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Can we ever believe anything the government charges a pain management physician with? I don’t think so. Here is a case of a doctor being charged with schemes involving kickbacks for patient referrals and tax evasion. Manoj D. Patharkar,MD 45, was a Physiatrist (Physical Medicine & Rehabilitation) in Edison NJ. In spite of the fact that he accepted a plea, how much can we believe is true?  As a victim of taking a plea to government charges for something that wasn’t true in order to avoid a life-destroying trial, I hesitate to believe any of this that has been reported.

Why?  First let’s look at the amount of money. He pleaded guilty to concealing roughly $3.6 million in income from his medical practices to evade taxes, paying kickbacks of up to $1.5 million to 13 other doctors. He was charged with first-degree conspiracy, first-degree money laundering, seven counts of third-degree filing fraudulent tax returns, and three counts of third-degree failure to pay taxes. He supposedly paid “phantom” employees to reduce his income tax obligations and then deposited checks for medical services into his personal bank account. His accountant was supposedly in on the fraud for a kickback.

I’m sorry, but all of this seems a bit far-fetched to me. I know from personal experience how the government can twist numbers. At my trial, they used my books, which showed a real income for myself of no more than $24,000 per year, to make a claim to the jury that I was “in it for the money”. The numbers they are throwing around here are just too big to be real. Another thing the government likes to do is add up all the money a doctor has received from government insurance, claim fraud, and then order all that money be returned. In other words, the doctor takes care of government-insured patients for all the years in practice for free. The government even charges fines for the supposed “fraud”, which means the doctor actually pays for the privilege of treating their patients. Here, Dr. Patharkar will be required to pay an anti-money laundering penalty of $500,000, Doctors need to stop taking government insurance across the board.

In my opinion, the REAL reason for the attack lies in the fact that he was also accused of “indiscriminately” prescribing a form of fentanyl called Subsys to a patient who overdosed. Being an independent minority pain management physician, the government just wants to shut him down and will use whatever trumped up charges that will do the job. I consider the timing of the charges to be very telling. If you have a possible charge of contributing to the death of a patient, which could give up to 30 year incarceration, it isn’t surprising that he would plead to the charges listed. However, what he possibly didn’t expect was that in Nov, 2016, the state of New Jersey revoked his license to practice permanently, and he was forced to close his practice.

The medical incongruity here is that Subsys was approved by the FDA for treating cancer pain. But that is how every drug gets its foot in the door—get approval for one thing. Then doctors have the “privilege” of using the drug off label for whatever it works on. For example, Neurontin was approved for seizures. It is now used for general pain syndromes. Pain is pain. Being approved for cancer pain gives any doctor the choice of using the drug for non-cancer pain, and it shouldn’t cause a doctor to be charged criminally.

 But the government makes off-label use sound bad: “Dr. Patharkar recklessly ignored the well-established risks associated with Subsys, and put his patients in grave danger of overdose or death by flouting the strict rules for prescribing it,” said Steve Lee, director of the state Division of Consumer Affairs. There aren’t any more risks with Subsys used correctly than any other immediate-release opioid.

Patharkar was the second doctor in the state accused of prescribing Subsys off-label. But the government is actively looking for people to turn other doctors in by telling them to contact them. That’s where the money is—attack the doctors. A record-number thirty-one doctors were attacked in New Jersey alone in 2016 for prescribing opioids.

Dr. Patharkar was supposed to be sentenced January 23, 2017 but there is no notice of such on the internet and he is not listed as an inmate in the NJ prison system. If anyone knows what has happened to his sentencing/plea agreement, please pass it on.