Prosecutor: Ex-Bordentown doctor prescribed 1.4M doses of opioids

Burlington County Prosecutors Office - Former Bordentown Physician Indicted for Narcotics Distribution and Fraud

During a three -year period between January 2015 and January 2018, Starkman is accused of prescribing nearly 1.4 million doses of Schedule II opioids to patients, including Oxycodone, Hydocodone, morphine and Fentanyl, making him one of the top prescribers of opioid drugs in both Burlington County and the entire state, prosecutors said.

MOUNT HOLLY — Patients came to Dr. Morris “Moishe” Starkman with neck and back pain, arthritis, fatigue and other ailments and left with prescriptions for huge sums of powerful and addictive opioid painkillers.

Burlington County prosecutors allege his actions weren’t just bad medicine; they were criminal.

During a three-year period between January 2015 and January 2018, Starkman is accused of prescribing nearly 1.4 million doses of Schedule II opioids to patients, including Oxycodone, Hydrocodone, morphine and Fentanyl, making him one of the top prescribers of opioid drugs in both Burlington County and the entire state, prosecutors said.

That’s more than three opioid pills for every man, woman and child residing in Burlington County, authorities said.

Starkman, who was the owner and operator Bordentown Family Medicine on Route 130 in Bordentown Township, had his medical license revoked last year for overprescribing narcotics and failing to establish or evaluate treatment plans. Now the 60-year-old Cinnaminson resident is facing multiple counts of health care claims and insurance fraud, and drug distribution.

His arrest is believed to be the first time in Burlington County that a physician has been charged with narcotics distribution for allegedly overprescribing opioids.

Earlier this year, North Jersey doctor Robert Delagente, 45, of Oakland, was charged by the U.S. Attorney’s Office with distribution of controlled dangerous substances and obstruction of justice for prescribing opioids such as oxycodone and Percocet, and other narcotics to patients without legitimate medical purpose. Federal authorities alleged he wrote prescriptions for patients without requiring an office visit or consultation of any kind and described himself as the “Candy Man” and the “El Chapo of Opioids.”

The arrests come as the United States is in the midst of the deadliest drug overdose epidemic in its history. About 68,000 people died of overdoses last year, according to preliminary government statistics reported in June, a drop from the more than 70,000 in 2017.

Last year, 152 people died from overdoses in Burlington County, up from 141 in 2017 and 81 in 2016, according to the Burlington County Medical Examiner’s Office.

Burlington County Prosecutor Scott Coffina said bringing to justice physicians who overprescribe opioids is part of the effort to combat the addiction scourge.

“Around 80% of heroin users started with prescription drugs. Physicians who have abandoned their medical judgment and indiscriminately prescribed opioids to patients they knew or should have known were becoming addicted to them must be held accountable for their role in this ongoing health crisis,” Coffina said in a statement announcing the charges against Starkman.

The criminal investigation of Starkman began in late 2016 after an insurance company contacted authorities about illegal activity at his practice due to the high volume of opioid prescriptions he was writing.

One of Starkman’s patients, a 22-year-old male, overdosed and died in May 2015, according to information released last year by the New Jersey Attorney General’s Office and state Division of Consumer Affairs when Starkman’s license was revoked.

No criminal charges have been filed against him in connection with the man’s death but prosecutors noted that Starkman continued to prescribe the patient opioid pills, despite noting that he was “slurring and falling asleep” during one doctors visit or that he had been discharged three days earlier from a week-long stay in a mental health and addiction treatment facility.

Court papers allege the 1986 Temple University Medical School graduate and former Virtua Memorial hospital resident sought to enrich himself through a “scheme or pattern of illegal conduct involving fraudulent health care and/or medical insurance billings and unlawful and excessive prescribing of prescription controlled dangerous substances.”

His alleged actions include overbilling insurance companies for over $50,000 worth of medical services he was either not licensed or certified to perform, such as drug screening tests, and for other more expensive exams and tests that were not needed or not performed.

In some cases, Starkman tried to bill an insurance company for breathing tests that he didn’t have equipment in his office to perform, according to authorities. In others, he is alleged to have billed insurers for detailed medical examinations, even though electronic and paper records of the cases fail to document or justify that such an examination was performed or needed.

The alleged fraud was first uncovered by Horizon Blue Cross Blue Shield during an audit of Bordentown Family Practice’s reimbursement requests that identified $142,244 worth of overpayments for unlicensed urine drug screenings and another $126,219 for overbilling for a breathing exam he lacked equipment to perform, according to court papers.

Even after being notified of the audit’s findings, Starkman is accused of continuing to over bill for drug screenings and other procedures. The affidavit of probable cause alleges he submitted bills for reimbursement for urine drug screenings 271 times between January 2015 and January 2018.

During that same time period he is accused of overprescribing massive amounts of opioid painkillers to many patients, which investigators said was intentional in order to “induce those patients to return regularly for return office visits. Starkman would then submit false or fraudulent claims to insurance companies for services that were medically unnecessary, not eligible for reimbursement and/or not provided as represented,” the probable cause statement said.

Court papers cite details from eight of Starkman’s patients who were each prescribed thousands of doses of opioids for ailments “without medical justification.”

One patient alone was prescribed more than 17,785 doses, including patches of powerful synthetic Fentanyl, amounting to more than 63 ounces of controlled narcotics, with records indicating the treatment was for “herniated discs in the neck, severe pain and spasms.”

The cases were reviewed by Dr. Andrew Kaufman, a professor of anesthesiology and director of the Pain Management Center at Rutgers University Medical School who found “no medical justification for all listed patients to be prescribed such high doses of schedule II opioids for such extended periods.”

In another case, a patient — identified only as Patient 5 — was prescribed 13,940 doses of pain pills, with records indicating he visited the office 16 times during the three years of the investigation, though court records indicate he began seeing the doctor as early as 2010.

The probable cause statement indicated that the patient also frequented the office without appointments, came in through the back door and received prescriptions from Starkman without being examined. The patient was uninsured and is believed to have paid for the prescriptions with cash, according to the probable cause statement.

Two of the eight patients cited in court papers were employees, including one who served as office manager at Starkman’s Route 130 facility from March 2015 until late September 2017.

According to the probable cause statement, the woman told investigators she was paid “sporadically” by Sparkman but was routinely prescribed opioid painkillers for several fractures in her foot without ever examining her injury.

Court documents indicate Starkman surrendered his license to prescribe narcotics in August 2017 after he learned he was under investigation by law enforcement and the Division of Consumer Affairs. Investigators said he then referred several of his patients to Rakesh Gupta, a pain management specialist with offices in Mount Holly, who gradually reduced their prescriptions to significantly lower doses of opioids or no opioids at all.

Starkman was arrested on Nov. 22 after officers executed a search warrant at his home and seized multiple electronic devices and business, financial and medical records.

He was released from custody after making a first appearance in Superior Court. He faces a possible prison sentence of between five to 10 years imprisonment if convicted.

Action News Story Trentonian Statement Of Probable Cause - 71 Pages PDF File

Burlington County Prosecutors Office Former Bordentown Physician Indicted for Narcotics Distribution and Fraud