West Virginia Doctor Found Guilty of Unlawfully Distributing Opioids

A federal jury found a West Virginia doctor guilty today of unlawfully distributing opioids to his patients.  The defendant was charged in a September 2019 indictment as part of the second Appalachian Regional Prescription Opioid (ARPO) Strike Force Takedown, a coordinated effort by the Justice Department’s Fraud Section to target unlawful drug diversion activities in areas of the country particularly hard-hit by the opioid epidemic.  

Following a six-day trial, Ricky L. Houdersheldt, D.O., 68, of Hurricane, West Virginia, was found guilty of 17 counts of distribution of controlled substances outside the scope of professional practice and without a legitimate medical purpose.  Sentencing is scheduled for Nov. 23, 2020, before U.S. District Judge Robert C. Chambers of the Southern District of West Virginia, who presided over the trial.

According to the evidence presented at trial, Houdersheldt prescribed hydrocodone, morphine, fentanyl, oxycodone, acetaminophen codeine phosphate, and diazepam to three patients which were outside the usual course of professional practice and without a legitimate medical purpose.  Evidence at trial established that Houdersheldt prescribed more than 150 opioid pills to one female patient in an effort to establish a sexual relationship and companionship with her, and that in many instances he would meet her in parking lots – rather than at his medical office – to provide the prescriptions for these drugs.  Evidence at trial also showed that Houdersheldt did not record these prescriptions in the female patient’s patient file for some of these unnecessary opioid prescriptions, and that many patients became addicted to the drugs as a result of Houdersheldt’s criminal conduct.

The evidence further established that for one of the patients, Houdersheldt prescribed more than seven times the dosage of opioid drugs recommended by the Centers for Disease Control, and that he commonly prescribed this patient the dangerous combination of morphine and the powerful opioid fentanyl.  

The DEA, along with the Hurricane, West Virginia Police Department, investigated the case.  Assistant Chief Kilby Macfadden and Trial Attorney Andrew B. Barras of the Criminal Division’s Fraud Section are prosecuting the case.

The Fraud Section leads the ARPO Strike Force.  Since its inception in October 2018, the ARPO Strike Force, which operates in 10 districts, has charged more than 70 defendants who are collectively responsible for distributing approximately 50 million pills. Thus far there have been 30 guilty pleas as a result of ARPO Strike Force’s efforts.  The ARPO Strike Force is part of the Medicare Fraud Strike Force Program, led by the Fraud Section.  Since its inception in March 2007, the Medicare Fraud Strike Force, which maintains 15 strike forces operating in 24 districts, has charged more than 4,200 defendants who have collectively billed the Medicare program for approximately $19 billion.  In addition, the U.S. Department of Health and Human Services (HHS) Centers for Medicare & Medicaid Services, working in conjunction with the HHS-Office of Inspector General, are taking steps to increase accountability and decrease the presence of fraudulent providers.

The year 2020 marks the 150th anniversary of the Department of Justice.  Learn more about the history of our agency at www.Justice.gov/Celebrating150Years.

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    GAO's analysis of Department of Health and Human Services (HHS) Centers for Medicare & Medicaid Services (CMS) data show that in fiscal year 2018, 287,547 Medicare fee-for-service beneficiaries had inpatient stays that included care for severe wounds. These wounds include those where the base of the wound is covered by dead tissue or non-healing surgical wounds. About 73 percent of the inpatient stays occurred in acute care hospitals (ACH), and a smaller percentage of stays occurred in post-acute care facilities. Specifically, about 16 percent of stays were at skilled nursing facilities (SNF), and about 7 percent were at long-term care hospitals (LTCH). CMS data show that Medicare spending on stays for severe wound care was $2.01 billion in fiscal year 2018, representing a decline of about 2 percent from fiscal year 2016, when spending was about $2.06 billion. Spending declined as a result of decreases in both the total number of these stays, as well as spending per stay, which both decreased by about 1 percent. The decrease in per stay spending was likely driven, in part, by a change in where beneficiaries received care. CMS data show fewer severe wound care stays in LTCHs, which tend to be paid higher payment rates. At the same time, more severe wound care stays were at two other types of facilities that tend to be paid lower payment rates: ACHs and inpatient rehabilitation facilities. GAO's analysis of CMS data also show that, while the number of LTCHs that billed Medicare for severe wound care decreased by about 7 percent from fiscal years 2016 to 2018, Medicare beneficiaries continued to have access to other severe wound care providers. For example, CMS data show that most beneficiaries resided within 10 miles of an ACH or SNF that provided severe wound care in fiscal year 2018. Figure: Percentage of Medicare Fee-for-Service Beneficiaries Residing within 10 Miles of a Health Care Facility That Provided Any Severe Wound Care, by Facility Type, Fiscal Year 2018 Note: The “other” category includes facilities such as psychiatric hospitals or units. There is limited information on how or whether the decrease in LTCH care for severe wounds may have affected the quality of severe wound care Medicare beneficiaries receive. For example, CMS collects information on the percentage of patients with new