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Daily Court Reporter - News Doctor practicing in Dublin charged with health care fraud, distributing controlled substance through pain cream scheme and Suboxone clinic

 

Doctor practicing in Dublin charged with health care fraud, distributing controlled substance through pain cream scheme and Suboxone clinic

A federal grand jury has charged a Central Ohio doctor with charges related to a health care fraud scheme that included marketing prescription creams in Sav-a-Lot and low-income neighborhoods and persistently mailing those creams to Medicaid customers, as well as prescribing and distributing Suboxone without medical necessity.

Bernard Oppong, 60, of Blacklick, Ohio was charged in a seven-count indictment on October 30 and appeared in federal court recently before U.S. District Judge Algenon L. Marbley.

Benjamin C. Glassman, United States Attorney for the Southern District of Ohio, Lamont Pugh III, Special Agent in Charge, U.S. Department of Health and Human Services, Office of Inspector General, Angela L. Byers, Special Agent in Charge, Federal Bureau of Investigation (FBI), Cincinnati Division, Timothy J. Plancon, Special Agent in Charge, Drug Enforcement Administration (DEA), Ohio Attorney General Mike DeWine and Steven W. Schierholt, Executive Director, State of Ohio Board of Pharmacy announced the charges.

According to the indictment, from January 2013 until April 2017, Oppong conspired to commit health care fraud.

Oppong was employed as a doctor at Health and Wellness Medical Center located on Perimeter Drive in Dublin. The center is affiliated with Health and Wellness Pharmacy on Blazer Parkway in Dublin. Co-defendants also previously operated a pharmacy location within Sav-a-Lot on Mock Road in Columbus.

Specifically, it is alleged Oppong and others sought to enrich themselves by billing for compound creams that were not provided or were not medically necessary, billing for counseling services that were not provided, billing for individual counseling sessions that actually occurred in a group setting and billing for counseling services performed by an unqualified individual when there was no proper supervising physician.

Compound Creams

As part of the conspiracy, it is alleged Oppong and others prescribed and Medicaid was billed for compound creams to treat pain, scarring and acne. Health and Wellness Pharmacy billed Medicaid $3 million for the creams, and Oppong was the ordering provider for more than half a million dollars of the claims.

For example, between January 2014 and April 2015, Health and Wellness Pharmacy submitted 1,436 claims for one compound cream, known as VersabaseA. The pharmacy with the second-highest amount of claims for that cream in that time period only submitted 202 claims.

During the first quarter of 2015, Health and Wellness would sometimes bill for less than 10 prescriptions per day, and on other days it would bill for as many as 477 prescriptions. It also billed for filling prescriptions on Saturdays and Sundays when the pharmacy was not open.

It was further part of the alleged conspiracy that co-conspirators billed for the creams with no medical necessity, as patients never requested the creams, were never actually prescribed them and had never met with Oppong.

The pharmacy allegedly marketed the compound creams at Clinic 5 (a Suboxone clinic), Sav-a-Lot and through a mobile van unit.

It is alleged patients with CareSource were targeted and told they were receiving free samples of pain cream. Then they began to receive more cream in the mail without requesting more. These were also billed to CareSource.

Customers at Sav-a-Lot and in low-income neighborhoods were asked to fill out a survey asking about any conditions that they suffered from. Then, they would allegedly receive the compound creams in the mail every month, even when customers directed the co-conspirators to stop sending them. Many of these customers never met with a doctor, nor did they know Oppong, the prescribing physician.

Suboxone

Oppong was registered through the DEA to prescribe the drug addiction treatment Suboxone to up to 275 patients at any one given time.

Health and Wellness Medical Center allegedly submitted fraudulent claims to Medicaid for psychotherapy services that were never rendered to patients.

Specifically, patients indicated they would sit in a room with a timer. When the timer went off, they were allowed to leave and receive their Suboxone prescription, which was written by Oppong and co-conspirators. No counseling services were provided during this time. Some patients reported coloring in coloring books during the time they were in the room.

Oppong allegedly pre-signed prescriptions for Suboxone and left them at the medical center for anyone to distribute. Prescriptions were issued to patients who had repeatedly failed urine tests.

It was part of the conspiracy, according to the indictment, that the medical center treated patients paying with cash differently than those with insurance. The patients paying with cash only had appointments every two weeks or once a month, and paid $300. Insured patients had appointments three times a week. Cash-paying patients were only required to attend 15 to 30 minutes of counseling, while insured patients were required to stay for one hour.

Oppong and co-conspirators averaged more than 150 patients per day.

