Unscrupulous pain-clinic owners, doctors and pharmacy workers took part in schemes to funnel hundreds of thousands of pills to the black market in Eastern Kentucky, federal grand juries have charged.
The indictments allege that six doctors, five pain-clinic owners or employees, a pharmacist and a pharmacy manager made millions by helping distribute pain and anti-anxiety pills in a region crippled by prescription-drug abuse.
"The conduct we allege in the indictments was motivated by greed," said U.S. Attorney Kerry B. Harvey, whose office is prosecuting the cases.
Harvey's office announced five separate indictments Friday. Some were returned weeks ago but were sealed until this week, court records show.
Most of the cases were not related, according to court documents.
The indictments allege that people got prescriptions for powerful drugs at clinics in Kentucky and other states, often with little or no real examination, and then sold or abused the drugs in Eastern Kentucky.
"The allegations would be that these were classic pill mills," Harvey said in an interview Friday.
In one case, a physician from Houston, Linda Roos, allegedly prescribed more than 125,000 oxycodone pills from September 2006 to July 2011 in a conspiracy involving several people from Pike County, according to an indictment and Harvey's office.
Others charged in that case include James Ronald Huffman, a Pike County pharmacist; Beverly Lockhart, who managed Huffman's office; and Dennis and Helen Varney, who were patients of Roos.
The Varneys and others from Eastern Kentucky went to Roos' office in Texas to get "unusually large amounts" of narcotics, according to the indictment.
Roos, 46, accommodated the Kentuckians by faxing copies of their prescriptions to pharmacies where Huffman worked so the drugs would be ready for them to pick up when they got home, the indictment said.
Every other month, Roos issued prescriptions, without performing examinations, to patients who faxed her a form, the indictment said.
Roos required them to pay her fee, according to the indictment.
Dennis Varney, 62, and his wife allegedly sold pills to a person cooperating with the Kentucky State Police.
There has been a problem in recent years with people from Eastern Kentucky going to other states — notably Florida and Ohio — to get prescriptions to avoid Kentucky's prescription-monitoring system.
Harvey said the trips people allegedly were making to Texas was further illustration of the lengths to which people will go to get drugs.
The pipeline from Texas is not as big as from other states, but Roos' indictment is not a "singular case," Harvey said.
In a related case, Huffman; Lockhart, 58; and Thad Ray Manning, 46, a doctor of osteopathy in Pike County, are charged with conspiring to sell prescription-drug samples from June 2007 until early this year.
Huffman and Manning were in the same building, and Manning gave Huffman nearly unlimited access to samples he'd received, the indictment said.
Huffman and Lockhart also are accused of submitting false reimbursement claims to Medicare and insurance companies for drugs they didn't provide to patients, and with money laundering, while Manning is charged with lying to the FBI.
The government is seeking a judgment of $3 million from Huffman and Lockhart, representing the amount they allegedly made from illegal activity.
Another indictment charges Jody Robinson, 37, who owned pain clinics in Plantation, Fla., and Portsmouth, Ohio; William James Muldoon Jr., a clinic official; and Clara Rodriguez-Iznaga, who worked for Robinson at Florida Global Medical, with conspiring to distribute drugs in Boyd, Lawrence and Green up counties from June 2008 to September 2009, and with money laundering.
A man from northeastern Kentucky, William Ossie Lucas, said in a related case that an unidentified doctor at the Florida clinic wrote him prescriptions for oxycodone with no exam.
The office visit cost $200, and the prescriptions, which he filled at the clinic before coming home to sell the pills, were $1,200 to $1,500, according to Lucas' plea deal.
Lucas was arrested in August 2009 for selling an undercover informant 400 oxycodone pills for $3,200, according to a court record.
The government is seeking $2 million from Robinson, Muldoon and Rodriguez-Iznaga.
The other two indictments announced Friday involve pain clinics in Johnson County.
In one case, a grand jury said that two clinic owners and two doctors who worked for them conspired to distribute pain pills and Xanax from July 2010 to June 2012.
Ray Douglas Stapleton, 34, and his wife, Tina Marie Stapleton, 33, owned a clinic called Auto, Accident & Health Care, the indictment said.
Physicians Stephen C. Arny and Emmanuel G. Acosta allegedly prescribed drugs improperly at the clinic.
Ray Stapleton also is charged with illegally possessing drugs in Magoffin County.
The government is seeking $1.3 million from the four.
In the other case, Shelby Lackey, 50, and Tammy Cantrell, 39, who jointly owned a clinic called Caremore Pain Management in Paintsville before Cantrell became the sole owner in December, and a doctor who worked there, Rano S. Bofill, were charged with conspiring to illegally distribute pain pills from December 2007 to February 2012, and with maintaining a drug-distribution establishment.
The indictment provides little detail, but Richard Albert, another doctor who once worked at Caremore, said in a separate case that he issued prescriptions to dozens of people a day at times, with little or no examination.
Albert pleaded guilty in a federal drug case and is awaiting sentencing.
In a case before the Kentucky Board of Medical Licensure, Bofill said he was recruited to work at Caremore in 2009 and was paid $6,000 a week.
Bofill surrendered his license early this year, acknowledging his practices at the clinic "failed to conform to acceptable and prevailing medical practices" in Kentucky, according to an order from the licensure board.
The clinic allegedly made $1.9 million illegally during the conspiracy. The government is seeking that much from the defendants.
There have been several doctors and pain-clinic officials charged in drug conspiracies in Eastern Kentucky, but not so many in such a short time.
Kentucky lawmakers approved a bill this year aimed at cracking down on illegitimate pain clinics and overprescribing by doctors.
Among other things, the law requires greater use by doctors of the state's prescription-drug monitoring system, and requires that pain-management clinics be owned by doctors.
Four clinics told state officials they would close because they couldn't comply with the law, and nine others had not applied for a license and will be investigated, Gov. Steve Beshear said last month.
The state has not released the names of the clinics, so it wasn't clear whether they included offices whose owners were charged in the indictments announced Friday.
Investigations that led to the indictments were conducted by the state police; the FBI; the Kentucky Attorney General's Office; the state Board of Pharmacy; the U.S. Food and Drug Administration; the U.S. Drug Enforcement Administration; and the Kentucky Office of Inspector General, Drug Enforcement Branch, according to Harvey's office.