Health Care Fraud Blog

SOUTH FLORIDA (AUGUST 17, 2011) - Despite new legislative efforts with stricter regulations on pain clinics and dispensing of narcotic painkillers, deaths from oxycodone overdoses continue to rise in South Florida. Governor Rick Scott believed the state's effort to make it harder for pill mills to operate in the state would decrease the number of deaths from narcotic painkillers. The numbers continue to rise.

The number of oxycodone-related deaths rose from 2009 by about 8 percent. Jim Hall, director of the Center for the Study & Prevention of Substance Abuse at Nova Southeastern University in Davie, feels there won't be much improvement in the numbers until late in the year.

WEST PALM BEACH, FLORIDA, (AUGUST 10, 2011) - In a raid that seized patient files, computers and the license of a West Palm Beach physician, authorities alleged that Dr. John Peter Christensen had been doling out prescriptions for painkillers without performing patient exams.

Christensen, under investigation since 2008, worked with a father and son team of chiropractors, Joseph Wagner and John Wagner, in Daytona Beach to bill insurance companies for exams that were never performed. The chiropractors asked patients to sign blank insurance forms which would later be filled in to reflect a patient exam by Christensen.

Records from the Palm Beach County Medical Examiner's Office show that Christensen gave out prescriptions to six young men who later died of drug overdoses. Parents of two former patients who died of drug overdoses have also sued Christensen, with one case settled and one still pending.

FORT LAUDERDALE, FLORIDA (July 6, 2011) - Armed with the new pill mill law, which took effect July 1, law enforcement officials have begun collecting narcotic pain killers and other addictive medications from doctors and clinics. The law effectively halted the dispensing of those medications by anyone other than a licensed pharmacist.

In a campaign deemed a "state of emergency" in combating prescription drug abuse by Florida Surgeon General H. Frank Farmer, Broward Sheriff's office and Florida Department of Law Enforcement officials combined efforts with the Florida Department of Health to visit one of the first targeted medical facilities, the Wellness and Pain Centers of Broward. Approximately ten officials arrived at 9 a.m. to confiscate pills.

Any medical office or clinic that has ordered at least 2,000 pills per month since the beginning of the year or with known history of questionable practices, can expect to receive a visit soon. Leftover sealed pills can be returned to the distributor for credit or refund or turned over to law enforcement where the pills will be destroyed.

BROWARD and PALM BEACH COUNTIES, FLORIDA - Continuing the crackdown on pill mills in Florida, local, state and federal law enforcement officials confiscated medical and financial records from three alleged pill-mills in Broward and Palm Beach counties, one week after Governor Rick Scott signed the "Pill Mill Bill".

Officers donned masks as "Operation Blue Spoon" raided Total Medical Express locations in Margate, Boca Raton and Palm Springs under the suspicions that the clinics operated without the proper licenses for pain clinics. Palm Beach County arrests included the pharmacy department manager, Marc Donegan and the office manager, Adelard LeFrancois; both charged with prescription-drug trafficking and failing to maintain required paperwork records to track movement of prescription drugs. Dr. Sherri Pinsely, the alleged pill supplier, was also arrested shortly after the raids on the same charge of failing to maintain required paperwork. The Clay County Sheriff arrested Richard McMillian of Delray Beach and Pasquale Gervasio of Parkland and charged the pair with operating the Orange Park clinic without a license.

At the time of these arrests, officials were looking for Dr. Arnold Aaron of Boca Raton, the manager of the clinics and a board-certified family practitioner and anesthesiologist, but learned the doctor had traveled to Michigan for surgery. Although previously led to believe the doctor was "on his deathbed," officials discovered he was actually living at a retirement home. He was booked on a $250,000 bond into the Oakland County Jail in Michigan on the Clay County warrant. Aaron confessed knowledge of the charges and anticipated his arrest because other Florida doctors involved with pain clinics had been arrested. Aaron waived extradition back to Florida.

Continue reading "POLICE BUST ALLEGED PILL MILLS IN SOUTH FLORIDA; ARREST FLORIDA DOCTOR IN MICHIGAN" »

DESTIN, FLORIDA - Robert Bourlier, a Destin physician was convicted on 126 counts of illegal prescription writing and 17 counts of health care fraud during a three-week trial. Dr. Bourlier prescribed the medications in quantities that led his patients to abusing, misusing and eventually becoming addicted to the drugs. As a result of his malfeasance, two patients died.

More than 76 witnesses came forward to testify to the doctor's actions of continuing to write prescriptions after he knew the patients had become addicts or in some cases, overdosed. Even after learning that patients were shopping for more drugs or selling them, he continued to write prescriptions.

Two patients died as a result of Bourlier's drug dispensing practices: one from methadone and alprazolam and the other from hydrocodone and alprazolam. Because one of the deaths involves methadone, Bourlier faces a mandatory sentence of 20 years to life in prison. For each health care fraud conviction he could receive 10 years and for each count of illegal dispensing of prescription drugs, 20 years.

