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Chantilly Pain Clinic: The Case’s Background

Oxycodone distribution, healthcare, tax fraud.

— On Aug. 3, the owner and president of a pain clinic in Chantilly was convicted in Federal Court of conspiring to distribute and actually distributing oxycodone, a controlled drug. Paul Photiadis Boccone, 56, was also found guilty of healthcare fraud and payroll tax evasion in connection with Chantilly Specialists Ltd. pain clinic.

Charles Brown Jr., 51, a nurse practitioner with the clinic, was convicted of the same two narcotics charges. And both were sentenced to prison, last Friday, Nov. 9, in U.S. District Court in Alexandria.

Boccone prescribed medication and sometimes referred to himself as a doctor, but didn’t have a medical license. And at least four of the clinic’s patients died of overdoses related to the drugs they’d received there.

Trial evidence revealed that Boccone treated patients and prescribed narcotics by either forging the signatures of medical practitioners or encouraging medical practitioners to endorse prescriptions that he wrote.

Brown was the lead nurse practitioner there, and prosecutors said he helped Boccone by continuing to prescribe large amounts of narcotics to patients without medical need for them.

The case against the two men was detailed in a federal indictment filed Dec. 22, 2011. A federal grand jury indicted Boccone on 28 criminal counts, and Brown – also known as Charles Conway – on four counts. The document stated the illegal activities occurred over a six-year period from Dec. 22, 2005 until the indictment date.

Boccone ran the clinic’s daily operations, hired and directed employees, approved payments from the company, signed payroll checks and made financial decisions on behalf of the company.

However, the indictment also states that he told medical providers at Chantilly Specialists that “customers were to be provided with Schedule II narcotic pain medication, sometimes in direct contrast with the medical provider’s clinical opinion.” Schedule II drugs have a high risk of being abused by their users and often lead to severe addiction.

People would often travel more than 350 miles one way to be treated for reported severe pain. But according to the indictment, “Chantilly Specialists would ‘examine’ 25 or more patients per provider per day. [But] each of these customers would receive only cursory examinations prior to being prescribed Schedule II narcotics.”

The document further states that “Medical providers at Chantilly Specialists, including Brown, provided large amounts of prescription medication to customers they knew to be drug addicts – including patients who were not examined in person prior to issuance of the prescriptions.”

It stated that Boccone would intercede on behalf of customers and “would coerce or threaten medical providers who did not prescribe the desired medication … He also would sign [a particular] supervising physician’s name on prescriptions.” In addition, existing patients were encouraged by Boccone to solicit new ones to the practice, regardless of their medical requirements.

According to the indictment, in a one-year period, under Boccone’s direction, Brown prescribed “over 800,000 oxycodone-based narcotic pills to approximately 600 customers. [One particular] customer was prescribed [some] 14,400 oxycodone-based pills.”

The document also noted that, under Boccone’s control, Brown “continued to prescribe excessive amounts of controlled substances, knowing that these distributions [had] resulted in numerous overdoses and, in some cases, deaths to customers.” And in fact, three men and one woman died Oct. 3, 2009, April 7, 2010, and Feb. 1 and March 4, 2011.

Adding to the conspiracy, the indictment stated that, at Boccone’s direction, Brown “altered at least one customer’s file after Chantilly Specialists learned of his death. [And] Boccone, under subpoena to produce certain customer files, altered those files.” Prosecutors also said the two men and others “obtained substantial income and resources from their illegal distribution of controlled substances.”

Regarding the healthcare fraud, to submit claims to Medicare for services rendered, a doctor must enroll with Medicare and obtain and register his or her individual Medicare Provider Number. But although the clinic treated patients on Medicare and submitted claims for their services, Boccone never obtained a provider number.

As for the payroll tax evasion, the indictment stated that from Jan. 1, 2006 until Dec. 31, 2008, Boccone “did willfully fail to truthfully account for and pay over to the Internal Revenue Service all of the federal income taxes and FICA taxes” he’d withheld from his employees’ paychecks.