Prescription Drug Abuse Looks To Be A Focus of More Criminal Investigations

Pain Management, among other forms of drug related treatment, has been receiving substantial scrutiny lately. Unlike some other fraud or abuse investigations predicated upon whether services were provided or claims were fraudulent, the primary focus is the treatment, why the physician is issuing particular prescription(s). In prescribing medications, are physicians treating patients or are they merely feeding client drug habits for a price?
The DEA has been aggressive in investigating and prosecuting some physicians for over prescribing medications. However, on the legislative side, federal law has lagged because the issue relates the practice of medicine itself, which is a state issue, not federal. The Ryan Haight Act, to outlaw most internet pharmacy operations, is a notable exception. The statute specifically prohibits a physician from issuing a prescription for a controlled substance where the internet is involved unless there has been at least a physical examination of that patient. Many states have tightened up statutes related to certain types of treatment: pain, weight loss, drug abuse treatment among others.
In conducting their investigations the authorities are relying more and more on numbers as an indicator of guilt, that is the amount of drugs prescribed and ordered. This year, Florida joined a number of other states in passing legislation to track controlled substance prescriptions by all providers in the state. The purpose is investigative, to focus in on physicians and patients, to prevent over prescribing of medications, prevent doctor shopping and to shut down purported “pill mills.”
In addition, the DEA, uses its own system, ARCOS (Automation of Reports and Consolidated Orders System), to track commercial purchases of controlled substances by distributors and providers. Providers and wholesalers who purchase large quantities of particular controlled substances, such as Oxycontin, can generally expect to receive some level of scrutiny from the DEA based upon the ARCOS reports. In many cases this can lead to a form of blacklisting, wherein wholesalers, after being questioned or warned about a particular provider, refuse to sell that provider out of fear for their own licenses.
While there is a substantial focus on Florida , Broward County alone was indicated to have 180 pain management clinics in a recent Sun Sentinel article, prompting the legislation and a visit from the National Drug Czar. However, the law enforcement efforts are cropping up all over on the state and federal level. Interestingly, days after a speech by the National Drug Czar in Colorado , raids were conducted by Federal officials on the offices of several doctors, both of whom have had other problems.
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