Bourlier's wife, Victoria Bourlier, aka Karen Victoria Ritchy, had earlier pled guilty to trying to cover up her husband's crimes by removing evidence at their home while law enforcement executed a search warrant at her husband's office. She faces a maximum sentence of 20 years.

Healthcare Fraud Blog Publisher, Attorney Robert Malove, is an expert criminal trial lawyer as recognized by The Florida Bar. Mr. Malove has extensive experience in the area of health care fraud defense.

Mr. Malove has extensive experience in the area of pill mill defense and represents the Florida Academy of Pain Medicine, Florida Academy of Physician Assistants, American Academy of Pain Management, and Florida Society of Neurology and has filed an amicus curiae brief in federal court challenging the constitutionality of the Florida statutes regulating the operation of pain clinics, i.e., pill mills.

If you, or someone you know is facing prosecution as a result of aggressive law enforcement activity of pill mills or doctor shopping, make sure you hire an experienced criminal defense attorney who is familiar with the issues.

Federal Healthcare Fraud Strike Force teams are currently operating in 9 locations: Miami, Los Angeles, Houston, Detroit, Brooklyn, Tampa, Baton Rouge, Dallas and Chicago.

If you or someone you know is a healthcare provider and in need of serious pill mills, doctor shopping or any healthcare fraud defense, please contact attorney Robert Malove, co-author of the noted treatise, WHITE COLLAR CRIME: HEALTH CARE FRAUD (West)(2010-2011 ed.) to arrange an immediate consultation.

PALM BEACH COUNTY, FLORIDA (May 26, 2011) - State Attorney Michael McAuliffe and Sheriff Ric Bradshaw will co-host Palm Beach County's Prescription Drug Abuse and Pain Clinic Summit. The event takes place today, May 26, from 9 a.m. to 12:30 at the Clayton Hutcheson Agricultural Center.

The summit focuses on prevention of the consequences surrounding addiction and prescription drug dealing before they occur.

This is the summit's second year and since that time the number of pain clinics dealing in the illegal prescription drug trade has dropped significantly; due in part to law enforcement's wide-sweeping raids.

In February of this year, as previously reported here, raids of 11 pain clinics spread from Miami to West Palm Beach netted 23 arrests and more than $2.5 million in cash and vehicles. State Attorney McAuliffe believes that integrating the message of public health with enforcement helps officials refine their philosophy and not focus simply on arresting people.

Healthcare Fraud Blog Publisher, Attorney Robert Malove, is an expert criminal trial lawyer as recognized by The Florida Bar. Mr. Malove has extensive experience in the area of health care fraud defense.

Mr. Malove has extensive experience in the area of pill mill defense and represents the Florida Academy of Pain Medicine, Florida Academy of Physician Assistants, American Academy of Pain Management, and Florida Society of Neurology and has filed an amicus curiae brief in federal court challenging the constitutionality of the Florida statutes regulating the operation of pain clinics, i.e., pill mills.

If you, or someone you know is facing prosecution as a result of aggressive law enforcement activity of pill mills or doctor shopping, make sure you hire an experienced criminal defense attorney who is familiar with the issues.

Federal Healthcare Fraud Strike Force teams are currently operating in 9 locations: Miami, Los Angeles, Houston, Detroit, Brooklyn, Tampa, Baton Rouge, Dallas and Chicago.

If you or someone you know is a healthcare provider and in need of serious pill mills, doctor shopping or any healthcare fraud defense, please contact attorney Robert Malove, co-author of the noted treatise, WHITE COLLAR CRIME: HEALTH CARE FRAUD (West)(2010-2011 ed.) to arrange an immediate consultation.

PALM BEACH COUNTY, FLORIDA (May 14, 2011) - South Florida, usually a premier destination for those desiring beautiful beaches, fine dining and luxury accommodations has become a major draw for out-of-state drug traffickers seeking, among other drugs, the popular narcotic painkiller, Oxycodone.

The out-of-towners, called "pillbillies" because of their connection to the Appalachian region, buy large quantities of prescription drugs, then head back to their home state to sell them. Local law enforcement resources have become overtaxed due to the large number of these out-of-state defendants frequently caught during a routine traffic stop.

The majority of offenders hail from Ohio, Tennessee and Kentucky and for the last five years, "pillbillies" have clogged up the Broward County court docket, which ultimately hits local residents' wallets. One day in jail costs the county $114 for each jailed defendant.

Florida's past lax regulations regarding prescription meds may have been to blame for the illegal trade gaining a foothold in the state. Florida legislators just recently tightened its grip on the pain management "pill mills," which may be netting more drug traffickers.

Miami doctor Bernd Wollschlager, past president of the Florida Academy of Family Physicians and staunch opponent of pill mills, reported that a pill mill doctor can make as much as $5,000 per day just writing prescriptions.

Healthcare Fraud Blog Publisher, Attorney Robert Malove, is an expert criminal trial lawyer as recognized by The Florida Bar. Mr. Malove has extensive experience in the area of health care fraud defense.

