A South Pasadena doctor is being accused of forcing patients to pay the full price for her medical services and using extreme measures in doing so, according to the Attorney General's office.
is being accused of using agressive tactics to receive payments from patients, from filing lawsuits, to taking out liens on patient's homes, the Los Angeles Times reported Friday.
Martello's use of aggressive tactics to collect fees from emergency room patients like Buck — including lawsuits, taking out liens on their homes and damaging their credit — prompted an unprecedented court case by state health officials and a judge's order for Martello to cease the practices.
The state's lawsuit against Martello, however, is the first of its kind, according to Marta Green, California Department of Managed Health Care spokeswoman.
Andrew Selesnick, attorney for Martello, insists his client has done nothing illegal in her pursuit of being adequately reimbursed.
“It's absolutely unconscionable what she did,” said Hauser, 57, a high school biology teacher. She and her insured daughter Margo Thornhill were sued by Martello in 2010 after she stitched up Thornhill's head in late 2009 following a fall. Although court records indicate Martello did not obtain anything beyond the out-of pocket costs Hauser had already agreed she was liable for under her insurance policy, she still placed numerous liens on Hauser's home and against her daughter. Martello did not respond to repeated telephonic, written and in-person requests for comment for this article through her attorney, Kevin Warren of Encino. Martello's sole communication with this publication came on March 19, when she called after it had posted a brief story about her activities on its website. “Where can I serve you papers?” she asked. Martello files most of her suits at the Pasadena Courthouse, according to records. Employees there said she and her assistant Jorge Garcia have been fixtures, with both appearing in blue medical scrubs and often making multiple filings at a time. They noted that Martello made such a habit of appearing late in the afternoon she was finally asked to show up no later than 4 p.m. so the clerk's office could close on time.
“They should cancel her privileges immediately,” said Jamie Court, president of Consumer Watchdog, an advocacy group that often assists in patient complaints. He termed Martello's conduct “extreme.” In light of her credentials, which also include residencies at Massachusetts General Hospital and the University of Kentucky Medical Center, Martello's behavior raises many questions about what may have driven her to such lengths. Such tactics appear in conflict for someone who not only specializes in digital reattachments – one of medicine's biggest challenges – but assisted on the first successful hand transplant performed in the United States in the late 1990s. It also appears to run counter to an individual who made a significant effort to join the ranks of Sanjay Gupta, Drew Pinsky and other celebrity physicians.
And Martello's conduct tends to dovetail with a growing trend of hospitals and their representatives using get-tough tactics with patients. The Minnesota Attorney General recently sued Chicago-based Accretive Health for planting its employees in the hospitals of Fairview Health System and sometimes refusing care prior to collecting payment. Carolinas Medical Center-Mercy in Charlotte, N.C. has sued more than 12,000 of its patients over the past five years, sometimes for nominal sums. However, observers say corporate culture tends to drive such institutional actions. In the Accretive case, employees were relentlessly pressured to collect. By comparison, an individual going to such lengths against their own patients is singular.
Physicians. Lopez-Guzman's organization does not represent surgical specialists such as Martello, but is well acquainted with the issues surrounding the delivery of emergency room healthcare. “Except for all her other cases, I've never seen anything like it,” said attorney David Cohen, who represents Buck and his wife Jae. He has been practicing law for nearly 25 years. Insured, Yet Not Indemnified The low-key Cohen practices in a modest Woodland Hills office filled with guitars and hockey sticks. He specializes in entertainment law, but he took on the case of Buck and his wife because they are personal acquaintances with clients of his law partner. The Bucks are now in the second year of their legal grapple with Martello. Bill and Jae Buck own Plumbridge Custom Cabinets. Its website features glitzy pictures of the high-end kitchens their company has outfitted over the years. However glamorous the end product, the Bucks, like most craftspeople, have an uneasy relationship with high-powered tools that can maim them if they make the slightest slip.
