Orlando Health Attorney Featured in Latest Issue of Medical Economics

Orlando, Fla. – March 15, 2012 - George F. Indest III, President and Managing Partner of The Health Law Firm, shares his knowledge of health law in the March 14 issue of Medical Economics. Mr. Indest was interviewed and quoted for an article concerning legal advice for primary care physicians who prescribe painkillers. In the article he provided information based on his experience in defending physicians charged with over-prescribing with the DEA and Florida DOH, Board of Medicine.

The article, “5 ways to avoid over-prescribing allegations,” includes tips written by Mr. Indest for physicians to follow if they practice pain management. The article can be read in its entirety here.

Mr. Indest is a well-known attorney specializing in the representation of health professionals and health care providers throughout Florida. His practice encompasses all aspects of health law, including pain management and pain medicine physician and clinic defense, defense of professional licensing cases, representation in investigations, defense in credentialing matters, Medicare and Medicaid audits, formation of corporations and limited liability companies (LLCs), Board of Medicine hearings, peer review actions, clinical privileges hearings, representation of medical students, and other matters of health care law and legal representation of health care professionals.

In 1999, Mr. Indest started The Health Law Firm, which has three Florida offices in Altamonte Springs, Orlando, and Pensacola. A former Navy JAG Corps attorney, he has practiced law for over 30 years.

For more information about The Health Law Firm visit http://www.thehealthlawfirm.com.

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About The Health Law Firm
The Health Law Firm was established in 1999, bringing together a team of experienced attorneys with decades of work in the legal and healthcare fields. With offices in Altamonte Springs, Orlando and Pensacola, Florida, the firm represents healthcare providers, including hospitals, nursing homes, physicians, dentists, mental health professionals and other licensed health professionals and entities. For more information about The Health Law Firm, visit http://www.thehealthlawfirm.com.

For additional information contact:
Kara Large
Office: (407) 331-6620, ext. 219
Cell: (407) 921-4322

Recent Changes to Florida’s Pain Management Laws

If you are a pain management physician, it is important for you to be aware of changes in the laws governing the practice of pain management. The following laws were updated this summer, so the Florida Department of Health (DOH) will be enforcing these changes, including new penalities for inappropriate prescribing and new regulations for prescribing controlled substances.

1. Minimum penalties for inappropriate prescribing for licensed health professionals – six (6) month suspension and $10,000 fine per count.  “Inappropriate prescribing” is in new Section 456.44, Florida Statutes.
2. Effective January 1, 2012, every physician prescribing controlled substances must designate himself or herself as a controlled substance prescribing practitioner on the physician’s profile maintained by the Florida Department of Health.
3. Effective July 1, 2011, new required elements must be documented in medical records of each pain management patient and there are new Standards of Practice for pain management physicians.
4. Effective July 1, 2011, each physician practicing in a pain management clinic must notify the Florida Board of Medicine within 10 days after beginning or ending practice at the pain management clinic.
5. Effective July 1, 2011, each physician practicing in a pain management clinic is personally responsible for the clinic’s compliance with all operational requirements. 
6. Effective July 1, 2011, each pain management clinic must report to the Department of Health:
     a.  the number of new and repeat patients;
     b.  the number of patients discharged due to drug abuse;
     c.  the number of patients discharged due to diversion; and
     d.  the number of patients who live outside Florida.
7. Effective July 1, 2011, dispensing physicians are no longer authorized to dispense Schedule II and Schedule III controlled substances. 
8. Dispensing physicians must return all Schedule II and Schedule III controlled substances to the distributors or dispose of them by July 10, 2011.
9. The Florida Department of Health will identify dispensing practitioners who purchase more than an average of 2,000 doses of Schedule II or Schedule III controlled substances per month and decide which of these practitioners poses the greatest risk to the public health. (We expect that individuals will be targeted by criminal law enforcement authorities, including the DEA, based on these reports.)
10. Three days after the effective date, the Department of Health and Law Enforcement will enter the businesses of all dispensing practitioners identified as posing the greatest threat to public health and ‘quarantine’ the practitioner’s inventory of Schedule II and Schedule III controlled substances.

If you are concerned about your pain management clinic, or if you are a pain management physician who has been subjected to raids or other investigations call us at (407) 331-6620 0r (850) 439-1001 or visit our website for more information at www.TheHealthLawFirm.com.

