Addicted to Fraud

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Geriatric doctor (geriatrician) consulting and diagnostic examining elderly senior adult patient (older person) on aging and mental health care in medical clinic office or hospital examination room

Psychiatrists are supposed to help those in need of mental health services but some take advantage of their patients’ frail states rather than fulfill their professional duties. One psychiatrist from Pennsylvania admitted to orchestrating a “pay for prescription” Medicaid fraud scheme.

Lancaster local Bassam El-Borno, M.D. was charged in June with illegally abusing his position as a psychiatrist to illegally prescribe drugs to patients. Dr. El-Borno was entrusted by Medicare and Pennsylvania’s Medicaid program to safely evaluate patients and provide them with the necessary treatment.

For years, Dr. El-Borno illegally billed Medicaid for ongoing mental health services that were not provided. Rather, he skirted the system by prescribing prescription drugs without properly assessing the patient first and fraudulently charged for continued treatment that never occurred. (Psychiatrists are supposed to help their patients heal from trauma, not cause it.)

Patients would be charged a monthly fee in exchange for being prescribed drugs rather than having to go in for mental health evaluation and treatment. The main drugs Dr. El- Borno illegally prescribed were Schedule II controlled substances such as Adderall and Ritalin. These types of drugs could easily become dangerous and addictive if not managed properly by a licensed mental health professional. (Dr. El-Borno was too addicted to the money he was making to stop and consider the repercussions of addictions he may be causing.)

Schedule II medicines are intended to only be prescribed to patients after being given a diagnosis and under the condition they will receive ongoing treatment. Dr. El-Borno skipped the mental health assessment and charged patients $50 to $75 in cash for each prescription. (He would either mail them to patients or tape the drugs in an envelope outside the office. Sounds like his “business” was more like a thinly veiled drug operation.) 

The U.S. is facing a prescription drug epidemic where addicts are eager to get their hands on stimulants. Those who have taken the oath to do no harm and properly treat their patients are unfortunately the ones most likely to be in the position of taking advantage of struggling addicts.

El-Borno will serve six months of house arrest and five years of probation after pleading guilty to felony charges for violating the Drug Act and Medicaid fraud. He must also pay a $50,000 fine, perform 50 hours of community service, and have his Pennsylvania medical license suspended. (This won’t make up for the irreparable harm he has caused his patients.)

If you think a loved one is abusing prescription drugs call the Substance Abuse and Mental Health Services Administration crisis line at 1-800-662-4357.

Today’s Fraud of the Day comes from an article, “Lancaster County psychiatrist gets house arrest, probation for illegally prescribing drugs,” published by WPMT-TV on September 3, 2020.

LANCASTER COUNTY, Pa. — A Lancaster County psychiatrist charged in June with illegally prescribing drugs to patients will serve six months of house arrest and five years of probation after pleading guilty Thursday, according to Pennsylvania Attorney General Josh Shapiro.

Bassam El-Borno, M.D., 64, will also pay a $50,000 fine, will have his Pennsylvania medical license suspended, and perform 50 hours of community service in exchange for pleading guilty to felony charges of violating the Drug Act for prescribing outside the good faith practice of medicine, failing to keep records, and Medicaid and Insurance fraud, Shapiro said.

 

 

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Larry Benson
Larry Benson is currently the Director of Strategic Alliances for Revenue Discovery and Recovery at LexisNexis Risk Solutions. In this role, Benson is responsible for developing partnerships for the tax and revenue and child support enforcement verticals. He focuses on embedded companies that have a need for third-party analytics to enhance their current offerings.