“IF EVER ONE THINKS THEY’RE TOO SMALL TO MAKE CHANGES, THEN THEY HAVE NEVER SLEPT WITH A MOSQUITO !!!”
BY
NORMAN J CLEMENT RPH., D.D.S., MALACHI F. MACKANDAL PHARMD, BELINDA BROWN-PARKER, IN THE SPIRIT OF JOSEPH SOLVO ESQ., INC.T. SPIRIT OF REV. C.T. VIVIAN, JELANI ZIMBABWE CLEMENT, BS., MBA., IN THE SPIRIT OF THE HON. PATRICE LUMUMBA, IN THE SPIRIT OF ERLIN CLEMENT SR., WALTER F. WRENN III., MD., JULIE KILLINGWORTH, LESLY POMPY MD., CHRISTOPHER RUSSO, MD., NANCY SEEFELDT, WILLIE GUINYARD BS., JOSEPH WEBSTER MD., M.B.A., BEVERLY C. PRINCE MD., FACS., NEIL ARNAND, MD., RICHARD KAUL, MD., LEROY BAYLOR, JAY K. JOSHI MD., M.B.A., ADRIENNE EDMUNDSON, ESTER HYATT PH.D., WALTER L. SMITH BS., IN THE SPIRIT OF BRAHM FISHER ESQ., MICHELE ALEXANDER MD., CUDJOE WILDING BS, MARTIN NJOKU, BS., RPH., IN THE SPIRIT OF DEBRA LYNN SHEPHERD, BERES E. MUSCHETT, STRATEGIC ADVISORS
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the indictment
DEPARTMENT OF JUSTICE DEPARTMENT WAR ON DRUGS AND THEIR CREATIVE PROSECUTIONS OF MEDICAL PROVIDERS
RAJENDRA BOTHRA, MD
Dr. Rajendra Bothra, MD, 77, is the owner and one of six doctors at two clinics in Warren and Eastpoint, Michigan, who is unbelievably charged with fraud because patients have to come back for a chronic condition. This goes to show the frank handing over the controls stick to the DOJ to do whatever they please against innocent citizens with no fear of responsibility.
The government is trying to create crime if a doctor orders appropriate tests or equipment for chronic pain conditions by coming back afterward and stating they were medically unnecessary, ineligible for reimbursement, and therefore fraud.
Once again, this is becoming the routine charge now against any doctor who takes government insurance. They are trying to offset the country’s $985 billion debt by confiscating all the payments made to doctors for the last 5 years. So doctors taking care of government-insured or Blue Cross Blue Shield, take note: You are treating these patients for free and you will lose your business through bankruptcy when the government charges and fines you to get their money back.
Dr. Bothra was a 30-year practicing surgeon who, as a Fellow in the American Society of Interventional Pain Physicians, has been doing interventional pain management exclusively for the last 5 years with expertise in epidural blocks, facet blocks, radiofrequency rhizotomy, and spinal cord stimulation implants, to name a few. The government, through Pub. Law 115-271, is even trying to get doctors to do more of these procedures by providing higher compensation. Is that just a trick to put more doctors in prison for asset forfeiture? Quite possibly. Doctors—BEWARE!!
Dr. Bothra is personally charged with 12 counts of aiding and abetting health care fraud for 12 claims between 2013 and 2018. Here are the claims he is being charged with:
GANIU EDU, MD
Ganiu Edu, MD, 50, an anesthesiologist and pain management specialist in Warren, Michigan is charged with 11 counts of aiding and abetting health care fraud and 2 counts of aiding and abetting the illegal distribution of controlled substances. The charges are for allegedly prescribing opioids as a way of inducing patients to come in for office visits, where patients were then allegedly given services in exchange for addictive drugs.
Now how does that translate into real language? Patients came to the office with chronic pain. The doctor used appropriate tests to diagnose and treat the pain. Per law, patients have to return for refills. That is called routine medical care in this country. If the return of a patient for chronic care is criminal, then every medical practice from pediatrics to geriatrics needs to watch out, because they could be next.
The real reason for these “aiding and abetting” charges is to force Dr. Edu to plea, so that the main target, Dr. Bothra, 77, has no choice but to plea, and the government rakes in the money that all 6 of the doctors charged have earned by taking care of government-insured patients.
The government is trying to say that the doctor’s tests and equipment were medically unnecessary and therefore ineligible for reimbursement. This is becoming the routine charge now against any doctor who takes government insurance. The $34 billion debt is being offset by confiscating all the payments made to doctors for the last 5 years.
So doctors taking care of government-insured or BXBS, take note: You are treating these patients for free and you will lose your business through bankruptcy when the government charges and fines you to get their money back.
FROM DOCTORS OF COURAGE
LESLY POMPY, MD
Lesly Pompy, MD of Monroe, Michigan is the latest pain management physician now under attack for treating pain. His office was raided by the usual DEA agents, and state and local law enforcement on Sept 26, 2016. His office is located at ProMedica Monroe Regional Hospital and he is affiliated with them, but the hospital immediately made public that his practice was not owned by the hospital.
Dr. Lesly Pompy is a trusted and reputable anesthesiologist and pain management specialist caring for the Monroe, MI community. Dr. Pompy obtained his medical degree from New York Medical College. He completed his residency in pain medicine and another residency in anesthesiology at Kings County Hospital Center.
He also completed his fellowship in anesthesiology and another fellowship in pain medicine at Cleveland Clinic. Dr. Pompy is a part of Interventional Pain Management Associates and is affiliated with Mercy Memorial Hospital in Monroe. He is certified in anesthesiology and pain medicine by the American Board of Anesthesiology. He is also certified by the American Board of Pain Medicine and the American Board of Addiction Medicine.
