Pain clinic doctor defends actions

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A local doctor accused of overprescribing prescription painkillers to patients and of Medicaid and insurance fraud intends to “vigorously” defend himself and his clinics.

A search warrant application alleges that Dr. Anthony Alexander or one of his nurse practitioners is responsible for eight drug overdose deaths of patients who received controlled substance prescriptions between 2008 and 2013. Alexander operates The Pain Medicine and Rehabilitation Center offices in Seymour and Jeffersonville.

“Ultimately, PMRC believes that the investigation will quickly reveal that PMRC is a safe and ethical practice compliant with

national standards in pain management,” according to a news release from Alexander.

Material collected from the Seymour office during a Dec. 11 search is being reviewed in consultation with the Jackson County Prosecutor’s Office, which will determine whether any criminal charges will be filed.

No one has been arrested, and no criminal charges have been filed.

Alexander said Tuesday he could not answer any other questions about the investigation.

Once the law enforcement agencies have completed their investigation, they will turn the case over to the prosecutor’s office, Jackson County Chief Deputy Prosecutor Jeff Chalfant said. He added that cases such as this one can require a lot of time.

No actions have been taken against Alexander’s license from the Indiana Medical Licensing Board since it was granted April 1, 1999.

“Before embarking on improving the quality of life of many members of our community who suffer from chronic pain, Dr. Alexander obtained education as a board-certified anesthesiologist,” according to the news release. “He then obtained additional training as a board-certified interventional pain specialist. Without question, he is considered among the most highly trained in his field.”

Former employees of Alexander’s clinics have alleged possible overprescribing of addictive opioid painkillers and fraudulent billing on the part of Alexander.

Treating patients with debilitating chronic pain conditions is a “very subjective” practice, Alexander said in the news release.

“The practice of pain management does not afford the practitioner diagnostic tools to measure a patient’s pain, thus there is a greater opportunity for outside parties who are unfamiliar with a particular patient’s symptoms and circumstances to scrutinize a practitioner’s decision-making,” according to the news release. “When all of the facts are out, however, PMRC fully expects Dr. Alexander to be fully vindicated.”

The state attorney general’s office had a consulting physician review a report obtained from INSPECT, Indiana’s prescription drug monitoring program. The physician found “an extremely high rate and volume of prescribing of opioids to a large population of patients, both short term and chronically.”

“PMRC treats thousands of patients annually and maintains very strict standards of care in both offices, including signed treatment compliance agreements, imaging studies, drug testing and INSPECT and KASPER reports,” Alexander said. “Unfortunately, there is a limited amount of data that can be gathered or evaluated if the patient does not take their medication as directed or if the patient does not disclose the truth when interviewed.”

As for the fraud allegations, Alexander said a small fraction of his patients may receive benefits from Medicaid, but he is a non-ordering, prescribing or referring provider that does not receive Medicaid reimbursements.

Alexander said the recent allegations highlight a primary reason that many members of the medical community have abandoned this area of practice in order to avoid excessive governmental scrutiny when treating patients.

“PMRC wants to reiterate that not all patients who are treated for chronic pain are drug addicts, and not all physicians who treat this patient population are profiteers intending on bilking the funds of Medicaid,” according to the news release.

“While PMRC affirms there is good reason for some governmental scrutiny with all DEA (Drug Enforcement Administration) licensed providers, as many new patients are referred to this practice on large doses of opioid therapy from either their primary care physician or another specialist and require a weaning or detox before Dr. Alexander can evaluate their needs or create a treatment plan.”

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