Federal Defense Lawyers for Ohio Pain Medicine Doctors

Is Your Pain Management Practice Putting You at Risk?

Is your pain management practice putting you at risk for federal prosecution? Are your opioid prescription practices raising “red flags” for the DOJ and the Opioid Fraud and Abuse Detection Unit? Could federal prosecutors be using your Medicare, Medicaid, or Tricare billings to build a case against you? While these are questions that most doctors would never think to ask, there is a very real possibility that the answer to each of these questions is, “Yes.”

With this in mind, what should you do?

The answer to this question depends on whether or not your pain management practice is (to the best of your knowledge) currently the target of a federal opioid fraud investigation. If you are not yet in the DOJ’s and the Opioid Fraud and Abuse Detection Unit’s crosshairs, then ensuring and documenting compliance should be your top priorities. If you have already been contacted by federal authorities, then you need to focus on resolving the investigation favorably before charges get filed.

1. Protecting Your Pain Management Practice (and Yourself) with Comprehensive Compliance

You own a pain management practice in Ohio, and you routinely prescribe opioid pain medications to your clients. You are not aware that anything you are doing is illegal, and you certainly have no intentions of violating federal law. Is this enough to protect you if federal authorities accuse you of unnecessarily prescribing opioid pain medications to drug-dependent patients?

Unfortunately, not. Due to the federal government’s aggressive stance against opioid fraud and abuse, all pain medicine doctors are at risk for being scrutinized. This is particularly true in Ohio, where the DOJ, DEA, and other agencies are placing particular emphasis on prosecution. Since no amount of compliance can prevent federal authorities from asking questions, Ohio pain medicine doctors need to be prepared to prove their compliance if and when the time comes.

With respect to prescribing opioid pain medications, compliance requires a multi-faceted approach. Numerous federal laws and regulations are implicated by the prescription of opioids, and doctors must establish, document, and maintain compliance with all relevant sources of federal authority. This includes, but is by no means limited to:

• Controlled Substances Act
• Anti-Kickback Statute
• Stark Law
• False Claims Act
• Health Care Fraud Statute
• Medicare, Medicaid, Tricare, Veterans Administration (VA), and Department of Labor (DOL) billing rules and regulations

Another increasingly-common allegation in opioid-related investigations is participation in a health care fraud conspiracy. In conspiracy investigations, federal prosecutors can pursue charges against affiliated and unaffiliated doctors, pharmacists, clinic administrators, and other individuals who are alleged to have contributed in some way to opioids ending up in the hands of drug-dependent patients or non-patients. In health care fraud conspiracy investigations, Ohio pain medicine doctors can face statutory fines and up to five years of federal imprisonment even if they themselves are not directly responsible for the diversion or other improper distribution of opioid medications. As a result, doctors’ compliance efforts must focus not only on their internal prescription and billing practices, but on their relationships with third-party health care providers as well.