Pain Management | The Health Law Firm Blog

Osceola County Commissioners Vote to Regulate Pain Management Clinics

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

On October 8, 2012, the Osceola County, Florida, Commissioners unanimously approved an ordinance that will regulate pain management clinics, according to the Orlando Sentinel. The ordinance will take effect on October 31, 2012, and will be in effect for 10 years.

Click here to see the ordinance passed at the Osceola County Commissioner’s meeting.

This is part of the continuing efforts by law enforcement to cut down on prescription drug abuse that plagues the state.

Ordinance Details.

The ordinance spells out what constitutes a pain management clinic, prohibits cash-only payments and requires pain management clinics to provide the names of employees to the county.

The ordinance also requires that clinics participate in the Department of Health’s (DOH) Prescription Drug Monitoring Program. That means pain management doctors will have to track and provide monthly reports on how many prescriptions are issued for controlled substances, and provide certain patient data, such as age ranges, race and gender.

Anyone caught violating these rules will be punished with the loss of their business tax receipt.

Any hospital or physician engaged in short-term treatment of pain (90 days or less) is exempt from the ordinance.

Seminole County Might Be Next.

Seminole County, Florida, Commissioners were set to vote on a similar ordinance at their meeting on October 9, 2012, but heard arguments from doctors. The ordinance will now be considered next month, according to the Orlando Sentinel.

Click here to read the entire article from the Orlando Sentinel.

Don’t Risk Your License. Read These Tips for Pain Management Doctors to Stay Inside the Law.

On top of following the new ordinance, Osceola County doctors and any doctor working in pain management, should read this article on tips to protect themselves from drug-seeking 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?

As a healthcare professional, what do you think of this ordinance? Please leave any thoughtful comments below.

Source:

Breen, David. “Osceola Ordinance Targets Pill Mills.” Orlando Sentinel. (October 9, 2012). From: http://www.orlandosentinel.com/news/local/breakingnews/os-osceola-pain-clinic-ordinance-20121009,0,2467210.story

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.

By The Health Law Firm|2024-03-14T10:00:38-04:00June 1, 2018|Categories: In the Know, In the News, Pain Management, The Health Law Firm Blog|Tags: controlled substances, defense attorney, defense lawyer, Department of Health (DOH), doctor, florida pill mills, Florida prescription drug abuse, Florida prescription drug crackdown, nurse, Osceola County pill mills, Osceola pain clinics, overprescribing, pain clinics, pain management, pharmacies, pharmacists, pharmacy, physician, pill mill, prescription drug monitoring program, prescription drug trafficking|Comments Off

Benchmark: DEA Conduct Resulted in Dismissed Charges

In light of the DEA‘s recent focus on Florida’s prescription drug trafficking problem, we wanted to discuss a former case in which the DEA‘s actions resulted in a favorable outcome for alleged drug dealers.

According to the Daily Journal, in 2004, U.S. District Judge Florence-Marie Cooper dismissed charges against three alleged methamphetamine dealers after an attorney to one of the defendants argued that the informant improperly relied on a “subinformant” to set up drug transactions in order for DEA agents to bust suspected dealers. According to the attorney, the informant used the intermediary to protect himself and the DEA from entrapment claims. Because of this, defense attorneys could not derive from the primary witness how the drug sale was arranged.

The attorney claimed that the subinformant contacted old friends and acquaintances in low-income areas and informed them of money to be made if they could find a large amount of methamphetamine for a prospective buyer. The informant posed as the buyer. By repeatedly calling these individuals to find a source for the methamphetamine transactions, the subinformant would turn the case over to the informant right before the transaction took place.

In this case, the DEA provided evidence only of the final interactions between the informant and the defendants. The attorney wanted to show that the entrapment actually occurred earlier, when the subinformant allegedly pressured the defendants to complete the methamphetamine deal.

In laying out the subinformant scheme in his discovery motion, the attorney cited phone records between the subinformant and the defendants in his case and in two other methamphetamine cases, U.S v. Parra, 03-CR- 121, and U.S. v. Corcuera, 03-CR-24. In the three cases, the subinformant had regular and frequent contact with the defendants, but the informant had very little or no contact with the defendants before the arrests.

