Healthcare Compliance Perspective:
Civil penalties for violating the Federal False Claims Act may result in fines up to three times the amount of damages sustained to the Government as a result of the false claims, plus penalties up to $21,916 per false claim filed. Individuals who submit false claims may also be subjected to imprisonment and exclusion from federal and state healthcare programs.
An Acting U.S. Attorney announced last week that a physician from Michigan had been sentenced to 10 months’ in prison following his guilty plea for writing fraudulent prescriptions to obtain controlled substances. The doctor will also pay restitution to a Michigan insurance company, which paid for a number of his fraudulent prescriptions. The doctor was required to surrender his DEA registration to federal authorities as part of this investigation.
Fraudulent Prescriptions Investigation and Background:
Between 2006 and 2015, the investigation revealed that the doctor wrote over 150 fraudulent prescriptions in the names of seven different people in order to obtain quantities of Ritalin, a Schedule II controlled substance. The amount he obtained ultimately exceeded five times the maximum FDA-approved adult dosage. The physician started issuing fraudulent prescriptions before he graduated from
medical school. He wrote fraudulent prescriptions while he was on state court probation for a domestic violence conviction, and continued writing fraudulent prescriptions after being fired by a northern Michigan hospital for his prescribing practices. Later, in 2015, prescriptions written to his girlfriend became the subject of a state licensing investigation. But, the doctor assured state investigators that, going forward, there was “zero chance” he would write prescriptions for anyone other than his patients. However, the very next day he continued writing prescriptions and concealed those prescriptions by writing them in the names of his girlfriend’s minor children and others who were unknown to licensing investigators.
During his nearly decade-long prescription fraud, the doctor boasted, in text messages, that he was “[s]ticking it to the man” by having some of his prescriptions paid for by other people’s private insurance. He also falsified progress notes in a patient’s medical record to cover other fraudulent prescriptions. When he became aware of the federal investigation, he instructed people not tell the DEA anything about his fraudulent prescriptions.
The doctor’s girlfriend, a registered nurse, also pled guilty to aiding and abetting in illegally obtaining controlled substances. She will be sentenced on January 5, 2018. To date, the U.S. Attorney’s Office has further recovered $46,200.00 in civil penalties from other individuals who filled fraudulent prescriptions and returned controlled substances to the doctor.
