Nation Rx Drug Abuse Summit Held in Central Florida-Leaders Share Struggles and Triumphs in “War Against Prescription Drugs”

11 Indest-2008-8By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

From April 2 through April 4, 2013, the country’s leading experts on the prescription drug epidemic met in Central Florida for the National Rx Drug Abuse Summit, according to the Orlando Sentinel. National leaders including the White House drug czar, the director of the Centers for Disease Control and Prevention (CDC), U.S. Food and Drug Administration (FDA) commissioner and Florida’s Attorney General (AG) shared ongoing challenges and strides each department has made in its fight against prescription drugs.

Good News in the War Against Prescription Drugs.

The Florida Department of Law Enforcement (FDLE) stated in its semi-annual report that oxycodone-related deaths statewide dropped between January and June of 2012, compared to the same period of time in 2011. In the first half of 2012, there were 759 oxycodone-related deaths in Florida. That number is down from 1,058 during the same time period a year before.

A look at the national numbers shows that the number of people abusing prescription drugs is down. According to the White House drug czar, seven million people abused prescription drugs in 2010. By 2011, that number had dropped to 6.1 million. Studies also show prescription drug use among young adults ages 18 to 25 is also on the decline. To read the article from the Orlando Sentinel, click here.

Summit Focused on Need for More State Prescriptions Drug Monitoring Programs.

During the summit leaders spoke of the need to help state prescription drug monitoring programs succeed.

Just in March 2013, three states made moves to tighten monitoring and prescribing of controlled substances. Legislators in California, Pennsylvania and Kentucky are contemplating new regulations regarding the use of prescription drug monitoring programs. What this means is that whatever state you may be in, you should be aware that lawmakers are implementing similar programs and laws in their governments. To learn more, click here.

Drug Monitoring Programs Can Be Used as a Prosecution Tool.

Health professionals should take note, these prescription drug monitoring programs can, and will be, used as a prosecution tool. Enforcement of drug laws and prescribing regulations has been ever increasing in recent years. The implementation of these databases and corresponding regulations are going to provide more tools for law enforcement and state medical boards to crack down on physicians. In order to avoid trouble it is crucial that you take time to review your state’s prescribing and record keeping laws with an experienced health care attorney.

From experience, we have seen the database in Florida used mostly as a tool for prosecution of pain management physicians and pharmacists. Even in cases where the pharmacist has been the one to notify the authorities of suspected forged prescriptions and where the pharmacist has cooperated in prosecuting the criminals, I have seen this database cited as evidence against him or her. I do not believe this is what the legislation intended. Physicians and pharmacists should consider using whatever database is implemented in their respective states, or otherwise remaining vigilant to avoid being labeled an overprescriber.

Contact Health Law Attorneys Experienced with Investigations of Health Professionals and Providers.

The attorneys of The Health Law Firm provide legal representation to physicians, nurses, nurse practitioners, CRNAs, pain management doctors, dentists, pharmacists, psychologists and other health providers in Department of Health (DOH) investigations, Drug Enforcement Administration (DEA) investigations, FBI investigations, Medicare investigations, Medicaid investigations and other types of investigations of health professionals and providers.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Comments?

Does the state where you are located have a prescription drug monitoring program? What do you think of these programs? Are they necessary? Please leave any thoughtful comments below.

Sources:

Pavuk, Amy. “‘We Can Stop This Epidemic,’ CDC Boss Says at Rx-Drug Abuse Summit in Orlando.” Orlando Sentinel. (April 2, 2013). From: http://www.orlandosentinel.com/news/local/breakingnews/os-prescription-drug-abuse-summit-20130402,0,4693169.story

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 1996-2012 The Health Law Firm. All rights reserved.

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Drug Enforcement Administration (DEA) Investigates Six Walgreens Pharmacies in Florida

5 Indest-2008-2By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

The Drug Enforcement Administration (DEA) served an Order to Show Cause (OSC) on a Fort Myers Walgreens pharmacy on February 21, 2013. According to the DEA, the OSC was served as a notice to provide Walgreens with an opportunity to show cause as to why their DEA registration should not be revoked. The Fort Myers pharmacy is one of six Walgreens pharmacies to be targeted for prescribing practices by the DEA.

Click here to read the press release from the DEA.

According to the DEA, these investigations are part of an effort to curb Florida’s prescription drug epidemic.

Six Walgreens Pharmacies and One Distribution Center Targeted by DEA.

In April 2012, the DEA served and Administrative Inspection Warrant (AIW) on the Fort Myers Walgreens pharmacy, as well as five other Walgreens pharmacies in Florida and its distribution center in Jupiter. According to the DEA, the AIWs were served to determine if the pharmacies were dispensing prescriptions for legitimate medical purposes.

