Thursday, April 22, 2010

DEA Suboxone Audit Update VIII

Continued from: Worst Experience of My Career: a Follow Up

After numerous phone calls and broken promises, as well as assistance from my congressman, I received a letter from Mark Caverly, Chief the the Liaison and Policy Section, Office of Diversion Control, DEA, responding to my request for a description of the buprenorphine record and stock inspection process when conducted under Administrative Inspection Warrant.

Although Mr. Caverly provided no such description, he did shed some light on what a physician might expect. I am left with the overall impression that the process differs little from an inspection conducted after a physician has signed Form 82, the chief difference being that the inspection is conducted without the physician's permission.

The most egregious aspect of the inspections from the physician's (an patients' present at the office) seems unchanged from the "permitted" inspection: agents will appear unannounced, thus unnecessarily disrupting medical care under the illusion that this will prevent physicians from preparing in advance, so the agents can catch offenders red handed. Because of this I see little advantage in declining to sign Form 82 when agents appear at your office.

Mr. Caverly failed to answer most of the rest of my questions:

"Will agents force entry if the physician is not present?"

He seems to have missed the fact that this is a yes or no question. He simply cited a statute with no reference to forced entry. The statute does refer to a "right" (Shouldn't that be authority?) to "enter such premises... in a reasonable manner," whatever that means.

"Will agents serve the warrant during regular business hours?"

The cited statute also specifies that inspections should be conducted at "reasonable times," whatever that means. Again, he does not seem to recognize a yes or no question.

"If the physician is present when the agents serve the warrant, and is prepared to provide access to the required records, will the audit be conducted as it would have been with Form 82 (Notice of Inspection) consent?"

Once more he evades a yes or no question. He simply tells us that the same records must be made available rather than addressing how the inspection will be conducted.

"Will agents be more or less likely to confiscate records than they would be with Form 82 consent?"

He evades this question as well but does tell us that the physician will be provided with a receipt for any records seized pursuant to the authority of the Administrative Inspection Warrant, and that the records will be returned when the process is completed.

"To what extent does national policy govern the process, and how much latitude and discretion does DEA afford local field offices?"

Once more his answer is uninformative and completely fails to address the question. It would be wonderful to see one of these people cross examined in court where they can't get away with such evasiveness. And these are public servants?

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