Tenn. doctor guilty of prescribing illegal drugs to KY people
A Tennessee doctor has admitted illegally prescribing painkillers that fueled southeast Kentucky’s drug problem.
James J. Maccarone of Clarksville, Tennessee, pleaded guilty to conspiracy to illegally distribute drugs in federal court in London on Monday.
Maccrarone ran Gateway Medical Associates PC, a pain management clinic in Clarksville.
Terry L. Prince of Barbourville, a Kentucky resident charged with the conspiracy, admitted he had sponsored people to go from the Knox County area to the Clarksville clinic, about four hours away, for prescriptions for receive painkillers called oxycodone and oxymorphone.
Prince gave people money to cover the cost of the trip, the exam fee at the clinic, and prescriptions. In exchange, he got some or all of the pills to sell illegally, or the people who went to the clinic sold the drugs and shared the profits, according to Prince’s plea agreement.
This type of sponsorship arrangement is common in the Kentucky drug trade, with dealers who pay the bills getting pills for sale. Many of the people sponsored by traffickers are drug addicts.
The case against Maccarone is related to a separate case against Calvin Manis, a former Barbourville pharmacist who is accused of filling prescriptions in collaboration with a drug dealer who, according to court records, sponsored other people to get the drug orders.
Prince sent people to the Maccarone Clinic because it served as a distributor of drugs to sell illegally, “not because (the clinic) provided legitimate medical care to the sponsored individuals,” according to his consent statement.
Maccarone acknowledged in his pleading that the people he wrote prescriptions for showed “obvious signs of drug diversion and abuse.”
These red flags included people who traveled long distances from the east end of Kentucky, sometimes in groups, and waited long hours, even into the evening or early morning hours, to see a doctor.
People who came to the clinic often tested positive for illegal drugs or negative for the pills they were prescribed at the clinic, according to Maccarone’s plea document, an indication that they were selling them rather than using them as prescribed.
People also didn’t show up for the pill count – which a doctor can use to ensure a patient is taking the medication prescribed – and paid more than $400 for each clinic visit.
Maccarone also acknowledged that he had “repeatedly failed” to adhere to accepted professional standards for managing pain.
Among other things, he did not try other treatments before prescribing opioid pain relievers, failed to establish a valid treatment plan for patients, and often performed only cursory doctor visits without an actual physical exam, according to his informed consent.
Prince and Maccarone face up to 20 years in prison on conspiracy charges, and Prince has agreed to forfeit $250,000 to the government.
Maccarone agreed to relinquish his medical license in Tennessee; forfeit the property of the clinic to the government; $204,186 of bank accounts abandoned; and pay the government $1.3 million to cover what he made of the conspiracy.
The period covered in the indictment was July 2016 to March 2021. Maccarone’s pleading said he was involved in the improper distribution of more than 46,000 pills.
Prince and Maccarone are later convicted.
Two other defendants are charged in the case: John L. Stanton, who worked as the medical director at the Clarksville Clinic and was allegedly involved in the illegal prescription scheme, and Jeffrey L. Ghent, who was allegedly selling drugs in Clay County.
Stanton has pleaded not guilty. Ghent has filed an application for a guilty plea.