Investigation Reports. Authorities are Cracking Down on the Massive Amounts of Oxycodone Pain Pills Disbursed Through Pain Management Clinics, Reaping Millions of Dollars
Some pain clinics have represented themselves as primarily focused on pain management, but they knowingly and intentionally conspired to distribute and dispense oxycodone pills in connection with their operation.
The abuse of prescription drugs, especially opioids, is a serious problem in our communities. This abuse leads to addiction, shattered lives, and even death.
Some Pharmacists have gone from pharmaceutical provider to drug dealer when they knowingly provided controlled substances without a legal medical purpose. Some conspired with others, including medical professionals and employees, to fill fraudulent prescriptions for oxycodone and dispense thousands of oxycodone pills in return for hundreds of thousands of dollars in cash.
Some medical professionals and their co-conspirators have schemed to provide medically unnecessary prescription drugs.
Americans rely on physicians and other healthcare providers to help their patients and to ‘do no harm.’ Pill-Peddling Physicians violate the law and betray the responsibilities of their profession by dispensing highly-addictive controlled substances.
Federal prosecutors accused Dr. Kirsten Van Steenberg-Ball, 69, of issuing illegal prescriptions for more than 1 million oxycodone pills. Ball, a primary care physician, operated a medical practice out of her Arlington home. Ball ran the drug distribution for more than a decade through a network of people posing as patients to whom she illegally prescribed oxycodone pills, according to the prosecution’s evidence.
The doctor’s office manager, Candie Marie Calix, of Front Royal, was sentenced to seven years in prison for conspiring to distribute oxycodone. Court records show that Ball prescribed Calix, also a patient, approximately 50,000 oxycodone pills over about 10 years.
The Virginia Department of Health Professions investigated Ball in 2014, 2015 and 2021 for excessive and improper prescribing of oxycodone. Ball falsified records that she submitted to the department to cover up the fact she prescribed the drug to patients for no legitimate reason and outside the course of professional practice, according to evidence prosecutors presented at trial.
Evidence also revealed that Calix, at Ball’s direction, recruited other people, including several immediate family members, to become patients so the doctor could prescribe similarly large amounts of oxycodone to them. Calix then sold the tens of thousands of pills that Ball had prescribed.
The prosecution also presented evidence to show that Ball prescribed oxycodone to drug traffickers and drug addicts in exchange for hundreds of dollars. Several patients became addicted to oxycodone.
Investigations show individuals and their businesses participating in a drug trafficking conspiracy that distributed massive amounts of addictive controlled substances from pain management clinics. These are not just crimes of greed, these are crimes that make this country’s opioid crisis even worse.
As the fight against the opioid crisis continues, State and Federal Authorities are working to shut down Pain Clinics that are really just fronts for criminals who divert pharmaceutical drugs and hook a new generation of addicts.
WARREN, MICHIGAN. Dr. Rajendra Bothra, 77, and Clinic Physician Dr. David Lewis, 41, prescribed more than 13 million doses of opioids and billed medical insurers almost $500 million, according to the grand jury indictment.
Among Pain Center doctors, Dr. Lewis had one of the highest rates of prescribing schedule II pain medication, a category that carries high potential for abuse and includes fentanyl and oxycodone, according to the FBI agent.
From 2016 to 2018, Dr. Lewis prescribed more than 930,000 doses of medication, and almost 94% were schedule II drugs, a category that includes fentanyl and oxycodone, according to the FBI.
The scheme described by investigators involved pain clinics owned by Bothra in Macomb County.
Until federal agents shut down the clinic, Warren’s Pain Center USA had an armed guard, a body count, and standing orders for patients to undergo unnecessary back injections in exchange for pain pills.
Dr. Bothra was being hunted in early December; he just didn’t know it yet.
“This is often indicative of physicians and medical clinics that operate as a ‘pill mill’ with little to no regard for patient health…,” the agent reported.
They also lived a lavish lifestyle during the alleged conspiracy, according to public records and the FBI.
There was a financial incentive for doctors to perform injections and prescribe pain pills. Pain Center doctors received a base salary and bonuses for medical services that could be billed to private or public insurance plans, according to the FBI.
“Dr. Lewis bragged that he earned $90,000-100,000 each month and drove a Rolls-Royce,” the FBI reported.
Secretary of State records showed that Dr. Lewis drove a 1965 Rolls-Royce Silver Cloud, and his Facebook page showed the luxury automobile parked outside his 4,000-square-foot home. Other social media posts feature snapshots of diamond rings and Gucci shoes.
The FBI describes a scheme involving pain pills and doctors billing insurance programs for unnecessary medical services. The services included back injections, sometimes performed by unskilled staff who jabbed patients with needles while hunting for the correct injection site, the FBI agent reported.
One patient walked into Pain Center USA but hobbled out with a cane after receiving back injections, according to an FBI agent.
“MG stated that these appointments were more of a social gathering than a typical medical clinic appointment,” the FBI agent reported. “MG also observed that some of the patients waiting in the parking lot were drinking alcohol and smoking marijuana.”
