On December 5, 2017, four Alabama health care providers were arrested after being indicted by a federal grand jury for their role in operating a “pill mill” that indiscriminately prescribed unnecessary and addictive opioid prescriptions. The “pill mill” operated out of Family Practice, a Montgomery, Alabama medical practice. The four providers arrested — Lillian Akwuba, a nurse practitioner; Julio Delgado, a physician; Steven Cox, a nurse practitioner; and Elizabeth Cronier, also a nurse practitioner — were all based in Alabama.
The owner of Family Practice, Dr. Gilberto Sanchez, previously a Montgomery physician, pleaded guilty on November 28, 2017 to drug distribution, health care fraud, and money laundering charges. The indictment in this case alleges that the defendants conspired with Dr. Sanchez to unnecessarily and illegitimately prescribe controlled substances to the patients of Family Practice. Additionally, the indictment charges the defendants with committing health care fraud by causing insurance companies to be billed for unnecessary office visits. The only purpose of those visits were to refill unnecessary medications. Lastly, the indictment alleges that Akwuba conspired with Dr. Sanchez to launder money.
The allegations contained in the indictment have sadly become commonplace over recent years as the opioid epidemic has unfolded across the nation. According to the Centers for Disease Control, since 1999, the number of overdose deaths involving opioids (including prescription opioids and heroin) quadrupled. From 2000 to 2015 more than half a million people died from drug overdoses and currently 91 Americans die every day from an opioid overdose. Correspondingly, the opioid prescriptions over the same time period have increased at the same rate, roughly quadrupling but there has not been an overall change in the amount of pain Americans report. The reason for such over-prescribing and corresponding death is often “pill-mills” such as Family Practice, which indiscriminately prescribe unnecessary opioids solely for their own financial benefit.
These indictments are the initial phases in criminal cases. However, under the qui tam provisions of the False Claims Act, whistleblowers with information about similar pill mills or unnecessary opioid prescribing may bring a civil case on behalf of the United States. The whistleblower can not only take a stand against the national crises of unnecessary opioids but also if the case is successful the government recover three times the amount the defendants fraudulently billed the government for such unnecessary opiates and the office visits associated with such prescriptions. The whistleblower, who originally filed the case, is entitled to 15-30% of the government’s recovery as well as their attorney’s fees.
To learn more about how the False Claims Act can fight the opioid crises, contact Frohsin Barger & Walthall.