January 1, 2024 - How Authorities are Dismantling Tennessee Pain Clinics Prescribing Massive Quantities of Opioid Pain Pills

Investigation Reports. Doctors, Physician Assistants, and Nurses convicted of dispensing addictive prescription pain medication under the guise of pain relief centers and/or using medical care facilities to over-prescribe and distribute opioid painkiller pills and other controlled substances.

IMPORTANT NOTE: Not all pain management clinics are engaged in criminal activity. Many clinics across the state operate legally and employ trained personnel and doctors who treat patients who legitimately suffer from pain.

Owner of Lafollette Wellness Center Sentenced for Her Role in Operating a Pill Mill (U.S. Attorney’s Office, Eastern District of Tennessee, November 2023)

KNOXVILLE, TENNESSEE. According to court documents, Sharon Naylor, a Nurse Practitioner, owned and managed a non-insurance, cash-equivalent Pain Clinic named Lafollette Wellness Center in Campbell County, Tennessee. Naylor continued to own and operate LWC despite knowing that the Medical Director, Co-Defendant Dr. Henry Babenco, and the physician’s assistant, co-defendant Alicia Taylor, were prescribing opioids to patients outside professional practice and for no legitimate medical purpose.

On November 2, 2023, Sharon Naylor, 58, was sentenced to 12 months in the United States District Court for the Eastern District of Tennessee at Knoxville.

As part of the plea agreement filed with the court, Naylor waived an indictment by a Federal Grand Jury and agreed to plead guilty to an information charging her with one count of maintaining a drug premises. Naylor also pleaded guilty to an indictment charging her with one count of money laundering. Naylor was also ordered to forfeit the proceeds of her crime, including approximately $1.9 million in real property, cash, gold and silver coins, and bouillon, all seized by the United States.

Naylor, Dr. Babenco, Taylor, and LWC office manager Gregory Madron were charged with drug-related offenses as part of the April 2019 Appalachian Regional Prescription Opioid Strike Force Surge. Taylor pleaded guilty to her role in the distribution of controlled substances in May 2021, Madron pleaded guilty to a misdemeanor offense for his role in September 2023. Babenco died in a plane crash in February 2021. Madron and Taylor are scheduled to be sentenced in January and February 2024, respectively.

The charges were the result of an investigation by the DEA, the FBI, the Tennessee Bureau of Investigation, and assisted by the Appalachian Regional Prescription Opioid Task Force.

Nurse Practitioner Convicted of Opioid Distribution Conspiracy (U.S. Department of Justice, April 2023)

JACKSON, TENNESSEE. According to court documents and evidence presented at trial, Jeffrey Young, 49, of Jackson, used his medical practice, Preventagenix, to illegally prescribe more than one million medically unnecessary controlled substance pills to hundreds of patients, including a pregnant woman and women with whom he had inappropriate physical relationships. Young maintained a party-like atmosphere at his clinic and prescribed these drugs, at least in part to boost his popularity on social media and promote a self-produced reality TV show pilot based on his self-identified persona, the “Rock Doc.”

Young was convicted of conspiracy to unlawfully distribute controlled substances, maintaining a drug-involved premises, and 13 counts of distributing controlled substances, six of which involved distribution to a pregnant woman. He faced a maximum penalty of 40 years in prison for each count involving distribution to a pregnant woman and 20 years in prison for each of the other counts of conviction.

The Drug Enforcement Agency and Tennessee Bureau of Investigation investigated the case, with valuable assistance from the Jackson Police Department.

Pain Clinic Medical Providers Sentenced for Their Roles in Operating Pill Mills in Tennessee (December 2020)

KNOXVILLE, TENNESSEE. On December 9 and 10, 2020, defendants Cynthia Clemons, Courtney Newman, and Holli Carmichael Womack, all of whom are Nurse Practitioners, were sentenced for their roles in prescribing massive quantities of opioids from pill mills in Knoxville, Tennessee. Clemons was sentenced to 42 months in prison, Newman was sentenced to 40 months in prison, and Womack received a sentence of 30 months in prison.

Clemons and Newman, both of Knoxville, Tennessee, and Womack, of Crossville, Tennessee, were sentenced by United States District Judge Thomas A. Varlan. All three defendants were found guilty by a jury on February 13, 2020, of using drug-involved premises for the purposes of distributing opioid narcotics.

The evidence at trial proved that, collectively, Clemons, Newman, and Womack prescribed millions of tablets of oxycodone, oxymorphone, and morphine from the pill mills. All told, the pill mills where these defendants worked generated over $21 million in revenue, with a corresponding street value of $360 million. The conspiracy involved four separate clinics in Tennessee, each of which the jury determined was drug-involved premises, i.e., pill mills. The proof at trial established that the vast majority of the patients at these pill mills were addicted to opioids.

“Our office is determined to seek prison sentences for medical providers who think their licenses will protect them from prosecution,” said United States Attorney J. Douglas Overbey. “The sentences imposed by Judge Varlan should demonstrate that there will be severe consequences for illegally dispensing addictive narcotics.”

