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Despite pill mill arrest, doctor free to get into drug rehab business

When investigators with the Florida Department of Health and Broward County Sheriff’s Office descended on a Pompano Beach pain clinic in 2012 to search for evidence of crime, Dr. Donald Willems was ready to talk.

The osteopathic physician admitted to signing blank prescriptions for powerful painkillers such as oxycodone. He admitted to letting a clinic manager fill them out, for patients he had not seen. He said he had been “irresponsible.” His prescribing, he said later, had been “incredibly stupid.”

Eight criminal charges were leveled against Willems, including racketeering and illegally providing oxycodone. With those felony charges still pending, Willems was arrested again Dec. 21, one of six named in a federal complaint alleging insurance fraud orchestrated by local treatment center operator Kenneth “Kenny” Chatman.

A patient checking out his background on the Florida Department of Health’s consumer website would never have known it.

On the site disclosing doctors’ license information, Willems’ license to practice remains listed as “clear and active.”

DOH, which participated in the 2012 clinic raid, did not file formal disciplinary charges against Willems until January 2016, three years after criminal charges were filed. None have been filed to date in the insurance fraud case.

Willems, meanwhile, has entered a not guilty plea in that Broward case, which is slated to go to trial in February, possibly while he is still out on bond for the new insurance fraud charges.

Lingering criticism

The Health Department has previously faced criticism for lags between the time a physician was arrested on drug-related charges and the time the state filed a disciplinary charge that could result in sanctions, which include revoking a doctor’s license.

Take Dr. Joseph M. Hernandez. In 2010, the Lake City physician was a veritable pharmacy on wheels, driving to patients and dispensing prescriptions from his car. He was charged with trafficking in oxycodone the same year.

His license remained active, though, and in the 17 months following his arrest, Hernandez wrote hundreds of prescriptions for oxycodone to Medicaid patients: 258,940 doses in all, a bill of $130,165 for taxpayers.

In March 2012, he was sentenced to five years of probation. In October 2013, he surrendered his license to practice medicine in Florida, three years after he was charged.

Similarly, obstetrician Dr. Zvi Harry Perper was working in a Delray Beach pain clinic founded by a convicted drug smuggler when he and 16 others were arrested February 2011, part of “Operation Pill Nation,” a joint federal-state sweep of pill mills. He faced 19 criminal counts involving trafficking in oxycodone.

One year later, his license remained clear and active on the state’s public website. A disciplinary charge was not filed by DOH until January 2014, according to state records, four months before Perper was sentenced for a single count of attempted trafficking. He gave up his license to practice.

Hamstrung by state law

In some ways, quick action by DOH is hampered by law.

For instance, state law doesn’t require that a doctor tell the department when he or she is arrested — only when there is a conviction, and years can pass between an arrest and a trial.

Information on allegations of a doctor’s wrongdoing can come from other sources, including newspaper stories and, of course, law enforcement investigators.

However, when law enforcement agencies tell the state an investigation is underway, said DOH spokesman Brad Dalton, “there are times when the department is asked to wait until a criminal case resolves … to protect the confidentiality of an active law enforcement investigation.”

The agency does not impose sanctions. After investigating, it may file a formal disciplinary charge — an administrative complaint — seeking disciplinary sanctions. The board overseeing the profession, such as the Florida Board of Osteopathic Medicine, makes a decision on sanctions based on the administrative complaint.

The burden of proof needed to justify such disciplinary charges is high, said Dalton. In a civil court suit, lawyers need to prove a “preponderance” of evidence to win their case, he points out. To prove a discipline case against a doctor, the state has to prove “clear and convincing” evidence.

Former state Rep. Fred Costello had at one point proposed legislation allowing the department to suspend a doctor’s ability to prescribe for 20 days when arrested or if they were under investigation for a drug-related crime.

After 20 days, a doctor could get back the right to prescribe if a panel ruled in his or her favor.

But opponents, including the Florida Medical Association, argued that the bill assumed doctors under investigation were guilty until proven innocent, robbing them of due process.

And in some cases, state action might be moot. Following an arrest, or as part of their own investigation, the Drug Enforcement Administration has in some cases taken away a doctor’s right to prescribe “controlled substances” — addictive drugs such as oxycodone. That would seem to remove the potential for prescription-related harm without any action by the state.

