Episode 394 - USA v Raj - The Trial That Changed Everything

All right, hey everybody, welcome to the compliance guide podcast as always. Let me begin by saying thank you to each and every single one of you who tunes in logs on and hangs out with me each and every single week and some of you hang out with me multiple times a week and I greatly appreciate that. This is an episode that you're going to want to stay tuned to because this is an episode that is tied to a case that is very important to me. Even years after the trial, this trial was so instrumental in laying the foundation and the groundwork for how people like myself and others who were involved in this multi-defendant, multi-count indictment by the Department of Justice, how it backfired on them and the lessons that we were able to learn moving forward to help properly defend and for the attorneys how to litigate against the Department of Justice in cases like this one or having some similarities. So joining me today in the studio and it's really an honor and a privilege is Dr. Raj Bothra. And Dr. Bothra is somebody who prior to his trial, I didn't have a lot of exposure to, I didn't really understand just who this gentleman was but when I was asked to come on to this case by Ron Chapman the second on behalf of some of the co-defendants and it's very important for me to make clear. I was not retained by Dr. Bothra's counsel or by Dr. Bothra however my testimony played across the four defendants in this case that was part of, I was one of the experts that helped to drive the jury to a full acquittal for Dr. Bothra and for Dr. Lewis and the others that were on trial. And I'm going to get to Dr. Bothra in a minute but I think this is very important. I said that I did not have a lot of understanding and exposure to Dr. Bothra prior to his trial and me being retained. But what I learned about Dr. Bothra was that not only is and was he an incredible physician, compassionate, caring, dedicated to his patients. But this is an individual, this is a gentleman who gave to the world. He is a philanthropist, he was engaged with mother Teresa. He did some incredible things and I want him to at some point through this conversation. Talk a little bit about some of what he did. And Dr. Bothra is a very humble individual and I don't want to put him into an uncomfortable situation. But I think it's critical to understand that if the government can target somebody like Dr. Bothra and his partners, they can target anyone. And they can make people believe prior to a trial that these individuals are criminals, that they are guilty and subject them to things that is inhumane. So with that said, Dr. Bothra, it is really, really a pleasure to see you. I've not seen you since the trial. I've not seen you since the jury handed out the full acquittal to you and your co-defendants. So thank you. I know you've not done a lot of interviews, but thank you so much for doing my podcast. It means a lot to me. And I think this is a story that needs to be heard by every single physician in the country that could be subjected to allegations of fraud, wasted abuse and deemed a criminal without ever having a day in court. But thank you. Thank you very much for inviting me. And I'm grateful to you for being a part of the trial because your testimony was very, very important to all of us. Basically, there were two charges. One was the Medicare fraud and another was the excessive distribution of the narcotics. And at time when there was a opioid crisis. So these were basically the two charges, where the counts were 54. And your testimony, particularly about the Medicare fraud and the Medicare regulations, which really nobody knew there. The prosecutors and attorneys and nobody was forget about being expert, but they did not have any idea about the Medicare regulations, and which are complicated. There are tens of thousands of regulations there. They change every year. It is almost impossible to keep up with it. The prosecutors and attorneys really had no idea at all about the Medicare regulation. So to prove that part of the case, it was very important to have someone like you. And I certainly believe, and I tell it from the bottom of my heart, that you are the best in the country, as far as these regulations are concerned. I don't know about your other work, but what I saw in the quote that nobody else can excel about the Medicare regulations, the kind of thing that you know. And it was very, very helpful to me. Thank you very much. I want to thank you. Yes. And you are welcome, but I want to say thank you to you, because your case was a landmark case. Prior to your case, I had done a lot of work in civil and criminal matters, but none that were to the magnitude of what your case was. Your case was 50 plus counts under the two count indictment. The dollar amount, we were approaching a half a billion dollars, $500 million dollars. And you are correct. The attorneys, because they are white-cold defense litigators, they don't do a lot of outside of Ron Chapman. They had not done a lot of the healthcare defense. And especially the areas where you had these criminal charges. And they're extremely complex. But what you are 100% correct about is that the prosecutors in this case knew even less than probably the jurors that were sitting in the stand listening to the arguments