Federal Jury ACQUITS Physicians Accused in $454 million Healthcare Fraud and Opioid trial
Insights from White Collar Criminal Defense Attorneys Trusted Nationwide
After a seven week trial in the Eastern District of Michigan, four physicians were acquitted of allegations that they unlawfully prescribed opiates and performed unnecessary interventional pain treatments on patients in the Detroit metropolitan area. Dr. David Lewis, one of the four physicians, was led in his defense by attorneys Ron Chapman of Chapman, Dowling & Mallek and Jeffrey Collins.
Dr. David Lewis and three other physicians were fully acquitted after allegations of $450 million in healthcare fraud[/caption]
Three years ago, the Government alleged that these doctors — Bothra, Edu, Lewis, and Russo — bilked Medicare, Medicaid, Blue Cross Blue Shield and other insurers by prescribing powerful opioid painkillers to swindle patients into receiving expensive and unnecessary back injections. Dr. Bothra, owner of the clinic at the center of these indictments, sat in custody for 48 months during the entirety of the COVID-19 pandemic patiently awaiting trial.
Two other physicians, Dr. Backos and Kufner, plead guilty, waiving their right to a trial and choosing to take the stand for the Government.
Seven weeks’ worth of trial commenced for an attentive, notes-taking jury. Seven weeks of presentations by a Government which seemed entirely too concerned with the physicians’ unapologetic popularity rather than their sworn, and now proven, duty to provide legitimate patient care.
On the morning of June 29, 2022, this diligent Detroit jury rendered its verdict:
Not guilty on all counts.
Healthcare fraud requires the Government to prove that a physician “knowingly and intentionally” devised a scheme or artifice to defraud a federal healthcare program. Typically this is proven when providers bill for services not rendered, or “upcode” the services rendered to receive additional compensation. To convict a physician of “unlawful prescribing” or running a “pill mill”, the Government must prove that the physician prescribed outside the usual course of professional practice for other than a legitimate medical purpose. This was a standard clarified in a recent Supreme Court decision handed down the day of deliberations in the Pain Center case.
Here the Government alleged that the physicians utilized opioid painkillers such as Hydrocodone to “hook” patients on the pain meds and then coerce patients to undergo unnecessary injections in order to continue to receive pain treatment. The jury didn’t buy it.
At trial, the Government provided over five weeks of testimony from investigators, patients, employees of the practice and an expert witness, Dr. Neel Mehta. Their goal was a lofty one, as they were tasked with proving that four board-certified interventional pain physicians violated their oath and prescribed unnecessary back injections and opioids to patients who “didn’t need or want them”.
Lacking from the Government’s case, as Attorney Ron Chapman II pointed out during closing argument, was a complete analysis of the patient population to prove that the physicians engaged in a pattern of unlawful conduct. Chapman also pointed out the improper standard utilized by the Government’s experts and investigators which sought to convict the physicians in what amounts to a mere difference of medical opinion.
The expert witness called by the Government, Dr. Mehta, reviewed only six charts of pain patients who received treatment. From this review the Government suggested that the clinic was rife with fraudulent conduct. As Ron Chapman pointed out during closing arguments, this is inappropriate and inconsistent with Medicare policies that require a valid statistical sample, proper review, and provider education before determining that claims to the Medicare program are maliciously false.
On the defense side, patients of the practice were called and testified that they received excellent care. The defense also called three physicians as expert witnesses to testify to the suitability of care rendered, as well as a coding and billing expert.
Two of the defendants, Dr. David Lewis and Dr. Gainu Edu chose to testify in their own defense and provided unimpeached testimony that the care they rendered was legitimate and necessary to treat the patients medical needs.
At the conclusion of these seven grueling weeks, the jury deliberated for just ten hours before reaching a verdict on Wednesday June 29, 2022.
Dr. Bothra, who has been incarcerated for over three years by an order of the Sixth Circuit Court of appeals, was released. Drs Lewis, Edu, and Russo are also now free from the weight of a federal indictment.
Subscribe and stay tuned to Federal Defense Blog for a deep dive into the strategy in the case and an analysis of how statistical sampling was used to successfully defend this indictment.
Ronald Chapman II is the founder of Chapman, Dowling & Mallek and a top-rated Michigan federal criminal defense attorney who represents clients in federal courts nationwide. His practice is focused on defending individuals and organizations in complex federal prosecutions, including white-collar criminal matters and healthcare fraud investigations.
Throughout his career, Mr. Chapman has helped clients avoid more than $550 million in potential penalties, primarily in cases involving physicians, healthcare providers, executives, and professionals facing federal charges. He is widely recognized for his work as a Michigan healthcare fraud defense attorney, as well as for his results in white collar criminal defense in Michigan, where cases often involve parallel civil, regulatory, and criminal exposure.
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Chapman, Dowling & Mallek is headquartered in Detroit, Michigan and represents clients in federal investigations and criminal matters across the United States. Our attorneys handle complex federal cases nationwide while maintaining offices in Michigan and other states.
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11 Comments
This was a fascinating case to consult on and testify in to say the least. The government had many missteps from start to finish and the jury saw right through it. Congratulations to one of in not the best healthcare trial attorneys in the country, Ronald Chapman, II...
