ATLANTA (CN) — Attorneys for a doctor convicted of defrauding insurers and illegally prescribing addictive opioids to patients at Florida drug treatment centers asked an 11th Circuit panel Wednesday to grant him a new trial.
After an eight-day trial last year, Dr. Arman Abovyan was sentenced to 11 years in prison and ordered to pay $1 million in restitution for conspiracy to commit health care fraud and illegally dispensing controlled substances.
While working as the medical director of two south Florida substance abuse treatment centers, Abovyan defrauded insurance companies by billing for expensive and medically unnecessary urine tests and other screenings multiple times per week.
Abovyan also prescribed buprenorphine, a highly addictive opioid commonly known as Suboxone, to patients without the required license as part of a scheme to attract them to the centers.
During a hearing Wednesday morning, Abovyan’s attorney told a three-judge panel of the Atlanta-based appeals court that the evidence wasn’t sufficient to convict his client.
Disputing the government’s trial argument that Abovyan wrote unnecessary Suboxone prescriptions, attorney David Markus of Markus/Moss argued that prosecutors failed to prove his client committed a crime under the Controlled Substances Act.
Suboxone can be used to effectively treat addicts by blocking brain receptors so they can’t get high off other opioids, including heroin. Due to the drug’s addictive nature, federal law requires doctors to take a special training course and obtain a Drug Enforcement Administration license known as an “X” number certificate before prescribing it for patients.
“These were patients who actually needed the Suboxone that was being prescribed,” Markus told the panel. “No patient said they didn’t need it. No witness said they didn’t need the prescription. Every single government witness said the Suboxone was necessary for the patient’s care.”
But Senior U.S. Circuit Judge Frank Hull, a Bill Clinton appointee, pushed back on Markus’ claims, pointing out that the evidence concerning Abovyan’s lack of a license to prescribe Suboxone “was really just part of the factual context” showing he acted outside of “medical necessity” in general.
“He never saw the patients really, he signed pads of prescriptions, he didn’t even have a license – all of this related to the backdrop that the jury had to know about in order to decide whether he was doing it for a legitimate medical purpose,” Hull said.
Markus argued that the evidence mentioned by Hull was only relevant to prove the health care fraud charge against Abovyan, not any of the charges related to prescribing Suboxone.
According to the government’s brief filed with the 11th Circuit, other evidence presented at trial showed Abovyan ordered “enormous” amounts of drug testing for patients but never shared or discussed the results with them, “even results revealing serious drug abuse, relapse, and tampering.”
The brief reveals that the rigorous drug screenings required hundreds of tests per urine specimen, costing insurers up to $6,000 each time they were performed.
Abovyan told an investigator that working at the treatment center was “easy money,” the brief states.
At least two patients died of overdoses while under Abovyan’s care.
Assistant U.S. Attorney Randy Katz told the panel that Hull “had it right” Wednesday.
“The government didn’t just rely on the theory that [Abovyan] didn’t have the [DEA] X number. There were so many other things… It’s the pre-signed blank prescriptions, it’s the lying on the medical records, it’s the treating private practice patients differently, it’s the fact that only those with insurance were tested,” Katz said.
The prosecutor added, “There was no treatment here. It was just prescribing and testing.”
Hull was joined on the panel by Senior U.S. Circuit Judge Stanley Marcus, a fellow Clinton appointee, and U.S. Circuit Judge William Pryor, a George W. Bush appointee. The panel did not indicate when it will reach a decision in the case.