AG Shapiro and 45th Statewide Grand Jury: Lancaster Doctor Charged With Unlawful Prescribing, Medicaid Fraud

June 22, 2020 | Topic: Criminal

HARRISBURG― Attorney General Josh Shapiro today announced that the 45th Statewide Investigating Grand Jury voted to charge Bassam El-Borno, M.D., a Lancaster County psychiatrist with felony violations of the Drug Act for prescribing outside the good faith practice of medicine, Medicaid fraud, theft by deception, insurance fraud, and a violation of the Wiretap Act. The Pennsylvania Office of Attorney General worked in partnership with the U.S. Health and Human Services, Office of Inspector General, on this case.

“Stopping this doctor from continually prescribing addictive and dangerous medications means we won a battle, but it is not the end of the work we need to do,” said Attorney General Shapiro. “My Office will continue to hold individuals accountable who recklessly put the lives of others at risk for profit, wherever those individuals are found.”

“Physicians take an oath to practice good medicine, as alleged in the presentment, Dr. El-Borno gave out prescriptions for addictive controlled substances without either seeing or monitoring patients,” said Maureen R. Dixon, Special Agent in Charge of the Office of the Inspector General for the U.S. Department of Health and Human Services in Philadelphia. “We will continue to work with our State partners to hold providers accountable and root out all forms of fraud, waste and abuse in our federal health care programs.”

El-Borno consistently prescribed Adderall and Ritalin, addictive Schedule II controlled substances, to multiple patients for years without a proper evaluation, diagnosis, or ongoing assessment of the patient.  El-Borno charged patients $50 or $75 cash per prescription, often mailing the prescriptions or taping the prescriptions in envelopes outside the office and generally without an office visit or any contact whatsoever with the doctor.  One patient told agents that El-Borno mailed 11 prescriptions for Ritalin over the course of a year for her seven year old child without him ever meeting, seeing or even speaking to the child.  For another patient, El-Borno wrote more than 70 Adderall prescriptions without ever meeting or seeing him and based solely on the man’s wife telling El-Borno on a phone call that she thought her husband “could use the drug.”  El-Borno would joke about being a “drug dealer,” and his patients being “addicts,” when prescribing these medications to patients. El-Borno also billed Medicaid and other insurance for office visits that did not occur.

A medical expert specializing in psychiatry reviewed patient files, prescription data and patient interviews obtained during this investigation. The doctor opined that El-Borno continually prescribed patients the Schedule II stimulant medications, Ritalin and Adderall, however, there was no evidence that a clinical assessment of the patients was done, there was no ongoing clinical contact with the patients and the prescribing was not done in good faith or by the standards expected of doctors.

This joint investigation was led by Special Agent Tucker Beecher from the Office of Attorney General (OAG), Medicaid Fraud Control Section, Narcotics Agent Donald Heffner from the OAG, Bureau of Narcotics Investigation and Drug Control, and Special Agent John Riley from the U.S. Health and Human Services, Office of Inspector General. Senior Deputy Attorney General Susann Morrison is prosecuting the case.

All charges discussed are accusations. The defendant is presumed innocent unless and until proven guilty.

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