Drug charges, healthcare fraud get doctors in hot water

Legal and regulatory issues
A number of doctors were indicted or sentenced this week on drug and healthcare fraud charges. (iStock/BCFC)

It’s a new year and there’s no shortage of headlines when it comes to doctors facing legal troubles. Here’s a roundup of doctors indicted and sentenced this week on charges:

In West Virginia, two physicians and a business partner were indicted on charges they illegally distributed controlled substances from a drug treatment center, according to the U.S. Attorney’s Office for the northern district of West Virginia.

Indicted by a grand jury were Felix Brizuela Jr., D.O., 61, of Harrison City, Pennsylvania, who operated an office in West Virginia, George P. Naum, D.O., 58, of Wheeling, West Virginia, and Eric Drake, 47, of Weirton, West Virginia. The three men are accused of conspiring with one another to illegally distribute controlled substances from Advance Healthcare, Inc., a treatment center in Weirton, from 2008 to 2016.

Brizuela is also charged with illegally distributing controlled substances in Monongalia County from 2013 to 2015 and accepting financial kickbacks in exchange for directing urine samples for drug testing to a certain company.

In Virginia, a Danville doctor was sentenced Tuesday to two years in prison on healthcare fraud and tax evasion charges, according to the U.S. Attorney’s office in the western district of Virginia.

Edwin Fuentes, D.O., 55, billed various insurers for services he never administered to patients, even after he was warned about the practice, prosecutors said. Fuentes, who had pleaded guilty to one count of healthcare fraud and one count of willfully evading taxes, was ordered to pay more than $1.7 million, as well as to repay more than $125,000 in investigative costs.

Fuentes owned and operated Morning Star Family Medicine in Danville. Prosecutors said he double-billed the same patient visits under two different billing codes and then attempted to conceal the fraud by falsifying notes in patient records.

In Wyoming, a psychologist was sentenced earlier this week to three years in prison for healthcare fraud, according to the U.S. Attorney’s office for the district of Wyoming.

Gibson Buckley Condie, 57, of Powell, falsely billed the state’s Medicaid program for mental health services, prosecutors said. He was ordered to pay approximately $2.28 million in restitution to the state and federal government. Condie previously pleaded guilty to one count of healthcare fraud.

Prosecutors said he claimed to be the treating provider even though almost all of the services were provided by unenrolled and often unlicensed persons not authorized to provide mental health services under Wyoming Medicaid laws.

In Michigan, a Livonia doctor and seven patient recruiters were charged this week in an $18 million illegal distribution of prescription drugs and healthcare fraud scheme, according to the U.S. Attorney’s Office for the eastern district of Michigan.

Zongli Chang, M.D., 52, of Novi, Michigan, and seven other individuals all from Detroit were charged with conspiracy to illegally distribute prescription drugs.

Chang is also charged with healthcare fraud. According to the indictment, Chang and his co-conspirators engaged in a large-scale drug diversion scheme from January 2012 to May 2017, when the state revoked Chang’s medical license.

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Prosecutors say Chang relied upon “patient recruiters” who paid cash to acquaintances to go to the doctor’s office, where the “fake patients” received prescriptions for controlled substances that had a conservative street value of more than $18 million.

In the face of the country’s opioid epidemic, the federal government has expanded efforts to go after doctors and other medical professionals who overprescribe opioids. The government has set up an Opioid Fraud and Abuse Detection Unit, which is designed to combat the overprescribing of opioid painkillers that have contributed to the country’s opioid epidemic, and has assigned 12 prosecutors to focus solely on opioid-related fraud cases in a dozen hot-spot locations around the country.