The clinic was a flurry of activity. Doctors each saw 60-70 patients daily during visits that lasted as little as two minutes.
“It is Physician-1’s understanding that the standing order at the Pain Center is to prescribe pain medication and to conduct unnecessary ancillary services … under unnecessary anesthesia,” the FBI agent reported.
Pain pill scalpers roamed the parking lot at a Macomb County clinic embroiled in one of the nation’s largest healthcare fraud cases, chugging booze, smoking weed, and buying drugs hot off the prescription pad, according to an FBI agent.
The FBI painted a deadly portrait of life inside Pain Center USA, which rose to prominence amid the nation’s opioid epidemic, as part of its federal filing to convince a judge to approve the seizure of almost $26 million from the clinic’s owner and medical team. On Dec. 4, the FBI received permission from U.S. Magistrate Judge Mona Majzoub to seize money from 19 bank accounts linked to Bothra and his team of doctors. According to the FBI, the money was generated by a complex scheme to commit health care fraud and money laundering.
The FBI infiltrated the clinic with an undercover agent and a whistleblowing doctor who claimed to be disgusted by the scene inside Pain Center USA.
“I don’t feel like a physician right now,” the doctor told FBI Special Agent Mark Kroger, according to the filing. “I feel like a fraud.”
The clinic, where one patient overdosed on heroin in a waiting room in October, is closed, and the parking lot is empty, except for a row of statues marking the doctors’ reserved parking spots. They depict Roman goddesses, including Venus and Diana the Huntress.
According to the government, patients left with two things, whether they needed them or not: Medical equipment, particularly back braces, and opioids.
Business was booming. Patient traffic spilled across Van Dyke into the parking lots of neighboring businesses, including an Italian restaurant and Jim Williams’ heating and cooling shop.
Dr. Bothra was almost finished paving a parking lot at one of the 12 properties his real estate company owned at or near the clinic. Bothra’s arrest halted the project.
Federal agents have spent months trying to pinpoint the value of Bothra’s fortune. Bothra initially told court officials he was worth $10.4 million. His lawyer later said Bothra’s net worth was as much as $35 million. Subpoenaed bank records show Bothra’s clinics received tens of millions of dollars, the FBI agent said.
The clinics had two primary bank accounts through which more than $43.6 million flowed, according to the FBI agent. The money was generated by the health care fraud and wire fraud scheme, and investigators followed the cash as it flowed from the clinics to doctors’ personal bank accounts, according to the FBI.
Federal agents seized at least $25.9 million from doctors indicted in the criminal case, relatives, and the pain clinics.
Dr. Bothra, a surgeon, humanitarian, and native of India who in 1999 received that country’s highest civilian honor, known as the Padmashri, amassed a fortune during his medical career.
Bothra and his real estate company owned four condominiums in downtown Royal Oak, three homes on two continents—including a $300,000 condo in Mumbai, India — and one retirement account worth $8.5 million. That is according to public records and evidence that emerged during Bothra’s fight to be released from jail pending trial.
FBI agents seized at least $17.2 million from bank accounts linked to Bothra and his family, according to a forfeiture notice filed in federal court.
The government left untouched an $8.5 million retirement account that Bothra was trying to liquidate so he could pay lawyers and leave jail on bond. He remained behind bars, though, because prosecutors were appealing a record $7 million bond Bothra received.
DR. ERIC BACKOS
Nobody charged in the case prescribed more drugs than Dr. Eric Backos. The 66-year-old Bloomfield Hills doctor prescribed more than 5.9 million pills from 2013 to 2018, according to the FBI. More than 86% of the drugs belong to a category that includes fentanyl and oxycodone.
In a 14-month period, three patients received prescriptions from Dr. Backos and died after leaving the clinic and overdosing, according to the FBI.
Warren resident Marcia Groves was a clinic patient and a pain pill addict after suffering a back injury while working at a Warren stamping plant.
Groves, 53, received treatment from three clinics in 2013, including Pain Center USA, according to court records. On Nov. 20, 2013, Groves met with Backos at the clinic, the government alleged.
After a 15-minute office visit, Dr. Backos prescribed morphine and hydrocodone, according to the FBI agent. Three days later, she was dead.
“I found her dead in her bedroom,” daughter Kara Boyd said. “This has put me through so much pain for so many years.”
The Macomb County Medical Examiner’s Office ruled her mother’s death an overdose due to multiple prescription drugs.
Nine months later, a Ferndale man overdosed on multiple prescription pain medications one day after Dr. Backos prescribed oxycodone, according to the FBI.
On New Year’s Day 2015, a Macomb County man overdosed on multiple prescription medications. State records showed the man received a Xanax prescription from a psychiatrist two days earlier and a hydrocodone prescription from Dr. Backos five days before the overdose.
Due to their greed, they have taken advantage of vulnerable people struggling with addiction, piling on to the enormous opioid epidemic ravaging our communities. The proceeds of their criminal enterprises are used to purchase luxury boats and cars, luxurious houses, and fuel their lavish lifestyles.
