Michael Jones, M.D.; Decision and Order, 20728-20732 [2021-08169]
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pursuant to 28 CFR 0.100(b) and the
authority vested in me by 21 U.S.C.
823(f), I hereby deny any pending
application of Mark A. Wimbley, M.D.,
to renew or modify this registration, as
well as any other applications of Mark
A. Wimbley, M.D. for additional
registration in California. This Order is
effective May 21, 2021.
D. Christopher Evans,
Acting Administrator.
BILLING CODE 4410–09–P
DEPARTMENT OF JUSTICE
Drug Enforcement Administration
Michael Jones, M.D.; Decision and
Order
On September 19, 2019, the Drug
Enforcement Administration
(hereinafter, DEA or Government)
Administrative Law Judge Charles Wm.
Dorman (hereinafter, ALJ), issued an
Order Granting Government’s Motion
for Summary Disposition and
Recommended Rulings, Findings of
Fact, Conclusions of Law, and Decision
(hereinafter, RD) on the action to revoke
the DEA Certificate of Registration
Number BJ5665281 of Michael Jones,
M.D. The ALJ transmitted the record to
me on October 15, 2019, and asserted
that no exceptions were filed by either
party. ALJ Transmittal Letter, at 1.
Having reviewed and considered the
entire administrative record before me,
I adopt the ALJ’s RD with minor
modifications, where noted herein.*A
Order
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Pursuant to 28 CFR 0.100(b) and the
authority vested in me by 21 U.S.C.
824(a), I hereby revoke DEA Certificate
of Registration No. BJ5665281 issued to
Michael Jones, M.D. Further, pursuant
to 28 CFR 0.100(b) and the authority
vested in me by 21 U.S.C. 823(f), I
hereby deny any pending application of
Michael Jones to renew or modify this
registration, as well as any other
pending application of Michael Jones,
*A I have made minor, nonsubstantive,
grammatical changes to the RD. Where I have made
more substantive changes, I have marked the
changes with an asterisk, brackets and explanatory
footnotes.
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D. Christopher Evans,
Acting Administrator.
Paul E. Soeffing, Esq., for the
Government
Robert C. Jenkins, Esq., for the
Respondent
Order Granting Government’s Motion
for Summary Disposition and
Recommended Rulings, Findings of
Fact, Conclusions of Law, and Decision
of the Administrative Law Judge
[FR Doc. 2021–08171 Filed 4–20–21; 8:45 am]
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for additional registration in Louisiana.
This Order is effective May 21, 2021.
The Assistant Administrator,
Diversion Control Division, Drug
Enforcement Administration (‘‘DEA’’),
issued an Order to Show Cause
(‘‘OSC’’), dated June 19, 2019, proposing
to revoke the Certificate of Registration
(‘‘COR’’), Number BJ5665281, of
Michael Jones, M.D. (‘‘Dr. Jones’’ or
‘‘Respondent’’), and to deny any
applications for renewal or modification
of such registration, and any
applications for any other DEA
registrations, pursuant to 21 U.S.C.
824(a)(5). The OSC alleges that
revocation is warranted because
Respondent has been mandatorily
excluded from all federal health care
programs under 42 U.S.C. 1320a–7(a).
The Office of Administrative Law
Judges (‘‘OALJ’’) received a copy of the
OSC on June 19, 2019. OSC, at 1. Dr.
Jones, through counsel, filed a hearing
request on July 19, 2019, the 30th day
from the date of the OSC. Thus, Dr.
Jones’s hearing request was timely filed.
On July 19, 2019, I issued an Order for
Prehearing Statements (‘‘OPHS’’),
directing the parties to file prehearing
statements and establishing a date for a
telephonic prehearing conference.
OPHS, at 1–2. The Government timely
filed its prehearing statement on August
2, 2019. Dr. Jones did not file a
prehearing statement by his deadline for
doing so.
I conducted a telephonic prehearing
conference with the parties on August
21, 2019. Following the conference, I
issued a Prehearing Ruling (‘‘PHR’’), in
which I directed Dr. Jones to file a
prehearing statement and a motion for
leave to file his prehearing statement
out of time.
On August 26, 2019, Dr. Jones filed
his prehearing statement along with a
motion for leave to file his prehearing
statement out of time. Because the
Government did not file an opposition
to Respondent’s motion for out-of-time
filing, on September 10, 2019, I issued
an Order Granting Respondent’s Motion
for Out of Time Prehearing Statement
and Notice Concerning Summary
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Disposition (‘‘Order Concerning
Summary Disposition’’), which granted
Respondent’s motion for out-of-time
filing as unopposed. My Order
Concerning Summary Disposition also
established a deadline for the
Government to file a motion for
summary disposition and for Dr. Jones
to respond to the Government’s motion
for summary disposition.
The Government timely filed its
Motion for Summary Disposition on
September 13, 2019. Dr. Jones timely
filed his Opposition to Government’s
Motion for Summary Disposition on
September 18, 2019 (‘‘Respondent’s
Opposition’’). Accordingly, I base this
ruling and Recommended Decision on
the Government’s Motion for Summary
Disposition, Dr. Jones’s Opposition, and
the Administrative Record before me.
The issue in this case is whether the
record as a whole establishes by a
preponderance of the evidence that the
DEA should revoke the Certificate of
Registration of Michael Jones, M.D., No.
BJ5665281/XJ5665281, and deny any
applications for renewal or modification
of such registration, and deny any
applications for any other DEA
registrations, pursuant to 21 U.S.C.
824(a)(5), because he has been excluded
from federal health care programs under
42 U.S.C. 1320a–7(a).
The Facts
I. Stipulations
During the telephonic prehearing
conference, the parties agreed to the
following stipulations (‘‘Stip.’’), which
are accepted as facts in this proceeding:
1. Respondent is registered with the
DEA as a practitioner-DW/30 in
Schedules II through V under DEA
Certificate of Registration BJ5665281/
XJ5665281 with a registered address of
3405 Saint Claude Ave., New Orleans,
LA 70117–6144, and a mailing address
of 2433 Bedford Dr., New Orleans, LA
70131–4703. Respondent’s registration
expires by its terms on December 31,
2021.