Mr. Malove has extensive experience in the area of pill mill defense and represents the Florida Academy of Pain Medicine, Florida Academy of Physician Assistants, American Academy of Pain Management, and Florida Society of Neurology and has filed an amicus curiae brief in federal court challenging the constitutionality of the Florida statutes regulating the operation of pain clinics, i.e., pill mills.

If you, or someone you know is facing prosecution as a result of aggressive law enforcement activity of pill mills or doctor shopping, make sure you hire an experienced criminal defense attorney who is familiar with the issues.

Federal Healthcare Fraud Strike Force teams are currently operating in 9 locations: Miami, Los Angeles, Houston, Detroit, Brooklyn, Tampa, Baton Rouge, Dallas and Chicago.

If you or someone you know is a healthcare provider and in need of serious pill mill defense, doctor shopping or any healthcare fraud defense, please contact attorney Robert Malove, co-author of the noted treatise, WHITE COLLAR CRIME: HEALTH CARE FRAUD (West)(2010-2011 ed.) to arrange an immediate consultation.

TALLAHASSEE, FLORIDA (May 10, 2011) - Florida's legislature scored a big win with the passage of the bill to target pill mills, prescription drug dealers and users. Supporters of the bill consider the loopholes minor.

House Bill 7095 bill makes provisions for a state prescription database and requires drugstores to log the sale of every prescription pain pill. It does not, however, require doctors and pharmacists to check the database before handing the patient their pills. Mandating a database check could catch abusers through cross-referencing all places where they fill prescriptions.

Certain doctors and practices also fall under an exemption for registration with the database. Board-certified pain specialists, such as anesthesiologists, neurologists and surgeons can dispense pain meds without registering the transaction. Non-exempt physicians must register their office, have an inspection and follow set standards of patient care. With more than one-half of Florida's pain clinics run by board-certified pain doctors, potential for abuse runs high. State officials offer that the class of exempted doctors generally are much less likely to abuse the system.

The last loophole concerns the lack of drug testing for patients. The medical board wanted patients to undergo regular drug screenings if they receive pain medications, but lawmakers struck down the idea in order to get the bill passed. Regular testing could cost patients $44, each or $60 million, collectively, per year.

Loopholes aside, the bill provides stiff penalties for abusers. An automatic six-month license suspension and $10,000 fine awaits doctors found guilty of prescription abuse.

Healthcare Fraud Blog Publisher, Attorney Robert Malove, is an expert criminal trial lawyer as recognized by The Florida Bar. Mr. Malove has extensive experience in the area of health care fraud defense.

Mr. Malove has extensive experience in the area of pill mill defense and represents the Florida Academy of Pain Medicine, Florida Academy of Physician Assistants, American Academy of Pain Management, and Florida Society of Neurology and has filed an amicus curiae brief in federal court challenging the constitutionality of the Florida statutes regulating the operation of pain clinics, i.e., pill mills.

If you, or someone you know is facing prosecution as a result of aggressive law enforcement activity of pill mills or doctor shopping, make sure you hire an experienced criminal defense attorney who is familiar with the issues.

Federal Healthcare Fraud Strike Force teams are currently operating in 9 locations: Miami, Los Angeles, Houston, Detroit, Brooklyn, Tampa, Baton Rouge, Dallas and Chicago.

If you or someone you know is a healthcare provider and in need of serious pill mill defense, doctor shopping or any healthcare fraud defense, please contact attorney Robert Malove, co-author of the noted treatise, WHITE COLLAR CRIME: HEALTH CARE FRAUD (West)(2010-2011 ed.) to arrange an immediate consultation.

COLUMBUS, OHIO (May 9, 2011) - Joining other states with similar legislation, Ohio's licensed doctors support the passage of regulations to curb the 'pill mill' problem and cut the rapid growth of the painkiller-addiction problem in the state. The physicians are also concerned, however, that patients with legitimate pain relief needs could find it harder to come by their drugs, if doctors are worried they'll be targeted for investigation. "Nothing about anything that we're doing is meant to dissuade good physicians," states Richard Whitehouse, executive director of the State Medical Board. Instead, the aim is to give the board more authority to target pill mills.

Ohio House Bill 93 seeks pharmaceutical licensure of free-standing pain management clinics, which is where the majority of patients receive the narcotic pain killers. In addition, doctors would be required to have an affiliation with a local hospital and be board-certified in pain management. Doctors would also have to report any narcotic pain prescriptions written to a state-monitored automated reporting system.

In the past, physicians prescribed strong pain killers mostly to their cancer patients. After reevaluation of pain as the "fifth" vital sign, doctors began to more freely write for pain killer medications. "Now, there's a crisis of drug abuse and diversion," states Dr. Robert Taylor of Ohio State University Medical Center.

Getting rid of the pill mills reduces the problem in part, but addicts and drug dealers may simply shop harder and use out-of-state sources. Taylor feels that although the legislation will help reduce the supply, the demand side of the problem will still be there.