that they were making, the questions that they were asking, and then me as well as your other incredible experts that you had systematically pulling apart their narrative and showing the jury just how fatally flawed it was. But before we get to that, could we go back to sort of the beginning as to what transpired with the FBI, with the Office of Inspector General, and how it led to the Department of Justice bringing charges against you and your co-defendants? Yes, yes, I'll be glad to do that. I really had never any issue with the hospital, with the local medical board, with the licensing board, with the DEA, with FBI, or with the government. I've been in practice for 45 more than 45 years. I was chairman of the Department of Surgery. I was president of the medical staff, and I've been always a leader in the hospital practice. I never had any issue. Now I see that they have been investigating for three or four years time, and basically they came up with the two charges that I told you. And they advertised it as $450 million that the Medicare paid us. The fact is that they paid $45 million over a period of six years for 133 employees, six doctors, four nurses, all these things combined together. And I was told by FBI that this was the biggest international pain practice in the country, with more than 25,000 patients. Now when they are talking about 25,000 patients, and when they are talking about $45 million, not $450, that was totally wrong. And if you put it together, that a usual practice is about 1,000 patients. So if it is 25,000 patients, that's a total of $4,000. Obviously, the Billings will be about 25 times more. The same thing happened on the narcotic side. They said that we have prescribed 2 million narcotic pills over a period of six years' time. What they did not say that it was not 1,000 usual practice, it was for 25,000 patients. And if you extrapolate to that, our narcotic prescription was much lower than the national average. So there was no case about that. We can easily prove it because any narcotic medication that you write is reported to a state of Michigan. Any payment is made to us is come through by the Medicare. So they have all the information about it. They knew it, but I was the poster child for them. It was the time of the opioid crisis. It was a huge practice. Government had to show that they are doing a lot about these fentanyl. The case are dying by the fentanyl, also by the prescription drugs. So they had to show to the people that they are doing it a huge deal of work and trying to put these prox, you know, into the prison. And so I was the poster child. Another thing, I'm an immigrant. I come from India. I came here. I'm very grateful to this country. It has given me a lot. And I made my life here. I was a surgeon when I came here. I did my surgical training in England. And I was a surgeon. But I started my practice here. I work very hard. I played by the rules and this country has given me a lot. But this last thing that happened, I had no idea. One morning, the FBI showed up at my door and they said that they have the warrant against me. I saw no reason to argue with them. They were doing their job and and that's how I came to know. Before that, I had no idea at all that there is something going on. So I want to stress this point. So prior to the FBI showing up at your door on that that fateful morning. There had been no precursors. There had been no prior audits. There's been there had been no prior education. Reach out, you know, anybody reaching out from Medicare, from the state of Michigan, from the OIG saying, hey, Dr. Bothra, listen, we have some concerns about your documentation or we have some concerns about your prescribing habits or we have some concerns about the use of. Ancillary or auxiliary personnel performing some of these services. This none of that transpired. This was, hey, a knock on the door that morning and they said, Dr. Raj Bothra, we have a warrant for your arrest. And then it proceeded from there. Mr. Vice, there was not a single Medicare audit. In my entire career as the interventional pain, especially, is not one audit. There was never any letter or anything from the state of Michigan Medical Board. There was nothing from the licensing board. There was no complaints by the patients. In my entire career of the interventional pain physician, there has never been one lawsuit of any kind, not one. So there was nothing in my career that this kind of thing would ever happen to me. No, I mean, and that's the thing, you know, I think you, I think you use the term adequately and properly, which is you were the poster child for what was transpiring at the height of the opioid epidemic in a area where there was known pill mills, where there was known addiction to drugs like fentanyl and some of these others. And relying on, and these are the things that we talked about. We had Ryan Vaughan, who was there, who worked with me, who came onto the stand and testified that the heat mass and the data analytics that were being produced by the government were incorrect. It was bad information. The fact that they had claimed you built the government for more than $450 million when it was $45 million. I mean, this was a case of, in my, in my opinion, this was a case of prosecutorial misconduct. This was a case of agents violating their oath