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Press Release

Florida And Tennessee Pain Clinic Owner Extradited From Italy To The United States To Face RICO Charges

For Immediate Release
U.S. Attorney's Office, Eastern District of Tennessee

KNOXVILLE, Tenn. – A dual U.S.-Italian national was extradited from Italy to the United States on November 20. The U.S. Marshals Service effectuated the transportation of Luigi Palma from Lamezia Terme, Calabria to Knoxville, Tennessee.

Luigi Palma, 54, a co-defendant of Sylvia Hofstetter, who, along with three medical providers, were convicted of numerous charges related to “pill mill” operations in Florida and Tennessee following a four-month trial earlier this year in Knoxville. Palma contested his extradition from Italy for approximately two years. The charges against Palma are varied and reflect his alleged role in owning and operating pain clinics in South Florida and the Knoxville area over the course of several years. Included in those charges are a Racketeer Influenced and Corrupt Organization (RICO) conspiracy and a conspiracy to distribute oxycodone, oxymorphone, and morphine outside the scope of professional practice and not for a legitimate medical purpose.

On November 23, 2020, Palma appeared before the U.S. Magistrate Judge Debra C. Poplin in the Eastern District of Tennessee and entered not-guilty pleas to all charges. Palma waived his immediate right to a detention hearing and remains in the custody of the U.S. Marshals. Trial has been set for March 30, 2021, before U.S. District Judge Thomas A. Varlan.

This sweeping prosecution, which has resulted in approximately 140 convictions so far, results from an investigation by the U.S. Attorney’s Office for the Eastern District of Tennessee, the Criminal Division’s Organized Crime and Gang Section, and the FBI’s High Intensity Drug Trafficking Area, comprised of investigators assigned to the task force by the Loudon County Sheriff’s Office, Knoxville Police Department, Blount County Sheriff’s Office, Roane County Sheriff’s Office, Harriman Police Department, and Clinton Police Department. 

The investigation that led to this prosecution, as described above, falls under the auspices of the Department of Justice’s Organized Crime and Drug Enforcement Task Force (OCDETF) program, the centerpiece of the Department of Justice’s drug supply reduction strategy. OCDETF was established in 1982 to conduct comprehensive, multi-level attacks on major drug trafficking and money laundering organizations. Today, OCDETF combines the resources and expertise of its member federal agencies in cooperation with state and local law enforcement. The principal mission of the OCDETF program is to identify, disrupt, and dismantle the most serious drug trafficking and money laundering organizations and those primarily responsible for the nation’s drug supply.

Other agencies provided invaluable assistance, including the Rome Attaché of the Justice Department’s Office of Internal Affairs, FBI’s liaison in Rome, FBI’s Miami Field Office, the Hollywood Florida Police Department, U.S. Department of Health and Human Services, the Tennessee Department of Health, and the U.S. Drug Enforcement Administration’s Knoxville Diversion Group. The Justice Department’s Office of International Affairs and FBI’s liaison in Rome were particularly instrumental in effectuating Palma’s extradition, as were Italian law enforcement agencies and prosecutors, including the Italian Ministry of Justice, Carabinieri Raggruppamento Operativo Speciale (ROS), and Interpol-Rome. The United States is particularly appreciative of their assistance.

The extradition of Palma was made possible by provisions of a treaty between the United States and Italy.  The United States is grateful to the Italian authorities for their robust cooperation in this matter.

An indictment is merely an accusation. A defendant is presumed innocent until proven guilty beyond a reasonable doubt in a court of law.

Assistant U.S. Attorney Tracy L. Stone, Deputy Chief Attorney Kelly Pearson, and Trial Attorney Damare Theriot of the Criminal Division’s Organized Crime and Gang Section, U.S. Department of Justice, represented the United States in the prosecution of this case.               



Rachelle Barnes
Public Information Officer
(865) 545-4167

Updated November 23, 2020

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