Earlier this month, U.S. Attorney General Jeff Sessions announced that the federal government would be implementing a new pilot program designed to target fraud and abuse involving prescription opioid medications. The Department of Justice’s (DOJ) new Opioid Fraud and Abuse Detection Unit will initially target twelve regions around the country, including Central North Carolina.
According to a press release issued by the DOJ:
“[T]he new Opioid Fraud and Abuse Detection Unit will focus specifically on opioid-related health care fraud using data to identify and prosecute individuals that are contributing to this prescription opioid epidemic. . . . [The DOJ] will fund twelve experienced Assistant United States Attorneys for a three year term to focus solely on investigating and prosecuting health care fraud related to prescription opioids, including pill mill schemes and pharmacies that unlawfully divert or dispense prescription opioids for illegitimate purposes.”
Federal Health Care Fraud and Opioid Prescriptions
Also according to the press release, the DOJ intends to target two specific forms of prescription drug fraud involving opioid medications: (i) physicians issuing illegal opioid prescriptions for profit, and (ii) pharmacists dispensing opioid medications pursuant to fraudulent prescriptions. The prosecutors on the Opioid Fraud and Abuse Detection Unit will be relying data analytics and working with agents from the Drug Enforcement Agency (DEA), the Federal Bureau of Investigation (FBI), the Department of Health and Human Services (DHHS) and local law enforcement to identify targets for investigation. Healthcare providers and pharmacists found responsible for illegally distributing opioid medications can face severe civil and criminal penalties, including: fines, damages, loss of government program eligibility, and even federal incarceration.
Some of the most-commonly-prescribed opioid medications include:
Factors the Opioid Fraud and Abuse Detection Unit will consider in deciding whether to prosecute providers include: “which physicians are writing opioid prescriptions at a rate that far exceeds their peers; how many of a doctor’s patients died within 60 days of an opioid prescription; the average age of the patients receiving these prescriptions; pharmacies that are dispensing disproportionately large amounts of opioids; and regional hot spots for opioid issues.”
Federal Efforts to Be Supplemented by New North Carolina Prescription Pain Killer Law
In June, North Carolina Governor Roy Cooper signed the Strengthen Opioid Misuse Prevention Act (the “STOP Act”) into law. The STOP Act establishes new limits on opioid prescriptions and enhances the reporting requirements for physicians who prescribe opioids in the state. The law also creates new obligations for pharmacies, hospices and other providers, and imposes civil penalties for certain reporting violations. In addition, physicians can risk losing their medical licenses if they fail to report violations of the new law.
Contact Cheshire Parker Schneider & Bryan, PLLC
The health care fraud and drug crime attorneys at Cheshire Parker Schneider & Bryan, PLLC provide experienced legal representation for providers facing audits, investigations and prosecution. If your business or practice is being targeted by state or federal law enforcement, call (919) 833-3114 or contact us online to speak with a lawyer in our Raleigh, NC offices today.