Indian-American doctor in line of fire as Trump administration cracks down on painkiller prescriptions

WASHINGTON: A prominent Indian-American doctor, politically savvy and well-connected both in the US and India, is in the dock in an alleged $500 dollar healthcare fraud, highlighting a rash of similar cases involving physicians of Indian-origin in the United States being indicted in the nation's opioid crisis.

Dr Raj Bothra, 77, who received a Padma Shri in 1999 for distinguished service both in India and the US, was freed by a Michigan judge on a record $ 7 million bond earlier this week, pending prosecution in what is described as one of the largest health care fraud cases in American history.

Incarcerated since December, Dr Bothra will exchange handcuffs and ankle chain for GPS tether and home confinement as he begins a fight to clear his name in a case government attorneys say helped fuel the nation’s opioid epidemic.

Bothra is facing 17 charges, including healthcare fraud, conspiracy to possess with intent to distribute drugs, and aiding and abetting the unlawful distribution of drugs. The felony drug charges invite up to 20 years in prison while the healthcare charges are punishable by up to 10 years.

According to government prosecutors, Bothra, along with five other physician colleagues who have also been charged, cheating Medicare, Medicaid and Blue Cross/Blue Shield of Michigan in a $464 million scam that began in 2013. At three pain clinics in Michigan owned by Dr Bothra, they forced patients to undergo painful medical procedures in exchange for illegally receiving more than 13 million doses of prescription pain medication, including OxyContin, Vicodin, hydrocodone and Percocet.

Bothra's clinics "sought to bill insurance companies for the maximum number of services and procedures possible with no regard to the patients’ needs," prosecutors alleged.

That is not the profile or the reputation Bothra’s professional career has had in the decades he has been in the public eye.

A high-profile Republican Party supporter in a community that has largely leaned Democratic over the years, the Indian-American physician hosted fundraisers for former President George HW Bush and other senior Republican luminaries in the US, and has been a regular at GOP conventions, even as he devoted time and money to worthy causes in India.

For about eight weeks each year, Bothra is said to leave his practice in Michigan and travel to India to work with Indian organisations on issues such as HIV/AIDS awareness, and drug, tobacco and alcohol addiction. He teamed with the Nargis Dutt Foundation to produce two documentaries, one on AIDS and another on tobacco abuse, and helped in the rebuilding of hospitals in Latur, Maharashtra, after the earthquake there.

For his services, the Indian government honored him with the Padma Shri, the nation’s fourth highest civilian award, in 1999.

"When you are educating an entire population, it is not a matter of a month or a year, but of many years. We are the blessed ones who are able to do it. If we do not do it, who will?" Dr. Bothra said at that time, according to a citation from the Indian Embassy in Washington, as he urged his Indian-America physician colleagues to become involved in voluntary work in India.

But according to US prosecutors, Bothra would go on to amass wealth they estimate at nearly $ 35 million both in America and India as he bilked the healthcare system in the US. His real estate portfolio is reported to include at least 22 commercial and residential properties.

In fact, government lawyers argued against the bond saying Bothra was a flight risk, citing his friendship with the Ambani family and other high-level connections in India.

"Dr. Bothra’s connection with the Ambani family gives him access to a fleet of corporate jets that routinely visit the United States and can provide him with a means to flee," Assistant US Attorney Brandy McMillion wrote in a court filing, according to The Detroit News.

"Dr. Bothra simply poses no risk to anyone — he is an elderly physician who has spent his entire life serving his community and has never been in trouble before in his entire life. He has neither the means nor the inclination to threaten or endanger anyone,” Bothra’s lawyers responded, and on Tuesday, the judge agreed to free him on what the paper described as a "Bernie Madoff-sized bond."

The case has cast a shadow on the otherwise sterling reputation of Indian-American physicians in the US, coming as it does on the heels of several similar cases in recent months.

In 2018 alone…

* Dr. Jayam Krishna Iyer, 66, who operated a pain management clinic in Clearwater, Florida, pleaded guilty to one count of health care fraud, after being charged with writing prescriptions for controlled substances, including oxycodone, for patients who never stepped into her office.

*Dr Pranav Patel, who owned and operated Palos Medical Care in a Chicago suburb, was indicted for submitting fraudulent claims for purported medical tests and examinations that were never performed.

*Dr Mustak Vaid was sentenced by US District Judge Lorna G. Schofield to 18 months in prison for his participation in a $30 million scheme to defraud Medicare and the New York State Medicaid Program.

*Cardiologist Dr Devendra Patel of Nevada pled guilty after being indicted by a Grand Jury for distributing highly-addictive prescription drugs Oxycodone and Hydrocodone to patients without a medical purpose

*Dr. Bharat Patel, 71 of Connecticut, pleaded guilty to narcotics distribution and health care fraud offenses, accepting that he wrote hundreds of medically unnecessary prescriptions for oxycodone and hydrocodone.

In addition, Indian-American pharma tycoon John Kapoor, founder of Insys Therapeutics Inc. was arrested in 2017, accused of bribing doctors to overprescribe a potent opioid and committing fraud on insurance companies solely for profit

The arrest and prosecution of so many Indian-American physicians, who form the largest group of foreign-origin doctors in the US outside of native born-Americans, appears to be part of the Trump administration’s crackdown on the opioid epidemic, which the President has declared a public health emergency.