2. On or about September 25, 2018,
Judgment was entered against
Respondent based on Respondent’s
conviction on one count of ‘‘Conspiracy
to Commit Health Care Fraud,’’ in
violation of 18 U.S.C. 1349, one count
of ‘‘Conspiracy to Pay and Receive
Illegal Health Care Kickbacks,’’ in
violation of 18 U.S.C. 371, and seven
counts of ‘‘Health Care Fraud,’’ in
violation of 18 U.S.C. 1347 and 2. U.S.
v. Michael Jones, No. 2:15–cr–00061–
SM–JCW (E.D. La. filed Sept. 28, 2018).
3. Based on Respondent’s conviction,
the U.S. Department of Health and
Human Services, Office of Inspector
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General (‘‘HHS/OIG’’), by letter dated
March 29, 2019, mandatorily excluded
Respondent from participation in
Medicare, Medicaid, and all federal
health care programs for a minimum
period of ten years pursuant to 42 U.S.C.
1320a–7(a), effective April 18, 2019.
4. Reinstatement of eligibility to
participate in Medicare, Medicaid and
all federal health care programs after
exclusion by HHS/OIG is not automatic.
5. Respondent is currently excluded
from participation in Medicare,
Medicaid and all federal health care
programs.
6. Respondent stipulates to the
admissibility of Government Exhibits 1–
4.
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I. Government’s Position
In its Motion for Summary
Disposition, the Government argues that
there is no dispute of material fact
requiring an adversarial hearing. Gov’t
Summ. Disp., at 1, 5–6. Specifically, the
Government notes that Dr. Jones does
not dispute that he is currently
excluded from federal health care
programs under 42 U.S.C. 1320a–7(a).
Id. at 5. After quoting the entirety of Dr.
Jones’s proposed testimony from his
Prehearing Statement and noting his
single proposed exhibit, the
Government argues that based on his
Prehearing Statement, Dr. Jones ‘‘does
not intend to provide any testimony or
documentary evidence as to why his
registration should not be revoked.’’ Id.
at 4–5. Continuing, the Government
argues that Dr. Jones’s Prehearing
Statement ‘‘makes no proffer as to why,
in the face of his exclusion, he should
be allowed to retain his registration.’’ Id.
Consequently, the Government argues
that granting summary disposition in
the Government’s favor is consistent
with DEA precedent because Dr. Jones
has failed ‘‘to identify any issue of
material fact in his Prehearing
Statement that would warrant the
holding of a hearing or the presentation
of testimony.’’ Id. at 1. In conclusion,
the Government requests that Dr. Jones’s
COR be revoked. Id. at 6.
II. Respondent’s Position
In his Opposition, Dr. Jones argues
that summary disposition is
inappropriate because he appealed his
conviction to the United States Court of
Appeals for the Fifth Circuit (‘‘Fifth
Circuit’’). Resp’t Opposition, at 1.
Although the Fifth Circuit has not yet
ruled on Dr. Jones’s appeal, his
Opposition states that he believes his
appeal has merit on the ground that the
prosecution ‘‘failed to present sufficient
evidence at trial to sustain his
convictions.’’ Id. The Opposition further
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states that Dr. Jones’s counsel intends to
‘‘outline the relevant issues in that
appeal at his [DEA] hearing.’’ Id.
Respondent’s Opposition reiterates the
substance of the testimony that is
contained in his Prehearing Statement
concerning his appeal pending before
the Fifth Circuit, but adds for the first
time that the DEA proceeding should be
‘‘deferred until after the Fifth Circuit
resolves the appeal.’’ Id.
Analysis
Under DEA precedent, ‘‘it is wellsettled that when no question of
material fact is involved, a plenary,
adversary administrative proceeding
involving evidence and crossexamination of witnesses is not
obligatory.’’ Michael G. Dolin, M.D., 65
FR 5661, 5662 (2000). This precedent is
based on the principle that ‘‘Congress
did not intend administrative agencies
to perform meaningless tasks.’’ Sandra
J.S. Tyner, M.D., 63 FR 56223, 56223
(1998). ‘‘ ‘[C]ommon sense suggests the
futility of hearings where there is no
factual dispute of substance.’ ’’ Richard
Jay Blackburn, D.O., 82 FR 18669, 18672
(2017) (quoting Veg-Mix, Inc. v. U.S.
Dep’t of Agric., 832 F.2d 601, 607 (D.C.
Cir. 1987)). The central inquiry when
deciding a motion for summary
disposition is whether there is ‘‘a
genuine issue for trial.’’ Anderson v.
Liberty Lobby, Inc., 477 U.S. 242, 249
(1986).
The ‘‘party moving for summary
disposition ‘must show, with materials
of appropriate evidentiary quality, that
every state of facts is excluded save that
which entitles [it] to relief.’ ’’ Bio
Diagnostic Int’l, 78 FR 39327, 39328–29
(2013). The underlying facts are
‘‘ ‘viewed in the light most favorable to
the’ ’’ non-moving party. Matsushita
Elec. Indus. Co., Ltd. v. Zenith Radio
Corp., 475 U.S. 574, 587 (1986) (quoting
United States v. Diebold, Inc., 369 U.S.
654, 655 (1962)). Once the moving party
satisfies its burden to show that there is
no genuine dispute of material fact, the
non-movant is tasked with presenting
‘‘ ‘competent evidence that could be
presented at trial showing that there is
a genuine dispute as to a material fact.’ ’’
William J. O’Brien, III, D.O., 82 FR
46527, 46529 (2017) (quoting 10B
Charles Allen Wright, et al., Federal
Practice and Procedure Civ. § 2727.2
(4th ed. April 2017)).
