By: Martin Merritt, esq.
Past President, Texas Health Lawyers Association
Past Chair, DBA Health Law Section
martin@martinmerritt.com
“Please Tell Me you Didn’t. . . How to Keep Clients Out of the Jailhouse, Poorhouse and Lawyers Out of the Nuthouse” -Blog
As you can tell, I love talking about health law & litigation issues, and general wellbeing, if you have any health law questions or better yet, need to refer a case, just call or drop me an email and I will happily talk.
“Doing the ironing.” A couple of weeks ago, you would have found me in my pajamas, ironing out Medicare audit letters, which were relevant to half a dozen multi-million-dollar anti-kickback cases stretching from New York to Miami (and from Arizona to the hills of the Eastern District of Kentucky.)
When I say, “ironing out,” I mean that literally. I had received a stack of 40 letters from Novitas, the MAC (or Medicare Contractor in Texas), which were 15 pages long each. But for some reason, Novitas still stuffs them into envelopes made to hold just three pages. (They are deeply creased.)
The only way to get them to go through the scanner, is for me to stand there in my pajamas and Iron them out flat enough to go through.
Now, I haven’t ironed clothes in 40 years. But I still have the iron I have been lugging around since college, when my mom taught me how, back in the 1980’s. This was when everyone first started wearing Polo button-downs in college in the Mississippi Delta.
Ralph Lauren dumped the seconds (the ones with little defects) at a local thrift store in Greenville, where we could buy them for $7 each. (It is the same concept as Nike donating to a third-world country, the Super Bowl championship T Shits which were pre-printed naming the team that didn’t win, Ralph Lauren likely figured nobody in the Delta could afford full price ones, so they weren’t hurting sales dumping the seconds on us.)
But for us, the logic was simple, way to attract the girl in college, was to have a crisp Polo. “Iron the shit. Get the girl.” (It is good to know how to do things.)
“It Crawled from the Abyss: Navigating Medicare Provider Clawbacks.” If you aren’t familiar with Medicare “clawbacks,” the 40-odd CMS letters demanded that my client, a little nurse practitioner practice in the middle of nowhere Texas; pay back $1.3 million in Medicare payments. (In Medicare, getting paid, really is considered “half-time.” Keeping the money is another matter.) As with many things in health law, this all related to the big business of selling Wound Graft Patches for as much as $500,000 a patch, which Medicare paid, then decided it wanted its money back.
This wound care business, has spun off a cottage industry, where everyone is suing everyone else. The government is suing the doctors, the doctors are suing the suppliers, the suppliers are suing the doctors. (And that is why I am ironing documents. I am going to need those in half a dozen cases.)
Note: I published an article this month, “It Crawled from the Abyss: Navigating Medicare Provider Clawbacks.” You can get it online in the Dallas Bar Association magazine, Headnotes. (On page 12 of May 2026 edition) at https://www.dallasbar.org/?pg=Headnotes
Now, as noted, before I can fight the Medicare “thing that Crawled from the Abyss” in half a dozen jurisdictions, somebody has to iron these documents.
James Bond, “Deal with It.” As with so many things a solo practitioner must do, it wasn’t a question of whether I could have “found someone” else to iron the documents. (I just couldn’t figure what I would do with that particular skill set, if I found it in a person, the other 39 ½ half hours of the week.)
So, I am standing there at the ironing board, looking at the wall. On it, I have framed one of those inspirational bits of art that keep me going when tasks like this are draining my battery.
The art is a framed photo of Daniel Craig, as James Bond, walking down the street after a building has nearly landed on him. Bond is wearing an impeccable suit and sunglasses, with the caption I had engraved on the frame, “Deal with It.”
I first saw the “Deal with it” meme on Facebook and decided to order a print and then, separately, an engraved frame. (The internet is very much like a 3D printer—anything I can think of; there is probably someone out there who sells it.) Sure enough, two weeks and $30 later, I have the James Bond photo on my wall, complete with the engraved frame.
“The Double Naught Spy.” Understand, since I was a kid, I wanted to be the guy in the suit fighting supervillains. But really, I am mostly doing something akin to standing in my pajamas ironing documents, chuckling, “some double-naught spy I turned out to be.”
“The Double Naught Spy,” is an episode of the 1960’s TV show, The Beverly Hillbillies, in which Jethro Bodine aspires to be a sophisticated international spy, when he is really just a naïve and bumbling idiot. (“Double naught” is Jethro’s somewhat idiomatic malapropism for “007”).
Whatever your “double naught spy” ambition might be, it is good to know how to manage the boring stuff. I learned a long time ago (ironing shirts to get the girl or practicing law), the difference between winning and being an incompetent “Jethro,” doesn’t always have anything to do with “double naught” heroics.
Sometimes, it means picking up an iron and doing whatever needs to be done to “win.” You can’t always brag to your friends about it. But the alternative is “losing.” Which is what really keeps me up at night. (And after all, those documents aren’t going to iron themselves.)