Oppong is charged with one count of conspiracy to commit health care fraud and one count of executing a health care fraud scheme (each punishable by up to 10 years in prison), as well as four counts of making false health care statements (five years per count) and one count of conspiracy to distribute a controlled substance (15 years).

Darrell L. Bryant, 43, and Gifty Kusi, 34, both of Hilliard, were charged July 2017 in a related indictment and are scheduled for trial on December 3. Bryant and Kusi owned and operated both Health and Wellness Pharmacy and Health and Wellness Medical Center. They are each charged with one count of attempt and conspiracy to commit health care fraud and four counts of health care fraud.

A final defendant Jornel Rivera, 54, of Dublin, pleaded guilty in May 2018 to making false statements related to health care matters. Rivera served as the Medical Director of Health and Wellness Medical Center. His sentencing hearing has not yet been scheduled.

“Just as we aggressively investigate and prosecute those perpetuating the opioid epidemic through prescription pain-killing opioids, we must identify and hold accountable those who are fraudulently prescribing addiction-treatment opioids,” U.S. Attorney Glassman said. “If we hope to extricate ourselves from this epidemic, we must also put an end to the abuse of Suboxone.”

“Oppong is accused of prescribing treatments that weren’t medically necessary, that weren’t actually provided, or that were for people he never met,” said Ohio Attorney General Mike DeWine. “Drug treatment should be effective and honest, but in this case, our investigation found that it wasn’t.”

U.S. Attorney Glassman commended the investigation of this case by the Ohio Attorney General’s Office’s Medicaid Fraud Control Unit, State of Ohio Board of Pharmacy, HHS-OIG, FBI and DEA, as well as Assistant United States Attorneys Kenneth F. Affeldt and Maritsa A. Flaherty, who are prosecuting the case.

This case is being prosecuted as part of the Department of Justice’s Opioid Fraud and Abuse Detection Unit. Assistant United States Attorney Flaherty represents the unit in the Southern District of Ohio, which is one of 12 Districts to receive funding for such a prosecutor.

An indictment merely contains allegations, and defendants are presumed innocent unless proven guilty in a court of law.

About the United States Attorney's Office for the Southern District of Ohio

Our mission is to protect and serve the citizens of the Southern District of Ohio through the ethical, vigorous and impartial enforcement of the laws of the United States, and in so doing to defend the national security, improve the safety and quality of life in our communities, protect the public funds and financial assets of the United States, maintain a courteous and professional working environment, and, with skill and integrity, seek to do justice in every matter

We are the United States Attorney’s Office for the Southern District of Ohio, one of 94 United States Attorney’s Offices in the country. We are a part of the Department of Justice. Our District is comprised of 48 counties in the southern half of the state.

We represent the interests of the United States, both criminal and civil, in federal court. It is our responsibility to enforce federal criminal laws. We work to prevent terrorism and promote the nation’s security. We are committed to preventing crime, enforcing federal laws, and representing the rights and interests of the American people. We strive to ensure the fair and efficient administration of justice for all Americans.

We prosecute those individuals and organizations that violate federal criminal statutes. We work with a multitude of federal, state, and local agencies, including the Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF), the Drug Enforcement Administration (DEA), the Federal Bureau of Investigation (FBI), the Bureau of Immigration and Customs Enforcement (ICE), the Internal Revenue Service (IRS), the U.S. Forest Service, the U.S. Park Service, the U.S. Marshal’s Service, the U.S. Postal Inspection Service, the U.S. Secret Service, The Ohio Highway Patrol, and multitude of local law enforcement agencies. We prosecute a wide-variety of offenses including domestic and foreign terrorism; child pornography and exploitation; civil rights violations; bank robbery and other violent crimes; firearms offenses; drug trafficking; health care fraud; immigration violations; public corruption; tax evasion; mail, bank and wire fraud; environmental offenses; and identity theft.

We also represent the United States in civil litigation, affirmative and defensive. As such, we sue individuals or entities who have violated federal civil laws. We also defend the interests of the United States when it, or one of its departments, agencies, or employees is sued, and we defend federal programs and agency actions.

We collect monies owed to the United States from forfeiture, restitution, and fines imposed as a part of the judgment in federal cases. We also pursue collection of civil debts owed to the United States, including student, small business, housing, and farm loans. Finally, we represent the interests of federal agencies in bankruptcy court.

Our district covers the bottom half of the state of Ohio.

Our district contains three staffed offices in Columbus, Cincinnati, and Dayton. The Columbus office is the headquarters of our District and is the largest, followed by Cincinnati then Dayton.

Date Published: November 27, 2018

 

The United States Attorneys Office Southern District of Ohio

 

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