Painkiller Prescription under Increased Scrutiny from DOJ

August 11, 2016
Rachel V. Rose, JD, MBA
Rachel V. Rose, JD, MBA

Rachel V. Rose, JD, MBA, advises clients on compliance and transactions in healthcare, cybersecurity, corporate and securities law, while representing plaintiffs in False Claims Act and Dodd-Frank whistleblower cases. She also teaches bioethics at Baylor College of Medicine in Houston. Rachel can be reached through her website, www.rvrose.com.

Recent fines and arrests should show physicians there is heightened scrutiny on their prescribing of painkillers.

The opioid epidemic is at the forefront of the Department of Justice's (DOJ) agenda. Physicians should be aware of changing policies and heightened scrutiny of prescribing habits.

Food and Drug Administration (FDA) approved pharmaceuticals must have a legitimate medical purpose in order to be approved. Palliative care and post-operative pain relief are two scenarios where pain medications are deemed appropriate.  The problems arise when providers continue to write prescriptions after they become medically necessary.

Two recent DOJ actions highlight the rising epidemic and the pivotal role physicians play in the cycle. Last month, the U.S. Attorney's Office for the Southern District of Texas announced that a Houston area physician, Richard A. Evans and a co-conspirator, David Devido were convicted of 19 counts of distributing hydrocodone and oxycodone. "Some of the patients testified as to lax procedures at the clinic and the ease with which they were able to obtain prescriptions. Evans charged patients $200-$240 cash for an initial office visit, at which time they would obtain a first prescription. Refills are not permitted for narcotics. However, the jury heard that patients were told they could obtain a new prescription in 30 days without an office visit as long as the patient sent a money order to Evans for $200-$240. Patients were also told they could obtain a third prescription without an office visit as long as they again sent the payment to Evans."

Nearly simultaneously in the Eastern District of Louisiana, Shannon Ceasar, a family medicine physician, was arrested for the illegal dispensing of controlled substances and threatening both law enforcement officials and the state medical board. "As alleged, rather than doing no harm as a physician, Shannon Ceasar illegally dispensed Oxycodone into a community struggling with an epidemic of opioid addiction," stated U.S. Attorney Polite. 

These are two of just many examples where physicians are being found liable for their prescribing habits. When assessing patients, consider the setting, the condition, the length of time they have been on painkillers, the dosage, and other options. Taking precautions now could potentially save both a physician's reputation, as well as a patient's life.