to the law and violating the Medicare regulations, violating statutes, acts and laws both at the state and federal level. But not only that, you were, you were put into prison during the public health emergency, correct? Let me tell you what happened. That is the reason that I have written the book about it and was published two months ago and the film is being made under production right now. What happened to me is this that I was presented to the judge in the morning, all six of us had the same charges, word by word in the indictment. He let five people go and bail that same morning, but he did not give me the bail citing that I'm a, I'm a flight risk. Now you can call anybody at flight risk. So, so I was put in the prison and not only that I was put in the prison, I went to the judge nine times for the bail nine times. I was in the prison for 1300 one day before I was presented in the court for the trial without trial. I spent 13 3 and a half years into the prison. Now, I tried bail for nine times. It was refused nine times. Every time they told me that you are a, you are a flight risk. Now, when I look back, I was not familiar with the judicial system. I'm an educated man. I've lived here for 50 years. I've worked in the political side. I've worked in the social side. As you know from my book and I had no idea what is going on in the judiciary and I assumed that it should be reasonably fair. At democracy cannot survive unless there is a good judicial system over a long period of time. So I just assumed that. But I found out when I was there, the only reason to keep me there was to break me and get a pill guilty plea from me. Get a guilty plea from me so that they can declare victory. They, they realize that there is no case there. I was never going to take a plea deal. My attorneys, I had a lot of fights with my attorney that I'm not going to take the plea deal. It is the question of my honor, question of my family's honor. It is the culture and tradition from the country that I come from. I come from India. This is the culture and tradition there that we live with dignity. They told me that you will die in the prison. I said, so wait. I'll die in the prison, but I'm not going to take the plea deal. My attorney told me to take the plea deal. They came and tried to blackmail my family, my daughter, that he will never come home unless it takes a plea deal. So now when I look back, it was all about that to break me so to force me to take a plea deal and that's the way they can win it. I was, as I said that I never did that. I don't give up. I don't give in. And I fought. I went to the trial. My attorneys and you and the other consultants did a great job to make the jury understand. Because I realized at that time that it is only the jury where I can get the justice from the from the grand jury to the prosecutors to the US attorney. And there I say to the judge, everything the mentality was to win at any cost right or wrong, fair or unfair, moral or immoral. It did not matter. They just have to win. And that was the mentality there. And you're right. And I will tell you though, the judge, when you finally got to trial, you had an excellent judge. I think he did a masterful job of addressing objections of dressing the sidebar arguments of stopping the prosecutions, misguided attempts to limit the testimony of your experts who were rebutting and refuting really poor evidence that was being presented. And faulty evidence that was being presented by the prosecution. They actually, as you know, they filed dog or motions against me to exclude me from testifying because it is the truth. And I was never terrified of what I was going to say on the stand and the fact that they could not refute the positions that Ron Chapman and I were going to make from an expert attorney perspective. You know, it was, it was really incredible the way after Ron Chapman direct examined me and then. your attorney actually did a direct examination on me as well. And then the prosecutor cross-examine me. And they just, and you actually in your book, and I will tell you, it was such an honor for you to even include my bit of work that I did. Because my work, even though it was a small piece, for me to be included in your book and telling your whole story, for me as an honor and a privilege. I have done a lot of work in India with offshore billing companies dating back to the mid-90s and into the early 2000s. And one of the things that I've learned about the culture, about the people of India, is they are very prideful. They are very respectful and they are very appreciative when people are there to assist them, to help them, to teach them the right way to be able to do things. And this book, folks that are watching the actual podcast, or if you're listening to it, the book is USAVRage. You can get it on Amazon, you can get it from any of your major book retailers. I promise you, it is an incredible read. I actually blogged about it because the book came to me, the day before I got on the plane, to fly over to Italy. And I actually took a picture of me on the airplane getting ready to fly to Italy. And I read this book halfway across the Atlantic Ocean. And when I got to page 259, it was interesting because I saw the name Scott West. And I said, wait a minute, who's Scott West? And I started reading and I reached