Our firm has represented many pharmacists who were investigated only because they were filling scripts written by “problematic” prescribers, mostly those with a restricted ability to prescribe controlled substances.
Many pharmacists complain that it is often difficult (if not impossible) to know if a prescriber has a suspended DEA registration, any prescribing restrictions, or a discipline that would justify rejecting a script.
While it is true that a pharmacy usually has no means of knowing of an open investigation due to the confidential nature of such investigations, there are several ways to research past records of a prescriber:
- Medical Board’s Records
The most obvious one and the most utilized investigation approach is to research the prescriber’s license on the Medical Board’s website. It will show past and current disciplines. But usually, you need to read the whole disciplinary record to understand if there are any prescribing restrictions or red flags that would warranty denying a script.
- Board of Pharmacy’s Website
As a pharmacist in California, you need to subscribe to the Board of Pharmacy’s email alerts. The Board periodically emails a list of prescribers with restricted authority for prescribing controlled substances. Also, on the Board’s homepage, under “Important Information for Licensee” you can find a link to prescribers with restricted authority for prescribing controlled substances.
- DEA’s Records
I’ve seen plenty of cases where pharmacists were dispensing scripts from prescribers with suspended or restricted DEA registration. But how can a pharmacist know about these issues? According to a Diversion Investigator (“DI”) from a recent DEA case, a pharmacy can request a current DEA registration from the prescriber. But as we all know, it is often difficult to obtain additional information from a prescriber’s office. According to the same DI, if you are unsuccessful in obtaining a DEA registration directly from the prescriber, you can contact your local DEA office and request a copy of this prescriber’s DEA registration or inquire whether the prescriber is in a good standing with the DEA.
While the above sources may help to determine prescribers with restricted authority to prescribe controlled substances, often there are no means of knowing if a prescriber is on the DEA’s or any other agency’s radar. I had cases where the DEA was investigating pharmacies because they worked with the prescribers with unrestricted prescribing privileges but had a discipline pertaining to controlled substances. The DEA considers it a red flag that has to be resolved.
In another case, the DEA argued that a pharmacy should not have supplied controlled substances to a prescriber for his office use (minimal quantities to alleviate shortages) because the prescriber was implicated in a child pornography scheme. When we argued that the pharmacy had no means of knowing about this investigation which did not relate to the prescriber’s medical practice, the DEA responded that the investigation was covered by a local newspaper and the pharmacy should have been familiar with the allegations and should have stopped working with this prescriber.
In a nutshell, when filling a script from new prescribers it is important to verify their licenses. If there is a disciplinary action based on prescribing controlled substances, pharmacists must use their professional judgment on whether to work with such a prescriber. It is also recommended to obtain a copy of the prescriber’s DEA registration (which is easier said than done). For known prescribers, a good practice is to verify prescriber’s good standings every 6 months. And as always, document your due diligence and keep all documents readily available in case of a DEA or BOP investigation.