Pain Management

Florida Walgreens Pharmacies Issued Inspection Warrants by the DEA

The recent investigation of a Walgreens distribution center and six Walgreens pharmacy stores in Florida shows that the U.S. Drug Enforcement Administration (DEA) is continuing to attack pharmacies, including the largest pharmacy chains.

On Wednesday, April 4, 2012, the DEA issued inspection warrants to the Florida Walgreens distribution center and six pharmacies. According to the warrant, the DEA is investigating these Walgreens pharmacies in Florida to determine if the pharmacies are dispensing controlled substances outside the scope of their registration in violation of federal laws and regulation.

The warrant was filed in U.S. District Court, Middle District of Florida and also stated that under the U.S. Controlled Substances Act, a warrant may be issued for valid public interest and without the type of probable cause needed under criminal law.

The inspection warrants will allow DEA investigators to review pharmacy’ records and receipts. The pharmacies are not required to stop selling controlled substances, which include painkillers like oxycodone and hydrocodone, during the DEA’s inspection.

The inspection of Walgreens’ pharmacies in Florida is only one of the latest attacks against pharmacies and pain management clinics by the DEA. Earlier this year, the DEA suspended Cardinal Health’s license to distribute controlled substances from one of its distribution centers in Florida. Two CVS pharmacies in Florida were also targeted by the DEA and suspended from selling controlled substances. Both companies are currently fighting the orders in court.

If you own or work at a pharmacy or pain clinic, visit our website at www.TheHealthLawFirm.com to learn more about legal matters concerning pain management and prescribing.

Doctor Sentenced to Almost 27 Years in Prison for Pill Mill Charges

4 Indest-2009-3By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

A doctor was sentenced to almost 27 years in prison on July 24, 2013, according to the Sun Sentinel. The former doctor, Sergio Rodriguez, had worked as a pediatrician at Children Plus Health Center near Palm Beach County, Florida. He was charged with operating a pill mill out of his office. He pleaded guilty to four counts of manslaughter, four counts of conspiracy to traffic oxycodone, one count of racketeering and one count of money laundering.

Click here to read the entire Sun Sentinel article.

Doctor Prescribed Pain Pills to Undercover Detectives.

Dr. Rodriguez is accused of illegally prescribing pain killers out of his office. He was initially arrested in 2008. Investigators claim the doctor did not have the proper training to prescribe the pain medications, but did so anyway. According to the Sun Sentinel, the doctor would prescribe oxycodone, methadone and xanax to patients, including undercover detectives, without an examination.

A Palm Beach, Florida, judge approved a plea agreement for Dr. Rodriguez. Under the agreement, the doctor reportedly admitted responsibility for the deaths of four people in early 2008. According to court documents, Dr. Rodriguez relinquished his license to practice medicine in the state of Florida in 2009.

Click here to read the administrative complaint against Dr. Rodriguez.

Civil Forfeiture of Property and Money: A New Weapon in the Government’s Arsenal Against Health Fraud and Pill Mills.

Dr. Rodriguez was also ordered to pay $200,000 in fines, and court costs. He will also be responsible for forfeiting $87,000, according to the Sun Sentinel.

Recently we have seen government prosecutors and agencies, including the Medicaid Fraud Control Unit (MFCU), the U.S. Attorney General’s (AG) Office, and local sheriff and police departments use the Florida Contraband Forfeiture Act against health professionals and health facilities in health-related cases. A prompt, aggressive defense to these actions may often recover the property or funds seized and, more importantly, a good defense can be used to help resolve any pending criminal charges. To read more on the forfeiture of property and money, click here to read a previous blog.

Legal Tips for Physicians to Manage Pain Patients.

Doctors, pharmacists and all healthcare professionals who are involved in schemes relating to overprescribing or trafficking in narcotics may be targeted by many different agencies, including the Drug Enforcement Administration (DEA). The DEA will often use undercover agents and informants to pose as patients, wired for audio recording. The DEA will often work with local law enforcement authorities and the Department of Health (DOH). Other investigations and arrests may be initiated by a statewide prosecutor’s office, which is under the AG. Still others have been initiated by the MFCU where Medicaid funds are used.

To avoid any legal actions altogether, we advise our physician clients to follow a simple list of suggestions in order to protect themselves from drug-seeking patients. Click here to see an article on our website with tips on how to help manage pain patients.

