Huntsville ‘Pill Mill’ Doctor Aggarwal Pleads Guilty

Huntsville physician Shinder Aggarwal, 48, admitted in federal court today to running a high-volume pill mill that flooded North Alabama with opioids while defrauding Medicare and Blue Cross Blue Shield of Alabama out of $9.5 million. Aggarwal, once the nation’s top Medicare prescriber of Schedule II opioids, pleaded guilty to distributing controlled substances outside legitimate medical practice and conspiring to commit health care fraud between January 2011 and March 2013.

Aggarwal operated Chronic Pain Care Services on Turner Street Southwest, where patients streamed in by the dozens—80 to 145 a day—only to be seen for five minutes or less. Initial visits were cursory, follow-ups often lasted under two minutes. He didn’t request prior medical records, offered no treatments besides opioids, and routinely asked patients what drugs they wanted—then filled the scripts. He prescribed to known drug users and ignored red flags of abuse or diversion, all while raking in millions.

The Prescription Drug Monitoring Program data shows Alabama pharmacies filled approximately 110,013 of Aggarwal’s controlled substance prescriptions in 2012 alone—nearly 423 per workday, totaling 12.3 million pills. He ranked as Alabama’s top prescriber that year, dwarfing the next closest by triple. Medicare records confirm he was the leading recipient of Schedule II opioid claims nationwide under the federal program in 2012, prescribing oxycodone, morphine, hydromorphone, and oxymorphone at an industrial scale.

Aggarwal’s plea agreement includes a video-recorded patient interaction in which he acknowledged federal scrutiny, telling a patient the DEA considered him the ‘biggest pill-pusher in North Alabama.’ He added, chillingly, that ‘many of my patients are dropping like flies, they are all dying.’ The admission underscores the deadly toll of his operation, where profit eclipsed medical ethics and human life.

On the fraud side, Aggarwal admitted to forcing patients to undergo medically unnecessary urine drug tests—$9.5 million worth—billed to Medicare and Blue Cross Blue Shield of Alabama. He required the tests not for patient care but as a condition of receiving prescriptions, a scheme investigators say was designed solely to inflate billing. He previously repaid $2.8 million to Medicare and $45,843 to Blue Cross after audits, but the damage was systemic.

As part of a binding plea deal, Aggarwal agreed to forfeit his Huntsville clinic and $6.7 million in assets. He faces a stipulated 15-year (180-month) prison sentence, though U.S. District Judge R. David Proctor has not yet accepted the agreement or set a sentencing date. Aggarwal surrendered his Alabama medical license and both state and federal DEA registration to prescribe controlled substances in 2013, ending a reign that left bodies in its wake and communities poisoned by pills.