Tennessee doctor guilty in case of illegal drug prescriptions that fed KY drug problems
A Tennessee doctor has admitted illegally prescribing pain pills that fed the drug problem in southeastern Kentucky.
James J. Maccarone, of Clarksville, Tenn., pleaded guilty Monday in federal court in London to conspiring to illegally distribute drugs.
Maccrarone operated Gateway Medical Associates P.C., a pain-management clinic in Clarksville.
A Kentucky resident charged in the conspiracy, Terry L. Prince of Barbourville, admitted that he sponsored people to go from the Knox County area to the Clarksville clinic, about four hours away, to get prescriptions for pain drugs called oxycodone and oxymorphone.
Prince gave people money to cover the cost of the trip, the examination fee at the clinic and the prescriptions. In return, 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.
That kind of sponsorship arrangement has been common in Kentucky’s illicit drug trade, with traffickers who foot the bills getting pills to sell. Many of the people sponsored by the traffickers are addicted to drugs.
The case against Maccarone is related to a separate case against Calvin Manis, a former Barbourville pharmacist charged with filling prescriptions in cooperation with a drug trafficker who was sponsoring other people to get the drug orders, according to court records.
Prince sent people to Maccarone’s clinic because it operated as a supply of drugs to sell illegally, “not because (the clinic) provided legitimate medical care to the sponsored individuals,” according to his plea agreement.
Maccarone acknowledged in his plea deal that the people he gave prescriptions “exhibited obvious signs of drug diversion and abuse.”
Those red flags included people traveling long distances from the eastern end of Kentucky, sometimes in groups, and waiting long hours to see a doctor, even into the evening or early morning hours.
The people coming to the clinic often tested positive for illegal drugs, or tested negative for the pills they were being prescribed at the clinic, an indication they were selling them instead of using them as prescribed, according to Maccarone’s plea document.
The people also failed to appear for pill counts — which are a way for a doctor to make sure a patient is taking medication as prescribed — and paid more than $400 for each clinic visit.
Maccarone also acknowledged that he “repeatedly failed” to adhere to accepted professional standards for treating pain.
Among other things, he didn’t try other treatments before prescribing opioid painkillers, failed to draw up a valid treatment plan for patients and often did only cursory office visits with no real physical examination, according to his plea agreement.
Prince and Maccarone face up to 20 years in prison on the conspiracy charge, and Prince agreed to forfeit $250,000 to the government.
Maccarone agreed to surrender his Tennessee medical license; forfeit the clinic property to the government; give up $204,186 from bank accounts; and pay the government $1.3 million to cover what he made from the conspiracy.
The time period covered in the indictment was July 2016 to March 2021. Maccarone’s plea deal said he took part in improperly distributing more than 46,000 pills.
Prince and Maccarone will be sentenced later.
There are two others charged in the case: John L. Stanton, who worked as medical director at the Clarksville clinic and allegedly took part in the scheme to illegally write prescriptions, and Jeffrey L. Ghent, who allegedly sold drugs in Clay County.
Stanton has pleaded not guilty. Ghent has filed a motion to plead guilty.
