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Fayette RegionalThis is the first case I’ve seen of hospital-owned physicians being charged.

David Neil Ringel, DO, family physician in Connersville, Indiana, entered a guilty plea in Fayette Circuit Court to a single count of conspiracy to commit forgery June 17, 2016. In exchange for his guilty plea, all other charges against him were dropped. He also agreed to testify in any future criminal cases stemming from this investigation by the DEA and the Indiana Attorney General’s Office. Dr. Ringel was sentenced to four years in state prison, four years of probation and 2,080 hours of community service, and he was fined $5,000.

Dr. Ringel was among four former employees of Fayette Regional Health System, the area hospital, arrested in 2013. Former doctor David Palmer and former physician’s assistant David Wulff have previously pleaded guilty to single counts of conspiracy to commit forgery. They each received the same sentence as Ringel. Physician’s assistant Jeff Ferryman also pleaded guilty to a single count of forgery and faces up to eight years in prison and a fine of up to $10,000 when he’s sentenced July 13.

The original charges filed on the group were:

  • Dr. Daniel Palmer, 56: seven Class A felony counts and two Class B felony counts of conspiracy to commit dealing in a narcotic drug, two Class A felony counts and one Class B felony count of conspiracy to deal in a controlled substance, and 11 counts of conspiracy to commit forgery as a Class C felony.
  • Dr. David Ringel, 54: two Class A felony counts and eight class B felony counts of conspiracy to dealing in a controlled substance and nine Class C felony counts of conspiracy to commit forgery.
  • Jerry Ferryman, 50, a physician’s assistant: six Class A felony counts and one Class B felony count of dealing in a narcotic drug, and seven counts of forgery as a Class C felony.
  • David Wulff, a physician’s assistant: more than 20 felony drug charges alleging unlawfully prescribing controlled substances, acquiring controlled substances by fraud, and forgery.

Those charges stem from Ringel, Wulff’s supervising physician, allegedly pre-signing prescription pads for Wulff. Those pre-signed prescriptions were then allegedly used by Wulff to prescribe controlled substances which were outside the scope of what Wulff, as a physician’s assistant, was legally allowed to prescribe. Palmer also is alleged to have pre-signed prescriptions for Ferryman, which Ferryman then allegedly used to prescribe controlled drugs outside of his scope to legally prescribe.

So basically all of them have pleaded guilty to only one of the lesser charges filed against them. Obviously, whether they were guilty or not, this is a case of accepting a plea because the alternative of going to trial is not an option based on the risk involved. Palmer faced 550 years in prison and fines of $200,000, Ringel faced 112 years in prison and fines of $80,000, while Ferryman faced 426 years in prison and fines of $150,000 if found guilty of all charges. Having been to trial myself and convicted on no evidence even though I was innocent, I can understand their making that decision.

In 2013 a search was conducted by the Indiana Attorney General’s Medicaid Fraud Control Unit with help of federal, state and local authorities. So basically they had nothing but the desire to snoop to look for something to charge them with as justification for their raid. When there is no just cause for a search warrant, charges of Medicare/Medicaid fraud will always get them in because every doctor in the country has done something wrong according to the laws for Medicare and Medicaid.  That’s why more pain management physicians are no longer accepting insurance—to avoid these “search and find” raids. But with the search, they landed on something that they could then use for charges against the doctors and their subordinates. The search of  Wulff’s office in the Fayette Regional Health Primary Care clinic turned up three blank prescription pads with 50 prescription slips each bearing Ringel’s signature and two blank prescription pads with 50 prescription slips each and a partial blank prescription pad, all pre-signed by Palmer. According to the affidavit, FRHS Dr. Bradley Dubois and Primary Care Clinic office manager Deanna Weber informed authorities during the investigation that hospital administration had asked doctors to sign blank prescription pads for use by physician’s assistants. However, Randy White, chief executive officer for FRHS, contradicted that statement saying that doctors and employees adhere to state law.

There is no proof that the signatures on the prescription pads were real. What is surprising is that the government went after hospital-owned physicians at all. Usually hospital-owned physicians are untouchable and the government targets the independent physician. I wonder if the hospital wanted to get rid of these particular doctors for some reason and used the government to do it. Or maybe the hospital isn’t playing the government game as instructed, and the government is wielding their power to teach the hospital a lesson.  It will be interesting to see if other hospital-owned clinics come between the crosshairs in the future. I’m also not quite sure, if the signatures are actually those of the doctors, how there can be charges of forgery in the first place.

Indiana Attorney General Gregory Zoeller made the usual comment to the media putting blame on doctors for the current drug abuse problem: “Overprescribing of powerful opiate painkillers across our state has contributed in part to the epidemic of prescription drug abuse in Indiana and fueled addiction at the expense of patients’ safety and health,”