Prescriber Convictions Warn Against Improper Controlled Substance Prescribing |

Prescriber Convictions Warn Against Improper Controlled Substance Prescribing

Criminal convictions against a New York nurse practitioner and separate convictions of four physicians announced August 11 illustrate the provider perils of prescribing medically unnecessary pain medicines or other controlled substances.

Nurse Practitioner Faces 20 Years

Nurse practitioner Danielle Simonson faces up to 20 years in prison after pleading guilty to distributing controlled substances outside the course of professional practice and for no legitimate medical purpose in Albany, New York.

Simonson admitted in her plea that from at least January 2020 through October 2022, she unlawfully prescribed controlled substances to a total of 54 patients. These included prescriptions for the opioids hydrocodone and oxycodone, benzodiazepines (clonazepam, diazepam, and lorazepam), and amphetamine (e.g. Adderall). For instance, Simonson admitted that she issued a total of 63 oxycodone prescriptions to two residents of Suffolk County, New York, without treating either of them for a medical condition. The Suffolk County residents usually paid Simonson by mailing her packages of cash.

In the accompanying civil settlement agreement, Simonson admitted that she improperly prescribed controlled substances to 105 patients (including the 54 listed in her criminal plea agreement), often without ever examining patients and maintaining medical records justifying her decision to prescribe controlled substances. Simonson agreed to pay $200,000 to settle civil claims that the United States could have brought against her pursuant to the Controlled Substances Act.

In the criminal case, sentencing is scheduled for December 15, 2023 before United States District Judge Anne M. Nardacci. Simonson faces up to 20 years in prison and a fine of up to $1 million, as well as up to 3 years of post-imprisonment supervised release.

Simonson’s plea agreement requires that she immediately surrender her nurse practitioner and nursing licenses to the State of New York. On December 8, 2022, Simonson surrendered her DEA registration (which had allowed her to prescribe controlled substances).

4 Doctors Face Lengthy Prison Sentences

Four Tennessee physicians face lengthy prison sentences after a federal jury in Frankfort convicted four on Friday of conspiracy to illicitly prescribe controlled substances and related fraud and money laundering offenses.

The trial evidence showed Evann Herrell, Mark Grenkoski, Keri McFarlane, and Stephen Cirelli were each physicians who worked for EHC Medical in Harriman and Jacksboro, Tennessee at two east Tennessee clinics, called EHC Medical. EHC Medical purported to offer treatment for opioid use disorder.

The evidence presented at trial showed the defendants agreed to unlawfully prescribe buprenorphine (the controlled substance in the drug known by its trade name, Suboxone) and benzodiazepine-class drugs, including clonazepam.

At trial, the United States presented evidence of a wide-ranging conspiracy to provide prescriptions for high doses and dangerous combinations of Suboxone and benzodiazepines to cash-paying customers. These drugs were being sold, traded, and abused throughout southeastern Kentucky. The evidence further established that the Defendants engaged in a conspiracy to falsify medical records, while putatively treating patients, and that Herrell, Grenkoski, and McFarlane conspired to cause millions of dollars in fraudulent submissions to Medicare, Kentucky Medicaid, and other health benefit programs for prescription drugs and urine drug testing.

The convictions of these four doctors follows earlier convictions of the founder of EHC Medical and a former EHC Medicak nurse. Robert Taylor, who opened EHC Medical in 2013 and operated it through late 2018, pleaded guilty to a drug trafficking conspiracy charge and was sentenced earlier this year to 30 months in prison. He forfeited $13.8 million and paid an additional fine of $200,000. Lori Barnett, a registered nurse who helped Taylor supervise day-to-day operations, and three other physicians – Matthew Rasberry, Helen Bidwaid, and Eva Misra – also pleaded guilty to related drug or money laundering charges and are awaiting

“These physicians focused on their own greed and self-interests, not the needs of their patients,” said Carlton S. Shier, IV, United States Attorney for the Eastern District of Kentucky. “Their illegal scheme had a damaging impact on their patients, fraudulently preyed on health benefit programs, and undermined the public’s faith in legitimate medical practices in this field. We, and our law enforcement partners, remain committed to holding those who take advantage of the medical licenses entrusted to them, to profit through unlawful prescriptions, accountable. The opioid epidemic created an acute need for responsible substance abuse treatment. Drug trafficking, operating under the guise of addiction treatment, is another despicable consequence of this problem.”

