Two Considerations When You Have Been Notified of Theft and Fraudulent Prescriptions of Controlled Substances

Our healthcare law firm works with many providers who prescribe medications, including controlled substances. A question that comes up is what a provider’s reporting obligations to the Drug Enforcement Administration (“DEA”) are when they discover that controlled substances have been stolen from their office or that prescriptions for controlled substances have been fraudulently submitted to patients under their names. This blog covers two considerations that providers should account for when they are notified of theft or fraudulent prescriptions. Please note that this blog post covers reporting obligations to the DEA, not any reporting obligations to state agencies. If you need assistance reporting theft or fraudulent prescriptions to the appropriate sources or would like to discuss this blog post, you may contact our healthcare law firm at (404) 685-1662 (Atlanta) or (706) 722-7886 (Augusta), or by email, info@littlehealthlaw.com. You may also learn more about our law firm by visiting www.littlehealthlaw.com.

First Consideration: The DEA Requires Providers to Report Theft of Controlled Substances and Fraudulent Prescriptions to the DEA Within One Business Day of Discovery of the Theft or Fraudulent Prescriptions

Under the DEA regulations, a provider must notify the local DEA Field Diversion Office in writing of any theft or significant loss of any controlled substances within one business day of the discovery of the theft or loss. The provider must file a complete and accurate DEA Form 106 with the DEA through the DEA’s website within 45 calendar days after discovery of the theft or loss. You will need your DEA number to complete DEA Form 106. The DEA regulations also have several factors to determine whether a loss is significant, including (1) the actual quantity of controlled substances lost; (2) the specific controlled substances lost; (3) whether the loss can be associated with access to the lost controlled substances by specific individuals or whether the whether the loss can be attributed to unique activities that may take place involving controlled substances; (4) a pattern of losses over a specific time period, whether the losses appear to be random, and results of efforts taken to resolve losses; (5) whether specific controlled substances are likely candidates for diversion; and (6) local trends and other indicators of the diversion potential of the missing controlled substance.

If fraudulent prescriptions are being submitted in a provider’s name, the DEA regulations require that the provider notify a designated individual (an individual designated by the provider to manage access control to the e-prescription application, such as an office manager) and the DEA within one business day of the discovery that one or more prescriptions that were issued under a DEA registration held by that provider were prescriptions the provider had not signed or were not consistent with the prescriptions the provider signed. A report of fraudulent prescriptions can be made to the DEA here.

Second Consideration: A Provider’s PDMP Can Help Flag Patients Who Are Filling Controlled Substances Too Quickly and Can Be a Tool to Discover Theft or Fraudulent Prescriptions

States have Prescription Drug Monitoring Programs (“PDMP”), which are electronic databases that monitor the prescribing and dispensing of controlled substances to patients. Prescribers are required to register with a state’s PDMP, and PDMPs are intended to help eliminate prescription drug abuse and the overprescribing of controlled substances.

Providers are required to register with a state’s PDMP before prescribing controlled substances and are required to check the PDMP before submitting a prescription for a controlled substance and enter prescription information for controlled substances within certain timeframes, such as 24 hours in Georgia. Monitoring the PDMP regularly can help providers detect possible fraudulent prescriptions or theft of controlled substances if patients are filling controlled substance prescriptions too frequently.

If you need assistance reporting a potential theft or fraudulent prescription to the DEA or would like to discuss this blog post, you may contact our healthcare law firm at (404) 685-1662 (Atlanta) or (706) 722-7886 (Augusta), or by email, info@littlehealthlaw.com. You may also learn more about our law firm by visiting www.littlehealthlaw.com.

 

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