US government sues Alabama psychiatrist for improper prescriptions to nursing home residents

Published 7:04 am Saturday, February 5, 2022

A psychiatrist, who has worked in several Alabama nursing homes, has been sued by the federal government for millions of dollars in fraudulent Medicare and Medicaid claims involving the improper prescriptions of the drug Nuedexta.

On Friday, U.S. Attorney Prim F. Escalona announced that the United States has filed suit against Dr. Charles T. Nevels, a psychiatrist who has worked in several nursing homes in Alabama. The complaint alleges that Dr. Nevels caused the submission to Medicare and Medicaid of false and fraudulent claims for the prescription drug Nuedexta, which is indicated only for the treatment of pseudobulbar affect (PBA), a condition characterized by involuntary laughing or crying.  Nuedexta has not been shown to be safe and effective in non-PBA types of emotional lability that can commonly occur, for example, in Alzheimer’s disease and other dementia.

The complaint alleges that from 2015 through 2019, the pharmaceutical company that manufactures Nuedexta paid Dr. Nevels more than $400,000 to make speeches, but the speeches had few attendees, little value, and were intended to compensate Dr. Nevels for prescribing Nuedexta.  For instance, in November 2016the pharmaceutical company paid Dr. Nevels a $2,000 speaker fee to give a presentation in Decatur, Alabama, that the company’s records show had no attendees.

“The Department of Justice will fight to protect nursing home residents, including by ensuring that prescribing decisions affecting them are free from undue influence, and the medications they receive are medically appropriate for them,” said U.S Attorney Escalona.

The complaint further alleges that the pharmaceutical company also paid Dr. Nevels for the expenses he claimed related to the presentations he gave.  For instance, in addition to the speaker fee he received for each presentation,  the pharmaceutical company paid Dr. Nevels over $1,500 for claimed expenses associated with a presentation at The Arrogant Butcher in Phoenix, Arizona, and over $1,200 for claimed expenses associated with a presentation at the Gamlin Whiskey House in St. Louis, Missouri.

Additionally, the complaint alleges, with Dr. Nevels’ assent, the pharmaceutical company’s sales representative visited nursing homes where Dr. Nevels worked and sought to convince nurses there to refer patients to Dr. Nevels, to help  him “build [his] base of business.”  In return, Dr. Nevels prescribed Nuedexta to nursing home residents who did not have pseudobulbar affect.  In 2015, Dr. Nevels accounted for more than half of all Medicare claims for Neudexta in Alabama, and between 2015 and 2019, he caused more than $6 million in Medicare claims and $800,000 in Medicaid claims for the drug.

The allegations of the complaint are allegations only, and there has been no determination of liability.