The four doctors are scheduled to appear for sentencing on December 4, 2023. The statutory maximum penalty for the drug trafficking conspiracy is 10 years, for the conspiracy to falsify documents in connection with delivery of health care services is 5 years, and for the fraud and money laundering counts is 20 years. The defendants also face potential fines, a forfeiture money judgment, and a judgment of restitution, as ordered by the Court.

Convictions Warn Others

These and other convictions demonstrate the significant consequences health care providers can face for illegally prescribing controlled substances. Because these consequences include felony convictions health care organizations and their leaders also are cautioned to manage their Federal Sentencing Guidelines exposures that can arise when employees or agents engage in these prohibited criminal actions by taking documented actions to prohibit and prevent improper prescribing and appropriate steps to report, discipline remediate potential violations. Providers and others discovering these violations also should consider and address reporting and other required actions under federal or state licensing and other laws.

For More Information

We hope this update is helpful. For more information about these or other health or other legal, management or public policy developments, please contact the author Cynthia Marcotte Stamer via e-mail or via telephone at (214) 452 -8297.

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About the Author

Recognized by her peers as a Martindale-Hubble “AV-Preeminent” (Top 1%) and “Top Rated Lawyer” with special recognition LexisNexis® Martindale-Hubbell® as “LEGAL LEADER™ Texas Top Rated Lawyer” in Health Care Law and Labor and Employment Law; as among the “Best Lawyers In Dallas” for her work in the fields of “Labor & Employment,” “Tax: ERISA & Employee Benefits,” “Health Care” and “Business and Commercial Law” by D Magazine, Cynthia Marcotte Stamer is a practicing attorney board certified in labor and employment law by the Texas Board of Legal Specialization and management consultant, author, public policy advocate and lecturer widely known for 35 plus years of health industry and other management work, public policy leadership and advocacy, coaching, teachings, and publications.

A Fellow in the American College of Employee Benefit Counsel, Co-Chair of the American Bar Association (“ABA”) International Section Life Sciences and Health Committee and VIce-Chair Elect of its International Employment Law Committee, Chair-Elect of the ABA TIPS Section Medicine & Law Committee, Past Chair of the ABA Managed Care & Insurance Interest Group, Scribe for the ABA JCEB Annual Agency Meeting with HHS-OCR, past chair of the ABA RPTE Employee Benefits & Other Compensation Group and current co-Chair of its Welfare Benefit Committee, and Chair of the ABA Intellectual Property Section Law Practice Management Committee, Ms. Stamer is most widely recognized for her decades of pragmatic, leading-edge work, scholarship and thought leadership on healthcare and life science, managed care and insurance and other workforce and staffing, employee benefits, safety, contracting, quality assurance, compliance and risk management, and other legal, public policy and operational concerns in the healthcare and life sciences, employee benefits, managed care and insurance, technology and other related industries. She speaks and publishes extensively on these and other related compliance issues.

Ms. Stamer’s work throughout her career has focused heavily on working with health care and managed care, life sciences, health and other employee benefit plan, insurance and financial services and other public and private organizations and their technology, data, and other service providers and advisors domestically and internationally with legal and operational compliance and risk management, performance and workforce management, regulatory and public policy and other legal and operational concerns. Scribe for the ABA JCEB Annual Meeting with the HHS Office of Civil Rights, her experience includes extensive involvement throughout her career in advising health care and life sciences and other clients about preventing, investigating and defending EEOC, DOJ, OFCCP and other Civil Rights Act, Section 1557 and other HHS, HUD, banking, and other federal and state discrimination investigations, audits, lawsuits and other enforcement actions as well as advocacy before Congress and regulators regarding federal and state equal opportunity, equity and other laws.

For more information about Ms. Stamer or her health industry and other experience and involvements, see www.cynthiastamer.com or contact Ms. Stamer via telephone at (214) 452-8297 or via e-mail here.

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This entry was posted on Monday, August 14th, 2023 at 4:03 pm and is filed under Health Care. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.