DOJ Tricks Used in Prescribing Prosecution

DOJ Tricks Used in Healthcare Fraud and Prescribing Prosecution – by Ron Chapman II on twitter: @HealthcareDef – June 2020

This is a sickening view into the murky drug-war tactics that our doctors have to face any time they prescribe opioids for chronic, ongoing pain.

I have had the opportunity to represent hundreds of healthcare professionals facing scrutiny from the federal government for healthcare fraud and drug trafficking. From this perspective I have been able to see the evolving playbook utilized by the DOJ to prosecute physicians.

Here are ten tricks used by the DOJ to convict physicians and other healthcare professionals for charges of healthcare fraud and unlawful prescribing.  

Pain Patients Angry and Fearful about Govt. Interference

Charges against pain doctor reveal undercurrent of anger, angst among patients at federal government – cleveland.com – By John Caniglia, The Plain Dealer – Jul 2020

For more than 25 years, patients suffering in pain sought out Dr. William Bauer. They had crippling injuries from car crashes and work accidents, chronic headaches and debilitating spine issues. At 83, Bauer had a practice in Sandusky that cared for many of the same patients for 10 to 20 years.

Federal prosecutors have accused the neurologist of illegally prescribing thousands of opioid pills between 2015 and 2018. 

But realistically, “prescribing thousands of opioid pills” for pain patients is medically appropriate. These drug-warriors should do the math before they toss around meaningless phrases like this just to create drama.

Doctor Fights State Over Opioid Tapering Ethics

Doctor Declines State’s Offer In Battle Over Opioid Tapering Ethics – Redheaded Blackbelt

Here’s another courageous doctor fighting back for us, staring down the medical board, refusing to taper her patients faster than medically appropriate, no matter what the medical board or the DEA says.

In an update with Humboldt Last Week, Arcata doctor Connie Basch said she’s declined an offer from the Medical Board of California to receive probation in exchange for an admittance of guilt in her case involving the overprescription of opioids.

The complaint against Basch surrounds what she would call five “legacy” patients that came to her several years ago on high doses of opioids and anti-anxiety meds.  

A new opioid crisis: beware lest you get what you asked for

America’s new opioid crisis, Politico – By SARAH OWERMOHLE – Apr 2020

This story definitely falls into the category of “beware lest you get what you asked for”.

The DEA has restricted the production of opioids by 50% over the last four years without concern for their medical use. They seemed to believe that all opioids are the same, whether bought, cooked, and injected in the street or prescribed by a doctor.

In their opinion, there were “too many” legitimate opioids being manufactured, so they set out to curtail that by cutting production quotas.

They were successful. They got what they asked for, and now we don’t have enough medication during a crisis.  And people are still overdosing just like before, with illicit opioids. 

DEA to raise quotas of opioids for COVID-19 care

DEA takes additional steps to allow increased production of controlled substances used in COVID-19 care – April 07, 2020

The Drug Enforcement Administration (DEA) announced today that it is increasing Aggregate Production Quotas available to pharmaceutical manufacturers for the production of controlled substance medications that are in high demand due to the coronavirus (COVID-19) pandemic. 

With its chokehold on necessary medicine, the DEA is now endangering the very citizens they claim to be protecting. Their bungled “drug-war” has become a war on science, public health, and honest reporting.

This is a turnaround from just a week ago when the DEA claimed that supplies were “sufficient”: Opioid supply crunch for U.S. coronavirus patients

Opioid supply crunch for U.S. coronavirus patients

Exclusive: Opioid supply crunch for U.S. coronavirus patients prompts appeal to relax limits – Reuters – Dan Levine – April 2, 2020

U.S. doctors running out of narcotics needed for COVID-19 patients on ventilators are asking the federal government to raise production limits for drugmakers, according to a letter seen by Reuters, after national quotas had been tightened to address the opioid addiction crisis.

It’s becoming ever more clear that the DEA has become an unacceptable impediment to healthcare delivery. They have no business regulating the practice of medicine when their purpose is the enforcement of the latest prohibition against an essential medicine.

The U.S. government sets annual limits on how much tightly regulated narcotics can be produced by pharmaceutical companies, and then allocates portions to various manufacturers.  

DEA Branching Out Into Regulating Medicine

Is the DEA Branching Out Into Regulating Medicine? | Cato @ Liberty – By Jeffrey A. Singer – Sep 2019

This truly seems to be happening. Until now, the “practice of medicine” was carefully defined and defended by the AMA and anybody who tried to step between doctors and their patients was hauled into court.

This time around, the AMA has been noticeable mainly by their silence in the face of this assault on the integrity of medicine, when politicians and law enforcement agencies are controlling what kind of medical care doctors are “allowed” to provide their patients.

After a few brave individual doctors had been pushing back for years, and when the CDC and FDA were close to issuing their own statements warning against the abandonment and forced tapers imposed on patients, only then did the AMA finally release its own statement advising against such barbaric (and virtually illegal, in the case of patient abandonment) practices. 

Prescription Opioid Diversion by Theft

Prescription Opioid Diversion & Abuse – a powerpoint presentation by John J. Coleman, PhD, DEA Assistant Administrator for Operations – Mar 2016

This is an interesting glimpse into how the DEA sees the “opioid crisis” as arising from diversion of medication prescribed to pain patients, instead of being fueled by the massive thefts from the supply chain.

The workers handling all those pills aren’t as monitored and scrutinized nearly as carefully as individual patients, who have to submit to random pill counts.

Drug Diversion: How It’s Done…

Doctor Shoppers (casual & pro): Probably account for more diversion than estimated

No: PDMP’s have shown there are fewer “doctor shoppers” than expected.

DEA: No Guidance for Opioid Wholesalers

The DEA expects opioid supply-chain wholesalers to report “suspicious” orders without the necessary information which is collected, but not shared, by the DEA itself. Below is a statement given by an opioid wholesaler to the House of Represenatives in May 2018 that explains the problem:

“WRITTEN STATEMENT OF JAMES CHRISTOPHER SMITH FORMER PRESIDENT AND CHIEF EXECUTIVE OFFICER, H.D.SMITH LLC BEFORE THE SUBCOMMITTEE ON OVERSIGHT AND INVESTIGATIONS COMMITTEE ON ENERGY AND COMMERCE U.S. HOUSE OF REPRESENTATIVES PRESENTED MAY 8, 2018″

H.D.Smith was only one part of a complex supply chain, and we could not see all the information up and down the chain that could flag a potential problem.  

Illegal drug classifications based on politics not science

Illegal drug classifications are based on politics not science – report | Global development | The Guardian –Karen McVeigh – @karenmcveigh – Jun 2019 

Illegal drugs including cocaine, heroin and cannabis should be reclassified to reflect a scientific assessment of harm, according to a report by the Global Commission on Drug Policy

The commission, which includes 14 former heads of states from countries such as Colombia, Mexico, Portugal and New Zealand, said the international classification system underpinning drug control is “biased and inconsistent”.

A “deep-lying imbalance” between controlling substances and allowing access for medicinal purposes had caused “collateral damage”, it said.