Irresistible Impulse

by Robert Tanenbaum

  “How did you do?”

  “He pounded me into the ground like a tent peg—what do you think?”

  “And your point is … ?”

  “I’m not sure,” said Karp, his forehead wrinkling. “Obviously, I want to win, but maybe even more I want to be in the game with this guy. He gets my juices flowing. You know, we win cases all the time because we only go in there, to court, when we think we have an overwhelming case, and when the mutt hasn’t got the sense to cop a plea. But the fact it, the system is skewed to let the guy off unless the prosecutor’s really sharp. We should get beat a lot more, and we would if we faced more people like Waley.”

  “Lucky us,” said V.T. “What am I hearing, you think you’ll get creamed?”

  Karp shrugged. “I’m not sure I’d bet my next three paychecks on me to win. He’ll go with NGI, so it’s going to be dueling shrinks, which is always a toss-up. Also, with him in there, I make one mistake it’s all over. But that’s the job: they let the bull in, you got to wave the cape. Otherwise, you walk up the aisles selling enchiladas. So what’re you up to?”

  What V.T. was up to was the undermining of a complex Medicaid-fraud scheme. He described the convolutions of this with verve and humor, while Karp, not really following the details, was content to relax and listen in the dim booth, occasionally dropping a piece of Mongolian beef into his mouth and nodding appropriately.

  Suddenly, however, he grew alert. “What was that doc’s name again?” he asked.

  “Which doc? Robinson?”

  “Yeah, Vincent Robinson. What do you have on him?”

  “Oh, Vince! Old Vincent is a rare bird. He runs a string of clinics, three in Harlem, one in Washington Heights, two in the South Bronx. A social benefactor, Dr. Robinson. He does well by doing good.”

  “These are Medicaid mills?”

  “We think so. Medicaid and Medicare.”

  “What’s the difference?”

  “You haven’t been listening. I’m hurt. To review, Medicaid is the federally funded program for people on welfare. Medicare is for the old, regardless of income. The federal government sets rates for particular payments for medical procedures and drugs in both cases, but with Medicaid the money is run through the state, and through city agencies with the state making a contribution. The paperwork is extremely complex. For example, you can have a health-service provider bill another provider for services, only some of which are Medicaid-eligible under Part Two—”

  “Snore,” said Karp. “Just the story on Robinson, please. What’s he up to?”

  “But all the fun is in the details!”

  “No, really, V.T. Tell me about Robinson.”

  “Well, since you insist, about a month ago the Southern District U.S. Attorney’s Office got an anonymous tip that Robinson’s clinics were dirty. They have a hotline for stuff like that. They did some preliminary screening and found discrepancies. Okay, no surprise there, the regs are so complicated that practically everyone in the program is in some kind of irregularity, but Robinson’s operation was big enough and funny enough to flash on the screen. Paul Menotti caught the case. You know him?”

  “By rep. A hard charger.”

  “To be sure. Anyway, Paul called me in, because of the state law violation, of course, but also because, though I blush to say it, if you want to find out where naughty money is flowing, I am The Man.”

  “And was there naughty money flowing?”

  “Mmm, that’s what we’re trying to determine. There’re a couple of different ways to defraud these programs. Most fraudulent docs just add on treatments they haven’t done and bill for them. An old lady comes in, they have some lackey slip her the happy pills, and then they bill for a full examination, with lab work. A little upscale from that is where they invent patients, which has the advantage that they don’t even have to have a real clinic, just a bunch of government patient numbers and a vivid medical imagination.”

  “Where do they get the numbers?”

  “Oh, from actual people, alive or dead. Mrs. Jones dies and they keep using her number for billing. Or Mrs. Jones wanders off to another provider, but she’s still, quote, getting her pills every week, unquote, and the feds’re paying. And then, finally, we have the whole lab and drug business, kickbacks to and from labs and pharmacies—the labs pad their billings and the clinics get a schmear off it. Or the clinic generates scrip for drugs, but the pharmacy doesn’t really supply them, and they get a cut of the billings. Or the pharmacy really does supply drugs, which the feds pay for, and then the drugs get sold on the street. The only limit is the human imagination.”

