BUFFALO, N.Y. - U.S. Attorney James P. Kennedy, Jr.
announced today that Dr. Eugene Gosy, 59, of Clarence, NY, pleaded guilty
before Chief U.S. District Judge Frank P. Geraci, Jr. to conspiracy to
distribute controlled substances and healthcare fraud. The charges carry a
maximum penalty of 20 years in prison.
Assistant U.S. Attorneys Jonathan P. Cantil, Brendan T.
Cullinane, and Charles J. Volkert, who are handling the case, stated that in
carrying out the conspiracy, Dr. Gosy and his employees at the Gosy Center,
which included nurse practitioners and physician assistants working under Dr.
Gosy’s direction and control, issued more prescriptions for controlled
substances annually than any other prescriber or prescribing entity in New York
State, including hospitals. Specifically, Dr. Gosy and his employees carried
out their conspiracy by:
• prescribing controlled substances without conducting a
physical examination and/or after conducting only a limited and inadequate
physical examination;
• prescribing controlled substances in ways that were likely
to cause, and did cause, dependence and addiction, and that contributed to
existing addictions;
• issuing prescriptions for controlled substances in dosages
and/or in combinations dangerous to the health and safety of the patient;
• issuing prescriptions for controlled substances despite
indications that patients were abusing and misusing the prescribed controlled
substances;
• prescribing controlled substances without monitoring or
using objective treatment information;
• recommending a course of treatment, including the
prescription of controlled substances, which caused patients to become so
addicted to opioid drugs that some eventually utilized heroin and other street
drugs, in order to satisfy their addiction;
• issuing prescriptions for controlled substances to
patients despite knowing that such patients had overdosed, or had otherwise
been hospitalized for conditions relating to misuse of controlled substances;
• continuing to prescribe controlled substances in the same
manner, and failing to adapt practices to prevent additional deaths and
overdoses, despite having notice that treatment they were following had
resulted in obvious drug-seeking behavior and addiction; numerous patient
overdoses; and patient deaths;
• signing death certificates, in the absence of an autopsy
or medical examination, for deceased patients to whom Gosy and/or his employees
had prescribed controlled substances despite aberrant behaviors;
• recommending a course of treatment, including the
prescribing of controlled substances, which caused the death of at least six
individuals, and contributed to the deaths of others;
• utilizing a telephonic patient prescription renewal
process, whereby patients could obtain prescriptions for Schedule II, III and
IV controlled substances that were prepared by persons who were not medically
trained and issued by mid-level providers who had inadequate knowledge about
the prescription and the patient, and without adequate review of the prescription
and the patient’s chart;
• Dr. Gosy pre-signing blank prescriptions and permitting
other persons to fill out the remaining information for the prescription, when
he would leave the Buffalo area for extended periods;
• Dr. Gosy failing properly to review and sign his own
patient file notes, and arranging for other, non-medical, personnel to sign
said patient file notes, to make it appear as if he had reviewed them;
• Dr. Gosy failing properly to review patient file notes/reports
prepared by mid-level providers working under his supervision and working in
collaboration with him, and arranging for other, non-medical, personnel to sign
said patient file notes, to make it appear as if he had reviewed them;
• failing adequately to review records provided to the
office from other providers, and failing to obtain a complete patient history
and information about present illness and conditions;
• prescribing controlled substances to individuals while
failing to refer the patient to and/or ensure compliance with drug addiction
treatment despite aberrant behaviors, and requests from patients and/or their
family members for help with addiction;
• prescribing methadone to individuals exhibiting aberrant
behaviors, outside of a methadone clinic setting, and without employing
additional safety precautions or referring the patient to addiction treatment;
• Dr. Gosy, beginning in 2008, circumventing state and
federal regulations by prescribing buprenorphine for the treatment of narcotics
addiction, improperly using his regular DEA number, and sometimes labeling the
prescriptions as for “pain management,” even when the drug was being prescribed
primarily for the purpose of treating narcotics addiction;
• Dr. Gosy issuing prescriptions to patients for
buprenorphine, a Schedule III controlled substance, for the treatment of
narcotics addiction, without having completed the required medical training
course in order to be a “qualifying physician” to treat narcotics addiction;
• Dr. Gosy failing to complete training requirements,
including Continuing Medical Education courses, Worker’s Compensation training,
and Infectious Disease Control training, and instead requiring members of his
office staff to take the online courses purporting to be the defendant; and
• Dr. Gosy engaging in prescribing patterns whereby
high-risk patients that had run out of their prescribed opioids were given
buprenorphine until Dr. Gosy could again prescribe other opioids.
