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Providing Daily Conference Coverage on Innovations in Addiction Medicine and Science

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Sunday, April 7, 2019

Physicians Must Be Proactive in Understanding Laws, Regulations

by | Apr 03, 2019

While everyone agrees much needs to be done to curb opioid deaths in the United States, some think the Department of Justice has gone too far in its more recent efforts to hold accountable addiction medicine physicians.

During Saturday’s session “The New Enforcement Environment: How to Keep Your License & Avoid Indictment,” Efrem Grail, J.D., principal at The Grail Law Firm in Pittsburgh, Pennsylvania, said the Department’s establishment of 12 Opioid Fraud and Abuse Detection Units under former U.S. Attorney General Jeff Sessions unfairly targets opioid prescribers.

Grail said local U.S. attorney’s offices, with the assistance of FBI, DEA, and HHS and other federal agency investigators, along with state medical boards and state attorneys general lawyers and agents, have focused on prescribers of buprenorphine and other medications to treat opioid use disorder in their efforts to detect and prosecute prescribers.

Arrests and convictions carry severe consequences, including prison terms, significant monetary fines, loss of a medical license, debarment from participation in federal healthcare benefit programs, and private insurance coverage panels. Some even face jail time.

During the session, Grail and Ericka Adler, Esq., shareholder at Roetzel and Andress in Chicago, Illinois, shared advice on how to stay on the right side of the law, survive a law enforcement investigation and avoid being targeted by an investigation in the first place.

“’Best practices include reasonable compliance procedures and ongoing education that puts patients and physicians on clear notice of what the law requires,” Adler said. “If your office manager, medical director or compliance officer does not have written and educational materials in place, and a process to assure patient and physician compliance, this is a task that must be addressed immediately. Noncompliance by a physician literally puts his or her medical license on the line.”

Grail’s message for doctors was forceful. “It is a tragedy that the United States government has made enforcement and prosecution of addiction treatment doctors a priority,” he said. “Physicians with the best of intentions have stepped on the landmines that federal and state law and regulation have littered across the practice and treatment of opioid addiction.  Rather than intervene at an early stage with corrective administrative warnings and require training, law enforcement has shamefully opted to view these doctors as organized crime figures and has treated them accordingly.”

As a result, he added, physicians must be proactive in understanding the rules necessary to keep their licenses and avoid investigation and enforcement by criminal authorities and state licensing boards.

Law enforcement, Grail said, now has immediate access to controlled substance prescribing frequency through state-run, online prescription drug monitoring programs, which allows investigators to quickly target addiction treatment professionals.

Many well-meaning physicians have inadvertently become “collateral damage” in the crackdown, he said, and are sometimes swept up in criminal prosecution and administrative enforcement initiatives for records violations and for misinterpretation of prescribing regulations and treatment regimens.

“Ericka and I aim to arm well-meaning, good doctors with the knowledge they need to both keep their licenses and continue helping the patients who need them,” he said.

 

Saturday, April 6, 2019

Physicians Must Be Proactive in Understanding Laws, Regulations

by | Apr 03, 2019

While everyone agrees much needs to be done to curb opioid deaths in the United States, some think the Department of Justice has gone too far in its more recent efforts to hold accountable addiction medicine physicians.

During Saturday’s session “The New Enforcement Environment: How to Keep Your License & Avoid Indictment,” Efrem Grail, J.D., principal at The Grail Law Firm in Pittsburgh, Pennsylvania, said the Department’s establishment of 12 Opioid Fraud and Abuse Detection Units under former U.S. Attorney General Jeff Sessions unfairly targets opioid prescribers.

Grail said local U.S. attorney’s offices, with the assistance of FBI, DEA, and HHS and other federal agency investigators, along with state medical boards and state attorneys general lawyers and agents, have focused on prescribers of buprenorphine and other medications to treat opioid use disorder in their efforts to detect and prosecute prescribers.

Arrests and convictions carry severe consequences, including prison terms, significant monetary fines, loss of a medical license, debarment from participation in federal healthcare benefit programs, and private insurance coverage panels. Some even face jail time.

During the session, Grail and Ericka Adler, Esq., shareholder at Roetzel and Andress in Chicago, Illinois, shared advice on how to stay on the right side of the law, survive a law enforcement investigation and avoid being targeted by an investigation in the first place.

