NJ doc disciplined for prescription scam

He never met Mass. patients, usually didn’t even talk to them

A correction has been added to this story.

THE STATE BOARD OF REGISTRATION in Medicine has disciplined a New Jersey-based physician for prescribing prescription drugs over the internet without ever having examined his patients.

The physician, 64-year-old Robi Rosenfeld, was part of a network set up to market pain creams, according to a consent order signed by Rosenfeld. A company called 24 Hour Physicians somehow lined up the patients experiencing pain, for which the doctor would prescribe a cream developed by pharmacies working with the firm.

24 Hour Physicians would create a history for each patient and then forward that to Rosenfeld, who would write a prescription, often without having any direct contact with the patient. Rosenfeld, an osteopath who is board-certified in family medicine, said he talked to a few patients by phone from his home office in New Jersey.

Rosenfeld received $30 for each prescription. The consent order estimates he wrote prescriptions for about 860 patients (80 of whom lived in Massachusetts), making $26,000 over a 10-month period.

Blue Cross Blue Shield of Massachusetts became suspicious and eventually blew the whistle on Rosenfeld in early 2016 after paying for the prescription creams he prescribed without receiving any requests from him for payment for the medical services he rendered.

The Board of Registration in Medicine signed a consent order with Rosenfeld in April 2018 and completed a probation agreement on February 28, 2019. A press release announcing the actions went out this month.

Jennifer Stewart, senior director of fraud investigation and prevention for Blue Cross of Massachusetts, said the company has received “numerous complaints” from members who received unwanted topical medications. She said the medications “have been ordered and dispensed as part of a large, nationwide health care fraud scheme.”

Bruce Nash, the chief physician executive at Blue Cross of Massachusetts, said topical medications, particularly those obtained over the internet, can be dangerous. “The ingredients in creams and other topical medications are absorbed into the body and can create serious health problems, just like any drug taken by mouth,” he said.

Rosenfeld told a board investigator that he had no knowledge of how 24 Hour Physicians obtained its patients.  Blue Cross, in the complaint it filed with the board, said the names of the prospective patients may have been captured from social networking websites. It’s also possible the patients contacted 24 Hour Physicians directly for help dealing with their pain.

Rosenfeld also told the investigator that he did not have any knowledge of whether personnel from 24 Hour Physicians who called the prospective patients had any medical credentials nor how the intake interviews, if any, were conducted.

Rosenfeld and 24 Hour Physicians, based in Florida, could not be reached for comment. [Due to an editor’s error, an earlier version of this story incorrectly said 24 Hour Physicians was based in Texas.]

Initially, the medical board indefinitely suspended Rosenfeld’s license to practice medicine in Massachusetts on the basis of his failure to take medical histories of the patients, to perform physical examinations, and to create and maintain medical records. The board subsequently stayed Rosenfeld’s suspension after he agreed to a probation agreement that allows him to continue practicing medicine as long as he agrees to have a worksite monitor.

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Rosenfeld must also complete 15 credits of continuing education relevant to his offense and must pay all of the probation expenses.  He is also required to provide copies of the consent order and probation agreement to various entities, including any facilities where he practices medicine and the medical boards of other states where he is licensed.

Jack Resneck, the chairman of the board of the American Medical Association, said that interacting with patients using internet technology can greatly enhance the quality of care.  “But the basics remain the same,” said Resneck, who is a dermatologist. “There needs to be a legitimate patient-physician relationship in place.”