Middle Tennessee - Federal prosecutors say they have uncovered connections between previously unconnected cases involving opioid prescribers, revealing a troubling pattern in two small-town pharmacies in Middle Tennessee. In a recent court filing, prosecutors detailed how cases against multiple medical professionals are linked through Dale Hollow Pharmacy and Xpress Pharmacy, where millions of pills were dispensed for prescriptions deemed questionable.

 

Patients reportedly traveled long distances, some up to three hours, to obtain prescriptions from medical professionals across Middle Tennessee, specifically targeting the small town of Celina. Despite its small population of about 2,000 residents and limited commercial resources, Celina became a hotspot for opioid distribution due to the activities of these pharmacies.

 

Among the medical professionals allegedly linked to these pharmacies were Gilbert Ghearing of Celina, who in 2023 was acquitted by a jury of 18 counts of health care fraud and CSA violations (scroll down for more or see links for past cases). Bowdoin Smith of Carthage, Hau La of Absolute Medical Care in Smyrna, Samson Orusa of Clarksville, and Willard West of Lebanon, who have also been convicted of unlawful distribution of controlled substances.

 

Additionally, Hemal Mehta, a Brentwood physician, and Heather Marks, a Murfreesboro nurse practitioner, face charges related to conspiracy to unlawfully distribute controlled substances. Their alleged involvement in promoting the sale of Subutex—a drug used to treat opioid addiction—underscores the extent of opioid-related crimes in the region.

More: In February of 2023, Defendants Thomas Weir, William Donaldson, and Pamela Spivey filed a Motion to Dismiss the Indictment, or alternatively, for Discovery, arguing that the government’s decision to prosecute their pharmacies—Dale Hollow Pharmacy and Xpress Pharmacy—was “arbitrary, random, and unreasonable.” They contend that their operations were less responsible for the opioid crisis compared to larger entities, like Walgreens and the Sackler family, who they argue were more culpable but were not prosecuted. Notably, they are not claiming that the prosecution was motivated by a discriminatory purpose but rather lacked rational basis.

In seeking discovery, they request specific government documents, including the prosecution memorandum, records of communications regarding their pharmacies, and any DOJ policies on prosecuting pharmacies for opioid-related offenses. The United States opposes the motion, asserting that the defendants have not established a prima facie case of selective prosecution and that they are applying an incorrect standard to justify their discovery requests.

However, court records show the U.S. Courts responded, "For the reasons set forth herein, the defendants' motion to dismiss and alternative request for discovery (Doc. No. 275) are both DENIED."

Looking back to March of 2023, the U.S. Attorney’s Office - Middle District of Tennessee released the following: NASHVILLE – A former Clay County, Tennessee physician was found guilty yesterday of 45 counts of violations relating to the Controlled Substances Act (CSA), health care fraud, and obstruction of justice, announced acting U.S. Attorney Thomas J. Jaworski. 

A federal jury began deliberating Friday and returned the verdict yesterday against Gilbert Ross Ghearing 69, of Crossville, Tennessee, following a five-week trial in U.S. District Court. The jury found Ghearing guilty of 21 counts of health care fraud, 22 counts of prescribing controlled substances without legitimate medical purpose outside the usual course of professional practice, and two counts of obstruction of justice.  The jury acquitted Ghearing of 18 counts of health care fraud and CSA violations.

“Doctors serve as the gatekeepers to our healthcare system and the system bestows a great deal of trust in physicians to make it work,” said Acting U.S. Attorney Jaworski.  “I commend our law enforcement partners and our trial team for their unparalleled dedication and commitment to ensure that justice was served in a long and protracted investigation and prosecution.”

According to the evidence presented at trial, Gilbert Ghearing, owned and operated a medical clinic in Celina, Tenn., located in direct proximity to four pharmacies.  He also provided medical services at another location in Fentress County, Tenn.  Between 2016 and 2019, Ghearing repeatedly violated the CSA by prescribing Schedule II and Schedule IV drugs, including benzodiazepines and opioids, outside the usual course of professional practice without legitimate medical purposes to people suffering from active substance use disorders, who abused the substances in combination with illicit drugs and alcohol, repeatedly overdosed, and were hospitalized.  The majority of Ghearing’s patients had Medicare or TennCare insurance, Tennessee’s Medicaid program.  Ghearing caused pharmacies to submit fraudulent claims to these insurance programs for controlled substance prescriptions written by him that were not medically necessary.

After Ghearing was indicted in June of 2019, he reportedly altered the medical records of the patients identified in the indictment.  A superseding indictment in October 2022 charged Ghearing with obstruction of justice based on the alterations.

Ghearing faces a maximum penalty of 20 years in prison on the CSA convictions, 20 years on the obstruction of justice, and 10 years on health care fraud convictions. A sentencing date has not yet been set. A federal district court judge will determine any sentence after considering the U.S. Sentencing Guidelines and other statutory factors.

This case was investigated by the Drug Enforcement Administration; the U.S. Department of Health & Human Services-Office of Inspector General; and the Tennessee Bureau of Investigation.  The DOJ Fraud Section Appalachian Regional Prescription Opioid (ARPO) Strike Force provided valuable investigative resource assistance.  Assistant U.S. Attorneys Sarah K. Bogni, Juliet Aldridge, and Amanda J. Klopf prosecuted the case.