Contact Health Law Attorneys Experienced with Investigations of Health Professionals and Providers.

The attorneys of The Health Law Firm provide legal representation to physicians, nurses, nurse practitioners, CRNAs, pain management doctors, dentists, pharmacists, psychologists and other health providers in Department of Health (DOH) investigations, Drug Enforcement Administration (DEA) investigations, FBI investigations, Medicare investigations, Medicaid investigations and other types of investigations of health professionals and providers.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Comments?

What do you think of Dr. Rodriguez’s sentence? As a health care professional, how do you manage pain patients? Please leave any thoughtful comments below.

Sources:

Freeman, Marc. “Former Doctor Sentenced to 27 Years for Overdose Deaths.” Sun Sentinel. (July 25, 2013). From: http://articles.sun-sentinel.com/2013-07-25/news/fl-doctor-overdose-deaths-plea-deal-20130725_1_sergio-rodriguez-former-doctor-children-plus-health-center

Muczyner, Michael. “Lake Worth Pediatrician Sentenced to Prison for Pill Mill Charges.” CBS 12 News. (July 25, 2013). From: http://cbs12.com/news/top-stories/stories/vid_9076.shtml

Department of Health v. Sergio Rodriguez, M.D. Case Number 2008-20504. Final Order. January 7, 2011. From: http://ww2.doh.state.fl.us/DocServiceMngr/displayDocument.aspx

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law.  He is the President and Managing Partner of The Health Law Firm, which has a national practice.  Its main office is in the Orlando, Florida, area.  www.TheHealthLawFirm.com  The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone:  (407) 331-6620.

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 1996-2012 The Health Law Firm. All rights reserved.

New Anti-Prescription Drug Abuse Campaign in Pinellas County

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

Pinellas County has started a new billboard campaign aimed at curbing prescription drug abuse. The billboard message reads, “We’re shutting down Pill Mills in Pinellas County.” The first two billboards were erected on April 1, 2012. Several smaller boards will be put up in the next few weeks, with even more planned for the future. This continues the long-standing battle by Pinellas County law enforcement authorities against pain management clinics that they describe as “pill mills.”  Pinellas County includes the cities of St. Petersburg, Clearwater and Seminole.

The billboard message is a statement from local coalition groups who have partnered with Pinellas County in order to curb the area’s prescription drug abuse problem. In 2010, Pinellas County allegedly had the most occurrences of accidental overdose deaths from prescription drugs when compared to all other counties in Florida.

The intention of Pinellas County in establishing this billboard campaign may be aimed at stopping prescription drug abuse, but the billboards also shed negative light on legitimate pain management clinics and physicians. Although anti-prescription drug abuse campaigns are laudable, these efforts should focus on assisting those with actual prescription drug abuse history, rather than creating a scapegoat out of the pain management industry.

If you work in the pain management industry (physician, pharmacist, pain clinic, pharmacy, etc.) and feel that your medical license, pharmacy license, or business is at risk or is under investigation by the Drug Enforcement Administration (DEA) or Florida Department of Health (DOH), please visit our website at www.TheHealthLawFirm.com for more information about this.

Sources Include:

WFTS Staff, “County Sends Billboard-sized Message About Prescription Drug Abuse,”  ABC Action News (Apr. 6, 2012).  From:  http://www.abcactionnews.com/dpp/news/state/county-sends-billboard-sized-message-about-prescription-drug-abuse

“We’re Shutting Down Pill Mills in Pinellas County,” Tampa Bay Newspapers (Apr. 10, 2012). From:  http://www.tbnweekly.com/pinellas_county/content_articles/041012_pco-01.txt

George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law.  He is the President and Managing Partner of The Health Law Firm, which has a national practice.  Its main office is in the Orlando, Florida, area.  www.TheHealthLawFirm.com

The DEA’s War on Pain Management

The Health Law Firm George F. Indest III HeadshotWithin the last few years, raids on pain management clinics, as well as pharmacies, have been increasingly commonplace. The doctors, pharmacists, nurses and other health care professionals involved are carted away in handcuffs and must defend their practice.

