(From the U. S. Attorney for the Western District of Missouri)A Nixa, Mo., physician was sentenced in federal court today after taking bribes from a drug manufacturer in exchange for prescribing its fentanyl drug to his patients so often that he ranked highest in the state in net sales of the product.
Randall Halley, 65, was sentenced by U.S. District Judge Stephen R. Bough to one year and one day in federal prison without parole. The court also ordered Halley to pay $400,565 in restitution to Medicare and to pay a fine of $150,000.
On Dec. 7, 2021, Halley pleaded guilty to one count of making a false statement to Medicare to obtain insurance coverage for a fentanyl prescription and to one count of conspiracy to use his DEA registration number for his employees to issue Schedule II controlled substances to patients in his absence.
Halley, a licensed physician, was employed by Ozark Community Hospital - Christian County Clinic in Nixa from 2004 to June 2019. He also was employed by several area skilled nursing facilities and residential care facilities.
According to court documents, Halley was only present at the Nixa practice, at most, two days of each week, as he was paid to provide care at several area nursing homes and regularly accepted additional money to travel and speak on behalf of pharmaceutical companies. One of the pharmaceutical companies he agreed to speak for was Insys, which produced a fentanyl medication, Subsys, that Medicare only approved for active cancer patients who were currently suffering from breakthrough cancer pain.
Halley accepted bribes from Insys in exchange for prescribing Subsys to his patients. Halley’s participation in Insys’s speakers program was a front designed to conceal the bribes Insys paid to Halley and other doctors. As long as Halley continued to prescribe Subsys, to increasing numbers of patients and in increasing dosages, Insys paid him to speak for them, increasing his compensation over time due to his prescriptions. There was a direct correlation between Insys’s payments to Halley and his issued Subsys prescriptions.
Halley had the highest net sales of Subsys of any physician in the state of Missouri and ranked 38th in the United States at one time. Altogether, Insys paid Halley $92,225 in bribes during their relationship.
The sham nature of this program was exhibited by the fact that Insys paid him for a program he never attended and labeled him as a “National” speaker at a higher payment rate despite the fact he only twice traveled outside the state of Missouri to speak for Insys, to neighboring Arkansas and Illinois. After the program Halley did not attend, he signed a sheet affirming that he attended and spoke at the program when, in fact, he had not. This led to Insys paying him $2,400 for the program.
Halley made false statements on pre-approval forms to ensure Medicare coverage of the expensive drug for these patients.
Halley also conspired with his employees at the clinic to use his registration number so they could provide prescription medication in his absence. Despite Halley’s absence at his clinic on three days of the week, and sometimes more due to his Insys travel, he directed clinic employees to continue scheduling patient visits on those days.
Some of these patient visits were conducted by employees of the clinic who could not legally prescribe Schedule II controlled substances. Halley directed them to write out prescriptions several days ahead of these office visits and he would pre-sign these prescriptions. Then, when the patient came into the clinic for their office visit, the employees would conduct the visit and issue the pre-signed prescriptions, all without Halley conducting an examination of the patient.
Former employees Nga A. Nguyen, 43, and Susan G. Morris, 64, both of Springfield, and Amber N. Moeschler, 39, of Ozark, Mo., have pleaded guilty and await sentencing for illegally using Halley’s DEA registration number in connection with the distribution of a controlled substance. Former employee Kimberly G. Hoffer, 50, awaits trial in December for related charges.
Halley disregarded the dangerousness of Subsys. Fentanyl is a highly addictive synthetic opioid that is up to 50 times stronger than heroin. It is a major contributor to fatal and nonfatal overdoses in the United States. The drug is so dangerous that all prescribers and patients who prescribe and receive Subsys must participate in the government-mandated Risk Evaluation and Mitigation Strategy program, involving education, the prescriber’s contractual commitment to mandatory prescribing rules, and compulsory patient disclosures.
Numerous patients received dangerous fentanyl medication they did not need, nor did they qualify for under Medicare, and Medicare was defrauded out of hundreds of thousands of dollars. In his plea agreement, Halley specifically admitted that he prescribed Subsys to a patient and submitted a request to Medicare for payment coverage of the prescription, falsely stating that the patient had a diagnosis of cancer. Halley knew that the patient did not have a diagnosis of cancer at that time, and was not being treated for breakthrough cancer-related pain – two conditions that Medicare required for payment coverage of Subsys. Due to Halley’s false statement, Medicare paid a total of $11,945 to cover the patient’s prescription and subsequent Subsys prescriptions. Halley committed similar conduct with additional payments, leading Medicare to pay hundreds of thousands of more dollars for Subsys prescriptions.
This case is being prosecuted by Assistant U.S. Attorneys Casey Clark and Nhan D. Nguyen. It was investigated by the Department of Health and Human Services, Office of Inspector General, the FBI, and the Drug Enforcement Administration.
Former employees Nga A. Nguyen, 43, and Susan G. Morris, 64, both of Springfield, and Amber N. Moeschler, 39, of Ozark, Mo., have pleaded guilty and await sentencing for illegally using Halley’s DEA registration number in connection with the distribution of a controlled substance. Former employee Kimberly G. Hoffer, 50, awaits trial in December for related charges.
Halley disregarded the dangerousness of Subsys. Fentanyl is a highly addictive synthetic opioid that is up to 50 times stronger than heroin. It is a major contributor to fatal and nonfatal overdoses in the United States. The drug is so dangerous that all prescribers and patients who prescribe and receive Subsys must participate in the government-mandated Risk Evaluation and Mitigation Strategy program, involving education, the prescriber’s contractual commitment to mandatory prescribing rules, and compulsory patient disclosures.
Numerous patients received dangerous fentanyl medication they did not need, nor did they qualify for under Medicare, and Medicare was defrauded out of hundreds of thousands of dollars. In his plea agreement, Halley specifically admitted that he prescribed Subsys to a patient and submitted a request to Medicare for payment coverage of the prescription, falsely stating that the patient had a diagnosis of cancer. Halley knew that the patient did not have a diagnosis of cancer at that time, and was not being treated for breakthrough cancer-related pain – two conditions that Medicare required for payment coverage of Subsys. Due to Halley’s false statement, Medicare paid a total of $11,945 to cover the patient’s prescription and subsequent Subsys prescriptions. Halley committed similar conduct with additional payments, leading Medicare to pay hundreds of thousands of more dollars for Subsys prescriptions.
This case is being prosecuted by Assistant U.S. Attorneys Casey Clark and Nhan D. Nguyen. It was investigated by the Department of Health and Human Services, Office of Inspector General, the FBI, and the Drug Enforcement Administration.
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