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American Board of Internal Medicine (ABIM) Tax Discrepancies Evidence Packet Westby G. Fisher, MD Director, Cardiac Electrophysiology NorthShore University HealthSystem Clinical Associate Professor of Medicine Pritzker School of Medicine, University of Chicago Blog: ”Dr. Wes” http://drwes.blogspot.com Twitter: @doctorwes

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Page 1: American Board of Internal Medicine (ABIM) · BMW 7-series Town Car Concierge Service ABIM Foundation’s $2.3 million ... * Reference: ABIM FY2016 IRS Form 990 ** Medscape Internist

AmericanBoardofInternalMedicine(ABIM)TaxDiscrepanciesEvidencePacket

WestbyG.Fisher,MDDirector,CardiacElectrophysiologyNorthShore UniversityHealthSystem

ClinicalAssociateProfessorofMedicinePritzkerSchoolofMedicine,UniversityofChicago

Blog:”Dr.Wes”http://drwes.blogspot.comTwitter:@doctorwes

Page 2: American Board of Internal Medicine (ABIM) · BMW 7-series Town Car Concierge Service ABIM Foundation’s $2.3 million ... * Reference: ABIM FY2016 IRS Form 990 ** Medscape Internist

• The American Board of Internal Medicine (ABIM) is a private corporation exempt fromfederal income tax under section 501(c)(3) according to Title 26 of the United StatesCode.

• The ABIM was founded in 1936 in Des Moines, Iowa (domicile state) and has its homeoffice at 510 Walnut Street, Suite 1700, Philadelphia, PA 19106-3699.

• The ABIM receives over 97% of its revenue from practicing physicians and receives noindustry funding.

• The ABIM confers its “certification” to nearly one quarter of all U.S. physiciansintended to denote a level of competency above and beyond a state’s medical license.

• The ABIM is the largest of 24 subsidiary member-boards of the American Board ofMedical Specialties (ABMS), a 501(c)(6) Business League

• The ABIM operates on a July-June fiscal year.

BACKGROUND:

Page 3: American Board of Internal Medicine (ABIM) · BMW 7-series Town Car Concierge Service ABIM Foundation’s $2.3 million ... * Reference: ABIM FY2016 IRS Form 990 ** Medscape Internist

• From 1936 through 1986, the ABIM issued life-time certificationto its physician diplomates that passed their examinationrequirement.• After 1990, ABIM changed its policy: lifetime certification was nolonger recognized as valid by the ABMS and its 24-member boards(including the ABIM) and only issued time-limited certificatesafter 1990. Repeat testing, later trademarked as “Maintenance ofCertification® (MOC®) by the ABMS) was required every 10 yearsor a physician’s initial certification would be rendered invalid.• Older physicians certified before 1990 were exempted from thisrule change and did not have to be subjected to recurrent life-longrecertification requirements.

BACKGROUND:

Page 4: American Board of Internal Medicine (ABIM) · BMW 7-series Town Car Concierge Service ABIM Foundation’s $2.3 million ... * Reference: ABIM FY2016 IRS Form 990 ** Medscape Internist

• OnOctober17,1989,theABIMcreatedtheABIMFoundation inPhiladelphia,Pennsylvania,butneverdisclosedthisentitytoitsphysiciandiplomates.(Source:PennsylvaniaDepartmentofStateBusinessFilingEntityHistory,accessed12/2/2014)• From1990through1999,over$55millionwassecretlytransferredfromtheABIMtotheABIMFoundation.• In1999,theABIMFoundationwasannouncedtophysiciandiplomatesandcarriedassetsof$59,618,428(Source:ABIMFoundation1998Form990)• InDecember,2007,theABIMFoundationpurchaseda$2.3millionluxurycondominiumcompletewithachauffer-drivenMercedesS-classtowncar.

BACKGROUND:

Page 5: American Board of Internal Medicine (ABIM) · BMW 7-series Town Car Concierge Service ABIM Foundation’s $2.3 million ... * Reference: ABIM FY2016 IRS Form 990 ** Medscape Internist

FundingofABIMFoundationfromABIMDiplomateTestFees“ABIMinitiallytransferred$5milliontotheFoundationin1990.Overnearly20years(between1990and2008),approximately$56millionwastransferredbyABIMtotheABIMFoundation.Therehavebeennotransferssince2008.”1

1ABIMFoundation.org Financeswebpage,accessed6Oct2017*Source:IRSForm990s

FactCheck: FY1999Fundbalance$59,618,428

AdditionalFundsTransferred:*FY2000:$3,300,000FY2001:$1,600,000FY2002:$1,000,000FY2006:$7,000,000FY2007:$6,000,000

