Opinion ID: 3153469
Heading Depth: 3
Heading Rank: 1

Heading: General Practices

Text: East Health Center opened its doors on February 21, 2011. LeFrancois testified that patients paid $250 to $300 to see a doctor and receive a prescription. Patients had to present a recent MRI in order to see a doctor, so that there could be documentation of a chronic-pain injury warranting medication. In order to obtain an oxycodone prescription, patients also had to provide a urine sample to establish that they already had oxycodone in their systems. They could not be seen by a doctor unless they passed the urine test. Barbuscia and Afthinos testified that they were “marketers” for East Health Center. In this capacity, they attempted to recruit clients by intercepting people as they were visiting other pain clinics, talking to people at gas stations and low-scale hotels, and looking for “raggedy” out-of-state cars. Barbuscia would hand out fliers advertising “incentives” at the clinic. Barbuscia agreed that clients he was targeting looked like “zombies” or “addicts.” LeFrancois wanted to keep a low profile, so he limited the number of patients that could visit the clinic each day and encouraged patients to park in alternative parking lots so that their out-of-state license plates would not attract 8 Case: 14-13703 Date Filed: 11/10/2015 Page: 9 of 60 attention. LeFrancois stocked East Health Center with limited medical supplies and some health-related posters. There were security cameras to deter patients from stealing from the clinic. The clinic never dispensed medication on site. East Health Center employees audited the cash each day. The clinic used patients’ cash payments to pay the doctors’ salaries, purchase lunch, pay for the employees’ rental house, pay the clinic’s lease, and cover any expenses such as electrical work and cable. The remaining cash was deposited at a bank at the end of each day. An agent from the Chatham-Savannah Counter Narcotics Team visited the clinic during the first two days of its operation. The agent advised LeFrancois that he needed more medical supplies to meet minimum requirements. LeFrancois went shopping and purchased the necessary equipment, which he agreed functioned as “prop[s].”