A Special Bulletin
By Bernard M. Cassidy
FORT LAUDERDALE, FL (October 12, 2011) The State of Florida and DEA, after spending the last two years dedicating substantial resources to eliminating so called “pill mills” have now turned considerable attention to pharmacies, particularly pharmacies associated with pain management clinics, and targeting pharmacies dispensing of what is perceived as large quantities of opioids such as oxycodone.
SOUTH FLORIDA (AUGUST 18, 2011) – The new legislation designing to halt the sale of painkillers and close down the largest pill mill industry in the nation, doesn’t target the real source of the problem it seems. Pharmacies, not doctors, sell about 80 percent of the narcotic painkillers that people get their hands on through doctor shopping.
A new state-wide database may cut that problem down, but the startup of the database has been stalled. Officials have rededicated their efforts to have the database up and running later this year. The database is designed to catch patients who jump from one doctor to the next, or who “doctor shop,” in order to keep their high prescription narcotic use under wraps. When a patient gives their prescription to a pharmacist, their name, doctor name and prescription drug information will be entered into a computer system. The system will flag any patients who attempt to buy more narcotics within too short a period of time.
SOUTH FLORIDA (AUGUST 17, 2011) – Despite new legislative efforts with stricter regulations on pain clinics and dispensing of narcotic painkillers, deaths from oxycodone overdoses continue to rise in South Florida. Governor Rick Scott believed the state’s effort to make it harder for pill mills to operate in the state would decrease the number of deaths from narcotic painkillers. The numbers continue to rise.
The number of oxycodone-related deaths rose from 2009 by about 8 percent. Jim Hall, director of the Center for the Study & Prevention of Substance Abuse at Nova Southeastern University in Davie, feels there won’t be much improvement in the numbers until late in the year.
TAMPA, FLORIDA (AUGUST 1, 2011) – The Office of the Inspector General in the Department of Health and Human Services is now calling Tampa, “ground zero for pain clinics and prescription drug diversion.” It seems Tampa has taken South Florida’s place in the number of pill mill clinics supplying the illegal painkillers trade. Chris Rule of the Hillsborough County Sheriff’s office said it likens back to the crack cocaine problem in the 1990s.
The death toll is rising. Out of 277 drug-related deaths in 2009, 199 of those could be attributed to an oxycodone overdose or other cocktailed drugs. And Rule further states that opiate-based painkillers are the easiest drugs to buy on the street these days. In order for the patients or dealers to get the drugs from the clinic, they need only submit to a blood pressure screening or an MRI.
Of the 70 pain clinics located in the county, 35 are in Tampa. Rule says he doesn’t feel every clinic is illegal trading in prescription painkillers. Some operate within the confines of the law and “some are shady,” he says.
PITTSBURGH, PENNSYLVANIA (JULY 29, 2011) – Three employees, including the medical director and a former registered nurse of the Allegheny Women’s Center were arrested and charged with several crimes involving prescription drug mishandling.
Dr. John Barrett, the clinic’s medical director allegedly wrote prescriptions under Dr. Alton Lawson’s DEA number for years, which Dr. Lawson permitted. One drug in particular, Diethylpropion, was used by another clinic employee, Mark Wagner, for his depression and anxiety. The drug actually treats obesity.
Over the years, Wagner received prescriptions for 20,000 pills. Wagner did not have a doctor/patient relationship with either doctor. Wagner viewed the drugs as payment for extra services he provided for the clinic, such as working overtime. Wagner also allegedly sold prescription tablets to a former registered nurse, Karen Kane who also received several bottles of the same drug.
WASHINGTON D.C. – Health care fraud task forces are turning their attention to the executive level of health care enterprises. In an effort to crackdown on those who would perpetrate health care fraud, investigators have begun aiming their efforts at the owners and operators of drug companies, medical device manufacturers, nursing home chains and any health care business involved with Medicare and Medicaid. Senior executives could find themselves facing criminal charges even if they had no knowledge of their company’s activities, but were in a position to stop it.
Prosecutors have become fed up with repeated violations, which cost taxpayers more than $60 billion per year and have decided to use enforcement tools that have long been in place, but simply not used. A simple writing of a check to repay the federal funds and a promise not to repeat the offense have been used too often, so now corporate executives must pay closer attention to how their company is billing Medicare and Medicaid lest they find themselves in hot water with the feds.
