Example Indictment

 

IN THE UNITED STATES DISTRICT COURT
FOR THE [DISTRICT NAME]
UNITED STATES OF AMERICA

v.

DEFENDANT’S NAME

 

VIOLATIONS:

21 U.S.C. ‘ 856 (maintaining a drug-involved premises – 2 counts)

21 U.S.C. ‘ 841(a)(1), (b)(1)(C)(distribution of controlled substances –200 counts)

18 U.S.C. ‘ 1347 (health care fraud – 33counts)

18 U.S.C. ‘ 1001 (false statements – 4counts)

18 U.S.C. ‘ 2 (aiding and abetting)

Notice of forfeiture

 

I N D I C T M E N T

COUNT ONE

THE GRAND JURY CHARGES THAT:

At all times material to this indictment:

 

BACKGROUND

2. From approximately [date], until approximately [date], defendant maintained a medical practice located in [location] and on the grounds of [name] Hospital. [Name] Hospital was a teaching hospital with X College of Osteopathic Medicine.
3. During this same time, defendant assisted with the medical training of doctors in training referred to as “residents,” who were graduates, but who had limited authority under their state licenses.
4. In order to bill for services, a physician was required to have actually seen the patient and to have participated personally in the patient’s care up to the level of service billed.
5. In June 2011, defendant was asked to vacate the office space rented to him by the Hospital. Defendant then maintained a medical practice, located in [location], from [date] to [date].
6. Oxycodone is a narcotic analgesic that is similar to morphine and is classified as a Schedule II controlled substance. Even if taken only in prescribed amounts, pills containing amounts as low as 5 milligrams of oxycodone can cause physical and psychological dependence. Such pills have a significant street value.
7. In August 2010, Perdue Pharma changed the formulation of their Oxycontin pills to make the tablet more difficult to manipulate for misuse and abuse.
8. Title 21, United States Code, Section 841(a) (1), provides that A[e]xcept as authorized by this subchapter, it shall be unlawful for any person to knowingly or intentionally manufacture, distribute, or dispense a controlled substance.
9. The Attorney General of the United States has exercised his rulemaking authority regarding the dispensing of controlled substances through the promulgation of 21 Code of Federal Regulations 1306.04, governing the issuance of prescriptions, which provides, that a prescription for a controlled substance must be issued for a legitimate medical purpose by an individual practitioner acting in the usual course of his professional practice. Moreover, an order purporting to be a prescription issued not in the usual course of professional treatment is not a prescription within the meaning and intent of section of the Act [21 U.S.C. ‘ 829] and the person issuing it as well as the person knowingly filling such a purported prescription, shall be subject to the penalties provided for violations of the law relating to controlled substances.
10. The [State named] Code of Professional and Vocational Standards, Title 49, Chapter 16.92, defines the authority of physicians to prescribe or dispense controlled substances:

(a) A person licensed to practice medicine, when prescribing controlled substances, shall carry out the following minimum standards:

(1) Initial medical history and physical examination, including an evaluation of the heart, lungs, blood pressure and body functions that relate to the patient’s specific complaint.

(2) Reevaluations. Factors to be considered in determining the number and frequency of follow-up evaluations are the diagnosis, the controlled substance involved, expected results and possible side effects. For chronic conditions, follow-up evaluations shall be recommended to monitor the effectiveness of the controlled substance in achieving the intended results.

(3) Patient counseling. Appropriate counseling shall be given to the patient about dosage levels, instructions for use, frequency and duration of use and possible side effects.

(4) Medical Records. Information shall be recorded on each occasion when a controlled substance is prescribed including the name, strength, quantity and date of the controlled substance, specification of the symptoms observed and reported, the diagnosis and the directions given to the patient. If the same controlled substance continues to be prescribed, administered or dispensed, the medical record shall reflect changes in the symptoms observed and reported, in the diagnosis of the condition for which the controlled substance is being given and in the directions given to the patient.

