DOJ Targets Adderall Healthcare Scheme. Is Fentanyl Next?
Updated
The pandemic had a consequential impact on the mental health market. Not only did it drive society into various states of anxiety, fear, and depression, locked in their homes in need of access to mental health, but it also enabled the loosening of critical regulations around telehealth prescribing of controlled substances as well as provider state licensure requirements. Needless to say, many quickly noticed the tremendous business opportunities available in prescribing drugs in a virtual setting. One such person was Ruthia He, the Founder/CEO and Clinical President of the digital health company Done—a pill-pushing racket to distribute Adderall over the internet that enabled her to pocket millions. Arrested on June 13, 2024, by the U.S. Department of Justice, He and David Brody, Clinical President of Done, are charged with operating a $100 million Adderall distribution and health care fraud scheme.
The Done indictment is the first Federal prosecution of criminal drug distribution related to telemedicine prescribing by a digital health company. No doubt prescribing controlled substances through telehealth is dangerous—Adderall is overprescribed and ruining the lives of young people. But the DOJ mustn’t stop there. As fentanyl glides over our borders and fuels the drug crisis, creating addicts and destroying lives every day, Attorney General Merrick B. Garland said of the Adderall scheme indictment:
“As alleged, these defendants exploited the COVID-19 pandemic to develop and carry out a $100 million scheme to defraud taxpayers and provide easy access to Adderall and other stimulants for no legitimate medical purpose.
Those seeking to profit from addiction by illegally distributing controlled substances over the internet should know that they cannot hide their crimes and that the Justice Department will hold them accountable.”
Like many exploiting the unprecedented changes brought about because of the pandemic (Cerebral comes to mind), Ruthia He saw the opportunity before her with the ease of telemedicine (which may come to an end this fall) and knew Done was a slam dunk. In control of all aspects of the business, He created a culture of deceit while using the company and its patients to generate personal wealth. Ms. He and Mr. Brody exploited their Telemed arrangement to distribute over 40 million pills, pocketing over $100 million.
Again, this fraudulent arrangement flourished thanks to the pandemic. Remember, the planned tyranny around COVID did wonders to destigmatize mental health and created a burgeoning group of people locked down yet in need of access to mental health care. Thanks to the largest ever de-regulatory period in healthcare, it was a breeze to set up startups like Done. And Ruthia He saw the opportunity to generate significant cash flow by pushing profits over patients.
How did Ruthia He do it? She created a simple and incredibly effective business model at Done. In a nutshell, the model involved booking new patients online, setting them up on Done’s monthly subscription fee, and refilling their prescriptions with as little follow-up from clinicians as possible. Once a patient had purchased the monthly subscription, the platform set up an “auto-refill” function that allowed subscribers to elect to have a message requesting a refill be auto-generated each month, according to court documents.
Moreover, court documents allege Done sought to “use the comp structure to dis-encourage follow-up” medical care by refusing to “pay Done prescribers for any medical visits, telemedicine consultation, or time spent caring for patients after an initial consultation, and instead paying solely based on the number of patients who received prescriptions.” Even after being made aware that “members had overdosed and died,” both He and Brody continued operating in such a careless manner. Done members described the company as a “straight-up pill mill” and a “drug-pushing scam to sell ADHD drugs and make a lot” of money, according to the indictment.
Done carelessly worked around state pharmacy reviews as well. In certain states, the company held each clinician to a 500-patient panel size to ensure the clinician could continue to prescribe legally and, therefore, wasn’t flagged by pharmacies. Once the clinician reached the 500 threshold, Done would merely license the clinician in a new state and repeat the process. Those that didn’t comply were fired and replaced.
Likewise, following the decision in 2022 by CVS and Walgreens not to fill Done prescriptions, the company shifted gears and targeted independent pharmacies using services such as RX Outreach and Scriptx. Done representatives would call up to fifteen pharmacies in any given market to find a pharmacy glad to fill its prescriptions. The indictment alleges that He and her crew made false and fraudulent representations about Done’s prescription policies and practices to coerce these pharmacies to fill their prescriptions. This resulted in Medicare, Medicaid, and commercial insurers paying over $14 million.
These shenanigans are bad enough and merely skim the surface. Still, Done’s ties to China are the most disturbing. The company’s U.S. operations team was systematically replaced with Chinese counterparts, meaning those not following He’s demands were fired. Presently, many operating documents are in Mandarin. While the company used to be anchored in San Francisco with over 40 employees, Done’s China-based team consists of roughly 35-40 individuals who have been blatantly violating U.S. law around patient data-sharing regulations. Specifically, Done’s China-based team used the CCP’s popular messaging service, WeChat, to openly send and share electronic health records (EHR) claims data with one another. In other words, patient health information from the United States.
Following the arrests of Ruthia He and Dr. David Brody, Done Global issued a statement declaring it will continue to operate and do everything in its power to ensure its patient customers continue to receive access to care. The CDC also chimed in after the indictment, releasing a Health Alert Network Health Advisory noting that the indictment may cause “potential disrupted access to care” as it coincides with an ongoing prescription drug shortage involving several stimulant medications commonly prescribed to treat ADHD. The agency warned that a disruption at Done could impact as many as 50,000 patients.
Clearly, Done has not put its patients or their care first. The China-tied firm—which deleted documents and communications in anticipation of an indictment—has put profits first at the expense of everything else. Yet, in true COVID fashion, they deny any and all wrongdoing. Insisting it is “fully aligned” with the Department of Justice and the Drug Enforcement Administration, Done’s statement adds:
“Done remains committed to its mission of providing “PATIENT FIRST” care to those seeking treatment for potential ADHD symptoms and giving them the ability to reach their fullest potential in life. With the prevalence of ADHD on the rise and an even greater number of undiagnosed and untreated individuals, we are proud to offer convenient, affordable, and compassionate treatment through our industry-leading clinicians.
Our team of dedicated professionals cares deeply for our patients and strives to ease the stigma and symptoms associated with this often debilitating disorder. We stand by the integrity of our services and are proud to continue this important work.”
But wait. From a more practical perspective, Done, the DOJ, the CDC, and others are blatantly ignoring the extensive omnipresent elephant in the room. “This often-debilitating disorder” may very well be tied to the toxic foods and medications American men, women, and children are subjected to at every turn. At the end of the day, Done and the federal agencies proclaiming to be out to get them are indeed in cahoots about fostering and normalizing mental health issues and pushing Big Pharma drugs as a way to fix the problem. Let’s watch and see how those in power rework this disaster. Meanwhile, these same agencies let the Fentanyl flow.