Commonwealth v. Frank Stirlacci (and 135 companion cases)

Summary

The Massachusetts Supreme Judicial Court reviewed the dismissal of indictments against physician Frank Stirlacci and office manager Jessica Miller involving improper prescribing, uttering false prescriptions, and false health care claims. The court held that sufficient evidence supported indictments against Stirlacci for improper prescribing and supported twenty false health care claim counts against each defendant, but that the evidence was insufficient for the uttering charges. It also held that the improper-prescribing statute does not impose liability on nonpractitioners such as Miller.

Holdings

1. A practitioner may be convicted of improper prescribing when the Commonwealth proves that the practitioner issued a controlled-substance prescription for a purpose other than genuine medical treatment. Legitimate medical purpose and usual course of professional practice are mutually reinforcing aspects of a single holistic standard, not separate statutory elements. Mere malpractice, without the requisite lack of legitimate medical purpose, is not criminal improper prescribing.
2. General Laws c. 94C, § 19(a), does not impose liability on a nonpractitioner, either directly as a practitioner or as an accessory to a practitioner's violation under that provision.
3. A false prescription is one that falsely purports to have been issued by the authorized practitioner named in it, such as a prescription issued using fake or unauthorized credentials. The prescriptions here were not false because Stirlacci genuinely authorized their issuance and Miller completed renewal forms within the scope of that authority.
4. The evidence established probable cause that Stirlacci and Miller knowingly and willfully submitted false health care claims for twenty of the twenty-two counts against each defendant. Billing records and testimony permitted the grand jury to infer that the claims falsely implied that Stirlacci had provided services when he was in Kentucky, and the defendants' awareness of the nurse practitioner's objections supported the required knowledge and willfulness.

Questions Presented

1. What standard governs improper prescribing under G. L. c. 94C, § 19(a), and whether the evidence established probable cause to indict Stirlacci.
2. Whether a nonpractitioner such as Miller may be prosecuted directly or as an accessory under G. L. c. 94C, § 19(a).
3. Whether the prescriptions issued using Stirlacci's pre-signed forms were false prescriptions under G. L. c. 94C, § 33(b).
4. Whether the evidence established probable cause that Stirlacci and Miller knowingly and willfully submitted false health care claims under G. L. c. 175H, § 2.

Disposition

reversed_and_remanded