DOJ Announces Nationwide Bust of Opiate Prescribers

The Department of Justice announced a nationwide take-down of pain pill prescribers.

Attorney General Jeff Sessions and Department of Health and Human Services (HHS) Secretary Tom Price, M.D., announced today the largest ever health care fraud enforcement action by the Medicare Fraud Strike Force, involving 412 charged defendants across 41 federal districts, including 115 doctors, nurses and other licensed medical professionals, for their alleged participation in health care fraud schemes involving approximately $1.3 billion in false billings. Of those charged, over 120 defendants, including doctors, were charged for their roles in prescribing and distributing opioids and other dangerous narcotics. Thirty state Medicaid Fraud Control Units also participated in today’s arrests. In addition, HHS has initiated suspension actions against 295 providers, including doctors, nurses and pharmacists.

The press release contains a link for more information, but as of now, the link is a dead one.

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    Sounds like good news (none / 0) (#1)
    by Peter G on Thu Jul 13, 2017 at 03:16:30 PM EST
    for white collar defense lawyers.

    i'm against this (none / 0) (#2)
    by linea on Thu Jul 13, 2017 at 07:38:39 PM EST
    they shouldn't arrest doctors for prescribing medications. any medication.

    Jeralyn will agree with you on this point (5.00 / 1) (#3)
    by Peter G on Thu Jul 13, 2017 at 08:07:34 PM EST
    The government claims that their prosecutions do not require a criminal jury to decide between two views of what is medically appropriate, but in truth, they often do.

    I'm a bit torn (none / 0) (#4)
    by CaptHowdy on Thu Jul 13, 2017 at 08:22:21 PM EST
    The hippie druggie side of me agrees with you.  Scripts for everyone.

    But I honestly think maybe you have to live in rural America to appreciate the carnage caused by the over prescription of opiates

    Seen so many lives destroyed.  Including family members.

    This doctor, the one who prescribes them for my niece, he knows she is an addict.  He knows her problems are psychological not physical.  He gives her the prescriptions just to get her out of his office, bill her, and bring in the next addict.

    He is well known for this. If this is a serious thing I will be surprised if he is not on the list.


    I'm not saying there aren't valid cases (none / 0) (#5)
    by Peter G on Thu Jul 13, 2017 at 08:38:07 PM EST
    for prosecution. I have seen some of them, too. Doc's office becomes a pill mill. No physical exam done, just pills (or prescriptions for pills) handed out for cash, customer (can't say "patient") after customer. Not making excuses for those cases, except that the punishments for the docs have been excessive, considering that the docs I'm seen taken down in those cases were elderly, often impaired themselves, and no longer able to maintain real practices. For that, I blame the medical profession for not self-policing as well as the legal profession seems to.

    The guy (none / 0) (#6)
    by CaptHowdy on Thu Jul 13, 2017 at 08:51:17 PM EST
    In my story is none of that.  He is younger than me.  He has a real practice.  And he is not the only one I could name.
    I'm very sympathetic to doctors who may be swept up who are just trying to ease suffering.  And there is plenty of suffering.
    But the hard truth is prescriptions, particularly addictive ones, are big business.

    I'm fully aware this atmosphere will make it much harder for people who need these drugs to get them.

    That is a bad thing.  But another hard truth is the over prescription of these drugs by doctors who are dealers by another name is a real problem.  It's destroying lives and families.

    I have no suggestion of a solution for any of this.  But I can confidently say no good solution involves Jeff Sessions.

    I am just reporting


    Just adding (none / 0) (#8)
    by CaptHowdy on Thu Jul 13, 2017 at 09:01:16 PM EST
    This is personal for me.  I have seen the life of my niece destroyed.  She has gone from a a happy productive person to a pathetic addict who almost never even gets dressed anymore.  Let alone leaves the house.  It has not just destroyed her but her family.  Especially her children but including her parents.

    Her problems are psychological.  Everyone knows this.  But the only person who could a actually do anything is her husband and he will not.  It's a long story.

    But everyone who knows her blames this doctor.  

    And the real point is, she is not that unusual.  Pretty much every family has one these days.


    im saying (none / 0) (#7)
    by linea on Thu Jul 13, 2017 at 08:55:01 PM EST
    there shoudnt be any prosecution of medical doctors for prescibing any legal medicine. in many counties, a druggist can give you anything you want. in the u.s. you need a doctor's prescription for everything.

    certainly, the example in the previous post would be an absolutte absurd basis to criminally prosecute a medical doctor.

    in my opinion.


