Ludlow Doctor Pleads Guilty in Connection With Illegally Prescribing Opioids to At-risk Patients
Doctor Prescribed Powerful Painkillers to Patients with Documented Substance Use Disorder; Fraudulently Billed MassHealth
SPRINGFIELD – A Ludlow physician has pleaded guilty to illegally prescribing opioids to patients for no legitimate medical purpose, some of whom had documented substance use disorder, and for defrauding the state’s Medicaid program (MassHealth), Attorney General Maura Healey announced today.
Dr. Fernando Jayma, age 74, a solo practitioner of general medicine in Ludlow, pleaded guilty yesterday in Hampden Superior Court before Judge Edward J. McDonough, Jr. to charges of Illegal Prescribing of Controlled Substances (22 counts), Medicaid False Claims (18 counts), and Larceny over $250 (1 count). He will be sentenced on May 16, 2017.
Dr. Jayma was indicted in November 2015 following an investigation by the AG’s Office after the matter was referred by MassHealth. In state fiscal year 2013, Dr. Jayma was the second highest MassHealth prescriber of schedule II opioids.
The investigation revealed that in multiple instances, Dr. Jayma prescribed opioids, including oxycodone, morphine, methadone and fentanyl, to patients for no legitimate medical purpose. Dr. Jayma prescribed the drugs, which have a high potential for abuse, to some patients despite their documented substance abuse. The illegal prescriptions Dr. Jayma wrote caused pharmacies to unwittingly falsely bill MassHealth for the medication.
In several instances, while patients’ urine drug screens were negative for prescribed opioids, Dr. Jayma continued to prescribe opioids to those patients even though they tested positive for heroin or other non-prescribed opioids.
Dr. Jayma also continued to prescribe fentanyl and oxycodone to a patient who in the recent past was determined to have overdosed on fentanyl.
In addition to the illegal prescribing, Dr. Jayma arranged for another doctor to see his patients when he was out of the country and directed his office staff to bill MassHealth as if Dr. Jayma were treating those patients. The other doctor was not credentialed with MassHealth, and MassHealth would not have paid the claims if it knew that he, and not Dr. Jayma, had provided the services.
At the time of Dr. Jayma’s indictment, the AG’s Office worked with the Department of Public Health, the Board of Registration in Medicine, and local health officials to ensure that patients of Dr. Jayma were referred for proper care and treatment by other medical professionals.
This case is just one way Attorney General Healey is working to address the opioid epidemic in Massachusetts. The AG’s Office is looking at a host of other practices, from marketing by pharmaceutical companies, to pill diversion and drug trafficking by criminal entities, to coverage for substance abuse treatment by insurance companies. The AG’s Office also continues to work on solutions that include eliminating barriers to treatment and supporting prevention and education initiatives across the state.
This case was prosecuted by Assistant Attorney General Steven Hoffman, Deputy Division Chief of the AG’s Medicaid Fraud Division, and Assistant Attorney General Alexandra Brazier, and was investigated by Medicaid Fraud Division Investigators Chris Cecchini and Nan Browne. The AG’s Office would like to acknowledge the assistance of the following: Ludlow Police Department, MassHealth, Massachusetts Office of Inspector General, Hampden County District Attorney’s Office, United States Department of Health and Human Services, and DEA New England Field Division.