Patients look to physicians and medical professionals for their expertise and knowledge, trusting that they will do what is best to take care of them. In these circumstances, medical professionals provided prescription drugs to those with no medical need. It is unacceptable that in this nation’s current opioid crisis, physicians and medical professionals are exploiting the well-being of their patients for profit.
Many of these investigations stem from business operations of what was, in essence, a ‘pill mill’ rather than a pain clinic or medical practice focused on pain management.
In the late 90s, going into the 2000s, the rate of prescription opioid use began to rise, as did the number of overdose deaths related to prescription opioids.
There were a lot of pill mills, a lot of unscrupulous physicians prescribing buckets full of oxycodone. There used to be the I-95, the “Oxy Express,” so people all along the East Coast of the United States would come to Florida and access these pill mills.
So basically, we have these pain management clinics giving people access to just excessive amounts of opioids. And it was very well known that it was that easy to access opioids in Florida.
Christopher George and Jeffrey George, twin brothers, operated, managed, and financed four pain management clinics in Broward and Palm Beach Counties. The George Brothers and their families were targeted in federal and state probes for overprescribing the pills and several overdose deaths. 32 Defendants in connection with charges stemming from Operation Oxy Alley were convicted due to a coordinated investigation into “Pill Mills” in Florida. From 2008 to early 2010, these pill mills distributed approximately 20 million oxycodone pills and made more than $40 million from the illegal sales of controlled substances. Thirteen of the 32 defendants were doctors. United States of America v. Christopher Paul George, Jeffrey George et al. (August 11, 2011)
Investigations in 2023
Shakeel Kahn, age 57, was convicted by a federal jury of crimes involving drug distribution, firearms possession, and money laundering. According to court records and trial evidence, between 2011 and 2016, Kahn was a licensed medical doctor who operated clinics in Casper, Wyoming, and Fort Mohave, Arizona. Kahn unlawfully distributed drugs by writing prescriptions for large quantities of opioids without any legitimate medical need in exchange for cash payments from his customers. Kahn possessed firearms in furtherance of his unlawful drug distribution, and at least one person died after overdosing on drugs distributed by Kahn.
The jury returned its verdict on Dec. 15 following a six-week week trial before U.S. District Court Alan B. Johnson in Casper. Kahn was previously convicted of these same crimes in 2019, but the United States Supreme Court overturned those convictions due to a faulty jury instruction. This crime was investigated by the Drug Enforcement Administration, IRS Criminal Investigation, and the Wyoming Division of Criminal Investigation.
According to the investigation, in January 2023, Jessica Martinis, 38, raised red flags when she tried to fill a hand-written prescription for oxycodone issued by Francis Martinis, 55, a urologist, at a pharmacy in Kings Park. The prescription was unusual as most prescriptions are transmitted electronically from a doctor directly to a pharmacy. Furthermore, Jessica Martinis was not the patient listed on the prescription. The pharmacist ultimately refused to fill the prescription and then called the Suffolk County Police Department.
Following this incident, members of the Suffolk County Police Department and the Drug Enforcement Administration, with assistance from Homeland Security, launched an investigation into the doctor’s most recent history of issuing prescriptions.
The investigation revealed that Francis Martinis had allegedly electronically transmitted numerous prescriptions for oxycodone to CVS Pharmacies within Suffolk County. In addition, the patients named on the prescriptions turned out to be former cast members on the Bravo television series “Below Deck,” none of whom were domiciled locally. The couple had previously appeared on the reality show series.
Once transmitted to the pharmacies, Jessica Martinis allegedly picked up and paid for the prescriptions with cash. The investigation further revealed that the prescriptions were never intended for or received by the patients listed on the prescriptions.
A medical clinic office manager was sentenced today to seven years in prison for operating a pill mill clinic that unlawfully distributed over 600,000 opioid pills in exchange for cash.
According to court documents and evidence presented at trial, Andres Martinez Jr., 30, of Laredo, Texas, was the office manager of Jomori Health and Wellness (Jomori), a purported Houston pain management clinic. Martinez operated Jomori with Dr. Oscar Lightner, 74, as a pill mill. Lightner, who was the owner of and physician at Jomori, unlawfully prescribed dangerous combinations of controlled substances — including hydrocodone, carisoprodol, and alprazolam — to his patients without a legitimate medical purpose in exchange for cash payments ranging from $250 to $500. Martinez, who is Lightner’s stepson, coordinated with crew leaders to bring multiple people, including individuals living in homeless shelters, into Jomori to pose as patients to obtain prescriptions for opioids and other controlled substances. Jomori received over $1.2 million in cash over 14 months through its scheme, which resulted in the unlawful distribution and dispensing of over 600,000 opioids and other controlled substances.
On April 11, Martinez and Lightner were convicted of unlawfully distributing and dispensing controlled substances and conspiracy. On Nov. 30, Lightner was sentenced to seven years in prison. The DEA investigated the case.
