USA v. Haney, et al

IN THE UNITED STATES DISTRICT COURT
EASTERN DISTRICT OF TENNESSEE
AT KNOXVILLE
UNITED STATES OF AMERICA, 	)
)
Plaintiff, 	)
)
v. 	) 	No. 3:24-CR-113-TAV-JEM
)
TIFFANY HANEY, 	)
ANNE WARREN, and 	)
TINA ROPER, 	)
)
Defendants. 	)
MEMORANDUM AND ORDER
This case is before the undersigned on the United States’ Motion to Exclude Expert
Testimony, seeking to exclude the testimony of Defendant Tiffany Haney’s expert Dr. Alan Kaye
[Doc. 203]. See 28 U.S.C. § 636(b). Defendant Haney is charged along with Codefendants Anne
Warren1 and Tina Roper2 in a Third Superseding Indictment with conspiracy to commit wire fraud
(Count One) [Doc. 217 ¶¶ 13–50]. The Third Superseding Indictment also charges Defendant
Haney with three counts of wire fraud (Counts Two–Four) [id. ¶¶ 51–52], one count of making
false statements relating to health care matters (Count Twelve) [id. ¶¶ 53–62], one count of
aggravated identity theft (Count Fifteen) [id. ¶¶ 63–64], one count of conspiracy to commit money
1 	In 	addition 	to 	the 	conspiracy 	to 	commit 	wire 	fraud 	alleged 	in 	Count 	One
[Doc. 217 ¶¶ 13–50], the Third Superseding Indictment charges Defendant Warren with three
counts of wire fraud (Counts Five–Seven) [id. ¶¶ 51–52], two counts of making false statements
relating to health care matters (Counts Eleven & Thirteen) [id. ¶¶ 53–62], two counts of aggravated
identity theft (Counts Fourteen & Sixteen) [id. ¶¶ 63–64], one count of conspiracy to commit
money laundering (Count Seventeen) [id. ¶¶ 65–66], and two counts of money laundering
(Counts Nineteen & Twenty-one) [id. ¶¶ 67–68].
2 	The Third Superseding Indictment charges Defendant Roper with one count of conspiracy
to commit wire fraud (Count One) [Doc. 217 ¶¶ 13–50] and three counts of wire fraud (Counts
Eight–Ten) [id. ¶¶ 51–52].
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laundering (Count Seventeen) [id. ¶¶ 65–66], and two counts of money laundering (Counts
Eighteen and Twenty) [id. ¶¶ 67–68].
Defendant Haney notified the Government that she intends to call Dr. Alan Kaye, an
anesthesiologist, pharmacologist, and director of pain medicine, “to explain the practice of pain
management, how topical analgesics and compounded pain creams work to treat certain pain
conditions, and their viability as safe and effective treatment alternatives to opioids and narcotic
controlled substances” [Doc. 203-2 p. 2]. Pursuant to Rules 702 and 403 of the Federal Rules of
Evidence, the Government moves to exclude his testimony [Doc. 203 p. 1]. The Government
argues Dr. Kaye’s testimony on the effectiveness and benefits of compound pain creams is
irrelevant to the issues before the jury, which turn on whether the Defendants were fraudulently
billing insurance plans for medications not authorized by prescribers [Doc. 203 pp. 1, 6]. It also
contends that even if relevant, the danger of confusing or misleading the jury substantially
outweighs the probative value of Dr. Kaye’s testimony [Id. at 6].
Defendant Haney responds in opposition, maintaining that Dr. Kaye’s opinions are directly
relevant to the core issues in the Government’s case and are needed to rebut the Government’s
experts [Doc. 210 pp. 1–2, 5–9]. She also contends that any risk of juror confusion can be alleviated
by appropriate jury instructions and placing “targeted boundaries” on Dr. Kaye’s testimony
[Id. at 2, 11–12]. Defendants Warren [Doc. 223] and Roper [Doc. 224] seek to adopt Defendant
Haney’s arguments.
After careful review of the parties’ filings and arguments and the relevant law, the
undersigned concludes by a preponderance of the proffered evidence that Dr. Kaye’s proposed
testimony is relevant and that any prejudicial or confusing effect of his testimony is best weighed
by the District Judge within the context of the trial.
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I. 	BACKGROUND AND PROCEDURAL HISTORY
The Government notified Defendants of its intent to use the expert3 testimony of Dr. Jodi
Sullivan and Dr. Elliot Cook [Doc. 203-1 p. 1].
