Why are eight Tennessee doctors charged in a Kentucky drug case?
Eight Tennessee doctors took part in a conspiracy that helped fuel illegal drug sales in several Kentucky counties, a federal grand jury has charged.
The doctors wrote prescriptions after only cursory examinations and gave people more monthly doses of one drug than they could generally get in Kentucky, drawing carloads of people from Kentucky, according to an affidavit in a related case.
Some witnesses said drug dealers paid the costs for them to get prescriptions from the doctors, the affidavit said.
At one time, 73 percent of the prescriptions from two Tennessee drug-treatment clinics involved in the case were filled in Kentucky, a federal agent said.
The company named in the indictment is EHC Medical Offices, PLLC, which had clinics in Harriman and Jacksboro.
Robert Taylor, a Tennessee doctor, owned the clinics during the time covered in the charges but sold them in 2018, according to court documents.
Taylor faces the most charges in the case, including conspiracy to illegally distribute buprenorphine and anti-anxiety drugs; conspiracy to falsify medical records, to launder money and to commit wire fraud and health fraud; money laundering; and taking part in transactions involving property derived from criminal activity.
Buprenorphine, often called by the trade name Suboxone, is a drug used to help people deal with an addiction to opioid drugs.
It is often diverted from legal sources and sold illegally. People addicted to drugs often use it to keep from getting sick from withdrawal when they can’t get drugs such as pain pills, but the U.S. Drug Enforcement Administration has said it can also be abused to get high.
The others charged in the case are physicians Evann Herrell, Mark Grenkoski, Kari McFarlane, Helen Bidawid, Stephen Cirelli, Eva Misra and Matthew Rasberry; nurse Lori Barnett, who managed EHC; and Kentucky residents Elmer Powers and Brian Bunch.
All the doctors are named in the drug-conspiracy charge but face additional charges as well, including conspiracy to commit money-laundering and to falsify medical records.
The most serious charges in the case have maximum sentences of up to 20 years in prison.
Powers and Bunch, the Kentucky residents, are named in the drug-conspiracy charge.
Bunch is serving a 17-year sentence for attempted murder, but has also faced state drug charges.
The conspiracy ran from 2013 to November 2018 and involved alleged illegal drug sales in Laurel, Knox and Whitley counties that flowed from prescriptions “not issued for a legitimate medical purpose” by doctors who weren’t acting within the usual course of professional practice, the indictment said.
The doctors have not had their initial court appearance or formally responded to the charges, but Taylor has denied allegations of improper practices at the clinics in a related case.
The indictment is related to criminal charges filed last year against Calvin Manis, a pharmacist and city council member in Barbourville.
Manis pleaded guilty last week to a charge of conspiring to illegally distribute pain pills. A man charged with him, John Pasternak, was scheduled to plead guilty Monday.
A federal agent said in that case that Manis allegedly filled prescriptions in cooperation with a person who was paying the costs for other people to get prescriptions from doctors.
In that arrangement, the person paying the bills is called a sponsor and typically gets some or all the drugs to sell. It has been a common practice in Kentucky.
The indictment against the Tennessee doctors also is related to an action the federal government filed in December 2018 seeking to forfeit millions worth of money and property from Taylor and others.
In a sworn statement in that case, Crystal Centers, an Internal Revenue Service special agent based in Lexington, cited several reasons authorities believe Taylor’s clinics amounted to pill mills.
Some patients told police that someone else paid for their office visits, and that they paid cash at the clinics, both potential indications of problems, Centers said.
One doctor who had worked at the clinics told police her name had been signed on files of patients she hadn’t examined, and another said other clinic employees filled out the physical exam record on patients before the doctor saw them, Centers said.
A pharmacist in Tennessee said that when patients from EHC brought in prescriptions to fill and she asked them which doctors they had seen, they didn’t know, an indication the drug order might have been pre-signed, according to Centers’ statement.
Several people who had been to the clinic told police that exams were cursory and that doctors at the clinics didn’t discuss treatment plans or counseling with them “or even bother to learn the nature of the patient’s addiction,” Centers said.
On undercover visits to the clinics, doctors came into the exam rooms with prescriptions already signed for people, the affidavit said.
“Despite the absence of any meaningful medical evaluation or substance abuse treatment, EHC physicians provided controlled substance prescriptions to each cooperating witness on every visit, with only one exception,” Centers said in the sworn statement.
She said the federal investigation showed EHC did not operate as a legitimate medical facility.
The indictment against Taylor and the other doctors, filed last week in federal court in Kentucky, charged that they wrote prescriptions for drugs in quantities and combinations that were not medically necessary and filled out forms saying doctors had examined patients and discussed treatment when that didn’t actually happen as the forms showed.
One object of the conspiracy was to up profits, the indictment alleged.
Centers said in her earlier statement that from early 2014 through April 2018, the EHC clinics generated more than $39 million.
The new indictment seeks to forfeit several properties in Tennessee and one in Florida; three cars, including a 2016 Porsche; and a total of $25.5 million, nearly all of it from Taylor.
Attorneys representing Taylor and others asked U.S. District Judge Robert E. Wier to dismiss the government’s earlier civil forfeiture case.
While prosecutors had equated EHC to a pill-mill type of practice, “nothing could be further from the truth,” the defense attorneys said in a March 2020 motion.
Taylor’s clinics developed detailed, evidence-based procedures and hired qualified doctors and addiction medicine specialists, Taylor’s attorneys said.
Patients at the clinics received detailed evaluations, proper treatment and case management and individual and group counseling, according to the motion.
Defense attorneys said Centers and others were not qualified to make judgments about appropriate treatment.
“Rather than facts showing criminal activity, the government openly relies on suspicion, conjecture, and statements regarding the practice of medicine that are contradicted, not just by opinion, but by the Tennessee, Kentucky and federal laws that govern office based opioid treatment,” Taylor’s attorneys argued in the motion.
Wier ruled in January that federal authorities had provided sufficient detail about alleged wrongdoing at the clinics to allow the forfeiture action to proceed. The was based on a different standard than required for a criminal conviction at trial.
“The government alleges particularized facts that reasonably paint EHC as (substantially) a sham operation set up to serve a patient cohort significantly funded by traffickers via prescriptions irregularly issued and serving no legitimate medical purpose,” Wier said in the decision.
This story was originally published March 8, 2021 at 2:23 PM.
