Pawankumar Jain Pleads Guilty to Unlawfully Dispensing Prescription Painkillers and Health Care Fraud
Physician, whose Medical License was Revoked in Dec. 2012, Prosecuted as Part of HOPE Initiative which Seeks to Reduce the Number of Opioid-Related Deaths in New Mexico
ALBUQUERQUE – Pawankumar Jain, 63, a physician whose license has been revoked, entered a guilty plea this morning in federal court in Las Cruces, N.M., to unlawfully dispensing controlled substances and health care fraud. The guilty plea was announced by U.S. Attorney Damon P. Martinez, Special Agent in Charge Will R. Glaspy of the DEA’s El Paso Division, and Special Agent in Charge Terry Wade of the FBI’s Albuquerque Division.
Jain initially was charged in a 111-count indictment filed in April 2014. The indictment charged Jain with 61 counts of unlawfully dispensing controlled substances and 50 counts of healthcare fraud. A 138-count second superseding indictment filed in June 2015 added new charges for a total of 79 unlawful dispensing charges and 59 healthcare fraud charges. The superseding indictment alleged that Jain committed the offenses charged between April 2009 and June 2010, in Doña Ana County, N.M. During that time, Jain was a licensed physician with a neurology subspecialty who operated a pain management medical practice in Las Cruces. Jain’s medical license was suspended in June 2012, and subsequently revoked in Dec. 2012 by the New Mexico Medical Board.
The 79 dispensing counts in the superseding indictment charged Jain with unlawfully dispensing prescription painkillers, primarily Oxycodone and methadone, to patients outside the usual course of medical practice and without a legitimate medical purpose. The 59 healthcare fraud counts alleged that Jain engaged in a scheme to defraud two federal health care benefit programs, Medicare and Medicaid, by submitting claims for payment for prescription medications he dispensed to patients outside the usual course of medical practice and without legitimate medical purpose. The superseding indictment included allegations that Jain’s criminal conduct resulted in the deaths of four patients.
Today Jain pled guilty to one count of unlawfully dispensing a controlled substance and one count of health care fraud. In his plea agreement, Jain acknowledged that from June 2007 through Feb. 2012, he was a licensed physician who practiced medicine in Las Cruces, and operated a “high volume practice, which included ‘pain management’ treatment for many patients.”
In his treatment of one patient identified as “M.E.B.,” Jain admitted conducting “cursory exams and [that he] did not document a therapeutic benefit from the narcotics he was prescribing for her.” Jain’s plea agreement states that he last saw M.E.B. as a patient on Nov. 25, 2009 when he “conducted a superficial exam … [and] wrote two prescriptions, each for 270 tablets of methadone 10 mg, one dated November 25, 2009, and the second dated December 23, 2009. M.E.B. filled each of these prescriptions, which were issued outside the usual course of medical practice and without a legitimate medical purpose. . . . Two days after she filled the second prescription, M.E.B. died on December 25, 2009.”
Jain also admitted committing health care fraud in connection with his treatment of M.E.B. Jain’s plea agreement states that he knew M.E.B. was insured by Medicare and that claims to cover the costs of the medication he prescribed for her would be submitted to Medicare for payment, which was in keeping with his scheme to defraud Medicare. It further states that each of the two prescriptions Jain wrote for M.E.B. on Nov. 25, 2009, were submitted to Medicare for payment, which was consistent with his intent.
Jain has been in federal custody since April 2014, and remains detained pending his sentencing hearing, which has yet to be scheduled. Under the terms of his plea agreement, Jain will be sentenced to a prison term within the range of 42 to 108 months followed by a term of supervised release to be determined by the court.
“This guilty plea should put health care providers who operate pill mills on notice that the authority to prescribe highly addictive controlled substances comes with accountability and responsibility. Doctors take an oath to ‘first, do no harm.’ To fulfill that oath, health care providers who prescribe opioid painkillers must be vigilant not only in their prescribing practices but also in the follow-up care they provide to their patients. Failure to do so can result in addiction and even death for their patients,” said U.S. Attorney Damon P. Martinez. “This guilty plea comes at a time when the abuse of opioid painkillers, such as Oxycodone, has become a national epidemic that is having a devastating impact on New Mexicans, and the efforts of the DEA and FBI in investigating this case must be commended. This case demonstrates that law enforcement can and will act forcefully with respect to those who supply drugs – including doctors.”
“Dr. Jain was entrusted with the care and well-being of patients in our community. Tragically, he took advantage of that trust and endangered the lives of his own patients,” said DEA Special Agent in Charge Will Glaspy. “Prescription drug abuse is a leading cause of heroin addiction and overdose deaths in the United States which has taken over 44,000 lives in the past year. Physicians are generally part of the solution to our medical concerns. Sadly, Dr. Jain was part of the problem.”
“Doctors who over-prescribe opioid pain medication contribute to a national epidemic of drug overdoses that annually kills thousands of people from every background and income level.
While this plea won't repair the damage done to the victims or their families, it will hopefully head off future tragedies by making some doctors think twice before recklessly prescribing pain-killers. If that happens, then all the hard work that went into this case will have been worth it,” said FBI Special Agent in Charge Terry Wade. “I thank the FBI Special Agents and support staff who worked closely with the DEA, New Mexico Medical Board and New Mexico Board of Pharmacy on this case, and I congratulate the U.S. Attorney’s Office for a successful prosecution.”
This case was investigated by the DEA’s Tactical Diversion Team in El Paso, Texas and the FBI’s Healthcare Fraud Unit with assistance from the New Mexico Medical Board and the New Mexico Board of Pharmacy. The case is being prosecuted by Assistant U.S. Attorneys Sarah M. Davenport and Richard C. Williams of the U.S. Attorney’s Las Cruces Branch Office.
DEA’s Tactical Diversion Squads combine DEA resources with those of federal, state and local law enforcement agencies in an innovative effort to investigate, disrupt and dismantle those suspected of violating the Controlled Substances Act or other appropriate federal, state or local statutes pertaining to the diversion of licit pharmaceutical controlled substances or listed chemicals.
This case is being prosecuted pursuant to the New Mexico Heroin and Opioid Prevention and Education (HOPE) Initiative. The HOPE Initiative is a collaborative effort between the U.S. Attorney’s Office and the University of New Mexico Health Sciences Center that is partnering with the Bernalillo County Opioid Accountability Initiative with the overriding goal of reducing the number of opioid-related deaths in the District of New Mexico. The HOPE Initiative is comprised of five components: (1) prevention and education; (2) treatment; (3) law enforcement; (4) reentry; and (5) strategic planning. The law enforcement component of the HOPE Initiative is led by the Organized Crime Section of the U.S. Attorney’s Office and the DEA in conjunction with their federal, state, local and tribal law enforcement partners. Targeting individuals who participate in drug diversion schemes, pill mills, rogue clinics and pharmacies, and prescription drug rings for investigation and prosecution is a priority of the HOPE Initiative.