According to the St. Petersburg Times, a South Florida pain management clinic has recently been shut down under emergency action by the Florida Department of Health (DOH). Several health care professionals at the clinic were arrested, their licenses revoked.

In this instance, the charges against these health care employees are not completely unwarranted. Patients confessed to authorities that members of the clinic knew they were shopping for drugs, and an employee revealed that he was asked to recruit patients by promising powerful drugs.

However, it is not uncommon for a pain management clinic or related practice to face investigation, especially in Florida. Federal and state agencies are doing everything and anything they can to prevent drug farming, which means a crackdown on health care providers. Dubbed “Operation Pill Nation,” this strict enforcement means more worries for health care professionals, who now must monitor patient needs under the DEA’s close watch.

If your medical practice specializes in pain management or a similar area, have a plan in place in the event that the DEA comes knocking on your door. Be aware of health lawyers that are familiar with these cases and can defend you in the event of a DEA raid. These proceedings are often very complicated, and you’ll want an experienced team of health law attorneys to properly defend you from criminal charges.

At The Health Law Firm, our team of lawyers specialize in the representation of doctors, nurses, pharmacists, physicians assistants, nurse practitioners and other health care professionals involved in Department of Health, Diversion Control and Drug Enforcement Administration in Florida and throughout the United States. For more information about our knowledge in the practice of health law and DEA cases read our article on Pain Management and the DEA.

Two Central Florida Physicians Connected to Statewide Pill-Mill Network

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

An Orlando and Jacksonville physician have been linked to a statewide pill-mill operation that brought in millions of dollars to pain clinic owners and doctors, according to the Orlando Sentinel. On June 27, 2012 seven doctors and seven pain clinic owners were arrested in the raid that was dubbed “Operation Pill Street Blues.” The two-year, multiagency investigation into the pill-mill operation spanned from Miami to Pensacola. The investigation included the Drug Enforcement Agency (DEA) and Florida law enforcement.

To view the DEA’s press release concerning the investigation, click here.

South Florida Firefighter Alleged Leader of Pill Mill.

Investigators named a 32-year-old Pompano Beach firefighter as the pill-mill’s ring leader. He allegedly used his image as a city firefighter and paramedic to develop a clean reputation with the local law enforcement.

He allegedly told his co-conspirators how to turn in other rogue doctors, pain clinics, and patients who abused drugs to authorities, so that their business would appear legitimate.

Millions of Oxycodone Pills were Prescribed in One Year.

Doctors recruited by the pill-mill network would allegedly write prescriptions to patients who did not have a medical need for the drugs or would prescribe excessive amounts of pills.

The seven doctors in the organization allegedly dispensed more than two million oxycodone tablets in one year. The Orlando and Jacksonville doctors allegedly prescribed more than 930,000 oxycodone pills between the two of them in a nine-month period.

Both Local Doctors Examined Undercover Detectives Posing as Patients During the Investigation.

Both doctors were visited by undercover detectives posing as patients. The Jacksonville doctor examined a detective who complained of minor back pain. She allegedly issued prescriptions for oxycodone and other drugs, even though the detective had no observable medical issues.

The affidavit details other undercover doctor visits, including those with the Orlando doctor at a pain management clinic in Fort Meyers. The initial exam between the doctor and the undercover detective allegedly lasted less than three minutes, before he gave the detective a prescription for oxycodone and other drugs.

Charges Vary from Racketeering to Manslaughter.

Those arrested for alleged involvement in the pill-mill scheme face charges ranging from racketeering, to trafficking of a controlled substance, to manslaughter.

On June 26, 2012, the day before authorities announced the charges, the Department of Health suspended the doctors’ licenses.

Pain management doctors click here to see if you’re in compliance with the recent changes to Florida’s pain management laws.

Patients with Severe Pain Speaking Out.

A former patient of a Vero Beach doctor arrested in the sting is one of hundreds who were prescribed strong narcotic pain medications at the alleged pill mills. Now she’s having a hard time finding the medications she needs to treat her conditions, including: a herniated disk, osteoarthritis and fibromyalgia. All of her conditions are listed in medical records and cause her severe pain. She is trying to find another doctor that is willing to prescribe her the medications she needs to function.

This situation is familiar to many patients in Florida with true medical need for prescription pain medications. These patients are finding it increasingly difficult to even locate a physician to treat them. Medical ethicists have commented on this problem, saying it is an issue that will become increasingly problematic for the foreseeable future.