‘‘A fact is ‘material’ if it ‘might affect
the outcome of the suit under the
governing law.’ ’’ Bazan v. Hidalgo Cty.,
246 F.3d 481, 489 (5th Cir. 2001)
(emphasis in original) (quoting Liberty
Lobby, Inc., 477 U.S. at 248). To be
considered material, a fact must be
‘‘outcome determinative.’’ Int’l
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Shortstop, Inc. v. Rally’s, Inc., 939 F.2d
1257, 1264 (5th Cir. 1991). In other
words, a material fact is a fact that has
the potential to affect the outcome of the
case. Failure to present material
evidence that could impact the outcome
of the case is fatal to the non-moving
party. William J. O’Brien, III, D.O., 82 FR
at 46529. An issue is genuine if the
evidence resolving the issue is sufficient
to support a ruling in favor of the party
opposing summary judgment. Prof’l
Managers, Inc. v. Fawer, Brian, Hardy &
Zatzkis, 799 F.2d 218, 222 (5th Cir.
1986). An issue must be ‘‘real and
substantial’’ to be considered genuine.
Bazan, 246 F.3d at 489.
The Administrative Record contains
‘‘reliable and probative evidence’’ to
support the conclusion that there is no
genuine issue of material fact requiring
an adversarial hearing. Richard Jay
Blackburn, D.O., 82 FR at 18672–73. To
begin, at the prehearing conference, the
Government and Respondent entered
into all the relevant factual stipulations
necessary to establish a prima facie case
for sanction under 21 U.S.C. 824(a)(5).
Specifically, the Parties stipulated that
Dr. Jones was convicted of federal
offenses involving health care fraud in
the United States District Court for the
Eastern District of Louisiana (‘‘District
Court’’) (Stip. 2); that as a result of his
convictions the HHS/OIG mandatorily
excluded Dr. Jones from participating in
Medicare, Medicaid, and all federal
health care programs for ten years
beginning on April 18, 2019 (Stip. 3);
that reinstatement in federal health care
programs is not automatic (Stip. 4); and
that Dr. Jones is currently excluded from
participating in federal health care
programs (Stip. 5). PHR, at 1–2. Lastly,
Respondent stipulated to the
admissibility of the Government’s
exhibits (Stip. 6). Id. at 2.
The Government attached evidence to
its Motion for Summary Disposition
corroborating the factual stipulations.
Specifically, the Government attached a
notarized Certification of Registration
History (Exh. 1); a copy of the judgment
entered by the District Court against Dr.
Jones (Exh. 2); a copy of the HHS/OIG
exclusion letter (Exh. 3); and a printout
from the HHS/OIG website (Exh. 4).
The notarized Certification of
Registration History, dated June 24,
2019, is signed by the Associate Chief of
DEA’s Registration and Program
Support Section. Gov’t Summ. Disp.,
Exh. 1, at 1. The Certification states that
Dr. Jones is registered with the DEA as
a practitioner-DW/30 to handle
controlled substances in Schedules 2–5
under COR No. BJ5665281 and that DEA
last approved the renewal of this
registration on November 29, 2018. Id.
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The Certification further states that this
registration expires on December 31,
2021, and that it is currently under
active pending status. Id. The
Certification additionally states that this
registration number is the only DEA
registration associated with Dr. Jones.
Id.
The Government’s next exhibit is the
judgment entered by the District Court
against Dr. Jones on September 25, 2018.
The District Court’s judgment form
shows that Dr. Jones was found guilty of
one count of conspiracy to commit
health care fraud (18 U.S.C. 1349); one
count of conspiracy to pay and receive
illegal health care kickbacks (18 U.S.C.
371); and seven counts of health care
fraud (18 U.S.C. 1347). Gov’t Summ.
Disp., Exh. 2, at 1. The judgment further
ordered Dr. Jones to pay $347,525 in
restitution to Medicare, and sentenced
him to serve three years in prison
followed by two years of supervised
release. Id. at 2–3, 6.
Next, the Government attached a copy
of the HHS/OIG exclusion letter, dated
March 29, 2019. That letter shows that
as a result of Dr. Jones’s convictions,
HHS excluded him from participating in
Medicare, Medicaid, and all federal
health care programs for ten years. Gov’t
Summ. Disp., Exh. 3, at 1. The letter
explains that Dr. Jones’s ten-year
exclusion would become effective
twenty days from the date of the letter.
Id. The letter further explains that Dr.
Jones’s exclusion is based on his
conviction of a program-related crime.
Id.; 42 U.S.C. 1320a–7(a)(1). In addition,
the letter explains that reinstatement in
federal health care programs is not
automatic. Id. at 3. Lastly, the
Government attached a printout from
the HHS/OIG website, which shows that
Dr. Jones has been excluded from
federal health care programs since April
18, 2019, for a program-related
conviction. Gov’t Summ. Disp., Exh. 4,
at 1.
The four exhibits attached to the
Government’s Motion are the same
exhibits the Government identified in
its prehearing statement. See Gov’t PHS,
at 3 (describing each of the
Government’s four exhibits intended for
use at the hearing). Respondent
stipulated to the information that is
contained in each of those exhibits
(Stips. 2–5) as well as the admissibility
of those exhibits if they were offered at
trial (Stip. 6). Based on the
Government’s exhibits and the Parties’
factual stipulations to the contents of
those exhibits, as well as their
admissibility, I find that the
Administrative Record contains
‘‘reliable and probative evidence’’ that
Dr. Jones is currently excluded from
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Medicare, Medicaid, and all federal
health care programs pursuant to a
program-related conviction. Richard Jay
Blackburn, D.O., 82 FR at 18672–73.
