The latest: The Supreme Court sides with doctors who overprescribe drugs

[cigaretteman]

Unanimous:

A Monday ruling from the Supreme Court will make it harder for the government to prosecute doctors who overprescribe drugs, Ann E. Marimow reports.
The court held that the government must prove beyond a reasonable doubt that a doctor knew or intended to prescribe drugs in an unauthorized manner when dealing with cases of overprescription.
Under federal law, licensed physicians are permitted to dispense controlled substances for “legitimate medical purpose” as part of their professional practice. The justices were deciding how to distinguish valid medical conduct from illegal overprescription of highly addictive drugs such as opioids.
The court, in making its decision, unanimously set aside the convictions of two physicians accused of operating opioid “pill mills.” The doctors, Xiulu Ruan and Shakeel Kahn, were convicted at trial of unlawfully dispensing and distributing drugs and sentenced to more than 20 years in prison. As Ann explains:

Ruan operated a medical clinic in Alabama and a pharmacy, which made more than $4 million during a four-year period and dispensed nearly 300,000 prescriptions, including many for opioids.
Kahn practiced in Arizona and Wyoming, operating mostly on a cash-only basis and accepting property as payment, including firearms.
The court rejected the government’s request to affirm the convictions and argued that requiring prosecutors to prove that a doctor knowingly or intentionally acted not as authorized would allow bad actors to escape liability. The justices unanimously returned the physicians’ convictions to the lower courts for further review.

The move could change the way the government investigates health care fraud cases, former prosecutors warned. The Justice Department, they said, could now be required to prove beyond a reasonable doubt that a doctor knew what they were doing was wrong when issuing a prescription.
“The DOJ has aggressively pursued health care fraud in a post-pandemic world and each of these investigations will have to be re-evaluated to determine if the DOJ has enough evidence to meet” the court’s new standard, Sean B. O’Connell, a former federal prosecutor with health care fraud experience, said in a statement.
The Justice Department declined to comment on the ruling.
Read more about Ruan v. United States and Kahn v. United States here.

https://www.washingtonpost.com/politics/2022/06/27/abortion-midterms-biden-g7/#link-IDMEGWETOFEFDP6XFMDG45U2MM

 

[Whiskeydeltadeltatango]

Sooo is this going to be the latest thing for the dems? Trash the SC.

 

[kc78]

This court is completely out of control.

 

[Jerome Silberman]

Sooo is this going to be the latest thing for the dems? Trash the SC.

Why let Republicans have all the fun?

 

[HawkMachine]

Sooo is this going to be the latest thing for the dems? Trash the SC.

 

[Titanhawk2]

This court is completely out of control.

Yeah, they should continue to let nebulous laws and opinion rule the day

 

[Colonoscopy]

This court is completely out of control.

I don't know that. Somebody needs to do a good job explaining why. Otherwise we're left to wonder if this just isn't partisan bitching about things not going their way.

 

[Aardvark86]

The thing about this case is that people tend to think that every doc but their own is a pill mill quack. And lord knows, these defendants sure sounds like they may have been just that. But the world of pain management is a very strange place - there are some patients who can and do take extraordinary volumes without significant adverse effect, and there are some specialists who prescribe that way because they see it work in their practice. The whole "clinical trial v. real world evidence" thingy.

I do think it's sort of funny though, how, in today's earlier WV v EPA discussion, you had a group of people arguing that experts should make the rules and bemoaning the fact that politicians should have a say in the matter. Yet here, the putative experts, who were indisputably about five steps closer to the facts on the ground than any assistant us attorney will ever be, are the ones who are instantly derided, and whose imprisonment is called for, probably because the commenters just don't like the deciders of the question, even when they decide it unanimously and the opinion is written by the court's senior liberal justice.

For my money, I want it to be hard to show the necessary intent to criminally prosecute a doctor for medical judgments that are often just as much art as science. That may not be these guys (and they may still be convicted on retrial), but next time around it might be your doctor, particularly given the 20/20 hindsight around opioid practices. Indeed, say your worst nightmare comes true and a statute is enacted criminalizing abortion other than in situations of danger to the life of the mother. Do you, or don't you, want the prosecutor to have a hard time arguing that the mother's life wasn't in danger...particularly if, say, the doc is the only one who does the procedure in a 150 mile radius, and so does a lot of them, making it look as if they're an abortion mill.

BTW, this isn't going to do much w/r/t fraud cases, particularly civil fraud cases, where the intent standard is considerably lower than that here.