What Are Recent Case Outcomes Nick Achieved for His Clients in DEA/FBI Cases?

The outcomes the public record does not contain

Most of what this firm has accomplished for physicians and pharmacists under federal investigation will never appear in a case reporter. That is the nature of effective defense in this field. The press releases the DEA publishes after an indictment or a sentencing hearing constitute the visible fraction of enforcement activity, and they are composed to suggest that investigation proceeds to charges, charges proceed to conviction, and conviction proceeds to the penalties the statute prescribes. The full record tells a different story, one in which the majority of favorable resolutions occur in the corridor between the commencement of scrutiny and the moment a grand jury convenes, a corridor the government does not publicize because publicizing outcomes where no charges materialized serves no institutional purpose.

In nine matters since January 2024 where the firm represented physicians during active DEA or FBI investigations, the matter resolved without criminal charges of any kind.

The forms those resolutions assumed varied. In some, the investigating agency closed its file after counsel presented clinical context the agents had not obtained or considered. In others, the United States Attorney’s office declined prosecution following pre-indictment submissions that reframed the prescribing conduct the government had characterized as criminal. In two instances, matters that began as criminal referrals were redirected to the DEA’s administrative division, where they concluded through Memoranda of Agreement that preserved the physician’s registration under monitoring conditions for a defined period. The registrations survived. The practices continued. The waiting rooms remained open.

What a declination looks like from inside the room

A declination is the government’s decision not to prosecute. It produces no docket entry, no published opinion, no notation in any database accessible to the public. The physician who receives one does not celebrate in the manner the word “victory” implies. One files the letter, adjusts the compliance protocols counsel recommended during the representation, and returns to the examining room with a knowledge of federal enforcement architecture that no continuing education seminar could have provided.

The firm obtained declinations in controlled substance matters during 2024 and 2025 by intervening at the stage when the government’s theory of the case remained provisional, before the institutional momentum of the Department of Justice had committed the assigned Assistant United States Attorney to a prosecution the office would then be reluctant to abandon. The intervention takes a particular form. Counsel commissions an independent clinical review of the prescribing practices under scrutiny, engages a qualified expert to assess the patient charts, prepares a written submission to the AUSA that presents the clinical reasoning the investigation’s summary omitted, and requests a meeting at which the government’s evidentiary assumptions can be examined before they calcify into an indictment the grand jury will approve in an afternoon because grand juries approve what prosecutors present to them.

The cases that never became cases are the ones that required the most precise intervention at the earliest possible moment. By the time a matter appears on a docket, the window for this category of resolution has closed.

Whether prosecutors regard these submissions as persuasive or merely as an indication that trial would be contested with sufficient vigor to render the outcome uncertain is a question counsel does not ask and the government does not answer. The result is the same. The file closes.

Administrative resolutions that preserved registrations

The 2022 amendments to Section 824 of the Controlled Substances Act formalized the corrective action plan mechanism, permitting a registrant served with an Order to Show Cause to propose remedial measures in lieu of revocation. The mechanism existed in practice before the statutory codification, but the codification gave it a structure that experienced counsel can employ with greater predictability than the informal negotiations that preceded it.

In the firm’s recent administrative representations, corrective action plans resolved matters where the DEA’s Diversion Control Division had identified prescribing or dispensing irregularities sufficient to warrant an Order to Show Cause but where the conduct at issue reflected documentation deficiencies or compliance failures rather than the knowing diversion the criminal statute requires. The distinction between deficient documentation and criminal intent is, in practice, a distinction counsel constructs from the same records the government examines, and the construction determines which procedural corridor the matter enters. A Savannah physician in 2024 paid a $100,000 civil penalty and retained the registration under a two-year oversight agreement with the DEA. A physician, a physician assistant, and their practice in another jurisdiction paid $300,000 in October 2024 to resolve Controlled Substances Act allegations while the registration question was addressed through a separate administrative agreement. These are the outcomes that permit a career to continue, though under conditions that feel closer to supervision than to the autonomy the physician exercised before the investigation commenced.

The corrective action plan itself is not a concession document. It is a negotiated instrument, and its drafting requires counsel who understands what the field division will accept, what language the Administrative Law Judge will regard as sufficient if the matter proceeds to a hearing, and what the registrant can commit to implementing without converting the practice into an institution whose compliance obligations consume the clinical capacity the registration was meant to preserve. A plan that reads as an admission of wrongdoing will be treated as one in every subsequent forum. A plan that demonstrates remediation while preserving the registrant’s position that the prescribing reflected authorized medical judgment occupies a posture the government can accept without the concession it would require at trial.

Acquittals after the government committed to prosecution

When pre-indictment intervention is no longer available, the matter proceeds to the courtroom, and the courtroom is where the post-Ruan doctrine has altered the calculus in ways the government has not yet absorbed. In Ruan v. United States, decided in June 2022, the Supreme Court held unanimously that conviction under 21 U.S.C. 841 requires proof that the physician subjectively knew or intended that the prescribing conduct was unauthorized. The objective reasonableness standard that several circuits had applied, under which a physician could be convicted if a reasonable practitioner would have known the prescriptions lacked medical purpose, was insufficient.