The Administrative Record further
establishes that Dr. Jones’s ten-year
exclusion from all federal health care
programs is the result of his convictions
related to health care fraud. The
Administrative Record also shows that
Dr. Jones’s exclusion began on April 18,
2019. And based on the Parties’ factual
stipulations, Respondent does not
dispute that he was convicted of fraudrelated crimes and then excluded by
HHS/OIG from all federal health care
programs.
To meet its burden for sanction under
21 U.S.C. 824(a)(5), the Government
must show that Respondent is excluded
from participating in Medicare,
Medicaid, and all federal health care
programs under one of the four bases for
mandatory exclusion in 42 U.S.C.
1320a–7(a). Mandatory exclusion from a
federal health care program under 42
U.S.C. 1320a–7(a) serves as an
independent basis for revoking a DEA
registration. 21 U.S.C. 824(a)(5); Terese,
Inc., d/b/a Peach Orchard Drugs, 76 FR
46843, 46847 (2011); Dinorah Drug
Store, Inc., 61 FR 15972, 15973 (1996).
Once the Government meets its
burden, the issue becomes which
sanction should DEA impose in light of
considerations concerning acceptance of
responsibility, mitigation,
egregiousness, and deterrence. Jeffrey
Stein, M.D., 84 FR 46968, 46972 (2019).
To resolve this issue, the DEA considers
whether the respondent ‘‘has presented
‘sufficient mitigating evidence to assure
the Administrator that [he] can be
trusted with the responsibility carried
by’ ’’ a DEA registration. Id. (alteration
in original) (quoting Samuel S. Jackson,
D.D.S., 72 FR 23848, 23853 (2007)); see
also Kwan Bo Jin, M.D., 77 FR 35021,
35023–25 (2012) (concluding the
Government ‘‘met its burden of proving
its Section 824(a)(5) claim’’ and then
considering the five public interest
factors to determine whether respondent
met his burden ‘‘to show that . . .
granting him a COR would not be
contrary to the public interest.’’). The
material issues in this case are,
therefore, quite simple: Is Dr. Jones
excluded under 42 U.S.C. 1320a–7(a),
and, if so, does the evidentiary record
support the Government’s requested
sanction?
As discussed above, there is no
dispute that Dr. Jones is currently
excluded from all federal health care
programs under 42 U.S.C. 1320a–7(a)(1).
There is no dispute because Dr. Jones
does not contest the fact that HHS/OIG
excluded him from eligibility to
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participate in all federal health care
programs for ten years beginning on
April 18, 2019. Stips. 3, 5. Thus, to
defeat the Government’s Motion, Dr.
Jones must present ‘‘ ‘competent
evidence that could be presented at
trial’ ’’ relevant to the issue of which
sanction should DEA impose. William J.
O’Brien, III, D.O., 82 FR at 46529
(quoting 10B Charles Allen Wright, et
al., Federal Practice and Procedure Civ.
§ 2727.2 (4th ed. April 2017)). In other
words, to raise an issue of material fact,
Dr. Jones would need to present
evidence relevant to acceptance of
responsibility, mitigation,
egregiousness, or deterrence. Jeffrey
Stein, M.D., 84 FR at 46972. He has
failed to do so.
Instead, Dr. Jones responded to the
Government’s Motion with the same
proposed evidence he raised in his
Prehearing Statement. And despite the
fact that Dr. Jones was allowed to file a
prehearing statement after the original
deadline for doing so, and despite my
advice to him at the prehearing
conference concerning the level of detail
that his prehearing statement should
contain, Dr. Jones filed a prehearing
statement with only a single sentence of
proposed testimony. That single
sentence previewed that Dr. Jones
would testify that he appealed his
criminal sentence to the Fifth Circuit
and he believes his conviction will be
overturned.1 Resp’t PHS, at 3. Dr.
Jones’s Prehearing Statement noticed
only one exhibit: A copy of the certified
notice of his appeal to the Fifth Circuit.
Id. In his Opposition to the
Government’s Motion, Dr. Jones states
that he appealed his conviction to the
Fifth Circuit and that he believes his
appeal has merit.2 Resp’t Opposition, at
1. Dr. Jones’s Opposition further
previews that his counsel intends to
‘‘outline’’ at the DEA hearing the issues
he has appealed to the Fifth Circuit.3 Id.
Dr. Jones’s appeal of his conviction
has no bearing on the issues relevant to
this case. First, the appeal of his
conviction does not change the fact that
beginning on April 18, 2019, HHS/OIG
excluded him from federal health care
programs for ten years. Furthermore, Dr.
Jones’s pending appeal does not change
the fact that he is currently excluded
1 Notwithstanding the irrelevance of this
proposed testimony, it is unclear how an appeal of
his sentence would affect the underlying
conviction.
2 Again, notwithstanding the irrelevance of this
statement, the basis for this belief is unclear.
3 Again, notwithstanding the irrelevance of his
appeal, it is unclear how Respondent’s counsel
intends to ‘‘outline’’ the issues of that appeal at the
hearing since he failed to disclose in his prehearing
statement, or his Opposition, what issues he
intends to ‘‘outline.’’
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from all federal health care programs for
a program-related conviction under 42
U.S.C. 1320a–7(a)(1). Because it is Dr.
Jones’s mandatory exclusion and not his
underlying conviction that forms the
basis for sanction in this case, his
appeal of the conviction is not a
relevant consideration. Second, the
appeal does not bear in any way on the
issue of whether Dr. Jones can be trusted
with handling controlled substances
during his ten-year exclusion. In other
words, the existence of a pending
appeal is not mitigating evidence that is
probative of Dr. Jones’s ability to
responsibly discharge the duties of a
DEA registrant and to comply with
controlled substance laws. Third,
whether Dr. Jones’s appeal will be
successful and, if so, whether HHS/OIG
will reinstate his eligibility to
participate in federal health care
programs, is pure speculation. Even if
his appeal is successful, and his
convictions are erased, it is speculative
at this time to predict whether and
when HHS/OIG will reinstate Dr. Jones’s
eligibility to participate in federal health
care programs. And ‘‘unsupported
speculation [is] not sufficient to defeat
a motion for summary judgment.’’