To read more on operation “Pill Street Blue,” click here.

Contact Health Law Attorneys Experienced with DEA Cases.

The Health Law Firm represents pharmacists, pharmacies, physicians, nurses, and other health providers in investigations, regulatory matters, licensing issues, litigation, inspections and audits involving the DEA, Department of Health (DOH), and other law enforcement agencies.

If you are aware of an investigation of you or your practice, or if you have been contacted by the DEA or DOH, contact an experienced health law attorney immediately.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Sources Include:

Pavuk, Amy. “Authorities Link Orlando doctor, Daytona Clinic to Pill-Mill Network.” Orlando Sentinel. (July 14, 2012). From: http://articles.orlandosentinel.com/2012-07-14/news/os-fernando-valle-pill-mill-network-20120714_1_pain-clinics-pill-mill-network-clinic-owners

Gordon, Lynn. “Former Patient of Vero Beach Doctor Arrested in Pill Mill Bust Talks.”WPEC-TV. (July 17, 2012). From: http://www.cbs12.com/news/top-stories/stories/vid_1092.shtml

About the Author:  George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law.  He is the President and Managing Partner of The Health Law Firm, which has a national practice.  Its main office is in the Orlando, Florida, area.  www.TheHealthLawFirm.com  The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone:  (407) 331-6620.

New Florida Drug Database Aimed at Preventing Drug Abuse

Recently, Florida pharmacists, physicians and pain management clinics have received negative attention over frequent Drug Enforcement Administration (DEA) raids. Now, Florida is once again in the spotlight as the state has launched a drug database in an attempt to reduce drug abuse perpetuated by visits to the doctor.

According to the Orlando Sentinel, this database will allow physicians and pharmacists to review a patient’s prescription history before issuing prescriptions for painkillers like OxyContin and other powerful drugs.

These preventative measures are not new to Florida health care providers. After garnering a reputation for frequent drug trafficking, proliferated by pain management clinics, the state passed legislation banning many doctors from dispensing dangerous controlled substances in their offices.

Currently, use of the database is not mandatory, but legislators are hoping to make it a requirement in the future. Both the Florida Medical Association and the Florida Osteopathic Medical Association are urging members to retrieve information from the database before writing prescriptions.

With this new database, physicians, pharmacists and pain management clinics can help prevent visits from the DEA and Department of Health (DOH). Instead of writing prescriptions for powerful painkillers every time a patient comes calling, doctors can now judge whether a patient is really in need or abusing drugs. Being able to see every instance that a patient has filled a prescription for drugs like OxyContin and Valium will allow physicians and pharmacists to understand the whole picture If a patient is shopping around for drugs, it will be made apparent.

Keep the DEA from your practice by taking every precaution, including querying the database before writing or administering a prescription. For more information on DEA cases see this article about defending yourself in the event of an investigation. Pharmacists can learn about more legal matters concerning their profession here.

Drug Enforcement Agency (DEA) Blocks Shipping of Controlled Substances at Walgreens Distribution Center in Florida

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law 

On September 14, 2012, the Drug Enforcement Agency (DEA) blocked the Walgreens distribution center in Jupiter, Florida, from shipping oxycodone and other controlled drugs to its pharmacies in Florida and the East Coast with an immediate suspension order, according to the DEA. In the press release, the DEA called the Walgreens distribution facility an “imminent danger” to the public.

To see the entire press release from the DEA, click here.

Back in April 2012, the DEA served an administrative inspection warrant at the same facility, as well as its six top retail Walgreens pharmacies in Florida. To see my blog post on that story, click here.

DEA Suspension Order Only Stops the Distribution of Controlled Substances.

The DEA said the Jupiter distribution center has been “the single largest distributor of oxycodone products in Florida” since 2009. The DEA issued the suspension order because it believes Walgreens failed to maintain proper controls to ensure its retailers didn’t dispense drugs to addicts and drug dealers.

The order only applies to the Jupiter distribution center and only suspends the distribution of controlled substances.

Whether or not bath salts fall into this category is unclear. The Florida Legislature recently banned the sale of bath salts and 90 other substances to help stop the big face-eating zombie outbreak in Florida. See my blog on bath salts and the zombie outbreak in Florida.

