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Trini
Doctor Charged With Medicaid Fraud |
Florida, August 2001: Rushing to catch a flight to Jamaica on Feb. 24, Dr. Denis Deonarine and his office manager made a midnight stop at a pharmacy to pick up a patient's prescription -- 120 OxyContin pills.
The stop raised the suspicions of pharmacist James Longo, not only because of the large amount of the narcotic involved but also because the patient was Wayna McCullom, the doctor's office manager.
"I believe Dr. Denonarine is not having a doctor-patient relationship with the patient," Longo wrote in a March 12 complaint to the state Agency for Health Care Administration.
Deonarine, 56, and McCullom, 42, were charged in June with five counts of defrauding Medicaid in connection with prescriptions for the powerful painkiller. The charges included defrauding Medicare of $67,000 in improper prescription of the pills and filing 72 unauthorized Medicare claims.
Officials were so worried that Deonarine would flee the country that they persuaded the judge to set his bail at $1 million. But in May the bail was substantially reduced.
A Trinidad & Tobago national who is a legal resident in the US, Deonarine has been a licensed physician since 1973. He is licensed in Florida, Tennessee, New York and the Caribbean. Deonarine might face more serious charges in conjunction with oxycontin, the generic name for Oxycodone. The drug is a narcotic pain medication that stronger and is more addictive than codeine. It is primarily used by terminal cancer patients in the end stages of their disease.
Prosecutors on July 24 released copies of investigative reports and doctor's office records that show Deonarine prescribed the drug to McCullom long after their relationship had turned romantic.
McCullom met Deonarine on Jan. 10 seeking treatment for lingering pain from a1998 car accident, she said in a sworn statement on May 16, the day before her arrest. Deonarine stopped treating her two weeks later and a "romantic relationship followed," according to her medical records.
However, she received several prescriptions from the doctor in the following months, according to records seized by investigators. And McCullom illegally billed Medicaid for OxyContin pills prescribed to her by Deonarine, investigators say.
Deonarine's attorney, Richard Lubin, said he hasn't seen the documents released by prosecutors on July 24, but argued that his client has never improperly prescribed medication.
"He would not prescribe drugs that he would not feel were appropriate," Lubin said. "He's not charged with prescribing medication to her that she didn't need."
Investigators have said four people died of overdoses from Deonarine's prescriptions, including the Feb. 8 overdose death of Michael Labzda, 21, of Jupiter. In fact the investigations were sparked by Lanzda's death. Labzda had spent the night after a party at some friends' home and had taken some prescription drugs. His friends woke the next day to find him in what one of the friends described as a "pool of blood". Labzda could not walk and soon died on the scene.
Labzda's parents have since sued the drug's makers, the pharmacy where he got the pills and Dr. Deonarine.
The Palm Beach County State Attorney's Office plans to present first-degree murder charges to a grand jury, a spokesman has said.
But Deonarine's attorney said there are no grounds for murder charges against his client.
"The doctor has done nothing wrong," Lubin said. "Every prescription was based on medical necessity. There is no basis in the law for first-degree murder or for homicide charges."
Lubin said Deonarine, who is on the staff at Jupiter and Palm Beach Gardens medical centers, prescribed the drug because he thought they needed it. "This man runs a legitimate practice. Let's start arresting every liquor store that sells liquor or every store owner that sells tobacco."
The percentage of patients who received prescriptions from Deonarine is "miniscule" compared with his total number of patients, Lubin said.
At a news conference in May, state attorney's investigators suggested that Deonarine may be funneling money earned from doling out the drug to an offshore account in Deonarine's name, Lubin said. That account, he explained, was established 15 years before OxyContin was sold to the manufacturer.
"There is not one shred of evidence that any of the money was earned in an improper way. This man works 16, 17, 18 hours a day. He has admitted thousand of patients a day. The implication that he made his money by OxyContin is ridiculous."
Officials also said Deonarine bought Jaguars and his home with cash, to which Lubin calls "ridiculous."
The prosecutors said he bought a Jaguar and didn't take a loan, and they said he doesn't have a mortgage on his house. The man had been a doctor for over 30 years, and God bless him if he can buy his home by writing a check on it."
It appears officials were first alerted to Deonarine around Feb. 6, when a Palm Beach Gardens pharmacist, Monica Sikora, complained to the state health department about some dangerously large prescriptions written for McCullom by Deonarine. The prescriptions were so large that the Eckerd pharmacy didn't carry enough OxyContin to fill them.
When McCullom brought the prescriptions in, staffers were suspicious: They were familiar with Deonarine's signature, and these didn't match. But then Deonarine himself came in asking for a free seven-day supply of OxyContin. The doctor and McCullom returned hours later to pick up the prescriptions, and Deonarine became enraged when he learned that they didn't have enough pills to fill the order.
"This was a gesture of kindness he was doing for this patient," Sikora recalled in a letter forwarded to health department officials. "How dare I accuse him of getting this prescription for himself."
A former office employee, Barbara Groseclose, 27, of Palm Beach Gardens, told investigators that Deonarine "knew that his patients were becoming addicted."
Groseclose -- another former patient turned employee -- said she quit in April "because she became frustrated with his prescribing narcotics for patients who were there just for that purpose."
An initial investigation had revealed that some of the Medicaid recipients who had received oxycontin from Deonarine had outstanding warrants for their arrest and others had criminal arrest records on charges including drug possession.
On April 20, a state attorney's investigator posing as a Medicaid patient attempted to get a "walk-in" appointment at Deonarine's office. According to the investigator, he was given an appointment on the promise that he would pay cash for the visit.
The investigator returned April 26 and was given prescriptions for oxycontin, lotrisome and Viagra without any request for medical history and only a check of his weight, the investigator said.
Sherry Katz, of Jupiter, said she had a similar encounter with Deonarine when he prescribed the anti-anxiety drug Xanax.
"He didn't do a urine sample; he didn't ask for a medical history," Katz said. "He just put me on Xanax."
Katz arrived at Deonarine's office for a follow-up appointment after ending up in the emergency room with Xanax withdrawal because she was unable to see Deonarine for a refill.
"The people in the emergency room told me you can't just give (Xanax) to someone and not refill it," Katz said.
Katz and her husband, David, said they reported Deonarine to Aetna, their insurance provider, and were told the company was taking him off its referral list and would be investigating.
(From reports in the Florida media)