or worsened pressure ulcers at post-acute care facilities, but it does not measure the quality of care they receive. Medicare beneficiaries with serious health conditions, such as strokes, are prone to developing severe wounds due to complications that often lead to immobility and prolonged pressure on the skin. These beneficiaries may require a long-term inpatient stay at an ACH or a post-acute care facility, such as an LTCH. LTCHs treat patients who require care for longer than 25 days, on average. In 2018, LTCHs represented about $4.2 billion in Medicare expenditures. Prior to fiscal year 2016, LTCHs received a higher payment rate for treating Medicare beneficiaries than ACHs. Beginning in fiscal year 2016, a dual payment system was phased in that paid LTCHs a rate similar to ACHs for some beneficiaries and a higher rate for beneficiaries that met certain criteria. As this payment system has moved from partial to full implementation, lawmakers had questions about how it may affect beneficiaries' severe wound care. The 21st Century Cures Act included a provision for GAO to review severe wound care provided to Medicare beneficiaries. This report describes facilities where Medicare beneficiaries received severe wound care, Medicare severe wound care spending, and what is known about the dual payment system's effect on access and quality. GAO analyzed Medicare severe wound care access and spending data for fiscal years 2016 and 2018 (the most recent data available); reviewed reports; and interviewed CMS officials, researchers, and national wound care stakeholders. HHS provided technical comments on a draft of this report, which were incorporated as appropriate. For more information, contact James Cosgrove at (202) 512-7114 or cosgrovej@gao.gov.
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  • Military Housing: Actions Needed to Improve the Process for Setting Allowances for Servicemembers and Calculating Payments for Privatized Housing Projects
    In U.S GAO News
    The Department of Defense (DOD) has established a process to determine basic allowance for housing (BAH) rates, which help cover the cost of suitable housing in the private sector for servicemembers. However, DOD has not always collected rental data on the minimum number of rental units needed to estimate the total housing cost for certain locations and housing types. GAO analysis found that 44 percent (788 of 1,806) of locations and housing types had fewer than the minimum sample-size target. Until DOD develops ways to increase its sample size, it will risk providing housing cost compensation that does not accurately represent the cost of suitable housing for servicemembers. DOD followed congressional requirements for calculating BAH reductions and payments to privatized housing projects. However, while the 2019 congressionally mandated payments lessened the financial effects of BAH reductions, as intended, they did not do so commensurate with the amount of the BAH reduction. GAO found that privatized housing projects received payments that were either over or under the amount of revenue lost from reductions made to BAH, in some cases by $1 million or more. (see figure) Number of Privatized Housing Projects and Amounts That Congressionally Mandated Payments Were Above or Below the Basic Allowance for Housing (BAH) Reduction Estimate (in 2019) These distortions occurred because the legal requirements for calculating the BAH reduction and the congressionally mandated payments differ. Specifically, the law requires that the BAH reduction be a set dollar amount, regardless of location, while payments to privatized housing projects are required to differ by location. This required method of calculating the BAH reduction amounts is consistent with how prior reductions were calculated. According to DOD, BAH rates were reduced so that servicemembers share a portion of housing costs, and that reduction amount was the same for servicemembers with the same pay grade and dependency status, regardless of location. Until Congress takes steps to ensure congressionally mandated payment calculations are consistent with how BAH reductions are calculated, some privatized housing projects will continue to receive more or less than was intended. DOD spent about $20 billion in fiscal year 2019 on BAH—often one of the largest components of military pay. BAH is designed to cover a portion of servicemembers' housing rental and utility costs in the private sector. Starting in 2015, DOD reduced BAH rates so that servicemembers share a portion of housing costs. The majority of servicemembers rely on the civilian housing market, while others rely on government housing or privatized housing projects. These projects rely on BAH as a key revenue source. In 2018-2020, Congress required DOD to make payments to these projects to help offset the BAH reduction. Senate Report 116-48 included a provision for GAO to review DOD's BAH process. This report evaluates, among other things, the extent to which (1) DOD established a process to determine BAH and (2) DOD's congressionally mandated payments to projects lessened the effects of BAH reductions. To conduct this work, GAO reviewed relevant guidance and other documents, analyzed key data, and interviewed cognizant DOD officials. GAO is making a matter for congressional consideration to revise statutory language to ensure payments to privatized housing projects are consistent with BAH reductions. GAO is also making three recommendations, including that DOD review its sampling methodology to increase sample size. DOD concurred with two recommendations. DOD also partially concurred with one recommendation, which GAO continues to believe is valid, as discussed in the report. For more information, contact Elizabeth A. Field at (202) 512-2775 or fielde1@gao.gov.
