Friday, August 12, 2011

Physicians and Pharmacists Scheme to Steal from Medicare

A large group of physicians and pharmacists were indicted today in U.S. district court of Michigan for healthcare fraud by billing Medicare, Medicaid and private insurers for illegally prescribed drugs.  Four physicians, 1 psychologist and 12 pharmacists used 26 pharmacies across Michigan to bill Medicare for Xanax, Vicodin and Oxycodone to the tune of at least $37.7 million.  They billed $20.8 million to the Medicaid program.

One pharmacist, Babubhai Patel, RPh, owned and managed the 26 pharmacies involved in the scheme.  He and his business associates gave kickbacks and bribes to physicians and podiatrists to write medically unnecessary prescriptions for patients.  They then billed third party payers for the fake encounters and bogus prescriptions.

What is even more astonishing is that these charges occurred since January 2009.  The pharmacies dispensed at least 4.6 million doses of Vicodin and 1.5 million doses of Xanax.  It seems that those amounts should raise a red flag somewhere.

I am pleased to shine a light on the indicted professionals.   I know they are presumed innocent until proven guilty but I expect a guilty verdict will be handed down so here they are:

Psychiatrist-Mark Greenbain, MD
General Surgeon and Internist-Paul Petre, MD
Internist-Mustak Vaid, MD
Podiatrist-Anmy Tran, DPM
Psychologist-Sanyani Edwards, PhD.

If guilty, I hope they serve long sentences for this crime.  It should be noted that the majority of physicians are struggling to survive under Medicare payments.


M.scott said...

Collusion or survival? That's the question. It seems that we have created an environment for physicians in this country that is financially untenable. Drug companies push medications, reap obscene profits, and bear little of the liability that physicians must assume.

It is a shame that we have created a situation where young physicians, saddled with ridiculous debt, have to seriously consider such morally challenged options just to practice medicine that they have striven so hard to learn.

Toni Brayer, MD said...

M.scott: You are too kind. Physicians are not the biggest victims in our health care environment. This is Fraud and theft, pure and simple...not some poor family practice physician trying to survive and care for people.

These scams are well orchestrated, often by organized crime and they can only occur because greedy, corrupt doctors allow their licenses and Medicare billing numbers to be used. I don't know, but I would bet that none of these doctors are "young and debt ridden". More likely they are playing the ponies and delivering shoddy medical care.

Michael Kirsch, M.D. said...

I want to echo your point that these folks should be presumed innocent. Press accounts can suggest guilt through distortion and omission as all facts may not yet be available. In addition, those charged usually cannot comment for legal reasons, which may add to the aura of guilt, when "no comment" is reported. We've all read about folks who at first 'seemed guilty', but weren't. Reputations can quickly be sullied, which may not be able to be restored.

Anonymous said...

I can personally tell you that Mark Greenbain is guilty! I reported him earlier this year for sending in dozens of false claims to Medicaid. He claimed to have seen my sister who lives in an adult foster care facility 27 times last year when he really saw her only once. He also did this false reporting with the other residents of the home. That was only last year's false claims; he has been doing this for years.

Anonymous said...

What has happened in this case? I worked with Dr. Vaid for a short time. We were all shocked beyond words!! If it is proven true then they should be severely punished.

Anonymous said...

I know Dr. Vaid and all he cares about is money so I am not surprised.

Anonymous said...

The final judgement came in as guilty (to some different degrees). It is just being greedy in trying to make money fast, with little work.