Charges Involve Over 350 Thousand Prescriptions for
Controlled Substances and Over 32 Million Pills; ARPO Strike Force Grows to 10
Districts, Expanding to Include the Western District of Virginia
Attorney General William P. Barr and Department of Health and
Human Services (HHS) Secretary Alex M. Azar II, together with multiple law
enforcement partners, today announced enforcement actions involving 60 charged
defendants across 11 federal districts, including 31 doctors, seven
pharmacists, eight nurse practitioners, and seven other licensed medical
professionals, for their alleged participation in the illegal prescribing and
distributing of opioids and other dangerous narcotics and for health care fraud
schemes. In addition, HHS announced
today that since June 2018, it has excluded over 2,000 individuals from
participation in Medicare, Medicaid and all other Federal health care programs,
which includes more than 650 providers excluded for conduct related to opioid
diversion and abuse. Since July 2017,
DEA has issued 31 immediate suspension orders, 129 orders to show cause, and
received 1,386 surrenders for cause nationwide for violations of the Controlled
Substances Act.
“The opioid epidemic is the deadliest drug crisis in
American history, and Appalachia has suffered the consequences more than
perhaps any other region,” Attorney General William P. Barr said. “But the Department of Justice is doing its
part to help end this crisis. One of the
Department's most promising new initiatives is the Criminal Division's
Appalachian Regional Prescription Opioid Strike Force, which began its work in
December. Just four months later, this
team of federal agents and 14 prosecutors has charged 60 defendants for alleged
crimes related to millions of prescription opioids. I am grateful to the Criminal Division, their
U.S. Attorney partners, and to the members of the strike force for this
outstanding work that holds the promise of saving many lives in Appalachian
communities.”
“Reducing the illicit supply of opioids is a crucial element
of President Trump’s plan to end this public health crisis,” said HHS Secretary
Alex Azar. “It is also vital that
Americans struggling with addiction have access to treatment and that patients
who need pain treatment do not see their care disrupted, which is why federal
and local public health authorities have coordinated to ensure these needs are
met in the wake of this enforcement operation.
The Trump Administration’s law enforcement and public health leaders
will continue to work hand in hand to end this crisis that has hit Appalachia
hard and steals far too many lives across America every day.”
Attorney General Barr and Secretary Azar were joined in the
announcement by Assistant Attorney General Brian Benczkowski of the Justice
Department’s Criminal Division; U.S. Attorney Robert M. Duncan Jr. for the
Eastern District of Kentucky; U.S. Attorney Russell M. Coleman for the Western
District of Kentucky; U.S. Attorney Benjamin C. Glassman for the Southern
District of Ohio; U.S. Attorney William J. Powell for the Northern District of
West Virginia; U.S. Attorney Michael B. Stuart for the Southern District of
West Virginia; U.S. Attorney J. Douglas Overbey for the Eastern District of
Tennessee; U.S. Attorney Don Cochran for the Middle District of Tennessee; U.S.
Attorney D. Michael Dunavant for the Western District of Tennessee; U.S.
Attorney Jay E. Town for the Northern District of Alabama; U.S. Attorney Thomas
T. Cullen for the Western District of Virginia; Executive Assistant Director Amy
Hess of the FBI’s Criminal, Cyber, Response, and Services Branch; Deputy
Inspector General for Investigations Gary L. Cantrell of the Department of
Health and Human Services Office of Inspector General (HHS-OIG), Assistant
Administrator John J. Martin of the DEA Diversion Control Division, and Centers
for Medicare and Medicaid Services (CMS) Deputy Administrator and Director of
the Center for Program Integrity (CPI) Alec Alexander.