16. Accordingly, as a physician, defendant was authorized to dispense Schedule II controlled substances to patients he examined for legitimate medical purposes and in the usual course of professional practice.
17. With the assistance of defendant’s medical staff who acted at his direction, patient-customers paid an “office visit” fee to obtain prescriptions for controlled substances from defendant, who prescribed narcotics outside the usual course of professional practice and without there being a legitimate medical purpose. Defendant did not even see many of these customers at his office, nor did he directly supervise staff who he had tasked to see these customers and distribute his prescriptions for controlled substances. Customers would often receive multiple prescriptions written by defendant during a single visit to defendant with certain of the prescriptions containing a notation written by defendant that the prescription was to be filled on a specific date in the future.
18. The patient-customers provided little or no recent medical records on their first visit to verify their claim of pain or prior history of prescribed opioid medications, or provided medical records that were not consistent with their claims of pain; nonetheless, at the first visit defendant gave them a prescription for a large number of pills each containing a Schedule II narcotic. The customers normally received only a cursory physical examination but little other medical care or treatment from defendant before receiving a prescription for controlled substances. Although many of the patient-customers had medical insurance, defendant stopped accepting most medical insurance in or around 2010, requiring most patients thereafter to pay for visits with cash, credit card, or money orders only.
19. Defendant’s prescribing habits mirrored the needs of drug addicts and drug traffickers. He prescribed pills each containing 5 or 10 (usually 10) milligrams of oxycodone in the form of the narcotic oxycodone acetaminophen, as well as OxyContin containing 80 or 40 milligrams of oxycodone. When the OxyContin pills were reformulated, their street value decreased, and the street demand for 30 milligram oxycodone pills increased. Defendant  stopped prescribing almost all OxyContin 80 and 40 milligram pills and, without adequate medical justification, switched his customers receiving those concentrations to 30 milligram pills. In response to customers requesting pills with specific concentrations of oxycodone, defendant met those requests and prescribed those customers pills with their requested concentration of oxycodone. Defendant sometimes lowered the number of pills containing oxycodone he prescribed without adequate medical justification and added other pain relief medications because of his concern that the high numbers of pills containing oxycodone prescribed would draw law enforcement attention.

Defendant did not counsel the patient-customers as to the dosage levels, instructions for use, frequency and duration of use and possible side effects.

20. After obtaining the prescriptions, customers had the prescriptions filled at a pharmacy and then either sold some or all of the pills, or, ingested the pills to satisfy a drug addiction, not for pain relief.
21. Defendant was aware of illegal drug use, addiction, and failure to use the oxycodone as prescribed but still continued to issue prescriptions for large amounts of oxycodone to customers. Defendant created what he called a “probation” for some of his customers who used illegal drugs and/or who did not use the drugs as he prescribed, required more frequent visits and the payment of additional “office visit” fees; however, he tasked others, who were often unlicensed, with seeing those customers.

Defendant pre-wrote and pre-signed prescriptions for oxycodone pills for others to give to the “probationers.” Even where they failed to comply with his rules, he frequently continued to prescribe large amounts of pills containing oxycodone. When defendant discharged a patient, he continued to prescribe large amounts of controlled substances beyond that permitted by accepted medical standards, even when the customer was using illegal street drugs or tested negative for the prescribed pills.
COUNT TWO
MAINTAINING A DRUG INVOLVED PREMISES

THE GRAND JURY FURTHER CHARGES THAT:

From [dates], in [location], and from [dates], in [location], defendant knowingly rented, used, and maintained a place for the purpose of unlawfully distributing controlled substances, including oxycodone.

In violation of Title 21, United States Code, Section 856(a)(1).

COUNTS THREE THROUGH TWO HUNDRED AND TWO
DISTRIBUTION OF OXYCODONE PILLS

THE GRAND JURY FURTHER CHARGES THAT:

On or about the dates listed below, in the [District], defendant knowingly and intentionally distributed and dispensed, and aided and abetted the distribution and dispensing of, outside the usual course of professional practice and not for a legitimate medical purpose, the below-noted number of pills, each pill of which is a mixture and substance containing a detectable amount of oxycodone, a Schedule II controlled substance.

Patient 1:
04/14/2011 360 pills of 30 milligrams of oxycodone
05/18/2011 720 pills of 30 milligrams of oxycodone
11/19/2012 480 pills of 30 milligrams of oxycodone

Patient 2:
07/27/2011 720 pills of 30 milligrams of oxycodone
04/19/2012 180 pills of 30 milligrams of oxycodone
12/19/2012 180 pills of 30 milligrams of oxycodone

Patient 3:
03/08/2010 180 pills of 40 milligrams of oxycodone and
120 pills of 5 milligrams of oxycodone
05/03/2010 180 pills of 40 milligrams of oxycodone and
320 pills of 5 milligrams of oxycodone
11/12/2010 90 pills of 40 milligrams of oxycodone and
160 pills of 5 milligrams of oxycodone

Patient 3:
07/24/2012 180 pills of 30 milligrams of oxycodone
09/27/2012 180 pills of 30 milligrams of oxycodone and
120 pills of 15 milligrams of oxycodone
10/25/2012 90 pills of 30 milligrams of oxycodone and
60 pills of 15 milligrams of oxycodone
01/02/2013 180 pills of 30 milligrams of oxycodone and
120 pills of 15 milligrams of oxycodone