“Opioid abuse destroys lives, and it devastates families. The FBI takes our responsibility to investigate those who exploit their medical license at the expense of those suffering from addiction very seriously. We, along with our federal, state, and local partners, will remain vigilant to assure that unscrupulous individuals are brought to justice,” said FBI Special Agent in Charge Joseph Carrico.

This sweeping prosecution resulted in approximately 140 convictions so far, is the result of an investigation by the United States Attorney’s Office for the Eastern District of Tennessee, the Organized Crime and Gang Section, U.S. Department of Justice, and the FBI High-Intensity Drug Trafficking Area (HIDTA), comprised of investigators assigned to the task force by the Loudon County Sheriff’s Office, Knoxville Police Department, Blount County Sheriff’s Office, Roane County Sheriff’s Office, Harriman Police Department, and Clinton Police Department. Other agencies provided invaluable assistance, including the Rome Attaché of the Office of International Affairs, the U.S. Department of Justice, the FBI’s liaison in Rome, the FBI’s Miami Field Office, the Hollywood, Florida, Police Department, the United States Department of Health and Human Services, the Tennessee Department of Health, and the Drug Enforcement Administration’s Knoxville Diversion Group.

The operation of a drug trafficking network peddling prescription drugs for profit under the guise of a medical practice not only violates the law, it undermines the public confidence in the healthcare profession.

If you are aware of controlled substance violations in your community, you can submit your anonymous tip through the DEA online Tip Line.

Operators of Three Texas Pharmacies and Two Pain Clinics Arrested for Illegally Dispensing Nearly Four Million Opioid Pills (December 2021)

Three Houston-area pharmacists, a doctor, and a pharmacy technician have been arrested for allegedly running three pharmacies and two clinics as “pill mills;” distributing hydrocodone, oxycodone, and other controlled drugs without a legitimate medical purpose.

According to court documents, since January 2018, Chrisco Pharmacy (Chrisco), Keystone Pharmacy (Keystone), and Peoples Pharmacy (Peoples) illegally dispensed nearly four million pills of the Schedule II opioids hydrocodone and oxycodone. Keystone owner and pharmacist-in-charge Anthony Obute, 46, of Houston, was indicted for illegally distributing and dispensing hydrocodone and the Schedule IV muscle relaxer carisoprodol. According to the filed criminal complaint, Obute operated Keystone as a pill mill, illegally distributing hydrocodone and oxycodone. The complaint further alleges that from about September 2018 to about September 2020, Obute directed Keystone Pharmacy to purchase around 1.1 million of the highest-strength, short-acting hydrocodone and oxycodone pills commercially available, which he then sold to so-called “crew leaders,” or drug traffickers who pay individuals to pose as patients in order to obtain pills to sell onto the black market.

According to court documents, from around January 2018, to around October 2021, Obaze was the pharmacist-in-charge and Tubbe was a pharmacy technician at Chrisco, which the two men used as a front to purchase and then illegally sell around 2.25 million of the highest-strength short-acting hydrocodone and oxycodone pills commercially available. The indictment alleged that Obaze and Tubbe sold the pills, in bulk, directly to drug traffickers, without the involvement of doctors, prescriptions, or patients.

What is Oxycodone and How Is It Used (United States Drug Enforcement Administration)

Registered Nurse at a Hospice Care Center Convicted of Fraudulent Opioid Pill Prescriptions (2022)

Contessa Holley was a resident of Pulaski, Tennessee. She was a Registered Nurse, licensed by the State of Tennessee Board of Nursing. Holley was employed at Compassus Hospice in Lawrence County from 2015 through 2019. Hospice care was an end-of-life pain management and comfort care program for those with a terminal illness.

Compassus Hospice contracted with OptumRX, a pharmacy benefit manager. OptumRx, on behalf of Compassus, received and paid claims for prescription drugs provided to patients.

From May 2017 through June 2019, Contessa Holley devised and executed a scheme to defraud Compassus Hospice, OptumRX, and various pharmacies through materially false and fraudulent pretenses, representations, and promises and by misrepresenting material facts. She fraudulently obtained Schedule II controlled substances by knowingly and intentionally submitting unauthorized prescriptions for oxycodone and hydrocodone. She created fictitious patient names, addresses, and dates of birth to put on the unauthorized prescriptions. As a Registered Nurse, Holly was not authorized to prescribe Schedule II controlled substances without physician authorization.

Holley submitted these fraudulent prescriptions via fax to multiple pharmacies in Williamson, Maury, and Lewis Counties, including a large retail pharmacy in Pulaski, Tennessee, causing them to fill the prescriptions and bill the cost to Compassus Hospice.

Once the submitted prescriptions had been filled, she picked up the opioid medications while purportedly acting on behalf of the listed patients and paid nothing. She obtained oxycodone and hydrocodone for her benefit to sell and/or use as she deemed fit. By doing so, Holley knowingly transmitted, and caused to be transmitted, by means of wire communication in interstate commerce, writings, signs, signals, and pictures to execute the scheme.

Holley’s indictment included the forfeiture of all real or personal property that constitutes or derived directly or indirectly from proceeds traceable to the commission of the offense, including but not limited to a money judgment.

Holley was also employed at Willowbrook Hospice as a Clinical Director from February 2021 until her dismissal on September 1, 2021. Willowbrook Hospice is a home health and hospice company in Williamson County, Tennessee.