Cooper agreed that the informant used an underling to keep the defense from analyzing the details of the drug deal. According to Cooper, using an intermediary to do the actual work assigned to the informant, allows the DEA to protect itself from inspection and from any charges of improper conduct.

“A law enforcement agency must not be allowed to shield itself from accountability by hiring someone outside of law enforcement who is free to violate citizens’ rights.” U.S. v. Alvarez, 02-CR-355.

With a subinformant, there is no requirement to monitor their actions. The DEA doesn’t tape, keep records or provide discovery for subinformants. The DEA has a history of failing to regulate its informants, including the nationwide Andrew Chambers scandal. An internal investigation launched by the DEA in 2000 revealed that Chambers repeatedly lied under oath over a 16-year period in which he earned almost $2 million to help bust drug felons.

However, even if informants were regulated it wouldn’t prevent subinformants from negotiating the transactions that entrap individuals.

These investigative measures by the DEA are also being used in operations directed at Florida pain clinics. In an effort to rid the state of pill mills, the DEA is using every tool to bust clinics, physicians and pharmacists that might be involved in a suspicious pain clinic.

For more information about legal matters concerning pain clinics, visit www.TheHealthLawFirm.com.

By The Health Law Firm|2024-03-14T10:00:26-04:00June 1, 2018|Categories: Health Care Industry, In the News, Pain Management, Pharmacy, The Health Law Firm Blog|Tags: attorney, dea, florida, informants, pain clinic, pill mills|Comments Off

Sarasota Sheriff Wants Patients to Waive HIPAA Privacy Rights

By Danielle M. Murray, J.D.

Law enforcement has been working hard to bust pill mills and stop prescription drug abuse. Pharmacists and pain management doctors are under intense scrutiny by various law enforcement agencies, including the Drug Enforcement Administration (DEA) and the Department of Health (DOH), for their role in giving out controlled substances.

“Doctor shopping” is a common phrase used to describe patients who see multiple doctors in a short period of time in an attempt to dupe doctors into giving them prescriptions for controlled substances. Doctors have been hampered somewhat by HIPAA privacy laws and have been unable to report suspicious patients to law enforcement agencies.

Sarasota County has a solution for that. According to the Sarasota Herald-Tribune, the county has devised a form, entitled “Authorization for Release of Protected Health Information,” and distributed it to pain management physicians. This form is to be signed voluntarily by patients and would allow doctors to discuss concerns with law enforcement. According to the sheriff’s office, the form intended to be limited to the patient’s name and the doctor’s concerns, and not to allow the release of medical records or other protected information.

To see the form for yourself, click here.

Physicians Not In Favor of the Form.

Critics say that the form is a blatant violation of patient rights and is simply a way for law enforcement to get around constitutional protections, such as search warrants.

It appears that some physicians agree with the critics. Not a single waiver has been returned to the Sarasota Sheriff’s Office.

In a Sarasota Herald-Tribune article, a pain management clinic owner states that his clients sign a contract that waives their rights if the clinic is approached by an investigator. He states “I understand HIPAA and am a firm believer in their rights, but if they’re doing something illegal, they’re jeopardizing my license.”

To see the full article from the Sarasota Herald-Tribune, click here.

Providers are at Risk.

The clinic owner is correct. Providers are at risk for their patients’ inappropriate prescription use. We have seen cases where providers are faced with criminal and civil liability when a patient overdoses on medication, whether intentional or not.

Click here to read a previous blog post on one Florida doctor who gave up his license due to allegations of malpractice and overprescribing pills.

In Orlando, Florida, a drug trafficking ring used fake prescriptions to access drugs at pharmacies around the city, and the responsible pharmacists are now facing disciplinary action for filling those prescriptions. There is a major crackdown underway to stop pill mills.

Recently the Polk County Sheriff’s Office issued 25 arrest warrants in connections to a pill mill investigation (click here to read the blog on this story). The big pharmacy chains are getting hit as well. A Walgreens distribution center in Florida was recently served with an immediate suspension order from the DEA (click here for that blog), and the DEA also pulled the controlled substance licenses from two Central Florida CVS Pharmacies (click here to read more).

Do Not Violate HIPAA.

