Pubdate: Tue, 08 Apr 2003
Source: Lexington Herald-Leader (KY)
Copyright: 2003 Lexington Herald-Leader
Contact:  http://www.kentucky.com/mld/heraldleader/
Details: http://www.mapinc.org/media/240
Author: Bill Estep, South-Central Kentucky Bureau

DOCTOR GUILTY OF DRUG COUNT

Jury Acquits On Fraud, Money Laundering

LONDON -- A doctor at a Paintsville clinic conspired to illegally prescribe 
hundreds of thousands of pills that fed drug abuse in Eastern Kentucky, a 
federal jury ruled yesterday.

Jurors deliberated more than seven hours before convicting Yakov Drabovskiy 
on one count of conspiracy to illegally distribute prescription drugs and 
two counts of writing prescriptions without legitimate medical reason. The 
jury acquitted Drabovskiy of one count involving money laundering and one 
count of Medicaid fraud.

Drabovskiy faces up to 20 years in prison. U.S. District Judge Karen 
Caldwell scheduled sentencing for Oct. 23.

Drabovskiy was among a number of Eastern Kentucky doctors arrested the last 
two years as state and federal authorities tried to crack down on improper 
prescribing by doctors -- one source of legal drugs being diverted for 
illegal sale and use.

With the verdict against Drabovskiy, five doctors who practiced in the 
region have been convicted or pleaded guilty. Three others still face charges.

Drabovskiy worked for Dr. Frederick Cohn at a pain clinic Cohn opened in 
Paintsville in August 2000. The clinic quickly gained a reputation as a 
"pill mill" where it was easy to get drugs.

People flocked to the office -- among them drug addicts and dealers -- 
lining the sidewalk outside at times, according to trial testimony. There 
were 10,000 patient files on hand when the state police and FBI raided the 
office Aug. 2, 2001, and shut it down.

Cohn, 70, of Albuquerque, N.M., pleaded guilty in February and is awaiting 
sentencing.

In closing arguments yesterday, Assistant U.S. Attorney Roger West told 
jurors that Cohn and Drabovskiy operated a shoddy practice aimed at making 
money by churning out prescriptions with little or no examination of the 
patients.

Tim Johnson, the FBI agent who investigated the case, testified that the 
two doctors saw a total of more than 200 patients one day in February 2001. 
But Drabovskiy also worked alone some days when Cohn was gone, and saw 
nearly 120 patients by himself on one occasion, according to Johnson's review.

Johnson said that in many cases, there was no blood pressure or other vital 
signs recorded in patient files. The diagnosis listed in hundreds of files 
was basically the same, and the treatment plan was similar despite the 
complaint, Johnson testified.

Many patients got a standard "Cohn cocktail" of Lorcet, Soma and either 
Xanax or Valium -- a painkiller, a muscle relaxer and an antidepressant -- 
according to testimony.

The high volume meant the doctors spent little time with some patients -- 
often three minutes or less. In one case, an undercover informant who saw 
Drabovskiy emerged with a prescription in 70 seconds, West said.

To save time, Cohn and Drabovskiy used prescriptions that office employees 
had written out before the patients arrived for office visits, so that all 
the doctors had to do was sign the slip.

"They didn't even come close to meeting minimal standards of care," West 
said. "It wasn't legitimate medical practice."

Altogether, the two doctors wrote prescriptions for 6.9 million pills in 
one year. The practice grossed $1.8 million, West said.

The clinic billed Medicaid for more than 300 patients Drabovskiy saw, even 
though he did not have the necessary clearance to charge for seeing 
Medicaid patients, Johnson said.

Drabovskiy, however, adamantly denied doing anything wrong. Drabovskiy, a 
Russian in his early 50s who said he came to the United States for work, 
represented himself with the help of interpreters and Steve Milner of 
Lexington, his advisory attorney.

Drabovskiy said it wasn't the prosecutor's job to judge how long a doctor 
should see a patient, and said he prescribed drugs because he thought 
patients needed them. It is legitimate to use drugs to treat pain; some 
doctors advocate using even more than he and Cohn prescribed, he said.

Drabovskiy said others in the office handled billing for Medicaid, and that 
he could not refuse to see those patients. And he said he did not agree 
with Cohn to break the law, describing himself only as an employee.

Cohn told him the mix of prescriptions to write, Drabovskiy said.

"A boss is a boss, and so that was his instructions," Drabovskiy said. "I 
do not understand why the guilt of one person is being transferred onto me."

West, however, said Drabovskiy was blaming others for his own improper acts.

After the verdict, West asked Caldwell to revoke the doctor's bond and 
order him held until sentencing.

Caldwell, however, allowed Drabovskiy to remain free, noting there is 
little risk he would flee because he has turned in his green card and passport.
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