Feds Continue to Unmask Pain Management Clinics

The Department of Justice (DOJ) has been aware for years of the ease at which pill mills can masquerade as “pain management clinics.” This trend does not discount the legitimacy of the vast majority of pain management clinics, but it shows the willingness of federal agents to aggressively investigate opioid-related violations in the midst of COVID-19 and the raging delta variant.

Characteristics of Illegitimate Pain Management Clinics

Warranted or not, a few traits naturally garner the attention of the DOJ or Office of the Inspector General. Signs a pain management clinic is merely an alter ego for doctors and pharmacists running a pill mill include:

• Only accepting cash for prescriptions, services, and medicine;
• Allowing patients a choice between different medications;
• Instructing patients to use a specific pharmacy;
• Employing private security; and
• Prescribing opioids and other controlled substances without first conducting necessary medical examinations, or merely performing a cursory exam.

What Do Recent Cases Tell Us?

The summer of 2021 yielded numerous arrests, pleas, convictions, and sentencings of alleged pill mill operators. A few notable cases include:

• An Arkansas doctor pleading guilty to a federal charge of unlawfully distributing a controlled substance. Donald E. Hinderliter, 85, was sentenced to four years in prison for indiscriminately prescribing Xanax to patients. Hinderliter was also alleged to have prescribed methadone, oxycodone, and hydrocodone in the same indiscriminate manner. Many patients drove hours to receive prescriptions from Hinderliter’s facility, Hinderliter Pain Clinic.
• An Ohio anesthesiologist getting hit with five years of probation and $524,000 of restitution after improperly prescribing opioids. Khaled Amr was alleged to have received kickbacks for prescribing certain drugs. However, drug trafficking was one of only 28 counts federal prosecutors levied against Amr. Falsification of documents, theft, telecommunications fraud, and insurance fraud were initially on the table, as well. The insurance fraud stemmed from a staged break-in Amr conducted on his own clinic, Columbus Pain Specialists.
• A North Carolina man posing as a substance abuse counselor admitting to providing illegitimate prescriptions for Suboxone and other opioids. Charles Adams, Jr. and other employees at Virginia pain management clinics also used DEA registration numbers from other providers to prescribe the controlled substances. Employees at the clinics “pre-signed” blank prescription sheets, which were then used to prescribe opioids to many individuals who did not need the drugs.

The Problem With Urinary Testing

In some cases, pain management clinics must submit urine tests for patients to show they are not taking too much—or, just as importantly, too little—medication. Proper urine testing is essential for doctors and prescribers to stay in compliance with best medical practices. The feds, however, are keen to find falsified urine test results or unnecessary urine testing that results in unlawful billings to Medicare.

As COVID-19 shifts from pandemic to endemic status, medical professionals should expect more arrests tied to opioid prescriptions and pill mill allegations. It’s now clear that federal investigators are not exclusively going after opioid manufacturers.

If you are operating or have operated a pain management clinic and are getting scrutiny from law enforcement, it’s time to speak with an experienced and aggressive Miami white collar defense attorney. Attorney Barry M. Wax has decades of experience handling charges related to health care fraud and Medicare fraud. Discuss your options with the team today over a free consultation.