Providers must be careful not to violate HIPAA. HIPAA violations may also result in administrative and civil action against you and your license, especially if the patient can prove they were damaged by the leak. A patient who was arrested due to the provider’s HIPAA violation would likely be able to show damages and cause action against the provider’s license.

You can read more on HIPPA violations on our two-part blog series. Click here to read part one and click here to read part two.

Contact a Health Law Attorney Experienced in Defending HIPAA Complaints and Violations.

The attorneys of The Health Law Firm represent physicians, medical groups, nursing homes, home health agencies, pharmacies, hospitals and other healthcare providers and institutions in investigating and defending alleged HIPAA complaints and violations and in preparing Corrective Action Plans (CAPs).

For more information about HIPAA violations, electronic health records or corrective action plans (CAPs) please visit our website at www.TheHealthLawFirm.com or call (407) 331-6620 or (850) 439-1001.

Comments?

What do you think of the “Authorization of Release of Protected Health Information” form? Do you think it goes too far? Please submit any thoughtful comments below.

Source:

Williams, Lee. “Sheriff wants doctors to have patients sign away rights.” Sarasota Herald-Tribune. (October 1, 2012). From: http://www.heraldtribune.com/article/20121001/ARTICLE/121009975/2416/NEWS?p=all&tc=pgall

About the Author: Danielle M. Murray is an attorney with 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.

Florida’s Pill Mills Still a Target

Last week, the DEA announced the results of enforcement efforts directed at Florida’s illegal prescription drug distributors.

According to the DEA, more than 100 individuals have been arrested in operations targeting pill mills in Florida, and the DEA, as well as Florida law enforcement, will continue to investigate and prosecute pain clinics, pharmacies and physicians who are contributing to Florida’s prescription drug trafficking epidemic.

Operation Pill Nation I, initiated in February 2011 in South Florida, has resulted in the arrest of 47 people, including 17 doctors and five clinic owners, and the seizure of more than $18.9 million in cash and assets. Furthermore, over 70 doctors, six pharmacy owners and five DEA Registered Controlled Substance Distributors have been stripped of their DEA registrations.

Operation Pill Nation II has resulted in enforcement actions against 22 individuals and one pharmacy allegedly involved in the illegal distribution of prescription drugs.

The DEA also announced the addition of a third Tactical Diversion Squad in Florida. Based in Orlando, this new group will be responsible for investigating prescription drug diversion in Central Florida.

According to the Orlando Sentinel, this new squad was created solely to investigate the illegal use and distribution of prescription drugs in the Orlando area. Currently, the Orlando squad is investigating doctors and pharmacies, their first case involves a Winter Park pharmacy.

Howell Branch Road’s The Medicine Shoppe is under investigation. It’s pharmacist is accused of providing more than 15,000 oxycodone pills that were illegally distributed.

Coinciding with the DEA’s announcements, was the investigation of Tampa pill mills. DEA agents, and Florida state and local law enforcement executed six search warrants and served two immediate suspension orders to a doctor and a pharmacy in Tampa. Immediate suspension orders revoke authority to dispense or prescribe controlled substances.

Earlier this year, the DEA commissioned a pill mill hotline in Florida. This 24-hour pill mill tip line and e-mail address allow the public to provide information on suspicious pain clinics. Additionally, laws targeting pill mills were passed that makes it much more difficult to dispense narcotics at a clinic. However, the DEA’s raids will continue in order to eradicate Florida’s pill mill problem.

For more information on Florida pain clinics and the laws and legal matters that impact them, visit www.TheHealthLawFirm.com.

George Indest is an attorney, board certified by the Florida Bar in Health Law, who represents health care professionals and providers, including pain management clinics and pain management physicians.

Most Physicians Not Using the Prescription Drug Monitoring Program

By Danielle M. Murray, J.D.

The Florida Prescription Drug Monitoring Program is apparently collecting dust as physicians are choosing not to use it. The Tampa Bay Times reported on October 5, 2012, that as few as one in twelve doctors have ever used the database. That is about eight percent (8%) of all physicians. Approximately fourteen percent (14%) of physicians are registered for the database.

Click here to read the entire story from the Tampa Bay Times.

Physicians Don’t Want to Use the Database.

Physicians interviewed for the article said the problem is that database use is not mandatory. Physicians are not required to review the database prior to accepting a new patient, or prior to giving out a prescription. Some physicians said they would ask the pharmacy or check the local arrest records if they had a suspicion that the patient was abusing drugs or “doctor shopping.”

