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A physician of Indian origin, considered the nation’s highest Medicare prescriber of opioid painkillers at the height of his practice, pleaded guilty Oct. 27 in federal court to illegally prescribing controlled substances and to health care fraud involving $9.5 million in unneeded and unused urine tests alone.
The former Huntsville, Alabama physician Shelinder Aggarwal, 48, was charged in July 2012, with one count of distributing a controlled substance outside the scope of professional practice and not for a legitimate medical purpose, and with one count of conspiring to execute a health care fraud scheme against Medicare and Blue Cross Blue Shield of Alabama between Jan. 1, 2011, and March 31, 2013.
Aggarwal pleaded guilty to those charges before U.S. District Judge R. David Proctor. His sentencing date has not been set, according to a press release from the office of the U.S. Attorney for the Northern District of Alabama.
As part of a plea agreement Aggarwal reached with the government, he will forfeit his former clinic on Turner Street Southwest in Huntsville, along with $6.7 million. Aggarwal earlier repaid $2.8 million to Medicare and $45,843 to Blue Cross following audits, according to the plea agreement. The agreement stipulates a 15-year prison sentence. Judge Proctor accepted Aggarwal’s guilty plea today, but reserved his decision on whether to accept the 180-month prison sentence until Aggarwal’s sentencing hearing. The agreement between Aggarwal and the government is a binding plea agreement, so either party may withdraw from it if the court does not accept the stipulated sentence.
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. He was a pain management doctor who operated Chronic Pain Care Services in Huntsville. His medical practice was a pill mill, according to Aggawal’s plea agreement.
The plea agreement states that in 2012, about 80 to 145 patients a day visited Aggarwal’s clinic, with him seeing the majority of patients and writing all prescriptions. Initial patient visits typically lasted 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 controlled substances 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.
The 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.”
The agreement cites the Prescription Drug Monitoring Program for Alabama, which tracks the dispensing of controlled substances, as well as Medicare data, to document Aggarwal’s prescribing practices.
According to the PDMP, Alabama 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.
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