Case 2:19-mj-01413 Document 1 Filed 08/20/19 Page 1 of 38
AO 106 (Rev . 04/10) Application for a Search Warrant

UNITED STATES DISTRICT COURT
for the
Eastern District of Pennsylvania
In the Matter of the Search of
(Briefly describe the property to be searched
or identify the person by name and address)

information associated with Institute of Advanced
Medicine & Surgery that is stored at premises controlled
by DrChrono

)
)
)
)
)
)

Case No.

I q ✓ t '-1 L"S -11

APPLICATION FOR A SEARCH WARRANT
I, a federal law enforcement officer or an attorney for the government, request a search warrant and state under
penalty of perjury that I have reason to believe that on the following person or property (identify the person or describe the
pr~e;iwat11W1a;~tt{ and give its location):

Northern

located in the

District of

person or describe the property to be seized):

California

- - - -- -- - -- --

, there is now concealed {identify the

See Attachment B

The basis for the search under Fed. R_ Crim. P. 4l(c) is (check one or more):

~ evidence of a crime;
0 contraband, fruits of crime, or other items illegally possessed;

r;;/ property designed for use, intended for use, or used in committing a crime;
0 a person to be arrested or a person who is unlawfully restrained.
The search is related to a violation of:

Code Section
18 USC 1347
18 USC 1343
21 USC 841(a)(1) and 846

Offense Description
Health Care Fraud
Wire Fraud
Conspiracy to Distribute Controlled Substances, among other statutes

The ~pplication is based on these facts:
See Affidavit

~ Continued on the attached sheet.
0 Delayed notice of _ _ days (give exact ending date if more than 30 days: _ _ _ __
under 18 U.S.C. § 3103a, the basis of which is set forth on the attached sheet.

Martin McDonald, Special Agent
Printed name and title

Sworn to before me and signed in my presence.
Date:
City and state: Philadelphia, PA

Timothy R. Rice, U.S. Magistrate Judge
Printed name and title

d

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IN THE UNITED STATES DISTRICT COURT
EASTERN DISTRICT OF PENNSYLVANIA
IN THE MATTER OF THE SEARCH OF
INFORMATION AS SOCIATED WITH
INSTITUTE OF ADVANCED MEDICINE
& SURGERY THAT IS STORED AT
PREMISES CONTROLLED BY
DRCHRONO

l C\
---=-----'-- 1c\
--=--t 's
-"---'
"'"I_. _ _
Case No. _ _

Filed Under Seal

AFFIDAVIT IN SUPPORT OF
AN APPLICATION FOR A SEARCH WARRANT
I, Martin McDonald, being first duly sworn, hereby depose and state as follows:

I.

INTRODUCTION AND AGENT BACKGROUND
1.

I make this affidavit in support of an application for a search warrant for

information associated with certain accounts that are stored at premises owned, maintained,
controlled, or operated by DrChrono, an electronic medical records software provider
headquartered at 328 Gibraltar Drive, Sunnyvale, CA 94089 (the "Subject Premises"). The
information to be searched is described in the following paragraphs and in Attachment A. This
affidavit is made in support of an application for a search warrant under 18 U.S.C. §§ 2703(a),
2703(b)(l)(A) and 2703(c)(l)(A) to require DrChrono to disclose to the government records and
other information in its possession pertaining to the subscriber or customer associated with the
accounts, including the contents of communications.
2.

I am a Special Agent with the Federal Bureau of Investigation ("FBI"), and have

been since June 2010. I am currently assigned to the Philadelphia Field Office where I
investigate health care fraud. My duties and responsibilities include conducting criminal
investigations of individuals, organizations, and businesses that have violated federal laws,
including, but not limited to, Title 18, United States Code,§ 371 (Conspiracy to Defraud the

 Case 2:19-mj-01413 Document 1 Filed 08/20/19 Page 3 of 38

United States), 18 U.S.C. § 1343 (Wire Fraud), 18 U.S.C. § 1347 (Health Care Fraud), 18 U.S.C.
§ 1349 (Conspiracy to Commit Health Care Fraud and Wire Fraud), Title 21 U.S.C. § 841
(Distribution of Controlled Substances), and Title 42, U.S.C., § 1320a-7b(b) (Illegal
Remunerations).
3.

I have participated in a variety of criminal health care fraud investigations, during

the course of which I have interviewed witnesses, conducted physical surveillance, executed
search warrants, and reviewed records, including claims data, bank records, phone records,
medical records, invoices, and other business records. I am familiar with the records and
documents maintained by health care providers and the laws and regulations related to the
administration of the Medicare program.
4.

The facts in this affidavit come from my personal observations, my training and

experience, and information obtained from other agents and witnesses. This affidavit is intended
to show that there is sufficient probable cause for the requested warrant and does not set forth all
of my knowledge about this matter.
5.

Based on my training and experience, the training and experience of other FBI

personnel with expertise in electronic information and stored communications, and the facts as
set forth in this affidavit, there is probable cause to search the information described in
Attachment A for evidence of crimes and contraband or fruits of crimes, as described in
Attachment B, specifically violations of Title 18, United States Code,§ 371 (conspiracy to
defraud the United States), Title 18, United States Code,§ 1343 (wire fraud); Title 18, United
States Code, § 1347 (health care fraud); Title 18, United States Code, § 1349 (conspiracy to
commit health care fraud and wire fraud), and Title 21, United States Code§§ 841(a)(l) and 846
(conspiracy to distribute controlled substances), among other statutes.

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II.

JURISDICTION
6.

This Court has jurisdiction to issue the requested warrant because it is "a court of

competentjurisdiction" as defined by 18 U.S .C. § 2711. 18 U.S.C. §§ 2703(a), (b)(l)(A), &
(c)(l)(A). Specifically, the Court is "a district court of the United States ... that has jurisdiction
over the offense being investigated." 18 U.S.C. § 2711(3)(A)(i).

Ill.

BACKGROUND
A. The Relevant Health Insurance Programs
7.

Medicare is a federally-funded health care program that provides benefits to

persons who are at least 65 years old or disabled. Medicare is administered by the Centers for
Medicare and Medicaid Services ("CMS"), a federal agency under the United States Department
of Health and Human Services ("HHS"). Individuals who receive benefits under Medicare are
referred to as Medicare "beneficiaries." Medicare is divided into multiple parts: Part A covers
hospital inpatient care, Part B covers physicians' services and outpatient care, Part C is Medicare
Advantage Plans, and Part D covers prescription drugs.
8.

A medical provider is required to enroll with the Medicare program in order to

submit claims for payment to CMS. To enroll in the Medicare program, a medical provider is
required to enter into an agreement with CMS in which the provider agrees to comply with all
applicable statutory, regulatory, and program requirements for reimbursement from Medicare.
By signing the Medicare enrollment application, the provider certifies that the provider
understands that payment of a claim is conditioned on the claim and the underlying transaction

3

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complying with Medicare regulations,1 Medicare program instructions, the law, and on the
provider's compliance with all applicable conditions of participation in Medicare.
9.

Medicare covers prescriptions that are obtained from a state licensed physician, or

other appropriately licensed health care provider, who is registered as required with the DEA.
Medicare requires that any drug prescribed by a participating provider must be safe arid effective
and otherwise reasonable and ·necessary and will only reimburse for claims for prescriptions that
were prescribed within the course of professional practice and for a legitimate medical purpose.
Generally, the pharmacy submits the claim to Medicare for the prescription medication using the
information contained in the prescription, such as prescribing physician' s name, patient
information, drug, strength, and quantity dispensed. Medicare relies on the accuracy of the
information in a claim when making payments and presumes that the underlying prescription
was written within the usual course of professional practice and for a legitimate medical purpose.
Medicare does not reimburse for medically unnecessary medications.
10.

The United States Office of Personnel Management ("OPM") serves as the chief

human resources agency and personnel policy manager for the federal government. Among its
many duties, OPM manages the Federal Employees Health Benefits Program ("FEHBP").
FEHBP benefits are afforded to all federal employees and their family members. Federal
employees may choose from over 300 FEHBP contracted health insurance carriers. Benefits are
administered by private insurance companies and paid for, in large part, by OPM. A medical

1

There are limited exceptions to this rule, none of which are applicable to this investigation.

4

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provider may enroll with OPM as a participating provider in order to submit claims to OPM for
medical services to federal employees and their family members.
11 .