One potential reason that physicians may not check the database is simply that they don’t want to know. If they know a patient is abusing prescription drugs, then that patient has to be sent away, and that is a loss of business. Another reason could be some doctors may not know the database exists, and other doctors may simply be too busy to bother.

In Some States the Database Is Mandatory.

The prescription drug database in Kentucky had a similar usage problem until the state made it mandatory for physicians to check the database. A mandatory law in Ohio resulted in shock when physicians saw the reality of the large number of prescription drug abusers in their practices.

For the foreseeable future, using the database will not be mandatory for physicians. However, physicians should consider using the database, or otherwise remaining vigilant to avoid being labeled an overprescriber.

For legal tips for working with pain patients, click here.

Does the Database a Make it Easier to Prosecute?

From my perspective, I have seen the database in Florida used mostly as a tool for prosecution of pain management physicians and pharmacists. Even in cases where the pharmacist has been the one to notify the authorities of suspected forged prescriptions and where the pharmacist has cooperated in prosecuting the criminals, I have seen this database cited as evidence against him or her. I do not believe this is what the legislation intended.

Contact an Attorney Experienced in Department of Health (DOH) and Drug Enforcement Administration (DEA) Investigations.

As a health care professional, you may one day be charged with overprescribing narcotics or even criminally charged in the death of a patient due to their drug habits. If you are contacted by the Department of Health (DOH) or the Drug Enforcement Administration (DEA), do not sign anything or make any statements to anyone. Call an experienced health law attorney to learn about your rights in such a case.

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

Comments?

As a physician, do you use the Florida Prescription Drug Monitoring Program? Why or why not? Please leave any thoughtful comments below.

Source:

Cox, John Woodrow, “Florida Drug Database Intended to Save Lives is Barely Used by Doctors.” Tampa Bay Times. October 7, 2012. http://www.tampabay.com/news/health/florida-drug-database-intended-to-save-lives-is-barely-used-by-doctors/1255062

“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.

By The Health Law Firm|2024-03-14T10:00:39-04:00June 1, 2018|Categories: DEA, Department of Health, In the News, Pain Management, Pharmaceutical Drugs, Pharmacy, The Health Law Firm Blog|Tags: board of medicine, controlled substances, criminal, dea, DEA investigation, defense attorney, defense lawyer, department of health, doctor, doh, drug enforcement administration, Florida prescription drug abuse, Florida prescription drug crackdown, nurse, overprescribing, pain management, pharmacies, pharmacist, pharmacist license, physician, pill mill, pill mill laws, prescription drug trafficking|Comments Off

From the DOH: Attention Pain-Management Clinics

From the Florida Department of Health:

Florida law requires pain-management clinics report specific data to the Board of Medicine. The designated physician shall report on a quarterly basis the following data:

a. The number of new and repeat patients seen and treated at the clinic who are prescribed controlled substance medications for the treatment of chronic, nonmalignant pain.

b. The number of patients discharged due to drug abuse.

c. The number of patients discharged due to drug diversion.

d. The number of patients treated at the pain clinic whose domicile is located somewhere other

OSTEOPATHIC PHYSICIANS:
Your next reporting period is the month of October and you will be reporting for the period July 1, 2011 – September 30, 2011.

ALLOPATHIC PHYSICIANS:
Your first reporting period is the month of October and you will be reporting for the period July 1, 2011 – September 30, 2011.
New Service Available for Data Reporting

We have now made data reporting easy for you with an online service. Simply follow these steps:

Go to http://www.doh.state.fl.us/mqa/index.html
Click on Login on the right side of the screen
The Designated Physician will login under his/her user id and pass code (same one used to renew medical license). If the physician does not remember the user name or password, have him/her go to the login web page. From there, the physician will select Get Login Help. If the physician is still unable to get logged in, then have him/her call (850) 488-0595 for assistance.
Once logged in, select the clinic data will be reported for and follow the online instructions to input the data.
Be sure to print your submission when prompted.

Recent changes to Section 458.3265 and Section 459.0137(2)(e), Florida Statutes, which became effective July 1,2011, require Medical and Osteopathic physicians to advise the Board of Medicine within 10 calendar days of beginning or ending practice at a pain-management clinic.