According to Martello's notes, she was brought in to consult on Bill Buck's injury by the attending physician, Selina Barba-Simic, M.D. The Bucks sensed something odd about Martello immediately. “She started telling us she was on the first team of hand transplant surgeons,” Bill Buck recalled, one of several patients who observed that Martello usually began a consultation by discussing herself. “Anyway, she walks out of the room, and my wife and I look at each other, and said, "What the hell was that?" If you're good, you don't need to brag.”
Martello operated on Buck the following day after making sure he was properly hydrated (“he was dry as a potato chip,” her notes remarked). She then submitted a bill to Anthem for $15,130. As per Anthem's guidelines, Martello was entitled to $2,502.50, about 17% of her charges. Anthem disallowed $2,630 of Martello's charges because they were not properly coded. The Bucks" PPO Share policy had a deductible of $2,500.
County Superior Court in Pasadena, seeking a sum nearly six times what she was legally entitled to. Thirty-nine days later, she returned the $2,502.50 to Anthem in the form of a cashier's check. Bill Buck chose to represent himself and his wife. He got the lawsuit against himself and his company dismissed. However, because of the way he filed his paperwork at the courthouse, Martello was able to obtain a default judgment against Jae Buck for $14,214.20. Martello then filed an order to get the Bucks" South Pasadena condominium sold. In the filing, she claimed that Jae Buck had been abusive toward her and that at one point Bill Buck had been the subject of a restraining order. Both Bucks say neither is the case. That is when the Bucks retained Cohen. He was able to get the default judgment against Jae Buck vacated, but Martello is appealing that ruling.
. Paid Anyway Bill Buck, like most other patients interviewed, received care at Huntington Memorial Hospital. And it is likely Martello was well compensated by Huntington on the day she was called in to treat him. Huntington spokesperson Andrea Stradling confirmed that at the time of Buck's injury, Martello had a contract with the hospital to provide on-call emergency services as a specialist in plastic surgery. Huntington would not disclose the terms of its contract, but industry observers say such pacts must be generous in order to get needed specialists into the ER. “The stipend will go as low as $200 to $300 a shift, but a specialist surgeon can get as much as $4,000 for a shift,” said Jim Lott, executive vice president of the Hospital Association of Southern California. The hospital will also pay such a specialist 120% to 125% of Medicare rates for any uninsured patients they treat, he added.
Stradling said Martello did not receive the level of compensation discussed by Lott or Jain, but declined to elaborate. In addition to receiving payment by Huntington, Martello could have also availed herself of the Maddy Fund for any uninsured patients she treated, according to Gusman-Lopez of Cal-ACEP. It provides compensation from the state to providers who work in hospital emergency rooms, although healthcare experts say it pays only nominal sums. Huntington “terminated” Martello's emergency services contract on June 30, 2011, according to an e-mail response from Stradling to questions posed by Payers & Providers. She declined to provide a reason why, although at least two patients had complained about her conduct to hospital officials. Practicing Law No Deterrent “Your actions have been intentionally and maliciously geared toward causing us distress and anxiety as a bargaining tool. I will not stand for it
On October 31, 2009, Meserkhani's young adult daughter Sarinea was seriously injured in a traffic accident. She was immediately admitted to Huntington's intensive care nit, where she spent the next four days. Martello billed the Meserkhanis $2,900. Among the charges was $750 for “social work/phone calls to locate family for (1.5) hours.” Typically that kind of work is performed by a nurse, social worker or discharge planner, according to Lott of the Hospital Association. In an interview and in a sworn statement, Seroj Meserkhani maintained Martello never treated Sarinea. “I am certain she provided no medical assistance or professional services to my daughter,” he said. “I don' remember seeing her there, nor dealing with her. I've seen volumes of records from the hospital, and her name doesn't come up anywhere. (Sarinea) certainly didn't need a plastic surgeon. All of her injuries were internal, under the bones.” The Meserkhani family had insurance with Health Net. A medical group that handles some claims processing for the plan paid Martello $133. As was the case with the Bucks, Martello returned the money.
