Federal Opioid Case Closed Against Health Care Provider

Dr. John Fothergill

A federal investigation opened a half-decade ago into a Colebrook health care provider for alleged violations in prescription drug practices led to a case that has now been closed with no charges or recent pleadings.

According to a check with the U.S. District Court for the District of New Hampshire, the case against North Country Medical and Wellness (NCMW), a practice launched in Colebrook in 2017 by Dr. John Fothergill after he left Indian Stream Health Center, was closed on Sept. 9.

Court representatives on Thursday said no pleading to advance the case has been filed by attorneys since 2018 and the case on their end appears to be completely closed.

The prosecutor, John Davis, of the U.S. attorney’s office, declined to comment or say if a new case will be filed or if his office will request that the previous cases — one criminal for the search warrant and the other civil — will be reopened.

After a criminal search warrant was approved, NCMW was searched by the U.S. Drug Enforcement Administration on April 9, 2019, about the same time that DEA agents and local and state police made a sweep in Coos County and arrested more than a dozen residents in separate criminal drug cases involving opioids.

According to federal court records, Fothergill’s case was launched in 2015, when he was still a provider at Indian Stream Health Center, also in Colebrook.

The court-approved search warrant application authorized the placement of undercover agents or informants at NCMW “in connection with an ongoing criminal investigation of the drug prescription practices of Dr. John Fothergill.”

The criminal case for a search warrant, originally under seal and non-public, was applied for in November 2018 and unsealed in April 2019, after the warrant was executed.

In the application for a search warrant, DEA Task Force Officer Steven Hamel said “agents have confirmed that Dr. Fothergill has issued a large number of suspect prescriptions for Schedule II and Schedule III controlled substances” and the investigation could yield possible criminal charges for violations of health care fraud, illegal distribution or dispensing of controlled substances, and other criminal statutes.

Among its practices, NCMW treats patients for substance use disorders, and Fothergill is specifically authorized by the DEA to prescribe Suboxone (a partial opioid to reduce opioid withdrawal symptoms through a treatment program) to a limited number of patients dealing with addiction, wrote Hamel.

In his declaration to support the application, Hamel told the court the investigation began in 2015 when the DEA was contacted by law enforcement officers in Colebrook and neighboring jurisdictions “who were concerned about what they believed to be the excessive prescribing of opioid medication (including Oxycodone) by Fothergill at Indian Stream Health Center.

The concerns originated from separate contacts with patients of Fothergill, Hamel wrote, and led to interviews with staff at Indian Stream and area pharmacists who “revealed Dr. Fothergill’s prescribing of opioids to be excessive and outside the usual and normal medical practice.”

According to an interview with a confidential source in July 2017, “80 percent of the files for Dr. Fothergill’s patients who were receiving narcotics contained no supporting documentation for the prescription they are receiving.”

According to an interview with another confidential source of information, Hamel said 100 percent of Fothergill’s younger patients being treated for pain were on narcotics and there were a lot of overdose deaths during the source’s employment at the Indian Stream Health Center, and the source felt they were attributed to Fothergill’s prescriptions.

Hamel also wrote that an analysis of Medicare claims in 2017 and 2018 shows Fothergill was prescribing controlled substances to some patients who had not had any office visits billed to Medicare and it appears he was continuing to write prescriptions for substances without seeing the patient since his days at Indian Stream ended in August 2017.

In July 2019, federal prosecutors made a motion to seal the entire case, which was granted by a judge in December 2019, with a subsequent request and judge’s order extending the seal until May 23, 2021.

On May 27, the judge told attorneys that the criminal case for the search warrant would be unsealed and all future pleadings filed in accordance with the court’s electronic filing rules.

No subsequent filings were submitted and that case was closed.

In June 2019, the judge told attorneys that the civil case would be unsealed and all future pleadings filed under the electronic filing rules.

Since June 4, 2019, no further pleadings had been filed in the civil case, which is the case that was officially closed last week.

Fothergill, a former state representative, could not be reached for comment by press time Thursday.

In April 2019, he told The Caledonian-Record that he had been aware that the DEA had been investigating him for several years and said, “There is nothing for them to find. They haven’t found anything and they won’t.”

The DEA investigation in early 2017 at Indian Stream Health Center, a designated Federally Qualified Health Center (FQHC), led to a large provider turnover, subsequent drop-off in patients, and steep loss in revenue and mounting debt, and played a large part in the proposal to merge Indian Stream Health Center with Upper Connecticut Valley Hospital and manage Indian Stream as a designated Rural Health Clinic and no longer a FQHC.

During a public hearing on the merger proposal on Tuesday, Fothergill, who is opposed to the merger, said he had been ranked the number one opioid prescriber in the state at one time, based on a database that indicated he was seeing more Medicaid patients than any other provider in the state.

The DEA investigation at Indian Stream came from a lack of communication, and no one had spoken to the providers, he said.

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