Work at a Pill Mill? You Could Earn Millions as a Whistleblower – And Be a Hero

To curb this epidemic, the U.S. Department of Justice has begun to focus its attention on the aggressive investigation and prosecution of medical professionals running “pill mills” that violate the federal Controlled Substances Act. Michigan, Ohio, Indiana, West Virginia, Kentucky, Tennessee, and other states along the I-75 corridor have opioid prescription rates as much as four times higher than the national average contributing to the skyrocketing number of opioid overdoses in the Midwest.

While there are legitimate uses for prescribed opioids such as in an acute care setting or in hospice, much of the increased usage is from prescription drug abuse.  Pill mills have saturated our communities, earning millions of dollars for the prescribing physicians while leaving our friends, family, neighbors, and co-workers with lifelong addictions.

What is a Pill Mill?

A pill mill refers to a clinic, pharmacy, or doctor in the practice of prescribing strong pain narcotics in an excessive and inappropriate manner. Some signs that a healthcare provider might be a pill mill include:

• Opioids are the only treatments used for pain;
• Patients do not receive physical exams or very cursory exams;
• There are no medical records or x-rays;
• The clinic or doctor has their own pharmacy to fill prescriptions;
• Cash payments are strongly encouraged;
• There are crowds, long lines, and security guards;
• Anyone can get Oxycodone, Fentanyl, Xanax, or similar medications with little to no effort;
• The clinic or physician has recruiters bringing patients in from the street;
• The clinic or physician buys the pills back from the patients after the prescription is filled.

Pill Mill Raids, Arrests and Convictions

In December 2019, several physicians in Warren, Michigan – Dr. Rajendra Bothra, Dr. Eric Bakos, Dr. Ganiu Edu, Dr. David Lewis, Dr. Christopher Russo, and Dr. Ronald Kufner – were arrested and charged with operating one of the nation’s largest healthcare fraud schemes – swindling the government and private health insurers of nearly $500 million dollars and unlawfully prescribing more than 13 million opioids.

This was just the latest multimillion-dollar pill mill that authorities discovered. Other illicit schemes uncovered in the last few years include:

• 2012: Dr. Hussein Awada of Warren, Michigan was charged with unlawful distribution of a controlled substance and conspiring to commit health care fraud. From 2010 to 2012, federal prosecutors reported that Awada wrote prescriptions without any medical justification for 80,000 doses of Oxycodone, Roxicodone, and other painkillers to groups of patients recruited by a marketer. The marketer then bought the pills from the patients he recruited and resold them to street drug dealers. Authorities estimate that Awada billed Medicare more than $11 million over five years for this illegal operation, which does not include private insurance payments or cash payments.
• 2013: Shannon Wiggins, a general practitioner in Lansing, Michigan was indicted and sentenced to two years in federal prison on charges of improperly distributing oxycodone and methadone — both schedule II substances — to a single patient over a four-month period in 2008 and 2009. It was alleged that the doctor distributed 2,700 OxyContin pills and 2,700 methadone pills to one patient on Jan. 23, 2009 alone, and that she prescribed patients OxyContin and methadone to be sold on the street.
• 2016: Dr. Fanny Dela Cruz of Livonia, Michigan was sentenced to eight years in federal prison for conspiring to illegally distribute prescription pills. Dela Cruz admitted she wrote pre-signed prescriptions and left the patient names blank. She then sold the slips so the buyer could fill in the name for someone who she had not examined. In a 13-month period, the doctor issued approximately 577,707 dosage units of Oxycodone HCl, 333,394 dosage units of Oxymorphone, 35,185 dosage units of Alprazolam, and 663,778 milliliters of Promethazine with Codeine.
• 2017: Dr. Mohammad Derani of Dearborn, Michigan was charged with overprescribing Oxycodone and other opioids and controlled substances. Michigan State Police said Derani ran a “pill mill”, writing an average of more than 43 controlled substance prescriptions each workday between January 2015 and August 2017. In fact, he prescribed more than 500,000 opioid pills in the first eight months of 2017. Investigators reported that half of the pills ended up on the street. “People lined up here at three in the morning,” reported investigators, and they would order food for delivery to the clinic while they waited.
• 2017: Anthony Conrardy and Dr. William McCutchen, III, of Washtenaw County, Michigan were sentenced to up to 20 years in prison after being found guilty of helping to operate an alleged pill mill. The pair of doctors regularly wrote medically unnecessary prescriptions for Oxycodone, Dilaudid, Vicodin, and other narcotics to “drug-seeking individuals purporting to be patients,” according to the U.S. Attorney. Their clinic generated roughly $4.5 million through illegal drug prescriptions between September 2011 and March 2015. It was alleged that the clinic’s doctors prescribed more than 1.5 million Oxycodone pills, among other drugs.
• 2018: Dr. Rodney Moret of Southfield, Michigan was sentenced, in part, for the illegal sale and distribution of dangerous prescription medications, including opioids, into nearby Metro Detroit communities from his clinic, Advanced Care Services (ACS). Moret sent recruiters to enlist patients to visit ACS and receive a cursory exam or sometimes no exam at all. After he wrote them medically unnecessary prescriptions for controlled substances, the patients filled those prescriptions and turned the medications over to the ACS recruiters in exchange for cash. The recruiters would then sell the drugs on the street where they had a total value of more than $15 million.

Pill Mills and Whistleblower Awards

The U.S. Department of Justice and local state agencies have been doing everything in their power to crack down on these pill mills, but they can’t do it without the help of those with inside knowledge of illegal activities.

Under the qui tam provisions of the federal False Claims Act, a current or former employee of a pill mill who has information about potentially illegal opioid prescribing may bring a civil case on behalf of the United States. The person filing the complaint is called a “relator” or whistleblower, and if the case is successful, the whistleblower can earn between 15 to 30% of the amount the government ultimately collects from the wrongdoers. With pill mills pulling in tens of millions of dollars, the awards can be significant.

To qualify as a whistleblower and receive an award, one must have inside, non-public, information. Present and former employees working in pill mills are ideal candidates, as are patient recruiters and pharmacists.

Not only can whistleblowers earn significant money, but they can also be heroes and take a stand against the opioid crisis in their communities and states.

Whistleblower Protections

It is important to note that whistleblowers are safe from retaliatory action by the accused person and organization. Moreover, a whistleblower doesn’t lose his or her protection if a lawsuit isn’t successful or if an investigation fails to reveal any wrongdoing, as long as the whistleblower acted in good faith.

If you have information about a suspected pill mill, a doctor whom you believe is overprescribing opioids, a pharmacy or pharmacist that you think is filling or dispensing illegal prescriptions, or allegations of any other healthcare fraud, please contact Lisa Esser-Weidenfeller at (248) 746-4015 or lesser@sommerspc.com.

Ms. Esser-Weidenfeller is actively involved in prosecuting those responsible for creating the opioid epidemic, and currently represents several municipalities suing Big Pharma for their role in this crisis. Rest assured, all communications are protected by the attorney-client privilege and will be kept strictly confidential. She can help you determine whether or not you have a case and are entitled to whistleblower protection.

Finally, if you acted as a patient recruiter, marketer, or worker in a pill mill and fear criminal or civil action, we can confidentially approach federal prosecutors on your behalf before any case is filed. It has been our experience that the federal and state authorities are much more interested in prosecuting doctors than others who had a small role before stepping forward to expose wrongdoing and illegal activities.