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Dr. Steven Mangar1Steven Keith Mangar, MD and his office manager Maria Eclavea will be in court June 23, 2016 in California for the Monterey County Superior Court judge to consider a motion to prohibit Dr. Mangar from practicing medicine while his criminal proceedings are pending. The cases’ preliminary hearing is set for August 25.

Dr. Mangar, 46, of Salinas, California is charged with 37 felonies, 26 for insurance fraud related to upcoding and billing for services not rendered as well as 10 felonies for unlawfully prescribing medications or furnishing drugs to an addict. He also faces enhancements alleging that his conduct resulted in him fraudulently receiving more than $500,000.

Eclavea, 49, was arrested and charged with 23 felonies related to the alleged medical insurance fraud scheme.

Dr. Mangar is an anesthesiologist and pain management specialist. He runs a multidisciplinary pain practice with Dr. Arthur Schuller, board-certified in neurology and psychiatry and board-eligible in internal medicine. They used various methods of treating pain, including interventional, pharmaceutical, physical therapy and psychological modalities.

In the usual press release hype, District Attorney Dean Flippo said “Multi-faceted insurance fraud schemes are exceedingly sophisticated.” “The investigators on this case have worked countless hours.” When the government can’t get access to a doctor’s office through legal means with a legitimate search warrant, they always use insurance fraud. The investigation took the usual two years. Many jobs in the justice department now depend on these investigations and criminal attacks on doctors. The case against Mangar was compiled by the district attorney’s office’s Disability/Healthcare Insurance Fraud Unit that was launched to investigate alleged prescription drug fraud by medical providers with help from the state Department of Insurance and The Medical Board of California. Imagine that! People brought into the office specifically to target doctors. That’s the same thing that happened to me. Southwest Virginia used money gleaned from the attack on Purdue Pharma to bring in Jenny Waering, the US Attorney that targeted me. I was also first attacked for “insurance fraud” to get access to my patient records, even though probably 1/3 of the records confiscated were uninsured patients.

The entire case against Dr. Manger has fish smell all over it. On February 14, 2014, Dr. Mangar was arrested on suspicion of driving under the influence of methamphetamine. But because of a supposed backup in the U.S. Department of Justice crime lab in Sacramento, his toxicology report wasn’t available until January, 2015. Lots of time to get the results fabricated. His office and home were then raided February 12, 2015 and he was arraigned February 13, 364 days after his arrest. Agencies involved included the Monterey County District Attorney’s Office’s Health Care and Workers’ Compensation fraud units, the State Medical Board, the Department of Insurance, the Drug Enforcement Agency and the DOJ Office of the Inspector General. Again, a lot of jobs are involved in the continuation of drug laws.

Dr. Mangar actually responded to the raid saying, “I have disproportionately higher numbers because of what I do and because of this I think I am being targeted.” “I got pulled over doing 85 mph in a 65 mph zone,” Mangar said. “The officer knew specifically what I did for a living as far as being a pain specialist. He thought I was on pain killers.” The field blood test showed THC (cannabis) in his blood, Mangar said. But, he argued, it wasn’t confirmed. And then a year later he gets charged with methamphetamine instead? Something very fishy is going on.

In April, 2015, it was reported that he would likely accept a plea deal related to his citation on suspicion of drugged driving. Twice, Susan Chapman, Mangar’s defense attorney, indicated the case was closing in on resolution. But there has been no report of that actually happening. So where is it?

Prior to the official charges and raid, the usual paper trail was set in motion by the State Board of Medicine. Dr. Mangar was sanctioned  in October 2012 for “Substandard Care, Incompetence or Negligence” and was put on three years’ probation by the State Medical Board. According to board records, Mangar kept shoddy records that indicated he examined the patient at times when there was no documentation. After the investigation, he was ordered to enroll in prescribing practices and record-keeping courses. This is standard Board procedure when the government is trying to lay a paper trail against a physician, and the findings aren’t necessarily fact. His Board of Medicine review is presented in shortened form here: Example BOM review.

On Nov. 6, 2014, Medical Board officials filed a petition to revoke Mangar’s probation because of the treatment of a 40-year-old man with chronic back pain. They used the new prescribing standards to attack him, stating that he “failed to develop an objective-oriented treatment plan”. In January, the board filed an amended accusation and petition to revoke the probation, alleging “gross and repeated negligence, incompetence and failure to maintain adequate and accurate medical records”. The filed document from the State Medical Board then goes on to detail the cases of specific patients, several who died supposedly from causes related to prescription drug abuse. But one of the things we need to get the public to understand is that doctors aren’t police. What a patient does with his medication should not be blamed on the doctor.

According to a news report by ProPublica, an independent, non-profit newsroom in New York that produces investigative journalism supposedly in the public interest,  an analysis  showed Mangar was the third-leading hydrocodone prescriber in California in 2012. Ahah! So that’s the basis for the attack! The government is targeting doctors in every state based on the amounts of opioids they prescribe. Then they fabricate the justification.

According to ProPublica, 72 percent and 55 percent of Mangar’s 241 patients filled Schedule II and Schedule III drug prescriptions in 2012. Actually, for a pain management office using pharmaceutical therapy and not just interventional steroid injections that don’t help but make the money, that’s not a bad percentage. And to have only 241 patients in a pain management office does not support the usual government agenda that he was “in it for the money”.

 

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