The United States Department of Labor Office of Workers' Compensation

Program ("OWCP") administers the f~deral workers' compensation program which provides
certain benefits, including health care benefits and wage loss replacement, to federal employees
who sustain a work-related injury. See 5 U.S.C. §§ 8101, et seq. All providers are required to
enroll with OWCP through its designated bill processing agent and may submit claims for
payment under their issued provider number.
12.

Independence Blue Cross ("IBC") offers health insurance plans for individuals

and families throughout southeastern Pennsylvania. IBC is the largest health insurer in the
Philadelphia area and offers a wide variety of health plans, including managed care and
traditional indemnity insurance. A medical provider may enroll with IBC as a participating
provider in order to submit claims to IBC for medical services to federal employees and their
family members.
13.

Like Medicare, OPM, OWCP, and IBC require that any drug prescribed by a

participating provider must be safe and effective and otherwise reasonable and necessary and
will only reimburse for claims for prescriptions for controlled substance that were prescribed
within the course of professional practice and for a legitimate medical purpose by a state licensed
physician, or other appropriately licensed health care provider.

B. Relevant Statutes and Guidelines
Wire Fraud
14.

It is a crime for any person, having devised or intending to devise any scheme or

artifice to defraud, or for obtaining money or property by means of false or fraudulent pretenses,

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representations, or promises, transits or causes to be transmitted by means of wire, radio, or
television communication in interstate or foreign commerce, any writings, signs, signals,
pictures, or sounds for the purpose of executing such scheme or artifice. See Title 18, United
States Code, Section 1343.

Health Care Fraud
15.

It is a crime for any person to knowingly and willfully execute, or attempt to

execute, a scheme or artifice to defraud any health care benefit program, or to obtain, by means
of false or fraudulent pretenses, representations, or promises, any of the money or property
owned by, or under the custody or control of, any health care benefit program. See Title 18,
United State Code, Section 134 7.
16.

A "health care benefit program" is any public or private plan or contract, affecting

commerce, under which any medical benefit, item or service is provided to any individual, and
includes any individual or entity who is providing a medical benefit, item, or service for which
payment may be made under the plan or contract. See Title 18, United States Code, Section 24.
17.

Title 18, United States Code, Section 1349, provides that any person who

attempts or conspires to commit health care fraud shall be subject to the same penalties as those
proscribed in 18 U.S.C. § 1347.
18.

Medicare, OPM, OWCP, and IBC are each a "health care benefit program," as

defined by Title 18, United States Code, Section 24(b).

Title 21 and the Controlled Substance Act
19.

The Controlled Substance Act ("CSA") governs the manufacturing, distributing,

and dispensing of controlled substances in the United States. See 21 U.S.C. §§ 801-971. "A
prescription for a controlled substance .. . must be issued for a legitimate medical purpose by an

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individual practitioner acting in the usual course of his profc:!ssional practice." See Title 21,
C.F.R, § 1306.04
20.

It is a crime to knowingly and intentionally dist~~ibute a controlled substance other

than in the usual course of professional practice and for a legitim'. ate medical purpose. See Title
i

21, U.S.C, § 84l(a)(l). It is also a crime to attempt or conspire td'..violate § 84l(a)(l). See Title
.
·,
21 , U.S.C. § 846
21.

\

The CSA classifies drugs into five schedules based on th~ii'·lli2Dicinal,. Yalue,

potential for abuse, and safety or dependence liability. Schedule I drugs (such as heroin and
LSD) have a high potential for abuse and no currently accepted medical use. Schedule II drugs
(such as methadone, oxycodone, fentanyl and morphine) may be used legitimately as painkillers,
but they are highly addictive and often abused. Abuse of Schedule II controlled substances may
lead to severe psychological or physical dependence. Schedule III drugs (such as codeine
products with aspirin), Schedule IV drugs (such as Xanax and Clonazepam), and Schedule V
drugs (such as Promethazine with codeine, a cough syrup) all have medical uses and have
successively lower potential for abuse and dependence. All Scheduled drugs, except those in
Schedule I, are legally available to the public with a valid prescription.
Pennsylvania Code of Professional and Vocational Standards
22.

The Pennsylvania Code of Professional and Vocational Standards, Title 49,

Chapter 16.92, defines the authority of physicians licensed in the Commonwealth of
Pennsylvania to prescribe controlled substances. Chapter 16.92 provides, in pertinent part: A
person licensed to practice medicine and surgery in this Commonwealth or otherwise licensed or
regulated by the Board, when prescribing, administering or dispensing controlled substances,
shall carry out, or cause to be carried out, the following minimum standards:

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a.

Initial medical history and physical examination. Before commencing

treatment that involves prescribing, administering or dispensing a controlled substance, an initial
medical history shall be taken and an initial examination shall be conducted unless emergency
circumstances justify otherwise. Alternatively, medical history and physical examination
information recorded by another health care provider may be considered if the medical history
was taken and the physical examination was conducted within the immediately preceding thirty
days. The physical examination shall include an evaluation of the heart, lungs, blood pressure
and body functions that relate to the patient's specific complaint.
b.

Reevaluations. Among the factors to be considered in determining the

number and the frequency of follow-up evaluations that should be recommended to the patient
are the condition diagnosed, the controlled substance involved, expected results and possible side
effects. For chronic conditions, periodic follow-up evaluations shall be recommended to monitor
the effectiveness of the controlled substance in achieving the intended results.
c.

Patient counseling. Appropriate counseling shall be given to the patient

regarding the condition diagnosed and the controlled substance prescribed, administered or
dispensed. Unless the patient is in an inpatient care setting, the patient shall be specifically
counseled about dosage levels, instructions for use, frequency and duration of use and possible
side effects.
d.

Medical Records. Certain information shall be recorded in the patient's

medical record on each occasion when a controlled substance is prescribed, administered or
dispensed. This information shall include the name of the controlled substance, its strength, the
quantity and the date it was prescribed, administered or dispensed to a patient. The medical
record shall also include a specification of the symptoms observed and reported, the diagnosis of

8

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the condition for which the controlled substance is being given and the directions given to the
patient for the use of the controlled substance. If the same controlled substance continues to be
prescribed, administered or dispensed, the medical record shall reflect changes in the symptoms
observed and reported, in the diagnosis of the condition for which the controlled substance is
being given and in the directions given to the patient.
Centers for Disease Control and Prevention ("CDC'') Guidelines

23.

According to CDC guidelines for prescribing opioids for chronic pain that were

issued in March 2016, clinicians should use caution when prescribing opioids at any dosage, and
should carefully reassess evidence of individual benefits and risks when considering increasing
dosages to more than/equal 50 MME per day2. According to the CDC, clinicians should avoid
increasing dosages to more than/equal to 90 MME per day or carefully justify a decision to titrate
dosage to more than/equal to 90 MME per day.
24.

In the March 2016 guidelines, the CDC defined chronic pain as pain that typically

lasts greater than three months or past the time of normal tissue healing. According to the CDC,
patients with chronic pain should receive treatment that provides the greatest benefits relative to
the risks. Although opioids can reduce pain during short-term use, clinical evidence found
insufficient evidence to determine whether pain relief is sustained and whether function or
quality of life improves with long-term opioid therapy. While benefits for pain relief, function

2

The CDC defines morphine milligram equivalents per day as the amount of morphine an opioid
dose is equal to when prescribed, and in its "CDC Guideline for Prescribing Opioids for Chronic
Pain" states the MME per day is often used as a gauge of the abuse and overdose potential of the
amount of opioid that is being given at a particular time.

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and quality of life with long-term opioid use for chronic pain are uncertain, risks associated with
long-term opioid use are clearer and significant. Based on clinical evidence review, the CDC
states long-term opioid use for chronic pain is associated with serious risks including increased
risk for opioid use disorder, overdose, myocardial infarction, and motor vehicle injury.