Clarksville Doctor Convicted of 36 Counts Related to Pill Mill Operation (September 2021)

CLARKSVILLE, TENNESSEE. Dr. Samson Orusa, 59, was convicted of federal drug charges, healthcare fraud, money laundering, and illegally distributing oxycodone at his medical practice.

Dr. Orusa was initially charged in a 45-count indictment in December 2018. The evidence at trial established that Dr. Orusa, while operating a pain clinic in Clarksville, routinely prescribed oxycodone and other Schedule II controlled substances without obtaining the patient’s prior medical history, performing a physical examination, or ordering diagnostic tests of patients. Evidence also established that two patients overdosed while inside Dr. Orusa’s clinic.

Trial testimony from former employees and patients described a standing-room-only lobby area at Orusa’s clinic, along with an unsanitary public bathroom. Patients with insurance coverage were forced to visit the clinic four to six times a month and undergo cortisone shots to receive pain medication. Dr. Orusa threatened to withhold pain management prescriptions from those who refused the injections. Cash-paying patients were generally not required to accept injections to receive prescriptions. Due to the excessive number of controlled substance prescriptions, Walmart and CVS pharmacies refused to fill prescriptions written by Dr. Orusa.

Other evidence and testimony established that Orusa conducted financial transactions designed to disguise the nature of the unlawful activity and that he transferred proceeds of the illegal activity to foreign bank accounts, used clinic proceeds to make a $12,451.00 down payment on a Mercedez-Benz, and wrote a check for the purchase of $100,000 in securities.

In one instance, Dr. Orusa billed Medicare for services he claimed to have provided to 57 patients in a single day despite being at the clinic for less than six hours.

Following a two-week trial, Dr. Orusa was convicted of maintaining a drug-involved premise, 13 counts of unlawfully distributing controlled substances without a legitimate medical purpose and outside the bounds of professional medical practice, 13 counts of health care fraud, seven counts of money laundering, and two counts of laundering more than $10,000 of criminally derived property. The jury acquitted Dr. Orusa of nine counts of illegal distribution of oxycodone.

After finding Orusa guilty of 36 of the 45 counts, the jury returned to hear evidence supporting the forfeiture of the ill-gotten proceeds of the crimes. After deliberations, the jury determined that five bank accounts, one annuity, and one 401-K, with a combined value of more than $918,000, were subject to forfeiture, and also a 2017 Mercedes Benz.

“Physicians like Dr. Orusa who violate their oath and engage in such reckless conduct and contribute to the opioid epidemic facing this nation can expect to bear the full force and effect of the federal justice system,” said Acting U.S. Attorney Stewart. “I commend our prosecutors and law enforcement partners for their exceptionally hard work in thoroughly investigating this case and preparing it for a successful prosecution.”

Orusa faced up to 20 years in prison on each drug-related count and up to 10 years in prison on each healthcare fraud and money laundering count.

This case was prosecuted by the U.S. Drug Enforcement Administration; the U.S. Department of Health & Human Services Office of Inspector General; the IRS-Criminal Investigation; the Tennessee Bureau of Investigation; the Clarksville Police Department; and the 19^th Judicial District Drug Task Force.

If you are aware of controlled substance violations in your community, you can submit your anonymous tip through the DEA online Tip Line.

Concerns Mount Over Pain Clinic Closures in Tennessee (NewsChannel 5, YouTube Video)

The abrupt closures of several Comprehensive Pain Specialist Clinics across middle Tennessee have patients and different organizations concerned about future of the opioid epidemic.

Comprehensive Pain Specialists and Former Owners Agree to Pay $4.1 Million to Settle Fraud Allegations (April 2021)

NASHVILLE, TENNESSEE. CPS, which was based in Brentwood, Tennessee, at one point operated over 40 pain clinics and had operations in 12 states, until it shut down in 2018.

“When physicians and health care companies engage in questionable business practices and unnecessary services, it compromises patient care and the integrity of HHS programs,” said Derrick L. Jackson, Special Agent in Charge for the Office of Inspector General of the U.S. Department of Health and Human Services. “Our agency will continue to investigate and hold accountable providers that put profits before patients.”

Pain Clinic Owner Sentenced for Role in Operating Pill Mills in Tennessee and Florida (October, 2020)

The government maintains that Sylvia Hofstetter was running several pain clinics, some strictly for cash, serving as many as 100 addicts a day. Others were described as legitimate operations that took insurance but referred people to facilities where prescriptions for oxycodone and other narcotics were written with no questions asked. One of them, the now-closed East Knoxville Healthcare Clinic, sits between a Waffle House and an adult bookstore.

Sylvia Hofstetter, 56, of Miami, Florida, was found guilty by a jury of Racketeer Influenced and Corrupt Organization (RICO) conspiracy, two counts of drug conspiracy, money laundering offenses, and maintaining drug-involved premises. Judge Varlan ordered the defendant to forfeit $3.6 million.

“We know, from interaction with law enforcement down there, that Tennessee license plate tags were frequently the most observed state tags in the parking lot on drug surveillances,” Chapman said of the Florida pill mills. Given that the customer base was in Tennessee, Hofstetter opened clinics there, in Knoxville and nearby Lenoir City. Some of them would see 1,000 patients a month.

