Montgomery County District Attorney Kevin R. Steele and other local, state and federal law enforcement officials announced today the arrests of four area doctors for various criminal offenses. The arrests, one of which came today, are the first four arrests in an ongoing, multi-jurisdictional effort to investigate and prosecute physicians who are engaged in illegal activity that includes the overprescribing of medications to patients, one of the physicians arrested, Brian C. Keeley, practiced in Ambler on Cavalier Drive.
Four physicians have been arrested in the last seven months. Arrested today was Lawrence I. Miller, 48, medical office in Lansdale, lived in Warminster, Pa. Previously arrested on unrelated charges were three other doctors: Joseph F. Cipriano, 56, medical office out of his home in Norristown; Brian C. Keeley, 61, medical office in Ambler, lived in Philadelphia; and Joseph M. Rybicki, 59, medical office in Lower Moreland Township, lived in Haddonfield, N.J.
The arrests of these four physicians came as a result of multi-agency investigations involving:
- Montgomery County Detective Bureau’s Narcotics Enforcement Team (NET)
- Liberty Mid-Atlantic HIDTA
- Drug Enforcement Administration (DEA) Task Force
- Hatfield Township Police Department
- Abington Township Police Department
- Ambler Borough Police Department
- East Norriton Township Police Department
- Lower Moreland Township Police Department
- U.S. Department of Health & Human Services Office of Investigations
- Pennsylvania Bureau of Enforcement and Investigation.
DA Steele has made fighting the opioid epidemic one of his office’s main priorities, which includes investigating and prosecuting anyone who distributes, traffics or sells drugs illegally. This includes doctors, who are illegally prescribing opioids and other medications to patients thereby fueling addictions and the opioid epidemic.
“The vast majority of physicians are concerned about their patients’ health, run their medical practices legally and follow the law in their prescribing methods,” said Steele. “However, these four physicians who we investigated and arrested were not upholding their legal or ethical obligations as doctors. By not following long-established standards of care, these defendants were contributing to the heroin-opioid epidemic and making it worse.”
HIDTA Mid-Atlantic has partnered with the District Attorney’s Office in these physician investigations. “The misuse and abuse of opioid prescription medications are major factors in the pathway toward addiction to heroin, and consequently, the horrendous death toll arising from heroin, fentanyl and fentanyl-related substances our state and nation suffer. The CDC estimates that four out of five heroin users previously misused prescription opioids,” said Daley. “Today’s announcement of arrests of prescribers who flagrantly dispensed prescription opioids without medical necessity is one more indicator that the root of our region’s heroin and fentanyl problem is often irresponsible prescribing for profit.”
These four physicians are currently unable to prescribe controlled substances due to these investigations and their arrests. Following, in reverse chronological order, are the criminal charges against each doctor and a summary of the investigation.
Lawrence I. Miller (DOB: 7/3/70): practiced family medicine as a sole practitioner at 1000 Walnut St., Suite 116 in Lansdale
CHARGES: Corrupt Organization (F1), 31 counts of Unlawful Prescribing (F), 18 counts of Prescribing to Drug Dependent Person (M) and Criminal Use of Communication Facility (F3).
ARRESTED Sept. 12, 2018: He was arraigned this morning before Magisterial District Judge Andrea H. Duffy, who set bail at $100,000 unsecured. He waived his preliminary hearing.
SUMMARY OF INVESTIGATION: The investigation revealed that Miller’s family practice became a magnet for drug addicts and drug traffickers. He prescribed large amounts of controlled substances to patients with little to no accompanying medical treatment. Law enforcement found that nine of Miller’s patients had died of drug overdoses. Although most died from a combination of drugs including street drugs, the decedents received prescriptions for controlled substances from the doctor in close proximity to their death. Prescriptions issued by Miller often put patients at high risk of overdose with some prescriptions being as high as 10 times the maximum dosage recommended by state and national guidelines. For some patients, Miller would issue single prescriptions of more than 500 pills of opioid painkillers. In addition, Miller would often prescribe medication without physically evaluating the patient for long periods of time or ever taking precautions to ensure the narcotics weren’t being abused or diverted. The investigation also revealed that several drug dealers had obtained narcotics from Miller.
Joseph F. Cipriano (DOB: 10/18/61): practiced family medicine at Cipriano Family Practice, 905 Dekalb St. in Norristown
CHARGES: Two counts of Corrupt Organization (F1), two counts of Dealing in Proceeds of Unlawful Activity (F1), eight counts of Welfare Fraud (F3), three counts of Insurance Fraud (F3), eight counts of Unlawful Prescribing (F), and eight counts of Prescribing to a Drug Dependent Person (M).
