It was a 95-degree day in July 2015, and emergency physician Martin Maag, MD, was driving down Bee Ridge Road, a busy 7-lane thoroughfare in Sarasota, Florida, on his way home from a family dinner. To distance himself from a truck blowing black smoke, Maag says he had just passed some vehicles, when a motorcycle flew past him in the turning lane and the passenger flipped him off.
“I started laughing because I knew we were coming up to a red light,” said Maag. “When we pulled up to the light, I put my window down and said, ‘Hey, you ought to be a little more careful about who you’re flipping off! You never know who it might be and what they might do.’ ”
The female passenger cursed at Maag, and the two traded profanities. The male driver then told Maag, “Get out of the car, old man,” according to Maag. Fuming, Maag got out of his black Tesla, and the two men met in the middle of the street.
Dr Martin Maag
“As soon as I got close enough to see him, I could tell he really looked young,” Maag recalls. “I said, ‘You’re like 12 years old. I’m going to end up beating your ass and then I’m going to go to jail. Go get on your bike, and ride home to your mom.’ I don’t remember what he said to me, but I spun around and said, ‘If you want to act like a man, meet me up the street in a parking lot and let’s have at it like men.’ ”
The motorcyclist got back on his white Suzuki and sped off, and Maag followed. Both vehicles went racing down the road, swerving between cars, and reaching speeds of 100 miles per hour, Maag says. At one point, Maag says he drove in front of the motorcyclist to slow him down, and the motorcycle clipped the back of his car. No one was seriously hurt, but soon Maag was in the back of a police cruiser headed to jail.
Maag wishes he could take back his actions that summer day 6 years ago. Those few minutes of fury have had lasting effects on the doctor’s life. The incident resulted in criminal charges, a jail sentence, thousands of dollars in legal fees, and a 3-year departure from emergency medicine. Although Maag did not lose his medical license as a result of the incident, the physician’s Medicare billing privileges were suspended because of a federal provision that ties some felonies to enrollment revocations.
Maag, 61, shared his story with Medscape to warn other physicians about the wide-ranging career ramifications that can happen as a result of offenses unrelated to medicine.
“Every doctor, every health professional needs to know that there are a lot of consequences that go with our actions outside of work,” he said. “In my situation, what happened had nothing to do with medicine, it had nothing to do with patients, it had nothing to do my professional demeanor. But yet it affected my entire career, and I lost the ability to practice emergency medicine for three years. Three years for any doctor is a long time. Three years for emergency medicine is a lifetime.”
The Physician Ends Up in Jail
After the collision, Maag pulled over in a parking lot and dialed 911. Several passing motorists did the same. It appeared the biker was trying to get away, and Maag was concerned about the damage to his Tesla, he said.
When police arrived, they heard very different accounts of what happened. The motorcyclist and his girlfriend claimed Maag was the aggressor during the altercation, and that he deliberately tried to hit them with his vehicle. Two witnesses at the scene said they had watched Maag pursue the motorcycle in his vehicle, and that they believed he crossed into their lane intentionally to strike the motorcycle, according to police reports.
“[The motorcyclist] stated that the vehicle struck his right foot when it hit the motorcycle and that he was able to keep his balance and not lay the bike down,” Sarasota County Deputy C. Moore wrote in his report “…The motorcycle was damaged on the right side near [his] foot, verifying his story. Both victims were adamant that the defendant actually and intentionally struck the motorcycle with his car due to the previous altercation.”
Maag told officers the motorcyclist had initiated the confrontation. He acknowledged racing after the biker, but said it was the motorcyclist who hit his vehicle. In an interview with Medscape, Maag disputed the witnesses’ accounts, saying that one of the witnesses was without a car and made claims to police that were impossible from her distance.
In the end, the officer believed the motorcyclist, writing in his report that the damage to the Tesla was consistent with the biker’s version of events. Maag was handcuffed and taken to the Sarasota County Jail.
“I was in shock,” he said. “When we got to the jail, they got me booked in and fingerprinted. I sat down and said [to an officer], ‘So, when do I get to bond out?’ The guy started laughing and said, ‘You’re not going anywhere. You’re spending the night in jail, my friend.’ He said, ‘Your charge is one step below murder.’ ”
“I Like to Drive Fast”
Aside from speeding tickets, Maag said he had never been in serious trouble with the law before.
The husband and father of two has practiced emergency medicine for more 15 years, and his license has remained in good standing. Florida Department of Health records show Maag’s medical license as clear and active with no discipline cases or public complaints on file.
“I did my best for every patient that came through that door,” he says. “There were a lot of people who didn’t like my personality. I’ve said many times, ‘I’m not here to be liked. I’m here to take care of people and provide the best care possible.’ ”
Sarasota County records show that Maag has received traffic citations in the past for careless driving, unlawful speed, and failure to stop at a red light, among others. He admits to having a “lead foot,” but says he had never before been involved in a road rage incident.