The FBI estimated that about 12 million prescriptions for opioids, including oxycodone, oxymorphone, and morphine, were prescribed by the clinics in four years. A typical visit cost a patient $325 to $350.

Court records and testimony show Sylvia Hofstetter worked for Florida businessmen Luca Sartini, Luigi Palma, and Benjamin Rodriguez – dubbed “the Italians.” The trio of businessmen were considered pill-mill kings in South Florida but repeatedly escaped prosecution and, amid a law enforcement crackdown in that state, decided to move their operation to East Tennessee, prosecutors said.

The men put Hofstetter, who had worked for the trio in South Florida, in charge, testimony showed. With her in charge, the Florida group dubbed “Italians” prospered in East Tennessee, netting $21 million in profits in four years, putting more than 12 million prescription painkillers into the hands of addicts and leaving a trail of dead patients, court records show. The conspiracy involved pain clinics in Lenoir City and Knoxville and a slew of related money laundering and drug distribution charges.

To neighbors, Sylvia Hofstetter was a wealthy businesswoman and grandmother who threw extravagant pool parties and went all out to decorate her upscale suburban home on Christmas and Halloween.

Hofstetter didn’t hide her affluence. She often had contractors renovating her 3,400-square-foot home in the winding Falcon Pointe development of cul-de-sacs, where neighbors smile and wave on their afternoon strolls.

That image was shattered when FBI agents raided the healthcare administrator’s Knoxville home. Federal prosecutors said the 51-year-old Florida native was running the largest illicit drug operation in the history of east Tennessee: a string of pill mills that raked in $17.5m in four years.

“This defendant reaped millions of dollars in personal profits by operating destructive opioid pill mills in multiple states, inflicting lasting harm on multiple communities,” said Acting Assistant Attorney General Brian C. Rabbitt of the Justice Department’s Criminal Division. “This prosecution demonstrates the Department of Justice’s steadfast commitment to combatting the opioid crisis and holding responsible the unscrupulous individuals who seek to profit from it.”

“The Eastern District of Tennessee remains at the forefront in the battle against illegal pain clinics and the mass-prescribing of opioids,” said U.S. Attorney J. Douglas Overbey for the Eastern District of Tennessee. “Through the cooperation and hard work of our local, state, and federal agencies, we continue to pursue and prosecute those who seek to endanger our communities by illegally distributing prescription painkillers. Let this sentencing serve as a deterrent for those who seek to profit from fueling a tragic cycle of addiction and pain killer abuse.”

“The nation remains in the midst of a drug crisis that is often fueled by pill mills. Drug addiction destroys lives and devastates families,” said Special Agent in Charge Joseph Carrico of the FBI’s Knoxville Field Office. “The FBI will work tirelessly with our federal, state, and local law enforcement partners to investigate, arrest, and hold accountable those who use illegal means and criminal behavior to take advantage of others.”

The evidence at trial proved that the pill mills owned and operated by Hofstetter and her co-defendants distributed over 11 million tablets of oxycodone, oxymorphone, and morphine that generated over $21 million in revenue, with a corresponding street value of $360 million. The conspiracy involved four separate clinics in Tennessee, each of which the jury determined were drug-involved premises, i.e., pill mills. Before coming to Tennessee, Hofstetter worked at a pill mill in Hollywood, Florida, owned by three of her co-defendants. The evidence at trial demonstrated that, as law enforcement shut down hundreds of pill mills in South Florida during that time, Hofstetter and her co-defendants planned the move to East Tennessee, where a large percentage of these clinics’ opioid-addicted customers lived.

Assistant U.S. Attorney Tracy Stone said Hofstetter was unrepentant about the destruction caused by the opioids the pill mills she operated pushed onto the streets of East Tennessee.

Hofstetter’s role in Tennessee was to run the pill mills and ensure that patient volume remained high, thus guaranteeing enormous profits for Hofstetter and her co-defendants. Once in Tennessee, however, Hofstetter opened her own pill mills in secret from her Florida employers and went into competition against them. Hofstetter personally reaped over $4 million from her role in these offenses.

This sweeping prosecution, which has resulted in approximately 140 convictions so far, is the result of an investigation by the U.S. Attorney’s Office for the Eastern District of Tennessee, the Criminal Division’s Organized Crime and Gang Section (OCGS), and the FBI High-Intensity Drug Trafficking Area (HIDTA), comprised of investigators assigned to the task force by the Loudon County Sheriff’s Office, Knoxville Police Department, Blount County Sheriff’s Office, Roane County Sheriff’s Office, Harriman Police Department, and Clinton Police Department.

Two Top Leaders in Italy and Five U.S. Residents Indicted for Racketeering, Health Care Fraud and Drug Trafficking Conspiracies to Distribute Opioids, Resulting in Deaths Involving “Pill Mills” Operating in Tennessee and Florida

KNOXVILLE, TENNESSEE. A federal grand jury returned a 14-count superseding indictment unsealed today charging seven individuals for their roles in a Racketeer Influenced and Corrupt Organization (RICO) conspiracy and drug trafficking conspiracy to distribute and dispense oxycodone, oxymorphone, and morphine outside the scope of professional practice and not for a legitimate medical purpose and resulting in deaths, maintenance of drug-involved premises, distribution of oxycodone resulting in death, conspiracy to defraud the United States through the solicitation and receipt of illegal healthcare kickbacks and money laundering.

