A Brookline physician who specializes in treating drug addiction and who faces Medicaid fraud charges was reprimanded and fined $2,500 by the state’s licensing board Wednesday for improperly seeking to have four women involuntarily hospitalized because he had heard they might be high or drunk and not because he had personally examined them and concluded they had psychiatric issues posing a hazard to themselves or others.
The disciplinary action against Dr. Punyamurtula Kishore, as well as his ongoing criminal case involving a drug-testing lab that he founded, involves the growing and unregulated industry of sober homes, which are mostly private rooming houses in residential neighborhoods that rent to recovering addicts.
The case before the Board of Registration in Medicine dates to 2006, at a time when Kishore himself ran at least one small sober home in Bridgewater, and just as his multimillion-dollar urine-testing business was rapidly expanding alongside his clinical practice.
According to board documents, the sober home at 15 Maple Ave. was operated by a nonprofit founded by Kishore called Families of Choice. On Aug. 4, 2006, Kishore met with four tenants of this sober home at his Brookline office and told them they needed to leave because he was “planning to close it and he gave the four patients a few days to relocate.”
Apparently after hearing this, the women made arrangements to return to Bridgewater. Around 11 p.m. that night, one of the sober home employees observed one of the women vomiting into a toilet. That night, the “house mother” called Kishore and said that the four women each “appeared to have been using drugs, alcohol, or both.” Kishore called the Bridgewater police requesting that they transport the women to the Brockton Hospital emergency department for drug testing. When the police arrived, they called Kishore and said they did not believe the women were under the influence of drugs or alcohol, according to the documents.
Minutes later, Kishore faxed to the police four forms for “temporary involuntary hospitalization,” one for each of the women. In each instance, Kishore indicated that each woman “posed a risk of danger to herself and/or to others by reason of intoxication and/or ingestion of drugs” and they should be drug tested. Around midnight, the police transported the women to the hospital and they were examined by physicians, though they were not tested for drugs because they allegedly declined and “testing was not medically indicated at that time.” All four women were released within two hours .
The women are not named in the licensing board’s documents.
The board reprimanded Kishore because he “failed to comport with the spirit and letter” of the state’s law regarding involuntary hospitalization, which relates to protecting patients from harming others or from self-harm based on mental conditions and requires a clinician’s direct observations, with only rare emergency exceptions.
According to the board’s records, Kishore and his attorney said that he did not have to personally examine the women because he was familiar with their medical histories and relapse potential and that he was not actually demanding hospitalization, but rather sought “transport of individuals to a facility for evaluation.”
Kishore’s Boston attorney, Paul Gitlin, said in a telephone interview Thursday that Kishore made a judgment call and did what he thought was appropriate to protect the women. Gitlin said the Bridgewater sober home was closed in 2007.
The action of the board — which includes a requirement that Kishore make known the board’s actions to all hospitals, nursing homes, and other facilities where he works — adds to ongoing legal problems faced by the 62-year-old physician. Last year, Kishore and his lab were indicted on charges they fraudulently billed Medicaid nearly $4 million for tens of thousands of urine screens from recovering addicts, business that he allegedly secured through kickback arrangements with landlords at sober homes.
Sober homes often require regular or random urine screening of tenants, and state investigators allege that Kishore medically ordered excessive testing of tenants and had such lab work funneled to his lab. Kishore has pleaded not guilty to those charges, and his trial is scheduled to begin in February.Patricia Wen can be reached at firstname.lastname@example.org.