C. Relevant Individuals and Entities
25.

Neil K. Anand ("ANAND") is a medical doctor who holds himself out as a

provider for pain management and addiction medicine. ANAND operates a medical practice that
focuses on pain management at three locations: 5000 Frankford Avenue, Suite 2, Philadelphia,
PA ("Location 1"); 5735 Ridge Avenue, Suite 101, Philadelphia, PA ("Location 2"); and 3554
Hulmeville Road, Suite 101, Bensalem, Pennsylvania ("Location 3") (collectively referred to as
the "PRACTICE"). ANAND graduated from Albany Medical College in 2001, and was issued
Pennsylvania medical license MD422681 on July 17, 2003 . ANAND was subsequently assigned
DEA Registration Number BA8444565 for the purpose of prescribing controlled substances in
Schedules II through V. ANAND was also issued DEA Registration Number XA8444565 for
the purpose of prescribing buprenorphine products, including Suboxone, a Schedule III
controlled substance, indicated for treatment of opioid dependence. 3
26.

ANAND owns several non-pharmacy dispensing sites which provide in-office

dispensing of medications to patients -~t the PRACTICE, including Anand Medical Investment

3

As of August 20, 2011, ANAND was authorized to administer, dispense, and prescribe
buprenorphine products, including Suboxone, for the purpose of drug addiction treatment.
Therefore, ANAND may qualify as a "program director" of a drug treatment center. Since the
confidentiality of patient records at authorized drug treatment programs is highly regulated and
subject to special restrictions and requirements as set forth in Titles 21 and 42 of the United
States Code and the Code of Federal Regulations, on November 5, 2018 and June 7, 2019, the

10

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("AMI"), Institute of Advanced Medicine and Surgery ("IAMS"), and Bucks County Pain and
Perioperative PLLC doing business as Bucks County Spine and Pain Medicine ("BCSPM")
(collectively referred to as the "DISPENSARJES"). Based on my review of Pennsylvania
Department of State Records ("P ADOS"), I am aware that ANAND is the owner and operator of
the DISPENSARJES, the DISPENSARJES are currently active, and the DISPENSARJES are
registered to 1313 Cheltenham Drive, Bensalem, Pennsylvania. Based on information learned
during this investigation, I am aware that 1313 Cheltenham Drive, Bensalem, Pennsylvania is
ANAND' s residence.
27.

ANAND and the DISPEN~ARJES participated in numerous federal and private

insurance health care plans, including Medicare, OPM, OWCP, and IBC.
28.

AtifMahmood Malik ("MALIK") is a foreign trained physician who received his

medical degree from Ayub Medical College in Pakistan in January 2013 . MALIK is not licensed
to practice medicine in the United States. According to documents obtained from the Educational
Commission for Foreign Medical Graduates ("ECFMG"), MALIK completed Step 1 of the
process to become licensed to practice medicine in the United States. 4 MALIK worked for
ANAND from 2018 through June 2019.
29.

Asif Khan Kundi ("KUNDI") is a foreign trained physician who received his

medical degree from Ayub Medical College in Pakistan in September of 2012. KUNDI is not

government obtained authorizations to use an undercover agent and/or confidential source and to
obtain records from the PRACTICE.
4

According to the ECFMG's website, an international medical graduate ("IMG") begins the
certification process by first confirming that his/her medical school meets ECFMG requirements.
Then, an IMG applies to the ECFMG for a USMLE/ECFMG Identification Number to use for
the application and examination. To be certified by ECFMG, an IMG must meet examination
and medical education credential requirements. These requirements include passing performance

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licensed to practice medicine in the United States. According to documents obtained from the
ECFMG, KUNDI failed to show up for the first examination required for licensure in the United
States. KUNDI has been working for ANAND for the past approximately two years and appears
to manage the DISPENSARIES.
30.

Former Employee 1 is a foreign trained physician who received his medical

degree from Katurba Medical College in India in March 2015. Former Employee 1 is not
licensed to practice medicine in the United States. According to documents obtained from the
ECFMG, Former Employee 1 completed Steps 1 and 2 of the process to become licensed in the
United States, passing Step 2 in July 2018. Between approximately July 2018 and November
2018, Former Employee 1 worked for ANAND an average of two days per week.
31.

Former Employee 2 is a nurse practitioner ("NP") who graduated from the nurse

practitioner program at Thomas Jefferson University in August 2017 and received board
licensing in November 2017. Former Employee 2 worked for ANAND from June-2018 through
January 2019.

IV.

DRCHRONO
32.

DrChrono provides a web-based Electronic Health Record ("EHR") system to

physicians. According to DrChrono's website, at www.drchrono .com, "DrChrono EHR is built
on a seamlessly integrated platform" to fit a particular practice's needs. According to this
website, "physicians using DrChrono have seen tremendous amount of efficiency and time

on medical science and clinical skills examinations- United States Medical Licensing
Examination ("USMLE") Step 1, Step 2 Clinical Knowledge, and Step 2 Clinical Skills are the
exams currently administered that satisfy these requirements-and primary-source verification of
the IMG's medical education credentials, including the final medical diploma, final medical ·
school transcript, and transcript(s) to document transferred academic credits (if applicable).

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savings through custom forms, pre-made specialty templates, and charting shortcuts that help
reduce charting time so they can focus on patient care" and the EHR comes with "patient portal,
check-in app, online schedule tools, ... automated features to engage your patients quickly and
effectively and reduce no shows, .. .integrated lab ordering, eFax, e-referrals task system, and
inter-practice chats."
33 .

Pursuant to a subpoena issued in July 2019, DrChrono disdosed that it maintained

an account associated with ANAND under the customer name of Institute of Advanced Medicine

& Surgery, for which there were numerous users. 5 The users associated with this account are as
follows:

EHR USERNAME
Cardiacgasman
Docbuc77
BStuetz
Vicktoriya
AooleHeart
Drsoccio
Jedshapiro
Cdwilliams2OLD
Docbucc77old
Smagsi
Williamleen
Batoulk
Atmalik
I
Billingindia3
Edandfrances
Eananieva
Davidshunwei
Shefali
Cetorres

NAME
Neil Anand
Robert Buckley
Bernard
Viktoriya Makarova
Deborah McGregor
Paul Soccio
Jed Shapiro
Charles Williams
Robert OLD
Shaheen Magsi
Bill Leen
Batoul k
AtifMalik
Sameep Bhardwaj
Francesca Martinez
Elis Ananieva
Shunwei Wang
Shefali Shah
Chelsea Torres

I

5

DrChrono produced records responsive to the July 2019 subpoena indicating the account holder
and users for tlie account associated with ANAND. Under 18 USC 2703(a), the government
seeks the instant search warr8J1t in order to obtain the records and content of ANAND's account.b Q.Qe.Y) l

. Oc O\ro"o \Q_o,utwY o,

.

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re r\ l,...; 4,fflcl',t
13

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 Case 2:19-mj-01413 Document 1 Filed 08/20/19 Page 15 of 38

EHR USERNAME
Mcostanzo
Billingindia2
Patti2525
Ashleybu
Cdovidio
Tjacob
Ninaanand
Jimikpatel
Mkundi
Susansoccio
Billingindia 1
Akundi
Jedscott
Pat1234
Docbuc7
JGarry1203
Loladavid
Batuol
JGarry
Smsoccio
Susansoccio 1
batuolk

NAME
Maria Costanzo
Mihir Parekh
Patricia Shapiro
Ashley Burgos
Courtney Dovidio
Theresa Jacob
Nina Anand
Jimik Patel
Maryann Kundi
Susan Soccio
Sujal Kanudawala
AsifKundi
JedScott Shapiro
Patrice Caiola
Robert Buckley
Joan Garry
Lola David
Batuol Kheiri
Joan Garry
Susan Soccio
Susan Soccio
Batuol Kheiri

34.

According to DrChrono's subpoena response on July 22, 2019, the date of the last

login to the account was July 22, 2019.
35.

In my experience investigating health care fraud, I have learned that EHR

document both services purportedly provided and the purported conditions of patients who
received services. Such information can be important evidence when attempting to determine
whether claims submitted to Medicare, OPM, OWCP, and IBC for services purportedly provided
by a physician were actually provided and medically necessary, and whether the physician
billing Medicare, OPM, OWCP, and IBC actually rendered these services. Administrative logs
within the electronic medical record system also indicate whether records were altered to hide
fraudulent activities.

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36.

In general, providers like DrChrono ask each of their subscribers to provide

certain personal identifying information when registering for an account. This information can
include the subscriber' s full name, physical address, telephone numbers and other identifiers, email addresses, and, for paying subscribers, a means and source of payment (including any credit
or bank account number). Providers typically retain certain transactional information about the
creation and use of each account on their systems. This information can include the date on
which the account was created, the length of service, records of log-in (i.e., session) times and
durations, the types of service utilized, the status of the account (including whether the account is
inactive or closed), the methods used to connect to the account, and other log files that reflect
usage of the account. In addition, providers often have records of the Internet Protocol address
("IP address") used to register the account and the IP address associated with particular logins to
the account. Because every device that connects to the Internet must use an IP address, IP
address information can help to identify which computers or other devices were used to access
the account.
37.

