Country’s biggest “Pill Mill” pusher sentenced to 15 years for $9.5 Million fraud

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A federal judge sentenced an Indian-origin doctor from Huntsville, Alabama, to 15 years of jail time Feb. 7. Shelinder Aggarwal, 48, is considered the nation’s highest Medicare illegal prescriber of opioid painkillers at the height of his practice, leading to health care fraud totalling $9.5 million

United States District Judge R. David Proctor sentenced 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. 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.

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,” said Acting U.S. Attorney Robert Posey of the Northern District of Alabama.

“This defendant directly contributed to the opioid epidemic that is plaguing our nation,” said FBI Special Agent in Charge Roger C. Stanton. “He also cost taxpayers millions of dollars by fraudulently claiming government reimbursement for thousands of lab tests that he never used to treat patients.”

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 what prosecutors described as 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 the drugs 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.”

According to Alabama’s Prescription Drug Monitoring Program, state 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.