DETROIT – Six Michigan doctors have been charged in connection with a scheme to defraud health care providers out of more than $450 million and unlawfully prescribe more than 13 million opioids.
Dr. Rajendra Bothra, Dr. Eric Bakos, Dr. Ganiu Edu, Dr. David Lewis, Dr. Christopher Russo and Dr. Ronald Kufner are accused of being part of the scheme from January 2013 through November 2018.
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Over the course of the conspiracy, the doctors submitted claims of more than $182.5 million to Medicare, $272.6 million to Medicaid and $9.2 million to Blue Cross Blue Shield of Michigan for services and equipment that were medically unnecessary, ineligible for reimbursement or misrepresented, according to court documents.
They are also accused of issuing more than 13,217,987 doses of opioids, including oxycodone, oxymorphone, hydrocodone and hydromorphine.
More about the doctors
Bothra, 77, and Backos, 65, are residents of Bloomfield Hills. Edu, 50, is a Southfield resident. Lewis, 41, is from Detroit. Russo,50, is from Birmingham, and Kufner, 68, is from Ada.
Bothra was a licensed physician who controlled, owned and operated the Pain Center and the Interventional Pain Center, according to court records.
The Pain Center is a professional limited liability company with officers at 27423 Van Dyke Avenue in Warren and 22480 Kelly Road in Eastpointe.
The Interventional Pain Center is also in the Van Dyke Avenue building in Warren.
Backos, Edu, Lewis, Russo and Kufner were licensed physicians enrolled as participating providers with Medicare for the Pain Center and the Interventional Pain Center, officials said.
All six doctors were licensed by the Drug Enforcement Administration to prescribe controlled substances and issued prescriptions to patients at the Pain Center, according to officials.
Purpose of the scheme
Officials said the scheme was created for Bothra and his accomplices to make money by prescribing opioids and other controlled substances so patients would become returning customers and need additional opioids.
The doctors would also prescribe opioids so patients would have to undergo medically unnecessary procedures, according to court records.
They are accused of submitting false claims to Medicare, Medicaid and Blue Cross for fraudulent reasons, covering up the false claims and using the funds from the claims for personal use.
Charges
All six doctors are charged with health care fraud conspiracy and conspiracy to distribute and possess with intent to distribute controlled substances.
Rajendra Bothra
Bothra is charged with 12 counts of aiding and abetting health care fraud for making 12 false claims between Sept. 13, 2013, and Jan. 4, 2018. The amounts billed ranged from $300 to $2,475, according to court records.
He is also charged with three counts of aiding and abetting the unlawful distribution of controlled substances for giving two patients hydrocodone-acetaminophen, according to court records. One patient received 90 doses on May 6, 2014, and another patient received 210 total doses on Nov. 11, 2017, and Nov. 25, 2017, officials said.
Eric Backos
Backos is charged with five counts of aiding and abetting health care fraud for making five false claims between March 4, 2014, and June 27, 2014. The amounts ranged between $135 and $360, according to court records.
He's also charged with four counts of aiding and abetting the unlawful distribution of controlled substances for giving a patient 270 doses of hydrocodone-acetaminophen and 45 doses of suboxone over during meetings in March, May and June of 2014, officials said.
Ganiu Edu
Edu is charged with 11 counts of aiding and abetting health care fraud for making 11 false claims between Jan. 26, 2015, and March 14, 2018. The amounts ranged between $96 and $2,400, according to records.
He's also charged with two counts of aiding and abetting the unlawful distribution of controlled substances for giving two patients hydrocodone-acetaminophen, officials said. One patient received 90 doses on Feb. 7, 2015, and the other received 60 doses on May 29, 2018, according to court records.
David Lewis
Lewis is charged with two counts of aiding and abetting health care fraud for making false claims on Oct. 27, 2017, for $1,300 and March 26, 2018 for $2,250, according to officials.
He's also charged with one count of aiding and abetting the unlawful distribution of controlled substances for giving 60 doses of hydrocodone-acetaminophen to a patient on June 26, 2018, according to court records.
Christopher Russo
Russo is charged with five counts of aiding and abetting health care fraud for making five false claims between April 25, 2017, and March 14, 2018. The amounts ranged between $25 and $2,475, according to court records.
He's also charged with one count of aiding and abetting the unlawful distribution of controlled substances for giving 90 doses of hydrocodone-acetaminophen to a patient on March 14, 2018, officials said.
Ronald Kufner
Kufner is charged with six counts of aiding and abetting health care fraud for making six false claims between May 28, 2014, and Nov. 30, 2016. The amounts ranged between $550 and $2,750, according to court records.
He's also charged with two counts of aiding and abetting the unlawful distribution of controlled substances for giving two patients 120 doses of hydrocodone-acetaminophen on Nov. 30, 2016, and June 11, 2014, according to court records.
If convicted, the doctors will have to forfeit any property resulting from the fraudulent money earned in this scheme, officials said.
Full criminal complaint
You can view the full criminal complaint below.