In some cases, account users will communicate directly with a provider about

issues relating to their account, such as technical problems, billing inquiries, or complaints from ·
other users. Providers typically retain records about such communications, including records of .
contacts between the user and the provider' s support services, as well records of any actions
taken by the provider or user as a result of the communications.

V.

PROBABLE CAUSE
38.

Based upon my review of: (1) interviews of former employees and patients; (2)

recordings made by Patient 7; (3) claims data; and (4) Pennsylvania Prescription Drug

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Monitoring Program ("PDMP") data, 6 there is probable cause to believe that ANAND, together
with others, submitted or caused the submission of false and fraudulent claims to Medicare,
OPM, OWCP, and IBC for the provision of medically unnecessary prescription medications.
Further, there is probable cause to believe that ANAND, together with others, knowingly and
intentionally distributed a controlled substance outside the usual course of professional practice
and not for a legitimate medical purpose.
39.

As a medical doctor, ANAND was authorized to prescribe medications to

patients, including controlled substances, for legitimate medical purposes and in the usual course
of professional practice. As the owner of non-pharmacy dispensing sites, ANAND could
dispense prescription drugs from the PRACTICE and submit claims to insurance programs for
those prescription drugs. The investigation revealed that ANAND operated a scheme in which
ANAND prescribed medically unnecessary prescription medications to patients at the
PRACTICE that were dispensed and billed by the DISPENSARIES to Medicare, OPM, and
IBC.7 As a matter of course, patients automatically received a bag of medications at each visit to
the PRACTICE which contained numerous medically unnecessary prescription medications,

6

The Pennsylvania Prescription Drug Monitoring Program ("PDMP") is a statewide computer
program which collects information regarding prescriptions of controlled substances submitted
by pharmacies and dispensing practitioners. These programs assist in the detection of patients
and clinicians who are diverting controlled substances.
7

The Dispensaries did not submit claims to OWCP because the Dispensaries were not enrolled
withOWCP.

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including Lidocaine 8 , Vanatol LQ/S9 , Temazepam 10 , Allzital 11 , Metaxalone

12

,

Diclofenac

Sodium Gel 13, Celecoxib 14, Nalfon 15 , and Omeprazole 16, among others. The bags of medications
were referred to as "Goody Bags" by patients and staff at the PRACTICE. To carry out his
scheme, ANAND not only dispensed unnecessary medications to patients under his care, but
surreptitiously recruited them as unknowing participants in his scheme because they had to
accept the Goody Bag in order to receive a prescription for a controlled substance and falsely

8

Lidocaine is an anesthetic and antiarrhythmic that can treat irregular heartbeats (arrhythmias). It
can also relieve pain and numb the skin.

9

Vanatol is an analgesic that can treat headaches. Vanatol can cause paranoid or suicidal
ideation and impair memory, judgment, and coordination. Combining with other substances,
particularly alcohol, can slow breathing and possibly lead to death.
10

Temazepam, a Schedule IV controlled substance, is a sedative that can treat insomnia. It can
cause paranoid or suicidal ideation and impair memory, judgment, and coordination. Combining
with other substances, particularly alcohol, can slow breathing and possibly lead to death.
11

Allzital is a sedative and analgesic that can treat tension headaches. It can cause paranoid or
suicidal ideation and impair memory, judgment, artd coordination. Combining with other
substances, particularly alcohol, can slow breathing and possibly lead to death.
12

Metaxalone is a muscle relaxant that can relax certain muscles. It can also relieve pain caused
by injuries, sprains, and strains.
13

Diclofenac Sodium Gel is a nonsteroidal anti-inflammatory drug that can treat pain, migraines,
and arthritis in its oral form. It can also treat actinic keratoses in its topical form.
14

Celecoxib is a nonsteroidal anti-inflammatory drug that is used to treat pain and inflammation
associated with arthritis and ankylosing spondylitis, and acute pain.
15

Nalfon is a nonsteroidal anti-inflammatory drug used to treat mild to moderate pain, and helps
to relieve symptoms of arthritis( osteoarthritis and rheumatoid arthritis), such as inflammation,
swelling, stiffness, and joint pain.
16

Omeprazole is a proton-pump inhibitor that can treat heartburn, a damaged esophagus,
stomach ulcers, and gastroesophageal reflux disease.

17

 Case 2:19-mj-01413 Document 1 Filed 08/20/19 Page 19 of 38

sign a tablet acknowledging payment of a co-pay for the Goody Bag. The investigation revealed
that patients did not want or need the goody bags, that patients were not told what medications
were in the goody bag or how the medications should be used, and that patients were told to toss
or give away unused Goody Bags.
40.

In order to facilitate his scheme and maximize the number patients seen at the

PRACTICE, ANAND employed foreign medical school graduates who were not licensed to
/

practice medicine in the United States, including MALIK, KUNDI and Former Employee 1,
among others (collectively referred to as "Foreign Graduates"). The Foreign Graduates presented
themselves as doctors to unsuspecting patients and were the primary providers of medical
services purportedly provided at the PRACTICE. The investigation revealed that patients
believed that the Foreign Graduates were licensed physicians because they introduced
·themselves as doctors and patients and staff referred to them as doctors. Generally, patients were
seen by the Foreign Graduates who provided medical advice to patients and prescribed
controlled substances to patients. The Foreign Graduates filled in the details of the prescription,
including drug information and dosage, on prescriptions that were either pre-signed by ANAND
or a license professional, such as Former Employee 2 or ANAND, would briefly enter the
examination room to sign a number of blank prescriptions. Further, when a patient with certain
insurance coverage, including Medicare and IBC, arrived at the PRACTICE, KUNDI identified
what medications the patient's insurance would cover and prepared a bag of medications for the
patient, the Goody Bag. The medications in the Goody Bag are pre-determined based on
insurance coverage, not the medical needs of a particular patient.
41.

I and other law enforcement officers have interviewed former employees and

patients seen at the PRACTICE.

18

 Case 2:19-mj-01413 Document 1 Filed 08/20/19 Page 20 of 38

Former Employee 1
42.

On or about July 16, 2019 and July 30, 2019, law enforcement interviewed

Former Employee 1 who worked for ANAND from July 2018 to November 2018. ANAND
described the duties of Former Employee 1 as medical intern or junior scribe, defined by
ANAND as someone who is learning the language of prescriptions and would write prescriptions
underANAND's guidance with ANAND signing off on the prescriptions. Former Employee 1
worked between two to four days a week primarily at Location 1 and Location 2. ANAND
employed four other foreign medical school graduates in addition to Former Employee 1,
including MALIK and KUND I.
43.

Former Employee 1 stated that patients were seen by the Foreign Graduates and

that ANAND or FORMER EMPLOYEE 2 merely signed prescriptions prepared by the Foreign
Graduates or ANAND left blank prescriptions for the Foreign Graduates. Former Employee 1
stated that there was a system in place at the PRACTICE that patients had to take the Goody
Bags at every visit and receive injections at every second or third visit, otherwise patients may
not receive prescriptions for controlled substances. KUNDI was responsible for preparing the
Goody Bags and the Goody Bags contained whatever medications were covered by a particular
patient's insurance. KUNDI brought the Goody Bag to the exam room and had patients sign a
tablet upon receipt of the Goody Bag.
Former Employee 2
44.

On or about July 8, 2019 and July 16, 2019, law enforcement interviewed Former

Employee 2 who worked for ANAND as a NP from June 2018 to January 2019. ANAND
described the duties of Former Employee 2 as visiting with patients, prescribing medications,
and assisting with injections. Former Employee 2 generally worked Mondays and Tuesdays at

19

 Case 2:19-mj-01413 Document 1 Filed 08/20/19 Page 21 of 38

Location 1 or Location 2. Former Employee 2 did not see ANAND often on those days. Former
Employee 2 was trained on how to use document patient visits in DrChrono.
45.

