Back Door Fraud

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56110395 - variety of non-proprietary medicine bottles and large pills on reflective surface with grey background.

Chronic pain, whether physical or emotional, is unpleasant no matter how you look at it. When people use unhealthy coping mechanisms to deal with their pain, situations often become worse. (Some turn to smoking, drinking, overeating, or using drugs to make their pain go away.) A Peru, Indiana pain doctor made the pain go away for two of his drug-addicted patients who overdosed on medication he prescribed and died. At the same time, he caused a great deal of pain to the government by committing Medicaid fraud. (The government healthcare plan picked up the tab for some of the scripts he illegally prescribed.)

The 70-year-old doctor, who lived on a farm near Bunker Hill, ran a pain management center that operated three offices in Peru, Bloomington and Indianapolis. When two of his patients died from an overdose after the doctor filled their prescriptions, the Drug Enforcement Administration (DEA) spent months surveilling his company headquarters located in Peru.

A former employee provided important details to investigators about some “back door” patients who never had to wait to see the doctor for an examination before obtaining a prescription for pain medication. (Most of his patients had to wait up to three hours for an examination.)

 Other details emerged when two other patients told investigators that they worked for the doctor on his farm, helping to repair vehicles or feed animals in exchange for their pain pills. The son of one of the doctor’s victims said the doctor knew he was treating drug-addicted patients and did not prescribe the pills for legitimate medical issues. (He also called the doctor’s clinic a “legal dope house.”)

After a three-year investigation, the Peru pain doctor was arrested on 55 felony charges for operating a “pill mill.” (The Miami County prosecutor urged the doctor to take a plea agreement so that the court would not incur costs that could be as high as $200,000.) As part of the plea agreement, the doctor pleaded guilty to five charges including possession of a narcotic drug, two counts of issuing an invalid prescription for legend drugs, insurance fraud and Medicaid fraud. (The other 50 fraud charges were dropped.)

 The doctor was sentenced to 10-and-a-half years of probation. (He didn’t get any jail time because as a combat veteran, he was declared 80 percent disabled. His disabilities and medical issues would have cost the prison system a lot of money.) The plea agreement also prevents the doctor from obtaining any medical license in Indiana or a license or permit from the DEA. (Translation: his medical career is over.)

But the story doesn’t end there, folks. The former Peru, Indiana pain doctor also faces charges in Indianapolis and Bloomington, but the prosecutors in those two cases agreed that any additional convictions would not increase his sentence set in Miami County. And, as if that is not enough, the doctor had his medical license previously suspended after investigators had discovered he traded prescription pills for sex with a female patient. (Addiction to pain medication can make some people do crazy things.) It looks like this pain doctor will no longer be using his practice’s back door to conduct his fraudulent scheme. (He’s very lucky he was not forced to walk through the front doors of a prison.)

Today’s “Fraud of the Day” is based on an article entitled, “Judge accepts plea agreement with no jail time for Peru ‘pill mill’ doctor,” published by Kokomo Tribune on November 30, 2017.

PERU – A Miami County judge Thursday accepted a plea agreement in which a Peru pain doctor arrested on 55 felony charges in connection to operating a “pill mill” will serve more than 10 years of probation but no jail time.

As part of the agreement, Dr. Tristan Stonger pleaded guilty to five of the charges in exchange for the remaining 50 charges being dropped. The charges to which he pleaded guilty include possession of a narcotic drug, two counts of issuing an invalid prescription for legend drugs, insurance fraud and Medicaid fraud.

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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.