  “This is big money?”

  “Immense. A bonanza. Fifteen billion in Medicare-Medicaid money goes through New York City every year. Robinson’s clinics alone have over thirty million bucks’ worth of the pie. How much of that is skim, God only knows.”

  “Assuming God is an accountant.”

  “Of course God is an accountant. It’s the basis of all morality.”

  “You can’t get to him? Robinson, not God.”

  “Not yet. As I said, he’s a rare bird. Very smart, very smooth.”

  “You’ve met him?”

  “Yes, we’ve had several dates. It’s all a big misunderstanding. Dr. Robinson is a Park Avenue specialist. He maintains an interest in St. Nicholas Medical Centers, Inc., which is the holding company for the clinics, out of noblesse oblige: he has an investment in the corporation, and he gets a modest return in exchange for his medical advice and his Harvard degree. The board of the corporation and the management of the clinics are full of local fronts, of the correct ethnicity. We find any fraud, in other words, his tame Negroes and Hispanics take the fall.”

  “So what happened to the money he’s supposed to be skimming here?” Karp asked.

  “Ah, that’s the question,” said V.T., beaming. “And the answer? The answer is, we don’t know yet. We have to move somewhat gingerly with Robinson. He is heavily accoutered with legal counsel. What we do know is, one, he set up St. Nicholas, and two, St. Nicholas is dirty. It follows that he has his fingers in the money stream somehow, but …” V.T. shrugged elegantly. “What’s your interest in the doctor? Prostate acting up again?”

  Karp laughed. “Au contraire. If anything, it is I who will be jamming large irregular objects up Doctor Robinson’s rectum. Tell me, does Dr. R. strike you as the sort of man who might remove a close associate if that associate grew troublesome?”

  “ ‘Remove’? You mean the Big M?”

  Karp nodded. “Could be. His nurse slash girlfriend turned up dead this past September, in his bedroom, and Robinson went through a lot of trouble to distance himself from the death. The death itself is suspicious.”

  “Oh-ho,” said V.T. and was silent for a moment, playing with his lip. Then he said, “Well, since you ask, I’d have to give that a qualified yes. There is a shitload of money floating free here, and if someone was, say, threatening to tell us where it is, or trying to grab a piece of it, then, yes, I’d say Robinson could do the deed. As a moral being, Dr. Robinson is easily distinguishable from Dr. Schweitzer.”

  “It sounds like it,” said Karp. “We’re digging up the nurse for a full postmortem. If it shows anything nasty, we’ll get the doc in for a frank exchange of views.”

  “Speaking of which, why don’t you sit in with me and Menotti before that? It might give you some sense of a possible motive, or maybe you’ll pick up something we missed.”

  Motive again, thought Karp, his mind drifting involuntarily back to Rohbling. Greed seemed so simple compared to whatever impelled young Jonathan. He made a mental note: if Waley pleaded NGI, he would have the defendant examined by somebody he trusted more than the usual Bellevue hacks.

  He realized V.T. was staring at him. “Oh, sorry,” he said. “Had a thought. Yeah, good idea. I’d like to meet Menotti.”

  “Then come with me,” said V.T. “There’s a meeting to talk about warrants at one-thirty today.”

&n
bsp; Still strained with each other, but holding hands nevertheless, Marlene and her daughter walked with the big dog down Canal Street toward Tranh’s noodle shop.

  “Oh, no!” cried Lucy when they had come near enough to see the debris on the pavement, the police sawhorses set up as barriers, the yellow crime-scene tape. Tranh’s was a black vacancy in the row of shops, stinking of char and dripping with dirty water, from out of which presently emerged a stocky middle-aged man in a firefighter’s coat and helmet. He paused at the barrier to write on a clipboard. Marlene approached him.

  “Excuse me, I’m a friend of the man who ran this place. Do you know … did anything happen to him?”

  “Not as far as I know,” said the man. “Somebody lived back there behind the restaurant, but he must’ve got out.”

  “This was an arson, wasn’t it?”

  The officer’s face grew blank. “It’s a case under investigation.”

  “Yeah, right. Look, I used to be with the D.A. Here’s my card. I saw a serious altercation the other day between the owner and a bunch of punks who were trying to extort him. I can ID them anytime you want.”

