Arlington Physician Gets 12 Years for Healthcare Fraud – D Magazine
Dr. Clinton Battle has been sentenced for coordinating a healthcare scheme that included prescribing controlled substances without legitimate medical purpose nor any medical exam. A federal judge ordered him to spend 12 years in federal prison and ordered to pay $376,368 in restitution for his crimes, which included 50,000 controlled substance prescriptions.
The 69-year-old Arlington physician pleaded guilty to mail fraud, and was convicted of one count of conspiracy to distribute controlled substances and one count of distribution of a controlled substance. Evidence at trial showed the Battle would routinely prescribe controlled substances such as hydrocodone, alprazolam, acetaminophen with codeine, and others without medical reason and at times without examining the patient.
According to the Institute of Medicine, 30 percent of all medical spending is ineffective, unnecessary, or overpriced, and Dallas-based SmartLight Analytics says that of the $358.7 billion spent on prescription drugs in 2020, $3.5 billion is estimated to be fraud, waste, and abuse.
ABC news reported that the nation’s opioid crisis cost the nation $1 trillion last year up from $700 billion in 2017. In 2013, 44,000 people died from drug overdoses. Last year, 100,000 Americans died from a drug overdose.
Battle communicated with office staff to order any prescriptions the patient wanted, and issued prescriptions for friends or family members that weren’t his patients. A former employee testified at trial that Battle would exchange illegal prescriptions in exchange for cocaine. He also received $200 payments for initial visits and $80 for return visits in exchange for controlled substance prescriptions.
Battle’s nurse practitioner Donna Green used his DEA registration number and credentials to issue illegal prescriptions, even though she wasn’t allowed to so. Green pled guilty to one count of acquiring a controlled substance through fraud.
Of the 50,000 controlled substance prescriptions, 17,000 were for hydrocodone, a powerful opioid. “Dealers of illegal drugs come in many forms. This is a case of the abuse of trust and position,” said DEA Special Agent in Charge Eduardo A. Chávez via release. “Dr. Battle and his co-conspirators used their authority to push pills into our neighborhoods disregarding the inherent harm they cause. DEA’s teamwork with our federal and local area law enforcement agencies make it possible to pursue any person distributing illegal drugs, no matter the disguise.”
Battle’s fraud went after payers as well. He and his team also upcoded his procedures to get higher reimbursement levels, despire not performing those procedures. Battle submitted claims to worker’s compensation and health insurance to submit claims for functional capacity evaluations that he claimed he conducted. FCEs are tests and observations conducted by physicians to determine the ability of a patient to perform job tasks that can take several hours. In truth, his unlicensed assistants conducted the exams, and at other times they were not conducted at all.
Battle originally faced 15 years in federal prison.
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