Background
Evann Herrell, Mark Grenkoski, and Keri McFarlane were licensed physicians who worked at Express Health Care, a clinic that operated as a pill mill rather than a legitimate addiction treatment facility. The clinic prescribed high volumes of controlled substances, including buprenorphine and benzodiazepines, in exchange for cash with little regard for legitimate medical needs. The defendants engaged in practices such as prescribing after brief visits, signing prescriptions for patients they had not seen, and falsifying medical records. They were convicted on charges of conspiracy to distribute controlled substances, healthcare fraud, and money laundering following a thirty-day jury trial.
The court’s reasoning
The Sixth Circuit reviewed the sufficiency of the evidence, evidentiary rulings, and jury instructions. The court held that the evidence was sufficient to prove the defendants subjectively knew their prescriptions were not for a legitimate medical purpose, satisfying the standard set forth in United States v. Ruan. The court affirmed the district court’s exclusion of evidence regarding the later elimination of the X-waiver rule, noting the timeline mismatch reduced its probative value. The court also upheld the admission of hearsay statements and speculative testimony as relevant to the existence of a criminal agreement. Finally, the court found no abuse of discretion in denying the motion to sever the trial, as the defendant failed to show specific and actual prejudice from the joint proceedings.
Because most of these challenges are meritless, and any errors that did occur were harmless, we affirm.
Opinion at Page 2
What it means going forward
The decision reinforces the ability of federal prosecutors to secure convictions against medical professionals operating pill mills by proving subjective knowledge of unauthorized prescribing, even when defendants argue that regulatory changes or expert testimony support their conduct.