A Johnson City oncologist who admitted to purchasing drugs from a company not approved by the FDA is back at home after completing a federal prison sentence.
In November 2012, Dr. Bill Kincaid pleaded guilty to the charge of receiving in interstate commerce a misbranded drug with the intent to defraud or mislead. He could have been sentenced to three years in prison, but instead, he got two years along with a year of supervised release and was ordered to pay a fine.
In the months leading up to Kincaid’s imprisonment in June 2013, supporters, including former patients and U.S. Congress Phil Roe (R-TN), called him a good man, a hero to his patients who never intended to hurt anyone.
But even louder were his critics. Some of them included former patients, and the families of former patients, who accused Kincaid of profit-based malpractice that, some feared, led to medical problems and even death. Some even filed a lawsuit against him.
For the first time, Kincaid is giving his version of what happened.
“If you cut off one of your arms, you never get back to normal,” Kincaid said in response to a question about whether life was back to normal a month after getting out of prison. “You have to adapt to the newness of it.”
He spoke to News Channel 11 on Friday, May 15th, almost one month to the day after his prison sentence officially ended and his supervised release began.
Kincaid said a cascading chain of events began with a 2007 with an email from a company in Canada called QSP offering discounted cancer medication from government approved sources.
He said the time was right because his practice was desperate to cut costs as Medicaid reimbursements dropped.
“It was difficult to stay above water, so you begin to look for things at the lowest price,” he said. “We had indigent patients, and we had a habit of giving away chemotherapy drugs. With reimbursements going down, you’re going to go bust sooner or later. Which we did eventually. So, buying at the lowest price is something most all business have to do.”
Kincaid said he and others at McLeod Cancer and Blood Center decided to do business with QSP and ultimately purchased more than $2 million worth of cancer treatment drugs over the period of several years.
After an employee voiced concerns about labeling on the drugs, Kincaid said he asked a California law firm to research the legality of the purchase of drugs from Canadian company.
According to a copy of the January 2008 legal opinion provided to News Channel 11 by Kincaid’s attorney, the law firm found “purchases through the Canadian company would be legitimate” and that the drugs faced “the same rigorous process of approval under the Canadian counterpart of the FDA.”
“I didn’t think of it as illegal activity,” Kincaid said. “That’s the best way I can say it”
“I guess I was proven wrong,” he said. “But at the time, no.”
But in court documents, the government said “the drugs provided by QSP to McLeod Center were drugs from foreign sources that were not inspected and approved by the FDA.”
The government said, after briefly halting purchases from QSP, Kincaid approved the resumption of purchases in 2009 and directed his office managers to have the drugs shipped to a storage business in Johnson City in an effort to deceive concerned staff.
“The drugs, after having been received at the storage business, were transported…and then placed by a pharmacy technician into the clinic’s drugs storage and control system,” court documents said.
Kincaid denies trying to deceive his employees.
“Actually I didn’t do that, but it was done by someone who worked for me,” Kincaid said. “And I didn’t keep a tight leash on that individual, and that was my responsibility.”
Between September 2009 and February 2012, the government accused Kincaid of overseeing the purchase of more than $2 million in misbranded and unapproved drugs, giving the drugs to patients and billing Medicare and TennCare for $2.5 million.
In 2011, the FDA and the Department of Justice started charging doctors who purchased misbranded drugs from sources not approved by the FDA.
Soon after, agents with the FDA came Kincaid’s office and seized medication from QSP. The Department of Justice then charged him with receiving in interstate commerce a misbranded drug with the intent to defraud or mislead.
From the start, Kincaid said he sensed the U.S. Attorney’s Office had no interest in hearing his side of the story.
“I practically begged for someone in the government to talk to me personally, and they refused time after time,” he said. “I think the decision was made, at what level I don’t know, to make an example out of somebody, and I was in the right place at the right time, or wrong place, depending on your point of view.”
Kincaid said prosecutors said set a deadline for him to enter a plea deal or agree to stand trial. He said prosecutors refused to wait for lab tests on the drugs seized from his office.
“My attorney at the time, Mark Slagle, was in the hospital sick and he subsequently died. Several times he and the US Attorney were shouting over the phone and Mark would say, ‘Why are you doing this to me? I wouldn’t do this to you?'”
No response came from the U.S. Attorney’s office when we asked for a response to Kincaid’s claim.
On December 11, 2012, Dr. Kincaid pleaded guilty and, along with character witnesses, begged for a lenient sentence, a decision he said he now regrets.
“I was scared, terrified really,” Kincaid said. “I didn’t know what to do. I was so upset at the time and distraught that I can’t say my thinking was ultra clear, so I went ahead and signed it under the threat that if you don’t we’re going to the grand jury.”
In a letter to U.S. District Court Judge Ronnie Greer, Kincaid took responsibility for what happened and pleaded for mercy in sentencing.
“I do realize laws of the USA were broken and I am responsible,” he wrote.
But now, Kincaid’s tone is more resolute.
When reminded that he admitted to breaking the law, Kincaid said, “Well, by definition yes. You read the statute. They say ‘known or should have known.’ Even if I had no knowledge, I’m still responsible, by statute. So in the broad extent, yes.”
One month after pleading guilty, the US Attorney’s office revealed the results of the tests on the seized misbranded drugs which found, “there were no counterfeit products.”
“There was nothing within the report that was earth shattering,” the special agent said in his summary of the tests emailed to the U.S. Attorney.
Kincaid said he never doubted that the drugs ordered from QSP were effective in caring for his patients.
“I didn’t doubt the drugs,” he said.
Kincaid said his regret over pleading guilty was strengthened when the Department of Justice made the stunning decision to drop its prosecution of Greeneville oncologist Dr. AK Sen, who was charged with similar crimes, a case an independent attorney’s group called “the definition of prosecutorial overreach.”
“It parallels my own argument in that I think the federal government went too far, and maybe it was their right, but they sure stretched it to the limit,” he said.
In July 2013, Kincaid reported to the Federal Prison Camp in Montgomery Alabama, called Club Fed by some alluding to the minimum security, dorm-like setting for non-violent offenders.
“My wife took me down the night before, took me to the gate, got out of the car, and got into the van,” Kincaid said. “An incredibly surreal experience, and it etches in your mind; one day you’re free, next day you’re not.”
There, the renowned oncologist served food in the cafeteria, cleaned up after meals and cleaned a bowling alley on base.
“First month I was kind of nuts, and then you adapt, and you try to make the best of it and go on.”
After 18 months at the federal prison work camp, Kincaid was transferred to a halfway house in Knoxville where he remained in the custody of the Bureau of Federal Prisons working on a maintenance crew.
Since last month, he’s been home in Washington County, Tennessee on supervised release.
“I’m glad it’s over with,” he said. “I can’t dwell on it, so I’m going to try and build a future as much as I can.”
For Kincaid, that future includes the desire to keep his medical license and practice medicine once again. A vote by the state board of medical examiners possibly later this month could decide if he keeps his license.
“I would like to see patients, to at least make a little bit of a living, and I would like to do some mission work.”
When news of the allegations broke, many of his former patients voiced outrage, accusing him of providing insufficient care in order to save money, even in some cases to the point of a patient’s death.
Some filed lawsuits against him, none of which have moved to trial.
But Kincaid remains confident.
“My patients to this day, by and large, still trust me as far as I know,” he said. “Some of them begged me to come back to the practice.”
“I just want to go on from here,” he said. “Help people if I can. Be helped – two way street. Forgive those the best I can and look to the future.”
And be forgiven?
“Yes, but I think that’s by in large happened.”
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