Dr. Sullivan, a licensed pharmacist and director of Medicare investigations, will “explain
pharmacy standards of practice, how drug plans operate, how Medicare Part D works, its coverage
for and coverage requirements for prescription drugs, and rules and regulations for provider
enrollment and billing [under] Medicare Part D” [Id. at 3]. She will present testimony on how
pharmacies ordinarily operate and on compounded medications [Id.]. Dr. Sullivan will testify
about the “practitioner/patient/pharmacist relationship,” also known as “the ‘triad’” and that a valid
prescription is one “for a medically accepted indication that facilitates the diagnosis or treatment
of illness or injury or to improve the functioning of a malformed body member” [Id. at 4]. She will
delineate the “[i]ndicators that a prescription is not valid” [Id. at 4–5]. Dr. Sullivan will also present
testimony on the “[m]edically indicated uses of particular drugs and [their] potential adverse side
effects” [Id. at 5].
Dr. Cook, a licensed pharmacist and the Chief Pharmacist at the Department of Labor
Office of Worker’s Compensation Programs, will “explain pharmacy standards of practice, how
the U.S. Department of Labor (DOL) Energy Workers Program under the Energy Employees
Occupational Compensation Program Act (EEOICPA) functions, its coverage and coverage
requirements for prescription drugs, and rules and regulations for provider enrollment and billing”
[Id. at 9]. Like Dr. Sullivan, Dr. Cook will testify about the way in which pharmacies typically
operate and about compound medications [Id.]. He will also speak to the relationship between
3 	The Government contends that not all of Dr. Sullivan’s and Dr. Cook’s testimony will be
expert testimony [Doc. 203-1 pp. 1, 9].
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prescribers, patients, and pharmacists; what constitutes a valid prescription; and the “[i]ndicators”
of invalid prescriptions [Id. at 10].
Defendant Haney notified the Government that she will present the expert testimony of
Dr. Alan Kaye [Doc. 203-2 p. 1]. Dr. Kaye will testify regarding the “practice of pain management,
how topical analgesics and compounded pain creams work to treat certain pain conditions, and
their viability as safe and effective treatment alternatives to opioids and narcotic controlled
substances” [Id. at 2]. Defendant Haney’s notice also states that in addition to these topics,
Dr. Kaye will testify about:
• 	Conditions for which topical analgesics and compounded pain
creams are commonly prescribed or for which they may be an
appropriate treatment;
• 	The extent to which a prescription for a topical analgesic or
compounded pain cream is medically appropriate for a specific
patient’s condition, including patients at Rocky Hill Pharmacy;
• 	The benefits of using topical analgesics and compounded pain
creams as a medically accepted alternative to opioids;
• 	The mechanisms of action, delivery method, side effects, safety,
and effectiveness of common ingredients found in compounded
pain creams and topical steroids that may be used in conjunction
with 	same, 	including 	(but 	not 	limited) 	to: 	diflorasone,
betamethasone, halobetasol, ketoprofen, diclofenac, baclofen,
cyclobenzaprine, ketamine, gabapentin, lidocaine, tetracaine,
and amitriptyline;
• 	Contraindications 	for 	common 	ingredients 	found 	in
compounded pain creams and topical steroids that may be used
in conjunction with same; and
• 	The extent to which topical analgesics and compounded pain
creams are an accepted and commonly prescribed treatment
amongst pain management practitioners.
[Id. at 3–4].
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The Government now moves to exclude the testimony of Dr. Kaye, arguing that it will not
be relevant or helpful to the jury and that it is substantially prejudicial so as to confuse or mislead
the jury, despite any probative value [Doc. 203 p. 1]. More specifically, the Government argues
Dr. Kaye’s testimony on the effectiveness and benefits of compound pain creams is irrelevant to
the issues before the jury, which turn on whether the Defendants were fraudulently billing
insurance plans for medications not authorized by prescribers [Id. at 1, 6]. It also contends that
even if relevant, the danger of confusing or misleading the jury substantially outweighs the
probative value of Dr. Kaye’s testimony [Id. at 6].
Defendant Haney responded in opposition to the Government’s motion, asserting that
Dr. Kaye’s testimony meets the low bar of relevance [Doc. 210 pp. 1–2]. Defendant Haney
maintains that Dr. Kaye’s opinions are directly relevant to the core issues in the Government’s
case and are needed to rebut the Government’s experts [Id. at 1–2, 5–9]. She argues that Dr. Kaye’s
testimony is also “reliable, as it rests on well-established medical science and peer-reviewed
principles[,] and helpful, as it will enable the jury to interpret complex pharmacological evidence
that lies far outside ordinary knowledge” [Id. at 2, 10]. She contends that any risk of juror confusion
can be alleviated by appropriate jury instructions and placing “targeted boundaries” on Dr. Kaye’s
testimony [Id. at 2, 11–12].
