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Are Pharmacies' Fears Driving Over-Prescription Prosecutions?

On Friday, Nov. 8, dozens of agents raided the home and clinics of a Central Florida doctor. Multiple state and federal agencies have been investigating this doctor's prescribing practices for at least two years -- apparently to no avail. These include seemingly redundant agencies ranging from the Osceola County Investigative Bureau to the U.S. Drug Enforcement Agency and a 14-agency task force of local, state and federal agencies called the Metropolitan Bureau of Investigation.

The agents raided the man's home and his two clinics in Orlando and Kissimmee. He was home at the time, cooperated with officers, and was not arrested or charged with any crime.

The Orlando Sentinel implies the doctor is suspected of over-prescribing drugs such as oxycodone and Xanax without sufficient medical justification. Reporters say the doctor was previously targeted by two administrative investigations by the Florida Department of Health, although it's unclear how those relate to this latest raid.

The Sentinel reports that one of those complaints involved a 23-year-old patient who saw the doctor in 2011 for back pain and anxiety. The doctor prescribed him oxycodone and Xanax, along with other drugs. Questions apparently arose because an MRI on that patient had turned out "essentially normal."

Do government officials contend that an "essentially normal" MRI should altogether overrule a doctor's professional judgment? Not all painful conditions are revealed by MRIs, and anxiety disorders certainly are not. In any case, the Sentinel story doesn't indicate that the doctor was bribed, that the patient complained, or even that the doctor knowingly over-prescribed for him.

The Sentinel does say, however, that the Osceola County Investigative Bureau and the DEA received "multiple complaints" alleging the doctor was over-prescribing drugs, although those agencies did not say from whom. Reporters also claim that CVS notified this doctor and around 20 other allegedly high-prescribing Florida doctors that its pharmacies would no longer honor their prescriptions -- presumably due to fears that it might be liable if the prescriptions were inappropriate. Was CVS responsible for those multiple complaints?

The fact is, prescription fraud is extremely hard to prove, but that hasn't stopped Florida law enforcement from trying to crack down on it. Whether pharmacies' liability fears or other factors are at play, an alphabet soup of agencies have focused on this single doctor for years without finding sufficient proof to charge him with any crime. Government authorities have targeted pharmacies and doctors for what is perceived as a major problem involving paid medications such as oxycodone. The goals of law enforcement can conflict with a patient's rights to a doctor relationship and may make it hard for those who need relief from pain to obtain legitimate relief. Doctors and pharmacists are not immune from the pressures of government agencies.

Source: Orlando Sentinel, "Agents raid home, offices of Central Florida physician suspected of improper prescribing practices," Amy Pavuk, Nov. 8, 2013

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