Case Explained: 26a0171p.06

Court: United States Court of Appeals for the Sixth Circuit Filed: 2026-06-16 The Sixth Circuit affirmed the convictions and sentences of Evann Herrell, Mark Grenkoski, and Keri McFarlane for conspiracy to distribute controlled substances, healthcare fraud, and money laundering. The court held that the evidence presented at trial was sufficient to prove beyond a reasonable doubt that the defendants knowingly distributed unauthorized prescriptions in violation of 21 U.S.C. § 846 and committed healthcare fraud under 18 U.S.C. §§ 1347 and 1349, applying the subjective mens rea standard required by *United States v. Ruan*. The court found that the defendants operated a “pill mill” by prescribing controlled substances in abnormal doses, failing to conduct proper patient screenings, falsifying medical records, and submitting fraudulent claims to Medicare, with evidence showing they subjectively knew these practices were unauthorized. Regarding evidentiary rulings, the court applied an abuse of discretion standard and found no reversible error in the district court’s exclusion of evidence regarding the elimination of the X-waiver rule due to its lack of probative value given the timeline mismatch, nor in the admission of lay witness testimony, hearsay statements offered to show their effect on the listener, text messages, and limited references to patient deaths. The court further ruled that the district court did not abuse its discretion in denying McFarlane’s motion to sever her trial from her co-defendants because she failed to demonstrate compelling, specific, and actual prejudice. The court also determined that the jury instructions regarding mens rea and deliberate ignorance accurately reflected the law as interpreted in *Ruan* and Sixth Circuit precedent. Finally, the court rejected Grenkoski’s claim for sentence reduction under Federal Rule of Criminal Procedure 35(a), noting the district court correctly dismissed the motion as untimely because it was filed after the 14-day jurisdictional deadline had passed. As a practical consequence, the defendants’ convictions and prison terms remain in effect: Herrell is sentenced to 120 months, Grenkoski to 108 months, and McFarlane to 52 months of imprisonment. The judgment of the United States District Court for the Eastern District of Kentucky is affirmed. Do It For The Case Law is a news reporting service. Nothing in this episode constitutes legal advice.