The Eleventh Circuit Court of Appeals has upheld a lower court’s decision to exclude pharmacist Wilton Clinton Meeks, III from participating in any federally funded healthcare programs for seven years. The ruling stems from Meeks’s 2018 guilty plea to acquiring Oxycodone by misrepresentation, deception, or subterfuge. The court found that the Secretary of the Department of Health and Human Services (HHS) was correct in concluding that Meeks’s actions warranted the exclusion.
Background of the Case
The case goes back to 2004, when Meeks established White Columns Consulting, which operated as Liberty Square Pharmacy. As a pharmacist and the sole owner, Meeks had access to prescription drugs. Following surgery, he developed an addiction to opioids. After his prescription ran out, he began obtaining unprescribed Oxycodone through his position at the pharmacy.
In 2018, Meeks voluntarily surrendered his pharmacist license and entered an addiction treatment facility. He transferred ownership of Liberty Square to a friend. He later settled with the government, paying a $150,000 fine for violating the Controlled Substances Act due to his failure to maintain proper records for the Oxycodone he used.
The following year, the government charged Meeks with knowingly and intentionally acquiring a controlled substance by misrepresentation. He pleaded guilty to this charge, admitting he acquired Oxycodone that had not been prescribed to him. He was sentenced to three years of probation, which was later terminated early.
Despite the reinstatement of his pharmacy license by the Georgia State Board of Pharmacy in 2021, the Inspector General of HHS (IG) notified Meeks that he was excluded from participating in Medicare, Medicaid, and other federal healthcare programs for eight years. This was later reduced to seven years. Meeks challenged this decision, leading to a hearing before an Administrative Law Judge (ALJ), who affirmed the exclusion. The Departmental Appeals Board of HHS (DAB) upheld the ALJ’s decision, prompting Meeks to seek review in the district court, which also sided with the government.
Arguments and the Court’s Decision
Meeks argued that the district court erred in upholding the Secretary’s decision. He claimed his felony conviction did not constitute an offense “relating to” fraud or theft “in connection with the delivery of a health care item or service,” as required for exclusion under 42 U.S.C. § 1320a-7(a)(3). He also argued the seven-year exclusion was arbitrary and capricious.
The Eleventh Circuit disagreed. The court’s decision, written *per curiam* (meaning “by the court” and not attributed to a specific judge), explained that the Secretary correctly determined Meeks’s crime related to fraud or deceit. The court cited the text of the statute, stating that the “nexus or common sense connection between fraud and [Meeks’s] felony conviction” was clear. The court pointed out that Meeks concealed his intentions regarding the use of the Oxycodone.
The court also found that Meeks committed his offense “in connection with the delivery of a health care item or service.” Because he had access to Oxycodone through his professional role, the court determined there was a contextual and causal relationship between his offense and the delivery of healthcare services.
Regarding the length of the exclusion, the court found the seven-year period reasonable. The Secretary found two aggravating factors: Meeks’s actions occurred over a period of more than a year, and he had a prior administrative sanction record (the loss of his pharmacy license). The court noted that Meeks did not present any mitigating factors.
Legal Standards Applied
The court applied a highly deferential standard of review. It could only overturn the Secretary’s decision if it was “arbitrary, capricious, an abuse of discretion, not in accordance with law, or [is] unsupported by substantial evidence in the record taken as a whole.” The court emphasized that it would not substitute its judgment for that of the agency. The court cited prior cases to support its analysis.
Impact of the Ruling
The ruling reinforces the HHS’s authority to exclude individuals convicted of healthcare-related offenses from federal programs. Meeks, as a result of this decision, cannot work in a facility that accepts federal health care funds for a period of seven years. The case serves as a reminder of the serious consequences that can arise from healthcare fraud and the misuse of prescription drugs, especially for those in positions of trust like pharmacists.