Florida’s Strike Force Raids Pain Management Physicians

Florida is reported to have one of the worst prescription drug abuse problems in the country. Because of this issue, pain management physicians have been under increasing scrutiny and attack by federal and state agencies.  If you are a pain management physician or you work in a pain a management clinic, you need to be aware of the measures that state and federal agencies are taking against doctors who practice pain management and the owners of pain management clinics.

A news release sent out by the Florida Department of Health (DOH) this summer discusses “inspections” of physicians’ offices across the state, allegedly to ensure compliance with Florida’s new prescription drug law (House Bill 7095).  However, many of these may be more aptly termed as “raids.”  These raids, under the guise of being inspections, have resulted in a massive quantity of narcotics being seized from clinics and physicians’ offices by the Strike Force. It is claimed that no search warrants are necessary as the Strike Force states it is performing an “administrative inspection.” The pain management physicians targeted by these inspections are identified based on their purchasing, prescribing and dispensing levels.

Often these “inspections” will include Department of Health Investigators, Florida Department of Law Enforcement Special Agents, local police and law enforcement agents, and Drug Enforcement Administration (DEA) Special Agents.

•  Our primary concern and warning to the physician or owner is to not talk to any investigators or inspectors, but call your personal attorney immediately. Have the investigator or inspector talk to your attorney. All communications should be with and through your attorney.
• If you are requested to “voluntarily” relinquish (give up) your DEA registration or your medical license or other professional license, do not do this.  It will not help you and it will make every aspect of your case more difficult to defend.
• Do not make any statement (oral or written) or allow yourself to be interviewed.
• Obtain the complete names, addresses, titles and agencies for each agent there.  Obtain their business cards (which they should have).
• Do not volunteer up any documents, items or information.

To read more about inspections from the document released by the Florida Department of Health click here.

If your office has been “inspected” and you need legal representation, you may call and speak to one of our health attorneys at (407) 331-6620 or (850) 439-1001.

CVS Refuses to Fill Prescriptions For Some Florida Doctors

The crack down on Florida pill mills continues with CVS pharmacies notifying some doctors that they no longer will fill their prescriptions for certain narcotic medications.

According to Health News Florida, this new policy appears to be limited to Florida, but CVS has not clearly stated what is being used to determine which doctors can have their prescriptions filled for which drugs (though oxycodone definitely appears to be a target).

The Florida Academy of Pain Management, released a letter via email alert that was sent by CVS to a Central Florida physician. The physician who received the letter had never been disciplined by state medical regulators and had extensive pain management training. The email alert, stated that CVS appears to “have initiated an internal program where they are profiling physicians’ controlled substance prescribing habits and possibly their patients’ prescriptions.”

A spokesperson for CVS said that the company is refusing to fill prescriptions for a “small number of Florida physicians” and is supporting measures by federal and state law enforcement officials to “keep controlled substances out of the wrong hands.”

While some pain physicians have not received a letter, they have been told by patients that they are being analyzed by CVS for writing prescriptions for narcotics, especially a specific combination of medications with high potential for abuse — oxycodone, Xanax and Soma. This trio has been widely prescribed at pill mills.

Although the actions taken by CVS may be extreme, other pharmacies and pharmacists are increasingly hesitant about filling certain prescriptions. With pain killers now responsible for more than seven overdose deaths a day in Florida, there is reason to be cautious, and pharmacists are professionally obligated not to fill prescriptions they find questionable.

However, stricter regulations on pain clinics, pain management physicians and prescription writing has left patients who face real pain unable to obtain necessary medication. Legitimate patients are being punished for the actions of a small group of corrupt practitioners.

Florida must find a way to get out of the Catch-22 in which the state is currently entangled. Yes, prescription drug abuse is a problem, but so is the real pain faced by many patients.

For more information on legal matters concerning pain clinics and pain management physicians, visit www.TheHealthLawFirm.com.

South Florida Painkiller Network Newest Target in String of Florida Pill Mill Raids

Another South Florida pill mill was busted by federal agents this month, adding to Florida’s increasingly negative reputation as one of the worst drug trafficking states.

According to the Miami Herald, 24 people were indicted on charges of defrauding Medicare while distributing oxycodone and oxymorphone across Miami-Dade and Broward counties. These healthcare providers were involved in a distribution network allegedly worth $40 million.