    There are drugs which are illegal to distribute (5.00 / 1) (#9)
    by Peter G on Thu Jul 13, 2017 at 09:13:53 PM EST
    to anyone, except in the ordinary course of medical practice. In order to get a criminal conviction, the government has to prove at trial, beyond a reasonable doubt, that the doctor dispensed the drugs outside the ordinary course of genuine medical practice. The doc, in other words, supposedly gets the benefit of any reasonable doubt. That's the applicable legal standard under our (U.S.) law.

    that is wrong (none / 0) (#14)
    by nyjets on Fri Jul 14, 2017 at 07:07:11 AM EST
    There are some drugs that are too dangerous to give out like candy. Just because a person wants the drug does not mean the person should get the drug.
    If the doctor is giving drugs to someone when there is no good medical reason for it, that is illegal and the doctor should be prosecuted. Or at least loose his or her medical license.

    In those cases.... (none / 0) (#11)
    by kdog on Fri Jul 14, 2017 at 06:10:23 AM EST
    They aren't doctors anymore, they're straight up drug dealers. Which I personally don't believe should be a crime, though it can be an immoral living profiting off misery...Which can be said of other professions besides slinging dope which are legal.

    More of the same wrong approach...We must help addicts who seek it, aka the demand side of the epidemic. Punishing the supply side accomplishes nothing but piling misery on misery, with more collateral damage.

    At the end of the day, it's not my brothers dealers fault my brother is an opiate addict. My brother has a disease, full stop. Locking up every dealer in America, M.D. or otherwise, is not treating the disease.


    I don't disagree with (none / 0) (#13)
    by CaptHowdy on Fri Jul 14, 2017 at 06:38:56 AM EST
    A single word of that.

    As I said, I have no suggestion for a solution.

    I'm just saying it's a very real problem.  And a quick web search will show you, like meth, it more of a rural problem than an urban one.


    Though it's a pretty big urban problem, too (none / 0) (#16)
    by jondee on Fri Jul 14, 2017 at 09:09:38 AM EST
    and even a cushy 'burb problem.

    You know there's some kind of deep-seated malaise at work in this country when That many people are willingly taking into their bodies the most addictive, dangerous substances known to mankind. American's may be stupid, but they're not That stupid. Rampant anxiety, depression, despair, apathy, and information overload have more to do with the 'opiate scourge' than do Big Pharma, unscrupulous doctors, and predatory drug dealers..

    We can say people have been criminally misinformed and it's no doubt true, but then we have to ask why it is other than some species of disempowered apathy that's prevents folks from educating themselves and seeking out healthier alternative ways of coping.


    Damn right it is... (none / 0) (#17)
    by kdog on Fri Jul 14, 2017 at 09:25:47 AM EST
    if you go simply by body count and heartbreak, there is no bigger social problem in this country right now.  Far worse than gun violence.

    My only suggestion for a solution is for addiction and/or psychological treatment on demand regardless of one's ability to pay for it.  Which would cost crazy dough...but if we rolled over the entire drug war budget for prosecutors, cops, weapons, equipment, prisons, guards, etc. into treatment we might be most of the way there already.  All that's lacking is the will and the brains, really...we can find the dough.


    I submit another problem (none / 0) (#20)
    by CaptHowdy on Fri Jul 14, 2017 at 10:43:38 AM EST
    People who are in denial and do not want treatment and their enablers.  My personal family problem.

    And in this area, a very common one.


    Very common in all areas... (none / 0) (#21)
    by kdog on Fri Jul 14, 2017 at 10:57:19 AM EST
    Sh*t I'm an enabler in some respects...it's really hard not to be.

    The hard realization is there is literally nothing you can do to help an addict who doesn't want to get clean, except not enable.  And not enabling is very hard line to walk.

    Example...if I don't feed my brother it's not like he's gonna use his dope money to buy food instead, he's gonna buy dope and not eat or find another sucker to feed him.  Same if I don't give him cigarettes, or a place to live.  And though maybe the best thing for him would be to live in a refrigerator box for awhile, I can't stomach seeing that go down. Sh&t is hard Man.


    sorry, no (none / 0) (#23)
    by CaptHowdy on Fri Jul 14, 2017 at 11:44:56 AM EST
    there are things that could be done.  she could be put in rehab.  but her husband will not allow it.

    they are still doctors (none / 0) (#15)
    by nyjets on Fri Jul 14, 2017 at 07:08:45 AM EST
    They are doctors not drug dealers. If a doctor knowingly gives a prescription to someone when he or she knows she should not, the doctor should be punished.

    Has this physican been reported (none / 0) (#10)
    by oculus on Fri Jul 14, 2017 at 12:58:48 AM EST
    to thebstate board with jurisdiction over licesning of medical progessionals?

    Not by me (none / 0) (#12)
    by CaptHowdy on Fri Jul 14, 2017 at 06:36:29 AM EST
    I can tell you I would not do that.  Partly because of the kdog point and partly because it's the kind of thing that might get your house burned or worse if it became known.  And not even necessarily by the doctor or his friends.

