Mt. San Rafael Hospital and Rural Health Clinic in Trinidad, Colo., and three of its physicians have agreed to pay a combined $650,000 to settle allegations that they improperly prescribed opioids and submitted invalid claims to Medicare and other federal healthcare programs.
The U.S. Attorney’s Office for the District of Colorado said the hospital and Sheryll Castro-Flores, MD, Joseph Jimenez, MD, and Douglas McFarland, MD, violated the Controlled Substances Act by dispensing high doses of opioids and unsafe drug combinations without legitimate medical justification between January 2016 and December 2023. The prescriptions were allegedly issued despite clear warning signs, including signs of addiction, cash payments despite insurance coverage, early refill requests and high-risk combinations of medications.
The federal government also alleged violations of the False Claims Act, stating the physicians and the hospital submitted claims for these prescriptions to Medicare and other federal programs.
To resolve the allegations, Drs. Castro-Flores and Jimenez each agreed to pay $112,500; Dr. McFarland will pay $100,000; and Mt. San Rafael Hospital will pay $325,000. The parties did not admit to any liability as part of the settlement.
In response, Mt. San Rafael Hospital has implemented new protocols to prohibit opioid prescribing for chronic pain and to ensure any opioid use for acute or sub-acute pain complies with state guidelines.
“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,” U.S. Attorney Peter McNeilly said in a Nov. 24 news release. “And, when doctors cause illegitimate prescriptions to be submitted to Medicare and other federal healthcare plans, taxpayers pay for those illegitimate prescriptions.”
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