Luca Sartini, 58, of Rome, Italy, and Miami; Luigi Palma aka Jimmy Palma, 51, of Rome, Italy, and Miami; Benjamin Rodriguez, 42, of Delray Beach, Florida; Sylvia Hofstetter, 53, of Knoxville; Courtney Newman, 42, of Knoxville; Cynthia Clemons, 45, of Knoxville; and Holli Womack aka Holli Carmichael, 44, of Knoxville were charged in the Eastern District of Tennessee.

On Jan. 19, Sartini and Palma were arrested in the Rome, Italy-area by Italian authorities. Extradition was sought by the United States. Rodriguez was set to self-surrender. All other defendants were previously charged in prior indictments.

According to the indictment, Sartini, Palma, Rodriguez, Hofstetter, and a co-conspirator charged in another indictment, from about April 2009 to March 2015, ran the Urgent Care & Surgery Center Enterprise (UCSC), which operated opioid-based pain management clinics, “pill mills,” in Florida and Tennessee, where powerful narcotics were prescribed and/or dispensed. The defendants were alleged to have hired medical providers with DEA registration numbers, which would allow the providers to prescribe controlled substances. The prescriptions were primarily large doses of highly addictive and potentially deadly controlled substances. As alleged in the indictment, individuals seeking prescriptions would often travel long distances, purporting to suffer from severe chronic pain.

The indictment alleged the defendants distributed quantities of oxycodone, oxymorphone, and morphine sufficient to generate clinic revenue of at least $21 million. As per the indictment, the clinics did not accept insurance, received gross fees, and ordered unnecessary drug screenings, defrauding Medicare. Shell companies were set up to launder the proceeds.

As alleged in the indictment, approximately 700 UCSC enterprise patients are now dead, and a significant percentage of those deaths, directly or indirectly, were the result of overdosing on narcotics prescribed by the USSC Enterprise. As alleged in the indictment, the narcotics prescribed by the UCSC enterprise contributed to the deaths of a significant percentage of those patients.

The indictment further alleges that many patients arrived in groups who were sponsored by drug dealers who paid for the pain clinic visits and prescriptions to obtain all or part of the opioids and other narcotics prescribed to the purported pain patients. In return, drug-addicted patients would receive a portion of prescribed narcotics for free from the sponsor.

As a result of this investigation, approximately 30 narcotics traffickers were charged and convicted federally, and approximately 80 to 90 smaller narcotic distributors were charged and convicted. This superseding indictment is among 35 related indictments charging approximately 140 individuals, including medical providers who worked at the pill mills, with various crimes.

“Throughout this country, and certainly in Tennessee and Florida, the illegal and unconscionable mass distribution of prescription opioids through the operation of illegal pain clinics has taken a heavy toll on our citizens, families, and communities,” said Attorney General Sessions. “This sort of profiteering effectively trades human lives for financial riches. The U.S. Department of Justice is determined to stamp out the operation of illegal pain clinics by all legal means, including finding and arresting those responsible wherever they may be in the world.”

“The Eastern District of Tennessee has been at the forefront in the battle against illegal pain clinics and mass-prescribing of opioids for years,” said U.S. Attorney Overbey. “Now, under the leadership of Attorney General Sessions, additional resources have been made available through recent Department of Justice initiatives, including the Opioid Fraud and Abuse Task Force. This latest indictment is a real and tangible result of all those combined efforts. The citizens of East Tennessee can be assured that we are committed to ridding our district of illegal pill mills.”

The charges in the indictment are merely allegations, and the defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law.

The superseding indictment is the result of an investigation conducted by the the U.S. Attorney’s Office for the Eastern District of Tennessee, Criminal Division’s Organized Crime and Gang Section, and the FBI High Intensity Drug Trafficking Area (HIDTA), which is comprised of investigators assigned to the task force by the Loudon County Sheriff’s Office, Knoxville Police Department, Blount County Sheriff’s Office, Roane County Sheriff’s Office, Harriman Police Department and Clinton Police Department. Other agencies provided invaluable assistance, including the Rome Attaché of the Justice Department’s Office of International Affairs; the FBI’s liaison in Rome; the FBI Miami Health Care Fraud Strike Force; the Hollywood, Florida Police Department; the U.S. Department of Health and Human Services; the Tennessee Department of Health; and the DEA’s Knoxville Diversion Group. The Department of Justice extends its gratitude to Interpol and the Italian Financial Police (Guardia di Finanza) for their assistance in locating and apprehending the defendants.

In light of the nationwide opioid epidemic, which led to the declaration of a public health emergency by the Acting Secretary of the Department of Health and Human Services on Oct. 26, 2017, this superseding indictment represents just the latest in a series of federal efforts in the Eastern District of Tennessee meant to combat the scourge of prescription opioids.

