What Are Pill Mill Charges and How Can You Defend Against Them?

Dec 26, 2018

The human and economic costs of the opioid epidemic rising every day. 42,000 deaths in the United States are caused by opioids each year. It only makes sense that state officials are trying to crack down on the causes of the crisis.

Florida is one of the states hit hardest by the epidemic, and pill mills are a major culprit. 

If your practice or clinic is facing pill mill charges, keep reading to find out what you can do to defend yourself. 

What is a Pill Mill?

First, you should understand the terminology (and charges) you’re dealing with. 

A pill mill is a term used by law enforcement agencies and the media. It describes a medical clinic or doctor’s office accused of distributing medication, usually narcotic painkillers.

This distribution is distinct for one of three reasons:

  1. It’s done without a legitimate medical reason
  2. It’s outside the usual course of medical practice
  3. It’s in excess of normal prescription practices 

As part of the effort to combat the excess flow of drugs into communities, the federal government often targets pain clinics. 

What Drugs are Most Commonly Sold?

Local, state, and federal law enforcement agencies are concerned with any type of pill mill. However, they are primarily concerned with controlled substances that have a high street value. 

They keep a particularly close eye on painkillers, especially Schedule II narcotics with a high potential for abuse. Commonly flagged drugs include: 

  • Codeine
  • Morphine
  • Hydrocodone and Acetaminophen (Vicodin, Lorcet, Norco, or Lortab)
  • Hydromorphone (Dilaudid, Exalgo)
  • Oxycodone and Naloxone (Targiniq ER)
  • Oxycodone and Acetaminophen (Percocet, Roxicet, or Endocet)
  • Fentanyl (Duragesic, Actiq, or Fentora)
  • Meperidine (Demerol)

Unfortunately, this sometimes means that law enforcement agencies unjustly flag certain clinics. This leaves a gap between patients and the doctors who are legitimately trying to help them. 

How Pill Mills are Investigated

First, you have to understand that audit and investigation are the same thing in these cases. 

With that in mind, there are a few ways that law enforcement agencies might initiate an investigation into your clinic. 

Any investigator will look for red flags that suggest the clinic in question might be a pill mill. This is done by monitoring your prescribing practices. They’ll look at what you’re prescribing, who you’re prescribing it to, and how much you’re prescribing. 

Unfortunately, many of these red flags can also be attributed to completely legal practices. 

For instance, young patients traveling long distances for prescriptions is a red flag. Unfortunately, the war on prescription drugs has made it increasingly difficult for patients with chronic pain to find treatment close to home, especially in rural areas. 

If your clinic charges high fees and accepts mostly cash payments, you may be targeted as a pill mill. This is despite the fact that, once again, these are entirely legal practices and may be common for clinics who serve patients without insurance. 

As we noted above, the DEA and other law enforcement agencies keep a close eye on specific prescriptions. Doctors who prescribe a lot of the drugs listed above, especially in combination with each other, will almost infallibly get the DEA’s attention. 

Once again, there’s an obvious problem with this: prescribing pain medication is a legitimate practice for a medical clinic and it is at the doctor’s discretion to assess what drugs or combination of drugs will best aid a patient with chronic pain who may have a higher tolerance to painkillers than most. 

Common Criminal Charges for Pill Mill Doctors

Keep in mind that these kinds of investigations rarely begin with the police knocking on your door, as drug enforcement officials don’t want to alert pill mills and give them time to hide practices that could get them charged with a crime. 

It’s more common for law enforcement officials to raid your practice, which means they already have a search warrant and the investigation is likely in the concluding stages. 

Among the most common charges brought against doctors and clinics is drug trafficking, including prescribing controlled substances, prescribing medication without a medical purpose, and prescribing medicine outside the usual course of medical practice. 

If there is more than one doctor involved, or if the entire clinic is being charged, its common for law enforcement to bring RICO charges, which is when two or more people conspire to commit an illegal act or to commit a legal act by illegal means. 

In addition, doctors may face healthcare fraud charges if they are accused of overprescribing to Medicare or Medicaid patients, or if they aided patients in getting flagged prescriptions authorized through Medicare and Medicaid. 

Crafting Your Defense

First, one of the best things your clinic can do is keep an attorney on retainer. 

Most doctors and clinics become aware of an investigation when a raid occurs. Because of this, having an attorney on retainer will help you start your defense as soon as possible. 

To that end, you should be proactive about protecting your clinic or practice. If you have any reason to believe law enforcement could be investigating you, get in touch with a criminal defense attorney. Ask to have an independent audit run. 

This will help you spot areas of potential criminal exposure and see what areas can be improved to protect your practice. 

If you don’t have an attorney on retainer, get in touch with an attorney. This should happen the minute you become aware of an investigation or an audit. 

Either way, you need to be completely honest with your attorney from the beginning. You need to give them access to anything that could qualify as evidence against you, even if it seems inconsequential. 

Remember: investigations like this can go on for months before a raid occurs. That means law enforcement has a significant head start. 

If You’ve Been Charged as a Pill Mill…

If your clinic has been charged as a pill mill, or if you have any reason to believe you may be under investigation, now is not the time to wait. You need an attorney that will fight for you. 

That’s where we come in. 

Get in touch with us today to see what we can do to help defend your practice.