We have made this easy for your physicians. By going to www.doh.state.fl.us/mqa physicians can login to Medical Quality Assurance Online Services and create a relationship with your clinic.

Simply have the physician login using his/her user name and password (same one used to renew the medical license ). If the physician does not remember the user name or password, have him/her go to the login web page. From there, the physician will select Get Login Help. If the physician is still unable to get logged in, then have him/her call (850) 488-0595 for assistance.

Once logged in, follow these instructions to establish the relationship between the physician and the pain-management clinic:

Select Maintain Related Licenses from the list on the left hand side of the screen
Complete the online instructions for adding (or deleting) relationships
Be sure to print the page when you are done for your records

At any time, the physician may use the View Relationship Summary located on the same web page to see a list of all relationships.

By The Health Law Firm|2024-03-14T10:00:27-04:00June 1, 2018|Categories: Department of Health, Pain Management, The Health Law Firm Blog|Tags: doh, florida, laws, pain management clinics|Comments Off

Tightened Restrictions Placed on Pain Management Clinics in Seminole County

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

Seminole County, Florida, is the latest county to adopt tightened regulations for pain management clinics. On November 13, 2012, County Commissioners unanimously voted to adopt the ordinance enacting Chapter 186 of the Seminole County Code to establish regulations regarding pain management clinics.

Click here to read the entire Seminole County Ordinance.

County Commissioners hope these new regulations will aid law enforcement in fighting illegal pill mill operations in Florida.

Officials Believe Restrictions Will Help Prevent Overprescribing.

The ordinance requires clinics to get a license, produce monthly reports on how many prescriptions are issued for controlled substances and report patient information, such as a patient’s address. This only applies to practices where doctors issue prescriptions for painkillers such as oxycodone to more than 20 patients a day. It does not pertain to hospitals and other major medical facilities.

Anyone violating the regulations can be charged with a misdemeanor and lose his or her business license.

Restrictions Have Doctors Upset.

The Orlando Sentinel interviewed a Boca Raton doctor who specializes in pain management. The doctor reportedly believes the regulations are helping to curb drug overdoses, but stated the regulations also limit legitimate board-certified medical specialists. He believes many Florida doctors are ready to move out of the Sunshine State and go to another state with fewer regulations.

To read the Orlando Sentinel article, click here.

Other Cities and Counties in Central Florida That Have Voted to Regulate Pain Management Clinics.

At the end of October 2012, Osceola County Commissioners voted to adopt a similar ordinance. I wrote previously wrote about that story, click here to read that blog.

In addition to Osceola County, Winter Park, Sanford, Oviedo and Maitland have opted to enact ordinances that regulate pain management clinics’ location and operation.

Contact Health Law Attorneys Experienced with 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?

As a healthcare professional, what do you think of this ordinance? Have you thought about leaving Florida due to the new regulations? Please leave any thoughtful comments below.

Sources:

Comas, Martin. “Seminole Tightens Regulations for Pain Management Clinics.” Orlando Sentinel. (November 13, 2012). From: http://www.orlandosentinel.com/news/local/seminole/os-pain-management-clinics-seminole-20121112,0,7626282.story

Seminole County Government. “Ordinance Chapter 186.” Seminole County Government. (November 13, 2012). From: http://www.thehealthlawfirm.com/uploads/Pain%20Management%20Ordinance.pdf

“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.

By The Health Law Firm|2024-03-14T10:00:40-04:00June 1, 2018|Categories: In the Know, Pain Management, The Health Law Firm Blog|Tags: controlled substances, defense attorney, defense lawyer, Department of Health (DOH), doctor, florida pill mills, Florida prescription drug abuse, Florida prescription drug crackdown, nurse, Osceola County pill mills, overprescribing, pain clinics, pain management, pharmacies, pharmacists, pharmacy, physician, pill mill, prescription drug monitoring program, prescription drug trafficking, Seminole County pain clinics, Seminole County pill mills|Comments Off

Kissimmee, Pine Hills Pain Clinics Investigated

Clinics in Kissimmee and Pine Hills are under investigation. A doctor involved with the clinics is accused of over-prescribing painkillers and other addictive medicine, according to the Orlando Sentinel.

