Pawankumar Jain Pleads Guilty to Health Care Fraud

Pawankumar Jain Pleads Guilty to Health Care Fraud

New Mexico: Pawankumar Jain, an Indian-American physician in New Mexico, whose license was revoked in 2012, pleaded guilty Feb. 11, to health care fraud that involved unlawfully dispensing drugs and health care fraud. Prosecutors alleged that some of his prescriptions led to the death of several patients.

Jain, 63, entered a guilty plea in federal court in Las Cruces, N.M. He has been in federal custody since April 2014, and his detention will continue until the sentencing hearing, which has yet to be scheduled. Under the terms of his plea agreement, Jain will be sentenced to a prison term within the range of 42 to 108 months followed by a term of supervised release to be determined by the court.

Jain was initially charged in a 111-count indictment filed in April 2014, including 61 counts of unlawfully dispensing controlled substances and 50 counts of healthcare fraud. A 138-count second superseding indictment filed in June 2015 added new charges for a total of 79 unlawful dispensing charges and 59 healthcare fraud charges, including allegations that his conduct resulted in the death of four patients, a press release from the U.S. Attorney for District of New Mexico said.

The superseding indictment alleged that Jain committed the offenses charged between April 2009 and June 2010, in Doña Ana County, N.M. During that time, he was a licensed physician with a neurology subspecialty who operated a pain management medical practice in Las Cruces. Jain’s medical license was suspended in June 2012, and subsequently revoked in Dec. 2012 by the New Mexico Medical Board.

Jain pled guilty to one count of unlawfully dispensing a controlled substance and one count of health care fraud. In his plea agreement, he acknowledged that in his treatment of one patient identified as “M.E.B.,” he conducted “cursory exams and [that he] did not document a therapeutic benefit from the narcotics he was prescribing for her.” When he last saw that patient on Nov. 25, 2009 Jain said, he “… wrote two prescriptions, each for 270 tablets of methadone 10 mg, one dated November 25, 2009, and the second dated December 23, 2009. M.E.B. filled each of these prescriptions, which were issued outside the usual course of medical practice and without a legitimate medical purpose. . . . Two days after she filled the second prescription, M.E.B. died on December 25, 2009.”

Jain also admitted committing health care fraud in connection with his treatment of M.E.B. Jain’s plea agreement states that he knew M.E.B. was insured by Medicare and that claims to cover the costs of the medication he prescribed for her would be submitted to Medicare for payment. Prescription drug abuse is a leading cause of heroin addiction and overdose deaths in the United States. It has resulted in more than 44,000 deaths in the past year.

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