Defendants Warren [Doc. 233] and Roper [Doc. 234] moved to adopt Defendant Haney’s
response.
The parties appeared before the undersigned on December 1, 2025, for a motion hearing
on the Government’s motion to exclude [See Doc. 240, Minutes]. Assistant United States
Attorneys Jeremy Dykes and Brian Samuelson appeared on behalf of the Government. Attorney
Anthony Mahajan represented Defendant Haney. Attorney Scott Saidak represented Defendant
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Warren. Attorney Keith Stewart represented Defendant Roper. All three Defendants were also
present. After arraigning Defendants on the Third Superseding Indictment, the undersigned heard
the parties’ arguments on the Government’s Daubert motion.
At the hearing, AUSA Samuelson asserted that the Government will present three types of
prescriptions at trial: fabricated prescriptions, altered prescriptions, and prescriptions filed without
a prescriber’s signature in violation of the prescriber’s orders. He asserted that the therapeutic
benefits of the prescribed medications are irrelevant to whether Defendants fraudulently billed
insurance plans for these prescriptions. AUSA Samuelson also argued that this testimony by
Dr. Kaye will confuse the jury because it sounds like a defense when it is not. He acknowledged,
however, that the Government does not object to Dr. Kaye’s proposed testimony explaining
compounded medications, how they are created, and generally when they may be prescribed
[See Doc. 203 p. 2 n.2].
Mr. Mahajan argued that expert testimony is relevant not only if it presents a defense to
the charge, but also if it makes a fact at issue more or less probative. He maintained that Dr. Kaye’s
testimony is relevant to Defendant Haney’s knowledge and intent in filling the prescriptions at
issue. According to counsel, whether the ingredients in a compounded medication are appropriate
for the patient and approved by insurance is relevant to Defendant’s knowledge and intent in filling
the challenged prescriptions. Mr. Mahajan argued that the pharmacy is permitted to substitute
ingredients in a compounded medication, and Dr. Kaye will testify about whether a substituted
ingredient is appropriate for the patient. Finally, Mr. Mahajan argued that the Government agrees
that some of Dr. Kaye’s proposed testimony is appropriate and exclusion of Dr. Kaye’s testimony
at this stage of the proceedings is premature.
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Mr. Saidak stated that Dr. Kaye is not contractually obligated to present testimony for
Defendant Warren. He argued, however, that all defense counsel would question Dr. Kaye and
would have the benefit of his testimony. In this regard, Mr. Saidak said he adopted Mr. Mahajan’s
arguments in opposition to the exclusion of Dr. Kaye’s testimony.
Mr. Stewart agreed with Mr. Mahajan’s and Mr. Saidak’s positions. He stated that
Defendant Roper would benefit from Dr. Kaye’s testimony, although he was not her witness and
had no contractual obligation to Defendant Roper. Mr. Stewart also argued that exclusion of
Dr. Kaye’s testimony is premature and that the Government is trying to limit the Defendants to its
theory of the case, which is that ingredients in compounded medications were substituted for profit
and to defraud.
AUSA Samuelson responded that while Defendants’ intent is at issue, the question is
whether Defendants knowingly made false representation to insurers, not whether they were
helping the patients. He asserted that whether a particular medication could be safely prescribed
does not matter if the provider did not prescribe that medication. AUSA Samuelson maintained
that Defendants substituted ingredients or medications to increase the cost to the insurer and
whether those substitutions were also generally beneficial is not relevant.
After hearing the parties’ arguments, the Court took the matter under advisement. It is ripe
for adjudication.
II. 	ANALYSIS
“Federal Rule of Evidence 702 obligates judges to ensure that any scientific testimony or
evidence admitted is relevant and reliable.” Kumho Tire Co., Ltd. v. Carmichael, 526 U.S. 137,
147 (1999) (quoting Daubert v. Merrell Dow Pharms., Inc., 509 U.S. 579, 589 (1993)). It provides:
A witness who is qualified as an expert by knowledge, skill,
experience, training, or education may testify in the form of an
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opinion or otherwise if the proponent demonstrates to the court that
it is more likely than not that:
(a) the expert’s scientific, technical, or other specialized knowledge
will help the trier of fact to understand the evidence or to
determine a fact in issue;
(b) the testimony is based on sufficient facts or data;
(c) the testimony is the product of reliable principles and methods;
and
(d) the expert’s 	opinion 	reflects 	a reliable application 	of 	the
principles and methods to the facts of the case.
