Paintsville doctor granted trial continuance
By TONY FYFFE
BSN Editor
PIKEVILLE — The trial of a Paintsville doctor charged with fraud and drug offenses has been continued until next year.
Dr. Loey Kousa was scheduled to stand trial July 13 in U.S. District Court at Pikeville, but Judge Robert E. Wier on Friday granted a request by Kousa to delay the proceedings.
Wier rescheduled the trial for Feb. 8, 2023, in federal court in Pikeville, although he said he may, as the trial nears, “evaluate moving the case to London, but will give parties an opportunity to weigh in on that issue.”
Kousa’s attorney, Ronald W. Chapman of Troy, Mich., requested the trial continuance in a motion filed June 13, saying he had received “hundreds of documents that must be properly reviewed.”
Wier agreed.
“The Court, familiar with cases of this nature, recognizes how additional time would allow the parties to properly prepare for trial and assess the tremendous discovery record,” Wier said in his order. “The particulars here, including complexity, discovery scope, and potential experts, coalesce to justify the additional time.”
Chapman also said that he was involved in another federal criminal trial that is expected to last until late June.
Kousa was indicted in April on five counts of unlawful distribution of a controlled substance, two counts of health care fraud and two counts of false statements relating to health care matters.
According to the indictment, Kousa wrote “controlled substance prescriptions for opioids, like hydrocodone and tramadol, to patients at East Kentucky Clinic who had no legitimate need for controlled substance prescriptions in order to have continued access to these patients whose purported treatment was paid in part by health care benefit programs, including Medicare and Medicaid.”
Kousa also “generally required patients to come to his clinic on a monthly, biweekly, or more frequent basis.”
“Patients sometimes waited for hours to see Kousa but had interactions with Kousa that lasted only a few minutes and sometimes only a few seconds,” the indictment says. “These patient interactions with Kousa included minimal or no substantive medical evaluation of the patient.”
During the visits, Kousa required patients to receive unnecessary medical services, such as electrocardiograms, and billed Medicare and Medicaid for those services, the indictment says.
Kousa is also charged with creating false medical records for patients “to make it appear that he had performed services that would justify his prescribing and billing.”
In addition, Kousa submitted or caused the submission of claims for upcoded office visits for established and new patients “falsely representing the level of visit, duration of the visit and medical decision-making used during the visit, in order to receive higher reimbursement from the health care benefit programs than what he was entitled to receive,” according to the indictment.
The alleged scheme occurred between Jan. 1, 2016, and February of this year, according to the indictment.
In addition, Kousa distributed and dispensed tramadol and hydrocodone without a legitimate medical purpose to a patient on five occasions in 2021, the indictment says.
The indictment also seeks the forfeiture of Kousa’s medical license, Drug Enforcement Administration registration, a money judgment in the amount of the gross proceeds obtained by Kousa as a result of the alleged violations and any property that constitutes or is derived from gross proceeds traceable to the commission of the alleged offenses.