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  • Environment and Natural Resources Division Recognizes Employees for Outstanding Service at Annual Awards Ceremony
    In Crime News
    The Environment and Natural Resources Division (ENRD) held its annual awards ceremony to highlight the past year’s achievements.
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  • Federal Court Enjoins Tuscon Area Tax Preparer From Preparing Tax Returns
    In Crime News
    The Justice Department announced today that a federal court in Arizona permanently enjoined a Tucson area tax return preparer from preparing federal income tax returns for others.
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  • Acting Attorney General Jeffrey A. Rosen Attends Security Briefing at FBI’s Strategic Information and Operations Center on Inauguration Planning and Recent Capitol Attack
    In Crime News
    Acting Attorney General Jeffrey A. Rosen attended a briefing today at the FBI’s Strategic Information and Operations Center (SIOC) on the recent attack on the Capitol building and law enforcement preparations for the upcoming presidential inauguration. Following the briefing, he addressed the assembled law enforcement partners and thanked them for their efforts.
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    In Human Health, Resources and Services
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  • Singaporean Shipping Company Fined $12 Million in a Multi-District Case for Concealing Illegal Discharges of Oily Water and Garbage and a Hazardous Condition
    In Crime News
    Pacific Carriers Limited (PCL), a Singapore-based company that owns subsidiaries engaged in international shipping, was sentenced today in federal court before U.S. District Court Judge Louise Flanagan in New Bern, North Carolina, after pleading guilty to violations of the Act to Prevent Pollution from Ships, obstruction of justice, and for a failure to notify the U.S. Coast Guard of a hazardous condition on the Motor Vessel (M/V) Pac Antares.
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  • Somerset County Man Admits Concealing Material Support to Hamas
    In Crime News
    A Somerset County, New Jersey, man admitted today that he concealed his attempts to provide material support to Hamas, Assistant Attorney General John C. Demers of the U.S. Department of Justice’s National Security Division, U.S. Attorney Craig Carpenito, FBI-Newark Special Agent in Charge George M. Crouch Jr., and FBI Assistant Director for Counterterrorism Jill Sanborn announced.
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  • Attorney General William P. Barr Delivers Remarks at the Pan Am 103 Press Conference
    In Crime News
    On this day 32 years ago, December 21, 1988, at 7:03 p.m. local time, a bomb destroyed Pan Am Flight 103 as it flew 31,000 feet above Lockerbie, Scotland. The massive Boeing 747 plane, known as the “Clipper Maid of the Seas,” exploded and fell to the ground in countless pieces scattered across 840 square miles, nearly the entire width of Scotland. The explosion killed all 259 people on board—243 passengers and 16 crew members, including 190 Americans. Falling debris claimed the lives of 11 Lockerbie residents on the ground, many of whom were in their homes and had just sat down for dinner.
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  • Antitrust Division Supports Modernizing Merger Filing Exemptions For Certain Investments
    In Crime News
    On Monday, September 21, Assistant Attorney General Makan Delrahim concurred in the Federal Trade Commission’s (FTC) Federal Register publication of a Notice of Proposed Rulemaking (NPRM) to revise the premerger notification rules (the Rules) that implement the Hart-Scott-Rodino Antitrust Improvements Act (HSR).