In addition to the cases announced today, Attorney General
Barr and U.S. Attorney Thomas T. Cullen announced today that the ARPO Strike
Force will expand into the Western District of Virginia, making it the tenth
ARPO Strike Force district. ARPO is a
joint law enforcement effort that brings together the resources and expertise of
the Health Care Fraud Unit in the Criminal Division’s Fraud Section (HCF Unit),
the U.S. Attorney’s Offices for ten federal districts in six states, as well as
law enforcement partners at the FBI, HHS Office of the Inspector General
(HHS-OIG) and U.S. Drug Enforcement Administration (DEA). In addition, the operation includes the
participation of the Tennessee Bureau of Investigation, multiple State Medicaid
Fraud Control Units, and other federal and state agencies. The mission of the ARPO Strike Force is to
identify and investigate health care fraud schemes in the Appalachian region
and surrounding areas, and to effectively and efficiently prosecute medical
professionals and others involved in the illegal prescription and distribution
of opioids.
The charges announced today involve individuals contributing
to the opioid epidemic, with a particular focus on medical professionals
involved in the unlawful distribution of opioids and other prescription
narcotics, a priority for the Department.
According to the CDC, approximately 130 Americans die every day of an
opioid overdose.
“Today’s takedown demonstrates the FBI’s unwavering
commitment to working alongside our Strike Force partners, including the
HHS-OIG and DEA, to fight the opioid epidemic and related criminal activity in
the Appalachian region,” said FBI Executive Assistant Director Hess. “We will
not stand by and allow the harmful and oftentimes deadly practice of
over-prescribing highly addictive drugs to continue unchecked. The FBI will
pursue medical personnel who misuse their positions of trust to blatantly
disregard others’ very lives for their own financial gain.”
“The opioid crisis has had a devastating impact in the
Appalachian region,” said Principal Deputy Inspector General Chiedi. “Addressing
this public health issue and ensuring beneficiaries have continuity of care
requires a collaborative approach with our federal, state, and local partners.
Our commitment is resolute. We will continue working together to protect the
health and well-being of all Americans and ending this terrible epidemic.”
“Opioid misuse and abuse is an insidious epidemic, created
in large part, by the over-prescribing of potent opioids nationwide, and
unfortunately, Appalachia is at the center,” said DEA Assistant Administrator
Martin. “Today’s announcement sends a
clear message that investigations involving diversion of prescription drugs
have been, and continue to be, a priority for DEA.”
“CMS CPI is proud to work very closely everyday with our law
enforcement partners to stop the exploitation of vulnerable patients and misuse
of taxpayer dollars,” said Deputy Administrator and Director of Center for
Program Integrity Alexander. “Nowhere is this collaboration more important than
in our fight against the opioid crisis in America. This is one of the
President’s highest priorities and we are proud to be an important part of the
largest prescription opioid enforcement effort ever undertaken. We will
continue to work tirelessly through investigation, data coordination and
administrative action to protect the health and wellbeing of all Americans.”
The ARPO Strike Force is made up of prosecutors and data
analysts with the HCF Unit, prosecutors with the 10 U.S. Attorney’s Offices in
the region, including the newly added Western District of Virginia, and special
agents with the FBI, HHS-OIG and DEA.
The ARPO Strike Force operates out of two hubs based in the Cincinnati,
Ohio/Northern Kentucky and Nashville, Tennessee, areas, supporting the 10
districts that make up the ARPO Strike Force region. In addition, the APRO Strike Force works
closely with other state and federal law enforcement agencies, including the
Tennessee Bureau of Investigation, State Medicaid Fraud Control Units.
*********
For the ARPO Strike force locations, in the Southern
District of Ohio, six individuals, including two doctors and three registered
pharmacists were charged with several counts, including unlawful distribution
of controlled substances and conspiracy to obtain controlled substances by fraud. In one case, a doctor who is alleged to have
been at one time the highest prescriber of controlled substances in the state,
and several pharmacists are charged with operating an alleged “pill mill” in
Dayton, Ohio. According to the
indictment, between October 2015 and October 2017 alone, the pharmacy allegedly
dispensed over 1.75 million pills. These
cases were brought with assistance from the FBI, DEA, and HHS-OIG, as well as
the Ohio Attorney General's Office, Medicaid Fraud Control Unit; the Ohio
Bureau of Workers' Compensation Ohio; the Ohio Board of Pharmacy and the Ohio
Medical Board.