Recently, the DEA revoked the controlled substance licenses from two CVS pharmacies in Sanford, Florida. The two stores are accused of dispensing an inappropriate number of prescriptions for oxycodone and had a suspicious number of sales of other controlled substances. There is a blog on this story on our website, click here to read it.

Millions of Oxycodone Pills Purchased by Walgreens Stores.

According to a USA Today article, six of Walgreens’ Florida pharmacies allegedly ordered more than a million oxycodone pills a year. One pharmacy in Oviedo, Florida, went from ordering more than 80,000 oxycodone pills in 2009, to nearly 1.7 million in 2011.

Click here to read the USA Today article
.

Continued War on Prescription Drug Abuse.

According to the DEA, this is an effort to curb Florida’s prescription drug epidemic. Special Agent Mark Trouville, with the DEA’s Miami Division, said all DEA licensees “have an obligation to ensure that medications are getting into the hands of legitimate patients. When they choose to look the other way, patients suffer and drug dealers prosper.”

Neither Agent Trouville nor the DEA was, apparently, requested to comment on the bath salts ban and its effect on the zombie outbreak, however.

Oxycodone Numbers Published for Shock Value.

I really do not see why the public or our elected representatives are shocked and awed by the meaningless numbers and statistics used in connection with these matters. The fact that Walgreens, the biggest pharmacy retailer in Florida, might distribute over a million oxycodone pills in a year, is a meaningless statistic by itself. If a doctor prescribes a pain management patient a prescription for three (3) pills a day, that is approximately 90 pills per month or 1,080 pills per year. If Walgreens has only 1,000 patients with such a prescription in a year throughout the entire state of Florida, that is in excess of one million (1,000,000) pills per year. I would venture to guess that many single Walgreens retail stores have more than 1,000 customers per day, much less all Walgreens stores throughout Florida.

My point is that any such statistics are meaningless out of context and are only meant to sound huge of one doesn’t stop and think about it.

Another concern is that many, if not the vast majority of the Walgreens customers who now will not be able to get their prescriptions filled, are legitimate pain management patients with legitimate prescriptions written by legitimate physicians.

Where Do Legitimate Chronic-Pain Patients Turn?

I am constantly being contacted by patients who are in dire straits, suffering because they cannot locate a pharmacy to fill their legitimate pain medicine prescriptions. These include injured military veterans, patients who are 100% disabled and on disability or social security, patients injured in automobile accidents and job-related accidents (whose medications are paid for by insurance, if they can find a pharmacy to fill it) and others with real chronic pain issues.

If the largest legitimate chains of pharmacies in the state and nation are not allowed to fill these prescriptions, where will these suffering patients turn? Are these actions driving our citizens into the hands of shady independent pharmacies that have fewer safeguards and less accountability? Are these actions driving our citizens to seek out illegal drug dealers and turn to illegal drugs to cope with their legitimate medical problems? I hope not.

Thank you. I will get off my soapbox now.

Contact Health Law Attorneys Experienced in Representing Pharmacies and Pharmacists.

The Health Law Firm represents pharmacists and pharmacies in DEA investigations, regulatory matters, licensing issues, litigation, administrative hearings, inspections and audits. The firm’s attorneys include those who are board certified by The Florida Bar in Health Law as well as licensed health professionals who are also attorneys.

To contact The Health Law Firm please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Sources:

Leinwand, Donna. “DEA Inspects Walgreens for Oxycodone Probe.” USA Today. (September 15, 2012). From: http://www.usatoday.com/news/nation/story/2012/09/14/walgreens-and-oxycodone/57782912/1

Pavuk, Amy. “DEA Blocks Controlled-Substance Distribution at Florida Walgreens Facility.” Orlando Sentinel. (September 14, 2012). From: http://articles.orlandosentinel.com/2012-09-14/news/os-walgreens-dea-suspension-20120914_1_distribution-center-dea-miami-field-division

DEA. “DEA Serves a Suspension Order on Walgreens Distribution Center in Jupiter, Florida.” DEA.gov. (September 14, 2012). From: http://www.justice.gov/dea/divisions/mia/2012/mia091412.shtml

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620. He does not own stock in Walgreens or any other pharmacy.

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.