The crackdown may result in a company’s ban from participating in Medicare and Medicaid reimbursements, but the power to ban lies solely with the inspector general, not a judge. The FDA has also begun using the “Park Doctrine” which allows prosecutors to bring criminal charges against executives. Any corporate officer in the chain of command could charged with a criminal misdemeanor if found to have the ability within their power to prevent the fraud.
FORT LAUDERDALE, FLORIDA – Florida’s Governor Rick Scott signed the “pill mill bill” into effect last Friday. The legislation is aimed at the pill pushing clinics that spawn drug addicts, dealers and deaths. Scott wants to end Florida’s “dubious distinction” as the “Oxycodone Capital” of the nation.
Particulars of the bill, effective July 1, include a ban on pill sales at doctor’s offices and clinics, an automatic suspension of six months for doctors who overprescribe, and penalties for pharmacies and drug wholesalers who fail to report suspicious prescribing activities. By October, the state will have a computer database to log all pain pill prescriptions, making it easier for doctors, pharmacists and law enforcement to monitor illegal activity.
The bill is not without its flaws and exempts pain clinic doctors and anesthesiologists with extra training in pain therapy. Some of these professionals have participated in pill mill activities in the past. Present at the bill signing (done at several different police stations throughout Florida), were members of law enforcement as well as political leaders, including the Mayor of Orange County, Theresa Jacobs and Dr. Jan Garavaglia, the Orange-Osceola Medical Examiner. Also in attendance, relatives who had lost loved ones to pain pill overdoses.
PALM BEACH COUNTY, FLORIDA (May 27, 2011) – Pill mill clinics of Florida provide hundreds of thousands of illegal prescription drugs per year, and law enforcement, from the local and state police to the FBI and DEA, collaborate on full-time task forces to crackdown on the illegal distribution of drugs. Last week, however, the Palm Beach County Sheriff’s office and State Attorney Michael McAuliffe targeted pill mills from another perspective, education.
On May 27, the second annual Palm Beach County Prescription Drug Abuse and Pain Clinic Summit was held, with law enforcement, health care professionals, advocates and State Senator Lizbeth Benacquisto, R-Fort Myers in attendance. Benacquisto believes the summit allows law enforcement to prevent pill mill activities before they start and lessen the need for the constant chase of the perpetrators.
Pill mills thrive on patients who become addicted to prescription pain killers typically after having a legitimate need for the medication. The most often abused drug, Oxycontin, carries a high probability of addiction, and ethical doctors cut off patients if the doctor suspects abuse or addiction. Patients often then search for pill mills, run by doctors who abuse their prescription writing privileges and their DEA license to prescribe narcotic pain killers. A crooked doctor can make a lot of money simply by writing illegal prescriptions. “They are doing it out of greed,” states Dr. Steve Rosenberg.
Fort Pierce, FL – Homero Izquierdo Ruiz could have been imprisoned for a maximum of 10 years for violating Title 18, Section 1347 of the United States Code. Instead, he was sentenced to serve two 39-month incarceration terms (which will run concurrently) on two counts of health care fraud. At the conclusion of his imprisonment, Ruiz will also have three years of supervised release. As restitution, Mr. Ruiz will also pay more than $1,000,000 to Medicare. Click here to read the official court judgment.
Stipulations of Fact in the Guilty Plea
According to the Criminal Complaint filed in US District Court for the Southern District of Florida, Fort Pierce Division, after purchasing Physical Therapy and Fitness in Martin County, Homero Izquierdo Ruiz, 46, of Miami, initiated fraudulent billing practices. The physical therapy practice received reimbursement for its rehabilitation services from Medicare Part A. In eight months from January to August 2010, the practice netted more than $500,000 in reimbursements from Medicare.
PALM BEACH COUNTY, FLORIDA (May 26, 2011) – State Attorney Michael McAuliffe and Sheriff Ric Bradshaw will co-host Palm Beach County’s Prescription Drug Abuse and Pain Clinic Summit. The event takes place today, May 26, from 9 a.m. to 12:30 at the Clayton Hutcheson Agricultural Center.
The summit focuses on prevention of the consequences surrounding addiction and prescription drug dealing before they occur.
This is the summit’s second year and since that time the number of pain clinics dealing in the illegal prescription drug trade has dropped significantly; due in part to law enforcement’s wide-sweeping raids.
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