Ten people who fell victim to a Brevard County doctor who back in the early 2000s ran one of the nation’s most active pill mills out of an unassuming office in unincorporated Indialantic.
“From pharmacist to pill pusher, Daniel Russo betrayed his years of medical training to pocket dirty money in return for illegally selling enormous amounts of oxycodone, which was invariably later sold on the streets,” stated United States Attorney Peace.
Russo owned and operated Russo’s Pharmacy in Far Rockaway, Queens. Between March 2011 and June 2014, Russo conspired with others, including medical professionals and employees, to fill fraudulent prescriptions for oxycodone and dispense thousands of oxycodone pills in return for hundreds of thousands of dollars in cash.
Over the course of the conspiracy, Russo’s co-conspirators delivered hundreds of fraudulent oxycodone prescriptions to Russo’s Pharmacy and would then retrieve the filled prescriptions—written out in various patients’ names—so that they could be dispensed elsewhere. Oxycodone illegally distributed by Russo led to at least one non-fatal overdose.
Russo accepted payment mostly in cash for the prescriptions. Russo then hid the proceeds from the scheme and filed false corporate income tax returns for his pharmacy for the years 2013 through 2016, omitting the illegal proceeds. Russo also filed false individual income tax returns for the years 2012 through 2016. In total, Russo failed to report over $1 million in earnings, much of it generated from his oxycodone distribution scheme. As a result, Russo fraudulently under-reported his tax obligations on those earnings by over $400,000.
More than a dozen physicians for whom Russo filled prescriptions have since been convicted of crimes related to the distribution of oxycodone.
This case is the latest in a series of federal prosecutions by the United States Attorney’s Office for the Eastern District of New York as part of the Prescription Drug Initiative.
DEA Special Agent in Charge Frank Tarentino said “Through today’s sentencing and prior plea, it is apparent that Daniel Russo will spend the next five years contemplating his ill-fated decision to use his business to illegally distribute prescription medication while enabling opioid addiction throughout New York. The investigation and prosecution meticulously brought to justice Russo’s tax fraud and his role in a major drug trafficking conspiracy.
“Russo distributed highly addictive drugs to the community he served, completely disregarding his sworn code of ethics as a pharmacist. And while using his position to commit criminal acts, he then failed to report and pay taxes on the proceeds of his illicit sales. It is with strong law enforcement partnerships that we were able to ensure Russo is now facing justice for his actions,” stated IRS-CI Special Agent-in-Charge Fattorusso.
Nor-Cal Pharmacies Inc., doing business as Lockeford Drug, and pharmacist/owner Lawrence Howen knew or deliberately ignored that they were dispensing controlled substances pursuant to prescriptions that were not for a legitimate medical purpose. Specifically, the injunction states that the defendants dispensed 116,330 pills, including more than 100,000 oxycodone and hydrocodone pills, based on invalid prescriptions presented by Joe Anthony Bernal, a defendant charged in the Northern District of California in a separate criminal case (4:19-cr-00585). They did so despite circumstances that were highly suggestive that Bernal was not presenting them with legitimate prescriptions. As also stated in the injunction, the defendants took no steps to determine the validity of Bernal’s purported prescriptions and were not concerned if those medications caused patient harm. Bernal is charged with conspiring with several others to illegally acquire and distribute oxycodone and hydrocodone.
“As a pharmacy that fills prescriptions for opioids and other dangerous drugs, the defendants had an obligation to fill only legitimate prescriptions,” U.S. Attorney Talbert said. “The defendants failed to comply with that obligation, and thereby failed in their responsibility to prevent the opioids from being diverted into illicit channels. This case demonstrates our firm commitment to enforcing federal laws involving prescription drugs.”
“The defendants went from pharmaceutical provider to drug dealer when they knowingly provided controlled substances without a legitimate medical purpose,” said DEA Special Agent in Charge Brian M. Clark. “This egregious behavior by a trusted individual and entity not only fuels the fire of the opioid epidemic, but also wreaks havoc on the community they serve. DEA is committed to keeping our communities safe and healthy and will hold registrants accountable by ensuring they are in compliance with the law.”
Lisa Ferraro, 65, of Hillsdale, New Jersey, is charged by complaint with one count of knowingly and intentionally conspiring and agreeing with others to distribute oxycodone, a Schedule II controlled substance, outside the usual course of professional practice and not for a legitimate medical purpose.
Ferraro practiced internal medicine in Paterson, New Jersey. From January 2020 to Aug. 23, 2023, she participated in a conspiracy to prescribe oxycodone, an opioid pain medication, to individuals who posed as patients, but whom Ferraro never physically examined or questioned about symptoms to determine whether there was a legitimate medical need for oxycodone. Among the patients were two individuals who were incarcerated while Ferraro was prescribing oxycodone in their names. Ferraro typically wrote prescriptions for 90 pills of 30mg oxycodone each, which were typically split three ways among Ferraro, a conspirator who recruited the fake patients, and the fake patients themselves.