In the Western District of Kentucky, a doctor was charged
with controlled substance and health care fraud counts in connection with
providing pre-signed, blank prescriptions to office staff who then used them to
prescribe controlled substances when he was out of the office, and for
directing staff at the clinic, including individuals not licensed to practice
medicine, to perform medical services on patients. In another case, a doctor, a Florida
compounding pharmacy and its owner were charged in connection with a scheme
that involved the payment of alleged kickbacks in return for writing
prescriptions for compounded drugs that included controlled substances, and for
fraudulently inflating the costs for prescriptions that were billed for
reimbursement by Medicare and TRICARE.
These cases were brought with assistance from the FBI, DEA, HHS-OIG, and
the Defense Criminal Investigative Service, as well as the Kentucky State
Police, the Louisville Metropolitan Police Department, the Kentucky Office of
Inspector General, the Kentucky Department of Insurance, and the Kentucky
Medicaid Fraud Control Unit.
In the Eastern District of Kentucky, a total of five people
were charged, including three doctors, a dentist and an office assistant who
were charged in connection with several health care fraud and/or controlled
substance schemes. In one case a doctor
operating a clinic that focused on pain management allegedly provided
pre-signed, blank prescriptions to office staff who then used them to prescribe
controlled substances when he was out of the office. In another case, a solo practitioner who
operates a five-clinic family practice focusing on pain management allegedly
billed Medicare for urine testing that was not done and for urine testing that
was not medically necessary. A dentist
was charged for alleged conduct that included writing prescriptions for opioids
that had no legitimate medical purpose and that were outside the usual course
of professional practice, removing teeth unnecessarily, scheduling unnecessary
follow-up appointments, and billing inappropriately for services. In yet another case, a doctor was charged for
allegedly prescribing opioids to Facebook friends who would come to his home to
pick up prescriptions, and for signing prescriptions for other persons based on
messenger requests to his office manager, who then allegedly delivered the signed
prescriptions in exchange for cash. These cases were brought with assistance
from the FBI, DEA, HHS-OIG, and the Kentucky Medicaid Fraud Control Unit.
In the Middle District of Tennessee, federal indictments
were unsealed today charging nine Middle Tennessee medical professionals,
including four doctors, four nurse practitioners and a pharmacist, with various
charges alleging their participation in illegally prescribing and dispensing
opioids and other dangerous narcotics and health care fraud schemes. Two cases involve doctors who were previously
sanctioned by the Tennessee Medical Board in connection with the
overprescribing of opioids, one of whom was sanctioned for providing
prescriptions to vulnerable patients, while the other allegedly prescribed
opioid pills after serving a Board imposed term of probation. Another case alleges that a doctor prescribed
opioids and other controlled substances to at least four individuals. In another case, an advanced practice
registered nurse at a pain management clinic allegedly wrote prescriptions for
opioids that had no legitimate medical purpose and that were outside the usual
course of professional practice.
Separately, a pharmacist was charged for allegedly dispensing large
amounts of opioids outside the usual scope of professional practice and for no
legitimate medical purpose. Finally, a
podiatrist was charged with unlawful distribution of controlled
substances. In addition to assistance
provided by the FBI, DEA, and HHS-OIG, these cases were brought in connection
with assistance from the Tennessee Bureau of Investigation, Medicaid Fraud
Control Unit; the 18th Judicial District Drug Task Force; the Sumner County
District Attorney’s Office; and the District Attorney General for the 22nd
Judicial District.
In the Eastern District of Tennessee, at total of eight
individuals, including five doctors, a nurse practitioner, a physician’s
assistant, and an office manager were charged in four cases. Four doctors, a nurse practitioner and a
physician’s assistant were charged with the unlawful distribution of
opioids. Two doctors were charged with
health care fraud violations. Three of
these cases are related to alleged pill mill operations in the Eastern District
of Tennessee. In addition to assistance provided by the FBI, DEA, and HHS-OIG,
these cases were brought in connection with assistance from the Tennessee
Bureau of Investigation, Medicaid Fraud Control Unit.