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  • U.S. Announces Humanitarian Assistance at the International Conference on Sustaining Support for the Rohingya Refugee Response
    In Crime Control and Security News
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  • Veterans Community Care Program: Improvements Needed to Help Ensure Timely Access to Care
    In U.S GAO News
    The Department of Veterans Affairs (VA) established an appointment scheduling process for the Veterans Community Care Program (VCCP) that allows up to 19 days to complete several steps from VA providers creating a referral to community care staff reviewing that referral. However, as the figure shows, VA has not specified the maximum amount of time veterans should have to wait to receive care through the program. GAO previously recommended in 2013 the need for an overall wait-time measure for veterans to receive care under a prior VA community care program. Subsequent to VA not implementing this recommendation, GAO again recommended in 2018 that VA establish an achievable wait-time goal as part of its new community care program (the VCCP). Potential Allowable Wait Time to Obtain Care through the Veterans Community Care Program Note: This figure illustrates potential allowable wait times in calendar days for eligible veterans who are referred to the VCCP through routine referrals (non-emergent), and have VA medical center staff—Referral Coordination Team (RCT) and community care staff (CC staff)—schedule the appointments on their behalf. VA has not yet implemented GAO's 2018 recommendation that VA establish an achievable wait-time goal. Under the VA MISSION Act, VA is assigned responsibility for ensuring that veterans' appointments are scheduled in a timely manner—an essential component of quality health care. Given VA's lack of action over the prior 7 years implementing wait-time goals for various community care programs, congressional action is warranted to help achieve timely health care for veterans. Regarding monitoring of the initial steps of the scheduling process, GAO found that VA is using metrics that are remnants from the previous community care program, which are inconsistent with the time frames established in the VCCP scheduling process. This limits VA's ability to determine the effectiveness of the VCCP and to identify areas for improvement. In June 2019, VA implemented its new community care program, the VCCP, as required by the VA MISSION Act of 2018. Under the VCCP, VAMC staff are responsible for community care appointment scheduling; their ability to execute this new responsibility has implications for veterans receiving community care in a timely manner. GAO was asked to review VCCP appointment scheduling. This report examines, among other issues, the VCCP appointment scheduling process VA established and VA's monitoring of that process. GAO reviewed documentation, such as scheduling policies, and referral data related to the VCCP and assessed VA's relevant processes. GAO conducted site visits to five VAMCs in the first region to transition to VA's new provider network, and interviewed VAMC staff and a non-generalizable sample of community providers receiving referrals from those VAMCs. GAO also interviewed VA and contractor officials. GAO recommends that Congress consider requiring VA to establish an overall wait-time measure for the VCCP. GAO is also making three recommendations to VA, including that it align its monitoring metrics with the VCCP appointment scheduling process. VA did not concur with one of GAO's recommendations related to aligning monitoring metrics to VCCP scheduling policy time frames. GAO continues to believe this recommendation is valid, as discussed in the report. For more information, contact Sharon M. Silas at (202) 512-7114 or silass@gao.gov.
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  • Former DeSales University Priest Indicted on Child Pornography Offenses
    In Crime News
    A former DeSales University priest was charged by indictment with three counts of child pornography offenses.
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  • Judiciary Calls for Passage of Security Legislation
    In U.S Courts
    The Judiciary implores Congress to pass the Daniel Anderl Judicial Security and Privacy Act of 2020 during the current lame duck session. The bipartisan bill if passed, would improve security at judges’ homes and at federal courthouses across the country.
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    In Space
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  • Political Scientist Author Charged With Acting As An Unregistered Agent Of The Iranian Government
    In Crime News
    A criminal complaint was unsealed today in federal court in Brooklyn charging Kaveh Lotfolah Afrasiabi, also known as “Lotfolah Kaveh Afrasiabi,” with acting and conspiring to act as an unregistered agent of the Government of the Islamic Republic of Iran, in violation of the Foreign Agents Registration Act (FARA). Afrasiabi was arrested yesterday at his home in Watertown, Massachusetts, and will make his initial appearance this morning in federal court in Boston, Massachusetts, before United States Magistrate Judge Jennifer C. Boal.
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  • Guild Mortgage Company to Pay $24.9 Million to Resolve Allegations it Knowingly Caused False Claims for Federal Mortgage insurance
    In Crime News
    Guild Mortgage Company has agreed to pay the United States $24.9 million to resolve allegations that it violated the False Claims Act by knowingly breaching material program requirements when it originated and underwrote mortgages insured by the Department of Housing and Urban Development’s (HUD) Federal Housing Administration (FHA), the Department of Justice announced today.  Guild Mortgage Company is headquartered in San Diego, California, with branches across the United States.
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  • Remarks by Attorney General William P. Barr at the Major Cities Chiefs Association Conference
    In Crime News
    I appreciate the invitation to address this group.  I want to start by thanking you, and the men and women you lead, for serving in what I think is the most noble profession in our country – enforcing the law and keeping our communities safe. 