Five pain management clinics in Miami, Hialeah and Plantation served as fronts for the fraud. A physician wrote prescriptions for oxycodone and oxymorphone to beneficiaries of Medicare and other prescription-drug insurance plans at these five clinics. Allegedly, these beneficiary patients were involved in the clinics’ scheme. The patients would then fill the prescriptions at certain pharmacies throughout Miami that were also involved in the network. When the prescriptions were filled, the pharmacy owners would bill Medicare, knowing that the drugs were unnecessary for the patients.

This bust follows a string of other DEA, DOH, and FDLE raids in Florida, including one in August. According to the Miami Herald, August’s Operation Oxy Alley involved pill mills being targeted as organized-crime for the first time. The country’s four largest pain clinics (located in Palm Beach and Broward Counties) were targeted, resulting in the arrest of 32 individuals, including 13 doctors.

Operation Pill Nation, the predecessor to Operation Oxy Alley, targeted pain management clinics in Palm Beach, Broward and Miami-Dade Counties. An effort to crackdown on Florida pill mills and drug trafficking perpetuated by medical clinics and doctors, Operation Pill Nation and similar investigations have resulted in the shutting down of clinics throughout South Florida according to the Palm Beach Post.

South Florida is not the only region where pill mills are running rampant. The entire state of Florida has been pegged by the DEA as one of the worst in terms of drug trafficking and about 85 percent of all oxycodone sold comes from Florida. Pain management clinics, pharmacies, pharmacists and doctors in Jacksonville, Melbourne, Mount Dora, Orlando, Miami, Fort Lauderdale, Delray Beach, West Palm Beach have been busted by Florida and federal agencies (DEA, DOH, FDLE) for unlawfully dispensing powerful narcotics, like oxycodone, to any patient that came in the door. In one instance, buyers of highly addictive oxycodone and Xanax, came all the way from Ohio, Kentucky, and Tennessee to get their fix at a Jacksonville pill mill.

The DEA and other federal and state agencies carry out relentless investigations in order to bust these clinics and doctors. Acting as patients, they may bribe a receptionist in order to immediately see a doctor, and then present unrelated symptoms in order to get a narcotics prescription. Drug companies also become involved in targeting pill mills, as they report any clinic or physician who orders narcotics in large quanities (like this Florida doctor who prescribed over 250,000 oxycodone pills in eight months).

Although the crackdown on pill mills and drug trafficking in Florida has eliminated many illegitimate practices, there have been serious consequences for any patient with real pain. Physicians are wary of writing any painkiller prescription, even for a patient whose pain warrants a stronger prescription.

If you are a pharmacist or physician dealing with pain management in Florida, be aware of the recent raids and learn more about what you can do to prevent the DEA, DOH, FDLE or local police from knocking on your door. Visit our website at www.TheHealthLawFirm.com or read this article on the DEA‘s involvement in the healthcare field for more information.

Florida Doctor Arrested for Drug Sales and Other Criminal Charges

Drug trafficking charges against a medical doctor are not a new concept, especially in Florida. Recent pill mill busts throughout the state have resulted in an omnipresent DEA, always on the lookout for illegal drug sales by pharmacies, pharmacists, pain management clinics and physicians. However, the recent arrest of a Central Florida doctor extends beyond the run of the mill “pill mill” bust, as the accusations in this case involve sex with a minor and delivering a controlled substance to a minor.

According to Florida Today, this Central Florida doctor was arrested Tuesday following a raid by the Florida Department of Law Enforcement. This is his second arrest after he was charged with possession of marijuana and drug paraphernalia in August.

Tuesday’s arrest resulted from evidence of the doctor’s sexual relationship with a high school student. The doctor was arrested in 2009 after being caught during a traffic stop with bags of marijuana in his car and allegedly having a sexual relationship with the 16-year-old passenger. Although charges were not filed after the girl recanted her evidence and claimed the marijuana was hers, that didn’t put an end to a steady stream of younger girls going into the clinic. According to residents of the area surrounding the clinic, girls were frequently seen going to see the doctor dressed in revealing attire. Aside from teenage patients, residents reported often seeing a line out to the street for people waiting to get into the clinic, a possible indicator of drug trafficking.