Brown v. City of Houston, 337 F.3d 539,
541 (5th Cir. 2003).
Rather than respond to the
Government’s Motion with probative
evidence that bears on the issue of
whether he can be trusted to handle
controlled substances, Dr. Jones has
collaterally attacked the criminal
proceedings underlying his mandatory
exclusion. A respondent cannot use
DEA proceedings to collaterally attack
proceedings litigated in another forum.
Kristen Lee Raines, A.P.R.N., 81 FR
14890, 14891–92 (2016); see also
Hicham K. Riba, D.D.S., 73 FR 75773,
75774 (2008) (same); Brenton D. Glisson,
M.D., 72 FR 54296, 54297 (2007) (same).
There is a proper forum for Dr. Jones to
litigate his criminal convictions, and the
DEA is not that forum. In addition, there
is a proper forum to litigate his
mandatory exclusion, and the
procedures for doing so are provided on
page 4 of the HHS/OIG exclusion letter
in a section titled, ‘‘How to Appeal Your
Exclusion.’’ Gov’t Summ. Disp., Exh. 3,
at 4. Dr. Jones may disagree with his
conviction and exclusion, but a DEA
proceeding is not the proper place to
voice that disagreement.
In sum, the Administrative Record
contains substantial, undisputed
evidence to establish a prima facie case
for sanction under 21 U.S.C. 824(a)(5).
Specifically, the evidence proves that
Dr. Jones is currently excluded from
Medicare, Medicaid, and all federal
health care programs under 42 U.S.C.
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1320a–7(a)(1) pursuant to a programrelated conviction involving fraudulent
activity. Dr. Jones’s exclusion from
federal health care programs under 42
U.S.C. 1320a–7(a)(1) is an independent
basis for sanction under 21 U.S.C.
824(a)(5). Furthermore, the evidence
that Dr. Jones has presented in response
to the Government’s Motion fails to
raise a genuine issue of material fact
necessitating an adversarial hearing.
The only evidence Dr. Jones has
presented concerns a pending appeal
and pure speculation about the appeal’s
chance of success. The evidence of Dr.
Jones’s appeal bears no relevance to the
issue of whether Dr. Jones can be trusted
with a DEA Certificate of Registration in
light of the fact that the Government has
satisfied its burden for sanction under
21 U.S.C. 824(a)(5). Because Dr. Jones’s
pending appeal cannot affect ‘‘ ‘the
outcome of [this case] under the
governing law,’ ’’ it is not a material fact,
and therefore, it is insufficient to defeat
the Government’s Motion. Bazan, 246
F.3d at 489 (quoting Liberty Lobby, Inc.,
477 U.S. at 248).
Accordingly, the Government’s
Motion for Summary Disposition is
granted, and the scheduled hearing in
this matter is, therefore, cancelled.
With respect to Dr. Jones’s request in
his Opposition to stay these proceedings
until the resolution of his appeal, that
request is denied. Dr. Jones cites no case
law to support the proposition that he
is entitled to a stay of these proceedings
pending his appeal. Furthermore,
staying this case pending Dr. Jones’s
appeal would significantly diverge from
well-established DEA precedent. [See
Grider Drug #1 & Grider Drug #2, 77 FR
44070, 44104 n.97 (2012); see also
Newcare Home Health Servs., 72 FR
42126, 42127 (2007).] *B Dr. Jones has
not pointed to any legal authority, and
provided no legal argument, to justify
diverging from DEA’s consistent
precedent against granting stays
pending the outcome of other
proceedings, *[and as noted herein, the
outcome of his appeal does not directly
affect this proceeding.]
Sanction
Once the Government makes a prima
facie case for sanction, the burden shifts
to the respondent to demonstrate that
despite the proven allegations,
maintaining his DEA registration would
not be inconsistent with the public
interest. Kwan Bo Jin, M.D., 77 FR at
35023. This would require the
respondent to credibly accept
responsibility for his misconduct or
point to evidence mitigating the gravity
*B Omitted
PO 00000
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Frm 00080
Fmt 4703
Sfmt 4703
20731
of his offense. Id. at 35026. Here,
because the Administrative Record
establishes a prima facie case for
sanction, the next question is ‘‘whether
revocation . . . is the appropriate
sanction in light of the facts’’ and
Respondent’s evidence. Samuel Arnold,
D.D.S., 63 FR at 8688.
Revoking a registration on the ground
that the registrant has been mandatorily
excluded from federal health care
programs is discretionary. Dinorah Drug
Store, Inc., 61 FR at 15973. Since
revocation is a matter of discretion, the
DEA has advised that the public interest
factors outlined in 21 U.S.C. 823(f) may
be consulted in determining the
appropriate sanction, although the ALJ
is not obligated to analyze them. Id.; see,
e.g., Johnnie Melvin Turner, M.D., 67 FR
at 71203–04 (revoking registration based
on mandatory exclusion without
conducting public interest inquiry). It is
not required that the underlying
misconduct involved controlled
substances, but that can be a relevant
consideration.4 Dinorah Drug Store, Inc.,
61 FR at 15974.
*C The Administrator has explained
that because DEA employs roughly
1,625 individuals to regulate over 1.8
million registrants, the Administration
relies heavily on a registrant’s honesty
and integrity ‘‘to complete its mission of
preventing diversion within such a large
regulated population.’’ Jeffrey Stein,
M.D., 84 FR at 46974. Because DEA
depends on the integrity of those it
entrusts with controlled substance
privileges, it takes a close look at a
registrant’s fraudulent activity. See
Nelson Ramirez-Gonzalez, M.D., 58 FR
52787, 52788 (1993) (noting fraudulent
activity ‘‘casts doubt upon [a
registrant’s] integrity’’). Although a
registrant’s fraud may not involve
controlled substances, fraudulent
activity indicates that a registrant
‘‘place[s] monetary gain above the
welfare of his patients, and in so doing,
4 DEA has reiterated its well-established
precedent in numerous final orders that the
underlying conviction that led to mandatory
exclusion does not need to involve controlled
substances to support sanction. See, e.g., Jeffrey
Stein, M.D., 84 FR 46968, 46971 (2019); Mohammed
Asgar, M.D., 83 FR 29569, 29571 (2018); Narciso A.
