Ex-Muskogee doctor indicted


June 2006 - Former longtime Muskogee pediatrician Dr. Alexander Theodore has been indicted in federal court in Salt Lake City on 83 felony counts.

Theodore, 63, practiced pediatric and industrial medicine for 15 years in Muskogee before leaving in early 1994, after selling his clinic to Muskogee Regional Medical Center for more than $1 million. Theodore still returns to Muskogee to visit family and friends.

The government is seeking forfeiture of $304,000 from Theodore along with his residence and any buildings he owns on Royal Lane in Sandy, Utah, the indictment states.

He is free on $25,000 property bond, pending trial, said Melody Rydalch, spokeswoman for the U.S. Attorney’s Office in Salt Lake City. Theodore has surrendered his passport, she said.

Theodore no longer has a phone listing in Salt Lake City or in Sandy, Utah, and could not be reached for comment. His attorney’s office was closed late Monday afternoon, and the attorney had no listed home phone.

The indictment alleges the continuing criminal enterprise Theodore is charged with involved the distribution and dispensing of OxyContin “not for a legitimate medical purpose and beyond the bounds of medical practice.”

Theodore also is accused of devising a scheme to defraud private insurers who paid for prescriptions not justified.

Some of the patients Theodore is accused of writing unneeded OxyContin prescriptions for were under the Medicare program, constituting false claims against the United States, the indictment states.

In connection with the writing of some of the prescriptions, Theodore is charged with aggravated identity theft.

Investigation began in 2004 Theodore had been under investigation in Utah by state and federal authorities after multiple pharmacies complained in October 2004 that individuals who appeared healthy were filling OxyContin prescriptions written by Theodore and his physician assistant, Utah court records show.

The Health Care Fraud Task Force, comprised of the FBI, Utah Department of Insurance, the U.S. postal inspector, Drug Enforcement Administration, Health and Human Services and the Utah Attorney General’s Office began an investigation, Joe Christensen, head of the task force, said earlier.

An affidavit filed in May 2005 in the Third Judicial District Court in Salt Lake City by Utah Department of Insurance Fraud Investigator Shane Tiernan alleged patients receiving OxyContin prescriptions Theodore wrote often paid for them with $600 in cash or a $191 cash co-pay.

A state data base at that time reflected Theodore wrote OxyContin prescriptions to at least 200 patients, Tiernan said.

The affidavit alleged Theodore initially charged patients a $700 cash fee per visit when he prescribed OxyContin, but that the fee later dropped to $400 per visit.

Records showed he often wrote patients receipts for only $100 per visit and reported the lower amount to his accountant for tax purposes. The filing stated there were two types of patients — those either addicted to OxyContin or using it recreationally or those who were only seeking monetary compensation. If the patient’s insurance paid for the OxyContin and they turned it all over to a “recruiter,” they were given $500, the filing stated. Otherwise, they just kept a portion of the drugs.

Most of the patients were between the ages of 18 and 25, the affidavit states. Tiernan attested he discovered patients prescribed OxyContin by Theodore who never met the physician or who saw him on a few occasions but yet had multiple OxyContin prescriptions issued to them.

The investigator reported that even the makers of OxyContin became concerned about Theodore’s prescribing practices based on reports from their local sales representatives and then related the information to an investigator.

A status hearing is scheduled for 3:30 p.m., July 11.

Reach Donna Hales at 684-2923 or [email protected]

Doctor Charged in Investigation
of Large Drug Ring

May 5th, 2006 SALT LAKE CITY (AP) -- A physician has been accused of writing prescriptions in a purported OxyContin drug ring that had gang ties.

Dr. Alexander Theodore was named in an 83-count federal grand jury indictment that included charges of ongoing criminal enterprise, crimes against the United States, conspiracy to distribute drugs and drug distribution.

Prosecutors have charged about 56 people in the OxyContin ring.

"It's huge," said Joe Christensen, director of the state Insurance Department's Insurance Fraud Division. "Absolutely huge.... The more we looked into it, the more it grew."

The ring allegedly included 234 people who recruited other patients.

The Utah Division of Professional and Occupational Licensing Web site shows Theodore's medical license status as "active on probation."

Theodore worked part time under contract with the University of Utah College of Nursing to provide medical services at the Salt Lake Valley Detention Center, where he treated residents as a physician. Theodore had been there about five years and no longer works there.

The alleged illegal prescription-writing did not take place at the detention facility.

An affidavit for a search warrant alleged that at Advanced Pain & Weight Management, Theodore charged supposed patients $400 to $500 for an office visit, which was for sole purpose of providing OxyContin.

The affidavit alleged that recruiters sought people whose insurance covered the pain medication and set up an appointment for them with Theodore.

The recruiters sometimes would pay the office visit fee, and in return would get at least 75 percent of the patient's OxyContin, the affidavit alleged.

Christensen said that for some, it was a way to make money, but most were feeding their own drug habit and did not view the prescriptions as insurance fraud.

"It just ballooned into this very complex organization," Christensen said. "It was very well organized."

Eventually, the drug ring cut into traditional heroin sales and crossed a street gang. As a result, the gang started to receive a cut of the OxyContin pills, which it sold to its clientele, and provided enforcers in the drug ring, Christensen said.

Enforcers allegedly also included a couple of juvenile detention center employees, who have been terminated from the center, The Salt Lake Tribune reported.

The drug ring came to the attention of state authorities by pharmacists who noticed younger people were coming in with OxyContin prescriptions and suspected something was going on.

Prescription drug lure traps
the addicted and the greedy

5/2005 - As Salt Lake City physician Dr. Alexander Theodore churned out thousands of prescriptions for the powerful painkiller OxyContin, the state's Controlled Substance Database quietly kept watch.