Copyright © 1996-2012 The Health Law Firm. All rights reserved.

Florida Doctor Arrested for Drug Sales and Other Criminal Charges

Drug trafficking charges against a medical doctor are not a new concept, especially in Florida. Recent pill mill busts throughout the state have resulted in an omnipresent DEA, always on the lookout for illegal drug sales by pharmacies, pharmacists, pain management clinics and physicians. However, the recent arrest of a Central Florida doctor extends beyond the run of the mill “pill mill” bust, as the accusations in this case involve sex with a minor and delivering a controlled substance to a minor.

According to Florida Today, this Central Florida doctor was arrested Tuesday following a raid by the Florida Department of Law Enforcement. This is his second arrest after he was charged with possession of marijuana and drug paraphernalia in August.

Tuesday’s arrest resulted from evidence of the doctor’s sexual relationship with a high school student. The doctor was arrested in 2009 after being caught during a traffic stop with bags of marijuana in his car and allegedly having a sexual relationship with the 16-year-old passenger. Although charges were not filed after the girl recanted her evidence and claimed the marijuana was hers, that didn’t put an end to a steady stream of younger girls going into the clinic. According to residents of the area surrounding the clinic, girls were frequently seen going to see the doctor dressed in revealing attire. Aside from teenage patients, residents reported often seeing a line out to the street for people waiting to get into the clinic, a possible indicator of drug trafficking.

Although his medical license has been suspended, this Florida doctor has yet to receive broader drug trafficking charges, despite his huge prescription distribution numbers. According to the Florida Department of Law Enforcement, this doctor prescribed 250,000 oxycodone pills in the first eight months of 2011. Compared to the entire state of California, which had 300,000 oxycodone prescriptions in the last six months of 2010, it is evident that this Florida doctor had a major painkiller operation. The Florida Department of Law Enforcement is calling him one of the worst offenders in the state of Florida. Upon further investigation, this doctor and anyone who may have assisted him in the drug trafficking of oxycodone may be charged for this offense.

While the possibility of drug trafficking charges is enough to scare any physician, other criminal charges can be equally damaging, especially depending on how the accused individuals plea to the charges. A health professional’s plea of nolo contendere, which may seem like the safe route, is actually treated the same as a plea of guilty for all purposes. There are ways to defend criminal charges (like the ones against the aforementioned Florida doctor) that can result in a more favorable outcome (e.g., attempting to obtain pre-trial diversion, pre-trial intervention or drug court), but legal advice should be sought from an attorney who frequently represents health care providers before any actions are pursued. To learn more about criminal charges against doctors and other health professionals see this recent post or visit our website at www.TheHealthLawFirm.com.

More Than 20 Arrest Warrants Issued by Polk County Sheriff’s Office in Connection to Pill Mill Investigation

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

The Polk County Sheriff’s Office issued 25 arrest warrants in connection to an ongoing pill mill investigation involving a medical clinic in Winter Haven, Florida. On September 19, 2012, the sheriff’s office announced that ten suspects in the case have been arrested, and 15 suspects with arrest warrants remain at large.

Click here to see the press release from the Polk County Sheriff’s Office.
Authorities Used the Prescription Drug Monitoring Program to find Suspects.

Last year the state launched the Prescription Drug Monitoring Program, which requires doctors and pharmacists who dispense controlled substances to report the information to a statewide database.

According to the Polk County Sheriff’s Office, the database was used to round up those associated with the Winter Haven medical clinic.

In an article in the News Chief, deputies said 13 of the suspects were allegedly acting as “smurfs” (people hired by a drug ring to take fake prescriptions to be filled, then turning the pills over to the ring). Another 12 people were accused of “doctor shopping,” which is the practice of going to multiple doctors to get many prescriptions for narcotics.

To read the entire article from the News Chief, click here.

This case was investigated by the Polk County Sheriff’s Office, the Florida Department of Law Enforcement (FDLF), the Florida Department of Health (DOH) and the Attorney General’s (AG) Office.

“These people are giving the smurfs a bad name,” Papa Smurf stated. “We should be happy that law enforcement is doing a good job rounding up the read ‘bad guys,’”added Brainy Smurf.
Legal Tips for Physicians to Manage Pain Patients.

