A Louisiana pain management specialist has been indicted for allegedly defrauding Medicare of millions of dollars through unnecessary urine drug tests conducted over a 13-year period. Dr. Michael E. Dole, 59, of Alexandria, Louisiana, is accused of billing Medicare for more than $32.7 million and receiving over $11.7 million for medically unnecessary tests. He now faces up to 60 years in prison if convicted.
According to the indictment, Dr. Dole owned and operated a pain management practice that included an in-house drug testing laboratory, co-owned with an unnamed co-conspirator. The Department of Justice (DOJ) alleges that between January 2010 and July 2023, Dole ordered comprehensive urine drug tests for his patients without valid medical reasons.
“Medically Unnecessary Tests”
Federal prosecutors claim that Dr. Dole routinely tested his patients for over 22 classes of drugs, even when there was no documentation or suspicion that the patients were using those substances. The indictment states that Dole ordered both “presumptive” tests, which identify whether any substances are present in the urine, and “definitive” tests, which determine the levels of those substances. He allegedly conducted these tests simultaneously for nearly all his patients, regardless of the results of the initial screenings.
“Medicare only covers medical items and services that are reasonable and necessary for the treatment of illness or injury,” the DOJ emphasized in its press release. “The services billed by Dr. Dole did not fall within these allowable parameters, and he must be held accountable.”
Prosecutors allege that Dr. Dole used pre-filled requisition forms that were not individualized for each patient, ordering comprehensive drug tests without considering the specific needs or symptoms of his patients. Some tests even included a drug that had been withdrawn from the market years earlier, the indictment reveals.
“Essential for Patient Care,” Claims Defense
Dr. Dole’s defense attorney, J. Michael Small of Alexandria, told *The Daily Muck* that his client will plead not guilty to the charges. Small argued that the tests were necessary for Dr. Dole’s patient base. “The federal folks contend that the services performed by Dr. Dole and billed to Medicare were medically unnecessary and therefore should not have been billed for,” Small said. “Dr. Dole, on the other hand, contends that due to the nature of his patient base, the medical tests he performed were not only necessary but essential for his patients’ well-being.”
Small expressed confidence in his client’s case, stating, “I am confident that after all facts are made known to a federal court jury, my client will be found not guilty of these charges.”
Potential Penalties and Financial Consequences
Dr. Dole is charged with one count of conspiracy to commit healthcare fraud and five counts of healthcare fraud. If convicted, he faces a maximum penalty of 10 years in prison for each count, totaling up to 60 years. Additionally, he could be required to reimburse the money he received from fraudulent claims.
The government is also seeking forfeiture of any property or personal items purchased with the money he received from the alleged fraudulent claims. If those assets are not available, the DOJ demands that Dr. Dole forfeit any other property up to the value of the funds he obtained through the scheme.
Also Read:
- Man Charged in $10 Million Music Streaming Fraud Using AI-Generated Songs
- New Hampshire CEO Pleads Guilty to $14.3 Million Payroll Tax Fraud
Healthcare Fraud Strike Force Program
The DOJ’s Health Care Fraud Strike Force Program, which was involved in the investigation, has been actively targeting healthcare fraud since its formation in 2007. Operating in 27 federal districts, the program has charged more than 5,400 defendants who have allegedly defrauded federal healthcare programs and private insurers of more than $27 billion.
“The Healthcare Fraud Strike Force will continue to pursue individuals who abuse the healthcare system for personal gain,” the DOJ stated. “These actions undermine the integrity of our healthcare programs and the trust of the American people.”
Legal Process Ahead
Dr. Dole is expected to appear before U.S. Magistrate Judge Joseph Perez-Montes on September 26 to enter his plea. While the indictment presents serious allegations, the DOJ reiterated that it “is merely an allegation, and all defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law.”
As the legal proceedings unfold, the case will highlight the complexities surrounding the use of medical testing in pain management practices and the boundaries of what constitutes necessary medical care under Medicare guidelines.