He is a member of the American Academy of Addiction Psychiatry and the American Medical Association. Dr. Pompy is trilingual in English, French, and Spanish. He received 1986: Board of Trustees Award; New York Medical College and 1973: New York Governor Huge Carey Citation Award. Dr. Pompy gives each patient his focused attention, and he prides himself on delivering the best treatment available.
CHRISTOPHER RUSSO, MD
Christopher Russo, MD, 50, of Birmingham, Michigan was charged on Dec. 6 along with his 5 colleagues with one count of health care fraud conspiracy and one count of conspiracy to distribute and possess with intent to distribute controlled substances. He was also charged with five counts of aiding and abetting health care fraud for five claims between April. 2017 and March 2018 and one count of aiding and abetting the unlawful distribution of controlled substances for 90 doses of hydrocodone-acetaminophen.
Now The Pain Center in Warren was a clinic that specialized in joint and spinal injury. And the description of Dr. Russo on the clinic’s website states:
A 1994 graduate of the University of Michigan Medical school, following residency Dr. Russo completed a 2-year Pain Medicine Fellowship followed by Post-Fellowship training in Advanced Interventional Pain Techniques. He has special interest in spinal cord and occipital nerve stimulation, trigeminal nerve disorders, vertebral compression fractures, radiofrequency ablation and chemical dependency
So injections are a basic part of the care of patients that Dr. Russo treats. Because conventional medicine doesn’t get to the cause of pain, the steroid injection into a joint is routine care. So it is laughable that the government charged Dr. Russo with fraud for a $25 steroid injection, for example.
They are really reaching the bottom of the barrel here. And using the Controlled Substance Act for 90 doses of Lortab? Unbelievable! The only reason for doing this is to allow the forfeiture that was supposed to be used against drug cartels, but as they were totally inept at that, the DEA turned the law illegally against doctors.
FROM DOCTORS OF COURAGE
DAVID LEWIS MD
David Lewis, MD, 41 is the youngest of the 5 physicians at The Pain Center in Warren, Michigan to be charged with fraud and distribution. After a Bachelor of Science in Biochemistry, medical degree from Meharry Medical College, residency in Anesthesiology, and a pain management fellowship, Dr. Lewis just completed board requirements to be certified with the American Board of Anesthesiology. So do you really think that after going through all of that, Dr. Lewis would choose to submit fraudulent claims to Medicare? Of course not! He is a victim of gross government misconduct in violation of constitutional rights as any doctor in the country is possible to be.
SO WHAT HAPPENS WITH DR. RUAN, DR. KHAN, AND PHYSICIANS FACING FEDERAL CHARGES?
BY RON CHAPMAN
Dr. Ruan and Khan’s convictions were vacated and remanded back to the Circuit court of appeals for the court to determine if the instructions given in their cases followed this new precedent. Justice Breyer believes that they likely did not but is giving the Circuit Courts the opportunity to interpret and apply this standard against instructions already given. Pending that decision, they will either get a new trial or have another visit in front of the Supreme Court.
As for other physicians, there are two categories: (1) those that have been convicted, and (2) those that are facing trial.
For the first category, their counsel must exhaust appellate remedies by arguing that their jury was improperly instructed under this new standard. They must show that they were faced with an “objective” standard that violates the express wording of Justice Breyer’s opinion. Those that received an “objective good faith instruction” will likely fair the best on appeal. An objective good faith standard is clearly inappropriate and failed to properly instruct the jury on the applicable intent for a violation of 21 U.S.C. 841.
Those facing trial must utilize this decision to craft jury instructions that plainly stated that the Government must prove that the physician “knowingly” and “intentionally” prescribed outside the usual course of professional practice and for other than a legitimate medical purpose. The trial strategy has also changed dramatically. Justice Breyer invited the Government to try to construct an “objective” standard during its case. They most certainly will try to do this by utilizing their expertise to construct a set of objective criteria that the expert deems appropriate i.e. “physician exams”, discharging patients with inconsistent urine drug screens, addressing “red flags” and prescribing within a certain range of morphine milligram equivalents.
The defense must then respond with appropriate expert testimony breaking down this objective standard and showing that the physician believed his conduct was reasonable given his training, education, experience, and history of treating his patient population. In the trial, I put a large emphasis on my client’s education and training during direct examination of my client.
Building the defendant up to seem as a reasonable person who made reasonable decisions helps greatly to rebut the contention that he/she abandoned the practice of medicine and engaged in “drug trafficking”. You must also show that the selection of the cases shown by the government constitutes the most difficult patients wherein the physician had to make difficult prescribing decisions. This, juxtaposed with his/her patient population of normal everyday patients will be helpful to show that this doctor generally made good decisions.
Sometimes, a trial judge will try to tell me that patients outside the indictment are irrelevant. The Ruan opinion strengthens the argument that this is vitally important. A physician should be given reasonable latitude to show the jury the vast number of patients who received detailed physical exams, reduced quantities of opiates etc. This can be done with statistical sampling and extrapolation.
If you need help with this feel free to reach out, I can help create graphs and charts of billing and prescribing data that will make sense for the jury.
If you are facing trial or have been convicted of an unlawful prescribing offense or you are an attorney for a physician accused of unlawful prescribing, don’t hesitate to contact me for a review of your case and your jury instructions to determine if you may get relief from the Supreme Court’s decision in Ruan v. the United States.
LIST OF HEALTH PROVIDERS THAT HAVE BEEN TARGETS OF DOJ-DEA
FOR NOW, YOU ARE WITHIN
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