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The Eleventh Circuit affirmed a nurse practitioner’s convictions for drug conspiracy and healthcare fraud in a “pill mill” case. The Court held there was sufficient evidence to convict her of the drug offenses despite the government’s failure to provide any patient testimony that the prescription medications they received were unnecessary, and it affirmed her conviction for healthcare fraud based on her knowledge and participation in filing claims to government programs for office visits where patients received illegal prescriptions. The Court held that the trial court erred in instructing the jury that the parties had stipulated to disputed fact, but held this did not amount to an improper directed verdict or deprive the defendant of her defense because the instruction did not relate to an element of the charged offense or any of the facts necessary to establish one of those elements, and the defendant was still able to present her theory of defense. The Court also rejected the defendant’s evidentiary claims.