National Appalachian Regional Prescription Opioid Strike Force Takedown Includes Charges Against 8 Healthcare Professionals in the Eastern District of Tennessee (April 2019)

KNOXVILLE, TENNESSEE – Attorney General William P. Barr and Department of Health and Human Services (HHS) Secretary Alex M. Azar III, together with multiple law enforcement partners, announced enforcement actions involving 60 charged defendants across 11 federal districts, including 31 doctors, 7 pharmacists, 8 nurse practitioners, and 7 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 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 HAD 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 12 prosecutors has charged 60 defendants for alleged crimes related to millions of prescriptions. 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.”

In the Eastern District of Tennessee, 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 healthcare fraud violations. Three of these cases relate to alleged pill mill operations in the Eastern District of Tennessee.

Included in the charges were the following indictments, which are on file with the U.S. District Court for the Eastern District of Tennessee:

On April 2, 2019, a federal grand jury returned an indictment against Dr. Charles Brooks, 61, of Maryville, Tennessee, charging him with one count of conspiracy to distribute Schedule III, IV, and V drugs as well as one count of healthcare fraud for aiding and abetting a false statement related to health care matters.

On April 16, 2019, a federal grand jury returned an indictment against Dr. Stephen Mynatt, 64, of Knoxville, Tennessee, and Dr. David Newman, 58, of Maryville, Tennessee, charging them with conspiracy to distribute Schedule II controlled drugs. Mynatt was also charged with two counts of distribution of Schedule II drugs. Both Mynatt and Newman were affiliated with Tennessee Valley Pain Specialists.

On April 16, 2019, a federal grand jury returned an indictment against Dr. Henry Babenco, 58, of Paducah, Kentucky; Sharon Naylor, 53, of Jacksboro, Tennessee; Alicia Taylor, 29, of Oneida, Tennessee; and Gregory Madron, 54, of Jacksboro, Tennessee, charging all of them with conspiracy to distribute Schedule II controlled drugs. Naylor and Babenco were also charged with money laundering. Babenco, Naylor, Taylor, and Madron were all associated with LaFollette Wellness Center.

On April 16, 2019, a federal grand jury indicted Dr. Harrison Yang, 75, of Manchester, Tennessee, with healthcare fraud violations.

“Unfortunately, the Appalachian Region, which includes the Eastern District of Tennessee, is experiencing a surge in drug abuse and overdose-related deaths,” said U.S. Attorney J. Douglas Overbey. “Today is an example of how our office is working with our law enforcement partners in the Appalachian Regional Prescription Opioid Strike Force to identify and prosecute dishonest medical professionals and others engaged in health care fraud schemes involving illegal prescription, distribution, possession, and use of opioids.”

Troy Sowers, Special Agent in Charge, Federal Bureau of Investigation, Knoxville Division, said, “Today’s arrests clearly and tragically illustrate these so-called medical professionals were not legitimately assisting their patients – they were contributing to the opioid crisis epidemic that has destroyed families and taken so many lives. Not only were they engaging in criminal behavior, they were profiting from the addiction and pain of unsuspecting victims. Working alongside our partners, HHS, DEA, TBI, THP, and many other state and local agencies, we will continue to vigorously pursue anyone involved in trafficking opioids in this country while protecting the public’s health and welfare.”

“The Drug Enforcement Administration and our law enforcement partners remain committed to targeting unscrupulous medical practitioners who choose profits over patients,” said D. Christopher Evans, Special Agent in Charge of DEA’s Louisville Field Division. “We will never stop fighting for those who have been rendered helpless by America’s ongoing opioid crisis.”

“Opioid fraud schemes have hit the Appalachian region particularly hard, resulting in staggering numbers of addiction, overdoses, and deaths of individuals to include Medicare and Medicaid beneficiaries,” said Special Agent in Charge Derrick J. Jackson of the Department of Health and Human Services Office of Inspector General. “Working hand-in-hand with our law enforcement partners, our agents will continue to address this devastating epidemic by thoroughly investigating corrupt providers who contribute to the ongoing opioid crisis and threaten the health and well-being of patients, as alleged in these cases.”

“The health and well-being of Tennesseans is of the utmost importance to the TBI and our law enforcement partners. It’s through efforts like this that we are able to further work toward attacking the opioid crisis and the effects it has on our residents,” said David Rausch, Director, Tennessee Bureau of Investigation.

In addition to the cases, Attorney General Barr and U.S. Attorney Thomas T. Cullen announced 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 and multiple State Medicaid Fraud Control Units. The mission of the ARPO Strike Force is to identify and investigate healthcare 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 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 115 Americans die every day of an opioid-related overdose.

The ARPO Strike Force comprises prosecutors and data analysts with the HCF Unit, prosecutors with the ten 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 ten 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 and State Medicaid Fraud Control Units.

If you are aware of controlled substance violations in your community, you can submit your anonymous tip through the DEA online Tip Line.

Purdue Pharma Pushed Pill Mill Doctors to Shell Out OxyContin, Hid Evidence (Jamie Satterfield, KnoxNews, July 14, 2018)

Makers of the opioid OxyContin promised to report pill mills to law enforcement in Tennessee but instead hid evidence and pushed providers to dole out more pills at higher doses for longer periods, even providing “savings coupons” to cash-paying addicts, court records show. A lawsuit filed on behalf of taxpayers by the Tennessee Attorney General’s office against Purdue, which raked in $3 billion annually in OxyContin sales, was unsealed last week. It reveals evidence the drug maker both aided Tennessee pill-mill operators in the illegal distribution of opioids and kept quiet evidence of their crimes.

