous employee of the
Wisconsin Department of Regulation & Licensing (DRL), one
Arthur Thexton, who, within that department, holds the
position of Prosecutor in the Health section of the Division
of Enforcement. Thexton is well known for his attacks on
Wisconsin "cutting edge" practitioners – and has been
recently disciplined, and reined-in for this activity,
openly, and very publicly, by new DRL management, Secretary
Donsia Strong Hill for his activities in other cases.
Indeed, Thexton has been ordered by his department "not to
talk to the media about his cases." Donsia Strong Hill, said
of Thexton in an earlier case (DRL v. Kadile) "What I
inherited were a group of prosecutors who basically had
functioned in the past with very little supervision over
them or direction or even the establishment of priorities,"
Strong Hill said. "We certainly have changed that." When
Madison CBS News 3 asked Strong Hill, "You're supervising
them more closely?" She responded, "They are definitely
being supervised more closely." Those earlier cases, three
of them, all of which Thexton lost, pointed out that Thexton
has connections to, and adheres to the policies of, a
national organization known as the "quackbusters." The
"quackbusters" rail against anything new in health care.
Their "bible," a website called "quackwatch.com," is
operated out of a basement in Allentown, Pennsylvania by one
Stephen Barrett MD, a man who hasn't been licensed to
practice medicine in any State, since 1993. Their
"flagship," the so-called National Council Against Health
Fraud (NCAHF) is operated out of the current NCAHF
president's business, a hair removal and ear piercing salon
in Braintree, Massachusetts.
I need relief.
Thexton, a well known power abuser, has recently, because of
other cases involving other cutting-edge practitioners, been
reined in, but that is no help to me in my current
situation. I may be the last case where he is allowed to
abuse someone, using his power, but it is unfair to me that
I have to continue this process, at my own emotional and
financial expense, after, so-to-speak, "the barn door has
been shut."
I am not being prosecuted, as it were, in a justified
administrative hearing. I am being persecuted by a known
abuser, an unethical, unscrupulous member of a national
crackpot organization (the quackbusters) dedicated to
stamping out new things in health care – Arthur Thexton.
Arthur Thexton has used extraordinary means to stop me in my
attempt to be properly paid for my services by health
insurance companies. On this, world-renowned Consumer
Advocate Tim Bolen wrote, in his Millions of Health Freedom
Fighters – Newsletter, that:
I see cases against practitioners all over North America,
and the Wisconsin DRL v. Suster case is, by far, the worst
thing I've ever seen anywhere. Thexton, for this case alone,
should lose his job at DRL, and his license to practice law,
for what he's done to Stuart and Mary Suster. Ruby Jefferson
Moore, the so-called Administrative Law Judge (ALJ), in the
case, deserves some serious review..., if not legal
disbarment, herself.
Thexton, a well known ABUSER, in the Suster case, pulled out
all the stops. Thexton used his position at DRL to act on
behalf of a group of health insurance companies involved in
a billing dispute with Stuart Suster MD. When Suster failed
to heed Thexton's warnings to "back off" on his attempts to
collect money owed him, Thexton began a series of events,
using his position at DRL, to destroy Stuart Suster.
Thexton's actions were so blatant on behalf of health
insurance providers that DRL, and police agencies, would do
well to examine Thexton's finances.
Thexton's actions smell of "payoff." In summary:
(1) First, Thexton accused Suster of being mentally
unstable, and "using drugs," forcing Suster to undergo
Psychiatric and Drug evaluation. While Suster was
undergoing this humiliation, Thexton called the
evaluator, attempting to influence the outcome. Suster
easily passed the evaluation. When that attempt
failed, Thexton moved to step
(2) Thexton went to the media to ruin Suster's
practice, and then
(3) went to police agencies trying to get Suster arrested.
When that didn't work, and police agencies rebuffed
Thexton, Thexton
(4) in a "secret hearing" filed eleven counts against
Suster with the Wisconsin medical board. The eleven
"counts" include over 50 accusations of criminal
activity which had been rejected for prosecution by the
appropriate police agencies. The new accusations
misconduct. Thexton then
(5) went back to the media with the new accusations, asking
the people of Milwaukee to "call the TV Station, the
DRL, the FBI, the DEA, or the local police if they knew
anything about Suster."