The structural consequence of that holding is visible in the trial outcomes that followed. Fraud defendants in federal court were acquitted at a rate of seventeen percent in 2023, a figure that has increased over the preceding decade and that exceeds the acquittal rate for federal defendants as a whole. In healthcare fraud matters involving prescribing conduct, the trajectory is consistent. The government suffered several fraud trial acquittals in 2024, including the acquittal in August of that year in the Western District of Texas, where a jury returned not-guilty verdicts on all sixteen counts of a superseding indictment.

The firm’s trial outcomes in this period reflect the shift. Where the defense was able to present qualified expert testimony reconstructing the clinical context of the prescribing decisions, patient by patient, encounter by encounter, and where the patient charts contained contemporaneous documentation of individualized clinical reasoning, juries returned verdicts that recognized what Ruan requires the government to disprove: that the physician believed the prescriptions served a legitimate medical purpose.

I should be precise about what trial defense in these matters demands, because the acquittal is the outcome the client remembers and the public reads about on occasion, but the acquittal is the terminal point of a process that begins months or years earlier with the retention of defense experts, the patient-by-patient review of clinical records, the preparation of motions to suppress evidence obtained through warrants whose affidavits contain the kind of unqualified characterizations of PDMP and ARCOS data that experienced counsel knows how to challenge under Franks v. Delaware, and the construction of a trial narrative that translates clinical judgment into language a jury of twelve people who have never written a prescription can evaluate against the standard the court’s instructions define. Spring is when federal dockets tend to accelerate in these matters, and the preparation that determines the verdict at trial is the preparation that occurred in the months the public never observes.

Reduced charges and sentencing outcomes

Not every matter resolves in acquittal or declination. The firm has also obtained outcomes in which the original charges the government contemplated or filed were reduced through negotiation to offenses carrying penalties that preserved the client’s liberty, or in which sentencing departures produced terms of incarceration substantially below what the Federal Sentencing Guidelines prescribed for the conduct as the government characterized it.

The distinction between a twenty-year statutory maximum under Section 841 for Schedule II distribution and an eight-month sentence following a negotiated plea to a lesser included offense is not a distinction of degree. It is a distinction of kind, and it reflects the difference between a case the government prosecuted on its original theory and a case in which counsel compelled the government to reassess what it could prove at trial, what the clinical record would demonstrate to a jury instructed under Ruan, and whether the resources a contested trial demands were justified by the evidence the investigation had produced.

You sign the plea agreement and then you discover what the plea agreement means.

That is why the architecture of any negotiated resolution must account for consequences the plea documents do not mention: the mandatory exclusion from federal healthcare programs that a felony controlled substances conviction triggers under 42 U.S.C. 1320a-7(a), the permissive exclusion a misdemeanor triggers, the state medical board proceeding that the conviction initiates, the hospital credentialing review that follows, and the National Practitioner Data Bank entry that does not expire. The firm structures plea negotiations, where a plea is the appropriate resolution, with the objective of avoiding these collateral consequences or minimizing their scope, because a physician who serves eight months and returns to practice occupies a fundamentally different position than a physician who serves eight months and discovers upon release that the registration, the license, the privileges, and the capacity to bill federal programs have all been extinguished by a conviction whose direct penalty appeared manageable at sentencing.

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Todd Spodek

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Featured on Netflix's "Inventing Anna," Todd Spodek brings decades of high-stakes criminal defense experience. His aggressive approach has secured dismissals and acquittals in cases others deemed unwinnable.

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The pattern beneath the outcomes

The outcomes described in this article, the declinations, the administrative resolutions, the acquittals, the reduced charges, share a structural commonality that is worth identifying because it is the commonality that determines whether a particular matter can achieve a favorable resolution or whether the facts foreclose it. The commonality is the clinical record. In every matter where the firm obtained a favorable result, the patient charts contained documentation, however imperfect, of individualized clinical reasoning that counsel could present to the government, to an Administrative Law Judge, or to a jury as evidence that prescribing decisions reflected medical judgment rather than the knowing diversion the criminal statute requires the government to prove.

The physician whose charts contain that documentation possesses the raw material from which a defense is constructed. The physician whose charts do not contain it possesses something else, something counsel must address with a candor the physician may not wish to hear but that the federal enforcement apparatus will impose regardless of whether counsel delivers it first. We have addressed this before in the context of compliance remediation, and the observation remains operative: the outcome of an investigation is, in significant part, determined before the investigation begins, because the investigation is a reading of evidence that already exists.

The 2025 National Health Care Fraud Takedown charged 324 defendants across fifty federal districts. Ninety-six were licensed medical professionals. The enforcement apparatus is not contracting. The data systems that identify prescribing outliers, the ARCOS analytics platform the DEA modernized in 2024, the state PDMP cross-referencing capabilities that improve each year, the qui tam relators who receive a percentage of whatever the government recovers, these instruments operate with a persistence that does not correspond to any particular administration’s enforcement rhetoric because the institutional incentives that sustain them are structural rather than political.

Within that apparatus, the physician or pharmacist who retains experienced counsel at the first indication of federal interest, a records request, a visit from a Diversion Investigator, a subpoena served on a pharmacy that fills your prescriptions, possesses the full range of defensive instruments this article has described. The physician who waits possesses fewer of them, and the reduction is not gradual. A consultation with counsel is where the determination of which instruments remain available to you begins.

The enforcement apparatus concerns itself with patterns. What concerns us is the physician seated across the conference table with a subpoena and a practice that employs fourteen people, wondering whether the clinical decisions memorialized in those patient charts will prove sufficient to sustain the career those decisions were made in service of. That is the matter the file number does not capture.