Other practices adopted and used in defendant Gosy’s office
included the following:
• Mid-level providers (Physician Assistants and Nurse
Practitioners) were encouraged to maximize volume of patients seen. Providers
who saw certain volumes of patients received monetary bonuses, and/or
gifts. Providers who saw less patients
were threatened with pay cuts. Providers
also earned credit towards bonuses for performing certain, more lucrative
procedures on patients.
• Beginning in 2012, a “script line” was established which
allowed patients seeking prescriptions, who were not scheduled for an office
visit, to call and request a prescription. The “script line” was attended to by
individuals with no medical training or certification. They were responsible
for drafting the requested prescriptions with the proper drug and dosage,
checking the patient’s file for “alerts,” and the New York State iStop program,
a Prescription Monitoring Program. Each week a mid-level provider was
designated to sign all, or almost all, prescriptions requested through the “script
line.” This typically amounted to hundreds of prescriptions per day, many of
which were for patients whom the practitioner had never seen and/or with whom
the practitioner had little or no familiarity.
• A system was in place for ordering urine drug tests
whereby, once the test was ordered, an employee other than the treating
practitioner would typically fill out the request form for the laboratory. As a
result, the drug screens often tested for the presence or absence of drugs
other than those actually prescribed to the patient. However, as part of the
usual course of medical practice, urine drug tests should have been ordered and
reviewed in consultation with the patient’s medical file, including history and
list of current prescribed medications. This
is because urine drug testing provided valuable objective information to assist
in diagnostic and therapeutic decision making, provided confirmation of
compliance with the treatment plan, and provided indication of overutilization
of prescribed drugs, diversion/non-use of prescribed drugs, the use of
prescription drugs not prescribed to a particular patient, and/or the use of
alcohol or illicit street drugs.
• As with the “script line,” toxicology results, including
urine drug screens, were reviewed by a mid-level provider, many of whom had
never seen the patient and/or with whom the practitioner had little or no
familiarity. As a result, tests were often labeled as “consistent,” and not
given appropriate attention, even when the tests showed the presence of a
non-prescribed drug, or the lack of a prescribed drug.
• Patient records often contained incorrect or insufficient
information to justify a diagnosis and warrant treatment. Mid-level providers
frequently dictated their office notes, failed to review their notes after
transcription, and “batch signed” large quantities of notes without review. In
addition, Dr. Gosy rarely, if ever, signed his own notes, and arranged for
others to affix his signature to office notes and patient files, in order to facilitate
more expeditious billing.
“Recognizing that our fight against the opioid epidemic
requires a 3-prong approach—which includes enforcement, treatment, and
prevention—today’s plea represents the high-water mark of success in our
enforcement efforts,” stated U.S. Attorney Kennedy. “Although even one death is
still too many, through the aggressive prosecution posture adopted by my
office, we have helped to turn the tide on the opioid epidemic in Erie County.
This prosecution has helped to enhance communication and cooperation between the
law enforcement and the medical communities. Together, we have come to
recognize and take advantage of the direct link that exists between public
health and public safety.”
“Dr. Gosy’s reckless prescribing endangered public welfare
and continued to fuel the opioid epidemic that plagues our nation,” said Scott
J. Lampert, Special Agent-in-Charge for the Office of Inspector General of the
U.S. Department of Health and Human Services. “Physicians will be held
responsible for their prescribing practices. We look forward to continue
working with our State and Federal law enforcement partners in fighting this
epidemic and safeguarding taxpayer-funded government health programs.”
“There isn’t a fine line between a patient who needs pain
medication for a legitimate reason and a customer needing a prescription to
feed a habit,” said DEA Special Agent-in-Charge Ray Donovan. “Today’s plea is
proof that Dr. Gosy knew the difference. I commend the DEA Buffalo Tactical
Diversion Squad and the Western District of New York for their diligent efforts
identifying, investigating and prosecuting illegal opioid sources of supply in
order to save lives.”
The plea is the result of an investigation by the Drug
Enforcement Administration, under the direction of Ray Donovan, Special
Agent-in- Charge, New York Field Division; the Federal Bureau of
Investigation’s Western New York Health Care Task Force, under the direction of
Special Agent-in-Charge Gary Loeffert; the Department of Health and Human
Services, Office of Inspector General, under the direction of Special
Agent-in-Charge Scott Lampert; the Army National Guard - New York National
Guard Counterdrug Task Force, under the direction of Lt. Col. Nicholas Dean;
the New York State Department of Financial Services, under the direction of
Superintendent Linda A. Lacewell; the New York State Office of the Workers’
Compensation Fraud Inspector General, under the direction of Inspector General
Letizia Tagliafierro; and the New York State Bureau of Narcotics Enforcement.
Sentencing is scheduled for May 21, 2020, at 9:30 a.m.
before Judge Geraci.
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