Health Care Fraud: Attention Deficit Disorder

The Honorable Janet Reno

Attorney General

U.S. Department of Justice

Main Justice Building, Room 5111

10^th and Constitution Avenue

Washington, DC 20530

Dear Attorney General Reno:

I am a career federal law enforcement officer and postal inspector who has spent most of his 26 years investigating white-collar crime, including health care fraud for the past five years. I am currently the lead agent in a $15 million Medicare fraud scheme involving home health care agencies in six states and their relationship to a Florida consulting company through hidden ownership and control. Fifteen defendants have been indicted and are awaiting trial in the District of Montana.

I know you are interested in a variety of issues including health care fraud, drug abuse, and child exploitation. I don’t know how familiar you may be with Attention Deficit Disorder (ADD) or more correctly, Attention Deficit/Hyperactivity Disorder (ADHD), which has become the number one childhood psychiatric disorder in America. Enclosed is a copy of a recent article from one of our regional hospital and HMO facilities on this topic. Also enclosed is a copy of my response. I urge you to carefully read both.

I think there may be at least reasonable suspicion, if not yet probable cause, to believe that ADHD is a bogus diagnosis, brought to market by CIBA-Geigy, now Novartis, the third largest pharmaceutical company in the world. Why? To inflate the demand for and increase the sales of Ritalin.

I am also enclosing a copy of CIBA’s 1990 “Booklet for the Classroom Teacher” on ADHD. CIBA produced a similar booklet for parents. You’ll find numerous references to “the brain” and no less than eight references (in a 15-page booklet) to “neurologically based.” On page 6 it states, “ADHD is caused by neurological differences in the child’s brain.” On page 12, it states, “These medicines do not cure ADHD. Instead, they appear to work by correcting for a lack of certain necessary brain chemicals in the nervous system. Parents should be aware that these medicines do not “drug” or “alter” the brain of the child. They make the child “normal” by correcting for a neurochemical imbalance.” In fact, I’m told there is no scientific evidence to support any of these statements.

These booklets were produced and distributed by CIBA in 1990 and soon produced a handsome return on investment. Over the next several years CIBA also pumped nearly $1 million into CHADD, the “Joe Camel” of the ADHD industry. By 1995, methylphenidate (Ritalin) consumption in the United States had increased six-fold (DEA) and Ritalin sales topped $350 million (Newsweek). According to the DEA, 85% of these prescriptions are written for school-age children, now numbering in the millions. Not bad for a product brought to market in 1955 to treat senility in adults.

Unfortunately, what ADHD lacks in science, it more than makes up for in political correctness. At present, it is backed by federal law under the Individuals with Disabilities in Education Act (IDEA). Even your own Office of Juvenile Justice and Delinquency Prevention (OJJDP) may have been duped into funding these pseudoscience experiments on children (see Federal Register, Vol. 63, No. 25, 02/06/98, pages 6354-55, “Multisite, Multimodal Treatment of Children with ADHD”).

Our children don’t need more federal ADHD studies. They need a federal grand jury to investigate, and if warranted, expose what may be the health care crime of the century. So far, only one government agency, the DEA’s Office of Diversion Control, has stood up to this psychopharmaceutical cartel.

At first blush, an experienced prosecutor might feel such an investigation would only lead to a battle of the experts, and there are many stakeholder/experts in the ADHD industry. Some of these individuals have built their careers around this “disorder.” Because their professional reputations and very livelihoods are on the line, they are not likely to say “oops” anytime soon. However, we may be able to show how some of these same “experts” have told different stories, depending on the audience. I also believe a thorough investigation may disclose, if not outright lies, a reckless disregard for the truth. Actually, there is already quite a lot of material in the public domain. It just needs to be organized and assembled.

I propose a DOJ task force investigation to include agents from the FBI, HHS OIG, DoEd OIG, IRS CID, DEA, and the Postal Inspection Service. There are a variety of issues to examine. You may find enough fraud to go around for everyone, not to mention the potential for official corruption, bribery, kickbacks, and ethics violations. I propose that you focus on the relationship between certain pharmaceutical companies, CHADD (and its influence at the local, state, and national levels), certain government researchers and officials, and other high profile figures and organizations from the ADHD industry. If, following a thorough investigation, there does not appear to be sufficient evidence to support criminal charges, there may well be sufficient evidence to support a civil RICO action involving millions, perhaps hundreds of millions, of dollars.

While there may be those who would exploit defenseless children for financial gain, there are also those who will fight to protect them. I look forward to hearing from you as soon as possible and will lend whatever assistance you deem appropriate.

Sincerely,

Michael F. Parry