TotalACTUALLYTransferred:$78,518,428

Page 6: American Board of Internal Medicine (ABIM) · BMW 7-series Town Car Concierge Service ABIM Foundation’s $2.3 million ... * Reference: ABIM FY2016 IRS Form 990 ** Medscape Internist

Chauffeur-drivenBMW7-series

TownCar

ConciergeService

ABIMFoundation’s$2.3millionLuxuryCondominium*

*Unit#11NW,210WestWashingtonSquare,Philadelphia,PA19106PurchasedDec2007

Whostayedthere?Investmentorperk?Underpressure,soldatlossfor$1.65M6/21/2016

Page 7: American Board of Internal Medicine (ABIM) · BMW 7-series Town Car Concierge Service ABIM Foundation’s $2.3 million ... * Reference: ABIM FY2016 IRS Form 990 ** Medscape Internist

ABIMFoundationOff-ShoresDiplomateFeestoCaymanIslands- 2014

Page 8: American Board of Internal Medicine (ABIM) · BMW 7-series Town Car Concierge Service ABIM Foundation’s $2.3 million ... * Reference: ABIM FY2016 IRS Form 990 ** Medscape Internist

TaxFormDiscrepanciesABIMFoundationForm990- 2015

• NodisclosureofCaymanInvestmentsmadein2014

Page 9: American Board of Internal Medicine (ABIM) · BMW 7-series Town Car Concierge Service ABIM Foundation’s $2.3 million ... * Reference: ABIM FY2016 IRS Form 990 ** Medscape Internist

ABIMBylawsChanged1998OkayforABIMBoardtoHaveUnlimitedConflicts

Page 10: American Board of Internal Medicine (ABIM) · BMW 7-series Town Car Concierge Service ABIM Foundation’s $2.3 million ... * Reference: ABIM FY2016 IRS Form 990 ** Medscape Internist

NumerousFinancialConflictsofInterestExistwithMOC®

Page 11: American Board of Internal Medicine (ABIM) · BMW 7-series Town Car Concierge Service ABIM Foundation’s $2.3 million ... * Reference: ABIM FY2016 IRS Form 990 ** Medscape Internist

Source:ABIMandABIMFoundationForm990sandConsolidatedFinancialStatements

Physicianshavepaidover$581milliontoABIMandonly$13.6millionremainJust23%ofrevenueusedforphysiciantesting

Page 12: American Board of Internal Medicine (ABIM) · BMW 7-series Town Car Concierge Service ABIM Foundation’s $2.3 million ... * Reference: ABIM FY2016 IRS Form 990 ** Medscape Internist

ABIM’sMountingLegalFees

$159,405 $152,671 $105,808 $131,068$209,722

$344,047$421,386

$1,028,770

$1,700,799

$2,319,356

$1,951,670

$1,052,722

$767,999

$947,441

$0

$500,000

$1,000,000

$1,500,000

$2,000,000

$2,500,000

1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

LegalFees

ABMSMOC®Introduced

Page 13: American Board of Internal Medicine (ABIM) · BMW 7-series Town Car Concierge Service ABIM Foundation’s $2.3 million ... * Reference: ABIM FY2016 IRS Form 990 ** Medscape Internist

ABIMOfficer,Director,Trustee,orKeyEmployeeCompensation

2015*

AverageUSInternistCompensation2015**

*Reference:ABIMFY2016IRSForm990

**MedscapeInternistCompensationReport2015

}$849,483

Page 14: American Board of Internal Medicine (ABIM) · BMW 7-series Town Car Concierge Service ABIM Foundation’s $2.3 million ... * Reference: ABIM FY2016 IRS Form 990 ** Medscape Internist

TaxFormDiscrepanciesTheABIMFoundation

• In2008,theIRSchangedForm990toincludeadditionalfilinginformation,includingtheorganization’sdomicilestateanddateofformation.(https://www.irs.gov/pub/irs-tege/990_whatsnew_purpose.pdf )

• ABIMFoundationmisreporteditsstateand/ordateofdomicileforsixyears

Page 15: American Board of Internal Medicine (ABIM) · BMW 7-series Town Car Concierge Service ABIM Foundation’s $2.3 million ... * Reference: ABIM FY2016 IRS Form 990 ** Medscape Internist

TaxFormDiscrepanciesTheABIMFoundation

SimilarmisinformationappearedonABIMFoundation’swebsite.