Over the course of the conspiracy, Ferraro wrote approximately 425 prescriptions for approximately 36,500 30 mg oxycodone pills. She was released on $150,000 secured bond.
Mount Pleasant, South Carolina. Jennifer Ann “Jen” Adams, 50, was charged with one count of conspiring to commit health care fraud, one count of conspiring to distribute medically illegitimate Schedule II controlled substances, and one count of conspiring to use the DEA registration number of another.
According to court documents, Adams served as the chief operating officer and practice manager for several pain clinics throughout Central and Southwest Virginia. These clinics were located in Lynchburg, Madison Heights, Woodlawn, Blacksburg, and Christiansburg.
The clinics represented themselves as primarily focused on pain management, which involved the prescribing of Schedule II opioids, as well as opioid addiction treatment, which involved prescribing Suboxone and other drugs.
“We face a moment in our country where more than 100,000 of our fellow Americans die each year from drug overdoses,” United States Attorney Christopher R. Kavanaugh said today. “We must do all we can to support those battling addiction disorders and prosecute those who prey on this disease.”
Crespo used his position as an HHS-OIG Special Agent working on health care fraud cases to protect his friend and associate Diaz Gutierrez’s Oxycodone operation. Crespo was acquitted on the conspiracy to traffic oxycodone charge.
From November 2016 to July 2020, previously convicted patient recruiters Jorge Diaz Gutierrez, Yandre Trujillo Hernandez, and Anais Lorenzo, were part of the illegal Oxycodone trafficking scheme involving patients, pharmacies, and medical clinics. The patient recruiters sent patients to selected medical clinics to obtain Oxycodone prescriptions that the patients did not need. Once the patients obtained the prescriptions, they would give them to the patient recruiters in exchange for money. The patients would fill the prescriptions at pharmacies selected by the recruiters and sell the Oxycodone pills (at a mark-up) to third party street dealers.
At its center, Painkiller is about the key moments that led to the opioid epidemic—and how they could have been stopped but weren’t. At one point, for instance, the lone FDA examiner charged with overseeing the approval process for OxyContin, Curtis Wright (Noah Harpster), became a serious roadblock for Purdue Pharma. But Wright would soon sign off on a drug application stating that “delayed absorption, as provided by OxyContin tablets, is believed to reduce the abuse liability of the drug.” The false claim, anchored by those two words—“is believed”—would quell the anxieties of doctors and patients around the country. And a year after OxyContin was approved, Wright left the FDA. He eventually went to work for Purdue.
In a complaint filed in October 2022, the United States alleged that Dr. Vivian Herrero, Christopher Ferguson, and Patricia Ferguson violated the CSA by issuing prescriptions for controlled substances without a legitimate medical purpose. The complaint also alleged that the Fergusons used Phoenix Medical Management Care Centers Inc., a Tarpon Springs, Florida pain clinic, to distribute controlled substances through the issuance of illegitimate prescriptions unlawfully. The complaint further alleged that two patients died soon after receiving opioid prescriptions issued by Dr. Herrero and that drug toxicity played a role in those deaths.
The court’s order, entered on June 29 pursuant to agreed stipulations, permanently prohibits the Fergusons from employment involving the distribution of controlled substances. The order prohibits Dr. Herrero from prescribing controlled substances for 10 years and permanently prohibits her from prescribing controlled substances relating to pain management, in addition to other restrictions. The complaint alleged that Herrero wrote illegitimate prescriptions for powerful opioids and other drugs despite obvious signs of abuse or diversion and without a legitimate medical basis. The court also ordered the defendants to pay nearly $20,000 in civil penalties based on the defendants’ ability to pay.
Dr. Qing McGaha was a Florida-licensed medical doctor who owned and operated MD Care Clinic, a Pain Management Clinic in Hillsborough County. Over a 20-month period, undercover agents with the Drug Enforcement Administration (DEA) conducted numerous appointments with McGaha. At each appointment, they received hydrocodone, hydromorphone, or oxycodone, Schedule II controlled substances not for a legitimate medical purpose in the usual course of professional practice. Between January 2016 and January 2021, Dr. McGaha distributed more than 2.1 million opioid pills.
A federal jury convicted family medicine physician Donald Siao of 12 counts of distributing the controlled substances Oxycodone and Hydrocodone outside the scope of his usual professional practice and without a legitimate medical purpose.
At trial, the evidence demonstrated that after identifying Siao in a separate prescription fraud investigation, investigators reviewed a California state database and discovered that Siao had written 8,201 prescriptions for controlled substance medications in just the one-year period from May 2016 to May 2017. An investigation ensued in 2017 and 2018 and resulted in Siao prescribing Oxycodone and Hydrocodone in increasing quantities in over seventeen visits with four separate undercover law enforcement agents posing as patients. The undercover agents received prescriptions from Siao despite complaining of only vaguely of pain or discomfort, requesting specific opioids by name, and admitting to sharing the pills with friends and coworkers.
