Six doc­tors charged in opi­oid case

Au­thor­i­ties al­lege $500M scheme cen­tered on three Ma­comb clin­ics

The Detroit News - - News - BY ROBERT SNELL The Detroit News

Detroit — Six doc­tors were charged in an un­sealed in­dict­ment Thurs­day with cheat­ing Medi­care and Med­i­caid out of al­most $500 mil­lion and fu­el­ing the na­tion’s opi­oid epi­demic by il­le­gally pre­scrib­ing more than 13 mil­lion doses of pre­scrip­tion pain med­i­ca­tion.

The dol­lars and drugs in­volved make the al­leged health care fraud con­spir­acy one of the largest in Michi­gan his­tory, and one of the largest na­tion­wide.

The scheme was fo­cused within three pain clin­ics in Ma­comb County: The Pain Cen­ter USA in War­ren and East­pointe, and In­ter­ven­tional Pain Cen­ter in War­ren.

The three clin­ics were owned and op­er­ated by Dr. Ra­jen­dra Bothra, 77, of Bloom­field Hills, a sur­geon, hu­man­i­tar­ian and politi­cian. In 1999, Bothra was pre­sented with the high­est civil­ian honor be­stowed in In­dia, known as the Pad­mashri.

Bothra was cited for hu­man­i­tar­ian ef­forts in In­dia, which in­cluded ed­u­cat­ing peo­ple about AIDS, the dan­gers of tobacco and al­co­hol, and fundrais­ing ef­forts for med­i­cal equip­ment.

Bothra’s clin­ics “sought to bill in­sur­ance com­pa­nies for the max­i­mum num­ber of ser­vices and pro­ce­dures pos­si­ble with no re­gard to the pa­tients’ needs,” pros­e­cu­tors al­leged.

“The dam­age that opi­oid dis­tri­bu­tion has done to our com­mu­nity and to the United States as a whole has been dev­as­tat­ing,” U.S. At­tor­ney Matthew Sch­nei­der said in a state­ment Thurs­day. “Health­care pro­fes­sion­als who prey on pa­tients who are ad­dicted to opi­oids in or­der to line their pock­ets is par­tic­u­larly egre­gious.”

The other doc­tors charged are Dr. Eric Backos, 65, of Bloom­field Hills; Dr. Ga­niu Edu, 50, of South­field; Dr. David Lewis, 41, of Detroit; Dr. Christo­pher Russo, 50, of Birm­ing­ham, and Dr. Ronald Kufner, 68, of Ada.

The doc­tors all worked at Bothra’s clin­ics and lured pa­tients there by pre­scrib­ing opi­oids, the in­dict­ment al­leges.

Af­ter ar­riv­ing at the clin­ics, pa­tients re­ceived the pain med­i­ca­tions and were forced to un­dergo treat­ments that in­cluded in­jec­tions, ac­cord­ing to the gov­ern­ment.

Bothra and Lewis were ar­raigned in fed­eral court Thurs­day.

The di­sheveled doc­tors were ar­rested early Thurs­day and brought to court in hand­cuffs and an­kle chains.

Bothra is be­ing held with­out bond pend­ing a de­ten­tion hear­ing Fri­day in fed­eral court. His lawyer de­clined com­ment.

Lewis was re­leased on $10,000 un­se­cured bond, barred from pre­scrib­ing drugs and billing Med­i­caid or Medi­care.

His at­tor­ney also com­ment.

Russo and Edu also were re­leased on $10,000 un­se­cured bond.

The 56-count in­dict­ment charges the six doc­tors with health-care fraud con­spir­acy, a 10-year felony, mul­ti­ple counts of aid­ing and abet­ting health-care fraud and drug crimes.

The scheme started in Jan­uary 2013 and con­tin­ued un­til last month and in­volved charg­ing Medi­care, Med­i­caid and Blue Cross/Blue Shield of Michi­gan for med­i­cally un­nec­es­sary ser­vices and equip­ment, the in­dict­ment al­leges.

The con­spir­acy cost Medi­care more than $182.5 mil­lion, $272.6 mil­lion to Med­i­caid and $9.2 mil­lion to Blue Cross/Blue Shield, ac­cord­ing to the in­dict­ment.

de­clined

The doc­tors also were re­spon­si­ble for pre­scrib­ing 13,217,987 doses of opi­oids, in­clud­ing OxyCon­tin, Vi­codin, hy­drocodone and Per­co­cet, the gov­ern­ment al­leges.

The al­le­ga­tions out­lined in the com­plaint are “ter­ri­fy­ing,” said Monique Stan­ton, pres­i­dent and CEO of CARE of South­east­ern Michi­gan, a Ma­comb County-based group that pro­vides sub­stance abuse treat­ment.

“It is im­per­a­tive that those med­i­cal of­fi­cials who abuse their pow­ers for fi­nan­cial rea­sons are held ac­count­able — we are in a life-and-death sit­u­a­tion in this epi­demic,” Stan­ton wrote in an email Thurs­day.

The al­leged con­spir­acy is the third to­tal­ing more than $100 mil­lion in re­cent years in Metro Detroit.

Dr. Frank Patino of Wood­haven was charged in June and ac­cused of or­ches­trat­ing a $112 mil­lion health-care fraud.

Patino is jailed while await­ing trial.

The Patino case is linked to an in­ves­ti­ga­tion in­volv­ing a $200 mil­lion scheme and busi­ness­man Mashiyat Rashid of West Bloom­field Town­ship.

The Rashid scheme dis­trib­uted 6.6 mil­lion doses of con­trolled sub­stances, fed­eral au­thor­i­ties said.

Dur­ing the Rashid in­ves­ti­ga­tion, fed­eral agents have seized more than $21 mil­lion worth of cash and real es­tate and want Rashid’s man­sion for­feited to the gov­ern­ment.

Rashid struck a plea deal with pros­e­cu­tors in Oc­to­ber

Hand­out / Hand­out

Clock­wise from left: Dr. Ga­niu Edu, Dr. Eric Backos, Dr. David Lewis and Dr. Ronald Kufner

Bothra

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In a sep­a­rate case, Dr. Frank Patino, 63, of Wood­haven is await­ing trial, ac­cused in a $112 mil­lion case of fraud.

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