Former Employee 2 stated that KUNDI handled the DISPENSARIES and that

each patient received a bag of pre-set medications. Former Employee 2 stated that every time a
patient came to the office, KUNDUooked up what medications the patient was receiving from
the DISPENSARIES and brought a Goody Bag to the exam room, at which time the patient
signed a tablet. Former Employee 2 heard patients state that they did not need the medications
and were told by KUNDI or MALIK to take the medication and use it later or give it to someone
else. Former Employee 2 heard ANAND tell patients that they would not get their Oxycodone
prescription if they did not receive an injection. Former Employee 2 believes that same principle
applied with the Goody Bags filled at the DISPENSARIES.
46.

Former Employee 2 stated that the Foreign Graduates saw the patients and told

Former Employee 2 what prescriptions a patient needed at which time Former Employee 2
signed the requested number of blank prescriptions and handed it to the Foreign Graduates who
filled in drug and patient information. On average, each patient received between two and three
prescriptions.
47.

Former Employee 2 stated that ANAND, office staff and patients referred to

Foreign Graduates as physicians. ANAND' left pre-signed prescription pads in a cabinet for the
Foreign Graduates to use.
Patient 1
48.

On or about June 3, 2019, law enforcement agents interviewed Patient 1, whose

identity is lmown to me. Patient 1 began seeing ANAND in approximately January 2015 for
lmee and lower back pain. Initially, Patient 1 paid approximately $400 cash for treatment

I

20

 Case 2:19-mj-01413 Document 1 Filed 08/20/19 Page 22 of 38

because ANAND did not accept Patient's 1 health insurance. In 2016, Patient 1 enrolled in
Medicare and Medicaid, at which time ANAND began giving Patient 1 injections and a bag of
medications that Patient 1 did not need or want.
49.

Based on my review of Medicare claims data, I am aware that on 35 dates

between February 26, 2016 and April 4, 2019, ANAND prescribed approximately 128 Goody
Bag medications to Patient 1 for which he was paid approximately $66,770. Below are a sample
of dates on which ANAND prescribed Goody Bags for Patient 1.

Approximate Date
Prescription Written

Medication Prescribed

Billing
Provider

Paid Amount

November 1, 2017
November 1, 2017
November 1, 2017
November 1, 2017
November 1, 2017
November 1, 2017
November 29, 2017
November 29, 2017
November 29, 2017
November 29, 2017
November 29, 2017
November 29, 2017
January 17, 2018
January 17, 2018
January 17, 2018
January 17, 2018
January 17, 2018
January 17, 2018
June 5, 2b18
June 5, 2018
June 5, 2018
June 5, 2018
June 5, 2018
June 5, 2018
June 5, 2018
June 5, 2018

Vanatol S
Diclofenac Sodium
Temazepam
Lidocaine
Cyclobenzaprine Hydrochlo
Fenoprofen Calcium
Naproxen Sodium CR
Diclofenac Sodium
Temazepam
Lidocaine
Cyclobenzaprine Hydrochlo
Nalfon
Naproxen Sodium CR
Diclofenac Sodium
Vanatol LQ
Temazepam
Omeprazole/Sodium Bicarbo
Cyclobenzaprine Hydrochlo
Omeprazole/Sodium Bicarbo
Allzital
Naproxen Sodium CR
Diclofenac Sodium
Diclofenac Sodium
. Vanatol LQ ·
Temazepam
Lidocaine

AMI
AMI
AMI
AMI
AMI
AMI
AMI
AMI
AMI
AMI
AMI
AMI
AMI
AMI
AMI
AMI
AMI
AMI
AMI
AMI
AMI
AMI
AMI
AMI
AMI
AMI

· $3,207.93.
$201.17
$125.58
$32.82
$343.38
$281.85
$1,036.59
$195.50
$110.35
$167.35
$345.32
$406.94
$813.81
$279.46
$3,508.00
$143.96
$2,359.81
$411.74
$1,106.12
$1,197.94
$1,614.50
$270.50
$386.83
$1,162.50
$157.71
$1,013.38

21

 Case 2:19-mj-01413 Document 1 Filed 08/20/19 Page 23 of 38

Approximate Date
Prescription Written

Medication Prescribed

Billing
Provider

Paid Amount

June 5, 2018
June 5, 2018

Cyclobenzaprine Hydrochlo
Nalfon

AMI
AMI

$462.08
$408.99

50.

Based on my review of PDMP data, I am aware that on 31 dates between January

28, 2016 and June 20, 2019, Patient 1 received approximately 31 prescriptions for controlled
substances from ANAND. Below are a sample of dates on which ANAND prescribed controlled
substances to Patient 1.

Approximate Date
Prescription Written

September 6, 2017
September 6, 2017
November 29, 2017
November 29, 2017
January 24, 2018
January 24, 2018

Prescribed
Schedule II
Controlled
Substance

Fentanyl 100
mcg/hr patch
Methadone hcl 10
mg tablet
Methadone hcl 10
mg tablet
Fentanyl 100
mcg/hr patch
Methadone hcl 10 ·
mg tablet
Fentanyl 100
mcg/hr patch

Quantity

Days of
Supply

MME/Per
Day

10

30

240.0MME

360

30

360.0MME

360

30

360.0MME

10

30

240.0MME

360

30

360.0MME

10

30

240.0MME

Patient 2
51.

On or about May 9, 2019, law enforcement agents interviewed Patient 2, whose

identity is known to me. Patient 2 stated that Patient 2 had IBC insurance and was a patient of
ANAND's for two years for back and shoulder pain. Patient 2 first visited Location 1 and
Patient 2 received prescriptions for Percocet from ANAND which Patient 2 filled at a local
pharmacy. At every appointment, Patient 2 re·ceived a bag of medications, including Lidocaine

22

 Case 2:19-mj-01413 Document 1 Filed 08/20/19 Page 24 of 38

cream, among other medications. Upon receipt of the bag of medications, Patient 2 was
instructed to sign a tablet indicating that Patient 2 paid a co-pay for the medications though
Patient 2 never paid a copay. Patient 2 was never asked if she wanted or needed the bag of
medications.
52.

Based on my review of IBC claims_data, I am aware that on 7 dates between June

13, 2018 and December 4, 2018, ANAND prescribed approximately 61 Goody Bag medications
to Patient 2 for which he was paid approximately $47,711 . Below are a sample of dates on
which ANAND prescribed Goody Bags for Patient 2.

Approximate Date
Prescription Written

Medication Prescribed

Billing
Provider

Paid
Amount

June 13, 2018
June 13, 2018
June 13, 2018
June 13, 2018
June 13, 2018
June 13, 2018
June 13, 2018
June 13, 2018
June 13, 2018
June 13,2018
September 11, 2018
September 11, 2018
September 11, 2018
September 11, 2018
September 11, 2018
September 11, 2018
September ·11, 2018
September 11, 2018
September 11, 2018
September 11, 2018

Cyclobenzaprine HCL
Diclofenac Sodium
Lidocaine
Lidocaine
Mebolic
Nalfon
Naproxen Sodium CR
Omeprazole/Sodium Bicarbo
Temazepam
Vanatol LQ
Cyclobenzaprine HCL
Diclofenac Sodium
Eszopiclone
Lidocaine
Nalfon
Naproxen Sodium CR
Omeprazole/Sodium Bicarbo
Tramadol HCL ER
Vanatol LQ
Xyzbac

AMI
AMI
AMI
AMI
AMI
AMI
AMI
AMI
AMI
AMI
AMI
AMI
AMI
AMI
AMI
AMI
AMI
AMI
AMI
AMI

$453.02
$814.35
$98.27
$562.56
$821.19
$298.58
$1,507.65
$468.10
$132.98
$1,051.25
$409.01
$778.65
$136.73
$576.52
$298.58
$1,541.90
$486.06
$209.83
$1,166.75
$1,822.28

53 .

Based on my review of PDMP data, I am aware that I am aware that on 13 dates

between June 13, 2018 and June 11, 2019, Patient 2 received approximately 13 prescriptions for

23

 Case 2:19-mj-01413 Document 1 Filed 08/20/19 Page 25 of 38

controlled substances from ANAND or Former Employee. Below are a sample of dates on which
ANAND or Former Employee prescribed controlled substances to Patient 2.

Approximate Date
Prescription Written

June 13, 2018
September 11, 2018

Prescribed
Schedule II
Controlled
Substance
Oxycodone HCL 10
mg tablet
Oxycodone HCL 10
mg tablet

Quantity

Days of
Supply

MME/Per
Day

120

20

90.0MME

120

30

60.0MME

Patient 3
54.

