Doctor Shopping Laws
Popular talk radio host Rush Limbaugh was arrested in 2006 for prescription fraud, following his public confession that he'd become addicted to the opioid painkiller OxyContin. Florida prosecutors accused him of prescription fraud after discovering he obtained roughly 2,000 pills prescribed by four doctors in the space of six months. Limbaugh, who denied the charge and pleaded not-guilty, was able to evade felony charges in exchange for seeking treatment.
More commonly known as "doctor shopping," federal and state laws make it a crime (typically a felony) to withhold information, falsify symptoms, or otherwise engage in fraud in order to obtain prescriptions for controlled substances.
This article discusses doctor shopping laws in general, examples of federal and state laws, and common punishments.
Doctor Shopping: Overview
Doctor shopping involves the use of deception and manipulation to encourage a doctor to prescribe drugs for illicit use or sale. Often this is accomplished by faking symptoms, withholding important information, claiming earlier refills were lost, and other tactics. Sometimes doctors are in on the scam, as is the case with so-called "pill mills" that are notorious for selling to addicts and dealers.
According to a study cited by the National Institute on Drug Abuse, one of out every 143 U.S. patients who received an opioid prescription in 2008 got them from multiple doctors in a pattern suggesting doctor shopping. What's more, the article points out, one subset of suspected doctor shoppers obtained an average of 32 opioid prescriptions from 10 different doctors over a 10-month period.
Since the crime involves deception and a certain level of trust (for instance, doctors don't know whether pain is real or faked), it's unclear just how widespread the problem is.
Federal Doctor Shopping Law
Federal law makes it a crime to "knowingly or intentionally... possess a controlled substance" unless it was obtained through a valid prescription (among other narrow exceptions). While the language is vague, the use of deception or manipulation in order to possess a controlled substance (such as a prescription painkiller) would render the prescription invalid. The code section goes on to state that the attempt or conspiracy to illegally obtain a controlled substance also is a criminal offense.
But these crimes generally are prosecuted by the states, all of which (in addition to the District of Columbia) have laws prohibiting doctor shopping.
State Doctor Shopping Laws
Every state has adopted some version of the anti-fraud provision found in the Uniform Narcotic Drug Act or the Uniform Controlled Substances Act. Nearly half of the states have more specific laws prohibiting patients from knowingly withholding information from the doctor they're currently seeing about prescribed controlled substances they've received from other healthcare practitioners.
The Uniform Narcotic Drug Act states the following:
No person shall obtain or attempt to obtain a narcotic drug, or procure or attempt to procure the administration of a narcotic drug ... by fraud, deceit, misrepresentation, or subterfuge or ... by the concealment of a material fact.
Examples of state doctor shopping laws include the following:
- Arizona - Information communicated from a patient to a doctor (or other care provider) in an attempt to procure controlled substances through fraud is not protected as privileged communication.
- Kansas - It is unlawful for a patient to provide false information, "with the intent to deceive" a practitioner "for the purpose of obtaining a prescription-only drug."
- Montana - Patients are prohibited from obtaining "the same or a similar dangerous drug ... from another source within the prior 30 days."
- Louisiana - Patients must disclose the name of any previously prescribed (within the prior 30 days) controlled substances, the amount prescribed, and the number of refills.
- Rhode Island - The state has two laws prohibiting such acts: those committed "by fraud, deceit, misrepresentation, or subterfuge" and those committed "by the concealment of a material fact."
Penalties for Doctor Shopping Offenses
Penalties for those convicted of (or who plead guilty to) doctor shopping violations vary from state to state and depend on the case. For example, first-time offenders with drug addiction problems are often given the option of attending drug treatment programs instead of serving time in prison. This option is similar to other diversion programs (often called "drug courts") for first-time drug offenders.
Otherwise, most convictions result in prison time and steep fines. For instance, a conviction in Florida can land you in prison for up to five years, with fines of up to $5,000. In California, prison sentences for doctor shopping can be up to three years but with a fine of up to $20,000. Virtually all states treat the offense as a felony.
Have More Questions About Doctor Shopping Laws? A Lawyer Can Help
If you're a physician or patient with a legitimate need for certain prescription drugs, such as opioids, but concerned about accusations of prescription fraud, you may want more information about these laws. Your best option is to get in touch with an experienced health care attorney near you.