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Nixa Physician Pleads Guilty to Healthcare Fraud

The Office of U.S. Attorney of the Western District of Missouri gets a guilty plea out of an area doctor on fraud and conspiracy charges.

According to a release from the District Office, a Nixa physician pleaded guilty in federal court Tuesday to making a false statement to Medicare to obtain insurance coverage for a fentanyl prescription and to conspiring with others to use his DEA registration number to issue Schedule II controlled substances to patients in his absence.
Randall Halley, 65, pleaded guilty before U.S. Chief Magistrate Judge David P. Rush on Tuesday to one count of making a false statement related to healthcare and one count of conspiracy to use a registration number issued to another person in connection with the distribution of a controlled substance.

Halley, a licensed physician, was employed by Ozark Community Hospital – Christian County Clinic in Nixa from 2004 to June 2019. He also was employed from 2009 to 2017 as the medical director at Magnolia Square, a skilled nursing facility in Springfield.

By pleading guilty Tuesday, Halley admitted that he prescribed Subsys, a fentanyl spray manufactured by Insys Therapeutics, to a patient. Halley submitted a request to Medicare for payment coverage of the prescription, falsely stating that the patient had a diagnosis of cancer. Halley knew 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 requires for payment coverage of Subsys. Due to Halley’s false statement, Medicare paid a total of $11,945 to cover the prescription and subsequent Subsys prescriptions.

Halley also admitted he conspired with others at the clinic to use his registration number so they could provide prescription medication in his absence, including Schedule II controlled substances. Halley was scheduled to only be present at the clinic in Nixa on Mondays and Thursdays. Although he was often absent on those days, he still scheduled patients for appointments. In order for the clinic to continue issuing prescriptions in Halley’s absence, he directed others at the clinic to prepare prescriptions ahead of time so that he could sign them several days before the patients’ appointments. On those days when Halley was absent, he directed others at the clinic to give the patients their prescriptions, including Schedule II controlled substances. Due to this illegal conduct, Medicare paid a total of $18,901 to cover the cost of those prescriptions.

Halley specifically admitted to conspiring with Susan Gail Morris, a nurse practitioner; Lily (Nga) Nguyen, a nurse practitioner; Amber Moeschler, a licensed practical nurse; and Kimberly Hoffer, a licensed practical nurse, to use his DEA registration number to distribute Schedule II controlled substances. Morris, Nguyen, and Moeschler have already pleaded guilty to crimes related to their conduct in this conspiracy. Co-defendant Hoffer has pleaded not guilty and is set for trial in February 2022.

Under the terms of Tueday’s plea agreement, Halley will pay a $92,225 fine and $44,887 in restitution to Medicare. The government may seek up to $355,678 in additional restitution to Medicare at the time of Halley’s sentencing hearing for conduct relevant to his false statement involving Subsys prescriptions. Additionally, Halley agreed to refrain from treating medical patients who may require the issuance of prescriptions for controlled substances, throughout the period of any post-sentencing supervision.

Under federal statutes, Halley is subject to a sentence of up to nine years in federal prison without parole. The maximum statutory sentence is prescribed by Congress and is provided here for informational purposes, as the sentencing of the defendant will be determined by the court based on the advisory sentencing guidelines and other statutory factors. A sentencing hearing will be scheduled after the completion of a presentence investigation by the United States Probation Office.

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, the FBI and the Drug Enforcement Administration.

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