ABIMFoundationwebsite“AboutUs”webpage27Nov2014*

*Source:TheInternetArchivehttps://web.archive.org/web/20141127195454/http://abimfoundation.org/About-Us.aspx

Page 16: American Board of Internal Medicine (ABIM) · BMW 7-series Town Car Concierge Service ABIM Foundation’s $2.3 million ... * Reference: ABIM FY2016 IRS Form 990 ** Medscape Internist

TaxFormDiscrepanciesABIMPolitics/UnreportedLobbyingExpenses

ChristineCassel,MD,PresidentandCEOoftheABIM,appointedtoPresidentBarackObama’sCouncilofAdvisorsonScienceandTechnology(PCAST)thesamedaytheABIMemploystheunreportedlobbyingfirmJenningsPolicyStrategies.JenningsPolicyStrategiesislistedas“consultant”onFiscalYear2012(2011Form990)taxformswhileForm990lobbyinglineitemleftblank.

Page 17: American Board of Internal Medicine (ABIM) · BMW 7-series Town Car Concierge Service ABIM Foundation’s $2.3 million ... * Reference: ABIM FY2016 IRS Form 990 ** Medscape Internist

TaxFormDiscrepanciesABIMForm990– 2010:DisclosedLobbyistas“Consultant”

Page 18: American Board of Internal Medicine (ABIM) · BMW 7-series Town Car Concierge Service ABIM Foundation’s $2.3 million ... * Reference: ABIM FY2016 IRS Form 990 ** Medscape Internist

TaxFormDiscrepanciesABIMLobbying

Source:CenterforResponsiblePoliticshttp://www.opensecrets.org

Source:ABIM2013Form990

Page 19: American Board of Internal Medicine (ABIM) · BMW 7-series Town Car Concierge Service ABIM Foundation’s $2.3 million ... * Reference: ABIM FY2016 IRS Form 990 ** Medscape Internist

TaxFormDiscrepanciesABIMSignatureLine/Auditor

ABIM2011Form990listingChristineCassel,MDas“SnrVP&CFO”whenshewasPresidentandCEOoftheOrganization.

McGladrey LLP,ABIM’slong-termauditor,hadseriousaccountingdeficienciesin2012reviewbythePublicCompanyAccountingOversightBoard(https://pcaobus.org//Inspections/Reports/Documents/2014_McGladrey_LLP.pdf )

Page 20: American Board of Internal Medicine (ABIM) · BMW 7-series Town Car Concierge Service ABIM Foundation’s $2.3 million ... * Reference: ABIM FY2016 IRS Form 990 ** Medscape Internist

ABIMTaxFormDiscrepanciesWhereDidtheMoneyGo?

ABIMForm990- 2011 ABIMForm990- 2012

2011Form990:Legal$2,287,145versus$1,886,145(Difference:$401,000)

Accounting$361,753versus$107,240(Difference:$254,153)

2012Form990:Legal$2,249,239versus$1,026,406(Difference:$1,222,833)

Accounting$348,139versus$88,625(Difference:$259,514)

Page 21: American Board of Internal Medicine (ABIM) · BMW 7-series Town Car Concierge Service ABIM Foundation’s $2.3 million ... * Reference: ABIM FY2016 IRS Form 990 ** Medscape Internist

ABIMFoundationMoneyLaundering?

ProgramRevenue:$0

Page 22: American Board of Internal Medicine (ABIM) · BMW 7-series Town Car Concierge Service ABIM Foundation’s $2.3 million ... * Reference: ABIM FY2016 IRS Form 990 ** Medscape Internist

TaxDiscrepanciesABIMFailstoAllowIndependentAudit

• AmericanMedicalAssociation’sHouseofDelegatesPassedResolution607requestingAMAtoperformindependentauditofABIMinJune2016.(Availableat:https://assets.ama-assn.org/sub/meeting/documents/i16-resolution-607.pdf )

• ABIM’sPresidentandCEOrespondedtoAMAandreferredABIMdiplomatestotheABIM’sConsolidatedFinancialStatementandIRSForm990’sforclarification.(Letterofresponseavailableathttp://www.medtees.com/content/ABIMresponsetoAMA.pdf )

Page 23: American Board of Internal Medicine (ABIM) · BMW 7-series Town Car Concierge Service ABIM Foundation’s $2.3 million ... * Reference: ABIM FY2016 IRS Form 990 ** Medscape Internist

PracticingUSPhysicianDemand

• SinceformaleffortstoresolvetheconcernsoftheABIM’sactivitieshavefailedwiththeAmericanMedicalAssociationandtaxfraudappearsrampant,practicingUSphysiciandiplomatesoftheABIMrequestaninvestigationbytheInternalRevenueServiceandtheDepartmentofJusticeintothefinancialandpoliticalactivitiesoftheAmericanBoardofInternalMedicine,theirboardofdirectors,andaffiliatedorganizations,including,butnotlimitedto,theAmericanBoardofMedicalSpecialties.