Meserkhani performed his own legal research, found the Prospect Medical Group case and other legal reasons why he did not need to pay her. He cited them to Martello in correspondence. “Your statement that “(we) have to depend on our insurance carrier to depend on our healthcare services falls on deaf ears,” Martello replied. She later ended the exchange with a statement other patients say she used: “See you in court.” On May 6, 2011, Martello sued Seroj and his wife Sylvia in Pasadena Superior Court, alleging fraud. She also sought punitive damages, which are rarely awarded in a contract dispute. The Merserkhanis and many of Martello's other defendants have had a recent ally join their court battles: The Department of Managed Health Care. Stepping In
Occasionally an individual physician will balance bill a patient, according to DMHC spokesperson Marta Bortner. Almost always the doctor stops doing so immediately if the agency contacts them. Martello did not. That prompted the DMHC to issue a cease and desist order against her on December 30, 2010. It finalized the order in March 2011 after Martello did not respond. Court records show Martello had been properly served with the order. The DMHC has issued more than 1,500 enforcement actions over the last decade. Virtually every one against an individual has been for their engaging in deceptive business practices to enroll Medicare enrollees into health plans. Martello is the only individual provider ever to be subject to such an action, according to Bortner.
On May 24, the DMHC obtained a preliminary injunction barring Martello from balance billing patients whose health plans are regulated by the agency. Harassment Alleged Meanwhile, the DMHC's voluminous court filings indicate the Bucks and the Meserkhanis had relatively mild encounters with Martello. Julia Sipos was treated by Martello at St. Joseph Medical Center in Burbank on November 14, 2009 after falling at home, breaking her nose and severely lacerating her upper lip. Although Sipos was insured by Cigna, Martello sought more than $8,800 from her. Cigna directly ordered Martello to stop billing Sipos. According to court records, Sipos" medical group, Lakeside Community Healthcare, offered to boost its initial payment of $1,431.51 by 65% to placate Martello
filed nearly two months after the DMHC order went into effect. “Before and after suing me, Dr. Martello and her agents…have harassed and threatened me by phone, mail and e-mail at my phone and work," Julia Sipos said in a sworn declaration taken by the DMHC in February. Julia Sipos also stated that Martello and her assistant “wrote me falsely representing that Cigna had no record of any insurance claim for me…they have made threats to (her and her sister's) to our credit reputations…the constant phone calls to me at my former workplace resulted in my being reprimanded by my manager.” Julia Sipos referred Payers & Providers to her sister Mary Beth, a partner with the firm Haight, Brown and Bonesteel in San Diego, for comment. She did not respond to phone calls or e-mails.
What prompted Martello – who along with her law degree possesses undergraduate and master's degrees from Stanford University and a medical degree from UCLA – is a mystery. One possibility lies in her work as an on-call ER specialist. Such physicians have long grumbled about not being properly compensated, industry observers say. By comparison, most plastic surgeons who run an office-based practice receive full payments in cash from their patients. “The more specialized the care, the more difficult it is to find someone willing to work with patients,” said Lopez-Gusman. Although insurers offered to pay Martello a fraction of her full charges, Lopez-Gusman said the issue is particularly acute regarding Medi-Cal rates, which are even lower than what commercial plans pay. “We have heard that specialists don't want to show up,” said Court of Consumer Watchdog. “They tend not to get paid enough, and they don't want to be woken up, which is another type of problem. She at least shows up, but not in the way patients need.” Martello's career mix of practicing plastic surgery while seeking media prominence are often traits seen in a difficult clinician, Court noted.
For years prior to becoming litigious, Martello tried to make herself and her professional company, Skin Deep, into household names. A decade ago, Martello hosted a radio show called “Skin Deep” that was carried in Southern California on the radio station KLSX on Saturday mornings, according to media publications from that period. Records from an arbitration case said the show had been syndicated in two dozen other markets. It no longer airs.
