Pill mills: Investigations and consequences
Pain clinics are abundant in many states and so are pill mills. In New York, Ohio and Chicago recent pill mill investigations caused raids and arrests of doctors and staff complicit in running pill mills where the doctors write prescriptions for pain narcotics like they are giving out candy at Halloween. The Drug Enforcement Administration is particularly focused on pill mills in high concentration in Florida and Texas, as the narcotics are getting stronger and people are getting addicted and dying from pain pill overdoses.
If you are an undercover investigator looking for a pill mills to add to the takedown list, you may be aware of some of the recent investigations and raids of pain clinics focused on cash and greed over patients and health. The cable television program, American Greed, recently reported on an Alabama pain clinic where the guilty physicians faced sentencing guidelines ranging from 30 to 240 years in prison. The doctors received shorter sentences but will still spend 20 and 21 years in prison, respectively. In the depiction of events, former patients reported that when the pain clinic established its own pharmacy to fill prescriptions, the business really boomed as the doctors received insurance reimbursements for pills instead of the local grocery store pharmacy down the street.
Sophisticated pill mills may appear close to normal unless you would know exactly what to look for. As physicians trying to maintain above-board health practices, being aware of pill mill investigations and consequences is important.
How does the patient know if they are going to a pill mill?
A pill mill is described as a clinic, pharmacy or doctor in the practice of prescribing strong pain narcotics in an excessive and inappropriate manner, in some cases for non-medical purposes. Patients should have a reasonable expectation that a doctor will examine them, take a relevant medical history and understand the needs of the patient before giving them pain pills. Especially knowing the severity of the opioid problem in the U.S., a reputable doctor will be working to assure they are not prescribing drugs to people who do not really need them or are diverting them for improper use or sale.
Some of the signs investigators note when looking at different pain clinics to determine if they are pill mills show a consistent lack of concern for the well being of patients. These pill mills are quick stop pain shops and just about anyone off the street can not only get Oxycodone, Xanax or fentanyl, which can be quite deadly. In many cases the patients could be receiving counterfeit pills that could be a mixture of drugs laced with other substances.
Signs the pain clinic might be a pill mill:
- Pain pills are the only treatments used for pain;
- Patients do not receive physical exams;
- There are no medical records or x-rays;
- They have their own pharmacy filling prescriptions;
- Only cash is accepted and there are crowds and security guards.
Aggressive investigation and prosecution of pill mill cases
The following is a summary of more detailed information from an article published by the Medical Association of the State of Alabama, “What’s at Stake for Medical Professionals in “Pill Mill” Investigations,” republished by JDSupra.com.
Criminal Prosecutions in Pill Mill Takedowns
The investigations preceding a pill mill raid are skilled and thorough. Many arrests lead to convictions when the investigators believe there will be enough evidence seized to help prove a case involving allegations of significant crimes. Every case may be unique and criminal charges can come from a variety of the facts and circumstances of the operation.
A common criminal charge in pill mill takedowns is violation of the Controlled Substances Act, the law controlling distribution of controlled substances and drug schedules based on medical use or drug abuse. A Controlled Substances Act violation requires proof that a physician knowingly and intentionally distributed a controlled substance and did so with no legitimate medical purpose and outside the usual course of practice. Especially when a patient suffers damages including death, there are enhanced sentences in certain circumstances.
Seizure and Forfeiture
Another common occurrence in pill mill cases is the government taking possession of and claiming the proceeds of alleged pill mills, including bank accounts, business and personal assets of the individuals under investigation.
Notorious pill mill cases where greed and profit has seemingly taken over, there are often luxury items, cars and vacation properties seized and forfeited.
Whistleblower lawsuits called “Qui Tam” involve the cooperation of a current or former employee of the targeted physician or practice and claims they have knowledge of violations. The cooperating witness who cooperates in a civil government lawsuit pursuant to the False Claims Act (FCA) may be awarded part of the recovery in the suit. To learn more please read our article, “False Claims Act lawsuits and the whistleblowers who share in recoveries.”
Administrative and Licensing Proceedings
State medical boards may investigate their licensed physicians following an investigation, raid or arrest in connection with a pill mill operation. It is important for healthcare professionals to understand that their standing with regulatory agencies could be affected by the variety of possible outcomes from the investigations and charging options of the DEA and other law enforcement. Even if a physician is not arrested, charged or sued, an investigation alone may trigger administrative and licensing activity that could lead to discipline, suspension or revocation of privileges and a license to practice.
About Attorney Michael V. Favia
Chicago healthcare licensing attorney, Michael V. Favia, is well known for advising and representing individuals and organizations with professional licensing and liability matters. As a former Chief of Prosecution for the Illinois Department of Financial and Professional Regulation (IDFPR), Favia is experienced in administrative law and proceedings affecting healthcare professionals. Call Michael V. Favia & Associates in Chicago to schedule a consultation by dialing (773) 631-4580.