White Collar Criminal Defense Group

DOJ’s New Opioid Fraud And Abuse Detection Unit To Investigate Physicians And Pharmacists For Opioid-Related Health Care Fraud

What happened?

Attorney General Jeff Sessions announced the formation of a DOJ pilot program to combat the opioid epidemic devastating communities across the country. The program, named the Opioid Fraud and Abuse Detection Unit, will prosecute opioid-related health care fraud using data analytics to identify and prosecute individuals allegedly contributing to the epidemic.

The Rundown

In remarks to the Columbus Police Academy in early-August, Attorney General Sessions announced that the newly formed Opioid Fraud and Abuse Detection Unit will analyze data like prescriptions and billing records to investigate and prosecute health care fraud related to prescription opioids.  As part of the program, DOJ is funding twelve AUSA’s for a three-year term to focus solely on opioid-related offenses like pill mill schemes and pharmacies that illegally dispense prescription opioids for illegitimate purposes. General Sessions said that in the crosshairs of the Detection Unit are “doctors, pharmacies, and medical providers who are furthering this epidemic to line their pockets.”

The pilot program will focus its efforts on the twelve communities hardest hit by the opioid epidemic, including local jurisdictions like the Western District of Pennsylvania, Southern District of Ohio, and Southern District of West Virginia.

For the Record

Attorney General Jeff Sessions: “I have created this unit to focus specifically on opioid-related health care fraud using data to identify and prosecute individuals that are contributing to this opioid epidemic. This sort of data analytics team can tell us important information about prescription opioids—like which physicians are writing opioid prescriptions at a rate that far exceeds their peers; how many of a doctor’s patients died within 60 days of an opioid prescription; the average age of the patients receiving these prescriptions; pharmacies that are dispensing disproportionately large amounts of opioids; and regional hot spots for opioid issues.” 

“With this data in hand, I am also assigning 12 experienced prosecutors to focus solely on investigating and prosecuting opioid-related health care fraud cases in a dozen locations around the country where we know enforcement will make a difference in turning the tide on this epidemic. These prosecutors, working with FBI, DEA, HHS, as well as our state and local partners, will help us target and prosecute these doctors, pharmacies, and medical providers who are furthering this epidemic to line their pockets.”

The Take Home

Unlike DOJ’s typical prosecution of drug crimes, which largely focuses on street-level dealers and their suppliers, the Opioid Fraud and Abuse Detection Unit will target physicians, pharmacists, and providers for health care fraud related to prescription opioids.

If you are a physician, pharmacist or health care provider and need the assistance of an attorney, please do not hesitate to contact us today.

Presidential Pardon Power In The Spotlight

What Happened?

On August 25, President Trump pardoned former Maricopa County, Arizona Sheriff Joe Arpaio. Arpaio was convicted last month of criminal contempt for violating a federal judge’s order that he stop detaining people based solely on suspicion of their immigration status. Arpaio’s pardon—the first of Trump’s presidency—brings attention to the pardon procedure.

The Rundown

Article II, Section 2 of the Constitution gives the President the authority to “grant Reprieves and Pardons for Offenses against the United States.” The power only applies to federal crimes, as only governors can issue pardons for state offenses. The President has the sole, almost limitless power to determine who to pardon and why. The Constitution only excludes cases of impeachment from the President’s pardon authority. While there are rules governing petitions for executive clemency, they are only advisory. 

A presidential pardon will remove legal disabilities imposed because of a criminal conviction, but will not remove the conviction from the pardoned individual’s criminal record. Criminal convictions can only be removed from an individual’s criminal record through expungement, a judicial remedy granted by the court of conviction.

In most cases, the clemency process is lengthy and involves several levels of review within the Department of Justice before reaching the President. Typically, an individual seeking a pardon submits a detailed application form and character references to the Department of Justice’s Office of the Pardon Attorney (OPA). The applicant or any third party acting in support of the applicant may also submit any additional information he or she believes may have bearing on the application. The OPA reviews the applications and communicates with any agencies that may have been involved in the applicant’s case. After the application and all other relevant information has been reviewed, OPA submits a proposed recommendation to the Deputy Attorney General. In making its recommendation, the OPA considers the applicant’s post-conviction conduct, character and reputation; the seriousness and relative recentness of the offense; the applicant’s acceptance of responsibility, remorse, and atonement; and the applicant’s need for relief. The Deputy Attorney General makes a final recommendation on behalf of DOJ to the President. 

For the Record

President Trump did not consult with the Justice Department before announcing his decision to pardon Arpaio, though a DOJ spokesman acknowledged after the pardon was granted that “[t]he President exercised his lawful authority and we respect his decision.” 

The Take Home

For the typical applicant, the clemency process is long and the likelihood of success is unpredictable. The President is not bound by any rules regarding the applications he grants, or whether he even needs to consider applications at all.