Reyes, M.D., 83 FR 61678, 61681 (2018); Richard
Hauser, M.D., 83 FR 26308, 26310 (2018); Orlando
Ortega-Ortiz, M.D., 70 FR 15122, 15123 (2005); Juan
Pillot-Costas, M.D., 69 FR 62084, 62085 (2004);
Daniel Ortiz-Vargas, M.D., 69 FR 62095, 62095–96
(2004); KK Pharmacy, 64 FR 49507, 49510 (1999);
Melvin N. Seglin, M.D., 63 FR 70431, 70433 (1998);
Anibal P. Herrera, M.D., 61 FR 65075, 65078 (1996);
Stanley Dubin, D.D.S., 61 FR 60727, 60728 (1996);
Richard M. Koenig, M.D., 60 FR 65069, 65071
(1995); George D. Osafo, M.D., 58 FR 37508, 37509
(1993); Nelson Ramirez-Gonzalez, M.D., 58 FR
52787, 52788 (1993); Gilbert L. Franklin, D.D.S., 57
FR 3441, 3441 (1992).
*C Omitted sentence for clarity.
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endanger[s] the public health and
safety.’’ George D. Osafo, M.D., 58 FR
37508, 37509 (1993).
The Government’s evidence does not
provide details concerning Dr. Jones’s
criminal misconduct; however, the
District Court’s judgment offers
sufficient information to find that Dr.
Jones committed fraudulent activity
related to medical services. Dr. Jones
was convicted of seven counts of
violating 18 U.S.C. 1347 (‘‘Health care
fraud’’). Gov’t Summ. Disp., Exh. 2, at
1. The elements of this statute require
proof that an individual knowingly or
willfully executed a scheme ‘‘to defraud
any health care benefit program,’’ or ‘‘to
obtain, by means of false or fraudulent
pretenses, representations, or promises,
any of the money or property owned by,
or under the custody or control of, any
health care benefit program.’’ 18 U.S.C.
1347(a). Dr. Jones was further convicted
of one count of violating 18 U.S.C. 371
(‘‘Conspiracy to commit offense or to
defraud United States’’), which subjects
persons who conspire ‘‘to commit any
offense against the United States, or to
defraud the United States,’’ to a
maximum prison sentence of five years,
or to payment of a fine, or both. The
District Court’s judgment specifies that
Dr. Jones’s violation of 18 U.S.C. 371
involved conspiracy to pay and receive
illegal health care kickbacks. Gov’t
Summ. Disp., Exh. 2, at 1. The District
Court sentenced Dr. Jones to three years’
imprisonment, to be served, if
practicable, after the term of
imprisonment of his co-defendant. Id. at
2. The District Court further imposed
two years of supervised release after Dr.
Jones serves his prison term, and
ordered him to pay $347,525 to
Medicare in restitution. Id. at 3, 6.
Despite the lack of evidence that Dr.
Jones’s criminal misconduct involved
controlled substances, the District
Court’s judgment shows that Dr. Jones
defrauded Medicare of hundreds of
thousands of dollars. This type of
criminal misconduct raises serious
concerns about Dr. Jones’s integrity and
honesty, especially in his dealings with
government agencies, and justifies
revocation even if his misconduct did
not involve controlled substances.
Anibal P. Herrera, M.D., 61 FR at 65078;
Nelson Ramirez-Gonzalez, M.D., 58 FR
at 52788; George D. Osafo, M.D., 58 FR
at 37509; see also Jeffrey Stein, M.D., 84
FR at 46972.
In fact, DEA has previously revoked
registrations for misconduct comparable
to Respondent’s. See Dan E. Hale, D.O.,
69 FR 69402, 69406 (2004) (denying
application based on material
falsification and mandatory exclusion
which resulted from fraud convictions);
VerDate Sep<11>2014
18:12 Apr 20, 2021
Jkt 253001
Johnnie Melvin Turner, M.D., 67 FR at
71204 (revocation based on exclusion
from Medicare program after federal
fraud conviction); Stanley Dubin,
D.D.S., 61 FR 60727, 60727 (1996)
(revocation for exclusion from federal
health care programs after state fraud
conviction).
Furthermore, the exclusion letter
notes that HHS/OIG deemed Dr. Jones’s
criminal misconduct to be egregious
enough to warrant an exclusion period
in excess of the statutory minimum.
Gov’t Summ. Disp., Exh. 3, at 1–2. The
exclusion letter explains that HHS/OIG
excluded Dr. Jones for ten years instead
of the statutory minimum of five years,
because (1) Dr. Jones’s fraudulent
activity was intended to cause financial
loss to a government agency of more
than $50,000; (2) he committed the
fraudulent activity over a period of six
years; and (3) the District Court’s
sentence included imprisonment. Id. at
2.
The DEA ‘‘carefully consider[s]
mitigating evidence provided by the
respondent’’ when deciding the
appropriate sanction in a Medicare
exclusion case. Jeffrey Stein, M.D., 84
FR at 46970. Dr. Jones, however, has
failed to provide any mitigating
evidence for the DEA to consider. Dr.
Jones’s failure to present mitigating
evidence is the reason why granting
summary disposition in the
Government’s favor is appropriate. It is
also the reason why, in light of the
egregiousness of his fraudulent activity,
revocation is the appropriate sanction.