Patient 4:
07/26/2011 720 pills of 30 milligrams of oxycodone
12/14/2011 720 pills of 30 milligrams of oxycodone
11/06/2012 540 pills of 30 milligrams of oxycodone and
720 pills of 30 milligrams of oxycodone

Patient 5:
06/10/2011 480 pills of 30 milligrams of oxycodone and
360 pills of 10 milligrams of oxycodone
08/02/2012 180 pills of 30 milligrams of oxycodone and
180 pills of 10 milligrams of oxycodone
11/19/2012 180 pills of 30 milligrams of oxycodone

Patient 6:
02/21/2012 90 pills of 30 milligrams of oxycodone
07/18/2012 360 pills of 30 milligrams of oxycodone
09/26/2012 180 pills of 30 milligrams of oxycodone

Patient 7:
01/26/2011 180 pills of 30 milligrams of oxycodone
03/28/2012 360 pills of 30 milligrams of oxycodone
09/10/2012 90 pills of 30 milligrams of oxycodone

Patient 8:
03/10/2011 360 pills of 30 milligrams of oxycodone
09/22/2011 180 pills of 30 milligrams of oxycodone
09/6/2012 180 pills of 30 milligrams of oxycodone

Patient 9:
04/11/2011 600 pills of 30 milligrams of oxycodone
08/1/2011 1080 pills of 30 milligrams of oxycodone
11/21/2012 480 pills of 30 milligrams of oxycodone and
480 pills of 10 milligrams of oxycodone

Patient 10:
04/06/2011 600 pills of 30 milligrams of oxycodone and
600 pills of 10 milligrams of oxycodone
07/19/2011 600 pills of 30 milligrams of oxycodone and
900 pills of 10 milligrams of oxycodone
09/10/2012 240 pills of 30 milligrams of oxycodone

Patient 11:
02/10/2010 60 pills of 80 milligrams of oxycodone and
120 pills of 10 milligrams of oxycodone
11/23/2010 90 pills of 80 milligrams of oxycodone and
240 pills of 10 milligrams of oxycodone
01/19/2011 300 pills of 30 milligrams of oxycodone and
120 pills of 10 milligrams of oxycodone
11/6/2012 540 pills of 30 milligrams of oxycodone

Patient 12:
03/08/2012 120 pills of 10 milligrams of oxycodone
04/16/2012 120 pills of 10 milligrams of oxycodone
04/27/2012 240 pills of 10 milligrams of oxycodone

Patient 13:
03/29/2012 30 pills of 30 milligrams of oxycodone and
120 pills of 10 milligrams of oxycodone
04/30/2012 30 pills of 30 milligrams of oxycodone and
60 pills of 10 milligrams of oxycodone

Patient 14:
11/02/2011 240 pills of 30 milligrams of oxycodone
11/22/2011 120 pills of 30 milligrams of oxycodone

Patient 15:
09/26/2011 720 pills of 30 milligrams of oxycodone

Patient 16:
07/13/2011 360 pills of 30 milligrams of oxycodone and
240 pills of 10 milligrams of oxycodone
09/07/2011 180 pills of 30 milligrams of oxycodone and
120 pills of 10 milligrams of oxycodone

Patient 17:
02/12/2010 100 pills of 10 milligrams of oxycodone
11/16/2011 120 pills of 30 milligrams of oxycodone
07/26/2012 180 pills of 30 milligrams oxycodone
03/16/2011 720 pills of 30 milligrams of oxycodone

Patient 18:
08/02/2011 800 pills of 30 milligrams of oxycodone
07/25/2012 90 pills of 30 milligrams of oxycodone and
60 pills of 10 milligrams of oxycodone

Patient 19:
04/14/2011 240 pills of 30 milligrams of oxycodone and
240 pills of 10 milligrams of oxycodone
08/17/2011 1080 pills of 30 milligrams of oxycodone and
1080 pills of 10 milligrams of oxycodone
11/29/2012 480 pills of 30 milligrams of oxycodone and
480 pills of 10 milligrams of oxycodone

Patient 20:
02/14/2011 300 pills of 30 milligrams of oxycodone
09/06/2011 300 pills of 30 milligrams of oxycodone
07/16/2012 90 pills of 30 milligrams of oxycodone

Patient 21:
02/09/2010 120 pills of 40 milligrams of oxycodone and
480 pills 10 milligrams of oxycodone
02/09/2011 240 pills of 30 milligrams of oxycodone and
480 pills of 10 milligrams of oxycodone
01/05/2012 150 pills of 30 milligrams of oxycodone

37 more patients followed with similar prescriptions.
All in violation of Title 21, United States Code, Sections 841(a)(1), (b)(1)(C), and Title 18, United States Code, Section 2.