In the Western District of Tennessee, 15 individuals were
charged, involving eight doctors and several other medical professionals. In one case, a nurse practitioner who branded
himself the “Rock Doc,” allegedly prescribed powerful and dangerous
combinations of opioids and benzodiazepines, sometimes in exchange for sexual
favors; over approximately three years, the doctor allegedly prescribed
approximately 500,000 hydrocodone pills, 300,000 oxycodone pills, 1,500
fentanyl patches, and more than 600,000 benzodiazepine pills. In another case, a nurse practitioner charged
with conspiracy to unlawfully distribute controlled substances allegedly
prescribed over 500,000 Hydrocodone
pills, approximately 300,000 Oxycodone pills, and approximately 300,000
benzodiazepine pills (mostly Alprazolam), along with a myriad of other
controlled substances. In another case,
a physician charged with controlled substances and health care fraud violations
allegedly prescribed approximately 300,000 hydrocodone pills, 200,000 oxycodone
pills, 2,500 fentanyl patches, and 180,000 benzodiazepine pills, and prescribed
medically unnecessary durable medical equipment that was billed to
Medicare. Another doctor charged with
controlled substances violations allegedly prescribed approximately 4.2 million
opioid pills, sometimes in dangerous combinations with other drugs, such as benzodiazepines,
and prescribed opioids to known addicts.
In addition to assistance provided by the FBI, DEA, and HHS-OIG, these
cases were brought in connection with assistance from the Tennessee Bureau of
Investigation, Medicaid Fraud Control Unit, the Tennessee Office of Inspector
General, and the West Tennessee Drug Task Force (28th District).
In the Northern District of Alabama, multiple individuals
were charged in five cases, including four doctors. In one case, the owners and operators of a
medical clinic and dispensary were charged with the unlawful distribution of
controlled substances and health care fraud.
In that case, a doctor allegedly prescribed opioids in high dosages,
dangerous combinations, and in many cases, after having knowledge that patients
failed drug screens and were addicts, preferring cash payments and charging a
“concierge fee” that ranged from approximately $50 per visit or $600 per
year. In another case, a doctor
allegedly recruited prostitutes and other young women with whom he had sexual
relationships to become patients at his clinic, while simultaneously allowing
them and their associates to abuse illicit drugs at his house. In yet another case, a doctor allegedly
dispensed controlled substances and other prescription drugs directly from the
clinic, and prescribed excessive quantities of controlled substances to the
same patients several times per month resulting in as many as 15 pills per day
for some patients. In that case, the doctor
also signed blank prescription forms to be completed by her staff when she was
not at the clinic.
In addition to assistance provided by the FBI, DEA, HHS-OIG,
the Defense Criminal Investigative Service and the Food and Drug
Administration, Office of Criminal Investigations, these cases were brought in
connection with assistance from the Hoover Police Department, the Huntsville
Police Department, the Huntsville Area HIDTA Drug Task Force Strategic Counter
Drug Team, the Marshall County Drug Task Force, the Alabama Medicaid Fraud
Control Unit, and the Madison County Sheriff’s Office.
In the Northern District of West Virginia, a case was
brought against an orthopedic surgeon who allegedly used fraudulent
prescriptions to obtain tablets of acetaminophen-codeine for his own use. To
obtain the pills, the surgeon allegedly wrote out prescriptions using his DEA
number, and in the names of a relative even though the pills were for his own
use, using a driver’s license that he had stolen from a colleague to obtain the
pills from pharmacy. This case was
brought in connection with assistance from the DEA and HHS-OIG.
In the Southern District of West Virginia, a doctor was
charged with allegedly distributing narcotics, including dextroamphetamine,
methylphenidate, and amphetamine salt, to a patient who did not have a medical
need for the drugs and whom the doctor never examined. This case was brought in
connection with assistance from the DEA and HHS-OIG.