Essentials,” it bore the tagline “Surgery Can Wait.” In a promotional video, Martello said the products were intended as a low-cost alternative to plastic surgery. “Not everyone can afford to go under the knife,” she said. Sales may have been slow – Walgreen's print ads from a variety of newspapers in 2007 showed the Skin Deep products being sold at discounts. It is no longer available through the chain. A Walgreen's spokesperson did not respond to requests about when Martello's line was introduced or dropped. It may still be purchased via online resellers for a fraction of the original retail price. Perhaps most ambitiously, Martello launched a national consumer magazine on plastic surgery issues that was also called Skin Deep. Its 2005 launch party in New York City featured model Carol Alt and a passel of physicians who were to contribute articles. Skin Deep published a handful of issues before apparently ceasing publication sometime in 2007,archived pages from its website suggest In addition to the radio, retail and publishing ventures, Martello made numerous appearances on television news and talk shows hosted by Rachael Ray, Bill O'Reilly, Leeza Gibbons and others
After Martello and Skin Deep were off the air, out of print and no longer in stores, the volume of lawsuits bearing her name increased from a trickle to a flood. Small Claims Court Although Martello usually prevails on the Superior Court level only if the defendant does not mount a legal challenge, she has won many cases in Small Claims Court, where most matters involving less than $10,000 under dispute are litigated. However, it's a legal venue where representation by an attorney is not permitted. Presumably, most defendants are unaware their best defense lies within the California Health and Safety Code and an obscure state Supreme Court decision. That's also assuming Martello's defendants in that venue actually had health insurance. Court records and interviews suggest some did not.
“When I told her I didn't have coverage, she went totally nuts,” said Gustavo Landgrebe. “Of course, I offered to pay. I wanted to pay her, $300, $400 a month. I'm not that kind of person who doesn't pay a bill.” Amputation Preferable Joseph Benincasa went through a similar experience in the spring of 2007 after he injured his left ring finger as the result of a motorcycle accident on the 110 Freeway. A student at Southwestern Law School at the time, Benincasa lacked insurance. He went to the Huntington ER for treatment. “I remember her telling me she was this preeminent hand specialist and that I needed surgery,” recalled Benincasa, now a criminal law attorney in Los Angeles. “I let her know that I didn't have insurance, and that this was not something I could pay for right away, and if that wasn't going to work, she should just stitch it up. She said we could work something out.” While Benincasa was undergoing physical therapy under Martello's care, he claimed she asked him to apply for a medical credit card. He said he balked when he saw the terms: A $700 fee upfront – about 15% of the sum he owed her – plus a 24% annual interest rate.
Court records indicate that Martello filed suit against Benincasa on April 3, 2007, just a few weeks after she began treating him. She won a judgment for $4,750 plus costs of $70. The following month, Benincasa was ordered by the court to repay Martello at the rate of $350 a month – less than the $500 a month he said he offered to pay Martello on his own. But as Benincasa completed the paydown of the debt to Martello, he was in for an unpleasant surprise. The last installment owed was less than $350. Benincasa wrote and called Martello so the two could agree on the specific amount for the final payment. She never responded, according to both Benincasa and court records. She also did not cash the final check he did send, he claimed. Instead, Martello filed a lien on Benincasa's Mid-City Los Angeles home for $396.97, records show. His wife Sarah was holding their then infant son in her arms when the Sheriff's deputy pounded on the front door and served the writ, she said." “She was so ferocious about this that I thought Joe had made a mistake somewhere,” Sarah Benincasa said. “I was wrong.”
“If I could go back, I would just have had my finger cut off,” Benincasa said. Benincasa eventually paid off most of the $20,000 in medical bills related to the accident, but said no one else hassled him regarding repayment.
Steve Avina, the finance firm sales employee, suffered a concussion and facial lacerations when he was jumped outside a Pasadena nightclub on the evening of June 8, 2008. Having been administered morphine for his pain, he doesn't remember signing Martello's financial liability form. However, he clearly recalled Martello saying she had made television appearances commenting on the fateful plastic surgery decisions of Kanye West's mother. Unlike Landgrebe and Benincasa, Avina had and still maintains HMO coverage with Blue Shield of California through his employer. Some weeks after Martello treated him, Avina said he received a phone call from what was supposedly Martello's receptionist, seeking about $1,400. “She told me that my insurance company doesn't pay anything, and that I had signed a promise to pay. I told her that you're barking up the wrong tree,” Avina recalled. The caller replied, “see you in court,” Avina said, and hung up. Avina said it was the only collection attempt made before Martello sued him in Small Claims Court on Sept. 3, 2008. As he was still trying to recover from his injuries, was embroiled with the criminal investigation of his assault and could not take time off from work, he did not appear. She won a default judgment of $1,448.78, and garnisheed 20% of his paycheck until it was paid off.