“’Best practices include reasonable compliance procedures and ongoing education that puts patients and physicians on clear notice of what the law requires,” Adler said. “If your office manager, medical director or compliance officer does not have written and educational materials in place, and a process to assure patient and physician compliance, this is a task that must be addressed immediately. Noncompliance by a physician literally puts his or her medical license on the line.”

Grail’s message for doctors was forceful. “It is a tragedy that the United States government has made enforcement and prosecution of addiction treatment doctors a priority,” he said. “Physicians with the best of intentions have stepped on the landmines that federal and state law and regulation have littered across the practice and treatment of opioid addiction.  Rather than intervene at an early stage with corrective administrative warnings and require training, law enforcement has shamefully opted to view these doctors as organized crime figures and has treated them accordingly.”

As a result, he added, physicians must be proactive in understanding the rules necessary to keep their licenses and avoid investigation and enforcement by criminal authorities and state licensing boards.

Law enforcement, Grail said, now has immediate access to controlled substance prescribing frequency through state-run, online prescription drug monitoring programs, which allows investigators to quickly target addiction treatment professionals.

Many well-meaning physicians have inadvertently become “collateral damage” in the crackdown, he said, and are sometimes swept up in criminal prosecution and administrative enforcement initiatives for records violations and for misinterpretation of prescribing regulations and treatment regimens.

“Ericka and I aim to arm well-meaning, good doctors with the knowledge they need to both keep their licenses and continue helping the patients who need them,” he said.

 

Friday, April 5, 2019

Physicians Must Be Proactive in Understanding Laws, Regulations

by | Apr 03, 2019

While everyone agrees much needs to be done to curb opioid deaths in the United States, some think the Department of Justice has gone too far in its more recent efforts to hold accountable addiction medicine physicians.

During Saturday’s session “The New Enforcement Environment: How to Keep Your License & Avoid Indictment,” Efrem Grail, J.D., principal at The Grail Law Firm in Pittsburgh, Pennsylvania, said the Department’s establishment of 12 Opioid Fraud and Abuse Detection Units under former U.S. Attorney General Jeff Sessions unfairly targets opioid prescribers.

Grail said local U.S. attorney’s offices, with the assistance of FBI, DEA, and HHS and other federal agency investigators, along with state medical boards and state attorneys general lawyers and agents, have focused on prescribers of buprenorphine and other medications to treat opioid use disorder in their efforts to detect and prosecute prescribers.

Arrests and convictions carry severe consequences, including prison terms, significant monetary fines, loss of a medical license, debarment from participation in federal healthcare benefit programs, and private insurance coverage panels. Some even face jail time.

During the session, Grail and Ericka Adler, Esq., shareholder at Roetzel and Andress in Chicago, Illinois, shared advice on how to stay on the right side of the law, survive a law enforcement investigation and avoid being targeted by an investigation in the first place.

“’Best practices include reasonable compliance procedures and ongoing education that puts patients and physicians on clear notice of what the law requires,” Adler said. “If your office manager, medical director or compliance officer does not have written and educational materials in place, and a process to assure patient and physician compliance, this is a task that must be addressed immediately. Noncompliance by a physician literally puts his or her medical license on the line.”

Grail’s message for doctors was forceful. “It is a tragedy that the United States government has made enforcement and prosecution of addiction treatment doctors a priority,” he said. “Physicians with the best of intentions have stepped on the landmines that federal and state law and regulation have littered across the practice and treatment of opioid addiction.  Rather than intervene at an early stage with corrective administrative warnings and require training, law enforcement has shamefully opted to view these doctors as organized crime figures and has treated them accordingly.”

As a result, he added, physicians must be proactive in understanding the rules necessary to keep their licenses and avoid investigation and enforcement by criminal authorities and state licensing boards.

Law enforcement, Grail said, now has immediate access to controlled substance prescribing frequency through state-run, online prescription drug monitoring programs, which allows investigators to quickly target addiction treatment professionals.

Many well-meaning physicians have inadvertently become “collateral damage” in the crackdown, he said, and are sometimes swept up in criminal prosecution and administrative enforcement initiatives for records violations and for misinterpretation of prescribing regulations and treatment regimens.

“Ericka and I aim to arm well-meaning, good doctors with the knowledge they need to both keep their licenses and continue helping the patients who need them,” he said.