    Bill Burroughs (none / 0) (#18)
    by jondee on Fri Jul 14, 2017 at 09:45:01 AM EST
    used to refer to  doctors like by the 1950s junkie slang term "croakers."

    They've always been viewed as precious commodity by the addict community, as it were.


    Dr. Feelgood... (none / 0) (#19)
    by kdog on Fri Jul 14, 2017 at 09:53:45 AM EST
    the dopeman with a degree has many names.  

    Pillmill docs have the sweetest racket in the business, they don't even have to buy/sell the dope, they just collect a cover charge to get in the drugstore.


    I am personally acquained w/an internist (none / 0) (#24)
    by oculus on Fri Jul 14, 2017 at 12:14:25 PM EST
    who permanentlt surrendered his license.  Second offense.

    "second offence" (none / 0) (#28)
    by linea on Fri Jul 14, 2017 at 08:23:29 PM EST
    just proves how brutally monitored medical doctors are.

    YES, the correct remedial action is withdrawal of medical license (not criminal charges and inprisonment). but i feel two offences in a thirty-year career is too strict. IN MY OPINION.

    again, in many other countries you can get anything on the street all this prescription stuff from a druggist. i feel like people are saying, "a person i know, tricks a medical doctor into 'scribing opiods... the doctor should go to jail."


    Second time undercover (none / 0) (#29)
    by oculus on Fri Jul 14, 2017 at 09:28:25 PM EST
    investigators caught him.  

    i dont know (none / 0) (#30)
    by linea on Fri Jul 14, 2017 at 09:59:19 PM EST
    anything about it.

    other than feeling that the appropriate sanction is loss of medical licence -- not a criminal trial and a prison sentance.

    that's my official position!!


    And that was the result. (none / 0) (#32)
    by oculus on Sat Jul 15, 2017 at 06:03:36 PM EST
    FWIW (none / 0) (#27)
    by CST on Fri Jul 14, 2017 at 02:08:37 PM EST
    You really don't have to live in rural America to appreciate the carnage.

    Is this thread about J's headline? Or (none / 0) (#22)
    by sarcastic unnamed one on Fri Jul 14, 2017 at 11:06:08 AM EST
    the actual meat of the story?
    for their alleged participation in health care fraud schemes involving approximately $1.3 billion in false billings.

    They stole 1.3B from us. From you and me.

    I doubt very much that the billings (none / 0) (#25)
    by Peter G on Fri Jul 14, 2017 at 12:42:25 PM EST
    (or most of them, at least) were "false" (or even alleged to be "false") in any way other than in the certifications that the 'scripts were written for the purpose of treating a disease or medical condition, or that they were written after conducting an individual examination of the "patient."

    It would be interesting (5.00 / 1) (#31)
    by ragebot on Sat Jul 15, 2017 at 01:12:54 PM EST
    to see a breakdown of the charges.  Not unexpected but the biggest portion of the DOJ charges were from South Florida, which has a history of massive health care fraud.  This history has had little to do with opiates.  In fact a lot of it was straight up fake bills for services never provided.  A lot of it involved doctors getting personal information (with or without knowledge of the patient) and using that information to bill the government.  Here is a blurb from a local paper(which is from Central Florida):

    "Central Florida had 10 defendants, who are accused of more than $14 million in false billing. They include one unnamed suspect who allegedly pretended to be a retired Lieutenant Commander of the United States Navy Submarine Service to convince Tricare beneficiaries to give him confidential information, investigators said."

    It is one thing for a doctor to write a script for a single patient and pocket a few bucks.  It is another thing for a doctor to get personal information for many patients and use that information without their knowledge.

    What the link Jeralyn provided says is that about 1/3 of those charged were health care professionals which means 2/3 were not doctors, nurses, and the like.  Not trying to say opiates are not a big problem.  Just that a lot of non opiate fraud is going on and in South Florida has been for quite a while.


    yup (none / 0) (#33)
    by sarcastic unnamed one on Sat Jul 15, 2017 at 08:20:42 PM EST
    A radiologist in L .A. Has been charged. (none / 0) (#34)
    by oculus on Sat Jul 15, 2017 at 08:30:40 PM EST
    His schtick::  kickbacks to physicians who direct patients to him for MRIs

    "According to court documents" (none / 0) (#26)
    by sarcastic unnamed one on Fri Jul 14, 2017 at 12:57:35 PM EST
    According to court documents, the defendants allegedly participated in schemes to submit claims to Medicare, Medicaid and TRICARE for treatments that were medically unnecessary and often never provided. In many cases, patient recruiters, beneficiaries and other co-conspirators were allegedly paid cash kickbacks in return for supplying beneficiary information to providers, so that the providers could then submit fraudulent bills to Medicare for services that were medically unnecessary or never performed.