CLEARFIELD-The case against a DuBois doctor accused of selling prescriptions for painkillers was discussed during motions court in Clearfield County on Tuesday, March 13.
Rajendra Yande, 47, Maple Avenue, DuBois, is charged with 11 counts of administration of controlled substance by practioner, four counts of proceeds of unlawful acts, and bribe/rebate furnish medical assistance. He is currently free on $200,000 bail.
The charges stem from an investigation by the attorney general’s office into Yande’s osteopathic practice which he ran out of his home. According to a press release the investigation began in March 2009. Undercover agents were able to buy 50 prescriptions for more than 2,180 narcotic pills.
The prescriptions written by Yande were for percocet, vyvanse, adderal, hydrocodone, halcyon, valium and xanax. He often provided his patients with prescriptions for multiple narcotics. Yande would see his patients in his living room, exercise room or kitchen without use of an exam table or scale. A blood pressure cuff and stethoscope were available, but were not used during the undercover visits, according the press release.
A grand jury found that he did not accept any insurance for his pain management patients and had a sign in the waiting room listing prices based on the narcotics prescribed.
After a search warrant was executed on his home, agents discovered that a large number of his patients were on medical assistance which has a minimal co-pay for office visits.
Attorney Ronald Collins who is representing Yande filed a three part omnibus pre-trial motion in the case. The first part challenged the search warrant.
He stated that there was no indication that Yande was not treating his patients “in good faith”. The affidavit is insufficient because it only says that the undercover officer went to the doctor for prescriptions and doesn’t indicate that Yande had asked for the officer’s medical records.
When he didn’t receive the medial records, Collins said, Yande then dismissed the officer as a patient.
Jeff Baxter who is prosecuting the case for the attorney general’s office responded that there was adequate probable cause for an examination of Yande’s medial records because his treatment of the patients was below medical standards.
Yande took the stand to testify regarding information in the warrant that was false, according to Collins.
Yande testified that the undercover officer came to him through another patient. He had several issues from an elbow and shoulder injury and also some back pain. Yande said he did a full range of motion exam on the patient to determine where the pain was. He was most concerned with the man’s shoulder and asked him for an x-ray or MRI during his first visit.
“The search warrant says that you didn’t do an exam on the first visit. Is this wrong?” Collins asked to which Yande replied “yes”.
Yande wrote prescriptions for x-rays for the officer but the officer later claimed he lost them. He also told Yande he had no insurance and couldn’t pay for them. Even though Yande said he could possibly work out something with the hospital, the man never provided or had any x-rays. The patient was then let go.
During Baxter’s cross examination, Yande stated that someone else in his office took the under cover officer’s blood pressure but because it wasn’t documented, he admitted he didn’t know this for sure.
When asked if he had talked to the patient about any other medication he was on, he responded yes and if he was told the patient was on any other medications he would have documented it.
“He lied to me about his history to get medication. That is obvious,” Yande said.
Baxter then asked that even though he never got what he asked for from the officer, he continued to give him narcotics, and Yande agreed. He also agreed that he even increased the dosage. Yande did not remember telling the patient that if he kept coming to him he would increase the fee.
Baxter finished with stating that the agent would testify differently regarding these office visits.
In the second part of the motion, Collins questioned the proceeds of unlawful activity charges referring to allegations that Yande deposited sums of money just below the $10,000 reporting requirement to avoid detection.
He is not required to make deposits of a certain amount, Collins said.
Baxter responded that intentionally depositing amounts to avoid the reporting requirements is “suspicious activity” and if it is done repeatedly as Yande did, it is against the law. The source of the money is irrelevant. Baxter explained that he believes this law came in under the Patriot Act as a way to spot money being transferred by terrorists.
A third part of the Collins motion involves the payments by patients who are covered under medical assistance. Collins stated that there is “no legal requirements for physicians to participate in Medicare”.
If they were getting cash and still billing Medicare, that would be something. Yande was simply not participating in the program, Collins explained.
Baxter responded that Yande was contracted as a provider with welfare and did nothing to remove himself from that program.
“If a recipient comes in, you have to accept their insurance,” he said. Instead Yande charged them from $75 to $100 for prescriptions.
Judge Fredric J. Ammerman gave Collins 30 days to submit briefs on these issues and after that Baxter has ten days to respond. After reviewing the information, the judge will then make his decision.