On or about May 8, 2019, law enforcement agents interviewed Patient 3, whose

identity is known to me. Patient 3 stated that Patient 3 had IBC insurance and became a patient
of ANAND' s in or about May 201 7 for lower back pain. Patient 3 initially sought treatment at
Location 1. Beginning with the first office visit and at each subsequent appointment, Patient 3
was given a bag of medications, consisting of creams and pills such as Lidocaine and
Temazepam, among other medications, but no one ever told Patient 3 what medications were in
the bag or how the medications should be used. Upon receiving the bag of medications, Patient
3 was instructed to sign a tablet indicating that Patient 3 paid a copay for the bag of medications,
though Patient 3 did not actually pay a copay. Patient 3 sometimes used the Lidocaine, but the
other medications just accumulated and got thrown away. Patient 3 stated patients and office
staff referred to the bag of medications dispensed by ANAND as Goody Bags.
55.

Based on my review of IBC claims data, I am aware that on 17 dates between

January 20, 2016 and February 13, 2019, ANAND prescribed approximately 59 Goody Bag
medications to Patient 3 for which he was paid approximately $22,955. Below are a sample of
dates on which ANAND prescribed Goody Bags for Patient 3.

24

 Case 2:19-mj-01413 Document 1 Filed 08/20/19 Page 26 of 38

Approximate Date
Prescription Written

Medication Prescribed

Billing
Provider

Paid
Amount

April 13, 2016
April 13, 2016
April 13, 2016
April 13, 2016
May 9, 2018
May 9, 2018
May 9, 2018
May 9, 2018
May 9, 2018
June 13, 2018
June 13, 2018
June 13, 2018
June 13, 2018

Du1oxetine HCL
Cyclobenzaprine HCL
Diclofenac Sodium
Lidocaine
Indomethacin ER
Eszopiclone
Vanatol LQ
Lidocaine
Cyclobenzaprine HCL
Indomethacin ER
Eszopiclone
Vanatol LQ
Cyclobenzaprine HCL

BCSPM
BCSPM
BCSPM
BCSPM
AMI
AMI
AMI
AMI
AMI
AMI
AMI
AMI
AMI

$350.33
$480.83
$388.05
$120.04
$70.45
$503.56
$1,047.50
$558.81
$449.27
$70.45
$503.56
$1,047.50
$449.27

56.

Based on my review of IBC claims data, I am aware that on 22 dates between

January 20, 2016 and August 16, 2018, Patient 3 received approximately 22 prescriptions for
Schedule III controlled substances from ANAND. Below are a sample of dates on which
ANAND prescribed controlled substances to Patient 3.
Approximate Date
Prescription Written

Prescribed Schedule III
Controlled Substance

Quantity

Days of Supply
,

April 18, 2016
May9, 2018
June 14, 2018

Suboxone
Suboxone
Suboxone

60
60
30

30
60
30

Patient4
57.

On or about May 22, 2019, law enforcement agents interviewed Patient 4, whose

identity is known to me. Patient 4 stated that Patient 4 is emolled in Medicare and had been a
patient of ANAND's for approximately three years for back pain. Patient 4 stated that Patient 4
received prescriptions for Oxycodone and Tramadol from ANAND that Patient 4 filled at a local

25

 Case 2:19-mj-01413 Document 1 Filed 08/20/19 Page 27 of 38

pharmacy and that Patient 4 was given a bag of medications at every appointment that contained
Lidocaine Cream, Diclofenac Sodium Gel, and Temazepam, among other medications. Patient 4
signed a tablet indicating that Patient 4 paid a copay for the bag of medications, though Patient 4
was only asked to pay a copay about four or five times. At no time did ANAND, or any staff
member, explain to Patient 4 what the medications were, how to use the medications, and why
the medications were needed. Patient 4 thought the bag of medications was shady and that
ANAND prescribed the bag of medications to make money. Patient 4 could not refuse to accept
the bag of medications because then Patient 4 would not get the prescriptions for the medications
Patient 4 really needed. Patient 4 discarded most of the medications dispensed .by ANAND.
58.

Patient 4 stated that Patient 4 left ANAND's practice and obtained Patient 4's

medical records upon leaving ANAND's practice.17 Based on my review of Patient 4's medical
records, I am aware that the medical records contained entries from DrChrono with notes for
office visits on September 9, 2018 and July 23, 2018 indicating that Former Employee 2 was
Patient 4' s medical provider on these dates. Patient 4 stated that Patient 4 had never been treated
by Former Employee 2.
59.

..

Based on my review of Medicare claims data, I am aware that on 34 dates

between April 27, 2016 and February 5, 2019, ANAND prescribed approximately 95 Goody Bag
medications to Patient 4 for which he was paid approximately $41,515. Below are a sample of
dates on which ANAND prescribed Goody Bags for Patient 4.

17

Based on my review of Patient 4's Medicare prescription drug claims, Patient 4 left ANAND's
practice in approximately March 2019.

26

 Case 2:19-mj-01413 Document 1 Filed 08/20/19 Page 28 of 38

Approximate Date
Prescription
Written

Medication Prescribed

Billing
Provider

Paid Amount

November 1, 2017
November 1, 2017
November 1, 2017
November 1, 2017
November 1, 2017
November 29, 2017
November 29, 2017
November 29, 2017
November 29, 2017
November 29, 2017
November 29, 2017

Diclofenac Sodium
Temazepam
Lidocaine
Omeprazole-Sodium
Cyclobenzaprine HCL
Naproxen Sodium CR
Diclofenac Sodium
Temazepam
Fluocinonide
Lidocaine
Omeprazole-Sodium

AMI
AMI
AMI
AMI
AMI
AMI
AMI
AMI
AMI
AMI
AMI

$287.27
$160.08
$107.64
$1,877.65
$394.52
$1,184.10
$287.27
$165.20
$1,091.91
$115.13
$1,877.65

60.

Based on: my review of PDMP data, I am aware that on 33 dates between March

31, 2016 and February 5, 2019, Patient 4 received approximately 65 prescriptions for controlled
substances from ANAND or Former Employee 2. Below are a sample of dates on which
ANAND or Former Employee 2 prescribed controlled substances to Patient 4.

Approximate Date
Prescription Written

November 1, 2017
November 1, 2017
December 19, 2017
December 19, 2017

Prescribed
Schedule II
Controlled ·
Substance

Oxycodone hcl 30
mg tablet
Morphine sulf er
200 mg tablet
Morphine sulf er
200 mg tablet
Oxycodone hcl 30
mg tablet

Quantity

Days of
Supply

MME/Per
Day

120

20

270.0MME

60

30

400.0MME

60

30

400.0MME

120

20

270.0MME

Patient 5
61.

On or about June 3, 2019, law enforcement agents interviewed Patient 5, whose

identity is known to me. Patient 5 stated that Patient 5 was enrolled into Medicare and had been

27

 Case 2:19-mj-01413 Document 1 Filed 08/20/19 Page 29 of 38

a patient of ANAND's for approximately three years for neck, back, and shoulder pain. Patient 5
stopped seeking medical care from the PRACTICE in April 2019. ANAND prescribed
Oxycodone and other medications to Patient 5 that Patient 5 filled at a local pharmacy. In 2016,
Patient 5 started receiving bags of medications from ANAND ' s DISPENSARIES, which
included Lidocaine, Vanatol, and Temazepam, among other medications. KUNDI usually gave
Patient 5 the bag of medication and instructed Patient 5 to sign a tablet indicating that Patient 5
paid a copay for the bag of medications, though Patient 5 did not actually pay a copay. At no
time did ANAND, or any staff member, explain to Patient 5 what the medications were, how to
use the medications, or why the medications were needed.
62.

Patient 5 further stated that on at least two occasions Patient 5 informed ANAND

that Patient 5 did not want the bag of medications and ANAND told Patient 5 that if Patient 5 did
not accept the dispensed medications, Patient 5 would not receive a prescription for Oxycodone.
Patient 5 usually discarded the bag of medications. Patient 5 provided law enforcement with two
unopened bottles ofMetaxalon (800mg/100 tablets), one unopened bottle of Temazepam
(22.5mg/30tablets), one unopened bottle of Celecoxib (200mg/60 tablets), two unopened bottles
ofNalfon (400mg), six unopened tubes ofDiclofenac Sodium, and nine unopened tubes of
Lidocaine Cream. All the medications were labeled Institute of Advanced Medicine and Surgery,
Dr. Neil Anand, MD, 5735 Ridge Avenue, Philadelphia, PA 19128.
63 .