 

COUNTS TWO HUNDRED AND THREE THROUGH TWO HUNDRED AND THIRTY-FIVE
HEALTH CARE FRAUD

THE GRAND JURY FURTHER CHARGES THAT:

BACKGROUND

THE SCHEME TO DEFRAUD

2. From [date] to [date], defendant knowingly and willfully executed a scheme to defraud health care benefit programs by submitting false and fraudulent claims for reimbursement.

MANNER AND MEANS

3. Defendant elected to travel from [date], to [date]. In advance of his trip, defendant made notations in the patient charts falsely indicating that he had personally seen and evaluated the patient-customers and directing what prescriptions were to be provided to the customers who would be seen at his office during that upcoming week.

Defendant signed the patient charts and signed the prescriptions for the patients he had not seen and who were scheduled for the upcoming week.

5. In anticipation of his absence, defendant did not reschedule patients or have a qualified physician supervise his residents and cover his practice in his absence. Defendant instructed residents, nurses, and other staff to see the patients for the week and to give them the pre-written and pre-signed prescriptions.
6. Defendant falsely told residents, nurses, and other staff that he had obtained approval from doctors at the supervising hospital for coverage in his absence.
7. Defendant instructed support staff to continue to run the office as usual.
8. Defendant caused false claims to be submitted to health care benefit programs with false charges for services purportedly rendered by him to patient-customers seen in his absence by unsupervised resident and other non-physicians.

Defendant caused to be submitted 25 claims for payment to Medicare and private insurance.

10. 33 charges for office visits are listed.

All in violation of Title 18, United States Code, Sections 1347 and 2.
COUNT TWO HUNDRED AND THIRTY-SIX THROUGH TWO HUNDRED AND THIRTY-NINE

FALSE STATEMENT

THE GRAND JURY FURTHER CHARGES THAT:

2. Defendant knowingly and willfully made a materially false, fictitious and fraudulent statement, in that defendant told FBI agents that he had sought and received approval from Doctor X, Dean of Medicine with X College of Osteopathic Medicine, to use  residents to staff his private medical practice while he was [away], when, as the defendant then knew, he had never sought and had never received permission to do so.
3. Defendant knowingly and willfully made a materially false, fictitious and fraudulent statement, in that defendant told FBI agents that, concerning the patients for whom he had pre-written prescriptions for the week he was to be away, that he had seen those patients in the seventy-two hours before he wrote the prescriptions, when he had not seen them.
4. Defendant knowingly and willfully made a materially false, fictitious and fraudulent statement, in that defendant told FBI agents that he had not filled out in advance any medical records for patients who were to be seen at his medical practice while he was to be away, when he did
5. Defendant knowingly and willfully made a materially false, fictitious and fraudulent statement, in that defendant told FBI agents that the supervising physicians for the medical residents he directed to see his patients while he was away were Doctor X, Chief of Medicine  and Doctor X, Head of the Internship Program, when those two doctors were not supervising physicians for these residents and, in fact, defendant had not even told Doctors X or X. that the residents were serving as physicians in defendant’s practice while he was to be out of the country, or even that defendant  would be out of the country.

In violation of Title 18, United States Code, Section 1001(a)(2).

NOTICE OF FORFEITURE

THE GRAND JURY FURTHER CHARGES THAT:

1. As a result of the violations of Title 21, United States Code, Section

841(a)(1) set forth in this Indictment, defendant shall forfeit to the United States of America:

1. any property used or intended to be used, in any manner or part, to commit, or to facilitate the commission of, such offenses;
2. any property constituting, or derived from, proceeds obtained directly or indirectly from the commission of such offenses, including, but not limited to:
   1. A sum of money equal to at least $2,000,000 representing the amount of proceeds obtained as a result of the violations of the Controlled Substances Act.
   2. If any of the property subject to forfeiture,
      1. cannot be located upon the exercise of due diligence;
      2. has been transferred or sold to, or deposited with, a third party
      3. has been placed beyond the jurisdiction of the Court;
      4. has been substantially diminished in value; or
      5. has been commingled with other property which cannot be divided

it is the intent of the United States, pursuant to Title 21, United States Code, Section 853(p), to seek forfeiture of any other property of the defendant(s) up to the value of the property subject to forfeiture.

All pursuant to Title 21, United States Code, Section 853.

A TRUE BILL:

______________________________

GRAND JURY FOREPERSON
[NAME]
UNITED STATES ATTORNEY