In the face of Dr. Jones’s exclusion, he
has not presented any evidence to
convince DEA that it can trust him with
the privilege and responsibility to
handle controlled substances. Dr. Jones
fraudulently obtained hundreds of
thousands of dollars from a United
States government agency over a period
of six years. Based on several
aggravating circumstances, HHS/OIG
found Dr. Jones’s criminal activity to be
sufficiently egregious to justify
imposing a longer exclusion period than
statutorily required. Dr. Jones has not
responded with any indication that he
intends to accept responsibility at the
DEA hearing or that he feels remorse for
his misconduct. In fact, Dr. Jones pled
not guilty to the criminal charges and
his position on appeal is that the
prosecution failed to present enough
evidence at trial. Gov’t Summ. Disp.,
Exh. 2, at 1; Resp’t Opposition, at 1.
Pleading not guilty and then attacking
the conviction on appeal is inconsistent
with a respondent who accepts
responsibility and feels remorse for his
misconduct. Furthermore, Dr. Jones has
not presented any mitigation evidence,
PO 00000
Frm 00081
Fmt 4703
Sfmt 4703
to include evidence that he has taken
steps to assure DEA that he will not
engage in fraudulent activity in the
future. In the absence of mitigation
evidence demonstrating that DEA can
entrust Dr. Jones with a registration,
revocation is appropriate.
Recommendation
For these reasons, it is recommended
that Dr. Jones’s DEA Certificate of
Registration, Number BJ5665281/
XJ5665281, be revoked, and that any of
Dr. Jones’s applications for renewal or
modification of such registration, and
any application by Dr. Jones for any
other DEA registration, be denied.5
Dated: September 19, 2019.
Charles Wm. Dorman,
U.S. Administrative Law Judge.
[FR Doc. 2021–08169 Filed 4–20–21; 8:45 am]
BILLING CODE 4410–09–P
DEPARTMENT OF JUSTICE
Drug Enforcement Administration
Javaid A. Perwaiz, M.D.; Decision and
Order
On June 1, 2020, the Assistant
Administrator, Diversion Control
Division, Drug Enforcement
Administration (hereinafter,
Government), issued an Order to Show
Cause (hereinafter, OSC) to Javaid A.
Perwaiz, M.D. (hereinafter, Registrant)
of Chesapeake, Virginia. OSC, at 1. The
OSC proposed the revocation of
Registrant’s Certificate of Registration
No. AP1844287. It alleged that
Registrant is without ‘‘authority to
handle controlled substances in
Virginia, the state in which [Registrant
is] registered with DEA.’’ Id. (citing 21
U.S.C. 823(f) and 824(a)(3)).
Specifically, the OSC alleged that
according to the records of the Virginia
Department of Health Professionals,
Registrant’s Virginia Medicine &
Surgery license expired on March 31,
2020. OSC, at 2. The OSC further
alleged that because Registrant’s
medical license was expired, Registrant
no longer held authority to handle
controlled substances in Virginia. Id.
The OSC notified Registrant of the
right to request a hearing on the
allegations or to submit a written
statement, while waiving the right to a
hearing, the procedures for electing each
option, and the consequences for failing
to elect either option. Id. (citing 21 CFR
5 Pursuant to 21 CFR 1316.66, a party may file
exceptions to this Recommended Decision
‘‘[w]ithin twenty days after the date upon which a
party is served a copy of’’ this Recommended
Decision. * [No exceptions were timely filed.]
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[Federal Register Volume 86, Number 75 (Wednesday, April 21, 2021)]
[Notices]
[Pages 20728-20732]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2021-08169]
-----------------------------------------------------------------------
DEPARTMENT OF JUSTICE
Drug Enforcement Administration
Michael Jones, M.D.; Decision and Order
On September 19, 2019, the Drug Enforcement Administration
(hereinafter, DEA or Government) Administrative Law Judge Charles Wm.
Dorman (hereinafter, ALJ), issued an Order Granting Government's Motion
for Summary Disposition and Recommended Rulings, Findings of Fact,
Conclusions of Law, and Decision (hereinafter, RD) on the action to
revoke the DEA Certificate of Registration Number BJ5665281 of Michael
Jones, M.D. The ALJ transmitted the record to me on October 15, 2019,
and asserted that no exceptions were filed by either party. ALJ
Transmittal Letter, at 1. Having reviewed and considered the entire
administrative record before me, I adopt the ALJ's RD with minor
modifications, where noted herein.*A
---------------------------------------------------------------------------
\*A\ I have made minor, nonsubstantive, grammatical changes to
the RD. Where I have made more substantive changes, I have marked
the changes with an asterisk, brackets and explanatory footnotes.
---------------------------------------------------------------------------
Order
Pursuant to 28 CFR 0.100(b) and the authority vested in me by 21
U.S.C. 824(a), I hereby revoke DEA Certificate of Registration No.
BJ5665281 issued to Michael Jones, M.D. Further, pursuant to 28 CFR
0.100(b) and the authority vested in me by 21 U.S.C. 823(f), I hereby
deny any pending application of Michael Jones to renew or modify this
registration, as well as any other pending application of Michael
Jones, for additional registration in Louisiana. This Order is
effective May 21, 2021.
D. Christopher Evans,
Acting Administrator.
Paul E. Soeffing, Esq., for the Government
Robert C. Jenkins, Esq., for the Respondent
Order Granting Government's Motion for Summary Disposition and
Recommended Rulings, Findings of Fact, Conclusions of Law, and Decision
of the Administrative Law Judge
The Assistant Administrator, Diversion Control Division, Drug
Enforcement Administration (``DEA''), issued an Order to Show Cause
(``OSC''), dated June 19, 2019, proposing to revoke the Certificate of
Registration (``COR''), Number BJ5665281, of Michael Jones, M.D. (``Dr.
