Healthcare Compliance Perspective:
Medicare abuse describes practices that result in unnecessary cost to the Medicare Program, including billing for unnecessary medical services. Medicare abuse can expose providers to criminal liabilities, exclusions, and civil monetary penalties.
The United States recently filed a civil lawsuit today against a physician in the Reading, Pennsylvania area, alleging that he wrote improper opioid prescriptions for several of his patients. According to the complaint, the doctor issued 343 opioid prescriptions to three of his patients that lacked a legitimate medical purpose and that were issued outside of the usual course of his professional practice.
The complaint alleges that for these three patients, the doctor prescribed approximately 123,660 opioid pills from 2014 through 2016. Those prescriptions were often written for oxycodone 30mg, one of the most heavily abused and most lucrative oxycodone prescriptions on the black market. An expert review of these prescriptions indicated that the prescriptions were dangerous, inappropriate, and susceptible to illicit use.
The United States and the physician have entered into a Stipulated Order and Consent Judgment, subject to the Court’s approval that would resolve the matter without litigation. If approved by the Court, the Judgment would require the doctor to pay $400,000 to the United States, prohibit him from ever seeking a future DEA controlled substance license, require that he voluntarily relinquish his license to practice medicine, and require him to execute an agreement with the U.S. Department of Health and Human Services to
