The Department of Justice has announced the creation of a new Opioid Fraud and Abuse Detection Unit to be comprised of 12 Assistance United States Attorneys in 12 different jurisdictions that will be exclusively assigned to prosecute criminal violations relating to prescription drugs.  The unit reportedly will use data to identify subjects that may be diverting or excessively prescribing or dispensing opioid drugs.  Among the data metrics will be physician prescription volumes looking for outliers relative to the physician’s peers, as well as pharmacies that are dispensing disproportionately large amounts of opioids.

The jurisdictions involved in the Unit are:

• Middle District of Florida,
• Eastern District of Michigan,
• Northern District of Alabama,
• Eastern District of Tennessee,
• District of Nevada,
• Eastern District of Kentucky,
• District of Maryland,
• Western District of Pennsylvania,
• Southern District of Ohio,
• Eastern District of California,
• Middle District of North Carolina, and
• Southern District of West Virginia.

 

Physicians involved in pain management in these jurisdictions should take special note and should review their prescribing and documentation practices, and well as their patients’ compliance with pain management agreements.  In those jurisdictions with prescription drug monitoring databases, physicians and pharmacists should be diligent in both inputting and review the data to identify patterns of doctor shopping by patients.  Pharmacies should review their protocols for identifying suspicious prescribing patterns, and should make is a regular practice to confirm opioid prescriptions with doctors and question suspicious behavior, and should decline to fill prescriptions they have legitimate questions about.

Physicians and pharmacists should familiarize themselves with the “red flags” of diversion, and establish protocols for doing so and document their efforts to establish their efforts if questioned by law enforcement.

The Department of Justice stated that the prosecutors would be supported by investigators from the FBI, DEA, HHS, as well as local and state law enforcement.  Any contract with, or requests for interviews by, any of the agencies should be taken very seriously and should prompt a call to competent health care regulatory counsel.

The attorneys at Nicholson & Eastin, LLP regularly advise physicians and pharmacies regarding prescription drug diversion, and represent physicians and pharmacies in diversion investigations.  Please do not hesitate to contact us for a consultation if you have any questions regarding diversion and compliance issues.