DEA Registration Suspended Doctor.

No, a suspended DEA registration does not suspend a physician’s medical license. A physician’s authority to prescribe controlled substances, however, is certainly suspended.

A DEA registration authorizes only the specific controlled-substance activities and substances listed in the registration, such as manufacturing, distributing, importing, exporting, dispensing, or prescribing. This is a very different authority than the one that underlies a physician’s authority to practice medicine, and that is the authority that underlies a physician’s state medical license.

While it might be a misconception to say that the DEA registration covers prescriptions of any kind, the truth is that a DEA registration is not required to issue a prescription for most medications. It is only required to issue prescriptions for controlled substances; and, if a physician’s DEA registration is suspended, then he or she can no longer issue prescriptions for those types of drugs.

The DEA is a federal agency, and it has federal authority; the authority of a state medical licensing board is state authority, and the authority of the DEA does not give it the power to suspend a state medical license.

When federal authorities want to suspend a physician’s medical license, they must do so through the state medical licensing board. Conversely, if a state medical licensing board decides that it is in the interests of justice to suspend a physician’s authority to prescribe controlled substances, it will generally inform the DEA that it has done so, and the DEA may suspend or revoke the physician’s DEA registration as well.

When Can the DEA Suspend a Registration Immediately, and Can a Doctor Refuse to Surrender His or Her DEA Registration?

The DEA may suspend a physician’s registration immediately in certain circumstances. Specifically, 21 C.F.R. § 1301.36(e) provides that the Administrator may suspend a registration when the Administrator finds an imminent danger to public health or safety.

This immediate suspension does not mean that revocation proceedings are not pending. In fact, an immediate suspension is generally in addition to pending revocation proceedings. Often, the immediate suspension order is issued at the same time as the Order to Show Cause. Because there is no specified seven-day response period for responding to immediate suspensions, it is imperative that they engage an experienced physician license defense attorney immediately.

When a DEA Special Agent learns of a violation of the Controlled Substances Act (CSA), he or she may contact the physician and inquire if the physician is willing to surrender his or her registration voluntarily. If the physician agrees, the DEA will not need to pursue administrative enforcement action. However, the physician is under no legal obligation to agree to a DEA agent’s request, at least not immediately. This conversation is generally not a formal administrative proceeding, and it may be in the physician’s best interests to decline until he or she has the opportunity to discuss the implications of a voluntary surrender with an experienced physician defense attorney.

If the physician refuses to voluntarily surrender his or her registration, the DEA may then issue an immediate suspension order and an Order to Show Cause. These are formal documents that require the physician to show cause why his or her registration should not be revoked (or, in the case of an immediate suspension, why the immediate suspension should not be enforced).

Which State, Conviction, Application, and Public Interest Facts Can Support DEA Action?

The DEA may take enforcement action, including, but not limited to, denying a physician’s application for DEA registration, in a wide range of scenarios. These scenarios include:

• Any state which denies, suspends, or revokes a practitioner’s state license may inform the DEA of its licensing action. This fact alone could be sufficient to support a DEA registration suspension, revocation, or denial.
• Any physician who has been convicted of a felony offense relating to controlled substances may have their DEA registration denied or revoked. While other offenses may also be used as a basis for enforcement action, a controlled-substance felony conviction is a primary ground for action against a practitioner’s registration.
• Any physician who has provided false information on his or her DEA registration application is also subject to registration denial or revocation. In fact, the DEA typically investigates any suspected inaccuracies on an application.
• Any physician who has been excluded from participating in a federal health care benefit program may also find their DEA registration suspended or revoked. This may include exclusion from Medicare, Medicaid, Tricare, or any other benefit program.
• Any physician who is found to have engaged in conduct that is inconsistent with the public interest will also face the possibility of DEA registration denial or revocation. In this context, the public-interest inquiry includes factors such as preventing diversion of controlled substances into other than legitimate medical, scientific, or industrial channels. As detailed below, this is a broad category and includes, but is not limited to, a history of substance abuse, failure to safeguard DEA-registered drugs, or, as the DEA defines it, any behavior which “is inconsistent with the public interest.”