Healthcare Fraud Blog Publisher, Attorney Robert Malove, is an expert criminal trial lawyer as recognized by The Florida Bar. Mr. Malove has extensive experience in the area of health care fraud defense.

If you, or someone you know is facing prosecution as a result of aggressive law enforcement activity of pill mills or doctor shopping, make sure you hire an experienced criminal defense attorney who is familiar with the issues.

Federal Healthcare Fraud Strike Force teams are currently operating in 9 locations: Miami, Los Angeles, Houston, Detroit, Brooklyn, Tampa, Baton Rouge, Dallas and Chicago.

If you or someone you know is a healthcare provider and in need of serious pill mills, doctor shopping or any healthcare fraud defense, please contact attorney Robert Malove, co-author of the noted treatise, WHITE COLLAR CRIME: HEALTH CARE FRAUD (West)(2010-2011 ed.) to arrange an immediate consultation.

WASHINGTON D.C. (May 6, 2011) - U. S. Senator Sherrod Brown (D-OH) has introduced the "Stop Trafficking of Pills Act’’ or the ‘‘STOP" Act target patients and drug dealers looking for narcotic pain medications. The Senator wants individual states to take a tougher stance in fighting Medicaid fraud where prescription medications are involved.

Last year Medicaid shelled out $820 million for prescription drugs in Ohio alone last year. Drug seekers use their Medicaid card to go from doctor to doctor and pharmacy to pharmacy, and although Florida boosts the highest number of Oxycodone prescriptions filled yearly, Ohio ranks number two. The Senator claims Oxycodone, morphine and methadone are the increasing deaths and overdoses.

Senator Brown's bill would require patients to "lock-in" their choice of a Medicaid provider and pharmacy, which is already required in many states now. The Ohio Highway Patrol has already been targeting prescription pill couriers on Ohio's interstates. In March alone, more than 1300 arrests were made for illegal prescription pills. One of the biggest corridors, for illegal prescriptions drugs, runs from Detroit, Michigan to southern Ohio before filtering into other states.

Healthcare Fraud Blog Publisher, Attorney Robert Malove, is an expert criminal trial lawyer as recognized by The Florida Bar. Mr. Malove has extensive experience in the area of health care fraud defense.

If you, or someone you know is facing prosecution as a result of aggressive law enforcement activity of doctor shopping or pharmacy hopping, make sure you hire an experienced criminal defense attorney who is familiar with the issues.

Federal Healthcare Fraud Strike Force teams are currently operating in 9 locations: Miami, Los Angeles, Houston, Detroit, Brooklyn, Tampa, Baton Rouge, Dallas and Chicago.

If you or someone you know is a healthcare provider and in need of serious doctor shopping, pharmacy hopping or any healthcare fraud defense, please contact attorney Robert Malove, co-author of the noted treatise, WHITE COLLAR CRIME: HEALTH CARE FRAUD (West)(2010-2011 ed.) to arrange an immediate consultation.

CINCINNATI, OHIO (May 3, 2011) The Oxy Express could be responsible for more deaths than any other drug-related death in the country. It comes as no surprise to local law enforcement then that the doctors who write the most prescriptions of Oxycodone have all practiced in the heart of the Oxycodone supply area, South Florida.

The more than 800 pain clinics in Florida issue 85% of the Oxycodone prescriptions in the country. Addicts climb into vans, cars and buses to make the trip from Kentucky, Ohio and Indiana to get their hands on powerful narcotic painkillers. They'll shoot it, snort it or smoke it, unless they're also dealers and buying for the lucrative resale market.

The DEA says pain clinics can make up to $20,000 in a morning and will even hire armed guards to patrol the clinic parking lot. The DEA makes it clear that it doesn't want to target legitimate doctors issuing legitimate pain prescriptions.

They target doctors who act like drug dealers and write thousands upon thousands of narcotic pain prescriptions per year. In Eastern Ohio where Portsmouth boasts half a dozen pain clinics, Oxycodone is known as "hillbilly heroin."

While the DEA crack down on Florida pain clinics has made some impact in the pipeline, pain clinic owners have gotten wise and started to move their practices to neighboring states. The special agent in charge of the crackdown has a message for those owners, "we probably made [undercover] buys in your clinic and we're probably coming for you at some point in time."

Healthcare Fraud Blog Publisher, Attorney Robert Malove, is an expert criminal trial lawyer as recognized by The Florida Bar. Mr. Malove has extensive experience in the area of health care fraud defense.

Mr. Malove has extensive experience in the area of pill mill defense and represents the Florida Academy of Pain Medicine, Florida Academy of Physician Assistants, American Academy of Pain Management, and Florida Society of Neurology and has filed an amicus curiae brief in federal court challenging the constitutionality of the Florida statutes regulating the operation of pain clinics, i.e., pill mills.

If you, or someone you know is facing prosecution as a result of aggressive law enforcement activity of pill mills or doctor shopping, make sure you hire an experienced criminal defense attorney who is familiar with the issues.