(6) Then, when Suster complained about Thexton's
manipulations, Thexton ordered so-called witnesses
"not to talk to Suster - although they were talking to
the media." Then
(7) Thexton, with Ruby Jefferson Moore, conspired to
eliminate "due process" from the so-called
Administrative Hearing, going so far as to not allow
Suster to cross-examine witnesses against him, nor call
any witnesses in his own defense. All the while,
Thexton had the TV station broadcast Thexton's
commentary about the hearing on a daily basis.
(8) Thexton, working in conjunction with Stephen Barrett
of quackwatch.com, broadcast the whole bogus
accusation/hearing situation worldwide.
And, the Susters are trying to recover from this.
Thexton is the one, you will remember, who UNSUCCESSFULLY
prosecuted Wisconsin leading-edge practitioner Eleazor
Kadile MD using nationally known CRACKPOT Robert S. Baratz
as his do-all, be-all "expert witness." Thexton also tried
to prosecute, Eleazar's wife Genial (a Nutritionist), but an
Administrative Law Judge (ALJ) threw out that spurious
attack. Thexton also "investigated" Robert Waters MD, for
about eight years. Thexton's superiors at DRL removed
Thexton from the Waters case, and the new prosecutor dropped
the investigation within a week.
New DRL management has, after examining Thexton's actions in
other cases, made significant policy changes, reining in
Thexton. Thexton has a history of abuse.
Bolen has a readership of over 200,000 for his newsletter
and his websites. He is a consultant nationwide, and is on
a "first-name basis" with DRL management, and Wisconsin
legislators. He is considered to be an expert in the
politics of health care in the United States. The whole
article he sent out, entitled "The Stuart Suster MD Case -
the Most Sadistic, Vicious, and Cruel So-Called
Prosecution I've Ever Seen…" can be read, in its entirety
at quackpotwatch.orgSuster2.htmOpen ↗.
I have also enclosed a copy of the entire article as
(Exhibit C).
A second article, detailing Bolen's concerns about the
health insurance industry's ability to shortcut the
Wisconsin DRL process, and misuse the Licensing Hearing
to deny, and discourage, health billings by
practitioners, is added as (Exhibit D). It can be found
on the internet at quackpotwatch.orgopinionpOpen ↗
ieces/WisconsinTestCase.htm.
There is significant reason, in this case, to suspect, and
call for an investigation of, "Foul Play."
(9) There are, in Wisconsin Regulations for the practice
of law, specific rules prohibiting prosecutors from
doing exactly what Arthur Thexton did, in my case.
Thexton's relationship with the media RUINED my
practice, and my good name, long before I ever had a
hearing on the issues.
(10) I am being persecuted BECAUSE I exercised my rights
under the law. Not only have I gone out of my way to
get expert assistance in my billing issues, but I
filed the claims against the health insurance
companies following THEIR EXACT procedures, then
moved on to using the Employee Retirement Income
Security (ERISA) guidelines. I AM STILL IN THAT
PROCESS. Thexton, and the insurance companies have
conspired to bypass that process, using the DRL
licensing hearing to change to a friendlier venue
(forum shopping) – one under Thexton's control. I
have over three hundred cases, totaling over a
million dollars in billing, going through the ERISA
appeals process. Thexton, working on behalf of the
health insurance industry, in an improper venue, is
attempting to castrate the United States government
Department of Labor ERISA claims process.
(11) The Wisconsin Medical Examining Board, for over a
year, has been unable to come up with "Pain
Management" guidelines. Evidence of this is clear
in their meeting minutes. How can I BE PROSECUTED
FOR VIOLATING PAIN MANAGEMENT GUIDELINES THAT DO
NOT EXIST?
(12) Arthur Thexton brought against me, and used as the
official "Case Advisor," a pain management
specialist, and Medical Examining Board member, who
is a geographical competitor to me in the greater
Wisconsin area. This is a definite conflict of
interest. This case advisor carried the case against
me to the board, and also acted as the witness. He
has since benefited from my loss of patients, due to
the media coverage by Milwaukee Fox 6 TV.