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  • Monaco National Day
    In Crime Control and Security News
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  • “We are ready to distribute vaccines all across America”
    In Human Health, Resources and Services
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  • Secretary Michael R. Pompeo Remarks at the Florida Family Policy Council Dinner Gala: Respecting Life in America’s Foreign Policy
    In Crime Control and Security News
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  • Secretary Pompeo’s Call with NATO Secretary General Stoltenberg 
    In Crime Control and Security News
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  • Federal Rulemaking: Selected EPA and HHS Regulatory Analyses Met Several Best Practices, but CMS Should Take Steps to Strengthen Its Analyses
    In U.S GAO News
    GAO reviewed 11 Executive Order (EO) 13771 rules—five significant Environmental Protection Agency (EPA) rules and six economically significant Department of Health and Human Services (HHS) rules. Seven of the 11 rules modified (i.e. repealed, amended, or delayed) existing rules (see table). GAO found that analyses for most of the seven rules monetized the same types of benefits and costs as analyses for the rules they modified, an indicator of consistency in the regulatory analyses. For example, one EPA rule modified an earlier rule that had established requirements for chemical risk management programs. EPA monetized anticipated changes to industry compliance costs for both rules. Where agencies monetized similar types of benefits and costs for both reviewed rules and modified rules, the value of some estimates differed, in part, because agencies had updated analytical assumptions, such as the number of entities subject to requirements or relevant wage data. Topics and Characteristics of 11 Environmental Protection Agency (EPA) and Department of Health and Human Services (HHS) Rules Selected for Review Agency Topics Modified existing rule(s) Monetized costs exceeded benefits EPA Risk management programs ● ○   Railroad ties as non-waste fuels ● ○   Chemical data reporting ● ●   Mercury reporting ○ ●   Effluent from dental offices ○ ● HHS, FDA Food labeling ● ○   Agricultural water requirements ● ● HHS, CMS End-stage renal disease treatment ● ●   Home health quality reporting ● ●   Patient discharge planning ○ ●   Diabetes prevention and appropriate use of imaging services ○ ● Legend: ● = Yes; ○ = No Source: GAO analysis of EPA, Food and Drug Administration (FDA), and Centers for Medicare & Medicaid Services (CMS) data. | GAO-21-151 Regulatory analyses for eight of the 11 rules GAO reviewed projected that monetized costs would exceed monetized benefits, though each identified other factors that may have led decision makers to determine that the total benefits justified the total costs, such as important, non-quantified effects. These eight analyses met about half of the selected best practices for economic analysis. However, some analyses developed by HHS's Centers for Medicare & Medicaid Services (CMS) did not fully meet best practices associated with analyzing regulatory alternatives, assessing important effects, and providing transparency. It is particularly important that agencies develop quality analyses for economically significant rules, such as those finalized by CMS. By meeting these best practices, CMS could help the public and other parts of government provide effective feedback and mitigate potential conflict with entities affected by rules. It could also help CMS assess whether a rule's benefits justify the costs. EO 13771 generally requires executive agencies to identify two rules for repeal for each new rule issued. Since EO 13771 went into effect in 2017, executive agencies have taken regulatory actions expected to generate over $50 billion in savings to society. Quality regulatory analysis provides agency decision makers and the public with a thorough assessment of the benefits and costs of different regulatory options. GAO was asked to review regulatory analyses for rules finalized under EO 13771. For selected agencies, this report examines (1) how the calculated economic effects of selected rules differed, if at all, from those of rules they modified; and (2) the extent to which agencies met best practices in analyzing the economic effects of selected rules for which monetized costs exceed monetized benefits. GAO reviewed analyses for 11 rules—and the rules they modified— finalized by EPA and HHS, the two agencies that finalized the most economically significant EO 13771 rules through fiscal year 2019. GAO compared analyses to selected best practices in GAO's Assessment Methodology for Economic Analysis . GAO recommends that CMS take steps to ensure its future regulatory analyses are consistent with best practices for analyzing alternatives, assessing important effects, and providing transparency. EPA said it appreciated GAO's findings. HHS generally agreed with the report, and CMS agreed with the recommendation directed to it. For more information, contact Yvonne D. Jones at (202) 512-6806 or jonesy@gao.gov.
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  • New York Businessman Pleads Guilty to Tax Evasion
    In Crime News
    A Woodsburgh, New York, businessman pleaded guilty today to tax evasion, announced Principal Deputy Assistant Attorney General Richard Zuckerman of the Justice Department’s Tax Division.
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