Federal Healthcare Fraud Strike Force teams are currently operating in 9 locations: Miami, Los Angeles, Houston, Detroit, Brooklyn, Tampa, Baton Rouge, Dallas and Chicago.

If you or someone you know is a healthcare provider and in need of serious pill mill defense, doctor shopping or any healthcare fraud defense, please contact attorney Robert Malove, co-author of the noted treatise, WHITE COLLAR CRIME: HEALTH CARE FRAUD (West)(2010-2011 ed.) to arrange an immediate consultation.

Healthcare providers have been subjected to increased scrutiny by the Drug Enforcement Administration (DEA) policing the medical profession’s prescriptive and dispensing policies with respect to Schedule II narcotics, including Vicodin, Percocet, OxyContin.

The IOS — Immediate Order of Suspension — is an emergency provision of federal law that permits the Attorney General to suspend a practitioner’s license to dispense narcotics without a hearing or presentation of evidence.

Under 21 U.S.C. §§ 823-824, the DEA has authority to shut down a medical provider’s practice. The IOS imposes a presumption of guilt and places the burden of establishing medical necessity on the practitioner.

Chronic pain is a condition affecting vast numbers of patients nationwide. The DEA largely misunderstands complex set of circumstances regarding the treatment of chronic pain and often times punishes health care providers for the exercise of sound professional medical judgment.

It probably goes without saying that there are unscrupulous health care providers that flaunt the law and properly fall within the scope of the statute’s broad reach. However, when there is direct physician/patient interaction, a medical history, and physical examination, it is reminiscent of Orwell's "Big Brother" and an abuse of government power to conclude as a matter of law that such conduct is intended to skirt federal and state statutes and DEA administrative regulations.

Healthcare providers must be vigilant in properly documenting the need for administration of opioids to patients and attentive to patients’ drug seeking behavior with no evidence to support medical necessity. Otherwise, the vast reach of the DEA may find otherwise ethical and dedicated and law-abiding physicians trapped within the wide net cast upon unscrupulous providers by the government second-guessing proper medical judgment.

Healthcare Fraud Blog Publisher, Attorney Robert Malove, is an expert criminal trial lawyer as recognized by The Florida Bar. Mr. Malove has extensive experience in the area of pill mill defense. Criminal defense attorney Robert Malove represents the Florida Academy of Pain Medicine, Florida Academy of Physician Assistants, American Academy of Pain Management, and Florida Society of Neurology and has filed an amicus curiae brief in federal court challenging the constitutionality of the Florida statutes regulating the operation of pain clinics, i.e., pill mills.

If you, or someone you know is facing prosecution as a result of aggressive law enforcement activity targeting pain clinics, i.e., pill mills, make sure you hire an experienced criminal defense attorney who is familiar with the issues.

Federal Healthcare Fraud Strike Force teams are currently operating in 9 locations: Miami, Los Angeles, Houston, Detroit, Brooklyn, Tampa, Baton Rouge, Dallas and Chicago.

If you or someone you know is a healthcare provider and in need of serious pill mill defense or healthcare fraud defense, please contact attorney Robert Malove, co-author of the noted treatise, WHITE COLLAR CRIME: HEALTH CARE FRAUD (West)(2010-2011 ed.) to arrange an immediate consultation.

PALM BEACH, FL – Palm Beach County State Attorney Michael McAuliffe announced the arrest and filing of criminal charges against 11 individuals, including five physicians, for a total of 172 counts which include Racketeering (RICO), Conspiracy to Commit Racketeering, Trafficking in Oxycodone, Money Laundering, Unlicensed Practice of Health Care Profession and other related criminal charges. The arrests follow a complex multi-agency investigation dubbed OPERATION “PILL NATION” involving roughly 340 undercover buys from doctors and medical personnel in pain clinics throughout a three county South Florida area.

OPERATION "SNAKE OIL” (click here to see an earlier post about this) also carried out the same day as “OPERATION “PILL NATION” is a result of the ongoing efforts by the Organized Crime Drug Enforcement Task Force (OCDETF), a partnership between federal, state and local law enforcement agencies. The OCDETF mission is to identify, investigate, and prosecute high level members of drug trafficking enterprises, bringing together the combined expertise and unique abilities of federal, state and local law enforcement and being prosecuted by the federal authorities.

“Legitimate pain management is a essential part of medical practice,” however “we cannot, and will not, allow medicine to be used by merchants of misery to corrupt the health of individuals and undermine the welfare of whole communities. We are in a continuing crisis, but the tide is turning and today’s enforcement actions provide a clear example of progress,” said State Attorney McAuliffe. To read the State Attorney's Office's Press release in its entirety, click here.