ARRESTED July 18, 2018; arraigned before Magisterial District Judge Francis Lawrence, who set bail at $200,000 unsecured; A preliminary hearing is scheduled for 11 a.m., Sept. 13, 2018, before Magisterial District Judge Greg Scott.
SUMMARY OF INVESTIGATION: Cipriano prescribed large amounts of controlled substances to several female patients in exchange for nude photographs, videos or sexual favors. Several of these female patients detailed how they would contact Cipriano over social media, usually Snapchat, to request prescriptions that he would then issue electronically or leave in the office mailbox. Cipriano frequently prescribed these women numerous controlled substances that are often abused including Oxycodone, Adderall, benzodiazepines and promethazine cough syrup. While one female patient was incarcerated, Cipriano charged Medicaid for several office visits, which could not have occurred, and issued opioid prescriptions to her that were filled at a local pharmacy by family members and a friend.
Brian C. Keeley (DOB: 11/5/56): practiced family medicine at Ambler Family Practice, 10 Cavalier Drive in Ambler
CHARGES: Corrupt Organization (F1), Dealing in Proceeds of Unlawful Activity (F1), 48 counts of Unlawful Prescribing (F), 3 counts of Insurance Fraud (F3) and 4 counts of Welfare Fraud (F3).
ARRESTED May 1, 2018; arraigned before Magisterial District Judge Patricia Zaffarano, who set bail at $50,000 unsecured; a preliminary hearing was held on May 14, 2018 before Judge Zaffarano. A trial date has not been set.
SUMMARY OF INVESTIGATION: The investigation revealed that Keeley was providing prescriptions for cash. During a months-long undercover operation, a confidential informant obtained prescriptions for Xanax, Adderall, Ambien and Percocet. The informant’s office visits usually involved his instructing the doctor about what to prescribe. Other patients detailed similar experiences where they would tell the doctor the medicine to prescribe and what quantity. Patients paid Keeley for writing prescriptions, with the price to the doctor based on the length of the prescription. In addition, law enforcement found unsafe and unsterile conditions, including carpets stained with animal excrement and patient injectables and other medical products stored improperly in a refrigerator with rotting animal food.
Joseph M. Rybicki (DOB: 2/12/59): practiced family medicine out of his residence on Grasshopper Road in Lower Moreland Township
CHARGES: 13 counts of Acquisition of Controlled Substances by Fraud (F), 15 counts of Unlawful Prescribing (F) and one count of Dealing in Unlawful Proceeds (F1).
ARRESTED Feb. 6, 2018; arraigned before Magisterial District Judge Jay Friedenberg, who set bail at $50,000 unsecured; a preliminary hearing was held May 9, 2018 before Judge Friedenberg. A trial date has not been set. Wife Anne Rybicki (DOB: 4/17/61) was also involved in the medical practice and is also facing criminal charges.
SUMMARY OF INVESTIGATION: In October 2015, Rybicki was evicted from his medical practice in Philadelphia. At that time, he began providing patients with hundreds of prescriptions for controlled substances, including opioids and benzodiazepines, through the mail in exchange for a monthly fee. Rybicki, with the assistance of his wife, would mail prescriptions for various drugs without ever seeing the patients. In addition, Rybicki wrote opioid prescriptions on numerous occasions for his own personal use with the sole purpose of abusing the medication. Further, he issued the prescriptions in his daughter’s name to conceal their purpose.
“The Drug Enforcement Administration (DEA) regulates over 76,000 registrants across Pennsylvania and more than 6,000 in Montgomery County alone. The vast majority of these registrants are doctors and other medical professionals that we entrust with the well-being and health of our families and ourselves. The doctors we are discussing today are accused of prescribing potentially dangerous and highly addictive controlled substances outside the course of good faith medical practice,” said the DEA’s Wilson. “Rogue registrants are a significant source of supply for illegally diverted opioids and other dangerous drugs, which all too often are the pathway to addiction, overdose, and death.”
The Philadelphia Regional Office of the U.S. Health and Human Services Office of the Inspector General was also integral to the investigations. Maureen R. Dixon, Special Agent in Charge, said: ““Protecting our beneficiaries from harm is a priority. We will continue to work closely with our law enforcement partners to investigate allegations of prescription drug diversion.”
Each physician’s case will be prosecuted by Assistant District Attorney James E. Price, who is specially assigned to work with our law enforcement partners in physician investigations as well as prosecute the cases in court, and Assistant District Attorney Lindsey Mills.
“We must stem the tide of deaths and the pain caused by heroin and opioid addiction through every avenue possible,” said Steele. “Dirty doctors—who run pill mills by selling scripts, who provide drugs to addicted people, who are operating outside of the legal bounds of recognized prescribing methods and quantities—are part of the problem, not part of the solution. Not only are they engaging in criminal behavior but they are profiting from someone’s addiction and pain, and making this epidemic worse. It’s got to stop.”