Northern Michigan doctor nabbed for illegally prescribing painkillers
A multi-jurisdictional narcotics enforcement team in northern Michigan noticed that many people they were arresting had narcotics prescriptions from one particular physician in their community. Some of these drug users were traveling more than 150 miles to see this physician and obtain their prescriptions.
The narcotics team enlisted the aid of Blue Cross Blue Shield of Michigan's Corporate and Financial Investigations department, who provided assistance that allowed undercover officers to obtain narcotics illegally prescribed by this physician.
Subsequently, the narcotics officers obtained an arrest warrant for the doctor and executed a search warrant on the doctor's office. CFI again provided assistance to the narcotics team by reviewing patient files, many of which were forwarded to our Medical Inquiry Unit.
The review found that these patient files failed to document the medical necessity for the pain killers being prescribed by the doctor. The review also found that the doctor was treating subscribers for opioid addiction, but this doctor did not have the proper federal or state licenses to do so.
The provider has been charged with four Counts of Delivery of Controlled Substances. Additional charges are pending as to the doctor writing non-medically necessary prescriptions.
Members who suspect health care fraud are urged to call our Anti-Fraud Hotline at 1-800-482-3787, or report fraud through our website.