Federal Health Care Fraud Defense Attorneys for Drug Enforcement Administration (DEA) Matters
The Drug Enforcement Administration (DEA) is among the numerous federal agencies involved in regulating the health care market and with responsibility for investigating and prosecuting cases of suspected health care fraud. Within the health care industry, the DEA’s primary focus is on the prescription, distribution, and administration of prescription medications, and its authority extends over physicians, pharmacists, clinics, hospitals, hospices, and other providers who deal in controlled prescription drugs.
The Help You Need to Deal with the DEA Investigations
The Criminal Defense Firm is a national health care fraud defense law firm that represents clients in DEA audits, DEA investigations, and other federal matters. Our team includes nationally-recognized defense lawyers and former federal prosecutors who have successfully represented clients in a broad array of cases, including cases involving allegations ranging from Medicare and Tricare billing violations to the illegal distribution of prescription medications. Regardless of the specific issue at hand, any matter involving the DEA investigations needs to be taken extremely seriously, as the potential penalties for prescription-related health care offenses can include exorbitant fines and years in federal prison. In many cases, DEA investigations will lead to multiple counts of alleged civil or criminal offenses, leading to multi-million-dollar exposure and the potential for an effective life sentence.
The DEA regulates all health care providers whose practices involve prescription medications, and all companies and practitioners that deal with prescription medications must have a DEA Certificate of Registration. Registration with the DEA is not automatic, and DEA registrations can be revoked. In addition to representing DEA registrants in civil and criminal enforcement matters, we also routinely assist clients with issues pertaining to DEA registration and renewal.
Experienced Representation for All Health Care-Related DEA Matters
Our DEA defense attorneys and former federal prosecutors represent DEA registrants and other health care providers nationwide in all DEA-related matters. The scope of our DEA practice includes:
The DEA routinely audits registered health care providers for compliance with the Controlled Substances Act (CSA) and various other federal laws and regulations. Although many of these DEA audits are conducted at random, the DEA can also inquire into a provider’s business or practice as a result of a tip received from a patient or other provider (such as a pharmacist concerned about a doctor’s prescription practices), or as a result of “anomalies” in a provider’s prescription rates and federal benefits program billing practices.
If you have received a DEA Form 82 (Notice of Inspection of Controlled Premises) or an administrative inspection warrant, it is imperative that you seek legal representation promptly. Providers have important rights during DEA audits and inspections, and you need to try to make sure that the DEA’s inquiry does not lead to a further government investigation.
DEA agents work closely with prosecutors at the U.S. Department of Justice (DOJ) and other agencies to prosecute health care providers suspected of fraud and other crimes involving the prescription, distribution, and administration of prescription drugs. When you are going through a DEA audit and investigation lawyer and defending against these types of allegations, it is critical to have legal representatives with a thorough understanding of Current Procedural Terminology (CPT) and ICD9/ICD10 coding guidelines, as lawyers without adequate knowledge of the health care billing system for federal program participants will need to spend time getting up to speed before they can begin building a strategic defense. At The Criminal Defense Firm, all of our health care fraud defense attorneys have extensive knowledge of the applicable medical and legal policies and procedures, and we are able to hit the ground running to quickly protect our clients in criminal DEA enforcement matters.
Disciplinary actions stemming from DEA audits and investigations lawyers can lead to consequences including loss of licensure, loss of DEA registration, and the potential for additional penalties resulting from a civil or criminal enforcement proceeding. We represent clients facing disciplinary action as a result of DEA investigations involving allegations of prescription drug diversion, unlawful distribution of controlled substances, failure to keep necessary records, prescription labeling violations, and all other forms of prescription drug fraud.
All physicians, pharmacists, dentists, nurse practitioners, and other medical professionals who prescribe, dispense, and administer prescription medications are subject to mandatory registration with the DEA. DEA registration can be a lengthy and difficult process, and facing a denial of registration or renewal can obviously have severe consequences for providers in all branches of the health care industry.
Before denying registration, the DEA must issue an order to show cause. It must also grant a hearing if you request one. Responding to a show cause order and appearing at DEA registration denial hearings are complicated procedures that should be handled by an experienced DEA defense attorney.
When DEA agents target practitioners in audits and investigations, they will often seek to have providers voluntarily surrender their DEA registrations. You are not required to surrender your registration at this time, and it is critical that you take appropriate steps to protect your rights including your right to practice. If you have been contacted by the DEA and asked to surrender your registration, you need to seek legal representation as soon as possible. If you have already surrendered your registration, you will need your lawyers to work with the DEA in order to mitigate any potential consequences of the surrender.
