The DEA and FBI aggressively bring “pill mill” charges against medical professionals who are involved in the treatment of patients suffering from chronic pain. The government uses federal drug conspiracy laws, typically used to prosecute street-level drug dealers, to go after healthcare professionals who work in pain clinics.
Experienced federal criminal defense attorney Hope Lefeber has represented doctors, physician’s assistants, pharmacists and other medical professionals in fighting federal “pill mill” charges. Ms. Lefeber understands the complicated medical evidence in these cases and consults with recognized medical experts to provide a strong defense to prove to the jury how her clients are lawfully and legitimately practicing medicine.
Law enforcement agencies, and now the media, use the term “pill mill” to refer to a medical clinic or doctor’s office that is accused of distributing pain medication (usually opioids) without a legitimate medical purpose or outside the usual course of a professional medical practice. By alleging as much, the government argues that it is not a legitimate medical office and is, effectively, just a “licensed” street-level drug dealer. The government also argues that the medical professional is not concerned about the welfare of patients and, instead, is just interested in making money.
The government typically identifies “red flags” that they believe suggest a medical clinic is operating as a “pill mill.” However, these are often entirely legal activities. Long-distance travel and/or the use of cash can be a “red flag” when there are entirely reasonable explanations for people to travel far to find a pain clinic and to use cash. It is often hard to find a pain clinic close to home because many have closed down as a result of the overzealous enforcement by the DEA and many people without health insurance use cash.
Doctors who prescribe a lot of pain medications such as Oxycodone, Hydrocodone, Fentanyl, or Morphine are often targeted by the DEA. Increasingly, the government is also prosecuting physician’s assistants, nurses, and office managers who work with the doctors. This is a frightening and alarming trend and it subjects healthcare professionals to draconian penalties as if they were drug dealers.
Most investigations of medical clinics involve federal agents obtaining much more than just prescription records. Investigators also obtain bank records, patient files, and wholesaler records. In many cases, the government will also send in undercover agents who pretend to be legitimate patients suffering from chronic pain. The agents will routinely lie to the doctors about their condition and symptoms in an attempt to trick the doctor into prescribing narcotic pain medication. Later, the government will take the position that the pain medication was not medically necessary. In many cases, the government will also try to hold the doctor and clinic responsible for patients who were abusing or selling (diverting) the pain medication they received from the clinic. Of course, the doctor is usually completely unaware of this illegal activity.
Usually, the government will then execute a search warrant at the clinic to obtain the patient files. The government will then hire its own “expert” to review the target’s prescribing habits and records. The “expert” will almost always opine that the prescriptions were “not medically necessary” and were “outside the scope of legitimate medical practice.” The government also often seizes bank accounts of the clinic and the personal accounts of the doctor or owner of the clinic through civil forfeiture.
In order to successfully defend these cases, it is necessary to secure expert medical testimony to prove that the prescribing practices of the medical professionals were legitimate and lawful.
When federal defense attorney Hope Lefeber is retained to represent a doctor or other healthcare professional in a “pill mill” case, she immediately gathers all of the evidence in the case including the relevant patient records and secures well-respected medical experts to review the records and the government’s “expert” opinions to vigorously refute the government’s theory that the prescriptions and course of treatment was illegal and outside the scope of medically accepted treatment.
This trend in prosecuting health care professionals in the pain management area is extremely alarming and represents a gross overreach of the federal criminal process by law enforcement. When there are gray areas of questionable prescription and medical treatment by healthcare professionals, this is best left to the state medical boards and the trained medical doctors on those boards to determine.
Defending doctors, pharmacists, and other healthcare professionals in “pill mill” cases can be extraordinarily difficult and hiring the right lawyer is critical. If you are under investigation or have been are facing “pill mill” charges, contact Hope Lefeber immediately to schedule a free, confidential consultation. Call (610) 668-7927 or complete the online form.
For TMF staff