out to a very good lawyer friend of mine. And I said, hey, I think my new name is Scott West. And he said, well, Sean, that's your gnome to gear. And I came to a very good understanding with yourself and with Jennifer, who helped co-authored the book. The reason why you didn't use the attorney names, why you didn't use my specific name. And for me, I know who Scott West is. And that's all that matters to me is knowing that when I read that name, I know it's me and I know how sincere you are in your appreciation for the work that I, along with the other experts and the attorneys, provided for you and your co-defendants in that case. Mr. West, let me correct myself or maybe either you misunderstood. I did not say that that just was a part of it. I think we had a, let me correct it. We had a wonderful judge. I'm just telling you the mentality what I saw in the system as a, as a world. That's what I was trying to point it out. I want to make it clear. No, you made it perfectly clear. I was bringing up the fact that, you know, and I don't know if you remember this, but after the cross-examination and then your attorney redirect examined me, the judge before he dismissed me from the stand decided to ask me several questions in front of the jury. And I think as he began asking me the questions and I gave him those answers, the jury was beside themselves. I'm not the jury. The prosecutors were beside themselves because this judge was driving home the point that Ron Chapman and your attorney were trying to make, which is, hey, this guy knows what he's talking about. And, you know, this guy has given lectures at this university, that university has done this work. And he was really making our case to the jury for us. So no, you weren't saying anything out of context or derogatory about Judge Miller. He was fantastic. I think you were correct in the fact that the system prior to getting to court is broken. That's the only way to describe it. Yeah. Well, let me tell you, let me tell you a couple of things, you know. I wrote the book. I wrote the book because there was a reason to write the book to inform the general public as well as the other people in the profession that what happened to me, it can happen to anybody as you said. Now, tell me how is it possible that you don't have any any kind of investigation, no audit, nothing and you directly are arrested. Number one, number two, the charges are the same and they let other five people go and keep me in the prison. Number three, how can you keep somebody for three and a half years in the prison without the without the trial? Number four, two doctors pleaded guilty for their own reason, not that they did, they worked there, they were honorable people, they did a good job, but they pleaded guilty for their financial reason or family reason or whatever it is. Now, these two people, they never spent a day in the prison and I'm very happy for them. I like these people, they're decent, honorable people, hardworking people, I'm happy for their family, they did not have to spend one day, but how do you justify that I did not plead guilty? I took the risk. As you know, it is almost impossible to win from the government, 97% of the people plead guilty and those who go to the code 0.03% win from the government and on the other side is 20 years in the prison, which is almost a life sentence for me at the age of 78. So, so they kept me in so that they can break me and get a guilty plea from me. How do you justify all these things and it is important that if it can happen to me who is an educated man who is in this country for 40, 50 years who has practiced every day I deal with the people, I've worked for the Republican Party here for the last 25, 30 years, I work for the presidents, I work for the senators, governors, I know the system, I did the same thing in India, I work for the political side there, I work with Mother Teresa as you said, I had an honor of my life to go and have an audience with the Holy Father John Paul and it spent a day, it spent a day with the Holy Father that was the honor of my life. So, I'm pretty much familiar with how the system is and if it can happen to me it can happen to anybody and I want people to know that it is not that easy in the judicial system, it is broken, it is corrupt in many ways and all they want to do is to get a conviction because it will help them in their promotions. Nothing else matters. And that is that is the unfortunate truth that when you're dealing with individuals who are not career prosecutors but those that made a commitment to work for the DOJ for two years, four years, five years, whatever it is, their goal is to rack up as many convictions, as many settlement agreements, as many deferred prosecutorial agreements as they can because that is what sets them up for a big corner office in New York City with a big law firm or in DC or Atlanta or Chicago or LA. What happened to you is a travesty. At the age of 78 during the public health emergency when they were letting hard core criminals walk to streets, you were held in prison without bail at 78 years old. And you're an individual who has dedicated your life to the good of humanity. You're a decent good person. As you said, you laid out your relations with Mother Teresa. To you know, to you use your own words, the honor of your life with one of my