Evidence at trial further established that Siao prescribed dangerous opioids to his patients E.J. and A.J., a mother and son, notwithstanding obvious red flags. Siao continued to prescribe opioids to the mother E.J. after she repeatedly claimed that her pills had been lost or stolen, despite Siao receiving an alert from E.J.’s insurer regarding her opioid prescriptions and despite Siao being advised that E.J. was jailed for selling pills, all documented in Siao’s medical file for E.J. Similarly, Siao prescribed opioids to the son A.J. even after two overdoses. Siao continued to prescribe opioids to A.J. after A.J. repeatedly claimed the opioids were lost or stolen and even after he had been flagged by his prior medical provider for drug-seeking behavior, after his mother reported he had stolen her medications, and after A.J.’s mother E.J. had fatally overdosed on opioids. These facts were all documented in Siao’s medical file for A.J.
Trial evidence also demonstrated that Siao refused to heed warnings that his prescriptions were dangerous. Evidence showed Siao was aware that DEA highly scrutinized opioid prescriptions, even pointing out to one of the undercover officers posing as a patient that a nationwide epidemic was underway in which large numbers of people were addicted to and dying from opioids. Siao nevertheless continued to prescribe opioids to the agents upon their request and with little to no physical examination, and sometimes during visits lasting only a few minutes. Law enforcement agents interviewed Siao in November 2018 about his prescribing practices, and Siao admitted he was aware of the California Medical Board’s Guidelines for Prescribing Controlled Substances for Pain, had learned the dangers of addiction, and had been taught how to identify drug-seeking patients.
9 individuals were indicted on charges filed by the Office of the Special Narcotics Prosecutor in Manhattan Supreme Court. The charges stem from narcotics-related activity that allegedly occurred in Manhattan, the Bronx, Pennsylvania and Rhode Island. The investigation resulted in the seizure of over 26,000 pills containing fentanyl; 2 kilograms of powdered fentanyl; nearly 50,000 pills, weighing about 41 pounds, containing methamphetamine; and 3 kilograms of powdered cocaine. The estimated street value of the drugs seized is approximately $2.5 million.
Oxycontin. Codeine. Fentanyl. All prescription drugs to which countless patients have become addicted. As America battles an opioid crisis that sees 170 citizens die everyday, lawyers and prosecutors are trying to bring an end to Big Pharma’s impunity. How did it happen?
Midwest City, Oklahoma. Family doctor Regan Nichols is on trial charged with five murders for over-prescribing opioids. Her lawyer insists that she was tricked into writing prescriptions by junkies and is being made a scapegoat. But others believe that doctors like Nichols bear a large responsibility for the crisis now engulfing the country.
Strong, opium-based pain killers like Oxycontin were traditionally only given to cancer sufferers. But in the mid-1990s, they were rebranded and aggressively marketed for all types of pain. Patients were assured that these highly addictive drugs were completely safe. By the time the dangers of these pills became apparent, and regulators started restricting access, it was too late. Denied the prescription drugs they had become dependent on and with a chronic lack of resources to treat addiction, people with a substance use disorder turned to harder drugs like heroin.
Chief U.S. District Court Judge L. Scott Coogler sentenced Mark Murphy, 66, and his wife, Jennifer Murphy, 66, both of Lewisburg, each to 20 years in prison for conspiracy to unlawfully distribute controlled substances and conspiracy to commit health care fraud, along with various substantive counts related to the same, and conspiring to defraud the United States and receiving kickbacks.
“Dr. Murphy and his wife preyed on countless vulnerable patients and stole tens of millions of dollars from Medicare and other taxpayer-funded health insurance programs,” said U.S. Attorney Escalona. “Our office will continue to prosecute drug dealers and health care fraudsters to the full extent of the law.”
“The abuse of prescription drugs, especially opioids, is a serious problem in our communities,” said DEA Assistant Special Agent in Charge Towanda Thorne-James. “All too often, this abuse leads to addiction, shattered lives, and even death. For the health and safety of our citizens, DEA and our law enforcement partners will continue to target those who illegally distribute these potentially dangerous drugs. We hope that the sentences in this case serve as a reminder to anyone who might illegally divert pharmaceuticals that they will be held accountable for the harm they cause.”
“Mark and Jennifer Murphy learned that unlawfully distributing controlled substances, committing health care fraud, and receiving kickbacks comes with hefty legal consequences,” said James E. Dorsey, Special Agent in Charge, IRS Criminal Investigation, Atlanta Field Office. “Their conviction serves as a lesson to others who think no one is paying attention.”
