(From release) A federal judge Tuesday sentenced a former Huntsville physician, who was the nation’s highest Medicare prescriber of opioid painkillers at the height of his practice, to 15 years in prison for illegally prescribing controlled substances and conducting health care fraud involving $9.5 million in unneeded and unused urine tests, announced Acting U.S. Attorney Robert Posey and FBI Special Agent in Charge Roger C. Stanton.
U.S. District Judge R. David Proctor sentenced Shelinder Aggarwal, 48, of Huntsville, in accordance with a binding plea agreement the physician entered with the government in September, ordering the 15-year sentence recommended by the government and directing Aggarwal to forfeit $6.7 million and his former clinic on Turner Street Southwest in Huntsville. The judge also ordered Aggarwal to pay $6.7 million in restitution to Medicare and Blue Cross Blue Shield of Alabama. Aggarwal must report to prison April 12. He will be on supervised release for three years after completing his prison sentence.
Aggarwal pleaded guilty in October to one count of distributing a controlled substance outside the scope of professional practice and not for a legitimate medical purpose in July 2012, and to one count of conspiring to execute a health care fraud scheme against Medicare and BCBS of Alabama between Jan. 1, 2011, and March 31, 2013. Aggarwal earlier repaid $2.8 million to Medicare and $45,843 to BCBS of Alabama following audits.
“Dr. Aggarwal used his medical license to generate tremendous profits by putting hundreds of thousands of pills on the street illegally,” Posey said. “As today’s sentence reflects, we are committed to prosecuting health care fraud and will seek severe penalties against any doctors who knowingly and illegally contribute to the growing epidemic of opioid drug abuse.”
“This defendant directly contributed to the opioid epidemic that is plaguing our nation,” Stanton said. “He also cost taxpayers millions of dollars by fraudulently claiming government reimbursement for thousands of lab tests that he never used to treat patients. I applaud the work of my agents and our partners to shut down Aggarwal’s pill mill and hold him accountable for his actions.”
Aggarwal surrendered his Alabama medical license in 2013, along with his Alabama and federal Drug Enforcement Administration certificates to prescribe controlled substances, after the Alabama Board of Medical Examiners initiated an investigation.
Aggarwal was a pain management doctor who operated a pill mill, Chronic Pain Care Services, in Huntsville. In 2012, about 80 to 145 patients a day visited Aggarwal’s clinic, with him seeing the majority of patients and writing all prescriptions. According to court documents, initial patient visits typically lasted five minutes or less, and follow-ups two minutes or less. Aggarwal did not obtain prior medical records for his patients, did not treat patients with anything other than controlled substances, often asked patients what medications they wanted and filled their requests, prescribed controlled substances to patients who he knew were using illegal drugs, and did not take appropriate measures to ensure that patients did not divert or abuse controlled substances. His plea agreement summarizes an interaction with a patient, which was captured on video. In it, Aggarwal notes that the DEA viewed him as the “biggest pill-pusher in North Alabama” and that many of his patients were “dropping like flies, they are all dying.”
Court documents cite the Prescription Drug Monitoring Program for Alabama, which tracks the dispensing of controlled substances, as well as Medicare data, to document Aggarwal’s prescribing practices.
According to the PDMP, Alabama pharmacies filled about 110,013 of Aggarwal’s prescriptions for controlled substances in 2012. That would equal about 423 prescriptions per day if he worked five days a week, and resulted in about 12.3 million pills. The PDMP rated Aggarwal as the highest prescriber of controlled substances filled in Alabama in 2012, with the next highest prescriber writing a third as many prescriptions.
Medicare data shows Aggarwal was the highest prescriber in the United States of Schedule II controlled substances under Medicare in 2012. Schedule II substances include the opioid painkillers oxycodone, oxymorphone, hydromorphone and morphine.
As to Aggarwal’s health care fraud scheme, he pleaded guilty to requiring patients to undergo unreasonable and unnecessary urine drug tests that he did not need or use in their treatment. Aggarwal acknowledged that the tests he ran depended not on patients’ treatment, but on how much he could bill for tests. He often ignored urine test results showing patients were using illegal drugs.
Between January 2011 and March 2013, urine drug tests accounted for about 80 percent of paid claims Aggarwal submitted to Medicare and Blue Cross, for a total reimbursement of $9.5 million. According to his plea agreement, “Aggarwal’s primary motivation for testing patients’ urine specimens, and submitting those claims for payment, was financial gain.”
The FBI investigated the case, based partly on an investigation conducted by the ABME. Assistant U.S. Attorneys Chinelo Dike-Minor and Russell Penfield prosecuted the case.