Between January 2004 and February 2005, five comparable pain clinic doctors wrote prescriptions for between 720 and 8,500 pills. Theodore prescribed more than 73,000.

But the escalating disparity went unnoticed for months - it took an old-fashioned tip to start an insurance fraud investigation that last week led to Theodore being stripped of his license to prescribe controlled drugs.

The missed clue highlights the difficulty the medical profession, state agencies and law enforcement face in detecting and controlling improper access to the popular OxyContin and other prescription narcotics.

Purdue Pharma L.P. makes OxyContin for chronic pain sufferers. It gives a steady stream of relief over 12 hours, but abusers tamper with the time-release by chewing, crushing or dissolving the pill, creating a rush similar to that of heroin.

The addictive and financial lure of OxyContin has created new challenges for law enforcement. Utah pharmacies have been targeted in robbery sprees; addicts go from one physician's office to another, "doctor shopping" to stock up on prescriptions. Doctors also misuse their access, abusing OxyContin and other narcotics themselves or trying to make money from improper sales.

Misuse of OxyContin surpassed Lortab trafficking four years ago, said Shane Tiernan of the FBI's health care fraud task force. A typical prescription for OxyContin that costs about $20 with health insurance can bring as much as $3,000 on the street, where it is quickly available, he estimates.

"From the people that we've talked to," Tiernan said, buying OxyContin "is really easy."

One of the weapons used to detect doctor shopping and prescription drug misuse is Utah's Controlled Substance Database, designed to compile all controlled substance prescriptions statewide. Started in 1997, it now holds more than 10 million records and collects data from as many as 450 stores.

Any pharmacy that fails to participate can be fined up to $1,000 for each record that is not reported, said Steve Davis, chief investigator for the Utah Division of Professional Licensing (DOPL) and administrator of the database.

In December, officials with the Department of Commerce, which oversees the database, began allowing doctors to log in to the system via the Internet. Any patient who appears to be doctor shopping can be run through the database, and all previous prescriptions will appear. Similar access is expected for pharmacists and law enforcement officials by the end of the year.

But the database has limitations: It is not programmed to recognize or flag any unusual patterns or spikes in sales or use.

Davis said the database could be programmed to send out alerts about unusual activity, but says there are not enough resources to design or monitor such reports.

"There are too many requests for us to investigate. Too many for the resources in the state. We have to rely on doctors to use the information responsibly," Davis said.

Theodore's patients were allegedly charged $400 to $500 for an office visit at Advanced Pain & Weight Management, at 1787 E. Fort Union Blvd., then given a prescription for OxyContin. After the prescription was filled under the patient's insurance, a recruiter allegedly would buy part or all of it from them, re-selling the pills at street value.

Tiernan said 90 percent of his caseload involves people "utilizing their health insurance to get the drug because it is so expensive."

Theodore and his assistant, David Dodd, remain under criminal investigation, but last week, the Physicians Licensing Board canceled Theodore's license to prescribe controlled substances for at least two years. Working under the DOPL, the board is responsible for hearing complaints and disciplining doctors who violate standards.

There are 7,500 licensed doctors in Utah. Last year, DOPL received complaints about 377. DOPL is monitoring 24 physicians who have licenses on probation or with restrictions.

Through March of this year, the board has held hearings on 13 medical doctors. Eight of those had their license to prescribe controlled substances previously or currently revoked. Other reasons for discipline include sexual misconduct and substance abuse.

Davis said the DOPL works with law enforcement, such as the Drug Enforcement Agency (DEA), patients, families of patients, the state Insurance Department's Insurance Fraud Division and Medicaid fraud units to discover doctors who are illegally prescribing drugs.

"Drug violations are a big part of our effort," Davis said. "We investigate a lot of medical practitioners who have drug and alcohol problems. They are no different than the general population, and often drugs are more readily available to them."

Of the 19,941 people treated for substance abuse in facilities that are paid for through local community substance abuse programs, 564 people were OxyContin abusers in 2004. That was up from 361 in 2003, said Janina Chilton, a spokeswoman for the Utah Division of Substance Abuse and Mental Health. Males ages 18 to 34 accounted for the largest increase.

"We're concerned about the rise of prescription drug use," Chilton said. "In this state, we don't have a high rate of alcohol abuse, but people tend not to realize prescription drugs can be just as harmful as alcohol. The other perception is they are legal."

From 1999 through 2003, the state saw deaths from prescription drugs, including OxyContin and methadone, rise from 45 to 181 per year, according to the Utah Department of Health.

"Society believes that drug overdose deaths happen to people using illegal drugs," said Christy Peterson-Porucznik, an epidemiologist with the health department."In Utah, the reality is that the typical person dying of drug poisoning is a young to middle-aged, overweight adult who was using drugs that can be obtained by prescription."

Investigation Into Alleged Drug Crime Ring

May. 9, 2005 SALT LAKE CITY (AP) -- An investigation is underway into a Utah doctor's role in an alleged prescription drug ring in the state involving more than 230 people.

In February, Salt Lake Valley pain management specialist Dr. Alexander Theodore and his assistant, David Dodd, had their licenses to practice and to prescribe controlled substances suspended.

Authorities said Dodd, Theodore and his son, are under investigation for their alleged involvement in a costly crime ring involving insurance fraud and illegal drug distribution.

The probe began after manufacturers of the painkiller OxyContin noticed a high volume of prescriptions for the drug coming out of one office.

According to court records, Theodore has been found to have allegedly prescribed nearly 74-thousand tablets during the past 12 to 16 months. Other local pain clinics averaged about three-thousand during the same time period.

Theodore declined to comment and his lawyer said he would not discuss the matter while an investigation is ongoing.

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