favorite popes, which was John Paul. You've led an extraordinary life. You've engaged with presidents. You've cared for them. You've cared for senators, congresspeople. You did all of the things that make you who you are, yet you were punished for being that good person. And my hope is that others hear this podcast. They listen to the things that you are talking about. They read this book so they can really understand the death to which the government went to try to force and coerce in blackmail you into a plea agreement so that they got their win. And the fact that you were unbreakable and that you held your position and that you waited for your day in court after 1,300 and some odd days, three and a half years in a federal prison before you got your day in court. It's an unbelievable story. I learned not too long ago that Bollywood Hollywood is actually in the process of producing this movie and that it's due out July 4th, 2026 if I'm not wrong. That is correct. That is correct on the movies and the production now. Again, the purpose is the awareness. People need to know that what is going on and maybe something should be done about it that it doesn't happen to others. That is the main criteria. Now, I worked here in the other field as I said. I had the charity organization. I was working in India about the drug abuse, AIDS and alcoholism and all this. This was my way of giving back to my old country and giving back to my this new country, America, which has given me a lot. So I had to do certain things which will make me feel good that I did something in return because it has given me a lot as I told you many times. Yes, sir. Well, listen, Dr. Bothera, it has been the honor of my life getting to serve you through your plate with the federal government as well as your co-dependence and the greatest moment for me was listening to the jury for person. Read off the not guilty acquittals and you being set free. Which is where you should have been from the beginning and watching you walk out of that courtroom watching you walk out of that courthouse as a free person. They they stripped you of three and a half years of your freedom, but they didn't strip you from the man that you are the integrity that you have and and the goodness that you have brought to this world. How can they forget that it is not just me. There are a lot of people behind me. They left 25,000 patients on the street. They never got any they never got any treatment. Some of them were there in the court to talk about it. Now another thing. I have a wife and I have a daughter. Did they ever think what they are going through? Did they ever think about it? So I'm not alone. There are a lot of people behind it. Those who had to suffer for this kind of attitude by the government and this kind of thing which is should not happen as you say to anybody at any time. And I hope that people will read the book. I hope that judicial people will read the book. I hope there will be some reforms in the prison and the system of the grand jury and the plea deal. These all need to be these all need to be reform. Otherwise it will happen again and again and again. And to your point about the grand juries, you know, it's unfortunate because when a grand jury is convened. They only get to hear the facts that the prosecution wants to present. There is no opportunity for the defense to make any counter arguments and nine out of 10 times they return what is referred to as a true bill, which is basically a rubber stamp for the government to now begin a prosecution. You are absolutely right that how can a grand jury can convene where the defendants are not present. They don't even know that anything is going on only the prosecutors and FBI is there is very easy to get a very easy to get not a conviction but as referral from the grand jury to the US attorney and US attorney is only reading what is there from the grand jury on that basis. He issues a warrant. Now this grand jury system is started in England in early 18th century. They gave it up because it became a tool of the government. The grand jury system is presently in the world only in two countries. Only in America and one of the other smaller country. Otherwise it has been given up and it should be given up here. There has got to be some other method of investigation and again there is a lot of things about the prison reform, a lot of things about the plea deal. The plea deal is another kind of thing which is which is totally out of line that people have no other choice but to take a plea deal. And how could 99.9% of the people never win from the government. Somebody should Congress should be looking into it. Public should be talking about it and something should be done about it. You know, one of the things and maybe this becomes you know a new quest for you. One of the things that I think President Trump has done so much for is justice system reform. You may you may despise him. You may you may not care for him. Whatever you want to call it. But if you actually do independent research on what president in the modern day error has had the biggest impact on the judicial system and the reforms. It's president Trump. He's not an order. Yeah. And the law and order. Law and order. He led that effort in his first administration when he was number 45 and he is taking it on again as president, you