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Feds indict owners of alleged Moody pill mill

Brandon Moseley

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Wednesday, a federal grand jury indicted a Springville couple and a prominent Moody doctor on charges they operated a pill mill in Moody, St. Clair County for four years.

U.S. Attorney Jay E. Town, Drug Enforcement Administration Assistant Special Agent in Charge Bret Hamilton and Internal Revenue Service, Criminal Investigation, Special Agent in Charge Thomas J. Holloman announced the twenty county indictments.

The 20 count indictment filed in U.S. District Court charges Cindy Louise Hyche Dunn, age 53; her husband, Thomas Mason Dunn, age 56, and Dr. John Ladd Buckingham, age 85, in a conspiracy to operate a clinic in Moody for the main purpose of illegally distributing or dispensing controlled substances outside the usual course of professional practice and not for a legitimate medical purpose.
Federal authorities claim the conspiracy was for the participants to enrich themselves. The group ran Cindy Dunn & Dr. Buckingham, M.D., Weight Loss Clinic and Pain Management (CDPM) at the prestigious Moody Professional Building from January 2012 through December 2015.

“Personal greed motivates the people who operate illegal pain clinics, mass-prescribing opioids without medical justification and with no regard to the larger pain they bring to individuals, families and communities,” Town said. “The Department of Justice is determined to stamp out the operation of illegal pain clinics by all legal means as part of the fight against opioid abuse, and the Northern District of Alabama is fully committed to the fight. As one of 12 districts across the county participating in the department’s pilot Opioid Fraud and Abuse Detection Unit, we are taking advantage of data collection and analysis and joining together federal, state and local law enforcement to investigate and shut down illegal pill mills for good.”

“The abuse of prescription drugs is a serious problem in our communities – leading to addiction, shattered lives, and even death,” Hamilton said. “For the health and safety of our citizens, DEA and our law enforcement partners will continue to target those who illegally obtain and distribute these potentially dangerous drugs. We hope that these indictments serve as a reminder to anyone who might illegally divert pharmaceuticals that they will be held accountable for the harm they cause.”

“This was a classic example of a pill mill and these individuals will be held accountable,” Holloman said. “We will continue to work with our law enforcement partners in tackling the opioid epidemic head on in the state of Alabama. In following the money, you can trace the drug proceeds to the beneficiaries and bring the entire conspiracy ring to justice.”

The indictment includes 16 counts charging Cindy Dunn and Dr. Buckingham with unlawfully dispensing a controlled substance, all containing opioids. As part of the conspiracy and in disregard for usual standards of professional medical practice. The indictment claims that Cindy Dunn, Buckingham and other co-conspirators prescribed more than 13,500 methadone-based pills to one patient and more than 8,200 oxycodone-based pills to another patient. They also prescribed more than 7,900 oxycodone-based and methadone-based pills, collectively, to a single patient, and 7,700 oxycodone-based and methadone-based pills, collectively, to another different patient.

Federal authorities claim that Cindy Dunn, owner and president of CDPM, operated the clinic, including hiring and directing physicians and staff and making financial decisions. She mainly hired relatives as clerical staff and, for the vast majority of the clinic’s operation, did not employ formally trained nurses or medical assistants. According to the indictment. Cindy Dunn had no known medical education of her own.
Thomas Dunn performed various administrative and financial duties for CDPM and received prescriptions for opioids from the clinic, according to the indictment. Buckingham was a licensed physician in Alabama and was very well known in the Moody community where he had been a general practitioner for decades. According to the indictment, Buckingham was not a certified pain management specialist.

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CDPM typically charged a $25 patient application fee, a $200 to $300 clinic visit fee for new patients, then a $90 to $125 monthly fee for follow-up visits, according to the indictment. The clinic did not accept insurance. The clinic required cash or credit payments. Patient examinations were “infrequent, and were typically minimal and cursory,” and Cindy Dunn and CDPM staff often issued controlled substance prescriptions that were pre-signed by Buckingham or other physician co-conspirators, according to the indictment.

The indictment charges that Cindy Dunn and Dr. Buckingham maintained a drug-involved premises, and charges all three defendants with participating in a money-laundering conspiracy by opening bank accounts for the clinic and conducting financial transactions with illegally obtained funds in order to keep the illicit business operating.

