This article originally appeared on the Philadelphia Business Journal.
Seventeen local defendants, including five medical professionals, are among those ensnared in a coordinated health care fraud enforcement action across Pennsylvania, New Jersey, New York, Connecticut and Washington, D.C., involving more than $800 million in loss and the distribution of over 3.25 million opioid pills in so-called pill mill clinics, the U.S. Justice Department said Thursday.
The takedown includes new charges against 48 defendants for their roles in submitting over $160 million in fraudulent claims. Of those 48 defendants, 15 are doctors or medical professionals, and at least 24 were charged for their roles in diverting opioids. In Eastern Pennsylvania alone, the conduct involved submission of more than $4 million in fraudulent claims and distribution of approximately 738,000 oxycodone pills to the streets of this District.
The announcement comes a year after federal officials formed the Newark/Philadelphia Regional Medicare Fraud Strike Force, which targets opioid-related wrongdoings. The joint law enforcement effort is designed to bring together the resources and expertise of the Health Care Fraud (HCF) Unit in the Justice Department’s Criminal Division’s Fraud Section, the U.S. Attorney’s Offices for the District of New Jersey and the Eastern District of Pennsylvania. Additional partners are the FBI, U.S. Department of Health and Human Services Office of the Inspector General and U.S. Drug Enforcement Administration.
“As today’s takedown demonstrates, this Strike Force has produced precisely what we hoped it would – and by that I mean tangible results,” said U.S. Attorney for the Eastern District of Pennsylvania William M. McSwain said in a statement.
Here is more on the locals who were charged:
- Timothy F. Shawl, 60, of Garnet Valley, a medical doctor, was charged with five counts of unlawful distribution of controlled substances. Prosecutors said he allegedly wrote prescriptions for controlled substances that were outside the usual course of professional practice and not for a legitimate medical purpose. The indictment said Shawl wrote prescriptions for controlled substances for patients without seeing, treating, or examining them. Shawl allegedly prescribed hundreds of prescriptions for oxycodone to approximately 16 patients, amounting to over 29,000 oxycodone tablets.
- Dr. Neil K. Anand, 42, of Bensalem and Asif Kundi, 31, Atif Mahmood Malik, 34, and Viktoriya Makarova, 33, all of Philadelphia. Anand, a medical doctor, Kundi and Malik, unlicensed foreign medical school graduates, and Makarova, a nurse practitioner, were each indicted on one count of health care fraud and one count of conspiracy to distribute controlled substances. Prosecutors said they submitted false claims to Medicare, health plans provided by the U.S. Office of Personnel Management, and Independence Blue Cross for “Goody Bags,” which were stuffed with medically unnecessary prescription medications that were dispensed by non-pharmacy dispensing sites owned by Anand. The Goody Bags cost those governmental entities more than $4 million. Patients were allegedly required to take the Goody Bags in order to receive prescriptions for controlled substances. According to the indictment, Malik and Kundi wrote prescriptions for controlled substances using blank prescriptions that were pre-signed by Anand or Makarova. Anand and Makarova provided over 10,000 prescriptions for controlled substances, of which over 7,000 were for oxycodone, for a total of over 634,000 oxycodone tablets distributed from this scheme.
- Separate indictments were unsealed Wednesday involving charges against 12 people for allegedly possessing oxycodone with intent to distribute. The indictments charge that, from September 2016 through June 2019, the defendants all presented forged prescriptions for oxycodone to various pharmacies outside of Philadelphia, in order to obtain oxycodone to distribute to others. The defendants, all from Philadelphia, allegedly drove to pharmacies in Marcus Hook, Drexel Hill, Kennett Square, and Mount Laurel, New Jersey pharmacy in Mount Laurel to fill them. They are charged with at least two, and up to 32, counts of possession with intent to distribute oxycodone and are charged with having received anywhere from 6,300 milligrams to 135,000 milligrams of oxycodone, which is approximately 75,000 oxycodone pills.