Drug agents with the Metropolitan Bureau of Investigation collected evidence and talked to patients at the Miracle Health Center/Pine Hills Medical Center, and at the Keneday Medical Clinic.

This doctor has had previous complaints filed against him by The Department of Health (DOH), and he may now face an emergency suspension order (ESO).

Criminal charges have not yet been filed but are expected.

The doctor is under investigation for allegedly prescribing more than 800,000 oxycodone tablets to patients in the last two years.

According to DOH records, the doctor has previously been accused of improperly prescribing painkillers to patients, and the criminal investigation concerning his over-prescribing has been in the works for months.

This investigation and others across Florida are part of a statewide effort to curb Florida’s prescription drug problem. For more information about pain clinics and legal matters involving pain management, visit www.TheHealthLawFirm.com.

By The Health Law Firm|2024-03-14T10:00:27-04:00June 1, 2018|Categories: In the News, Pain Management, The Health Law Firm Blog|Tags: florida, investigation, medical clinic, orlando, pain clinic, pill mill, pine hills|Comments Off

Hydrocodone Combination Drugs Could Be Reclassified to Schedule II Category of Controlled Substances

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

A Food and Drug Administration (FDA) advisory committee voted 19 to 10 in favor of moving hydrocodone combination drugs from schedule III into the more restrictive schedule II category of controlled substances. According to a number of different sources, on January 25, 2013, the committee presented this recommendation to the FDA. If approved, hydrocodone combination drugs, such as Vicodin, will be harder for physicians to prescribe.

The advisory committee met because the Drug Enforcement Administration (DEA) is requesting the FDA to approve the reclassification of hydrocodone combination products. The DEA wants to help curb the growing number of people across the country addicted to painkillers.

Click here to read an FDA briefing document given to the advisory committee.

It is now up to the FDA to decide whether or not to implement the advisory committee’s decision as to whether hydrocodone combination drugs will stay labeled as schedule III controlled substances or move to schedule II controlled substances. If medications containing hydrocodone are moved to schedule II, they will be in the same category as the widely abused oxycodone.

Hydrocodone Abuse is Serious.

Currently, hydrocodone products are the most widely prescribed drugs in the U.S., according to an article on MedPage Today. Records show that painkiller abuse kills more people in America than heroin and cocaine combined. The DEA argues that since these drugs are so frequently abused, they should be more tightly controlled.

To read the MedPage Today article, click here.

What You Need to Know as a Health Care Provider.

This change would have wide-spread consequences for health care professionals, especially doctors and pharmacists. Under the schedule II category of controlled substances, physician assistants (PAs) and nurse practitioners would no longer be legally allowed to prescribe hydrocodone combination drugs.

If the recommendation is accepted, it would be more difficult for patients to obtain refills on hydrocodone combination drugs. Refills without a new prescription, faxed prescriptions and prescriptions called in by telephone would all be banned. Only written prescriptions from a doctor would be allowed.

If the recommendation is adopted, much stricter scrutiny on the purchasing, prescribing, retailing and use of these medications can also be expected. Prosecutions and administrative actions can also be expected to follow.

The FDA is also debating the DEA’s request to limit prescriptions of hydrocodone combination pills to a 90-day supply instead of the current regulations which permit five refills within six months.

Arguments Heard Against the Reclassification.

According to an article in The New York Times, many opponents spoke against the recommendation. Advocates for nursing home patients argued that weak and elderly residents with chronic pain would have to make a difficult trip to see a doctor just to get a prescription refilled. Click here to read The New York Times article.

Some committee members questioned if there was another option to consider versus changing the scheduling. They questioned whether greater use of e-prescribing and Prescription Drug Monitoring Programs, as well as better education efforts for clinicians and patients would be better solutions for the drug abuse epidemic.

Now it remains to be seen how the FDA will interpret the advisory committee’s recommendation.

Florida’s Prescription Drug Abuse Epidemic.

Florida law enforcement including the DEA, the Federal Bureau of Investigation (FBI), and Department of Health (DOH) all seem to be having a hard time keeping up with prescription drug abuse in Florida.

We have written a number of blogs on the abuse of narcotics in Florida. See our blog on a fake prescription ring busted in Osceola County, and a Central Florida nurse accused of illegally obtaining prescriptions for painkillers, for example. Check our website for similar blogs.