Based on the DEA’s findings, the Walgreens distribution center was served with an immediate suspension order (ISO). Click here to read our previous blog on the ISO served on the distribution center.

Between November 2012 and February 2013, the DEA has served OSCs on six Florida Walgreens pharmacies.

According to an article in Naples News, no action has been taken against the stores’ licenses, so they are still able to fill prescriptions pain medications and controlled substances. An administrative hearing will be held in April 2013. The hearing is an opportunity for Walgreens to present their cases. To read the entire Naples News article, click here.

Two CVS Stores in Sanford, Florida Lost Controlled Substance Licenses.

In September 2012, the DEA revoked the controlled substance licenses from two CVS pharmacies in Sanford, Florida. The two stores are accused of dispensing an inappropriate number of prescriptions for oxycodone and had a suspicious number of sales of other controlled substances. There is a blog on this story on our website, click here to read it.

The Ultimate Results of Such Crackdowns.
I am constantly being contacted by patients who are in dire straits, suffering because they cannot locate a pharmacy to fill their legitimate pain medicine prescriptions. These include injured military veterans, patients who are 100% disabled and on disability or social security, patients injured in automobile accidents and job-related accidents (whose medications are paid for by insurance, if they can find a pharmacy to fill it) and others with real chronic pain issues.

If the largest legitimate chains of pharmacies in the state and nation are not allowed to fill these prescriptions, where will these suffering patients turn? Are these actions driving our citizens into the hands of shady independent pharmacies that have fewer safeguards and less accountability? Are these actions driving our citizens to seek out illegal drug dealers and turn to illegal drugs to cope with their legitimate medical problems? I hope not.

Contact Health Law Attorneys Experienced in Representing Pharmacies and Pharmacists.

The Health Law Firm represents pharmacists and pharmacies in DEA investigations, regulatory matters, licensing issues, litigation, administrative hearings, inspections and audits. The firm’s attorneys include those who are board certified by The Florida Bar in Health Law as well as licensed health professionals who are also attorneys.
To contact The Health Law Firm please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Comments?

What do you think of these investigations on big pharmacies? Please leave any thoughtful comments below.

Sources:

Drug Enforcement Administration. “DEA Serves an Order to Show Cause on Walgreen’s Pharmacy in Fort Myers.” Drug Enforcement Administration. (February 22, 2013). From: http://www.justice.gov/dea/divisions/mia/2013/mia022213a.shtml

Freeman, Liz. “DEA Targets Fort Myers Walgreens, 5 Other State Stores.” Naples News. (March 7, 2013). From: http://www.naplesnews.com/news/2013/mar/07/dea-targets-fort-myers-walgreens-5-other-state/?print=1

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620. He does not own stock in Walgreens or any other pharmacy.

 

The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 1996-2012 The Health Law Firm. All rights reserved.

Walgreens Files a Petition to Lift the Immediate Suspension Order

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

There’s a firefight brewing between Walgreens and the Drug Enforcement Administration (DEA). On October 10, 2012, Walgreens filed a petition asking a federal judge to lift the Immediate Suspension Order (ISO) that bans its distribution center in Jupiter, Florida, from shipping controlled substances to its stores in Florida and on the East Coast.

Back on September 14, 2012, the DEA issued an ISO on the distribution center, calling it an “imminent danger” to the public. Click here to read a blog I previously wrote when the DEA issued the ISO.

Walgreens Claims the DEA Ignored Relevant Information.

In its petition, Walgreens claims the DEA ignored and “conspicuously omitted” recent and relevant information in its ISO. The pharmacy said it took voluntary steps designed to address concerns about the number of new prescriptions for controlled substances presented by pain clinic patients. Earlier this year the company also voluntarily stopped selling all Schedule II drugs, including OxyContin, at eight pharmacies that were of concern to the DEA and that were serviced by the Jupiter distribution center. Walgreens claims as a result of these efforts, the number of oxycodone pills and pain clinic prescriptions filled in recent months is an extremely small percent of the 2011 numbers, on which DEA relied upon to issue the ISO.

Walgreens is asking the federal appeals court to clear the ISO against the distribution center.

To see the Orlando Sentinel article, click here.

 

Numbers Released for Mean Nothing.

In an earlier blog I wrote that according to the DEA, six of Walgreens’ Florida pharmacies allegedly ordered more than a million oxycodone pills a year. That number might seem big at first, but after breaking it down, it’s actually not all that scary. You have to remember that Walgreens is the biggest pharmacy retailer in Florida.

For example, if a doctor issues a pain management patient a prescription for three (3) pills a day, that is approximately 90 pills per month or 1,080 pills per year. If Walgreens has only 1,000 patients with such a prescription in a year throughout the entire state of Florida, that is in excess of one million (1,000,000) pills per year. I would guess that many single Walgreens retail stores have more than 1,000 customers per day, much less all Walgreens stores throughout Florida.