(13) Arthur Thexton took over 100 names of my patients,
names he got from several health insurance providers,
to Fox 6 TV. The TV station invited them all to a
meeting where those that attended, all formerly HAPPY
patients of mine, were indoctrinated by Thexton,
health insurance so-called "fraud" investigators, and
local TV personages to believe that there were
significant criminal acts being committed in
these patients, prior to this indoctrination had ever voiced
a complaint, except that "my insurance company doesn't want
to pay for my treatment here..." Thexton wrote a "release"
to be used by Fox 6 TV, where all of the patients gave Fox
TV 6, Thexton, and the insurance companies access to their
complete medical records, anywhere, and everywhere (Exhibit
E). Since that indoctrination meeting, several formally
HAPPY patients have come to believe that I am a criminal –
and refuse to communicate with me. All of my formerly HAPPY
patients showed marked improvement in their pain issues
during my treatment of them.
(14) Arthur Thexton, working with Fox 6 TV, convinced a
formerly HAPPY patient to act in an illegal manner,
coming into my office to argue over "her bill." with
a concealed TV camera. The purpose of the visit was
to embarrass me on Milwaukee TV, and further
Thexton's previous unfounded assertion that I was
"loud and angry." The TV station played this
recording, and interviews gleaned from other
indoctrinated formally HAPPY patients, continuously.
This severely damaged my business, my personal
reputation, and has brought me several DEATH THREATS
(Exhibit F).
(15) Arthur Thexton convinced my formally HAPPY
patients that my
pain need comforting, and a sense that there is hope ahead
for relief. I, and my staff, provide, in every case, that
emotional support. "Touching," sometimes called "Therapeutic
Touch," is one of our techniques. It is our office policy to
hug our patients, make eye contact, and to act in a warm,
friendly, but firm about following the treatment plan,
manner. Thexton's crackpot "quackbuster" organization rails
against "Therapeutic Touch," although he, Thexton, is well
aware that the University of Wisconsin teaches "Therapeutic
Touch" on campus. Office policy also dictates that at no
time am I ever alone with a female patient. Thexton is also
aware that I suffer significant physical limitations, and
limited range of motion, in that
misconduct," are preposterous – and simply NOT POSSIBLE.
(16) Arthur Thexton has intentionally misconstrued, for
purposes of unwarranted prosecution, several aspects
of my pain management program for my patients. "Pain
Management" is not an easy specialty, in that most
patients can, and do, become too reliant on, and
sometimes addicted to, dangerous drugs – opiates.
Care must be taken that the patient follow the EXACT
guidelines I set out for them in their personal
treatment plan. It is part of my treatment policy to
have the patient bring in their medication at each
visit, and hand their pills to the office nurse, who
will count the pills to insure that the right amount
has been taken, and that there are none "missing."
When I change a patient's medication, for whatever
reason, I impound the old medication. These opiates
are dangerous by themselves, and worse, when
improperly combined by a patient involved in chronic
pain, and not thinking clearly. Thexton, without
justification, has attempted to suggest about those
impounded pills, that I am "either taking the pills
myself, or selling them out the back door…"
(17) I was recently invited to, and attended a meeting in
the State capitol, where over a dozen "cutting-edge"
Wisconsin health practitioners were discussing the
proper ways, in the proper venues, to file complaints
against Arthur Thexton, and another State DRL
prosecutor named James Polewski, both of which were,
and are, "quackbusters," regarding a statewide
"pattern of abuse," Those complaints are forthcoming,
and will have a bearing on Thexton's credibility.
There are, I believe, SIX separate complaints being
filed against Thexton, each going to three separate
agencies. Committee members are meeting with
?Wisconsin legislators regarding the abuse issues.
(18)Arthur Thexton conspired with Ruby Jefferson Moore, the
Wisconsin DRL Administrative Law Judge (ALJ) to deny me
any semblance of "due process," in my administrative
case. This case is a "railroad." As Consumer Advocate
Tim Bolen so aptly explains "Thexton, with Ruby
Jefferson Moore, conspired to eliminate "due process"
from the so-called Administrative Hearing, going so far
as to not allow Suster to cross-examine witnesses
against him, nor call any witnesses in his own defense.
All the while, Thexton had the TV station broadcast
Thexton's commentary about the hearing on a daily
basis." All this is true. But there is more in the
complaint - much more.
I am one more victim of Arthur Thexton, in his quest to rid
the world of those, who in his crackpot "quackbuster" view
of health care, need to be stopped by any means. And,
Arthur Thexton is capable of using "any means," and has
done so in my case.
Stuart Suster MD Sunday, March 21, 2004 Milwaukee, WI
-----------------------------------
Stay tuned...
Tim Bolen - Consumer Advocate