Prescription drug fraud is a type of healthcare fraud that involves the unlawful prescription of medicine by a variety of types of providers. With the recent increase in unlawful prescriptions involving opioids that have contributed to the nationwide opioid epidemic, state and federal scrutiny (and funding) surrounding prescription drug fraud has also risen significantly.
Given these circumstances, if you or your practice has been accused of prescription drug fraud, it is more critical than ever that you get quality healthcare fraud defense. The Dallas healthcare fraud attorneys at Westfall Sellers have the trial-tested experience you need to aggressively defend your rights, your reputation, and your career.
Learn more about the charges, penalties, and defenses involved in prescription drug fraud cases, and call Westfall Sellers at 817-928-4222 for a free initial consultation today.
What is prescription drug fraud?
The term prescription drug fraud actually encapsulates a number of different types of unlawful actions. These can include but are not limited to:
- False or fraudulent prescriptions, including prescription forgery
- Prescribing drugs without performing an adequate in-person or telemedical patient evaluation
- Calling in prescriptions illegally
- Prescribing unnecessary drugs after submitting a false patient evaluation
- Over-prescribing prescription drugs when commercially-available drugs provide adequate treatment
- Prescribing drugs in order to receive kickbacks
- Illegally importing prescription drugs
- Providing more medication than indicated in the prescription
- Providing a prescription medication as an unauthorized refill
- Prescription diversion (giving yourself or someone else who was not the intended recipient of a prescription the prescription)
As you can see, these practices can involve many different types of practitioners, from pharmacists to doctors and other types of medical professionals who prescribe medication.
State and federal prescription drug fraud laws
If you are being charged with prescription drug fraud, you are going to run into both federal and state standards.
You can find an overview of the federal standards in the 2021 review of the Controlled Substances Act (Title 21 of the United States Code). In this review, it stated that a practitioner puts their patients in danger when they prescribe “controlled substances outside the usual course of professional practice without a legitimate medical purpose.”
Meanwhile, Texas prescription laws as they relate to prescription drug fraud are outlined in the Texas Controlled Substances Act (Title 6, Subtitle C, Chapter 481 of the Health and Safety Code).
The most common charges for prescription drug fraud involve prescriptions of Schedule II drugs. Schedule II drugs are currently legal for medical use but are earmarked as being highly addictive. They include pain relievers such as Methadone, Hydrocodone (Vicodin) and Oxycodone (Oxycontin, Percocet, etc.) as well as ADD and ADHD treatments such as Ritalin and Adderall.
Note that drugs are “scheduled” according to the legality of their medical use and their potential to cause dependency. Schedule I drugs are highly addictive and not permitted for medical use (ie Heroin); schedule V drugs are legal to prescribe and have a very low potential for abuse (ie Robitussin AC).
Prescription drug fraud penalties
The penalties for unlawful prescribing or prescription drug fraud range significantly depending upon the substances involved and the extent of the fraud.
For example, one instance of prescription drug fraud of a Schedule IV or V drug is likely to be classified as a Class B Misdemeanor, meaning a guilty conviction can land you with up 180 days in prison and a fine of up to $2,000. The same charge involving a Schedule I or II drug could land you with a 2nd Degree Felony — 2-20 years in prison and a fine of up to $10,000.
Charges may be increased depending on how many counts of fraud are perpetrated and whether or not you were found guilty of a similar charge previously.
In addition to these fines, you might also face the loss of your medical license, loss of your DEA registration, asset seizure, and other penalties.
Defenses for unlawful prescribing and prescription drug fraud
There are many types of healthcare fraud defense that can be applied during a case involving prescription drug fraud — you can find a more comprehensive list in our article on Healthcare Fraud Defense. However, the most common defense that the healthcare fraud defense lawyers at Westfall sellers see in cases involving unlawful prescribing is that of lack of intent.
Not only are Texas prescription requirements complex, but the recent surge in audits and investigations surrounding drug fraud during the opioid epidemic means that innocent practitioners are getting caught in the crossfire.
In order to be convicted of prescription drug fraud, the government must first prove that you actually intended to take part in a scheme or artifice involving unlawful prescribing. They must provide adequate evidence to substantiate this charge beyond a reasonable doubt.
If such evidence is lacking or it can be proved that you have, in fact, taken steps to stop prescription drug fraud from occurring in your practice or pharmacy, then the government’s case against you will not be very strong.
Work with a top prescription drug fraud defense firm in Texas
The various state and federal bodies in charge of auditing and investigating practices pursue prescription drug fraud cases very vigorously. The minute that you suspect that you are under investigation, it is likely in your best interest to seek legal representation.
An experienced and strategic healthcare fraud defense attorney can actually preemptively help iron out communication and compliance issues between you and these authorities. If charges are made, having representation from the start means that you will already have the building blocks of a strong defense and will have avoided making wrong steps in the meantime.
At Westfall Sellers, we fight for our clients with full knowledge of just how much is at stake for them during this time. We know what you know — that you only get one shot at this, so you better handle it right the first time around.
For aggressive healthcare fraud defense, contact Westfall Sellers online or call us at 817-928-4222 today.
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