*********
In addition to the ARPO Strike Force districts, today’s
enforcement actions include cases brought in the Eastern District of
Pennsylvania and the Eastern District of Louisiana.
In the Eastern District of Louisiana, a neurologist at an
alleged pill mill was charged with conspiracy to dispense controlled substances
and conspiracy to commit health care fraud.
The defendant allegedly pre-signed prescriptions for controlled
substances, including oxycodone, for patients whom he did not personally
examine to determine medical necessity for the prescriptions, and pre-signed
prescriptions for controlled substances while he was travelling
internationally. The defendant allegedly
knew that certain of these patients used their Medicare Part D and Medicaid
benefits to pay for the medically unnecessary prescriptions. In addition to
assistance provided by the FBI, DEA, HHS-OIG, these cases were brought in
connection with assistance from the U.S. Departments of Veterans Affairs –
Office of Investigations.
In the Eastern District of Pennsylvania, a former licensed
practical nurse allegedly filled fraudulent prescriptions for oxycodone in her
name and in the names of others at a local pharmacy in order to obtain the
pills for herself and to distribute to others. In addition to assistance
provided by the FBI, DEA, HHS-OIG, the Office of Personnel Management, the U.S.
Marshalls Service, these cases were brought in connection with assistance from
the Caln Township Police.
*********
For any patients impacted by the law enforcement operations,
DOJ, DEA, HHS-OIG, HHS’ Substance Abuse and Mental Health Services Administration,
Centers for Disease Control and Prevention, and all five State Departments of
Health are deploying federal and state-level strategies to address patient harm
and insure continuity of care.
Additional information regarding available treatment programs and where
patients can turn for assistance is available as follows:
Alabama: The Alabama Department of Mental Health has a
dedicated telephone number to connect those affected by the closure. The
toll-free substance abuse number is 1-844-307-1760. Information about substance abuse and
opioids is available at the following websites:
http://www.alabamapublichealth.gov/pharmacy/opioid-and-heroin.html
https://mh.alabama.gov/understanding-the-opioid-crisis/
Kentucky: If you are in Kentucky and are suffering with
addiction you can find help by calling 833-8KY-HELP or logging in at
Findhelpnowky.org
Ohio: If you are seeking help in Ohio, please call the
OhioMHAS patient helpline, at 1-877-275-6364
Tennessee: If you are seeking help in Tennessee:
For a referral to
addiction treatment services, call the Tennessee REDLINE: 800-889-9789.
In a mental health
crisis, call the Statewide Crisis Line: 855-CRISIS-1 (855-274-7471).
For help accessing
substance abuse or mental health services call the Tennessee Department of
Mental Health and Substance Abuse Services Helpline: 800-560-5767 or
615-532-6700. This line is staffed
Monday-Friday, 8 a.m. - 4:30 p.m. CT.
West Virginia: If you are in West Virginia and are suffering
with addiction you can find help by calling 1-844-HELP-4WV or logging in at
https://HelpandHopeWV.org
For individuals seeking help in other states, please call
1-800-662-HELP
The Fraud Section leads the Medicare Fraud Strike Force,
which is part of a joint initiative between the Department of Justice and HHS
to focus their efforts to prevent and deter fraud and enforce current
anti-fraud laws around the country. Since its inception in March 2007, the
Medicare Fraud Strike Force, which maintains 14 strike forces operating in 23
districts, has charged nearly 4,000 defendants who have collectively billed the
Medicare program for more than $14 billion.
The Medicare Fraud Strike Force, including the ARPO Strike Force, has
charged more than 200 individuals with opioid-related crimes.
If you, a family member, friend or loved one believe you may
be a victim in any of these cases or in connection with any charged defendant,
please visit the following website for additional information:
https://www.justice.gov/criminal-vns/case/ARPO
Additional documents related to this announcement are
available here:
https://www.justice.gov/opa/documents-and-resources-april-17-2019-press-conference
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