Newly Created Appalachian Opioid Strike Force Charges 60 Defendants for Alleged Involvement in Distribution of Over 32 Million Pills

As the opioid addiction epidemic rages on, various Federal government agencies continue enforcement efforts in an attempt to stem the supply of prescription opioids fueling the epidemic. On April 17, 2019, the Department of Justice (“DOJ”) announced that they brought charges against 60 defendants, 53 of which are medical professionals, for allegedly participating in illegally prescribing and distributing opioids and other narcotics, and for health care fraud schemes.

The investigation was conducted by the new Appalachian Regional Prescription Opioid (“ARPO”) Strike Force, which was formed in October 2017 with the mission of identifying and investigating “health care fraud schemes in the Appalachian region … and to effectively and efficiently prosecute medical professionals and others involved in the illegal prescription and distribution of opioids.” The Strike Force is a joint law enforcement effort involving a number of agencies, including the DOJ Health Care Fraud Unit, the U.S. Attorney’s Offices for nine federal districts, the Federal Bureau of Investigation (“FBI”), the Department of Health and Human Services Office of the Inspector General (“HHS-OIG”) and the Drug Enforcement Agency (“DEA”). In creating the ARPO Strike Force, Assistant Attorney General Benczkowski noted that “[w]hile the opioid epidemic continues to inflict untold pain and suffering on people across the country, the devastation in the Appalachian region and adjacent areas has been particularly staggering.”

The alleged illegal conduct spanned a confounding array of activities and occurred in the following states:

Ohio: Alleged activities related to operating a “pill mill,” which dispensed over 1.75 million pills in the two-year period spanning October 2015 to October 2017.

Kentucky: Alleged activities involving providing blank, pre-signed prescriptions to office staff for use while the doctor was out of the office, billing Medicare for tests that were not medically necessary and for tests that were not completed at a pain management clinic, writing opioid prescriptions that had no legitimate medical purpose, prescribing opioids to “Facebook friends,” and for providing opioid prescriptions in exchange for cash.

Tennessee: Alleged activities involving with unlawful distribution, engaging in health care fraud, and operating a pill mill. The activity involved prescribing millions of opioid prescriptions. In one case, a nurse practitioner branded himself the “Rock Doc” and provided opioid prescriptions, sometime in dangerous combinations with other drugs, and sometimes in exchange for sexual favors. Another doctor prescribed opioids to known addicts.

Alabama: Alleged activities involving unlawful distribution and fraud. In one case, a doctor allegedly prescribed opioids in high doses, dangerous combinations, and to known addicts. That doctor also preferred cash payments, and charged a “concierge fee” of $50 per visit or $600 per year. Another doctor allegedly recruited prostitutes and other young women to become patients at his clinic and to abuse illicit drugs at his home.

West Virginia: Alleged activities involving using fraudulent prescriptions to obtain codeine for personal use, and distributing narcotics to patients that did not have a medical need.

Louisiana: Alleged activities involving operating a pill mill, pre-signing prescriptions for use when the doctor was out of town, providing prescriptions for patients that the doctor did not personally examine, and providing prescriptions that were medically unnecessary.

Pennsylvania: Alleged activities involved filling fraudulent prescriptions to obtain drugs for personal use and to distribute to others.

In addition to the indictments noted above, the DEA and HHS have also taken action to stem the tide of opioid abuse. Specifically, since July 2017, in connection with violations of the Controlled Substances Act, the DEA has issued “31 immediate suspension orders, 129 orders to show cause, and received 1,385 surrenders for cause.” Further, since June 2018, HHS has excluded over 650 providers from participation in Federal healthcare programs, including Medicare and Medicaid, for conduct related to opioid abuse.