Purdue’s own records — obtained by the attorney general as part of the state’s 2007 civil enforcement agreement with the drugmaker — link the firm’s employees to some of East Tennessee’s largest and deadliest pill mill operations.

In 2007, Tennessee was fertile ground for pill mill operations. Anyone could own a “pain management” clinic. There was little regulation or supervision. At the same time, Florida, the nation’s first haven state for pill mills, was tightening enforcement and regulation, driving opioid street dealers to search for new supply clinics.

Maryville Pill-Mill Providers ‘Willfully Blind’ to Role in Opiate Epidemic (Jamie Satterfield, KnoxNews, November 2016)

Oxycodone was a money-maker – for the drug makers, pharmacies, and, through increased patient visits, for doctors. By the early 2000s, a cottage industry sprang up – pain management clinics where those with complaints of chronic pain were supposed to find long-term solutions but instead found legal prescriptions for massive doses of the drug. There were no rules. Anyone could open one.

There was one key ingredient, though. Someone with legal authority to prescribe opiates was required, and that meant doctors, physician’s assistants, and nurse practitioners were in high demand.

The money was good – $500 to $1,000 a day. The job was easy – ask a question or two and write a prescription. Sometimes, the questioning wasn’t even necessary, just the signature.

Sure, these medical providers admitted they were a bit queasy. After all, none of them knew a thing about pain management and only slightly more about the deadly drugs they were doling out. And, there were plenty of warning signs that the clinic in which they worked was no clinic at all – cash-only payments, gun-toting workers, entire families as patients with identical pain complaints, no medical referrals, no prior testing, no medical equipment, no appointments and a boss with zero medical experience.

But clinics like the one at which these eight medical providers worked were perfectly legal and completely unregulated, so, they say, it was easy to convince themselves they were doing nothing wrong.

That willful blindness has put Lewis and his seven medical co-workers at the Breakthrough Pain Therapy Center in Maryville on the road to prison. Lewis, physician’s assistant Walter David Blankenship, nurse practitioners Jamie Chiles Cordes, Sherry Ann Fetzer, Buffy Renee Kirkland, and Donna Jeanne Smith, and supervisory doctors James Brian Joyner and Deborah Gayle Thomas have all pleaded guilty to federal drug conspiracy charges.

Each worked at the clinic part-time in 2009-2010, earning anywhere from $500 a day to, for the doctors, $1,000 a day. Their boss, Sandra Kincaid, was an opiate addict who opened the clinic with her husband, Randy Kincaid, as a way to make money and feed her addiction. She not only ran the clinic but paid patients to give her a percentage of the pills they received – known as a “sponsor” in the pill mill game. In just 17 months, the clinic pulled in $12.5 million – all in cash.

Federal authorities raided the clinic in December 2010 and indicted the Kincaids, two family members, and Breakthrough’s medical staff, not for overprescribing or fraud, but for dealing drugs – just like the hustlers on the street peddling crack cocaine.

Among the law changes in Tennessee is a requirement that doctors own pain clinics. But the 2015 case of a $17.5 million pill-mill operation in Knoxville and Lenoir City showed pill mills still existed with a doctor paid to serve as nominee owner. A database was set up to log every opiate prescription, and both pharmacists and doctors are required to use it to ferret out patients who are going from one doctor to the next to get drugs. But identifying potential drug seekers doesn’t stop doctors from writing prescriptions to them or pharmacies from filling them so long as the supply is limited to 30 days.

In East Tennessee, where opiate addiction is rampant, federal prosecutors are taking an aggressive approach, using drug conspiracy laws against medical providers.

Chattanooga Pill Mill Operator Sentenced to 280 Years in Prison (August 2015)

CHATTANOOGA, TENNESSEE – Dr. Barbara Lang was charged along with three other individuals. Her daughter, Faith Blake, pleaded guilty to conspiring to illegally distribute drugs through Superior One Medical Clinic, a business she operated with her mother. Blake also pleaded guilty to conspiring to illegally distribute drugs through Elite Care, another Chattanooga pain clinic that she operated.

On August 27, 2015, Barbara Lang, a.k.a. “Aunt Bea,” 61, of Rossville, Georgia., was sentenced by the Honorable Curtis L. Collier, U.S. District Judge, to serve 280 years in federal prison.

After a 25-day trial that spanned almost three months, Dr. Lang was convicted of two counts of conspiring to distribute and dispense Schedule II and IV controlled substances outside the scope of professional practice and not for a legitimate medical purpose; five counts of maintaining a premises for the purpose of distributing controlled substances; and fourteen counts of structuring financial transactions to evade reporting requirements.

Dr. Jerome Sherard, Superior One’s Medical Director, pleaded guilty to conspiring to illegally distribute drugs at Superior One Medical Clinic and the Sherard Clinic, his own practice. Sherard was sentenced to serve five years in federal prison. Sherard was also ordered to forfeit $192,956.31 to the United States.