According to court documents and evidence presented at trial, Mark Murphy and Jennifer Murphy owned and operated North Alabama Pain Services (NAPS), which closed its Decatur and Madison offices in early 2017. Mark Murphy was the sole doctor at the two locations, and the evidence at trial showed that some patients went months or years without seeing him during their monthly office visits, even though they continued to get opioid prescriptions that he had pre-signed. Over the approximately five-year period leading up to the clinic closing its Alabama locations, the evidence at sentencing showed Murphy wrote prescriptions for more than ten million opioid pills, including millions of oxycodone 30 mg tablets. During the same five-year period, Murphy and his wife Jennifer, who helped run the clinics, ordered tens of millions of dollars of unnecessary items and services that were paid by taxpayer-funded and private insurance programs. The Murphys received kickbacks for those orders and prescriptions. In all, Medicare, TRICARE, and Blue Cross Blue Shield of Alabama were billed more than $280 million due to the fraud and kickback schemes and paid more than $50 million. Mark Murphy and Jennifer Murphy were each ordered to pay more than $50 million in restitution. Jennifer Murphy was also convicted of tax-related charges for underreporting clinic income.
Also, co-conspirator Christie Rollins, 52, of Petersburg, Tennessee, was sentenced to twenty-four months in prison for her role in selling medically unnecessary durable medical equipment and expensive topical creams at NAPS. Rollins agreed to pay restitution of more than $564,000.
The investigation of the practice determined that the conspiracy issued nearly 160,000 prescriptions for controlled substances while ignoring numerous “red flags,” indicating that the prescriptions were not issued for legitimate medical purposes.
“Our job as law enforcement is to seek out those responsible for supplying poison, from the street-level dealers to the professional dealers in lab coats. Years of negligence from three medical professionals causing destruction and pain has come to an end with the sentencing of Dr. Anderson.,” said Jeff Davis County Sheriff Preston Bohannon.
Detroit, Michigan: Two Doctors and the Operators of Three Pain Clinics Charged with $2.6 Million Illegal Opioid Distribution Conspiracy (U.S. Attorney’s Office, Eastern District of Michigan, November 18, 2022)
The indictment charged the defendants with a drug conspiracy involving Schedule II controlled substances, including Oxycodone, Oxymorphone, Oxycodone-Acetaminophen (Percocet), and Hydrocodone (Norco), some of the most addictive and commonly diverted opioids having a significant street value. Charged in the indictment were:
Angelo Foster, 33, Detroit, Michigan
Brandy King, 33, Detroit, Michigan
Dr. Juan Bayolo, 48, Lake Mary, Florida
Dr. Renee Gonzalez Garcia, 62, Henderson, Nevada
Latrina Williams, 45, Sterling Heights, Michigan
Edward King, 33, Northville, Michigan
The Indictment alleged that Foster, Edward King, and Brandy King operated several pain clinics in the Metro Detroit area, including Priority One Health Management, Lincoln Park Health Management, and Priority One Health Essentials. At each clinic location, patients were recruited by “patient recruiters,” such as Williams, to see Drs. Bayolo and Gonzalez Garcia via telehealth. These doctors were paid to illegally issue opioid prescriptions, with no physical examination, for patients who had no legitimate medical need for the drugs.
As alleged in the indictment, these telehealth appointments allowed members of the conspiracy to receive cash payments in exchange for controlled substance prescriptions issued by doctors. According to the indictment, Drs. Bayolo and Gonzalez Garcia, along with other medical professionals, prescribed more than 500,000 dosage units of Schedule II controlled substances. The prescribed controlled substances carried a conservative street value of more than $2.6 million.
“It is particularly disturbing when physicians break their oaths and illegally distribute highly addictive drugs. My office remains committed to pursuing medical providers who abuse their roles as physicians to harm our community.” U.S. Attorney Ison said.
“When medical professionals and others scheme to illegally provide medically unnecessary prescription drugs, they put patients at risk and drive up the cost of health care for everyone,” said James A. Tarasca, Special Agent in Charge of the FBI’s Detroit Field Office. “The FBI and our law enforcement partners will continue to investigate this type of health care fraud scheme and bring those who operate these criminal schemes to justice.”
Baltimore, Maryland: Medical Director of Baltimore County Pain Management Clinic Pleads Guilty to Conspiracy to Distribute and Dispense Oxycodone (U.S. Attorney’s Office, District of Maryland, June 16, 2022)
Norman Rosen, age 84, of Towson, Maryland, pleaded guilty to conspiracy to distribute and dispense oxycodone in connection with his operation of Rosen-Hoffberg Rehabilitation and Pain Management Associates, P.A., where he was Medical Director and part owner. Baltimore County Police Department.
A Florida man was sentenced in the Southern District of Florida to 200 months in prison for illegally distributing opioids at his pain management clinic in Miami, Florida.
According to court documents, Habib Geagea Palacios, 40, of Miami, owned General Care Center Inc., a cash-only pain management clinic in Miami. At General Care, Palacios paid doctors to prescribe opioids to nearly all patients who visited the clinic, resulting in the illegal distribution of more than three million oxycodone pills and generating $9 million in cash. Seven doctors who worked at General Care were charged in connection with their unlawful prescribing practices at the clinic, and six pled guilty.
Palacios pleaded guilty to one count of conspiracy to distribute a controlled substance and one count of distributing a controlled substance. In addition to the term of imprisonment, Palacios was sentenced to serve three years of supervised release.