Although his medical license has been suspended, this Florida doctor has yet to receive broader drug trafficking charges, despite his huge prescription distribution numbers. According to the Florida Department of Law Enforcement, this doctor prescribed 250,000 oxycodone pills in the first eight months of 2011. Compared to the entire state of California, which had 300,000 oxycodone prescriptions in the last six months of 2010, it is evident that this Florida doctor had a major painkiller operation. The Florida Department of Law Enforcement is calling him one of the worst offenders in the state of Florida. Upon further investigation, this doctor and anyone who may have assisted him in the drug trafficking of oxycodone may be charged for this offense.

While the possibility of drug trafficking charges is enough to scare any physician, other criminal charges can be equally damaging, especially depending on how the accused individuals plea to the charges. A health professional’s plea of nolo contendere, which may seem like the safe route, is actually treated the same as a plea of guilty for all purposes. There are ways to defend criminal charges (like the ones against the aforementioned Florida doctor) that can result in a more favorable outcome (e.g., attempting to obtain pre-trial diversion, pre-trial intervention or drug court), but legal advice should be sought from an attorney who frequently represents health care providers before any actions are pursued. To learn more about criminal charges against doctors and other health professionals see this recent post or visit our website at www.TheHealthLawFirm.com.

New Florida Drug Database Aimed at Preventing Drug Abuse

Recently, Florida pharmacists, physicians and pain management clinics have received negative attention over frequent Drug Enforcement Administration (DEA) raids. Now, Florida is once again in the spotlight as the state has launched a drug database in an attempt to reduce drug abuse perpetuated by visits to the doctor.

According to the Orlando Sentinel, this database will allow physicians and pharmacists to review a patient’s prescription history before issuing prescriptions for painkillers like OxyContin and other powerful drugs.

These preventative measures are not new to Florida health care providers. After garnering a reputation for frequent drug trafficking, proliferated by pain management clinics, the state passed legislation banning many doctors from dispensing dangerous controlled substances in their offices.

Currently, use of the database is not mandatory, but legislators are hoping to make it a requirement in the future. Both the Florida Medical Association and the Florida Osteopathic Medical Association are urging members to retrieve information from the database before writing prescriptions.

With this new database, physicians, pharmacists and pain management clinics can help prevent visits from the DEA and Department of Health (DOH). Instead of writing prescriptions for powerful painkillers every time a patient comes calling, doctors can now judge whether a patient is really in need or abusing drugs. Being able to see every instance that a patient has filled a prescription for drugs like OxyContin and Valium will allow physicians and pharmacists to understand the whole picture If a patient is shopping around for drugs, it will be made apparent.

Keep the DEA from your practice by taking every precaution, including querying the database before writing or administering a prescription. For more information on DEA cases see this article about defending yourself in the event of an investigation. Pharmacists can learn about more legal matters concerning their profession here.

The DEA’s War on Pain Management

Within the last few years, raids on pain management clinics, as well as pharmacies, have been increasingly commonplace. The doctors, pharmacists, nurses and other health care professionals involved are carted away in handcuffs and must defend their practice.

According to the St. Petersburg Times, a South Florida pain management clinic has recently been shut down under emergency action by the Florida Department of Health (DOH). Several health care professionals at the clinic were arrested, their licenses revoked.

In this instance, the charges against these health care employees are not completely unwarranted. Patients confessed to authorities that members of the clinic knew they were shopping for drugs, and an employee revealed that he was asked to recruit patients by promising powerful drugs.

However, it is not uncommon for a pain management clinic or related practice to face investigation, especially in Florida. Federal and state agencies are doing everything and anything they can to prevent drug farming, which means a crackdown on health care providers. Dubbed “Operation Pill Nation,” this strict enforcement means more worries for health care professionals, who now must monitor patient needs under the DEA’s close watch.

If your medical practice specializes in pain management or a similar area, have a plan in place in the event that the DEA comes knocking on your door. Be aware of health lawyers that are familiar with these cases and can defend you in the event of a DEA raid. These proceedings are often very complicated, and you’ll want an experienced team of health law attorneys to properly defend you from criminal charges.

At The Health Law Firm, our team of lawyers specialize in the representation of doctors, nurses, pharmacists, physicians assistants, nurse practitioners and other health care professionals involved in Department of Health, Diversion Control and Drug Enforcement Administration in Florida and throughout the United States. For more information about our knowledge in the practice of health law and DEA cases read our article on Pain Management and the DEA.