Fed. R. Evid. 702.
The requirement that an expert’s testimony must assist the jury in understanding evidence
or determining a contested fact “goes primarily to relevance.” United States v. Fairley,
137 F.4th 503, 516 (6th Cir.) (quoting Daubert, 509 U.S. at 591), cert. denied, 2025 WL 2824046
(Oct. 6, 2025). “[A] party must show, by a ‘preponderance of proof,’ that the witness will testify
in a manner that will ultimately assist the trier of fact in understanding and resolving the factual
issues involved in the case.” Coffey v. Dowley Mfg., Inc., 187 F. Supp. 2d 958, 970–71
(M.D. Tenn. 2002) (quoting Daubert, 509 U.S. at 593–94), aff’d, 89 F. App’x 927 (6th Cir. 2003);
see also United States ex rel TVA v. 1.72 Acres of Land in Tenn., 821 F.3d 742, 749 (6th Cir. 2016)
(explaining that the party offering the expert has the burden of proving admissibility). A district
court evaluating evidence proffered under Rule 702 must act as a gatekeeper, ensuring “that any
and all scientific testimony or evidence admitted is not only relevant, but reliable.” Daubert,
509 U.S. at 589.
The Government challenges only the relevance of Dr. Kaye’s testimony under Rule 702,
arguing “the [benefits and] efficacy of pain cream is neither an element of the charges nor is it
relevant to any defense” [Doc. 203 p. 1]. To be relevant, an expert’s testimony must “logically
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advance[] 	a 	material 	aspect 	of 	the 	proposing 	party’s 	case.” 	United 	States 	v. 	LaVictor,
848 F.3d 428, 442 (6th Cir. 2017) (citation omitted and modified). Indeed, the “relevancy bar is
low.” Id. (citation omitted). The United States Court of Appeals for the Sixth Circuit “has held that
‘Rule 702 should be broadly interpreted on the basis of whether the use of expert testimony will
assist the trier of fact.” Id. (citation omitted) “The ‘rejection of expert testimony is the exception,
rather than the rule.’” Id. (citation omitted).
Defendant Haney is charged with conspiracy to commit wire fraud. To convict her, “the
government must prove beyond a reasonable doubt that [she] knowingly and willfully joined in an
agreement with at least one other person to commit an act of [wire] fraud and that there was at
least one overt act in furtherance of the agreement.” United States v. Cunningham, 679 F.3d 355,
373 (6th Cir. 2012) (quoting United States v. Jamieson, 427 F.3d 394, 402 (6th Cir. 2005) (internal
citations modified and omitted)). As part of the manner and means of the wire fraud conspiracy,
the Third Superseding Indictment alleges that Defendants Haney, Warren, and Roper “submitted,
caused to be submitted, or aided and abetted the submission of, via wire transmission in interstate
commerce[,] additional claims for medications that were not dispensed pursuant to a valid
prescription, and therefore not eligible for reimbursement” [Doc. 217 ¶ 28].
Defendant Haney argues Dr. Kaye’s testimony is relevant to her mens rea, to rebut the
Government’s experts, and to explain compounded medications to the jury. Before turning to those
arguments, Defendants Warren and Roper seek to adopt Defendant Haney’s arguments for the
relevance and admissibility of Dr. Kaye’s testimony [See Docs. 223 & 224]. At the motion hearing,
both Defendants acknowledged that Dr. Kaye is not their witness, that they did not provide notice
to the Government of their intent to call him as a witness, and that they have no contractual
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relationship with Dr. Kaye. Thus, Defendants Warren and Roper have demonstrated no basis to
join in Defendant Haney’s response.
Starting with Defendant Haney’s argument about mens rea, the Government submits that
“the issue for the jury is whether Defendant Haney and the other defendants unlawfully and
fraudulently added medicines to medical providers’ prescriptions without authorization and
whether they unlawfully and fraudulently fabricated prescriptions” [Doc. 203 p. 5]. Defendant
asserts that Dr. Kaye, an anesthesiologist, pharmacologist, and director of pain medicine, will
testify regarding “[t]he extent to which a prescription for a topical analgesic or compounded pain
cream is medically appropriate for a specific patient’s condition, including patients at Rocky Hill
Pharmacy” [Doc. 203-2 p. 4]. She claims that “[b]efore determining whether [Defendant Haney’s]
conduct was fraudulent, the jury must first assess whether the medications allegedly ‘added’ or
‘fabricated’ were in fact medically appropriate, therapeutically justified, and consistent with
accepted pain-management practices, i.e., the kinds of compounds a legitimate prescriber would
prescribe for the patients at issue” [Id. at 6]. She maintains that whether the filled medications are
medically appropriate “will assist the jury in determining whether the prescriptions at issue were
fabricated or whether [she] lawfully dispensed medications pursuant to valid prescriber orders”
[Id. at 7]. At the hearing, Mr. Mahajan explained that if the medications were medically necessary
and appropriately substituted, it would show lack of intent or knowledge on the part of Defendant
Haney. Hence, that a particular medication provided or substituted is medically appropriate to treat
a specific patient is relevant to Defendant Haney’s knowledge that the prescription was invalid.
