September 27, 2026 · AxonCPT Team · telehealth, clinical practice, ADHD assessment

Lessons From the Done Global Case for ADHD Prescribers

In November 2025, a federal jury in San Francisco convicted the founder/CEO and the clinical president of Done Global, a telehealth ADHD company. The charges were conspiracy to distribute controlled substances, distribution of controlled substances, and conspiracy to commit health care fraud. In July 2026 the two were sentenced to 72 months and 24 months in prison [1][2]. For ADHD prescribers, and especially for the PMHNPs who staff many telehealth platforms, the case is worth studying for one reason. The practices the Department of Justice described are specific and recognizable, and each one has a defensible alternative.

Wooden gavel on a dark desk beside a closed book, representing the Done Global federal case Photo by Sasun Bughdaryan on Unsplash

This article relies only on public DOJ press releases and DEA’s Federal Register text. It does not add commentary on the individuals involved. It is not legal advice, so talk to healthcare counsel about your own practice. Here we focus on what an individual prescriber can control. Good care, and good documentation of that care through tools such as objective ADHD testing with AxonCPT, are the practical defense.

What happened in the Done Global case?

These facts come from DOJ’s public releases:

  • Arrest (June 2024). DEA later cited the arrests of the company’s founder and clinical president in its proposed telemedicine rule. It described an alleged scheme that provided “easy access to controlled substances in exchange for a monthly subscription fee” [3].
  • Conviction (November 19, 2025). Ruthia He, founder and CEO, and David Brody, clinical president, were each convicted of one count of conspiracy to distribute controlled substances, four counts of distribution of controlled substances, and one count of conspiracy to commit health care fraud. He was also convicted of conspiracy to obstruct justice [1][2].
  • Sentencing (July 7, 2026). He was sentenced to 72 months in prison and Brody to 24 months. Each was fined $1 million [2].

DOJ’s figures shifted between releases. The conviction release described “over 40 million pills of Adderall and other stimulants” and about $14 million in insurer payments. The sentencing release described “over 37 million pills of Adderall” and more than approximately $12.3 million paid by Medicare, Medicaid, and commercial insurers [1][2].

What practices did DOJ describe?

According to DOJ, the scheme included [1][2]:

  1. Marketing to drug seekers. More than $40 million was spent on social media advertising, and the company “paid for targeted keyword search advertisements for drug seekers who wanted to obtain Adderall without a legal prescription.”
  2. Shortened evaluations. Clinicians were pressured “to diagnose ADHD in initial visits capped at half the length of a typical examination.”
  3. Pressure to prescribe. Clinicians were pressured “to prescribe stimulants to patients who the clinicians did not believe had ADHD or who were at risk for serious side effects.”
  4. Auto-refills without visits. An “auto-refill” feature meant prescribers “signed prescriptions for Adderall based on an automatically generated message that a patient desired a refill.” DOJ said some patients “went years without seeing clinicians,” and refills continued “even through involuntary psychiatric holds or after the patients had died.”
  5. Pay tied to volume. DOJ said the company paid “up to $60,000 per month to clinicians who signed Adderall prescriptions every 30 seconds.” The conviction release said nurse practitioners around the country were paid up to that amount “to refill prescriptions without clinical interaction.” DOJ also said the company “refused to hire or fired Done clinicians who did not participate.”
  6. False prior authorizations. Requests to insurers “claimed that Done followed the DSM-5 in diagnosing ADHD, utilized urine drug screens, and falsely claimed that non-stimulants had previously been tried without success.”
  7. Ignored contraindications. Stimulants were distributed “to patients who the company was warned were suffering from Adderall psychosis, bipolar, depression, anxiety, and other mental health conditions that were worsened by stimulant prescriptions.”

Why this case matters for PMHNPs

DOJ specifically named nurse practitioners as clinicians who were paid to refill prescriptions without clinical interaction [1]. Many PMHNPs work as contractors for telehealth platforms, where the platform controls visit length, refill workflows, and pay. The case shows that platform policy does not change a prescriber’s own responsibility. The DEA registration, the state license, and the signature on the prescription all belong to the clinician.

The case also shaped regulation. DEA’s January 2025 special registration proposal cited these allegations as reason to “judiciously evaluate when a practitioner has a legitimate need for a Special Registration” [3]. For what that proposal would require of PMHNPs, see DEA special registration for telemedicine, explained.

Seven practice lessons for ADHD prescribers

Each lesson below pairs a practice DOJ described with a defensible alternative.

DOJ-described practice Defensible alternative
Evaluations capped at half the typical length Take the time a full DSM-5-TR workup needs, over more than one contact if necessary
Pressure to diagnose and prescribe Clinical judgment is documented, and “not ADHD” is an acceptable outcome
Auto-refills without visits Every refill is tied to a clinical contact on a set schedule
Pay tied to prescription speed Pay isn’t tied to prescription volume or speed
Prior auth claims not backed by the chart Attest only to what is documented
Ignoring warnings about psychosis or bipolar disorder Screen for the differential and reassess when new information arrives
Advertising that promised medication Intake language that promises an evaluation, not a prescription

1. Make the evaluation proportionate to the risk. A Schedule II prescription needs a full workup: DSM-5-TR criteria, childhood onset, impairment in two or more settings, differential diagnosis, and a PDMP check. Our guide to running a telehealth ADHD evaluation sets out the steps.

