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tentially illegal prescribing of pain medi- cations and controlled substances. Any- one can file a confidential complaint on the TMB website, www.tmb.state.tx.us/ consumers/complain/complain.php, by filling out a short form. In addition, she says, media coverage or contact from the Texas Department of Public Safety (DPS) or other law en- forcement agencies can alert the board to possible criminal activity. Board rules stipulate that unless it would jeopardize an ongoing investigation, TMB will give at least five business days notice before an on-site investigation. In addition to inspecting a pain management clinic, TMB rules authorize the board to ex- amine a physician’s documents, such as medical records. TMB has conducted education and


outreach for physicians related to the pain management clinic regulations. Ms. Robinson says the board has included in- formation about the rules on its website, www.tmb.state.tx.us, and in its bulletin. Ms. Robinson also spoke at a pain medicine continuing medical education (CME) seminar hosted by the Texas Pain Society at TexMed 2011 in Houston. The seminar, “Pain Clinic or Pill Mill — What’s the Difference?” informed attend- ees about the rules and updated them on what the board is doing to stop the illegal flow of prescription drugs and save lives.


Houston hot spot


All of the 11 pain clinic certificates TMB had suspended at press time were in the Houston area. On Jan. 11, a TMB disciplinary panel temporarily suspended the pain man- agement clinic certificate of Houston’s Spring Wellness Center, barring it from operating until further notice, after de- termining it was a continuing threat to the public. The board found the clinic violated state law requiring it to be owned and operated by a medical director who is a physician practicing in Texas with an unrestricted license; requiring the owner of the clinic to be on site at least 33 per- cent of the clinic’s operating hours; and requiring physician assistants to be su- pervised by a physician.


44 TEXAS MEDICINE July 2011


TMB investigators and DEA agents inspected the clinic. They learned it is owned and managed by Jillian S. Gra- ham and Derrick Z. Goodwill, both li- censed Texas physician assistants, even though the pain management certificate had been issued to Jesus Caquias, MD, of Brownsville, in 2010. But, according to Mr. Goodwill and the evidence, Dr. Caquias does not own and has never vis- ited the clinic. In February, the medical board en-


tered a final order for the voluntary and permanent surrender of Dr. Caquias’ cer- tificate for the clinic. This was TMB’s second enforcement action against a pain clinic. The first order came in October 2010 when the board temporarily suspended the medical license of David Shin, MD, and temporarily suspended the pain management clinic certificate of Better Life Pain Clinic LLC in Houston. On Oct. 26, 2010, the clinic resumed operating with a suspended pain man- agement certificate until DEA officers searched it on Nov. 4. An investigation by a Harris County Sheriff’s and the DEA Task Force revealed employees who weren’t licensed physicians, physician assistants, or advanced practice nurses had been administering prescriptions for controlled substances to patients. On Nov. 19, Dr. Shin was indicted in Harris County on a felony count of engaging in organized criminal activ- ity. On Dec. 7, a TMB disciplinary panel suspended Dr. Shin’s medical license and his pain management clinic certificate. Since then, the board has continued cracking down on pill mill activity. In February, it temporarily suspended the certificates of four clinics, three in Hous- ton and one in The Highlands, barring them from operating until further notice. On Aug. 20, 2010, TMB had issued


four pain management clinic certificates to Akili Graham, MD, as owner and op- erator of the clinics. However, on Jan. 6, 2011, during an investigation of pre- scribing habits at the clinics, board staff obtained information that neither Dr. Graham nor any other physician owned the clinics.


The clinics investigated were:


• Imed Clinic Inc., in Houston, owned by Danny A. Muhammad, a nonphysi- cian;


• Preferred Medical Clinic in Houston, owned by Durce Muhammad, a non- physician;


• The Oaks Medical Clinic Inc., in The Highlands, owned by Danny A. Mu- hammad; and


• UMAT Clinic, LLC, in Houston, owned by Tamu Muhammad, a nonphysician.


TMB said the clinics were prescribing


large amounts of dangerous drugs and controlled substances and were a threat to the public.


April was also a busy month for the


board. On April 15, TMB temporar- ily suspended without notice the Texas medical license of Rosemary Ann Stogre, MD, as well as the two pain manage- ment certificates she held for two clin- ics: South Houston Treatment Center, LLC, in Webster, and Alliance Treatment Center LLC, in Houston.


DEA and TMB investigators visited


Dr. Stogre in her office at South Houston Treatment Center the previous month to discuss reports of nontherapeutic pre- scribing and pill mill-type activities. Dr. Stogre voluntarily surrendered her DEA and DPS controlled substance privileges, barring her from prescribing them in Texas. According to TMB, pharmacy re- cords showed, however, that Dr. Stogre continued to prescribe controlled sub- stances to several patients after March 1. On April 25, the board temporarily suspended the medical license of Victo- ria physician Uma Rani Gullapalli, MD, and certificates for two Houston pain management clinics that had been is- sued to her for Winrock Medical Clinic and Houston Pain & Rehabilitation Clin- ic after determining a physician did not own them. According to TMB, Dr. Gullapalli ad- mitted someone else owns the clinic and pays her $20,000 a month with a bonus of $5,000 “if business has been good.” Dr. Gullapalli said she saw patients for their initial visit only. TMB discovered the clinic em-


ployed two unlicensed foreign medical graduates who examined patients and wrote prescriptions, which Dr. Gulla-


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