Pain Management Physicians Beware: Your Practice is Under Scrutiny

Wednesday, May 21, 2014
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

The practice of pain management remains under direct scrutiny here in Florida. The Orlando area recently entered the limelight again after federal agents raided a local pain clinic with heavy allegations against the owner and his sole practitioner.

On May 8, 2014, Metropolitan Bureau of Investigation (MBI) agents and Florida Department of Health (DOH) officials raided the Pain Care Place of Central Florida located in Winter Garden. The clinic owner was arrested on charges of racketeering, extortion and trafficking in oxycodone. The MBI agents and DOH officials confiscated patient files, computers and a Mercedes Benz automobile. MBI records accused the clinic of selling more than 10,000 controlled substance pills illegally. However, it must be remembered that these are only accusations at this point in time and have not been proven in court.

To read the entire article from the WFTV, click here.

The Plot Behind This Raid.

The sole physician working at the clinic told authorities that the clinic owner allegedly pressured her numerous times into signing off on prescriptions for patients she had not seen. The physician described one incident in October 2013, when the owner became angry after she called in sick two days. Upset about losing money, the clinic owner showed up unannounced at the hospital where the doctor was being treated. He allegedly demanded that the physician complete patient files and write prescriptions for powerful drugs for the patients she was supposed to see those days. Threatening to fire her and withhold her pay, the pain management physician indicated she felt forced to comply. This was not an isolated incident. According to the doctor, the owner often made these demands. The physician finally came forward in March 2014, with these allegations against the clinic's owner.

According to the Orlando Sentinel, records also show that the owner would allegedly pretend to be a physician and had credit cards proving so. Agents interviewed former patients of the clinic which shed light on further illicit acts of the office owner. Patients testified to authorities that the owner would steal prescription forms and write numerous oxycodone prescriptions for themselves, family and friends. Allegedly, the owner would also trade the pills for cocaine and sex. He was well known amongst his clients to leverage his availability of prescription drugs in return for personal incentives.

To read the entire article from the Orlando Sentinel, click here.

Pain Management Clinics Under the Microscope.

The Sunshine State is known for pain management clinics that double as "pill mills." With dozens of pain clinics shut down in the past few years, physician offices and clinics providing pain management services have quickly become law enforcement's new targets. Regulations have increased and penalties against over-prescribing physicians have become more severe. In recent state legislation, most physicians were banned from directly dispensing drugs to patients in their offices. Florida's governor also created a strike force to eliminate any pain clinics found to be suspicious. With these crackdowns, patients with true medical need for prescription pain medications are finding it difficult to locate physicians who will treat them.

Often, when a clinic is the target of a shut down, a multi-agency task force is put together. These groups typically consist of agents from the federal Drug Enforcement Administration (DEA), Florida's DOH, the Florida Attorney General's (AG) Office and local police agencies. Often these raids will be called "inspections," however the purpose is to make seizures and arrests. The physical raid will take place after an investigation has already taken place by the DEA or the other agencies and most evidence has been gathered.

The DEA will typically mandate an emergency suspension order (ESO). This immediately suspends the DEA registration number and practice of the clinic. At this point, no narcotics or controlled substances can remain in the owner or physician's possession or on the premise.

To read more, click here for a previous article.

How You Can Avoid Legal Issues.

As a physician, you should be proactive in avoiding drug seeking patients and illicit clinic owners or coworkers. With the power of prescribing comes a great responsibility. Don't find yourself behind bars when it can all be prevented. Here are some tips to learn from the recent pain management clinic raids.

    1.    Avoid working for practices or clinics that have reputations as pill mills.

    2.    Most physicians subject of investigations, such as the one written about here, are typically the sole physician in the clinic. Join a team setting in a group practice with other full-time physicians.

    3.    Document everything. Make sure all records meet state and federal laws. Verify all patients' identities and be wary of false identifications.

    4.    Make sure you know everything going on in your office. Maintain a loyal and trustworthy staff who will report irregular behavior to you as physician. Have a zero tolerance for staff violations.

    5.    Do NOT ever allow a lay person or non-physician to be in charge of your office. Do not give anyone like this access to medical records, billing, bank accounts and scheduling. You will be held accountable for this person so you should remain in control.

To read more physician tips on protecting yourself and your license, click here.

Contact Health Law Attorneys Experienced with Investigations of Health Professionals and Providers.

The attorneys of The Health Law Firm provide legal representation to physicians, nurses, nurse practitioners, CRNAs, pain management doctors, dentists, pharmacists, psychologists and other health providers in Department of Health (DOH) investigations, Drug Enforcement Administration (DEA) investigations, FBI investigations, Medicare investigations, Medicaid investigations and other types of investigations of health professionals and providers.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at


As an owner or physician at a pain management clinic, what steps do you take to ensure your business is compliant with laws and regulations? Please leave any thoughtful comments below.


Pavuk, Amy "MBI: Doc Forced to Write Illegal Prescriptions." Orlando Sentinel. (May 8, 2014). From:

"Owner of Winter Garden Pain Clinic Accused of Coercing Doctor to Write Prescriptions." (May 8, 2014). From:

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law.  He is the President and Managing Partner of The Health Law Firm, which has a national practice.  Its main office is in the Orlando, Florida, area.  The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone:  (407) 331-6620.

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