Years later, Martello's litigation still had an impact: Avina had to produce mountains of paperwork to guarantee a mortgage lender that the judgment had been satisfied. “If you get denied credit, you're treated like a nobody,” Avina said. One other small claims court case further highlights Martello's use of the legal system. That case was filed in January 2011 at the Pasadena courthouse against a Mechelle Jones, a Medi-Cal enrollee whose son was treated by Martello at Huntington in 2009. The court concluded that the defendant did not owe anything on the claim. It was a rare instance in Small Claims court where Martello was defeated. Jones, a hair stylist who lives in Long Beach, did not return phone calls seeking comment. Martello was undaunted by the setback. She filed a successful motion to remove the trial judge Jan Pluim (legal experts say judges rarely resist such challenges). Pluim had granted a motion against Martello in a 2007 Superior Court case that led to its dismissal. In Martello's seven-page affidavit of prejudice, she claimed Pluim had violated her constitutional right to earn a living, among other accusations.
The new judge denied Martello's motion for a retrial, records show. He cited the section of the Code of Civil Procedure that explicitly bars a small claims plaintiff from appealing an adverse decision. The End Game How much longer Martello will be permitted to practice medicine remains to be seen. In August 2011, the Medical Board of California moved to revoke her license, alleging incompetence. In its complaint it cited a breast augmentation procedure Martello performed in 2007 with the wrong-sized implants. The procedure cut off the blood supply to the patient's chest, leading to the loss of skin and flesh and the eventual exposure of one of the implants, the complaint alleged. Martello removed only one of the implants when the patient complained, according to the Medical Board. In March, the Medical Board amended its complaint to add charges of unprofessional conduct – specifically Martello's balance billing and suing of patients. A hearing on the case is scheduled in October, according to Medical Board spokesperson Dan Wood. Ironically, Martello's worked in the past with the Medical Board, serving as a consultant to enforcement division's probation unit
Meanwhile, the former television and radio staple is keeping a decidedly lower profile. Martello's websites only open to blank pages. Her office phone lines are disconnected, and her practice, housed in a weathered bungalow among a mix of private residences and converted medical offices hard by the Gold Line train, was deserted on a midweek in late April. “It's been pretty dead there,” a neighbor observed. Even the courthouse employees noted that Martello has not been making her regular appearances; records indicate she stopped filing lawsuits after the Medical Board lodged its initial complaint last summer. She also did not show for a recent hearing involving the DMHC case. “Her filings are slowing down,” an employee said. Two people interviewed for this article said they believe Martello took the California Bar exam in February. A State Bar spokesperson declined to confirm if she did so. Her name was not on the pass list released by the Bar earlier this month
Stephen Glass, the former journalist who penned dozens of fabricated articles that appeared in the New Republic in the 1990s, has been fighting a decade-long battle to gain admission to the California Bar after earning a law degree from Georgetown University. His fabulist past sparked some public outrage and damaged the New Republic's reputation, but did not traumatize already injured individuals or damage their credit. Martello would have her work cut out for her for just one of the many personal disclosures Bar applicants have to make: All the lawsuits they have been party to in California. Each case has to be individually detailed, including case number, disposition and other facts. For this section alone, Martello's testimony would run more than 100 pages. As for Martello's patients, those who are no longer legally entangled with her have tried to put the incidents behind them. The Benincasas are focused on their family. Landgrebe has been building business at his restaurant. Avina and his children recently moved into the home he bought in Cudahy with his girlfriend
“I don't sign anything anymore,” Avina said.