2. Keep “no” available. Document the cases where you don’t diagnose ADHD or don’t prescribe a stimulant. A practice where every evaluation ends in a prescription is itself a red flag.

3. Tie refills to contact. Set a follow-up schedule, and document response, side effects, vitals, and PDMP checks at each visit.

4. Watch for red flags when you take a contract. Be cautious of pay per prescription or per minute of visit time, fixed visit lengths too short for an evaluation, refill queues that bypass visits, and marketing that promises medication.

5. Tell the truth on prior authorizations. Only attest to criteria, drug screens, and prior trials that your chart actually supports. Our ADHD medication prior authorization guide covers what payers commonly ask for.

6. Screen for the differential, and keep screening. Bipolar disorder, psychosis, anxiety, depression, and substance use disorders all change the risk of a stimulant. Reassess when a family member, pharmacist, or hospital raises a concern.

7. Make your reasoning auditable. A reviewer should be able to see why you diagnosed ADHD and how you know the medication is working. See ADHD documentation for stimulant prescribing.

Try it with your next patient. AxonCPT gives you 2 free tests every month — no card required. Send a link, your patient finishes in ~16 minutes from home, and you get a norm-referenced report instantly. Create your free account →

Where objective data fits

Self-report rating scales are easy to fake. A review in Brain Sciences concluded that no questionnaire has proved robust enough against false positives [4]. A continuous performance test adds a behavioral, norm-referenced measure. A 2025 meta-analysis found CPTs can help flag noncredible performance, with a moderate effect, though never as the only validity check [5]. A CPT can’t diagnose ADHD and can’t replace the interview. What it does is give the chart a dated, objective data point at baseline and at each dose change.

How this looks in practice

  1. Intake. Verify the patient’s identity and location, check the PDMP, and set expectations: “This is an evaluation, not a prescription guarantee.”
  2. Interview and collateral. Complete the DSM-5-TR workup, with informant input where possible.
  3. Objective baseline. Send an AxonCPT link. The patient takes the test at home in their browser in about 16 minutes, with no app or login, and you get an instant report with five metrics, cohort-matched norms from a 20,000+ reference dataset, and a Q1–Q4 vigilance breakdown. See what the report looks like.
  4. Decision and documentation. Record your reasoning across all data sources, including when the answer is “not ADHD.”
  5. Scheduled follow-up. Tie refills to visits, and retest at dose changes to document response.

Frequently asked questions

Were individual Done clinicians charged? The DOJ releases cited here describe the prosecution of the company’s founder/CEO and clinical president [1][2]. For the status of any other individuals, check DOJ’s official releases directly.

Is it illegal to prescribe stimulants by telehealth? No. Through December 31, 2026, DEA’s temporary flexibilities allow it when their conditions are met [6]. The Done case was about prescribing without a legitimate medical purpose, not about telehealth as such.

What should I do if a platform pressures me to prescribe? Document your clinical judgment, don’t sign prescriptions you can’t support, and get independent legal advice. Your license and DEA registration are your own responsibility.

Does using a CPT protect me legally? No single tool does. A CPT adds objective data to a well-documented evaluation. That strengthens the record, but it doesn’t replace clinical judgment.

Start testing your patients with AxonCPT

The clearest lesson of the Done Global case is that every stimulant decision should rest on an evaluation you could defend to a colleague or an auditor. AxonCPT gives PMHNPs a fast, home-administered objective measure that makes that record stronger at baseline and at every follow-up. Create your free AxonCPT account with 2 free tests every month and no card required, or learn more at axoncpt.com.

References

  1. U.S. Department of Justice, Office of Public Affairs. Founder/CEO and Clinical President of Digital Health Company Convicted in $100M Adderall Distribution and Health Care Fraud Scheme. November 19, 2025.
  2. U.S. Department of Justice, Office of Public Affairs. Founder/CEO and Clinical President of Digital Health Company Sentenced to 72 Months and 24 Months, Respectively, for $90 Million Scheme to Distribute over 37 Million Pills of Adderall. July 7, 2026.
  3. Drug Enforcement Administration. Special Registrations for Telemedicine and Limited State Telemedicine Registrations (proposed rule). Federal Register, 90 FR 6541, January 17, 2025 (footnote 27).
  4. Sadek J. Malingering and Stimulant Medications Abuse, Misuse and Diversion. Brain Sci. 2022;12(8):1004.
  5. Toptas P, et al. Evaluating Continuous Performance Tests as Embedded Measures of Performance Validity in ADHD Assessments: A Systematic Review and Meta-Analysis. Assessment. 2025.
  6. Drug Enforcement Administration & HHS. Fourth Temporary Extension of COVID-19 Telemedicine Flexibilities for Prescription of Controlled Medications. Federal Register, 90 FR 61301, December 31, 2025.