Healthcare Fraud Blog Publisher, Attorney Robert Malove, is an expert criminal trial lawyer as recognized by The Florida Bar. Mr. Malove has extensive experience in the area of pill mill defense. Criminal defense attorney Robert Malove represents the Florida Academy of Pain Medicine, Florida Academy of Physician Assistants, American Academy of Pain Management, and Florida Society of Neurology and has filed an amicus curiae brief in federal court challenging the constitutionality of the Florida statutes regulating the operation of pain clinics, i.e., pill mills.

If you, or someone you know is facing prosecution as a result of aggressive law enforcement activity targeting pain clinics, i.e., pill mills, you need to make sure you hire a criminal defense attorney who is familiar with the issues regarding pill mill defense. For serious pill mill defense, throughout South Florida including Miami-Dade, Broward and Palm Beach counties, call Florida pill mill defense lawyer and criminal trial law specialist Robert Malove immediately.

Defendants Owned and Worked at Seven Area Clinics that Prescribed over 660,000 Pills, Profited More than $22 Million

FORT LAUDERDALE, FL - The United States Attorney for the Southern District, Drug Enforcement Administration (DEA), Internal Revenue Service (IRS) Criminal Investigation, announce the indictment of six South Florida residents for their participation in the illegal distribution of pain killers.

Today’s case, dubbed Operation Snake Oil, is a result of the ongoing efforts by the Organized Crime Drug Enforcement Task Force (OCDETF), a partnership between federal, state and local law enforcement agencies. The OCDETF mission is to identify, investigate, and prosecute high level members of drug trafficking enterprises, bringing together the combined expertise and unique abilities of federal, state and local law enforcement.

This prosecution targets the owners and operator of seven pain clinics located in Broward and Miami-Dade Counties. Charged in the indictment are Vincent Colangelo, 42, of Davie, Nicholaus Thomas, 28, of Fort Lauderdale, Rachel Bass, 27, of Pompano Beach, Michael Plesak, 26, of Plantation, Jeremiah Flowers, 31, of Fort Meyers, and Wayne Richards, 45, of Lighthouse Point. Five of the six have been arrested. Defendant Flowers remains at-large. To read the indictment, click here.

All of the defendants have been charged with conspiring to distribute and dispense more than 660,000 dosage units of oxycodone. Three defendants (Colangelo, Plesak and Bass) are also charged with one count of conspiring to launder the proceeds of the pain clinics and twenty-six counts of money laundering. In addition, the indictment seeks forfeiture of more than $22 million in cash and assets. Among the assets sought to be forfeited are more than 46 vehicles and vessels, including a Mercedes-Benz SLR Mclaren, numerous Dodge Vipers, and two Lamborghinis, as well as expensive real estate and a trailer park in Okeechobee.

The indictment alleges that the defendants operated the pain clinics as pill mills that offered patients prescriptions for oxycodone and other controlled substances where there was no legitimate medical purpose and not within the usual course of professional medical practice. The indictment says that the defendants marketed the clinics through more than 1,600 internet sites, required immediate cash payments from patients for a clinic “visit fee,” directed the patients to obtain MRIs that the defendants knew to be inferior, over-aggressively interpreted MRIs in order to justify prescriptions, and falsified patients’ urine tests for a fee to justify the highly addictive pain medications.

“According to recent estimates, Florida prescribes ten times more oxycodone pills than all other states combined. Operation Snake Oil is part of our concerted effort to keep South Florida from drowning in pill mills. Working together with our state and local partners, we are shutting down these shady storefronts through the systematic prosecution of doctors, clinic owners and operators who deal drugs while hiding behind a medical license,” said U.S. Attorney Wifredo A. Ferrer.

“Prescription drug abuse is our country’s fastest growing drug problem, and pill mills such as those in Florida are fueling much of that growth. As a result, citizens in communities across Florida and around the nation are faced with growing drug addiction that is accompanied by pain, suffering, and even death,” said DEA Administrator Michele M. Leonhart.

“Rogue doctors who run these operations violate their professional oaths and are, in fact, drug dealers. Florida today is “ground zero” in the fight against pill mills, and we are determined to continue to aggressively pursue those who are responsible for this nationwide epidemic.”

IRS Special Agent in Charge Daniel W. Auer stated, “We are pleased to have lent our financial investigative expertise to this investigation. IRS- Criminal Investigations’ role was to trace the flow of the monies derived from the illegal operation of these pill mills, to identify the individuals who profited from these illegal activities and to help seize any assets purchased using the ill-gotten gains.”

According to the indictment, demand of oxycodone has grown to epidemic proportions in South Florida and other parts of the United States, where drug dealers can sell a 30 mg Oxycodone pill on the street for $10 to $30 or more. Oxycodone has a high potential for abuse and can be crushed snorted, or dissolved and injected, to get an immediate high. This abuse can lead to addiction, overdose, and sometimes death.

Healthcare Fraud Blog Publisher, Attorney Robert Malove, is an expert criminal trial lawyer as recognized by The Florida Bar. Mr. Malove has extensive experience in the area of pill mill defense. Criminal defense attorney Robert Malove represents the Florida Academy of Pain Medicine, Florida Academy of Physician Assistants, American Academy of Pain Management, and Florida Society of Neurology and has filed an amicus curiae brief in federal court challenging the constitutionality of the Florida statutes regulating the operation of pain clinics, i.e., pill mills.