The final count of the indictment charges Cindy Dunn with engaging in a monetary transaction involving criminally derived property valued at more than $10,000. The charge cites a $25,000 deposit into a CDPM account at Regions Bank with money from a clinic account at Metro Bank.

Both the conspiracy to distribute controlled substances outside the usual course of professional practice charge and each substantive count of illegally distributing controlled substances carry a maximum penalty of 20 years in prison and a $1 million fine. The charge of maintaining a drug-involved premises carries a maximum penalty of 20 years in prison and a $500,000 fine. Money-laundering conspiracy carries a maximum penalty of 20 years in prison and a $250,000 fine. Engaging in monetary transactions involving criminal proceeds carries a maximum penalty of 10 years in prison and a $250,000 fine.

The DEA and IRS-CI investigated the case, which Assistant U.S. Attorney Mohammad Khatib is prosecuting.

An indictment is not proof of guilt. Everyone is presumed innocent until a jury of their peers votes to convict them beyond a reasonable doubt. Dr. Buckingham and the Dunns will have an opportunity to defend themselves in a court of law.

Alabamians have the most prescriptions per capita for opioids of any people anywhere in the world.

Alabama, unlike neighboring states, does not hold doctors criminally liable for the reckless over prescribing of narcotics, thus pill mills and “Dr. Feel Goods” are able to operate their unscrupulous practices with no fear of the local authorities. Legislation to change this situation was sponsored by State Representative Christopher John England (D-Tuscaloosa) during the last legislative session. It passed the House but was killed by Senators allied with the powerful Alabama Medical Association in the state Senate.

Over 60,000 Americans were killed last year by drug overdoses. Many of them first became addicted by their doctors’ frivolous over-prescription of opioids.

This reporter knows Dr. Buckingham and routinely does business with the other businesses in the Moody Professional Building.

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Guest Columnists

Opinion | With COVID-19 policy, don’t blame your umbrella. The rain got you wet

Monica S. Aswani, DrPH, and Ellen Eaton, M.D.

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Monica S. Aswani, DrPH, is an assistant professor of health services administration and Ellen Eaton, M.D., is an assistant professor of infectious diseases.

Editor’s note: The opinions expressed in this perspective are those of the authors.


As states re-open for business, many governors cite the devastating impact of physical distancing policies on local and state economies. Concerns have reached a fever pitch. Many Americans believe the risk of restrictive policies limiting business and social events outweighs the benefit of containing the spread of Covid-19.

But the proposed solution to bolster the economy — re-opening businesses, restaurants and even athletic events — does not address the source of the problem.

A closer look at the origins of our economic distress reminds us that it is Covid-19, not shelter-in-place policy, that is the real culprit. And until we have real solutions to this devastating illness, the threat of economic fallout persists.

Hastily transitioning from stay-at-home to safer-at-home policy is akin to throwing away your umbrella because you are not getting wet.

The novelty of this virus means there are limited strategies to prevent or treat it. Since humans have no immunity to it, and to date, there are no approved vaccines and only limited treatments, we need to leverage the one major tool at our disposal currently: public health practices including physical distancing, hand-washing and masks.

As early hot spots like New York experienced alarming death tolls, states in the Midwest and South benefited from their lessons learned.

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Indeed, following aggressive mandates around physical distancing, the number of cases and hospitalizations observed across the U.S. were initially lower than projected. Similarly, the use of masks has been associated with a reduction in cases globally.

As the death toll surpasses 100,000, the U.S. is reeling from Covid-19 morbidity and mortality. In addition, the U.S. has turned its attention to “hot spots” in Southern states that have an older, sicker and poorer population. And to date, minority and impoverished patients bear the brunt of Covid-19 in the South.

Following the first Covid-19 case in Alabama on March 13, the state has experienced 14,730 confirmed cases, 1,629 hospitalizations and 562 deaths, according to health department data as of Monday afternoon.

Rural areas face an impossible task as many lack a robust health care infrastructure to contend with outbreaks, especially in the wake of recent hospital closures. And severe weather events like tornadoes threaten to divert scarce resources to competing emergencies.

Because public health interventions are the only effective way to limit the spread of Covid-19, all but essential businesses were shuttered in many states. State governments are struggling to process the revenue shortfalls and record surge in unemployment claims that have resulted.

The Coronavirus Aid, Relief and Economic Security Act, or CARES Act, allocated $150 billion to state governments, with a minimum of $1.25 billion per state. Because the funds were distributed according to population size, 21 states with smaller populations received the minimum of $1.25 billion.

