HUNTINGTON -- Federal prosecutors expect a former Marshall University cardiology fellow to plead guilty after he became the first person charged with crimes related to an alleged prescription drug operation involving millions of dollars a year, according to court documents.

A two-count information filed in U.S. District Court charges Dr. John Theodore Tiano with conspiracy to misuse a registration number, along with aiding and abetting health care fraud.

The alleged crimes took place between 2005 and March 31, 2007. That time period coincides with Tiano's moonlighting stint at the Justice Medical Complex near the Wayne-Mingo county line, although the clinic is not mentioned by name in the charging documents filed this week against Tiano.

Federal search warrants targeted the clinic and its neighboring Sav-Rite pharmacies earlier this year. Affidavits alleged both companies conspired to distribute massive amounts of pain medication illegally. The operation attracted customers from near and far, allowing Sav-Rite to purchase more of the pain killer hydrocodone for distribution than all but 21 retail pharmacies in the nation during 2006, according to court affidavits.

In an investigator's affidavit filed in March, the Sav-Rite owner estimated workers filled one prescription every minute in 2006, when the pharmacy grossed $6.5 million. Sav-Rite received 3.2 million dosage units of hydrocodone in 2006, dramatically above the national average of 97,431 units per pharmacy.

Tiano was one of several people named in the search warrant affidavits. Allegations contained in the affidavits indicate more people could be charged.

The filing of an information typically indicates the defendant is cooperating with prosecutors. It allows both sides to bypass a grand jury indictment to resolve the case. Assistant U.S. Attorney Monica Schwartz requested a guilty plea hearing Thursday, but no date was scheduled as of midday Friday.

Generally guilty plea agreements include promises the defendant will cooperate fully with investigators.

Fallout from Tiano's moonlighting stint at Justice Medical already led to sanctions from the state Board of Medicine and a 30-day furlough during his cardiology fellowship at the Marshall University School of Medicine. Tiano successfully appealed the furlough and completed the fellowship on schedule June 30.

Tiano's drug dispensing certificate was listed as expired Friday, according to the state Board of Medicine Web site.

Tiano's defense attorney, J. Timothy DiPiero, declined comment Friday.

This week's information states Tiano conspired with others to allow the intentional misuse of a registration number used to acquire and distribute hydrocodone and alprazolam. The number was issued to Tiano, but used by others, according to the document.

Count two of the information states Tiano helped others defraud Medicare of $119,785.57. He had allowed clinic employees falsify billing documents to indicate he had personally treated patients, whom he normally did not meet, examine or evaluate face-to-face, the charges against him said.

The scheme was designed to have nurse practitioners perform those examinations and evaluations, the information states. Through the course of allowing others to treat his patients, Tiano allowed the clinic and its employees to use his name, Medicare number and Drug Enforcement Administration registration number in treating patients without his face-to-face contact, according to this week's filing.

Previous court filings state Tiano received more than $253,00 in wages and benefits from his moonlighting role at Justice Medical Complex. Those earnings were received from at least August 2005 to September 2007, all while the university was his primary employer as he continued work on the cardiology fellowship, court affidavits state.

An anonymous complaint, received by the state Board of Medicine in September 2007, alleged Tiano was prescribing excessive amounts of prescription drugs at the clinic.

The Board of Medicine investigated the matter, and Tiano agreed it found probable cause to believe he had violated state code in his prescribing of pharmaceuticals at the Justice clinic. The doctor agreed to sanctions in December 2008, which included a public reprimand, three years' probation, a book report, a four-day controlled substance management course and orders to confine his practice to cardiology.

The university placed Tiano under intense supervision once a separate anonymous tip in mid-2007 indicated he was moonlighting without permission.

The university then enacted the 30-day furlough April 8, 2009, when federal search warrants revealed other allegations.

Dr. Charles H. McKown Jr., who was unavailable for comment Friday, serves as the university's dean and vice president of health sciences. He said Tiano's successful appeal, combined with the Board of Medicine's decision against suspension or revocation, left the university with little choice but to reinstate Tiano before the 30-day furlough expired.

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