If you, or someone you know is facing prosecution as a result of aggressive law enforcement activity targeting pain clinics, i.e., pill mills, you need to make sure you hire a criminal defense attorney who is familiar with pill mill defense. For serious pill mill defense, throughout Miami-Dade, Broward and Palm Beach counties, call Florida pill mill defense lawyer Robert Malove immediately.

Continue reading "OPERATION SNAKE OIL - SOUTH FLORIDA PILL MILLS TARGETED - FIVE DOCTORS AMONG THOSE ARRESTED" »

When it comes to chronic pain, the current DEA war on pain management leads to a question: How much authority should the DEA have over the treatment of patients? According to the Association of American Physicians and Surgeons, “If you’re thinking about getting into pain management using opioids as appropriate: DON’T. Forget what you learned in medical school – drug agents [from the DEA] now set medical standards.” For more on this click: here.

Chronic pain, pain that lasts longer than 24 hours, affects approximately 25 percent of the U.S. population, that is 76 million people, according to the National Centers For Health Statisitics. Of those that reported chronic pain, 43% reported that pain has persisted longer than a year. More than 26 million people report having persistent back pain. Ouch! (To read more on this, click: here).

The treatment options, depending on the cause of the pain involve invasive measures such as surgery and injections, however such results can be short lived. Also, physicians who practice interventional pain find it difficult to get privileges to perform services at hospitals and have very high malpractice insurance premiums. Chiropractic adjustment and physical therapy are less invasive and less expensive, but for chronic pain are also considered by many patients to be of limited use.

What is left is treatment through combinations of other therapies and prescription drugs. The problem for physicians is that pain medications are being prescribed to help a person get through their day, not to solve the underlying medical issue that causes the pain. Therefore, the analysis is very subjective, a combination of the condition causing the pain, the patient’s history of previous treatment, and the amount of prescription drugs that currently work to ease that patient’s suffering. The challenge to the physician prescribing drugs designed to treat chronic pain, opioids, is to discern how much should be prescribed and when and if a patient should be cut off due to potential abuse.

Here is where the war on drugs encounters the reality of medical practice and pain management. As the advice of the AAPS makes clear, doctors are advised to and many doctors stay away from treating pain with narcotics because they are at risk of prosecution or discipline for doing so even when it is a necessary and valid treatment. Accordingly, there is a narrower and narrower pool of physicians willing to treat pain and do so largely in pain management practices. The result is that such physicians prescribe much more pain medications than ordinary physicians, because those are the only patients they see, those physicians will also likely be more liberal in the prescribing of those medications simply because they are so used to seeing chronic pain.

In comes law enforcement, curiously timing high profile raids on pain clinics smack dab in the middle of the Florida legislative session which ends in several weeks while two competing pain management bills are debated. (To read the proposed legislation, click here and here). Reporters, as they do with every law enforcement crime du jour, breathlessly report about how dangerous and prolific “pill mills” are, never once addressing any reason for the need or treatment of pain. Law enforcement describes how oxycontin pills sold to patients in Florida for $5 end up being sold in Kentucky for $20 on the street, without examining whether those people paying those premiums are merely drug addicts, or patients who cannot get pain treatment in Kentucky due to fearful physicians there.

The DEA, using only the vaguest of regulations, declares that physicians treating pain are criminals, dispensing excessive amounts of medications. The DEA does so without legislating, regulating or providing any guidance on the limitations of such dispensing. For example, if the DEA believes no patient should receive more than a certain amount of oxycontin in a prescription, create and publicly debate such a measure.

There is certainly much that can be debated in the treatment of pain and the prescribing of narcotics, but it is rarely debated, often with the words “pill mill” substituting for actual analysis of a much larger and complex issue. Tragically, many of those issues find their way into criminal courts, with jurors instead of health care officials, debating the medical validity of prescription medication dispensing.

According to an article in the South Florida Sun-Sentinel, at least 45 pain clinics opened in Broward and Palm Beach counties in the past year, while state law makers and state and local law enforcement agencies stepped-up their efforts to put an end to the operation suspected “pill mills.”

In August 2008, 66 pain clinics were open for business in Broward and Palm Beach counties combined. The Sun-Sentinel article reports that according to data available from the Florida Department of Health, the number centers issuing narcotic pain medications currently is more than the times what it was in August 2008 - with 122 in Broward to 122 and in Palm Beach County to 108.

Pain clinics “are proliferating despite our efforts," Broward Sheriff Al Lamberti said last week, after state and federal agents executed search warrants at three pain clinics owned or controlled by Christopher and Jeffrey George in Palm Beach County. The Georges' homes were also searched.