Although states with larger populations, such as Alabama and Louisiana, received higher appropriations in absolute terms, they received less in relative terms given their Covid-19 related medical and financial strain: the CARES Act appropriations do not align resources with state need.

As unemployment trust funds rapidly deplete, these states have a perverse incentive to reopen the economy.

Unemployment claimants who do not return to work due to Covid-19 fears, per the Alabama Department of Labor, can be disqualified from benefits, perpetuating the myth of welfare fraud to vilify those in need.

The United States Department of Labor also emphasized that unemployment fraud is a “top priority” in guidance to states recently.

Prematurely opening the economy before a sustained decline in transmission is likely to refuel the pandemic and, therefore, prolong the recession. Moreover, it compromises the health of those who rely most heavily on public benefits to safely stay home and flatten the curve.

Some would counter this is precisely why we should reopen — for the most vulnerable, who were disproportionately impacted by stay-at-home orders.

The sad reality, however, is that long-standing barriers for vulnerable workers in access to health care, paid sick leave and social mobility pre-date this crisis and persist. And we know that many vulnerable Americans work on the frontlines of foodservice and health care support where the risk from Covid-19 is heightened.

A return to the status quo without addressing this systemic disadvantage will only perpetuate, rather than improve, these unjust social and economic conditions.

Covid-19 has exposed vulnerabilities in our state and nation, and re-opening businesses will not provide a simple solution to our complex economic problems.

No one would toss out their umbrella after several sunny days so why should America abandon public health measures now? After all, rain is unpredictable and inevitable just like the current Covid-19 crisis.

The threat of Covid-19 resurgence will persist until we have effective preventive and treatment options for this novel infectious disease.

So let’s not blame or, worse, discard the umbrella. Instead, peek out cautiously, survey the sky and start planning now to protect the vulnerable, who will be the first to get wet.

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Health

New COVID cases in Alabama increasing faster than 46 other states

Chip Brownlee

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Alabama reported more cases of COVID-19 last week than any other week since the pandemic began, and the increase in new cases reported last week compared to the previous week was higher than 46 other states and the District of Columbia.

An analysis of data collected by The COVID Tracking Project, a volunteer-run effort to track the pandemic, shows that only West Virginia, Maine and South Carolina reported a larger increase in new cases last week compared to the new cases they reported in the previous week.

According to The COVID Tracking Project’s data, Alabama recorded 2,556 new cases during the week ending Sunday, May 24, compared to 1,994 new cases during the previous week ending Sunday, May 17.  That’s an increase of 28 percent.

The Alabama Department of Public Health’s daily case totals show an increase of 17 percent last week over the previous week, which is still higher than 38 other states, according to the analysis performed on The COVID Tracking Project’s data.

COVID Tracking Project has a standardized method of capturing each state’s new cases from health departments, making it possible to compare the trajectories of each state. Twenty-four states and the District of Columbia saw new cases decline last week, while 25 states saw new cases increase last week compared to the previous week.

Compared to other states, testing showed no similar increase. The number of new tests reported in Alabama last week only grew 2 percent compared to the previous week, according to the COVID Tracking Project’s data. That’s lower than 31 other states.

APR‘s data showed an increase of 13 percent over the previous week, but that is still a smaller increase than 25 other states. Both our data and an analysis of The COVIDTracking Project’s data show the percent of total tests that are positive rose last week compared to the previous week.

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The Alabama Department of Public Health does not provide historical data for how many tests were performed on each day. Both APR and the COVID Tracking Project calculate test increases by tracking the change to the cumulative total of tests performed.

Several other Southern states also saw rising cases and no similar increase to tests performed. In Mississippi, new cases rose by 9 percent last week compared to the previous week while tests per week fell by 21 percent. In Tennessee, new cases rose 15 percent while tests per week declined 8 percent.

Georgia saw new cases rise 21 percent, but tests also rose by 22 percent. Florida, South Carolina and North Carolina also reported both rising cases and more tests compared to the previous week.

Cases have been rising in Alabama since the beginning of the month. Testing has also increased, and public health officials, including State Health Officer Dr. Harris, have said they are not sure if the increase in cases is directly attributable to more tests or more disease.

Some areas of the state, like Madison County and Lee County, have seen little or no rise in new cases, while others, like Montgomery County and Tuscaloosa County, are experiencing worsening outbreaks.