Doctors, pharmacists and all healthcare professionals who are involved in schemes relating to overprescribing or trafficking in narcotics may be targeted by many different agencies.

We have represented physicians who have been the subjects of Drug Enforcement Administration (DEA) investigations. The DEA will often use undercover agents and informants to pose as patients, wired for audio recording. The DEA will often work with local law enforcement authorities and the Department of Health (DOH).

Other investigations and arrests may be initiated by a statewide prosecutor’s office, which is under the Attorney General (AG). Still others have been initiated by the Medicaid Fraud Control Unit (MFCU) where Medicaid funds are used.

Click here to see an article on our website with tips for to help manage pain patients.

Give us your thoughts on this story below.

Contact Health Law Attorneys Experienced in Representing Health Care Providers in DOH Cases.

The Health Law Firm represents pharmacists, pharmacies, physicians, nurses, and other health care providers in investigations, regulatory matters, licensing issues, litigation, inspections and audits involving the DEA, Department of Health (DOH), and other law enforcement agencies.

If you are aware of an investigation of you or your practice, or if you have been contacted by the DEA or DOH, contact an experienced health law attorney immediately.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.
Sources:

Parody, Clifford. “25 Warrants Issued in Ongoing Pill Mill Case.” News Chief. (September 20, 2012). From: http://www.newschief.com/article/20120920/NEWS/209205012

Pavuk, Amy. “25 Arrest Warrants Issued in Pill-Mill Probe.” Orlando Sentinel. (September 19, 2012). From: http://articles.orlandosentinel.com/2012-09-19/news/os-polk-pill-mill-arrests-20120919_1_pill-mill-probe-arrest-warrants-fraudulent-prescriptions

Eleazer, Carrie. “25 Arrest Warrants Issued in Connection to On-Going Pill Mill Investigation.” Polk County Sheriff’s Office. (September 19, 2012). From: http://www.polksheriff.org/NewsRoom/News%20Releases/Pages/09-19-2012.aspx
About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law.  He is the President and Managing Partner of The Health Law Firm, which has a national practice.  Its main office is in the Orlando, Florida, area.  www.TheHealthLawFirm.com  The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone:  (407) 331-6620.

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.Copyright © 1996-2012 The Health Law Firm. All rights reserved.

In Brief: Florida Pain Management Clinic Laws

Every health profession has its own set of rules and regulations. This week, we’re examining Florida laws under which pain management clinics operate.

Because Florida has one of the worst drug trafficking problems in the country, law enforcement is making sure that punishments for any violations are severe. For example, if a patient dies of drug overdose and the prescriber is found to be responsible, he or she can be charged with homicide, which was the case for a Palm Beach County pain management physician (see this New York Times article).

The DEA, Florida Department of Health and Florida law enforcement are watching pain management clinics very closely in order to keep Florida’s drug trafficking problem under control. Make sure that your clinic abides by the following legislation, in order to prevent any interference with your practice.

The 2011 Florida Statutes

Section 458.3265, F.S.:

Definition of Pain Management Clinic:

Pain-management clinic” or “clinic” means any publicly or privately owned facility:
(I) That advertises in any medium for any type of pain-management services; or
(II) Where in any month a majority of patients are prescribed opioids, benzodiazepines, barbiturates, or carisoprodol for the treatment of chronic nonmalignant pain.

Registration:

Every pain-management clinic must register with the Florida Department of Health UNLESS:

1. That clinic is licensed as a facility pursuant to chapter 395;

2. The majority of the physicians who provide services in the clinic primarily provide surgical services;

3. The clinic is owned by a publicly held corporation whose shares are traded on a national exchange or on the over-the-counter market and whose total assets at the end of the corporation’s most recent fiscal quarter exceeded $50 million;

4. The clinic is affiliated with an accredited medical school at which training is provided for medical students, residents, or fellows;

5. The clinic does not prescribe controlled substances for the treatment of pain;

6. The clinic is owned by a corporate entity exempt from federal taxation under 26 U.S.C. s. 501(c)(3);

7. The clinic is wholly owned and operated by one or more board-certified anesthesiologists, physiatrists, or neurologists; or

8. The clinic is wholly owned and operated by one or more board-certified medical specialists who have also completed fellowships in pain medicine approved by the Accreditation Council for Graduate Medical Education, or who are also board-certified in pain medicine by a board approved by the American Board of Medical Specialties and perform interventional pain procedures of the type routinely billed using surgical codes.

