They took an oath to do no harm.

But instead they fed America's opioid addiction to make money, lots of money — until the feds closed in, prosecutors say.

In what federal prosecutors are calling one of the largest health care scams in U.S. history, six doctors from across Metro Detroit have been charged with running a $500 million opioid scheme out of Macomb County.

The lead defendant is Dr. Rajendra Bothra, 77, a well-connected Bloomfield Hills surgeon, philanthropist and politician who owns the pain clinics at the center of the case: The Pain Center USA in Warren and Eastpointe; and Interventional Pain Center in Warren.

According to an indictment unsealed Thursday in U.S. District Court, Bothra and five other doctors cheated Medicare and Medicaid out of nearly $500 million by illegally prescribing more than 13 million doses of prescription pain pills.

Their scheme involved getting patients hooked on pain pills, prosecutors allege, and then forcing them to undergo painful procedures if they wanted more. Among the addictive painkillers they prescribed were Oxycontin, Percocet, Opana, Vicodin and Dilaudid, the indictment states.

The scheme ran from 2013 through 2018, according to the indictment.

Bothra, the lead defendant, is currently jailed pending a detention hearing on Friday, when a judge will determine whether to keep him locked up or release him on bond. His attorney, Jeffrey Crapko, could not be reached for comment.

Three of Bothra's co-defendants were released on bond. Two of the doctors have been appointed taxpayer-funded attorneys.

Bothra has practiced in Warren for 30 years, during which he made a name for himself as an accomplished physician, philanthropist and political insider. According to India Today magazine, he was appointed co-chairman of the Asian-American Coalition for the U.S. presidential election in 1988.

Bothra was also awarded the fourth highest civilian award in India, known as the Padma Shri, in 1999 and is known for his work with the poor and sick in India and his efforts to increase awareness of HIV/AIDS and drug, tobacco and alcohol addiction.

But outside his philanthropic work, Dr. Bothra was a pill pusher who got rich cheating the government with the help of his doctor associates, according to the 37-page indictment.

Prosecutors allege the doctors committed a variety of crimes, including prescribing opioid pain medication to induce patients to come in for office visits. Once there, in order to receive the highly addictive pills, the patients were forced to undergo services such as painful joint and block injections.

The physicians are also accused of submitting fraudulent claims to Medicare, Medicaid and Blue Cross for services and medical devices that were medically unnecessary, not eligible for reimbursement or not provided as they were presented. They also referred patients for tests that were medically unnecessary, such as MRIs, the indictment states.

“The damage that opioid distribution has done to our community and to the United States as a whole has been devastating,” said U.S. Attorney Matthew Schneider. “Healthcare professionals who prey on patients who are addicted to opioids in order to line their pockets is particularly egregious. We will continue to prosecute such individuals who choose to violate federal law and their ethical oaths.”

Charged in the indictment are:

Dr. Eric Backos, 65, of Bloomfield Hills

Dr. Ganiu Edu, 50, of Southfield

Dr. David Lewis, 41, of Detroit

Dr. Christopher Russo, 50, of Birmingham

Dr. Ronald Kufner, 68, of Ada

Lewis was released on bond and has a private attorney, who could not be reached for comment. Edu and Russo also were released on bond and have court-appointed lawyers.

News of the indictments had patient advocates and social activists reeling, particularly given that the accused are doctors.

"It’s such a violation of the oath that they take — that they will first do no harm," Monique Stanton, president and CEO of CARE of Southeastern Michigan, said Thursday. "Physicians see people at their most vulnerable, especially those suffering from severe pain — so this is a major breach of trust to see them take advantage of patients in this way."

For Stanton, opioid addiction is both a social and personal concern. Her mother is recovering from a heroin addiction, so she knows first hand the devastation caused by drug addiction. Hearing that doctors may be contributing to the problem "is both terrifying and reason to be outraged," she said.

"Instead of getting people the help they need, they’ve really just perpetuated a disease. And it appears only for profit," Stanton said.

Also alarming for Stanton is where the alleged pill scheme occurred: Macomb County, which sees "some of the highest numbers of opioid addiction, and deaths, nationwide," she said. "We are in a life and death situation in this epidemic. News of this indictment will have a ripple effect countywide."

Medical malpractice attorney Brian McKeen, who is representing the family of a woman who died of a fentanyl overdose while under the care of a doctor, echoed Stanton's concerns.

"Today’s news illustrates that there exists a small but growing segment of physicians in our community who have caused a rampant epidemic of dangerous narcotic pain medication abuse," McKeen said. " The fact that we face this opioid crisis is largely because of the gross negligence of a small group of bad doctors who care more profits than they do about patients safety."

McKeen noted that this is not an isolated incident, citing recent examples of doctor scams that put greed ahead of safety:

In February, West Bloomfield Dr. Gavin Awerbuch was sentenced to 32 months in prison after admitting that he wrote prescriptions for a fentanyl-based cancer pain medication for non-legitimate uses and committed health care fraud. Among his patients was Stephanie Lopez, a Bay County woman who died in 2013 from an overdose of fentanyl that had been prescribed by Awerbuch. McKeen is representing Lopez's family in a pending lawsuit against Awerbuch and others.

In 2015, Dr. Farid Fata of Oakland Township was sentenced to 45 years in prison for diagnosing people with cancer who didn't have it, pumping patients with dangerous amounts of chemotherapy and fraudulently billing the government to make millions.

In 2017, Dr. Aria Sabit, a neurosurgeon from Birmingham, was sentenced to nearly 20 years in prison for performing poor or unnecessary spinal surgeries in Michigan and California and then fraudulently billing public and private insurers $2.8 million for it.

Dr. Yasser Awaad, a Bloomfield Hills neurologist, is accused of diagnosing hundreds of children with epilepsy who didn't have it, according to a longstanding class action lawsuit. Awaad fled the country last year.

McKeen argues that Michigan's personal injury damage caps have encouraged these widespread abuses and maintains that "until there is full accountability for the negligence of health care providers, we can look forward to additional instances of patient abuse.”

The case was investigated by multiple agencies, including the U.S. Department of Health and Human Services, Office of Inspector General, FBI and DEA.

The FBI urges anyone with information about this case - or about any other activity of this type - to contact the FBI at 313-965-2323.

Tresa Baldas: tbaldas@freepress.com. Follow her on Twitter @Tbaldas