Six Area Doctors Charged in Connection with $464 Million Health Care Fraud Scheme Involving Unnecessary Injections and Unlawfully Prescribed Opioids
A grand jury returned an indictment Tuesday that charges six doctors as part of an investigation into a $464 million health care fraud scheme that involved over 13 million unlawfully prescribed opioid prescription drugs, United States Attorney Matthew Schneider announced today.
Schneider was joined in the announcement by Special Agent in Charge Lamont Pugh III of the U.S. Department of Health and Human Services Office of Inspector General’s (HHS-OIG) Chicago Regional Office and Special Agent in Charge Timothy R. Slater of the FBI’s Detroit Division.
The 56-count Indictment charges that Dr. Rajendra Bothra, 77, of Bloomfield Hills, owned and operated a pain clinic in Warren, Michigan that sought to bill insurance companies for the maximum number of services and procedures possible with no regard to the patients’ needs. 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, all worked at the clinic in varying capacities but each prescribed opioid pain medication to induce patients to come in for office visits. Once there, in order to receive the highly addictive opioid prescriptions, patients were forced to undergo ancillary services, such as painful facet joint and facet block injections
“The damage that opioid distribution has done to our community and to the United States as a whole has been devastating,” said U.S. Attorney Schneider. “Healthcare professionals who prey on patients who are addicted to opioids in order to line their pockets is particularly egregious. We will continue to prosecute such individuals who choose to violate federal law and their ethical oaths.”
“Our enforcement actions underscore the commitment of the FBI and our partners to investigate vigorously physicians who use opioid prescriptions to induce patients to submit to unnecessary medical procedures,” said Timothy R. Slater, Special Agent in Charge of the FBI’s Detroit Division. “Today’s charges should signal to the community that we take these cases seriously and I encourage anyone who has information about this case - or about any other activity of this type - to contact the FBI at 313-965-2323.”
“Physicians who engage in the illegal and negligent prescribing of controlled substance in order to unjustly enrich themselves of taxpayer dollars will be held accountable” said Lamont Pugh III, Special Agent in Charge, U.S. Department of Health & Human Services, Office of Inspector General – Chicago Region. “The OIG will continue to prioritize the investigation of allegations involving fraud schemes that incorporate the illegitimate prescribing of Opioid medications in order to protect the health and safety of patients. We will continue to work diligently with our federal, state and local partners to preserve the integrity of federal funded health care programs such as Medicare and Medicaid and the people that these programs support.”
The case was investigated by the U.S. Department of Health and Human Services, Office of Inspector General and the Federal Bureau of Investigation with the assistance of the Drug Enforcement Administration, the City of Warren Police Department, and Blue Cross/Blue Shield - Corporate and Financial Investigations. It is being prosecuted by Assistant United States Attorney Brandy R. McMillion.
McMillion serves as the Opioid Fraud Abuse and Detection Unit Prosecutor for the Eastern District of Michigan. This Department of Justice initiative uses data to target and prosecute individuals that are contributing to the nation’s opioid crisis. The Eastern District of Michigan is one of the twelve districts included in the Opioid Fraud Abuse and Detection Unit.
An indictment is only a charge and is not evidence of guilt. Each defendant is entitled to a fair trial in which it will be the government’s burden to prove guilt beyond a reasonable doubt.