Troy doctor charged in Medicare fraud scheme

By: Terry Oparka | Troy Times | Published October 20, 2011


A Troy doctor could face 10 years in prison on charges he participated in a fraud and drug distribution scheme.

Dr. Russell Crispell and eight others were indicted on charges they defrauded Medicare in a fraudulent diagnostic testing scheme at World Health Care LLC and Wyoming Medical Centers PLC.

The indictment states that the defendants billed Medicare more than $2 million for tests and services, and dispensed Oxycontin, a controlled substance, when it was medically unnecessary.

According to the U.S. Attorney’s Office, defendants recruited Medicare beneficiaries to see Crispell, who was employed by World Health Care, and transported them to World Health Care and then to pharmacies to fill the Oxycontin prescriptions. The patients were reportedly paid $150 to $800 in cash for their time, the use of their Medicare cards for billing purposes and the prescriptions.

World Health Care operates offices on Plymouth Road in Redford.

The indictment states the scheme required Medicare recipients to visit Wyoming Medical Centers in East Lansing and see a doctor, who would not perform an examination, but would submit a claim to Medicare for various diagnostic tests. Then the patients would allegedly return to World Health Care to receive a prescription for Oxycontin.

Lamont Pugh III, special agent in charge of the U.S. Department of Health and Human Services, Office of the Inspector General for the Chicago Region, said the arrests and indictments illustrate the Office of the Inspector General’s commitment to the fight against fraud in federal health care programs.

James Burdick, Crispell’s attorney, said that Crispell is innocent of any intentional wrongdoing.

He said Crispell, 85, is a highly regarded anesthesiologist who had nothing to do with billings and had no knowledge that patients were “recruited” to be seen at the clinic.

Burdick said that Crispell came out of retirement to work part time at the pain clinic and was paid a salary as a sub-contracted doctor, not per patient.

He said Crispell ordered MRIs, CAT scans and X-rays to be sure the patients’ complaints were supported. Crispell also checked urine screen tests to be sure the patient was taking the previously prescribed pain medication and the Michigan Automated Prescription Service to be sure the patient was not getting pain medication from another doctor, Burdick said.

“He was kept completely in the dark,” Burdick said. He noted that Crispell’s medical license, which he lost when the charges surfaced about a year ago, has been reinstated.

“It is a misfortune he was included in this,” Burdick said. Crispell posted $10,000 personal bond after his arrest Oct. 7.