Defendant also argues that Dr. Kaye’s testimony is relevant to rebut the testimony of the
Government’s experts. The Government provides notice that its experts, Drs. Sullivan and Cook,
will testify regarding the relationship between prescribers, patients, and pharmacists; what
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constitutes a valid prescription; and the “[i]ndicators” of invalid prescriptions [Doc. 203-1 pp. 4–
5, 10]. Defendant asserts that Dr. Kaye will counter this testimony by showing that compounded
pain 	medications 	are 	accepted 	in 	legitimate 	pain 	management, 	thereby 	“rebut[ting] 	the
Government’s implication that such formularies are inherently suspicious or signal invalidity of
the prescription” [Doc. 210 p. 9]. Dr. Kaye will also testify about physician-pharmacist
relationship and how prescribers and pharmacists collaborate “to tailor compounds to patient-
specific needs, 	[which] 	contradicts 	the Government’s 	portrayal 	of 	these prescriptions 	as
automatically invalid or unauthorized because of additions and/or changes made to any given
prescription” [Id.]. Thus, Dr. Kaye’s testimony is relevant to the jury’s determination of whether
a prescription is valid or invalid and Defendant’s knowledge of its validity or invalidity.
Finally, Defendant argues that Dr. Kaye’s testimony is relevant to explain compounded
medications to the jury. She asserts that Dr. Kaye “will explain when and why physicians prescribe
compounded topical preparations for pain management, particularly when oral opioids or
conventional therapies are contraindicated, [and] how [compounded medications] are formulated
and dispensed, including that compounding is routinely performed for individualized patient needs
in compliance with professional standards” [Id. at 6]. She maintains Dr. Kaye will also testify to
the ingredients commonly used in compounded pain creams [Id.]. The Government “concedes that
an explanation regarding compounding in general terms is relevant” [Doc. 203 p. 2 n.2.]
For these reasons, Defendant demonstrates by a preponderance of the evidence Dr. Kaye’s
proffered testimony “logically advance[s] a material aspect of [her] case,” i.e., that she did not
knowingly fill invalid prescriptions. LaVictor, 848 F.3d at 442.
But even relevant expert testimony may be excluded if “its probative value is substantially
outweighed by a danger of . . . unfair prejudice, confusing the issues, [or] misleading the jury.”
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Fairley, 137 F.4th at 516 (quoting LaVictor, 848 F.3d at 444 & Fed. R. Evid. 403) (omission in
original). The Government argues that if the Court finds Dr. Kaye’s testimony is relevant, it should
still be excluded under Rule 403 because it risks confusing the jury. At the motion hearing, AUSA
Samuelson argued that Dr. Kaye’s testimony on the therapeutic benefits of compounded pain
creams may foster an erroneous belief by the jurors that a beneficial medication is a defense to
altering or fabricating a prescription. But the jury will have the benefit of the District Judge’s
instructions on the proper law to apply and the testimony of the Government’s experts. So, at this
time, the undersigned does not find the Government has demonstrated the risk of juror confusion
substantially outweighs the probative value of Dr. Kaye’s testimony. The Government may
nevertheless raise an objection to Dr. Kaye’s testimony pursuant to Rule 403 again in the context
of the trial.
III. 	CONCLUSION
After careful consideration of the parties’ arguments, the relevant law, and the record in
this case, the undersigned finds no basis to exclude the testimony of Defendant Haney’s expert
Dr. Alan Kaye under Rule 702. But the Government may raise an objection to Dr. Kaye’s
testimony pursuant to Rule 403 in the context of the trial. Accordingly, the Court DENIES the
Government’s motion [Doc. 203]. And for the reasons explained here, the Court DENIES
Defendant Warren’s and Defendant Roper’s motions to adopt Defendant Haney’s response
[Docs. 223 & 224].
IT IS SO ORDERED.
ENTER:
________ 	_________________
Jill E. McCook
United States Magistrate Judge
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