  The investigator took the card and expressed his thanks. Then Lucy shouted, “Mr. Tranh!” and pointed across Canal Street, where, indeed, Mr. Tranh was emerging from the all-night Chinese movie theater. He was dressed in an army blanket, black trousers, and flip-flops, and carried a cheap Day-glo orange vinyl duffel bag. Marlene and Lucy dashed across the wide thoroughfare to him and deluged him with a babble of questions in Cantonese and French, while the dog sniffed suspiciously at Tranh’s blanket.

  Tranh responded to Marlene in the latter tongue. “Madame, I beg you, relieve yourself of any concern. I am perfectly well.”

  “But what happened, M. Tranh?”

  “I was visited in the early morning by arsonists. Interesting, because I had just made up my mind to purchase a grille for the window. This demonstrates the necessity of acting swiftly upon one’s instincts, does it not? In any case, they threw a stone through the glass, followed by a gasoline bomb. I am not a heavy sleeper, and so I was warned and was able to escape through the back door.”

  “My God! I didn’t realize you lived behind the restaurant. You must have lost everything.”

  “Yes. Everything, save for these trifles.” Tranh indicated the duffel bag with his toe. “I regret only my little library, some items of which had sentimental value. This is now the third time I have lost everything. One grows accustomed to it, I find: to having nothing.”

  “But where will you stay?” Marlene asked. “And you can’t go wandering around in a blanket. It is the autumn already. Have you got any cash?”

  “A little, thank you. And I am given to understand that there are facilities for the destitute—”

  “Ah, your compatriots of the Vietnamese community will provide for you?”

  “I fear not. The Vietnamese community and I are not in communion. No, I refer to the establishment of the city itself.”

  “The men’s hostels? Never! They are, you comprehend, a species of hell, full of robbers and those of degenerate tastes. I will not allow it. No, I have a suite of small rooms connected with my business. You will stay there until we can devise a better solution.”

  “Madame, I could not possibly impose upon you …”

  “Nonsense!” cried Marlene. “I insist. Are you not my friend?” she said. “And it is no imposition. In return, you can perform a valuable service for me perhaps. I operate a security business. I detect that you are not altogether lacking in useful skills associated with such work. Therefore, let us walk!” She took the man’s arm, whereupon he nodded in assent and lifted his bag.

  “Mom! What’re you talking about?” demanded Lucy, who was unused to being the one who was missing the story, at least in Chinatown.

  “Mr. Tranh is going to live behind my office,” said Marlene.

  “With Sym and Posie?” Lucy began to giggle.

  “We’ll work something out,” said Marlene, an interesting idea beginning to form in her mind.

  SEVEN

  Paul Menotti was a short, stocky, energetic man: a fireplug was the usual expression, which denoted not only his approximate shape but also carried the notion that in the event of a conflagration, he would be a good source of the wherewithal to extinguish it. Karp sat in a comfortable chair in Menotti’s office in the federal building off Foley Square reflecting, not for the first time, that the offices of those who pursued the violators of federal law were more stately than those occupied by mere state prosecutors. Menotti’s mahogany was bright, his brass shone, and his leather was thick and soft. He had a rug of some generalized colonial pattern on the floor and federally supplied artwork on the walls. He also had two windows opening on Foley Square.

  With Karp and Menotti in the room were V.T. Newbury and a slim young woman with light blue eyes and nice cheekbones. Her dark blond hair was neck-long and held back by a tortoiseshell clip, but it fell forward as she wrote on the pad she had on her lap, hiding her face. She had been introduced as Cynthia Doland, Menotti’s special assistant, with no indication of what was special about her and what she assisted in. Apparently, she was there to take meeting notes, since after the introductions she had kept mum.

  Menotti and V.T. were now engaged in a technical argument, clearly one of long standing, about how to draft a warrant against St. Nicholas Health Care so as to extract enough information to nail Dr. Robinson without at the same time putting him wise to the extent of their suspicions and (possibly) prompting him to crank up his shredder. V.T. was holding out for the incremental approach, the Death of a Thousand Cuts, as he called it—a small demand, followed by another and another, until there was enough cause to justify a major raid. Menotti wanted to seize everything at once.

