However, the twist here is that the government alleges that the prescriptions were pre-signed by the neurologist and that he did not see the patients. However, it is not clear if any other providers saw the patients or who else completed the prescriptions. One would assume there must be other facts relating to this pain management clinic that are not alleged in the charging documents.
On April 18, 2019, a two-count bill of information was filed against neurologist Anil Prasad, M.D., charging him with conspiracy to unlawfully dispense controlled substances and conspiracy to commit health care fraud. If Dr. Prasad does not waive Indictment or reach a plea agreement, there will probably be an Indictment arising from the information. An information is a charging document and is not evidence and Dr. Prasad is presumed innocent of all charges.
Specifically, Dr. Prasad was charged with one count of prescribing controlled substances outside the course of professional practice and for no legitimate purpose and one count of conspiracy to commit health care fraud. According to court documents, between November 2016 and July 2018, Dr. Prasad worked at a pain management clinic in Slidell, and during the course of his employment he pre-signed prescriptions for controlled substances, including oxycodone and hydrocodone, without performing patient examinations to determine medical necessity.
Additionally, the government alleges that Dr. Prasad knew or should have known that some of those patients used their
Medicare and Medicaid benefits to fill those prescriptions. In total,
Medicare and Medicaid paid approximately $1,657,461.15 for those prescriptions.
Attorney Commentary: One of the issues with controlled substances is that even if the patient had medical necessity for the medications, if the physician "pre-signed" the prescription and allowed staff to write the hard copy refill for the patient who was not seen by a health care provider, the DEA laws would take the prescription out of the protection of the DEA laws. Interestingly, there are no allegations that the neurologist billed fraudulently for the Medicare visits. One of the ways it may have been determined to proceed on a health care fraud case is that the records may have shown no physician visits when the prescriptions were written.
With controlled substances, the prescriptions cannot be called in and must be picked up in hard copy. It is hard to know at this time if this was a convenience for patients or if, in fact, there was true lack of legitimate medical purpose. There are no allegations at this time of fraudulent medical records or that the pharmacy paid the neurologist for the prescriptions which has me question the motivation of the neurologist in the alleged offense.
I question whether a physician who writes a refill prescription without seeing a patient could be held liable under this same theory. Certainly, many physicians will leave a prescription for a patient when the patient runs out or the patient cannot obtain a timely appointment. The "pre-signed" allegation makes it seem that a staff member wrote in the details on a blank pad but that is not clear here. In any event, it is a reminder for prescribers to be careful when writing refill prescriptions when the patient is not being seen even for very valid reasons and to document the reasons and to get the patient in as soon as possible.
The potential sentences on these type of counts can be high. For example, if convicted, Dr. Prasad could face a possible maximum sentence of 20 years imprisonment and a $1,000,000 fine as to Count 1 of the Information, and a possible maximum sentence of 10 years imprisonment and a $250,000 fine as to Count 2 of the Information. The federal sentencing guidelines and a federal judge determine the sentence, however, this is why it is critical to avoid these type of charges at all cost.
Posted by Tracy Green, Esq.
Green and Associates, Attorneys at Law
Attorney Commentary: One of the issues with controlled substances is that even if the patient had medical necessity for the medications, if the physician "pre-signed" the prescription and allowed staff to write the hard copy refill for the patient who was not seen by a health care provider, the DEA laws would take the prescription out of the protection of the DEA laws. Interestingly, there are no allegations that the neurologist billed fraudulently for the Medicare visits. One of the ways it may have been determined to proceed on a health care fraud case is that the records may have shown no physician visits when the prescriptions were written.
With controlled substances, the prescriptions cannot be called in and must be picked up in hard copy. It is hard to know at this time if this was a convenience for patients or if, in fact, there was true lack of legitimate medical purpose. There are no allegations at this time of fraudulent medical records or that the pharmacy paid the neurologist for the prescriptions which has me question the motivation of the neurologist in the alleged offense.
I question whether a physician who writes a refill prescription without seeing a patient could be held liable under this same theory. Certainly, many physicians will leave a prescription for a patient when the patient runs out or the patient cannot obtain a timely appointment. The "pre-signed" allegation makes it seem that a staff member wrote in the details on a blank pad but that is not clear here. In any event, it is a reminder for prescribers to be careful when writing refill prescriptions when the patient is not being seen even for very valid reasons and to document the reasons and to get the patient in as soon as possible.
The potential sentences on these type of counts can be high. For example, if convicted, Dr. Prasad could face a possible maximum sentence of 20 years imprisonment and a $1,000,000 fine as to Count 1 of the Information, and a possible maximum sentence of 10 years imprisonment and a $250,000 fine as to Count 2 of the Information. The federal sentencing guidelines and a federal judge determine the sentence, however, this is why it is critical to avoid these type of charges at all cost.
Posted by Tracy Green, Esq.
Green and Associates, Attorneys at Law
