Georgia pain clinics run afoul of new rules

Sanction: $10,000 fine

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Comprehensive Pain Care, Marietta

Violation: Operating while license application was pending

Sanction: $10,000 fine

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Georgia Pain Physicians, Ringgold

Violations: Operating before applying for a license and while application was pending

Sanction: $10,000 fine

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Macon Medical Center, Macon

Violation: Operating while license application was pending

Sanction: Includes a $10,000 fine, two year probation and monitoring

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Specialty Clinics Spine Intervention, Braselton

Violation: Operating while license application was pending

Sanction: $500 fine

At a time when Georgia is imposing tough new laws to prevent prescription drug abuse, its medical board granted licenses to five pain clinics that ran afoul of the rules before they were cleared to open.

All five did business before they were licensed, according to records from the state Composite Medical Board. One clinic submitted an application listing a convicted felon as its owner. Another is owned by a Marietta doctor whose medical license was suspended this year for three months.

It is a felony to operate a pain management clinic without a license, according to legislation passed in 2013 as part of the state’s fight against so-called “pill mills.” While legitimate pain clinics provide necessary services to people in chronic pain, pill mills cater to addicts and drug dealers by prescribing highly addictive pain medication without regard for medical need.

The board approved licenses for the five clinics on a provisional basis and imposed fines as high as $10,000 each.

Medical board Executive Director LaSharn Hughes said it has denied licenses to other clinics because they posed threats to the public, were owned by felons or had other problems. Records of these rejections have not been made public, and she said confidentiality laws bar her from commenting on specific cases.

“We are not holding back because the rules are new,” Hughes said. “We enforce them equally with everyone.”

Georgia lawmakers approved tougher laws in recent years out of fear that pill mills were moving here from Florida, which had been notorious as a haven for these clinics but was cracking down.

In 2011, Georgia legislators passed legislation that created a prescription drug-monitoring program, which is a database that lets prescribers and pharmacists check if their patients have obtained suspicious amounts of controlled substances.

They passed another measure in 2013 that requires pain clinics to be licensed and allows only physicians licensed in Georgia to open new clinics. Experts think practices with non-doctor owners are more likely to be pill mills, and some credit the law with helping to push those clinics out of Georgia.

This law also bars felons from ownership and states that the medical board may deny a license if it deems that granting one is “not in the public interest.”

Sex, drugs, Econo Lodge

As of early December, 196 pain management clinics held active licenses. Some apparently were slow to adjust to the new requirements.

An initial pain clinic application from Macon Medical Center listed as its owner a man who is not a licensed Georgia doctor but is a convicted felon, according to a board order sanctioning the practice. Board staffers said they could not provide details of the man's criminal history or identifying information other than his first and last name without approval of its members. The Atlanta Journal-Constitution could not verify his identity.

The practice’s manager later backtracked on ownership, telling the medical board she misunderstood and listed the wrong person, according to a public reprimand of the clinic. The real owner was Dr. Ademola Opanuga of Atlanta, while the felon owned the clinic’s medical management company.

At first, the board rejected the application, concerned about the felon’s involvement in management. Later it relented when the practice submitted documents showing Opanuga severed ties with that medical management company and hired a different one, Vision Medical Management.

Yet this new arrangement also raises eyebrows. The address that Vision Medical Management lists in state corporate records is an Econo Lodge near Hartsfield-Jackson International Airport. Opanuga is listed as chief executive officer, chief financial officer and secretary of Pain Clinic of AIMR in Atlanta, whose former owner was convicted on federal health care fraud, tax fraud and money laundering charges in 2013. No one else at the clinic was charged.

Opanuga did not respond to requests for comment. The owner of Vision Medical Management declined comment through an attorney.

Marietta's Comprehensive Pain Care obtained a pain clinic license in October, although it, too, operated before being granted one, records show. The medical license of owner Dr. Donald Taylor had been suspended in January after he was found to have engaged in professional sexual misconduct with a patient, board records show. He had been sanctioned for the same problem previously.

Taylor’s medical license was reinstated by the board in April. Under the terms of his probation, he must take regular polygraph tests, be chaperoned when treating female patients and submit to counseling and other requirements. He did not return calls from the AJC.

Georgia Pain Physicians of Ringgold is part of National Pain Care, a chain that advertises that it runs 14 other clinics, six of them in Georgia. Its owners did not submit its application until March — after the office opened, according to a board order.

They failed to complete it until May. Chain management did not return calls from the AJC.

Brazen mills in decline

The new laws have not been a cure-all.

One pain clinic licensed by the board in 2013 was accused on Monday of operating as a pill mill. A tip from medical board investigators led Cherokee County authorities to search the clinic near Acworth, seizing more than $10,000 in cash, a handgun and several pre-signed blank prescriptions.

The clinic’s owner, chiropractor Tom Hourin of Woodstock, was arrested on 18 felony charges. Also arrested was Dr. Kelvin White, of Fayetteville, who was the doctor of record for the clinic. Although White worked at a Fulton County urgent care clinic, his signature ended up on prescriptions for the pain practice, said Cmdr. Phil Price of the Cherokee Multi-Agency Narcotics Squad.

In 2008, the medical board had sanctioned White after they found he prescribed controlled substances to five patients while failing to document whether he examined them to see if they needed the medications, but that board order was lifted in 2010.

Medical board data does show that new licensing rules are weeding out other clinics that are not wholly owned by physicians. The 2013 law grandfathered in existing practices with certain types of non-physician owners, but of those that applied for licenses, only half were approved. By contrast, the approval rate for practices with full doctor ownership stood at 90 percent. Rejected applicants included owners with felony convictions or licensing restrictions concerning controlled substances, according to the state Attorney General’s Office.

There are signs that measure and others may be helping to make an impact, although how much credit they should get is unclear because the laws were enacted as law enforcement has been cracking down.

In 2013, state overdose deaths involving prescription drugs were the lowest they’ve been in six years, according to figures released by the Georgia Bureau of Investigation in July. However, its figures covered only autopsies performed by GBI, so Cobb, DeKalb, Fulton, Gwinnett, Hall, Henry and Rockdale counties were not included.

The most brazen pill mill activity is dying down, said Barbara Heath, Atlanta division manager of the U.S. Drug Enforcement Administration’s program to stop illegal sales of prescription drugs. Large billboards at Tennessee’s border advertising Georgia pain clinics are gone, and complaints of packed parking lots filled with dazed patrons and cars bearing out-of-state tags are rare.

“With heightened awareness that it [prescription drug abuse] leads to heroin abuse, and how it leads to destroyed communities, a lot of people are paying attention,” Heath said.