No arrests have been made yet, however, a federal law law suit has been filed in U.S. District Court in West Palm Beach. According to the law suit, three of the Georges’ clinics collected $14 million last year and dispensed more than 2.1 million pills. [To read the law suit, click: here.] Additionally, five doctors who worked at the clinics have had their DEA numbers to prescribe pain medications suspended. The doctors can either voluntarily agree to the suspension or can challenge the suspension before a DEA Administrative Law Judge at a hearing scheduled for May.

Independent sources close to the investigation indicate that patient files were properly documented, regular MRI's were required and prescriptions that issued were 100% medically necessary. From time to time, patients who were suspected of phony symptom ology were discovered, refused treatment and escorted off the premises. If you or someone you know has ever suffered from debilitating pain, then no one has to tell you that life can be pure hell without taking pain medication just to get through the day and attempting to perform even the simplest of tasks. The real tragedy in the "gung-ho, rah, rah" attitude of law enforcement targeting pain clinics, is that the overwhelming majority of patients have well-documented injuries requiring pain medication for treatment. These legitimate pain sufferers are the forgotten "victims" who unfortunately wind up as unintended by-product caught in the overreaching net of law enforcement, much like innocent dolphins caught in the nets of profit-driven commercial fisherman.

Palm Beach County and several cities in both counties have temporarily banned new pain clincs, reported by the HCFB here and here. "Palm Beach County is ahead of us [in law enforcement efforts aimed at detecting criminal activities at pain clinics]. We're [Broward County is] trying to play catch up now," Lamberti said. "On the street, [there are] too many targets, not enough deputies. We're really trying to be hard on it because it causes crime in the community. We think they know we are serious."

To read the Sun-Sentinel article, click here.

The City of Delray Beach, Florida, is considering requiring pain management patients to give their fingerprints so those fingerprints can be used to immediately electronically check against a database to make sure the patient is not doctor shopping. That sounds great, but there is currently no electronic patient fingerprint network or database anywhere and for Delray Beach to create and maintain one itself it would cost more than they likely have budgeted for much of the services the city provides.

To read more, click here.

One bill pending before the Florida legislature proposes requiring that all physicians issuing a prescription for Schedule II and III controlled substances use a “multi-state electronic prescribing network” to verify whether a patient is doctor shopping. Unfortunately, no such network exists for controlled substances. In addition, the statute does not provide any way to fund it except for grants from unknown sources. For more, click here.

In an intriguing development in the war on pain, Palm Beach County, Florida, passed an ordinance designed to prevent new pain clinics from opening up and are intending to pass ordinances to curb the practices of existing pain clinics. This is a somewhat unusual development and may form the basis for legal challenges. The county commissioners, with some harsh words for pain clinics, are apparently attempting to regulate the medical profession through zoning regulations.

To read more, click: here.

As part of the recent focus of a task force in the Tampa area, a physician and a physician’s assistant who owned and operated 8 clinics were arrested for health care fraud and drug trafficking charges.

The clinics, Neurology & Pain Centers, operated in Tampa , Lakeland , Sarasota , Orlando and Jacksonville . State officials say that prescription drug overdose deaths are now more prevalent than overdose deaths for street drugs such as heroin and cocaine. The Tampa area, according to State officials, is responsible for 25% of those deaths. The allegations contained in the indictment include that the PA, Troy Wubbenna, offered free drugs to a 17 year old to recruit other high school students and that the physician, Dr. Jeffrey Friedlander, signed blank prescription pads so that drugs, particularly Oxycodone and Oxycontin, could be dispensed when he was not around.

To read more, click here.

The federal agents arrested 20 people for a Palm Beach operation that engaged in buying up oxycontin from Broward County pain clinics and pharmacies and shipping those drugs to Tennessee, Kentucky, West Virginia, Virginia and North Carolina . The operation had been going on for several years, with participants visiting up to five pain clinics a day to obtain drugs.

To read more, click here.

As a follow up to last week’s posting on pain management enforcement, we indicated that investigations concerning abuse in pain management focus on the treatment as opposed to a fraudulent claim.

There is no crime of practicing bad medicine; physicians in these cases are charged under narcotics laws for trafficking using the same laws as are used for drug dealers. Under federal law, that a physician issued a prescription for a legitimate medical purpose is only a defense to a charge of narcotics trafficking and not an exclusion under the statute. In many senses, every time a physician issues a prescription or dispenses a controlled substance, the physician is making a judgment that subjects him or her to potential criminal liability.

The question generally asked by investigators is whether the physician has given up his role as a physician and turned into a narcotics trafficker. In pain management, the propriety of issuing a prescription and the medical judgment is what is called into question. Often when health care providers are investigated or arrested for fraud or abuse, not much is heard from actual patients.

Interestingly, the reaction to search warrants being issued at your doctor’s office can vary, it appears the physician at the heart of the investigation, Dr. Sam Jahani, does have some supporters and detractors among his patients. The Denver Post; Channel KJCT8 and NBC 11 News posted some of those reactions below. The NBC11 article features a patient who says the physicians caused her and her husband to be drug addicts, the others feature some positive reactions by patients.