A Nixa, Mo., physician was sentenced in federal court 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 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. 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.
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.