Charles Larmore, a Nurse Practitioner employed by Dr. Lang at Superior One and Primary Care, pleaded guilty to conspiring to distribute drugs at both clinics illegally. Larmore was sentenced to 13 years in federal prison. Larmore was also fined $20,000 and ordered to forfeit $375,829.20 to the United States.

“We are very pleased with this very lengthy sentence given to this defendant, who disbursed these very addictive drugs to many people over a long period. Illegal opioid pain medication distribution organizations, such as this, contribute to an epidemic of addiction in the United States. We thank the cooperative work of the federal, state, and local agencies, who investigated this case and participated in this very lengthy trial. She will never be able to participate in the illegal distribution of prescription drugs again,” said U.S. Attorney Bill Killian.

Daniel R. Salter, Special Agent in Charge, Drug Enforcement Administration, stated, “The dispensing of addictive prescription pain medication under the guise of a doctor’s care is not about the good of the community or an individual’s specific health needs; it is about greed and those involved in “pill mill” activity are in fact drug dealers. The sentencing of this defendant makes the Chattanooga area a safer place today.”

Law enforcement agencies participating in the joint investigation which led to the indictment and subsequent conviction of Lang, Blake, Sherard, and Larmore included the Drug Enforcement Administration (DEA); IRS – Criminal Investigation; Tennessee Bureau of Investigation; Hamilton County Sheriff’s Office; Chattanooga Police Department; Roane County Sheriff’s Department; and Rockwood Police Department.

America’s Pill Mills (American Addiction Centers, November 2023)

Of the survey respondents who said they were on prescription painkillers for minor surgery (such as a tooth extraction), 1.6 percent have been on medication for more than a year. About 48 percent have been on painkillers for between one week and one month. When it comes to chronic pain, though, 38 percent of respondents being treated have been on opioids for more than a year. For injuries, 10.7 percent have been on painkillers for more than a year, while 13 percent of respondents being treated for major surgery have been on medication for more than a year.

While addiction doesn’t always happen immediately, opioid tolerance does increase, resulting in a need for higher dosage. A patient being treated for a minor surgery may then find themselves needing more medicine because the original dosage is no longer adequately relieving pain.

The opioid crisis and drug overdoses continue to devastate our states and local communities.

Pill mills are a problem. If the citizens of the community report they see signs of suspicious activity and more businesses keep an eye out for the above-mentioned signs as well, hopefully, these pill mills can be limited. You can submit an anonymous tip through the DEA online Tip Line and report the doctor or facility.

As the fight against the opioid crisis continues, State and Federal Authorities are working to shut down phony Pain Clinics that are really just fronts for criminals who divert pharmaceutical drugs and hook a new generation of people with an addiction.

Pain Killer by Barry Meier

Between 1999 and 2017, an estimated 250,000 Americans died from overdoses involving prescription painkillers, a plague ignited by Purdue Pharma’s aggressive marketing of OxyContin. Families, working class and wealthy, have been torn apart, businesses destroyed, and public officials pushed to the brink. Meanwhile, the drugmaker’s owners, Raymond and Mortimer Sackler, whose names adorn museums worldwide, made enormous fortunes from the commercial success of OxyContin.

In Pain Killer, Barry Meier tells the story of how Purdue turned OxyContin into a billion-dollar blockbuster. Powerful narcotic painkillers, or opioids, were once used as drugs of last resort for pain sufferers. But Purdue launched an unprecedented marketing campaign claiming that the drug’s long-acting formulation made it safer to use than traditional painkillers for many types of pain. That illusion was quickly shattered as drug abusers learned that crushing an Oxy could release its narcotic payload all at once. Even in its prescribed form, Oxy proved fiercely addictive. As OxyContin’s use and abuse grew, Purdue concealed what it knew from regulators, doctors, and patients.

Here are the people who profited from the crisis, those who paid the price, those who plotted in boardrooms, and those who tried to sound alarm bells. A country doctor in rural Virginia, Art Van Zee, took on Purdue and warned officials about OxyContin abuse. An ebullient high school cheerleader, Lindsey Myers, was reduced to stealing from her parents to feed her escalating Oxy habit. A hard-charging DEA official, Laura Nagel, tried to hold Purdue executives to account.

In Pain Killer, Barry Meier breaks new ground in his decades-long investigation into the opioid epidemic. He takes readers inside Purdue to show how long the company withheld information about the abuse of OxyContin and gives a shocking account of the Justice Department’s failure to alter the trajectory of the opioid epidemic and protect thousands of lives. Equal parts crime thriller, medical detective story, and business exposé, Pain Killer is a hard-hitting look at how a supposed wonder drug became the gateway drug to a national tragedy.

Understanding Drug Overdoses and Deaths (Centers for Disease Control and Prevention)

Researchers from the Centers for Disease Control and Prevention report that Schedule II prescription painkillers, like oxycodone, cause more drug overdose deaths than cocaine and heroin combined. Oxycodone and other Schedule II drugs have a high potential for abuse and can be crushed and snorted or dissolved and injected to get an immediate high. This abuse can lead to addiction, overdose, and sometimes death.

Within the last decade, abuse and misuse of certain prescription drugs, especially pain medications, has become prevalent. The opioid crisis and drug overdoses continue to devastate our states and local communities.

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