While the DEA can seek to suspend or revoke a provider’s registration for a number of reasons, its power to suspend and revoke registrations is not absolute and providers must act carefully in order to avoid wrongful interference with their ability to prescribe, dispense, and administer prescription medications. Whether you have just received a show-cause order or your DEA registration has already been suspended or revoked, our DEA audit attorneys can execute a comprehensive defense strategy designed to protect your right to practice.
FAQs: The DEA and Health Care Fraud Enforcement
Q: Is it true that the DEA must obtain a provider’s informed consent before conducting an audit?
In most cases, yes. When the DEA seeks to obtain information about a health care provider pursuant to a DEA Form 82, it must obtain the provider’s informed consent prior to initiating the audit. However, the DEA is not required to obtain the provider’s informed consent in the following scenarios.
- The audit is of a provider applying for its initial DEA registration.
- The audit is being performed pursuant to an administrative subpoena.
- The audit is being conducted due to a threat of “imminent danger” to public health or safety and there is not sufficient time to obtain a warrant.
In all other cases, unless a specific exception applies, the DEA must obtain an informed consent or an administrative inspection warrant prior to inspecting a health care provider’s books and records.
Q: Should I refuse to give informed consent to a DEA audit?
This is a question that requires individual and case-specific legal advice, so you will need to discuss your situation with a DEA defense attorney. What we can tell you, however, is that you have every right to seek legal representation when the DEA contacts you, and this includes the right to seek legal advice about the DEA’s request for informed consent.
Q: Can I lose my medical license as a result of a DEA audit, inspection, or investigation?
Potentially, yes. Since medical licensure is a matter of state law and the standards for maintaining a medical license vary from those for civil or criminal liability under federal health care law, it is possible that a provider could lose their license as a result of a DEA inquiry even if the inquiry does not ultimately lead to federal charges. And if you are convicted, this can trigger an automatic suspension or revocation of your license.
The licensing implications of a DEA audit, inspection, or investigation are among the numerous collateral effects of being targeted for federal enforcement and are among the numerous reasons why providers who are in the DEA’s crosshairs must choose experienced legal representation.
Q: What are some common allegations in DEA criminal and civil enforcement matters?
The DEA investigates a wide range of prescription-related health care law offenses. DEA registrants targeted in these investigations are commonly being suspected or accused of:
- Compound pharmacy fraud
- Conspiracy to possess and dispense controlled prescription medications
- Dispensing prescription medications without proper labeling
- Dispensing or prescribing medications outside of the scope of professional practice
- Failure to keep appropriate records
- Falsifying prescriptions and patient records
- Offering or accepting illegal kickbacks in exchange for patient referrals
- Prescribing controlled substances without medical necessity or without performing an in-person exam
- Prescribing or dispensing medications to someone who is drug-dependent
- Prescription drug diversion
- Unlawful distribution of prescription medications
- Upcoding, double-billing, and other forms of billing fraud
Q: On what grounds can the DEA legally deny registration to a provider who seeks to prescribe, dispense, or administer controlled substance medications?
There are five statutory bases on which the DEA can lawfully deny registration to a health care provider seeking to prescribe, dispense, or administer controlled substance medications. These are:
- Supplying false information on a registration application
- Prior felony conviction
- Prior denial, suspension, or revocation of a state license or registration
- Exclusion from Medicare, Medicaid, Tricare, or another federal health care benefit program
- Engaging in acts that the DEA considers to be “inconsistent with the public interest”
Q: What does it mean if the DEA has denied my registration application on the basis that registration would be “inconsistent with the public interest”?
If the DEA has denied your registration on the basis that registration would be “inconsistent with the public interest,” this means that the DEA believes one or more of the factors below.
- You have ineffective controls against the diversion of controlled prescription medications.
- You have failed to comply with state or local law.
- You have a prior state or federal conviction involving the manufacture, dispensing, or distribution of controlled substances.
- You lack experience in the distribution of controlled substances.
- There are other factors that apply in your case which make registration dangerous to public health and safety.
Do You Have a Question About Any DEA Matter? Schedule a Free and Confidential Consultation at The Criminal Defense Firm
If you need help for any issue involving the DEA, we encourage you to contact us promptly to arrange a free and confidential consultation. To speak with the DEA defense lawyers at The Criminal Defense Firm, please call 866-603-4540 or submit your information online today.