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Prescription Fraud: Doctors Under the Microscope

By Los Angeles Criminal Defense Attorney on March 30, 2019

As the opioid crisis in America has escalated, with media reports about prescription drug use and abuse filling the headlines every week, doctors have come increasingly under fire. The actions of physicians and healthcare workers who can write prescriptions are under review more than ever before, and charges of prescription fraud have become increasingly common. While there have certainly been negligent, even malicious, medical practitioners who have contributed to this epidemic, there are also a lot of honest doctors caught in the blast zone of these investigations.

A charge of prescription fraud can be extremely serious. Not only does a doctor facing these charges need to worry about repercussions in the justice system, including potential jail time, but there are also professional considerations. A charge of prescription fraud is likely to trigger an investigation by the state licensing board that can result in revocation of a doctor’s license to practice medicine.

What Is Prescription Fraud?

Although it can take many different forms, in general, prescription fraud refers to any use of a prescription to receive drugs that are not legitimately necessary. While patients and pharmacists can certainly be involved in prescription fraud, physicians can also face criminal charges related to this practice. Specifically, California Health & Safety Code 11153 HS deals with prescription fraud perpetrated by medical professionals.

This can apply to not just doctors, but also dentists, nurse practitioners, and psychiatrists who all have the legal ability to issue prescriptions for patients. For these professionals, they violate California state law if they issue a prescription knowing it is:

  1. Not for legitimate medical needs, and/or
  2. Outside the usual course of their area of practice.

How Is Prescription Fraud Charged?

Under California law, prescription fraud is what is known as a “wobbler,” which means it can be charged as either a misdemeanor or a felony. The decision on how to charge suspected prescription fraud is at the discretion of the prosecutor who looks at all the details of a case before making a decision. This includes such things as the nature of the allegations, the scope of the alleged fraud, and the professional or criminal history of the defendant.

As the opioid crisis has received more attention, however, there is greater pressure on prosecutors to pursue prescription fraud more aggressively. That means a felony charge is more common than it would have been in the past, especially when any kind of opioid is involved. A relatively minor offense that would have been a clear misdemeanor charge a few years ago could easily be a felony now just so the prosecutor can appear strong and “send a message.”

What Are the Consequences of a Conviction?

The consequences of a conviction for prescription fraud depend on how the prosecutor chooses to pursue the case. If it is charged as a misdemeanor, then a conviction can result in:

  • Misdemeanor probation
  • Up to one year in county jail
  • A fine of up to $1,000

On the other hand, if someone is convicted of felony prescription fraud charges, they can face:

  • Felony probation
  • At least 16 months, but up to three years in jail
  • A fine of up to $20,000

As you can see, that distinction between a misdemeanor and felony charge can have serious consequences for a defendant.

What Are Some Defenses Against a Charge?

In order for prescription fraud to occur, a physician must know that the prescription is fraudulent. If they write a prescription in good faith, believing that a patient truly is in need of prescribed drugs, then fraud cannot have occurred. This is one of the strongest defenses against a fraud charge, especially when dealing with a patient who is the one defrauding the physician. It is important to remember, that a good-faith prescription for someone a physician believes is addicted to medication can still violate laws against prescribing a controlled substance to an addict.

Are There Professional Repercussions?

A prescription fraud charge will almost certainly trigger a professional investigation into a physician’s practices. This can result in suspension or complete revocation of a physician’s professional license, ruining that person’s career. Even if a doctor is found not guilty or charges are dismissed, a professional investigation may still continue.

Do I Really Need a Lawyer?

Yes, the moment you believe you are under suspicion or have been charged with prescription fraud, you absolutely need a lawyer. Do not answer any questions from law enforcement or a prosecutor without your attorney present. Even the briefest statement you make will be used against you in court to make you appear guilty. An experienced white collar crime defense attorney knows how to fight for you and provide you with the strongest defense possible. If you’ve been accused of prescription fraud, contact the experienced legal team at Werksman Jackson & Quinn LLP by dialing (213) 688-0460.


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