Amid a handful of overprescribing convictions, one doctor has a 30-year fraud history
A psychiatrist indicted for illegally selling prescriptions for nearly 10,900 pain pills has a history of illegal prescribing practices and Medicare fraud dating back 30 years, according to lohud.com.
Alfred Ramirez, a state-licensed psychiatrist, was arrested in October for writing medically unnecessary prescriptions in exchange for cash, a scheme that led to the death of a school teacher who overdosed on oxycodone and alprazolam prescribed by Ramirez. In fact, pharmacist Christine Bolton reported Ramirez to Medicaid regulators in the 1980s after seeing a steady stream of patients high on prescription drugs coming into her pharmacy with prescriptions from the same physician.
According to records obtained by lohud.com, Ramirez stole $47,860 from Medicaid between 1982 and 1984 by filing claims for treatment he never provided. He pleaded guilty to felony charges and was excluded from Medicare and Medicaid in the 1980s, but retained his medical license. Later, a judge reduced the amount of money Ramirez was required to pay back to the state.
Ramirez was reinstated to Medicare and Medicaid in 2010 and two years later, he was selling pain prescriptions out in a parking lot, according to court records obtained by the publication. Some have pointed to the case as way to highlight the disconnect between Medicare and Medicaid exclusions and licensure actions taken against medical providers.
Meanwhile, physicians across the country are facing similar charges for overprescribing painkillers. A physician who practiced in Kentucky and Indiana recently pleaded guilty to 31 charges of money laundering and fraud, according to WDRB. Jaime Guerrero was accused of billing insurers for 15-30 minute counseling sessions that actually lasted three minutes, while also overprescribing pain hydrocodone and methadone.
On Monday, the owner of a Bronx medical clinic was sentenced to 12 years in prison for distributing five million tablets of oxycodone over a five-year period and collecting more than $7 million in cash for sham doctor visits, according to the Department of Justice. Kevin Lowe oversaw 23 doctors, clinic workers and recruiters that referred patients to the clinics for medically unnecessary prescriptions.
Opioid prescribing has grown 156 percent in the last nine years, leading to $3.9 billion in Medicare Part D spending and drawing concerns from watchdog agencies and legislators. In last year's historic fraud bust, 44 of the 243 people arrested were involved in schemes that targeted Part D. Meanwhile, states like Pennsylvania have pushed for more regulations to limit doctor shopping that fuels fraud schemes.
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