Doctor Warning: Opioid Drug CEO Indictment Is Tip of Health Care Fraud Arrest Iceberg

Last week, two big things happened in the Prescription Drug World which will impact doctors and health care providers in the Dallas, Fort Worth, and North Texas area.  How?

More and more, Texas doctors and local physicians are going to find themselves the subject of criminal investigation and some are going to be shocked as they are arrested on serious federal felony charges.

Opioid National Public Health Emergency

Why?  Well, here’s what happened.  First, the President declared a national public health emergency over the misuse or prescription pain medication (opioids).   He points to scary facts that include:

• Drug overdose deaths represents a rate of 175 deaths a day (based upon 2016 data); and
• Drug overdose deaths from opioids exceed the number of Americans killed during the Vietnam War.

You can read the White House announcement here.

The impact of this presidential declaration on Texas doctors includes allowing doctors to prescribe drugs without seeing the patient personally, face to face.  It doesn’t provide any additional money; Congress will have to appropriate funding for the opioid crisis.

Insys Therapeutics CEO Arrested for Pushing Doctors to Push Pain Meds

Second, that same day, the Justice Department swooped down on the 74 year old founder of Insys Therapeutics, John Kapoor, over in Phoenix.  His company sells prescription opioid medications.

They announced that the FBI had arrested and charged him “… with leading a nationwide conspiracy to profit by using bribes and fraud to cause the illegal distribution of a Fentanyl spray intended for cancer patients experiencing breakthrough pain.”  (Six other Insys Therapeutics executives are also a part of the indictment.)

Felony charges against Kapoor include:  (1) RICO conspiracy; (2) conspiracy to commit mail fraud; (3) conspiracy to commit wire fraud; and (4) conspiracy to violate the Anti-Kickback Law.

Read the Justice Department news release describing the Kapoor arrest and indictment here.

Key here:   Mr. Kapoor’s big criminal act here wasn’t selling opioids under the table to users who abused the drugs.  No.  What he is accused of doing is bribing doctors and physicians to prescribe his opioid medications to their patients.  Look at the wording of the News Release:

• “Conspiracy.”
• “Bribes and fraud.”
• “Illegal distribution. “

Next consider what the FBI Special Agent in Charge says in the news release:

“As alleged, these executives created a corporate culture at Insys that utilized deception and bribery as an acceptable business practice, deceiving patients, and conspiring with doctors and insurers.

“The allegations of selling a highly addictive opioid cancer pain drug to patients who did not have cancer, make them no better than street-level drug dealers. Today’s charges mark an important step in holding pharmaceutical executives responsible for their part in the opioid crisis.  

“The FBI will vigorously investigate corrupt organizations with business practices that promote fraud with a total disregard for patient safety.”

And here is where local doctors and physicians need to perk up and take notice. Right now.

“Ask Your Doctor if [insert drug name] is Right for You.”

Everyone has seen the drug company commercials.  They’ve been around for years:  this drug or that drug is described in a fluffy visual that may or may not include kids or dogs, and then a pharmaceutical company spokesman ends the ad with the suggestion “ask your doctor if it’s right for you.”

You’ve seen these ads.  The commercials have to include the doctor because these are prescription drugs.  The targeted customer can’t just go buy their product – they have to go to the doctor’s office or to the clinic or to the hospital emergency room and get the doctor to give them a prescription for it.

Doctors know this – and the drug companies have made sure that patients understand the procedure, too.

Drug Companies Market Directly to Doctors, Too

Of course, the big marketing push for these companies isn’t to the patient.  It’s to the doctor, and this is the way it has been for years and years.  Pharmaceutical company representatives have regional assignments where they are building careers getting their company’s drugs sold in a big way via the doctors in their assigned area (sales region).

See, e.g., “Pharma Selling: What Doctors expect from Medical Sales Reps?” published by Medismo Technologies.

And they pay doctors, too.  Some doctors generate a nice bit of personal income from these big drug companies.   Pro-Publica explains this in a 2014 article published in Scientific American entitled “How Much are Drug Companies Paying Your Doctor?”

Health Care Fraud and Pain Medications

Not every doctor in Dallas or Plano or Fort Worth or Richardson is guilty of over-prescribing pain medications or conspiring with drug companies to push opioids just so the doctor can get more stuff or make more money.

But the federal government attitude will not assume you or your physician colleagues at the pain clinic or community hospitals are as ethical as surgeon B.F. “Hawkeye” Pierce from M.A.S.H.  In fact, law enforcement is zealously going after the opioid crisis and that means doctors who write pain med prescriptions are going to be met with suspicion.

News reports are that one doctor has already negotiated a plea deal with federal authorities after being investigated for being paid $200,000 in speaking fees by Insys Therapeutics.

Warning to Texas Doctors From Criminal Defense Perspective

If you practice medicine in Texas today, then you need to be proactive and consider the risks you may face of being included in a federal opioid investigation.

Lots of innocent people are investigated for criminal behavior.  And innocent people get arrested every day.   

However, for medical professionals even the hint of being scrutinized by law enforcement can hurt their reputations and damage their practices.  Rumors or gossip that a doctor is in the FBI headlights in an opioid investigation can be devastating.

And this is going to be happening here in North Texas.  We’ve warned about this before.  The time is here.

For more on the current climate involving pharmaceutical companies, doctors, opioid medications and drug prescriptions, watch John Oliver:

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For more information, check out our web resources, read Michael Lowe’s Case Results, and read his in-depth article,” Pre-Arrest Criminal Investigations” as well as

1. Arresting Texas Doctors for Health Care Fraud: What You Need to Know;
2. Health Care Fraud: 21 Indictments in Forest Park Medical Center Case;
3. The New DEA Drug Report: Drug Cartels, Doctors, and Health Care Fraud.