Gov. Kay Ivey lifted the state’s stay-at-home order on April 30 and has since relaxed restrictions twice more, saying the economics of the pandemic must be addressed. The state reported an unemployment rate of 12.9 percent last week, higher than during any point during the Great Recession.

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National

Monday is Memorial Day

Brandon Moseley

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Today, the last Monday in May, is the day we set aside to remember all of the many soldiers, sailors, airmen, and Marines who have died defending this country in this nation’s many wars over the last 245 years.

Memorial Day is a state and national holiday. There will be no mail service and banks, courthouses, and many government buildings, as well as many offices and businesses, will be closed today.

Many people have the day off and are spending the holiday with family and friends.

A number of Alabama leaders have released statements paying their respects to America’s fallen heroes.

“Memorial Day is a time for all of us to pause and remember the courageous Americans who made the ultimate sacrifice to defend this great nation,” said Congresswoman Martha Roby (R-Montgomery). “Everyone should take this opportunity to honor and reflect on those men and women in uniform who lost their lives fighting to protect the freedoms we enjoy. “

“I realize that Memorial Day is the unofficial kickoff to summer. However, I hope you will take time to remember what the holiday is truly about,” said Congressman Robert Aderholt (R-Haleyville). “Veterans Day in November is about honoring all veterans, but Memorial Day is specifically for those who gave the ultimate sacrifice and died for our country.”

“On Memorial Day and every day, it’s important to remember and honor the sacrifice made by the members of our military – those who gave their lives in service to our country, the veterans who are still with us today and those who have passed, and the brave men and women who are currently wearing the uniform,” Rep. Roby said. “I extend my sincere condolences to those who lost a family member in the line of duty and my gratitude to those who served or are currently serving. America continues to shine as the Land of the Free, even in the midst of a global pandemic, because of the heroic men and women who sacrificed their lives for our country’s future and prosperity.”

“It’s great that we’re able to be out of our homes this Memorial Day,” said Second District Congressional District candidate Barry Moore. “Hot dogs and hamburgers on the grill are incredible, but as good as they are we don’t need to forget what this day is about. Memorial Day is our special day to honor those who have given their all in the service to our great nation, and May–Military Appreciation Month–is the month dedicated to letting our Veterans and serving military personnel know that we appreciate them and their service. As a Veteran from a family with a strong and proud history of service, and a new father-in-law to an Army Ranger 1st Lieutenant, this day and month have special meaning to me.”

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“I’m thankful we have a President whose example we can follow in honoring our fallen,” former State Rep. Moore continued. “In February, when President Trump traveled to Dover Air Force Base and saluted the coffins of Sgt. Javier Jaguar Gutierrez and Sgt. Antonio Rey Rodriguez when they returned home, he showed the reverence and respect these two young men were due. This Memorial Day we all need to be equally diligent in showing that respect for those who have borne the battle. Take time today to think about what this day means, and if you get the chance during the rest of this month, tell a Vet or serviceman or woman that you’re thankful for them. God Bless our troops and those who gave the ultimate sacrifice.”

“Together, our nation pays immortal tribute to the extraordinary courage, unflinching loyalty, and unselfish love, and supreme devotion of the American heroes who made the ultimate sacrifice,” said President Donald J. Trump (R) on Thursday. “It’s the ultimate sacrifice, and it is indeed. They laid down their lives to ensure the survival of American freedom. Their names are etched forever into the hearts of our people and the memory of our nation. And some of you, it’s been very close — very, very close. It’s very close to your heart. We’ll cherish them and our Gold Star families for all time. We take good care of them. They’re very special to us. Just as we’ll always remember the nearly 82,000 Americans missing in action.”

Here is a video that Aderholt and his team put together a few years ago to honor the fallen from Alabama’s 4th District.

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National

SEC clears path for member schools to resume athletics training on June 8

Brandon Moseley

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The Southeastern Conference announced on Friday, that voluntary in-person athletics activities may resume on Southeastern Conference campuses, at the discretion of each university, beginning June 8 under strict supervision of designated university personnel and safety guidelines developed by each institution.

The coronavirus crisis ended Spring sports such as baseball and softball and cost both men and women’s basketball teams most of their post-season play. Spring football camps were eliminated. No training has been allowed in on-campus athletics facilities since March 12. The SEC had suspended all athletics activities through May 31.