  With no direct role in this argument, Karp was free to muse, and to examine the delightful line of Ms. Doland’s neck. She was wearing a scoop-necked dress, and as she bent over recording the ever changing proposed language of the warrant in question, Karp had a nice view of her small, pointed breasts, enclosed in a pale rose bra. Karp was as faithful as a chow, but he had no objection to observing what was in plain view, as allowed by the Fourth Amendment.

  Karp became aware that the discussion had ceased, that Menotti was looking at him, that Menotti knew where he had lately cast his eyes. A brief cloud crossed Menotti’s face; Karp sensed that his relationship with the tasty Ms. Doland was not entirely professional. Or perhaps it was; Karp had never been very great shakes at ferreting out the intimacies of the people he met in a business way. In any case, Menotti had asked him a question.

  “Well, it’s not my area,” Karp responded, “but if I had to choose, I’d go with V.T.’s slow and steady. I don’t want this guy spooked.”

  “Why not?”

  “Because your boy could be a killer as well as a fraud.” V.T. had briefly mentioned the affair of the dead nurse at the start of the meeting, and Menotti grunted in acknowledgment. Karp went on, “The point here is that if in fact he went to that extreme, he’s not going to cavil at trashing some records. Or somebody else.”

  They all thought about that for a while.

  Then V.T. said, “Just an idea. Is it at all possible that our anonymous tipster was this nurse?”

  Karp said, “Anything’s possible, but how the hell would we ever find out?”

  “They record all the calls on the hotline,” said Ms. Doland. They all looked at her. She blushed faintly and batted long-lashed eyes.

  “Check it out, would you, Cynthia?” said Menotti.

  The woman made a note on her pad.

  “I meant now, Cynthia.”

  She nodded and left the room. Since clearly no federal business could transpire without a note taker, the three men talked sports and politics in a desultory fashion until Cynthia Doland returned, about twenty minutes later, the time being punctuated by Menotti accepting several calls, during which he did a good deal of snarling and did not spare the obsc
enities.

  When Doland came back, she was carrying a Sony portable tape recorder.

  “You got it,” said Menotti. It was not a question.

  “They played it over the phone,” she said. “It’s fuzzy, but you can make out the type of voice.” She sat down and pushed the Play button.

  A voice said: “St. Nick’s is ripping you all off big time. That Dr. Robinson got his hand in deep. They got phony patients, they got phony treatments, and there’s something bad going on with the pharmacy, I don’t know what.”

  “Sounds black. Middle-aged, I’d say,” offered Menotti.

  Doland clicked off the recorder and seemed about to say something. They all looked at her, but she shook her head and blushed again.

  Then they all looked at Karp, who frowned and said, “Evelyn Longren was a twenty-eight-year-old white woman, so unless she was a pretty good mimic, that’s someone else.”

  “In any case, are you going to pursue this as a homicide?” Menotti asked.

  “Providing it’s a homicide I will,” said Karp. “They’re doing the full autopsy now. I’ll let you know when I know.”

  “I thought we weren’t going to do this,” said Karp, discontented in the bosom of his family. The twins had been efficiently bedded down by Posie, who was now watching the Mary Tyler Moore Show in the kitchen with Lucy, Lucy having done her homework with less row than usual. Butch and Marlene were in the living room of the loft discussing the new domestic arrangements.

  “Yes, that’s what I thought too,” said Marlene. “No live-in nannies for me. No, I was going to run a business, and take care of Lucy, and a set of twins, and continue to be married and have a relationship with a man, you. Did I leave anything out? Oh, yeah, prepare meals, and not just meals but good ones, with home-made sauces and noodles, and baking once a week. And go to church. And go to the bathroom. Well, here’s a flash: I can’t do it. I give up. I have to be able to sleep, and I can’t, and I have to be able to set my own hours and come and go more or less at will, and I can’t. And I need more time with Lucy. So that’s why Posie has to live in. We can leave the twins here in the morning now. We don’t have to schlep them down the stairs and then up the stairs to my office. We can work on weekends without having to break off every ten minutes.”