(STL.News) – The owner and operator of a Hamilton pain clinic was sentenced in U.S. District Court today for illegally distributing controlled substances, committing health care fraud and violating the anti-kickback statute.
Nilesh Jobalia, 55, of Cincinnati, was sentenced to 120 months in prison and ordered to pay nearly $2.2 million in restitution to Medicaid, Medicare and the Bureau of Workers’ Compensation.
According to court documents, Jobalia owned and operated Cincinnati Centers for Pain Relief in Hamilton, Ohio from March 2013 through December 2017. Although the practice was not licensed as such, it operated almost exclusively as a pain clinic.
Patients were prescribed fentanyl, oxycodone, methadone, morphine and other controlled substances on many occasions without actually being seen by the doctor.
“Prescribing controlled substances outside the usual course of professional practice and for illegitimate medical purposes is illegal,” said Lamont Pugh III, Special Agent in Charge, U.S. Department of Health & Human Services, Office of Inspector General – Chicago Region. “This defendant’s actions put the health and safety of his patients at risk and further exacerbated the ongoing opioid epidemic. The OIG will continue to work with our law enforcement partners to ensure that individuals who that engage in this illegal behavior are held accountable.”
“He was a dope dealer with a white coat and a license, and now he has neither,” Ohio Attorney General Dave Yost said. “He shares responsibility for the misery of addiction and death that we call by the clinical name of the opiate crisis, and I am glad to support the work of the United States Attorney in bringing him to justice.”
Jobalia’s practice also billed Medicare, Medicaid and the Bureau of Workers’ Compensation for medically unnecessary prescriptions and services not rendered.
For example, prescriptions to one customer alone caused the Bureau of Workers’ Compensation to pay more than $450,000 for medically unnecessary drugs. In total, Jobalia caused more than $2 million in false claims.
Jobalia also received more than $103,000 from a pharmaceutical company for purported speaking engagements about a fentanyl spray, a medication intended for breakthrough cancer pain.
The speaking engagements were actually sham programs, though, in which many attendees were not medical professionals permitted to prescribe the fentanyl spray. Usually, Jobalia, some of his staff and the pharmaceutical sales representative were the only people present at the engagements, which were held at fine dining restaurants in the Cincinnati area.
Jobalia was indicted by a federal grand jury in June 2018 and pleaded guilty in September 2019.
Congress sets the maximum statutory sentence. Sentencing of the defendant is determined by the Court based on the advisory sentencing guidelines and other statutory factors.
David M. DeVillers, United States Attorney for the Southern District of Ohio; Lamont Pugh III, Special Agent in Charge, U.S. Department of Health and Human Services, Office of Inspector General; Ohio Attorney General Dave Yost; Anthony Groeber, Executive Director, State Medical Board of Ohio; Steven Schierholt, Executive Director, State of Ohio Board of Pharmacy; and Stephanie B. McCloud, Administrator, Ohio Bureau of Workers Compensation, announced the sentence imposed by U.S. District Court Judge Susan J. Dlott. Assistant United States Attorney Salvador A. Dominguez is representing the United States in this case.