June 8 will begin a transition period that will allow student-athletes to gradually adapt to full training and sports activity after this recent period of inactivity. Each university has been instructed to develop plans that are consistent with state and local health directives. Under the new directive, certain activities will be permitted based on the ability to participate in controlled and safe environments, while also maintaining recommended social distancing measures.

The decision to resume athletics activities, which at this time is limited by the NCAA to voluntary activities supervised by strength and conditioning personnel, was made with the guidance of the Conference’s Return to Activity and Medical Guidance Task Force.

The task force was created by the SEC’s Presidents and Chancellors in April and is comprised of a cross-section of leading public health, infectious disease and sports medicine professionals from across the SEC’s 14 member institutions. The Task Force will remain active to provide continued advice and guidance to the SEC and its members as they prepare for a return to competition.

“The safe and healthy return of our student-athletes, coaches, administrators and our greater university communities have been and will continue to serve as our guiding principle as we navigate this complex and constantly-evolving situation,” said SEC Commissioner Greg Sankey. “At this time, we are preparing to begin the fall sports season as currently scheduled, and this limited resumption of voluntary athletic activities on June 8 is an important initial step in that process. Thanks to the blueprint established by our Task Force and the dedicated efforts of our universities and their athletics programs, we will be able to provide our student-athletes with far better health and wellness education, medical and psychological care and supervision than they would otherwise receive on their own while off campus or training at public facilities as states continue to reopen.”

As part of its recommendations, the Task Force prepared a series of best practices for screening, testing, monitoring, tracing, social distancing and maintaining cleaned environments. These recommendations are to serve as a roadmap for each school prior to and upon the return of student-athletes to their campuses.

“While each institution will make its own decisions in creating defined plans to safely return student-athletes to activity, it is essential to employ a collaborative approach that involves input from public health officials, coaches, sports medicine staff, sports performance personnel and student-athletes,” Sankey said. “Elements of the Task Force recommendations provided key guidance for determining the date of the return to activity.”

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The protocols include a three stage screening process that involves screening before student-athletes arrive on campus, within 72 hours of entering athletics facilities and on a daily basis upon resumption of athletics activities.

Testing of symptomatic team members (including all student-athletes, coaches, team support and other appropriate individuals) is part of the protocols.

It is recommended that schools immediately isolate team members who are under investigation or diagnosed with COVID-19. This is to be followed by contact tracing, following CDC and local public health guidelines.

Since most of the athletes have not been allowed to do anything but the most basic of workouts, there is to be a transition period that allows student-athletes to gradually adapt to full training and sport activity following the long period of inactivity.

During the month of June, NCAA regulations permit only strength and conditioning personnel to supervise voluntary on-campus athletics activities in the sports of football and men’s & women’s basketball. A current waiver that permits eight hours of virtual film review has been extended through June 30 for football and basketball.

Consistent with NCAA regulations, organized practices and other required physical activities remain prohibited in all sports. A previously announced suspension of in-person camps and coaches clinics conducted by SEC institutions remains in effect until July 31.

Many SEC schools hope to play their football seasons this fall on schedule. While football fall camps don’t begin until early August, coaches says that student-athletes need to be improving their strength, speed, and agility to get in the appropriate physical condition so that they can compete in fall camps. Without that strength and conditioning, coaches feel that more players could get injured in those practices.

On Thursday, Alabama Governor Kay Ivey (R) issued a new Safer at Home order that allowed schools to begin using their athletics facilities for strength and conditioning. Schools and educational institutions will be allowed to open subject to social-distancing and sanitation rules and guidelines on June 1. Gyms across the state were allowed to reopen subject to social distancing and occupancy limits on May 24.

The relaxation of the health rules mean that the athletes will be able to compete in football seasons resume. It is still not known if there will be fans in the stands for those games, though University of Alabama Athletics Director Greg Byrne recently said that that is the school’s plan. Both the University of Alabama and Auburn University are members of the Southeastern Conference.

Fox Sports reported on Friday that if the 2020 football season was not played, the members of the ‘power five’ conferences (including the SEC), would lose over $5 billion in revenue. The cost cutting moves necessary to balance budgets after that hit would end virtually all non-revenue generating sports, including every women’s sport, on campus. Athletics budgets were already hit from the loss of NCAA basketball tournament revenue.

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