“I’m not going to lie, I like to drive fast,” he said. “I like that feeling. It just seems to slow everything down for me, the faster I’m going.”
After being booked into jail that July evening in 2015, Maag called his wife to explain what happened.
“She said, ‘I can’t believe you’ve done this. I’ve told you a million times, don’t worry about how other people drive. Keep your mouth shut,’ ” he recalled. “I asked her to call my work and let them know I wouldn’t be coming in the next day. Until that happened, I had never missed a day of work since becoming a physician.”
After an anxious night in his jail cell, Maag lined up with the other inmates the next morning for his bond hearing. His charges included felony aggravated battery and felony aggravated assault with a deadly weapon. A prosecutor recommended Maag’s bond be set at $1 million, which a judge lowered to $500,000.
Michael Fayard, a criminal defense attorney who represented Maag in the case, said even with the reduction, $500,000 was an outrageous bond for such a case.
“The prosecutor’s arguments to the judge were that he was a physician driving a Tesla,” Fayard said. “That was his exact argument for charging him a higher bond. It shouldn’t have been that high. I argued he was not a flight risk. He didn’t even have a passport.”
The Florida State Attorney’s Office did not return messages seeking comment about the case.
Maag spent two more nights in jail while he and his wife came up with $50,000 in cash, in accordance with the 10% bond rule. In the meantime, the government put a lien on their house. A circuit court judge later agreed the bond was excessive, according to Fayard, but by that time, the $50,000 was paid and Maag was released.
New Evidence Lowers Charges
Maag ultimately accepted a plea deal from the prosecutor’s office and pled no contest to one count of felony criminal mischief and one count of misdemeanor reckless driving. In return, the state dropped the two more serious felonies. A no contest plea is not considered an admission of guilt.
Fayard said his investigation into the road rage victim unearthed evidence that poked holes in the motorcyclist’s credibility, and that contributed to the plea offer.
“We found tons of evidence about the kid being a hot-rodding rider on his motorcycle, videos of him traveling 140 miles an hour, popping wheelies, and darting in and out of traffic,” he said. “There was a lot of mitigation that came up during the course of the investigation.”
The plea deal was a favorable result for Maag considering his original charges, Fayard said. He added that the criminal case could have ended much differently.
“Given the facts of this case and given the fact that there were no serious injuries, we supported the state’s decision to accept our mitigation and come out with the sentence that they did,” Fayard said. “If there would have been injuries, the outcome would have likely been much worse for Dr Maag.”
With the plea agreement reached, Maag faced his next consequence — jail time. He was sentenced to 60 days in jail, a $1000 fine, 12 months of probation, and 8 months of house arrest. Unlike his first jail stay, Maag said the second, longer stint behind bars was more relaxing.
“It was the first time since I had become an emergency physician that I remember my dreams,” he recalled. “I had nothing to worry about, nothing to do. All I had to do was get up and eat. Every now and then, I would mop the floors because I’m kind of a clean freak, and I would talk to guys and that was it. It wasn’t bad at all.”
Maag told no one that he was a doctor because he didn’t want to be treated differently. The anonymity led to interesting tidbits from other inmates about the best pill mills in the area for example, how to make crack cocaine, and selling items for drugs. On his last day in jail, the other inmates learned from his discharge paperwork that Maag was a physician.
“One of the corrections officers said, ‘You’re a doctor? We’ve never had a doctor in here before!’ ” Maag remembers. “He said, ‘What did a doctor do to get into jail?’ ” I said, ‘Do you really want to know?’ ”
About the time that Maag was released from jail, the Florida Board of Medicine learned of his charges and began reviewing his case. Fayard presented the same facts to the board and argued for Maag to keep his license, emphasizing the offenses in which he was convicted were significantly less severe than the original felonies charged. The board agreed to dismiss the case.
“The probable cause panel for the board of medicine considered the complaint that has been filed against your client in the above referenced case,” Peter Delia, then-assistant general counsel for the Florida Department of Health, wrote in a letter dated April 27, 2016. “After careful review of all information and evidence obtained in this case, the panel determined that probable cause of a violation does not exist and directed this case to be closed.”
A Short-Lived Celebration
Once home, Maag was on house arrest, but he was granted permission to travel for work. He continued to practice emergency medicine. After several months, authorities dropped the house arrest, and a judge canceled his probation early. It appeared the road rage incident was finally behind him.
But a year later, in 2018, the doctor received a letter from the Centers for Medicare & Medicaid Services (CMS) informing him that because of his charges, his Medicare number had been revoked in November 2015.
“It took them three years to find me and tell me, even though I never moved,” he said. “Medicare said because I never reported this, they were hitting me up with falsification of documentation because I had signed other Medicare paperwork saying I had never been barred from Medicare, because I didn’t know that I was.”