In short, if any of these categories applies to you, then you may be at risk for enforcement action by the DEA, and you should speak with our experienced and dedicated attorneys promptly so that we can get to work protecting you and your practice.

Todd Spodek cross-examined Alec Baldwin at the 2013 stalking trial in Manhattan.

How Does the DEA Move From Prescription Anomalies to an Inspection of a Physician’s Controlled Premises?

When the DEA begins investigating a physician’s prescribing patterns, the investigation could potentially trigger scrutiny of the physician’s office and any other premises that are “controlled” by the physician. This process typically begins in one of three ways:

• A patient complains about the physician’s prescribing practices (which might then trigger a call from the DEA Special Agent to the patient and his or her pharmacy);
• A provider tips off the DEA about a physician’s prescribing practices (which might trigger a call from the DEA Special Agent to the provider); or,
• The DEA notices anomalies in the physician’s prescribing records. Anomaly detection is a routine aspect of DEA investigations, and there are many different types of anomalies that DEA agents and analysts look for. For example:
• When the volume of the physician’s prescriptions for controlled substances is unusually high, the DEA may look for diversion. However, the DEA may also examine evidence of unlawful distribution, or it may investigate whether the physician has been prescribing controlled substances without a medical necessity for the treatment of a legitimate patient condition.
• When the DEA discovers abnormal geographic patterns among the physician’s patients, it could indicate that the physician is serving as a drug-trafficker’s prescription mill. The DEA may also examine the physician’s (or any other provider’s) missing records, falsified prescriptions, or inaccurate patient records.

These are just two examples of the type of prescribing anomalies that could lead to further scrutiny of a physician’s practice and/or premises. As the investigation progresses, DEA agents may look closer at a physician’s prescription labeling and controlled-substance recordkeeping practices; and, eventually, agents could also begin to inspect the physician’s office to see if any of their findings are consistent with what is actually occurring within the physician’s controlled premises.

What Happens After an Order to Show Cause Reaches a Federal Hearing?

Generally speaking, after DEA notifies a registrant of its intent to suspend or revoke the registrant’s registration, the DEA will issue an Order to Show Cause. As explained above, if the DEA determines that the registrant’s registration to dispense controlled substances poses an imminent danger to public health or safety, it can immediately suspend the registration. An Order to Show Cause sets forth the legal and factual basis for the proposed revocation, and generally, the registrant has 30 days from the date the DEA provides service to request a hearing on the Order to Show Cause.

If the registrant fails to request a hearing within 30 days, he or she waives his or her opportunity to appear at a hearing, and the DEA will simply move forward and suspend or revoke the registration based on the DEA’s findings, evidence, and/or any other facts that may be before the DEA.

A show-cause hearing is conducted by a federal administrative law judge (ALJ). During the hearing, the DEA must present its evidence, and the physician has the opportunity to present his or her evidence in return. If the physician’s registration has not been suspended or revoked, then the DEA bears the burden of proof to establish that grounds for suspension or revocation exist. If the physician’s registration has already been suspended, the DEA must still prove by a preponderance of the evidence that the registration should be suspended or revoked.

At the conclusion of the show-cause hearing, the ALJ will issue a proposed decision recommending a course of action. In many cases, it will be appropriate for a DEA attorney to intervene and request that the DEA adopt the ALJ’s proposed decision in its final order or opinion. But, in other cases, it will be in a registrant’s best interests to fight the proposed decision. The DEA ALJ issues a proposed decision that recommends, but does not require, action by the DEA against the registrant’s registration. Because these are recommendations, registrants whose proposed decisions are unfavorable have the opportunity to file exceptions and make substantive legal arguments.

Contact a Federal Criminal Defense Attorney

Nothing here is legal advice, and the details of your case matter. Todd Spodek and Spodek Law Group take federal criminal and white collar cases nationwide, from offices in New York, Brooklyn, Queens and Los Angeles. You can reach the firm at 888 348 8028.