ANAND told Patient 5 to use different insurance providers every month for his

prescriptions, which included Express Scripts and Envision. ANAND instructed Patient 5 to
write a letter, falsely indicating that Patient 5 wanted, needed, and utilized the medications
dispensed by ANAND ' s office that ANAND would submit to Patient S' s insurance provider.
ANAND informed Patient 5 that if Patient 5 did not provide this letter, Patient 5 would not

28

 Case 2:19-mj-01413 Document 1 Filed 08/20/19 Page 30 of 38

receive prescriptions for Oxycodone.
64.

Based on my review of Medicare claims data, I am aware that on 36 dates

between November 23, 2015 and April 1, 2019, ANAND prescribed approximately 139 Goody
Bag medications to Patient 5 for which he was paid approximately $69,938. Below are a sample
of dates on which ANAND prescribed Goody Bags for Patient 5.
Approximate Date
Prescription Written

Medication Prescribed

Billing Provider

Paid Amount

July 28, 2017
July 28, 2017
July 28, 2017
July 28, 2017
July 28, 2017
July 28, 2017
July 28, 2017
July 28, 2017
July 28, 2017
October 20, 2017
October 20, 2017
October 20, 2017
October 20, 2017
October 20, 2017
November 13, 2017
November 13, 2017
November 13, 2017
November 13, 2017
November 13, 2017

Lidocaine
Allzital
Naproxen Sodium CR
Diclofenac Sodium
Vanatol LQ
Temazepam
Omeprazole/Sodium
Cyclobenzaprine
Nalfon
Vanatol S
Lidocaine
Omeprazole/Sodium
Cyclobenzaprine
Fenoprofen Calcium
Vanatol S
Lidocaine
Omeprazole/Sodium
Cyclobenzaprine
Nalfon

IAMS
IAMS
IAMS
IAMS
IAMS
IAMS
IAMS
IAMS
IAMS
IAMS
IAMS
IAMS
IAMS
IAMS
IAMS
IAMS
IAMS
IAMS
IAMS

$200.25
$1,205.66
$1,036.59
$340.17
$1,170.00
$106.09
$467.49
$344.52
$406.94
$3,207.93
$191.93
$360.38
$343.01
$288.48
$3,207.93
$173.58
$358.18
$345.44
$406.94

65.

Based on my review of PDMP data, I am aware that I am aware that on 43 dates

between November 23, 2015 and April 29, 2019, Patient 5 received approximately 83
prescriptions for controlled substances from ANAND or Former Employee 2. Below are a
sample of dates on which ANAND or Former Employee 2 prescribed controlled substances to
Patient 5.

29

 Case 2:19-mj-01413 Document 1 Filed 08/20/19 Page 31 of 38

Approximate Date
Prescription Written

July 28, 2017
July 28, 2017
October 20, 2017
October 20, 2017
November 13, 2017
November 13, 2017

Prescribed
Schedule II
Controlled
Substance
Fentanyl 100
mcg/hr patch
Oxycodone hcl 30
mg tablet
Fentanyl 100
mcg/hr patch
Oxycodone hcl 30
mg tablet
Fentanyl 100
mcg/hr patch
Oxycodone hcl 30
mg tablet

Quantity

Days of
Supply

MME/Per
Day

10

30

240.0MME

120

30

180.0MME

10

30

240.0MME

120

20

270.0MME

10

30

240.0MME

120

20

270.0MME

Patient 6
66.

On or about June 6, 2019, law enforcement agents interviewed Patient 6. Patient 6

has been seeing ANAND for pain management for approximately six or seven years. Patient 6
sees ANAND for a work-related injury sustained in 2004 while employed at the School District
of Philadelphia. Patient 6 stated that all services provided by ANAND and medications
prescribed by ANAND should have been billed to the School District of Philadelphia worker's
compensation program. Patient 6 enrolled in Medicare in about 2003.
67.

According to Patient 6, Patient 6 receives paper prescriptions from ANAND for

Percocet 30mg and OxyContin 40mg and that ANAND also prescribes Lidocaine cream, a sleep
medication, and muscle relaxers which are dispensed out of ANAND's in-house pharmacy.
Patient 6 told ANAND that all services provided by ANAND and medications prescribed by
ANAND should be billed to the School District of Philadelphia worker's compensation program.
Patient 6 stated the medications from ANAND's in-house pharmacy were automatically
dispensed.

30

 Case 2:19-mj-01413 Document 1 Filed 08/20/19 Page 32 of 38

68.

Based on my review of Medicare claims data, I am aware that on 27 dates

between September 26, 2016 and May 21, 2019, ANAND prescribed approximately 80 Goody
Bag medications to Patient 6 for which he was paid approximately $39,495. Below are a sample
of dates on which ANAND prescribed Goody Bags for Patient 6.
Approximate Date
Prescription Written

Medication Prescribed

Billing Provider

Paid Amount

October 24, 2016
October 24, 2016
October 24, 2016
October 24, 2016
July 18, 2017
July 18, 2017
July 18, 2017
July 18, 2017
August 1, 2017
August 1, 2017
August 15, 2017
August 15, 2017
August 15, 2017

Diclofenac Sodium
Temazepam
Lidocaine
Cyclobenzaprine
Calcipotriene
Naproxen Sodium CR
Teinazepam
Omeprazole/Sodium
Fluocinonide
Cyclobenzaprine
Calcipotriene
Naproxen Sodium CR
Omeprazole/Sodium

IAMS
IAMS
IAMS
IAMS
AMI
AMI
AMI
AMI
AMI
AMI
AMI

$822.47
$536.12
$2,353.62
$857.52
$332.05
$1,184.10
$160.08
$1,877.65
$908.92
$320.63
$332.05
$1,184.10
$1,877.65

69.

AMI
AMI

Based on my review of PDMP data, I am aware that I am aware that on 42 dates

between December 24, 2015 and July 17, 2019, Patient 6 received approximately 84
prescriptions for controlled substances from ANAND or Former Employee 2. Below are a
sample of dates on which ANAND or Former Employee 2 prescribed controlled substances to
Patient 6.

Approximate Date
Prescription Written

July 18, 2017

Prescribed
Schedule II
Controlled
Substance

Quantity

Oxycodone HCL
ER 40 mg tablet

60

31

Days of
Supply

30

MME/Per
Day

120.0MME

 Case 2:19-mj-01413 Document 1 Filed 08/20/19 Page 33 of 38

July 18, 2017
August 15, 2017
August 15, 2017

Oxycodone HCL 20
mg tablet
Oxycodone HCL 20
mg tablet
Oxycodone HCL
ER 40 mg tablet

120

20

180.0MME

120

20

180.0MME

60

30

120.0MME

Patient 7
70.

On or about October 25, 2018, law enforcement agents interviewed Patient 7,

whose identity is known to me. Patient 7 stated that Patient 7 had been a patient of ANAND's
for over three years and was treated at Location 1 and Location 2 for lower back pain resulting
from a motor vehicle accident. ANAND prescribes several medications for Patient 7, including
oxycodone. In about August 2018, Patient 7 enrolled in IBC at which time ANAND began
giving Patient 7 a bag of medications at each office visit, that included Lidocaine Cream,
Vanatol, Temazepam, Allzital, Metaxalone, and Diclofenac Sodium Gel. KUNDI was usually
the person who handed Patient 7 the bag of medications. At one visit, Patient 7 tried to reject the
bag of medications and was told by office staff that Patient 7 should just take the bag because the
insurance company covered the cost of medications. At no time did ANAND, or any staff
member, explain to Patient 7 what the medications were, how to use the medications, and why
the medications were needed. Patient 7 never paid a copay for the medications. Patient 7 gave
agents unused medications, including three unopened bottles of Allzital (25mg/100 tablets), two
unopened bottle of Metaxalone (800mg/ 100 tablets), and one unopened tube of Diclofenac
Sodium Gel. All the medications were labeled AMI Pharmacy, Neil Anand MD, 5000 Frankford
Avenue, Philadelphia, PA 19124.
71.