Maag hired a different attorney to help him fight the 3-year enrollment ban. He requested reconsideration from CMS, but a hearing officer in October 2017 upheld the revocation. Because his privileges had been revoked in 2015, Maag’s practice group had to return all money billed by Maag to Medicare over the 3-year period, which totaled about $190,000.
A CMS spokeswoman declined to comment about Maag’s case, referring a Medscape reporter to an administrative law judge’s decision that summarizes the agency’s findings.
According to the summary, in separate reconsidered determinations, the CMS hearing officer concluded that the revocation was proper under section 424.535(a)(3). The regulation, enacted in 2011, allows CMS to revoke billing privileges if a provider was convicted of a federal or state felony within the preceding 10 years that the agency determines is detrimental to the Medicare program and its beneficiaries.
The hearing officer reasoned that Maag “had been convicted of a felony that is akin to assault and, even if it were not, his actions showed a reckless disregard for the safety of others.” She concluded also that CMS could appropriately revoke Maag’s Medicare enrollment because he did not report his felony conviction within 30 days as required.
Maag went through several phases of fighting the revocation, including an appeal to the US Department of Health and Human Services Departmental Appeals Board. He argued that his plea was a no-contest plea, which is not considered an admission of guilt. Maag and his attorney provided CMS a 15-page paper about his background, education, career accomplishments, and patient care history. They emphasized that Maag had never harmed or threatened a patient, and that his offense had nothing to do with his practice.
This past February, Judge Carolyn Cozad Hughes, an administrative law judge with CMS, upheld the 3-year revocation. In her decision, she wrote that for purposes of revocation under CMS law, “convicted” means that a judgement of conviction has been entered by a federal, state, or local court regardless of whether the judgement of conviction has been expunged or otherwise removed. She disagreed with Maag’s contention that his was a crime against property and, therefore, not akin to any of the felony offenses enumerated under the revocation section, which are crimes against persons.
“Even disregarding the allegations contained in the probable cause affidavit, Petitioner cannot escape the undisputed fact, established by his conviction and his own admissions, that the ‘property’ he so ‘willfully and maliciously’ damaged was a motorcycle traveling at a high rate of speed, and, that two young people were sitting atop that motorcycle,” Hughes wrote. “Moreover, as part of the same conduct, he was charged — and convicted — of misdemeanor reckless driving with ‘willful and wanton disregard for the safety of persons or property.’ Thus, even accepting Petitioner’s description of the events, he unquestionably showed no regard for the safety of the young people on that motorcycle.”
Hughes noted that although Maag’s crimes may not be among those specified in the regulation, CMS has broad authority to determine which felonies are detrimental to the best interests of the program and its beneficiaries.
A New Career Path
Unable to practice emergency medicine and beset with debt, Maag spiraled into a dark depression. His family had to start using retirement money that he was saving for the future care of his son, who has autism.
“I was suicidal,” he said. “There were two times that I came very close to going out to the woods by my house and hanging myself. All I wanted was to have everything go away. My wife saved my life.”
Slowly, Maag climbed out of the despondency and began considering new career options. After working and training briefly in hair restoration, Maag became a hair transplant specialist and opened his own hair restoration practice. It was a way to practice and help patients without having to accept Medicare. Today, he is the founder of Honest Hair Restoration in Bradenton.
Hair restoration is not the type of medicine that he “was designed to do,” Maag said, but he has embraced its advantages, such as learning about the business aspects of medicine and having a slower-paced work life. The business, which opened in 2019, is doing well and growing steadily.
Earlier this month, Maag learned CMS had reinstated his Medicare billing privileges. If an opportunity arises to go back into emergency medicine or urgent care, he is open to the possibilities, he said, but he plans to continue hair restoration for now. He hopes the lessons learned from his road rage incident may help others in similar circumstances.
“If I could go back to that very moment, I would’ve just kept my window up and I wouldn’t have said anything,” Maag said. “I would’ve kept my mouth shut and gone on about my day. Would I have loved it to have never happened? Yeah, and I’d probably be starting my retirement now. Am I stronger now? Well, I’m probably a hell of a lot wiser. But when all is said and done, I don’t want anybody feeling sorry for me. It was all my doing and I have to live with the consequences.”
Fayard, the attorney, says the case is a cautionary tale for doctors.
“No one is really above the law,” he said. “There aren’t two legal systems. You can’t just pay a little money and be done. At every level, serious charges have serious ramifications for everyone involved. Law enforcement and judges are not going to care of you’re a physician and you commit a crime. But physicians have a lot more on the line than many others. They can lose their ability to practice.”
Alicia Gallegos is a reporter for Medscape Business of Medicine based in the Midwest. She has previously written for the American Medical News, the ACP Internist, and the AAMC Reporter. Contact Alicia at [email protected] or via Twitter at @Legal_med
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