And doctors may simply give up the DEA privileges after an arrest.

That’s what Willems did in 2012.

Leaving prescriptions behind

When Willems saw police executing search warrants at Pompano Beach Pain Management clinic in Broward in mid-June of that year, he drove up, got out of his car, and started talking.

A Broward County Sheriff’s detective said that after being read his Miranda rights, Willems admitted that every patient he saw walked out with a painkiller prescription. Some got it without seeing him. On Mondays, when he often left at noon, he would leave behind pre-signed blank prescriptions, he said. The clinic’s co-owner would fill in the name of the medicine.

Sometimes, the drugs took a trip, the police investigation found. For instance, on Nov. 9, one patient was prescribed 180 oxycodone 30 mg tablets, a strength favored by users and sellers alike. The prescription was sent to a reputable mail-order pharmacy, filled and shipped back to the clinic. This enabled the clinic to buy the pills at a lower price and then sell them at a much higher price — sometimes double — to the patient. In this case, the clinic immediately mailed out the pills to a Best Western hotel in Jacksonville.

From there, the pills could have gone anywhere. Florida doctors and clinics supplied drugs to dealers and addicts in multiple states at the height of the pill mill frenzy.

Willems’ patients lived in 353 different zip codes, detectives said. His prescriptions were filled at 872 different pharmacies. On average, Willems wrote 27 oxycodone prescriptions every single day for a year, they calculated.

Willems voluntarily signed away his DEA-authorization to prescribe controlled substances the day of the clinic raid.

Willems has since entered a plea of not guilty to prescribing charges, the gist of which are echoed in the administrative complaint filed by DOH in January 2016, three years after his arrest.

“There were a number of factors that delayed the filing of the administrative complaint,” said DOH’s Dalton. “The department was working to obtain all elements necessary for a legally sufficient complaint. This included all interviews and expert witness testimony as well as monitoring to see if the criminal case was able to be resolved.”

With his license in good standing, Willems eventually found work in another health business, one that is thriving in part because of opiate overprescribing: addiction treatment.

Magnets for violence

Kenny Chatman may not have the largest addiction treatment and sober home business in Palm Beach County, but his is easily the most notorious. He served time in federal prison for stealing credit card numbers. He has no background in addiction or treatment.

That did not stop him from cashing in on the region’s thriving addiction treatment and sober home industry.

And by 2015, The Post reported, his sober homes were magnets for violence, drug use, overdoses and reports of human trafficking,. The federal complaint filed in December details conditions at a women’s sober home where doors were locked, windows screwed shut and belongings, including phones and keys, were confiscated. Residents were left without money or the ability to leave.

Patients and employees told investigators of bribes or threats used to get clients — and their urine.

A test that will detect drugs in urine is cheap. It can be bought for as little as $25 at local drugstores.

But a single, sophisticated “confirmatory” urine test can reap thousands of dollars for a treatment center from the patient’s insurance company. Over testing has been at the heart of a multimillion-dollar treatment fraud in Palm Beach County detailed by The Post. As an example, just one urine testing bill for one patient topped $300,000 in nine months.

Insurance pays only if a doctor green-lights the expensive test as medically necessary.

For eight months between October 2015 and May 2016, Willems was medical director for Reflections Treatment Center, Chatman’s Broward strip mall operation.

Familiar problems, different clinic

Some allegations in the Chatman addiction treatment center case mirror the practices Willems admitted to in the 2012 pill mill case.

Then, he told investigators, he allowed the pill mill clinic co-owner to tell him what painkillers to prescribe, and the other co-owner told him in what strength. Willems admitted he would leave pre-signed drug prescriptions for patients after he left for the day, without examining the patients. Someone else would fill in the drug name.

In the Chatman case, one confidential informant said Chatman told Willems which tests to order. And Willems is alleged to have written standing orders for the expensive urine tests for patients he had not examined.

It’s not known whether the Florida Department of Health has launched an investigation into Willems based on the new criminal charges. As of this date, the Broward pill mill case “is the only public action on the license for Dr. Willems,” Dalton said.

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