My point is that such statistics are meaningless out of context and are only meant to sound huge if one doesn’t stop and think about it.

Click here to see the press release from the DEA with the number of oxycodone pills purchased by store.

 

Contact Health Law Attorneys Experienced in Representing Pharmacies and Pharmacists.

The Health Law Firm represents pharmacists and pharmacies in DEA investigations, regulatory matters, licensing issues, litigation, administrative hearings, inspections and audits. The firm’s attorneys include those who are board certified by The Florida Bar in Health Law as well as licensed health professionals who are also attorneys.

To contact The Health Law Firm please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

 

Comments?

What do you think of the appeal? Should the DEA have taken this action against Walgreens? Please leave any thoughtful comments below.

 

Source:

Pavul, Amy. “Walgreens Fights Back Against DEA, Wants Ban at Florida Distribution Center Lifted.” Orlando Sentinel. (October 11, 2012). From: ttp://www.orlandosentinel.com/news/local/breakingnews/os-walgreens-dea-oxycodone-20121011,0,1860346.story

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620. He does not own stock in Walgreens or any other pharmacy.

 

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.

Copyright © 1996-2012 The Health Law Firm. All rights reserved.

CVS Has Allegedly Been Refilling Prescriptions and Submitting Insurance Claims Without Patients’ Permission

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

The Office of Inspector General (OIG) for the U.S. Department of Health and Human Services (HHS) has reportedly launched an investigation into CVS’ practice for refilling prescriptions. According to an article in the Los Angeles Times, authorities are looking into reports that CVS has been refilling prescriptions and submitting insurance claims without patients’ permission. The Los Angeles Times article, released October 12, 2012, names an official with knowledge of this matter as the source.

We want to emphasize that this is from an unconfirmed news story. The government rarely announces investigations of specific subjects ahead of time.

Click here to read the entire article from the Los Angeles Times.

CVS Has Not Been Notified of Prescription Refill Investigation.

A related article in Reuters states that CVS said it has not been contacted by the government about the investigation. The pharmacy also said, as a policy, the company does not condone unauthorized refills. Officials said to allow unauthorized prescription refills could be considered insurance fraud, especially if insurers weren’t refunded for any drugs rejected by patients.

The probe might be, in part, related to the programs offered by many drugstores that allows a pharmacy to refill prescriptions even before a refill request has been made by the patient.

Click here to read the entire article from Reuters.

So far there is no news from the OIG for the HHS officially confirming this investigation.

Tempest in a Teapot?

It is unclear to me why there would be any cause to investigate CVS, if Medicare was not being billed until the customer actually picked up the prescription. If the customer fails to pickup the prescription, every drug store I know of restocks the medication after a short period and no one is ever billed for it. It seems that it would be a quick and simple matter for the OIG to check this.

Furthermore, it could also be argued that CVS actually is promoting good health by this practice. Patients may forget to renew or refill their prescriptions or may fail to notice they are running low.

Two Central Florida CVS Stores Get Controlled Substance Licenses Revoked by DEA.

On September 12, 2012, the U.S. Drug Enforcement Administration (DEA) revoked the registrations (controlled substance licenses) from two CVS pharmacies in Sanford, Florida. The two pharmacies are no longer able to fill prescriptions for drugs such as oxycodone, Dilaudid, Vicodin, Ritalin and Xanax. This decision was in response to a government crackdown on the distribution of painkillers. Click here to read a blog on this story.

Contact Health Law Attorneys Experienced in Representing Pharmacies and Pharmacists.

The Health Law Firm represents pharmacists and pharmacies in DEA investigations, regulatory matters, licensing issues, litigation, administrative hearings, inspections and audits. The firm’s attorneys include those who are board certified by The Florida Bar in Health Law as well as licensed health professionals who are also attorneys.

To contact The Health Law Firm please call (407) 331-6620 or (850) 439-1001 and visit our website at http://www.TheHealthLawFirm.com.

Comments?

What do you think of this story? Do you think CVS is doing anything wrong? How is this any different from the practice of many managed care plans mailing out 90 days of medications to its patients at a time? Please leave any thoughtful comments below.

Sources:

Lazarus, David. “CVS Caremark Prescription Refills Under Scrutiny, Source Says.” Los Angeles Times. (October 12, 2012). From: http://www.latimes.com/business/la-fi-lazarus-20121012,0,1032269.column

Alawadhi, Neha, Wohl, Jessica, and Morgan, David. “CVS Unaware of Any Government Prescription Refill Probe.” Reuters. (October 12, 2012). From: http://www.reuters.com/assets/print?aid=USBRE89B19520121012

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. http://www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.

Copyright © 1996-2012 The Health Law Firm. All rights reserved.