Prescription for Disaster

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It must be fun to be an undercover agent. They get to pose as a variety of characters to get sufficient evidence to convict criminals. Sometimes the job is dangerous and involves disguises, but at other times they can pose as a normal person without risking life or limb to get evidence. A story published in the Chicago Sun Times tells about an undercover agent who busted a doctor for prescribing a controlled substance that was not needed.

The article reports that the physician got into trouble by prescribing oxycodone, a powerful pain medication, to a healthy undercover agent posing as a Medicare beneficiary with shoulder pain from a previous injury. It turns out that the doctor had written five prescriptions for the drug over a period of a year to this agent even though he had never conducted an examination. It turns out that the physician had been prescribing oxycodone and other controlled substances to other patients and billing Medicare approximately $500,000. (He was able to collect about $216,000 for the services he did not provide.)

The 47-year-old doctor pleaded guilty to health care fraud and illegally prescribing drugs. As part of a plea bargain, he agreed to surrender his Drug Enforcement Agency (DEA) registration and approximately $126,000 that was seized upon his arrest along with two BMW’s and a Lexus. (Now we know what he spent some of that fraudulently obtained money on.)

Authorizing controlled substances without an exam is a prescription for disaster. This is a habit-forming drug that can fall into the hands of unscrupulous people who want to sell the drug for a profit. It’s hard to tell what sentence this doctor may get, but for now he will definitely not be writing any more prescriptions or submitting any false claims to Medicare.

Source: Today’s ”Fraud of the Day” is based on an article titled, ”Suspended Darien Doctor Pleads Guilty to Federal Fraud Charge,” published by the Chicago Sun Times on September 4, 2014.

A suspended west suburban physician pleaded guilty Thursday to federal charges of health care fraud and illegally prescribing prescription drugs.

Sathish Narayanappa Babu, 47, owner of Anik Life Sciences Medical Corp. in Darien, pleaded guilty to one count of health care fraud and one count of illegally prescribing a controlled substance, according to the U.S. Attorney’s office.

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Larry Benson is currently the Director of Strategic Alliances for Revenue Discovery and Recovery at LexisNexis Risk Solutions. In this role, Benson is responsible for developing partnerships for the tax and revenue and child support enforcement verticals. He focuses on embedded companies that have a need for third-party analytics to enhance their current offerings.