The two doctors face about 70 charges each, including health care fraud resulting in death, money laundering, and dispensing of controlled substances.
Both men appeared in court on Aug. 30 for the half-hour arraignment and discovery conference and pleaded not guilty, according to court documents. Jahani is being represented by Todd Mair and Peper’s attorney is listed as Anthony Leffert.
Jahani, 49, started Urgent Care clinics in 2005 in Montrose, Grand Junction and Delta, and Peper, 53, worked in the Delta and Grand Junction offices.
Both men were indicted by a federal grand jury on Aug. 3 and were arrested at their respective residences in Florida and Texas.
According to the indictment, between Jan. 1, 2006 and April 30, 2010, Jahani and Peper defrauded Medicaid and Medicare and commercial health plans “by means of material false and fraudulent pretenses….”
U.S. Attorney John Walsh of the District of Colorado stated that “Jahani and Peper allegedly prescribed controlled substances to patients without determining a sufficient medical necessity for the prescription to patients in a manner which was inconsistent with the usual course or professional practice and for other than legitimate medical purposes.”
The press release goes on to state that the doctors had patients fill prescriptions at “various pharmacies,” allowing the pharmacies to file claims and “obtain reimbursement for those prescriptions from health care benefit programs.”
The two men also falsified medical records, Walsh claimed, using a practice known as “upcoding” to get more money from Medicare and Medicaid, including charging for services not rendered, even after a patient’s death. Walsh said the two had a “scheme” to cause patients “…to abuse, misuse, and become addicted to the controlled substances.”
As a result of these practices, the indictment claims that four people died.
One of them was Kelly Gwinn, who died at the age of 39 on July 3, 2008, according to court documents. Her husband, David Gwinn, filed suit against Jahani earlier this year in which he alleges that Jahani prescribed an excessive amount of drugs for his wife that resulted in her death. An autopsy showed that Kelly Gwinn had “near toxic/fatal levels of Fentanyil and Citalopram in her system at the time of her death” and the cause of death was polydrug overdose.
According to court records, the autopsy performed by Dr. Nicholas Radovich showed significant findings including “a history of congestive obstructive pulmonary disease (COPD), pulmonary anthroacocis, and emphysematous destruction alveolar septa, right plural apical adhesions, aspiration, gastric contents, hepatisteatosis and polydrug toxicity.” Also in her system at the time of her death were the drugs Oxycodone, Hydrocondone, Olanzapine, Diazepam and Nordiazepam.
“From a clinical point of view,” the autopsy states, “there was no necessity or justification for the broad variety of opiate medications and Benzodiazepine medications prescribed by Dr. Jahani to treat Kelly Gwinn’s Medical conditions” and that the doctor “failed to consider that Kelly Gwinn was at high risk of sudden death from the combination of drugs he prescribed.”
David Gwinn’s lawsuit seeks unspecified damages for “…grief, loss of companionship, impairment of the quality of life, inconvenience, pain and suffering, and emotional distress” as well as burial costs. Both men could face life in prison if convicted of the charges related to the overdose deaths, up to 20 years for several of the charges, and millions of dollars in fines.
The case is being prosecuted by Assistant U.S. Attorney Michelle Heldmyer. The case was investigated by the DEA, Health and Human Services Offices of the Inspector General, Western Colorado Drug Task Force, Grand Junction Police Department, the Colorado Attorney General’s Medicaid Fraud Control Unit, and the Internal Revenue Service Criminal Investigation unit.
All three of Jahani’s Urgent Care offices were raided on Oct. 13, 2009 by federal agents, and Jahani’s lawyer at the time, Gabriel Imperato, said he hoped “at the end of the day it would be clear Dr. Jahani acted in a compliant fashion in his medical practice.”
Before opening his clinics in Colorado, Jahani reached a civil settlement in an alleged Medicare fraud case in Texas where he was medical director of Integrated Health Services, a Dallas Hospital. He is also facing a pending case by a former employee, Tonya Creel, who claims that she was fired for being a whistleblower about fraudulent Medicare reports by Jahani.