know, 47 because of the law fair that he has been subjected to. I'm not a partisan politician. I'm a pragmatist. I've done work for both Republicans and Democrats alike. I don't care. My concern is the American people. I've always been an advocate for the American patient and for the American physician irrespective of whether it is Republican or Democrat. But maybe one of your callings is to reach out to Bobby Kennedy at the Department of Health and Human Services to reach out to president Trump and to say listen. I I am the poster child for what is wrong with the American justice system. Let me help you help this country reform it so that it's it's it's not guilty until proven innocent. It's innocent until proven guilty. You are exactly right. What I was going to tell you that I would I would like to meet with Bobby Kennedy. I would like to meet cash Patel who is the FBI director and hopefully some time I'm able to present this book to the president of United States. And from the point of view that that something need to be need to be reformed and I'm sure the president will be very very kind to this kind of thing because he went through the same thing if they can do to the president of the United States who am I an ordinary citizen and immigrant person with a brown skin. Who am I nobody. You know it can happen to anybody. It can happen to anybody. You're an American citizen first and foremost second, you're an advocate for your patients. And you're an advocate for doing the right thing. I'll tell you what I'll do because I do have very strong ties into the Department of Health and Human Services to secretary Kennedy to. I believe you sit on the committees, the medical committees you sit on that so yeah so there's some that I'm in the process of working through yes sir and I have advised in the past. I will make this book available and I will actually send my copy to my White House contact who works directly for president Trump and I will ask him to please give this book to president Trump and to find a way to meet with you now that he is completed his tour of Asia. It looks like things are coming together with China and Malaysia and Japan. I will I may need to get a couple more versions because I'd like to send this to Dr Oz who I know personally who I met within DC Bobby Kennedy as well. So I'm going to get a couple more copies of this book. I'll send you a few copies. And I promise you the books that I can hand deliver I will personally hand deliver those and the ones that I cannot personally hand deliver I will give them to the person that can put it into president's hand. And let's see if we can't get you a meeting with president Trump and Bobby Kennedy in the very near future because I think they need to read your story. I think they need to meet you and you now need to be the poster boy and the poster person for justice system reform that has taken place. It will be an honor to be able to do some kind of service and something good can come out of it. Well, you have my commitment once I get a couple more of these books. I will get them into the right hands. I promise you and then let's see if you and I can work together to get you a meeting with secretary Kennedy and with the president of the United States because I think it would be an honor of their lifetime. you to shake your hand to hear your story. and to have you help them lead the charge in justice system reform. Thank you very much. I appreciate it very much. All right. I want to say thank you to Dr. Raj Bathra for taking time out of his schedule and me getting again an honor of a lifetime to meet and spend time with somebody who has done so much for the world, not just a profession of healthcare. And I've given him my commitment that I will do everything I can using the contacts that I have to get him a meeting with Secretary Kennedy, with Secretary Oz and with the President of the United States. Hopefully they will take him up on this offer and we will get that meeting and I will follow the progress of that on the compliance guide podcast. If you get an opportunity, please get out to Amazon or onto one of your favorite book websites. Pick up USA V Raj. I promise you it is an incredible read. Learning about the history of Dr. Raj Bathra, learning about all of the individuals that he has been able to collaborate with, that he's been able to work with. There's a ton of pictures throughout the book of his engagement with Mother Teresa, with Pope John Paul, with others, the charitable work that he's done with President George H. Bush during his term. So get out, get the book, pay cost attention. Once the movie is released in 2026, I'll make sure that you all know when it is, where it is, and how to be able to view it. And again, I want to thank Dr. Raj Bathra for hanging out with me today on the podcast. I want to say thank you to each and every single one of you who has tuned in, logged on and hung out with me for the last, gosh, since the beginning of COVID, 390 episodes ago. So thank you all so much for making this podcast a top 3% global podcast and one of the top 10 podcasts here in the United States. I'm going to be back next week with an all brand new compliance guide podcast with some more incredible guests. So until then, remember be good to yourself, but more importantly, y'all be good to each other. Take care.