On or about November 6, 2018, at the direction of law enforcement, Patient 7

recorded Patient 7's appointment at LOCATION '1. Based upon my review of the recording, I am

32

 Case 2:19-mj-01413 Document 1 Filed 08/20/19 Page 34 of 38

aware that Patient 7 was seen by Former Employee 1 and that during the office visit, KUNDI and
Former Employee 2 entered the exam room. KUNDI handed Patient 7 a plastic bag and referred
to it as a Goody Bag. Patient 7 stated that Patient 7 was overstocked on the medications and
KUNDI replied that Patient 7 should take the Goody Bag because the insurance was already run
and ANAND would be mad if Patient 7 did not take the bag. Former Employee 1 told Patient 7
to donate the medications that Patient 7 does not need. KUNDI instructed Patient 7 to sign a
tablet. Former Employee 1 told Former Employee 2 that he needed two prescriptions, Former
Employee 2 gave Former Employee 1 two pre-signed blank prescriptions and Former Employee
1 filled out for Oxycodone and provided the prescriptions to Patient 7. Patient 7 gave the goody
bag to law enforcement. Based upon my review of the contents of the goody bag, I am aware
that the goody bag contained numerous prescription medications that were dispensed by AMI
including Metaxalone, Omeprazole/Sodium Bicarbonate, Allzital, V anatol, and Temazepam.
72.

18

On or about December 4, 2018, at the direction oflaw enforcement, Patient 7

recorded Patient 7's appointment at LOCATION 1. Based upon my review of the recording, I am
aware that Patient 7 was seen by MALIK. During the appointment, MALIK exited the exam
room and KUNDI entered the exam room and handed a Goody Bag to Patient 7 that contained
V anatol, Diclofenac Sodium, Allzital, and Metaxalone dispensed by AMI. Patient 7 told KUNDI
that Patient 7 did not the medications, to which KUNDI replied that he will stop giving them to
Patient 7 next time until Patient 7 finishes the medications. KUNDI instructed Patient 7 to sign a
tablet to document the payment of a copay, but Patient 7 did not actually pay a copay. MALIK

18

At this time we do not have claims data for Patient 7 for the Goody Bags. We are waiting on
records from Geico that should contain claim information.

33

 Case 2:19-mj-01413 Document 1 Filed 08/20/19 Page 35 of 38

returned to the exam room and wanted to give Patient 7 an injection. Patient 7 resisted the
injection and MALIK ultimately stated that Patient 7 would have to get the injection next time
otherwise it would be a problem with authorization for the medications. Former Employee 2
entered the room and asks about the injections. MALIK explains how they have to give
injections, therapy and medications. MALIK told Former Employee 2 that he needed four
prescriptions, Former Employee 2 handed MALIK four pre-signed blank prescriptions and
MALIK filled in the prescriptions, including one for Oxycodone, and gave them to Patient 7.
73.

Based on my review of the PDMP data, below is a summary of prescriptions for

Schedule II controlled substances that ANAND or Former Employee 2 prescribed for Patient 7. I
am aware that on 28 dates, ANAND or MAKAROV A prescribed morphine and/or oxycodone to
Patient 7 and the average MME/day was approximately 160. On 22 of those dates, the
prescriptions were for Morphine ER 30 mg tablets and Oxycodone HCL 15 mg tablets.

Approximate Date
Prescription Written

August 14, 2018
August 14, 2018
November 6, 2018
November 6, 2018
December 4, 2018
December 4, 2018

Prescribed
Schedule II
Controlled
Substance

Quantity

Morphine sulf ER
30 mg tablet
Oxycodone HCL 15
mg tablet
Morphine sulf ER
30 mg tablet
Oxycodone HCL 15
mg tablet
Oxycodone HCL 15
mg tablet
Morphine sulf er 3 0
mg tablet

34

Days of
Supply

MME/Per
Day

60

30

60.0MME

120

30

90.0MME

60

30

60.0MME

120

20

135.0 MME

120

30

90.0MME

60

30

60.0MME

 Case 2:19-mj-01413 Document 1 Filed 08/20/19 Page 36 of 38

74.

Based upon my review of ANAND's foreign travel history and border crossings, I

am aware that ANAND was out of the United States from August 26, 2015 and September 8,
2015, September 2., 2016, and September 18, 2016 and March 9, 2017 and March 25, 2017.
Based upon my review of PDMP data and claims data from IBC and Medicare, I am aware that
ANAND submitted claims for Goody Bags and purportedly wrote prescriptions for controlled
substances while he was not in the United States. Specifically, the PDMP data revealed 31
Schedule II controlled substance prescriptions in ANAND's name; Medicare data revealed that
ANAND purportedly wrote a total of 67 Goody Bag prescriptions and was paid approximately
$25,494; and IBC data revealed that ANAND prescribed approximately 15 Goody Bag
medications and was paid approximately $13,401.
75.

Between November 1, 2015 and July 17, 2019, ANAND was paid a total of

approximately $4,080,167 by Medicare, OPM, and IBC for medically unnecessary Goody Bag
medications. Below is a chart demonstrating the approximate amount paid by each health
insurance benefit program: 19
Health Insurance

Amount Paid

Medicare

$1,813,425

OPM

$11,655

IBC

$2,255,267

19

As stated earlier, the DISPENSARIES were not enrolled in OWCP. ANAND has billed
OWCP approximately $27,387 for services and was paid approximately $12,254. OWCP claims
data does not include the name of the prescribing physician. Based upon a review of patient
charts seized pursuant to the order requested in this application, we would be able to determine
what medications ANAND prescribed to the OWCP claimants.

35

 Case 2:19-mj-01413 Document 1 Filed 08/20/19 Page 37 of 38

VI.

INFORMATION TO BE SEARCHED AND THINGS TO BE SEIZED
76.

I anticipate executing this warrant under the Electronic Communications Privacy

Act, in particular 18 U.S.C. §§ 2703(a), 2703(b)(l)(A) and 2703(c)(l)(A), by using the warrant
to require DrChroiio to disclose to the government copies of electronic medicalrecords
maintained under Anand's account, and other information particularly described in Section I of
Attachment B. Upon receipt of the information described in Section I of Attachment B,
government-authorized persons will review that information to locate the items described in
Section II of Attachment B.

VII.

CONCLUSION
77.

Based on the foregoing, there is probable cause to believe that the Subject

Premises contains the items set forth in Attachment B, which constitute evidence, contraband,
and/or instrumentalities of the violations of Title 18, United States Code, § 3 71 (conspiracy to
defraud the United States), Title 18, United States Code, § 1343 (wire fraud); Title 18, United
. States Code, § 134 7 (health care fraud); Title 18, United States Code, § 1349 (conspiracy to
commit health care fraud and wire fraud), and Title 21, United States Code§§ 841(a)(l) and 846
(conspiracy to distribute controlled substances), among other statutes.
78.

Based on the information contained herein, as well as Affiant's training and

experience, Affiant believes there is probable cause to believe that ANAND has submitted or
caused the submission of false and fraudulent claims to Medicare, OPM, OWCP, and IBC for the
provision of medically unnecessary prescription medications. Further, there is probable cause to
believe that ANAND knowingly and intentionally distributed a controlled substance outside the
usual course of professional practice and not for a legitimate medical purpose. Based on the
information listed above, as well as Affiant's training and experience, there is probable cause to

36

 Case 2:19-mj-01413 Document 1 Filed 08/20/19 Page 38 of 38

believe that there exists at the Subject Premises in Attachment A, items described in Attachment
B which will constitute evidence of such crimes.
79.

Based on the forgoing, I request that the Court issue the proposed search warrant.

80.

Pursuant to 18 U.S.C. § 2703(g), the presence of a law enforcement officer is not

required for the service or execution of this warrant.

VIII. REQUEST FOR SEALING
81 .

I respectfully request that this Court issue an order sealing, until further order of

the Court, all papers submitted in support of this application, including the application and search
warrant. These documents discuss an ongoing criminal investigation that is neither public nor
known to the targets of the investigation. Premature disclosure of the contents of this affidavit
and related documents may have a significant and negative impact on the continuing
investigation and may severely jeopardize its effectiveness. Accordingly, there is good cause to
seal these documents.

ecial Agent
Federal Bureau Of Investigation

Subscribed and sworn to before me on August

~ 2019

OJ- ~~
UNITED S T A T E ~ ! ~

37