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Prosecutors charge 5 NY doctors in Medicare, Medicaid opioid fraud schemes


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Prosecutors charge 5 NY doctors in Medicare, Medicaid opioid fraud schemes

U.S. prosecutors charged five New York doctors, a pharmacist, a nurse practitioner and three other people in schemes involving millions of opioid pills that were prescribed unnecessarily to bilk the federal government's Medicare and Medicaid programs and private insurers out of millions of dollars.

The schemes mostly involved the opioid oxycodone, a narcotic pain reliever sold under the brand-name OxyContin by Purdue Pharma LP and in multiple generic forms by a number of drugmakers.

"Instead of caring for their patients, these doctors were drug dealers in white coats," said Geoffrey Berman, the U.S. Attorney for the Southern District of New York. "They hid behind their medical licenses to sell addictive dangerous narcotics. They pumped out massive amounts of medically unnecessary pain pills that were ultimately sold on the streets of New York. And they did it for a very simple reason: greed."

Berman noted that the arrests come as the U.S. is confronting a nationwide addiction crisis — an epidemic in which 72,000 Americans died of an overdose in 2017.

A bill Congress recently passed aimed at addressing the opioid crisis is awaiting enactment by the White House.

One of the doctors charged by New York prosecutors, Dante Cubangbang, and his nurse practitioner John Gargan prescribed more than 6 million oxycodone pills to people they knew did not need the drugs for any legitimate medical reason, Berman told reporters during an Oct. 11 news conference.

Together with the doctor's office manager Michael Kellerman and receptionist Loren Piquant, who acted as so-called "crew chiefs" — people who recruit fake patients for the purpose of filling prescriptions with the intent of selling the medicines to drug dealers — Cubangbang and Gargan made over $5.7 million in illicit funds under their scheme, Berman said.

Cubangbang and Gargan were the highest prescribers of oxycodone in the state of New York, Berman said.

Many of Cubangbang's and Gargan's prescriptions and those involved in the other Oct. 11 arrests were paid for by Medicare, the government's insurance program for the elderly and disabled, and Medicaid, which covers the poor.

Carl Anderson, another doctor who was charged, prescribed nearly a million oxycodone pills to patients he knew had no legitimate medical need for the medication, Berman said.

Anderson conspired with Arthur Grande, another defendant who was charged, and others to sell the pills on the street, prosecutors said. Anderson only saw patients in the middle of the night, "prescribing opioids under cover of darkness," according to Berman.

"It was not uncommon for crowds of people to form outside his office at 3 or 4 in the morning, prompting 911 calls from his neighbors," Berman said.

Several of Anderson's former patients overdosed and died, including two of his employees, the U.S. attorney added.

Prosecutors also charged Anthony Pietropinto, an 80-year-old Manhattan psychiatrist, with prescribing oxycodone to over 200 patients, despite not specializing in pain management.

Over five years, Pietropinto wrote 600,000 prescriptions for oxycodone at generally the highest dosages, Berman stated, adding that Pietropinto prescribed over 12,000 oxycodone pills to one patient alone. Some of the opioid prescriptions Pietropinto wrote were for people who had just been released from rehab, he noted.

Another doctor, Nkanga Nkanga of Staten Island, N.Y., was charged with writing unnecessary prescriptions for more than 500,000 oxycodone pills and wrote thousands for other controlled substances.

Prosecutors noted that many of Nkanga's patients displayed "visible signs of drug addiction." He allegedly prescribed to patients who did not even visit his medical office and would give multiple prescriptions to one person under the names of several people.

Endocrinologist Nadem Sayegh also was charged with issuing thousands of oxycodone prescriptions for no legitimate medical purpose — some written in his name, variations of his name, his family members' names and the names of other individuals — in exchange for thousands of dollars in cash, expensive dinners, high-end whiskey, cruises and all-expense-paid trips.

Sayegh even wrote prescriptions for people overseas and for one patient who was incarcerated.

Also charged by New York prosecutors was Long Island pharmacist Marc Klein, who allegedly filled hundreds of "sham" prescriptions for large quantities of oxycodone.

Berman described Klein as "brazen," noting that the pharmacist told one of his employees, "I guess you could call us licensed drug dealers" and that "Oxy pays the bills around here."

The U.S. attorney urged anyone who thinks their doctors are overprescribing opioids to report their concerns to the FBI and other law enforcement.