Let’s hope all of this nonsense is stopped soon. Government needs to stay out of healthcare. I’m so tired of having to prove my pain every month from Multiple Sclerosis, Lupus, Ehlers-Danlos, MeCFS, Stenosis, Spondylosis & more.
I even fight for my prescription from the pharmacy—they have literally held me back from over 3 months of prescriptions… I had to give the scrips back to my doctor so she could destroy them! And this was AFTER I was force tapered to 90MME!
I thought “officials” were supposed to be smarter than that.
Great job to the physicians and you too Mr. Chapman. Thanks to each of you for doing a great job. As the old saying goes, "the truth will set you free!"
A win for the chronic pain community and the extensive overreach of the DEA in treating ligit pain patients. There are more physicians out there who have been wrongly incarcerated due to this exact situation. Justice is finally being balanced and once again shows the DEA has no place to practice medicine without a license or make decisions over a highly educated physician period!
I’m so happy for the physicians and their families. It’s a shame for the 2 who plead guilt when there was none. Way to go Ron Chapman and team! This is going to be a change of the tide for the chronic pain community, Drs and patients alike! This is the best news ever!!!
A wonderful victory for these doctors! Now my question is, who is going to compensate Dr. Bothra for 3 years lost income while he sat in jail, and who is going to stand up for any pain patients who lost treatment during this circus trial? I'm eternally grateful for the SCOTUS decision that has settled the issue regarding practicing medicine and prescribing "in good faith". Now laws need to change that currently place doctors in the same category as drug dealers, where they're viewed and treated at guilty until proven innocent, and stripped of their place of business and all assets and means of taking care of their family and securing their future. At this time, I do not believe there is any recompense for these doctors even when acquitted of all charges. Hopefully the SCOTUS decision and subsequent cases won by attorneys with wisdom for the practice of medicine, such as Mr. Chapman, will encourage the DEA to stop making up rules as they go along and actually do their due diligence with conducting proper investigations based on the law and not their opinion of opioid medications. Sorry DEA - it appears the "low lying fruit" just got a nice boost out of easy reach!
Will this case eventually lead to state level so there is defense against false accusations by boards? Will it set precedence for other lawyers to defend the medical professional from false accusations when they take medicine for their medical disability for chronic pain while in their working years? Will it help the chronic pain patient? Verifying supreme court that patients and medical providers need protection from false accusations in pain management.
Is there any recourse for Dr. Bothra for being wrongly incarcerated for 4 years?
Great job, Ronald Chapman, II!
You are first in my Rolodex to call if anyone needs healthcare defense representation. I will call Sean Weiss 2nd.
Wow, When the DOJ could have mandated all the states in the US, and all the doctors prescribing the controlled substances use the PRescrtiption Drug Monitoring Act (PDMP). DOJ had a request for service in 2022-2003 requesting a solution to prescription fraud. Two of us responded with essentially the same solution. Use a third person where the doctor prescribes, the pharmacist must verify that a prescription was written and then dispenses to a patient. I called it the triangle. All three should be looked at. If a doctor or pharmacy was prescribing more than normal. I cautioned if they did not use such a program, I foresaw an "opioid crisis". The Government is never honest about its contribution to this problem. They could have prevented so many deaths. Instead, the CDC combined the illicit and legal deaths to raise their numbers. This made it very confusing. What a mess.
Wow, When the DOJ could have mandated all the states in the US, and all the doctors prescribing the controlled substances use the Prescription Drug Monitoring Act (PDMP). DOJ had a request for service in 2022-2003 requesting a solution to prescription fraud. Two of us responded to the Request for Services with essentially the same solution. Use a third person or entity where the doctor prescribes, the pharmacist must verify that a prescription was written and then dispenses to a patient. I called it the triangle. All three should be looked at if a doctor or pharmacy was prescribing more than normal. Patients that were doctor shopping would be caught. I cautioned if they did not use such a program, there would be an "opioid crisis". The Government has never been honest about its contribution to this problem. They could have prevented so many deaths. Instead, the CDC combined the illicit and legal deaths to raise their death from opioids in 2016. The public would not decipher what was legally prescribed and what deaths resulted from illicit drug activity from heroin and fentanyl. The CDC established low recommended MME . Patients that had tried everything else could not get their prescriptions. Pain doctors resorted to making more money in the operating room doing the same procedures that did not work in the past. Ohio, for one, sued the drugmakers. At some point in time, didn't they realize they had a problem and required physicians to use the PDMP? It was only in 2018, that all states used the system making it safer for patients, doctors, and pharmacies. But wait, in 2023, the DEA became involved. Now they are unnecessarily making it difficult for the patients to obtain opioids. To date, there isn't a substitute for opioids. Why don't the CDC and the government work diligently on a solution? This made it very confusing. What a mess!
It is disgusting what the DEA has been doing. They harass doctors and cause them to lose patients and the ability to support their family. They seem to think they have more medical knowledge than the many doctors they send to jail who have years of education and practice . Good job to the Chapman group and especially to Attorney Ron Chapman. I wish the doctors going through this injustice were able to hire such an excellent attorney.