Southern Colorado hospital, doctors to pay $650K after alleged illegal opioid prescriptions
TRINIDAD, Colo. (KRDO) – Mt. San Rafael Hospital in Trinidad and three of its physicians have agreed to pay a combined $650,000 to settle federal allegations that they unlawfully prescribed high-dose opioids and other controlled substances, and then billed federal health care programs for them.
According to the U.S. Attorney’s Office for the District of Colorado, the hospital and three doctors, Dr. Sheryll Castro-Flores, Dr. Joseph Jimenez, and Dr. Douglas McFarland, were accused of violating both the Controlled Substances Act and the False Claims Act between 2016 and 2023.
Federal investigators allege that during that timeframe, the three physicians repeatedly issued invalid prescriptions for controlled substances like opioids while seeking payment for the prescriptions from Medicare and other federal health care programs.
"According to the allegations, these prescriptions were not issued for a legitimate medical purpose or were outside the usual course of professional practice," the U.S. Attorney's Office said.
The physicians were also accused of ignoring multiple "red flags" that indicated the prescriptions they had handed out were unsafe – including high daily opioid doses and prolonged use, signs of substance abuse, cash payments despite insurance coverage, long-distance travel to obtain prescriptions, and repeated early refill requests.
Because the doctors were employees of Mt. San Rafael Hospital, federal officials say the hospital is also liable – both for the illegal prescribing and for allowing those prescriptions to be billed to government health programs.
To resolve the allegations, the doctors and hospital have agreed to pay a combination of penalties under the Controlled Substances Act and damages under the False Claims Act as follows:
- Dr. Castro-Flores has agreed to pay $112,500
- Dr. Jimenez has agreed to pay $112,500
- Dr. MacFarland has agreed to pay $100,000
- Mt. San Rafael Hospital has agreed to pay $325,000
According to the U.S. Attorney's Office, the hospital has also issued new policies and implemented new protocols to disallow opioid prescriptions for chronic pain management and to ensure that their prescriptions are done safely in the future.
"When doctors write prescriptions for opioids despite red flags signaling that the prescriptions may be invalid, they place the patient at risk of harm, and they increase the likelihood of illegal diversion," United States Attorney Peter McNeilly said. "And, when doctors cause illegitimate prescriptions to be submitted to Medicare and other federal healthcare plans, taxpayers pay for those illegitimate prescriptions. We will continue to hold doctors and hospitals accountable when they disregard these important obligations.”
The allegations were investigated by the DEA’s Rocky Mountain Division and the Department of Health and Human Services, Office of Inspector General.
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