Physician Responsibilities:

1. A physician may not practice medicine in a pain-management clinic, if the pain-management clinic is not registered with the department. Any physician who qualifies to practice medicine in a pain-management clinic pursuant to rules adopted by the Board of Medicine as of July 1, 2012, may continue to practice medicine in a pain-management clinic as long as the physician continues to meet the qualifications set forth in the board rules. A physician who violates this paragraph is subject to disciplinary action by his or her appropriate medical regulatory board.

2. A person may not dispense any medication on the premises of a registered pain-management clinic unless he or she is a physician licensed under this chapter or chapter 459.

3. A physician, a physician assistant, or an advanced registered nurse practitioner must perform a physical examination of a patient on the same day that the physician prescribes a controlled substance to a patient at a pain-management clinic. If the physician prescribes more than a 72-hour dose of controlled substances for the treatment of chronic nonmalignant pain, the physician must document in the patient’s record the reason for prescribing that quantity.

4. A physician authorized to prescribe controlled substances who practices at a pain-management clinic is responsible for maintaining the control and security of his or her prescription blanks and any other method used for prescribing controlled substance pain medication. The physician shall comply with the requirements for counterfeit-resistant prescription blanks in s. 893.065 and the rules adopted pursuant to that section. The physician shall notify, in writing, the department within 24 hours following any theft or loss of a prescription blank or breach of any other method for prescribing pain medication.

5. The designated physician of a pain-management clinic shall notify the applicable board in writing of the date of termination of employment within 10 days after terminating his or her employment with a pain-management clinic that is required to be registered. Each physician practicing in a pain-management clinic shall advise the Board of Medicine, in writing, within 10 calendar days after beginning or ending his or her practice at a pain-management clinic.

6. Each physician practicing in a pain-management clinic is responsible for ensuring compliance with facility and physical operations requirements

Inspection:

1. The department shall inspect the pain-management clinic annually, including a review of the patient records, to ensure that it complies with this section and the rules of the Board of Medicine.

2. During an onsite inspection, the department shall make a reasonable attempt to discuss each violation with the owner or designated physician of the pain-management clinic before issuing a formal written notification.

3. Any action taken to correct a violation shall be documented in writing by the owner or designated physician of the pain-management clinic and verified by followup visits by departmental personnel.

Penalties and Enforcement:

1. The department may impose an administrative fine on the clinic of up to $5,000 per violation for violating the requirements of this section; chapter 499, the Florida Drug and Cosmetic Act; 21 U.S.C. ss. 301-392, the Federal Food, Drug, and Cosmetic Act; 21 U.S.C. ss. 821 et seq., the Comprehensive Drug Abuse Prevention and Control Act; chapter 893, the Florida Comprehensive Drug Abuse Prevention and Control Act; or the rules of the department. In determining whether a penalty is to be imposed, and in fixing the amount of the fine, the department shall consider the following factors:

  • The gravity of the violation, including the probability that death or serious physical or emotional harm to a patient has resulted, or could have resulted, from the pain-management clinic’s actions or the actions of the physician, the severity of the action or potential harm, and the extent to which the provisions of the applicable laws or rules were violated.
  • What actions, if any, the owner or designated physician took to correct the violations.
  • Whether there were any previous violations at the pain-management clinic.
  • The financial benefits that the pain-management clinic derived from committing or continuing to commit the violation.

2. Each day a violation continues after the date fixed for termination of the violation as ordered by the department constitutes an additional, separate, and distinct violation.

3. The department may impose a fine and, in the case of an owner-operated pain-management clinic, revoke or deny a pain-management clinic’s registration, if the clinic’s designated physician knowingly and intentionally misrepresents actions taken to correct a violation.

4. An owner or designated physician of a pain-management clinic who concurrently operates an unregistered pain-management clinic is subject to an administrative fine of $5,000 per day.

5. If the owner of a pain-management clinic that requires registration fails to apply to register the clinic upon a change of ownership and operates the clinic under the new ownership, the owner is subject to a fine of $5,000.

For more information about Florida pain management clinics, visit www.TheHealthLawFirm.com.

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