Sixteen Michigan and Ohio-area defendants, including 12 physicians, have been sentenced to prison for a $250 million health care fraud scheme that included the exploitation of patients suffering from addiction and the illegal distribution of over 6.6 million doses of medically unnecessary opioids. Five physicians were convicted in two separate trials, while 18 other defendants pleaded guilty.
Yutong Zhang, 63, of Berwyn, PA, a physician, pleaded guilty before United States District Court Judge Michael M. Baylson to charges stemming from his operation of what was, in essence, a ‘pill mill’ rather than a medical practice focused on pain management located in St Davids, PA.
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.
Baltimore, Maryland – A criminal complaint charged the manager of a pain clinic, her boyfriend, and several customers with conspiracy to distribute controlled substances, including oxycodone and oxymorphone.
“This doctor’s prescription pad was as lethal as any murder weapon,” D.A. Singas said. “We allege that Dr. Blatti showed depraved indifference to human life, total disregarded for the law, his ethical obligations, and the pleas of his patients and their family members when he prescribed massive quantities of dangerous drugs to victims in the throes of addiction, ultimately killing five patients who entrusted him with their care. The Nassau County Police Department’s Asset Forfeiture and Intelligence Unit began an investigation into several opioid overdoses, both fatal and non-fatal, in August 2018. That investigation revealed that certain individuals had an inordinate number of prescriptions for opioids written by the same physician, Dr. George Blatti.
3 Sentenced for Prescribing Massive Quantities of Opioids from Pill Mills in Knoxville—The Pill Mills Generated over $21 Million in Revenue, with a Corresponding Street Value of $360 Million (WBIR Staff, December 11, 2020).
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.
Santa Ana, California: Doctor Among 10 Facing Federal Drug Trafficking Charges Related to Distribution of Opioids Through Bogus Pain Clinics Across SoCal (U.S. Attorney’s Office, Central District of California, August 5, 2020)
Law enforcement authorities arrested four defendants charged in two federal grand jury indictments alleging a narcotics trafficking ring that sold illegal opioid prescriptions for cash through a series of sham medical clinics.
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.
St. Bernard Parish, Louisiana. Dr. Jacqueline Cleggett-Lucas pled guilty to conspiracy to dispense and distribute controlled substances, including oxycodone.
Authorities said that from 1999 until early 2002, Cleggett, who was a doctor, ran a pain management clinic on Chef Menteur Highway in New Orleans. Her medical license was later revoked. The clinic operated at unusual hours, from the late afternoon until 2 a.m. or later, authorities said, adding that there was always a large number of patients at her office regardless of the time of day, according to the press release.
In addition, a large number of the cars had Mississippi or Florida license plates, and all payments for visits were on a “cash only” basis, the press release said. In addition, authorities learned through a joint investigation conducted by the U.S. Drug Enforcement Administration and the Tri-County Narcotics Task Force in Jackson, Miss., that Cleggett had supplied prescriptions for Oxycontin to a group of people who redistributed the drugs throughout Mississippi.
Delaware Chronic Pain Management and Detox Center—Trolley Square Doctor Operated a Pain Clinic as a Pill Mill, at which drug dealers and addicts could buy prescriptions for frequently abused controlled substances … without any medical necessity (Karl Baker & Nick Perez, Delaware News Journal, April 6, 2020)
Employees at the clinic, which operated under the legal name DE CPM and Detox Center LLC, deposited $13.7 million into a WSFS Bank account. The money flowed to the clinic because of its prescriptions of oxycodone, morphine, oxymorphone and methadone, prosecutors said.
If you are aware of controlled substance violations in your community, you can submit your anonymous tip through the DEA online Tip Line. Concerns about prescription drug abuse or diversion can also be reported to the DEA.
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 and 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.
The king of the Florida pill mills was American Pain, a mega-clinic expressly created to serve addicts posing as patients. From a fortress-like former bank building, American Pain’s doctors distributed massive quantities of oxycodone to hundreds of customers a day, mostly traffickers and addicts who came by the vanload.
American Pain chronicles the rise and fall of this game-changing pill mill, and how it helped tip the nation into its current opioid crisis, the deadliest drug epidemic in American history. The narrative swings back and forth between Florida and Kentucky and is populated by a gaudy and diverse cast of characters. This includes the incongruous band of wealthy bad boys, thugs and esteemed physicians who built American Pain, as well as penniless Kentucky clans who transformed themselves into painkiller trafficking rings. It includes addicts whose lives were devastated by American Pain’s drugs, and the federal agents and grieving mothers who labored for years to bring the clinic’s crew to justice.
“We face a moment in our country where more than 100,000 of our fellow Americans die each year from drug overdoses,” United States Attorney Christopher R. Kavanaugh said. “We must do all we can to support those battling addiction disorders and prosecute those who prey on this disease.”
If you are aware of controlled substance violations in your community, you can submit your anonymous tip through the DEA online Tip Line.
Nationwide Opioid Pain Pill Investigations
How Pain Clinic Owners Turned Patients’ Pain into Enormous Profits
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