Pain doctors in Indiana, Texas face fraud charges

Fraud, waste and abuseA pain doctor with offices in Louisville, Kentucky and Jeffersonville, Indiana faces a possible life sentence after being indicted by a federal grand jury for illegally prescribing pain medication that resulted in five patient deaths, according to a release by the U.S. Attorney's Office.

According to the 32-count indictment, Jaime Guerrero, M.D., is charged with unnecessarily prescribing oxycodone, methadone and hydrocodone to patients from 2009 through 2012. Guerrero is also charged with two counts of healthcare fraud for allegedly submitting false claims for patient healthcare counseling and fraudulently billing healthcare benefit programs.

The U.S. Attorney's release points to specific dates in May and June of 2011 when Guerrero allegedly billed for more than 100 patients on each day, spent approximately three minutes with each patient, and then billed the office visits for a higher reimbursement code. Guerrero is also accused of directing an unlicensed staff member to provide drug education and bill for 15- to 30-minute counseling sessions while he was out of the office. Five patients died between February 2010 and March 2012, allegedly due to pain medication Guerrero distributed.

Elsewhere in Indiana, a Fort Wayne pain physician pleaded not guilty to eight felony charges accusing him of over-prescribing pain medications, according to the Associated Press. William Hedrick, M.D., who operated several pain clinics in Indiana, was arrested early this month by the U.S. Drug Enforcement Agency, along with a nurse practitioner who he employed. Hedrick is charged with Medicaid fraud, reckless prescribing and three counts of registration offense and forgery, according to the AP.

These recent cases add to a Houston investigation involving a doctor and a pharmacist who allegedly prescribed 1.6 million pain pills over the course of three years using fake prescriptions, according to the Houston Chronicle. The 24-count indictment, which includes healthcare fraud and money laundering in addition to conspiring to distribute controlled substances, describes how Richard Arthur Evans, M.D., and David D. Devido allegedly had patients pay $200 to $240 in cash to receive a prescription for pain medication. Patients would send cash to renew the prescription every 30 days.

FierceHealthPayer: AntiFraud previously reported on the legislative push to improve controls surrounding pain medication without hurting patients suffering from chronic pain. Additionally, the sometimes-cozy relationship between physicians and pharmaceutical companies speaks to the need for better compliance programs.

For more:
- here's the U.S. Attorney's Office release
- read the Associated Press article and DEA statement
- read the Houston Chronicle article