6 Michigan Pain Doctors charged w/ $500M opioid/insurance scheme

[lobelsteve]

House was janky. TVs on wall not angled correctly, not right size for the wall. Decor was horrific. Maybe they want to go with an insanity defense.

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[gaseous_clay]

Okay house, but totally not worth going to jail in Detroit for.

Why the electric tape over the toilet seat?
Omen?

Never said any of it was worth the risk of going to jail. Just making the point that “private island” doesn’t equal Larry Ellison money.

 

[gaseous_clay]

The indictment lists 'The Pain Center USA, PLLC' and 'Interventional Pain Center,

I stand corrected, but still surprised a practice 5 years old was able to have one in a CON state. It makes sense in terms of the high charges as office based procedures, ancillaries, and E&M codes will only take you so far.

 

[emd123]

Never said any of it was worth the risk of going to jail. Just making the point that “private island” doesn’t equal Larry Ellison money.

Agree

 

[paindoc007]

And another :

Tennessee doctor charged with 'massive opioid fraud distribution and healthcare fraud scheme'

 

[SommeRiver]

"The pattern was so bad, they said, that on the same day this past September that the state of Tennessee revoked his pain management certificate, Orusa wrote 12,754 Schedule II controlled substance prescriptions."

Wait...what now?

 

[callmeanesthesia]

"The pattern was so bad, they said, that on the same day this past September that the state of Tennessee revoked his pain management certificate, Orusa wrote 12,754 Schedule II controlled substance prescriptions."

Wait...what now?

From another article:
“However, on the same day the State of Tennessee permanently revoked Orusa’s pain management certificate, Orusa wrote 164 individual prescriptions for approximately 12,754 Schedule II controlled substance pills, according to the U.S Attorney's Office. ”

Makes a little bit more sense. Or is at least somewhat physically possible without your hand falling off.

 

[SommeRiver]

I figured that was the case and they just wrote it poorly in the article.

Either way - 164 scripts in one day is vile.

 

[ziggyziggy]

I figured that was the case and they just wrote it poorly in the article.

Either way - 164 scripts in one day is vile.

Which one would you prefer? wrt pill counts..for 30 days supply.

Tramadol 50 2tab QID #240
Norco 5/325 QID #120
Norco10/325 BID or 0.5 tab QID #60
or Fentanyl 12.5 Q7 #4

I am just curious which one and why? Because the investigators just looks at the number of pills.

 

[lobelsteve]

Which one would you prefer? wrt pill counts..for 30 days supply.

Tramadol 50 2tab QID #240
Norco 5/325 QID #120
Norco10/325 BID or 0.5 tab QID #60
or Fentanyl 12.5 Q7 #4

I am just curious which one and why? Because the investigators just looks at the number of pills.

You meant fentanyl #10 q3d.
Or Butrans 10 #4 q7d

Here is my $.02 advice (actually $7000). Ultram at high qty. Not schedule 2. Fentanyl is a street drug and I would not start new patients on it and have been rotating existing patients off of it. I will have less than 10 total on it including my palliative care folks. Norco is Norco. Street cred, cash. If you throw Butrans as a choice it ties with Ultram. 4 patches, hard to overdose and less likability.

So Ultram due to its scheduling by DEA.

 

[gaseous_clay]

Which one would you prefer? wrt pill counts..for 30 days supply.

Tramadol 50 2tab QID #240
Norco 5/325 QID #120
Norco10/325 BID or 0.5 tab QID #60
or Fentanyl 12.5 Q7 #4

I am just curious which one and why? Because the investigators just looks at the number of pills.

It seems the # of pills (dosage units) has more shock value to the public than MMEs. Also, if they are busting these guys on illegal distribution charges, it’s probably easier to get an indictment on larger quantities of pills.

 

[ziggyziggy]

Plus, some insurance companies are putting restriction based on pill count rather than MME.

Isn't higher pill count assoc with higher risk of abuse, overdose and diversion?

 

[lobelsteve]

240 tramadol more likely ro lay dormant in a medicine cabinet. 10 Norco likely to make the traveling team.

 

[Ducttape]

who prescribes qweekly fentanyl (assuming patch)?

 

[lonelobo]

who prescribes qweekly fentanyl (assuming patch)?

a drug dealer

 

[callmeanesthesia]

a drug dealer

Chew 1 patch q day prn breathing

 

[epidural man]

Do you guys think it’s smart to reach out to the local dea agent to discuss rules, policies, procedures, and verify in fact your practice is doing things appropriately ?

Or is this just giving your practice attention that it didn’t need to begin with

We used to have a DEA agent come to our site and give us a presentation every year...it was a fun lecture, and the DEA AGENT was super cool.

And the agent enjoyed coming to talk, and it was very useful.

He would show us a video of them catching a pharmacist here in San Diego...on camera...drinking out of the codeine bottle on the pharmacy shelf. He also reiterated as what many have said on here - that if you just do what is right and reasonable, you won't be a target.

I suspect they are very busy and so probably won't answer the call.

I think maybe someone in our clinic met the guy somehow, started talking to him, and asked if he would come meet us. I'm pretty sure it didn't happen because we reached out to the DEA directly.

If I worked in a private practice setting, I wouldn't get a DEA license. That would make my life as a pain physician 1000x easier.

 

[Cassowary]

Thats an amazing house