August 5, 2011 — A grand jury indictment handed down this week describes what might resemble some new provider network concocted under healthcare reform — 4 physicians, 1 psychologist, and 12 pharmacists working together with 26 pharmacies across Michigan.
Instead, these professionals and 9 others were charged in US district court in Detroit, Michigan, with conspiring to commit healthcare fraud by billing Medicare, Medicaid, and private insurers for illegally prescribed drugs — mostly various opioids, but also alprazolam (Xanax, Pfizer). Authorities claim that the 26 pharmacies billed Medicare for at least $37.7 million worth of medications over the course of the alleged scheme. The medication tab for Medicaid was put at $20.8 million.
According to the grand-jury indictment, the conspiracy's ringleader was pharmacist Babubhai "Bob" Patel, RPh, in Canton, Michigan, who owned and managed the 26 pharmacies and hired pharmacists to staff them. Patel and his business associates, the indictment states, gave kickbacks and bribes to physicians and podiatrists to write medically unnecessary prescriptions for patients who were recruited into the scheme. The clinicians would bill third-party payers for the encounters and direct patients with the bogus prescriptions to fill them at one of the 26 pharmacies. Individuals who recruited the patients into the plot were rewarded with a cut of the drugs. One of the recruiters was licensed psychologist Sanyani Edwards of Ferndale, Michigan, the indictment states.
The grand jury estimated that between January 2009 to the time of the indictment, the pharmacies dispensed at least 4.6 million doses of acetaminophen and hydrocodone (Vicodin, Abbott), 250,000 doses of other opioids such as oxycodone, and 1.5 million doses of alprazolam.
The 4 physicians named in the indictment are psychiatrist Mark Greenbain, MD, of Farmington Hills, Michigan; general surgeon and internist Paul Petre, MD, of Rochester Hills, Michigan; internist Mustak Vaid, MD, of Brownstown Township, Michigan; and podiatrist Anmy Tran, DPM, of Macomb Township, Michigan. The 4 physicians were charged with conspiracy to commit healthcare fraud and distribute controlled substances. Some of the clinicians also were charged with aiding and abetting these crimes.
None of the defendants have yet entered a plea of guilty or not guilty, according to court records.
The US Drug Enforcement Administration, the FBI, and the Department of Health and Human Services conducted the investigation that led up to the grand jury indictment, with other law enforcement agencies providing assistance.
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Cite this: Physicians, Pharmacists Indicted in Giant Pain Drug Scam - Medscape - Aug 05, 2011.