Pharmacists, pharmacies, legal distributors and physicians are often too caught up in the frenzy to stem prescription drug abuse and to eliminate “pill mills.”

Call Experienced Health Law Attorneys for Your Legal Needs.

The Health Law Firm routinely represents pharmacists, pharmacies, physicians, nurses and other health providers in investigations, regulatory matters, licensing issues, litigation, inspections and audits involving the Drug Enforcement Administration (DEA), Federal Bureau of Investigation (FBI), Department of Health (DOH) and other law enforcement agencies. Its 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.
Sound Off.

As a health care professional, do you think hydrocodone products should be labeled as a schedule II controlled substance? What are the positive and negative effects of this decision? Please leave any thoughtful comment below.
Sources:

Fiore, Kristina. “FDA Panel Votes for Tighter Controls on Vicodin.” MedPage Today. (January 25, 2013). From: http://bit.ly/X8qlsu

Tavernise, Sabrina. “F.D.A. Likely to Add Limits on Painkillers.” The New York Times. (January 25, 2013). From: http://www.nytimes.com/2013/01/26/health/fda-vote-on-restricting-hydrocodone-products-vicodin.html?_r=0
About the Authors: Lance O. Leider is an attorney with 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 Avenue, Altamonte Springs, Florida 32714, Phone: (407) 331-6620.

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.

By The Health Law Firm|2024-03-14T10:00:45-04:00June 1, 2018|Categories: Administrative law, Department of Health, In the Know, Pain Management, The Health Law Firm Blog|Tags: administrative hearings, defense attorney, defense lawyer, Department of Health (DOH), doctors, Drug Enforcement Administration (DEA), Federal Bureau of Investigation (FBI), Food and Drug Administration (FDA), hydrocodone, license defense counsel, nurse practitioner, pharmacists, physician assistants (PAs), physicians, schedule II controlled substances, schedule III controlled substances|Comments Off

CVS Refuses to Fill Prescriptions For Some Florida Doctors

The crack down on Florida pill mills continues with CVS pharmacies notifying some doctors that they no longer will fill their prescriptions for certain narcotic medications.

According to Health News Florida, this new policy appears to be limited to Florida, but CVS has not clearly stated what is being used to determine which doctors can have their prescriptions filled for which drugs (though oxycodone definitely appears to be a target).

The Florida Academy of Pain Management, released a letter via email alert that was sent by CVS to a Central Florida physician. The physician who received the letter had never been disciplined by state medical regulators and had extensive pain management training. The email alert, stated that CVS appears to “have initiated an internal program where they are profiling physicians’ controlled substance prescribing habits and possibly their patients’ prescriptions.”

A spokesperson for CVS said that the company is refusing to fill prescriptions for a “small number of Florida physicians” and is supporting measures by federal and state law enforcement officials to “keep controlled substances out of the wrong hands.”

While some pain physicians have not received a letter, they have been told by patients that they are being analyzed by CVS for writing prescriptions for narcotics, especially a specific combination of medications with high potential for abuse — oxycodone, Xanax and Soma. This trio has been widely prescribed at pill mills.

Although the actions taken by CVS may be extreme, other pharmacies and pharmacists are increasingly hesitant about filling certain prescriptions. With pain killers now responsible for more than seven overdose deaths a day in Florida, there is reason to be cautious, and pharmacists are professionally obligated not to fill prescriptions they find questionable.

However, stricter regulations on pain clinics, pain management physicians and prescription writing has left patients who face real pain unable to obtain necessary medication. Legitimate patients are being punished for the actions of a small group of corrupt practitioners.

Florida must find a way to get out of the Catch-22 in which the state is currently entangled. Yes, prescription drug abuse is a problem, but so is the real pain faced by many patients.

For more information on legal matters concerning pain clinics and pain management physicians, visit www.TheHealthLawFirm.com.

By The Health Law Firm|2024-03-14T10:00:27-04:00June 1, 2018|Categories: Department of Health, Health Care Industry, In the News, Pain Management, Pharmacy, The Health Law Firm Blog|Tags: CVS, florida, pain clinics, pain management, pain physician, pill mills|Comments Off