Jones'' or ``Respondent''), and to deny any applications for renewal or
modification of such registration, and any applications for any other
DEA registrations, pursuant to 21 U.S.C. 824(a)(5). The OSC alleges
that revocation is warranted because Respondent has been mandatorily
excluded from all federal health care programs under 42 U.S.C. 1320a-
7(a).
The Office of Administrative Law Judges (``OALJ'') received a copy
of the OSC on June 19, 2019. OSC, at 1. Dr. Jones, through counsel,
filed a hearing request on July 19, 2019, the 30th day from the date of
the OSC. Thus, Dr. Jones's hearing request was timely filed.
On July 19, 2019, I issued an Order for Prehearing Statements
(``OPHS''), directing the parties to file prehearing statements and
establishing a date for a telephonic prehearing conference. OPHS, at 1-
2. The Government timely filed its prehearing statement on August 2,
2019. Dr. Jones did not file a prehearing statement by his deadline for
doing so.
I conducted a telephonic prehearing conference with the parties on
August 21, 2019. Following the conference, I issued a Prehearing Ruling
(``PHR''), in which I directed Dr. Jones to file a prehearing statement
and a motion for leave to file his prehearing statement out of time.
On August 26, 2019, Dr. Jones filed his prehearing statement along
with a motion for leave to file his prehearing statement out of time.
Because the Government did not file an opposition to Respondent's
motion for out-of-time filing, on September 10, 2019, I issued an Order
Granting Respondent's Motion for Out of Time Prehearing Statement and
Notice Concerning Summary Disposition (``Order Concerning Summary
Disposition''), which granted Respondent's motion for out-of-time
filing as unopposed. My Order Concerning Summary Disposition also
established a deadline for the Government to file a motion for summary
disposition and for Dr. Jones to respond to the Government's motion for
summary disposition.
The Government timely filed its Motion for Summary Disposition on
September 13, 2019. Dr. Jones timely filed his Opposition to
Government's Motion for Summary Disposition on September 18, 2019
(``Respondent's Opposition''). Accordingly, I base this ruling and
Recommended Decision on the Government's Motion for Summary
Disposition, Dr. Jones's Opposition, and the Administrative Record
before me.
The issue in this case is whether the record as a whole establishes
by a preponderance of the evidence that the DEA should revoke the
Certificate of Registration of Michael Jones, M.D., No. BJ5665281/
XJ5665281, and deny any applications for renewal or modification of
such registration, and deny any applications for any other DEA
registrations, pursuant to 21 U.S.C. 824(a)(5), because he has been
excluded from federal health care programs under 42 U.S.C. 1320a-7(a).
The Facts
I. Stipulations
During the telephonic prehearing conference, the parties agreed to
the following stipulations (``Stip.''), which are accepted as facts in
this proceeding:
1. Respondent is registered with the DEA as a practitioner-DW/30 in
Schedules II through V under DEA Certificate of Registration BJ5665281/
XJ5665281 with a registered address of 3405 Saint Claude Ave., New
Orleans, LA 70117-6144, and a mailing address of 2433 Bedford Dr., New
Orleans, LA 70131-4703. Respondent's registration expires by its terms
on December 31, 2021.
2. On or about September 25, 2018, Judgment was entered against
Respondent based on Respondent's conviction on one count of
``Conspiracy to Commit Health Care Fraud,'' in violation of 18 U.S.C.
1349, one count of ``Conspiracy to Pay and Receive Illegal Health Care
Kickbacks,'' in violation of 18 U.S.C. 371, and seven counts of
``Health Care Fraud,'' in violation of 18 U.S.C. 1347 and 2. U.S. v.
Michael Jones, No. 2:15-cr-00061-SM-JCW (E.D. La. filed Sept. 28,
2018).
3. Based on Respondent's conviction, the U.S. Department of Health
and Human Services, Office of Inspector
[[Page 20729]]
General (``HHS/OIG''), by letter dated March 29, 2019, mandatorily
excluded Respondent from participation in Medicare, Medicaid, and all
federal health care programs for a minimum period of ten years pursuant
to 42 U.S.C. 1320a-7(a), effective April 18, 2019.
4. Reinstatement of eligibility to participate in Medicare,
Medicaid and all federal health care programs after exclusion by HHS/
OIG is not automatic.
5. Respondent is currently excluded from participation in Medicare,
Medicaid and all federal health care programs.
6. Respondent stipulates to the admissibility of Government
Exhibits 1-4.
I. Government's Position
In its Motion for Summary Disposition, the Government argues that
there is no dispute of material fact requiring an adversarial hearing.
Gov't Summ. Disp., at 1, 5-6. Specifically, the Government notes that
Dr. Jones does not dispute that he is currently excluded from federal
health care programs under 42 U.S.C. 1320a-7(a). Id. at 5. After
quoting the entirety of Dr. Jones's proposed testimony from his
Prehearing Statement and noting his single proposed exhibit, the
Government argues that based on his Prehearing Statement, Dr. Jones
``does not intend to provide any testimony or documentary evidence as
to why his registration should not be revoked.'' Id. at 4-5.
Continuing, the Government argues that Dr. Jones's Prehearing Statement
``makes no proffer as to why, in the face of his exclusion, he should
be allowed to retain his registration.'' Id. Consequently, the
Government argues that granting summary disposition in the Government's
favor is consistent with DEA precedent because Dr. Jones has failed
``to identify any issue of material fact in his Prehearing Statement
that would warrant the holding of a hearing or the presentation of
testimony.'' Id. at 1. In conclusion, the Government requests that Dr.
Jones's COR be revoked. Id. at 6.
II. Respondent's Position
In his Opposition, Dr. Jones argues that summary disposition is
inappropriate because he appealed his conviction to the United States
Court of Appeals for the Fifth Circuit (``Fifth Circuit''). Resp't
Opposition, at 1. Although the Fifth Circuit has not yet ruled on Dr.
Jones's appeal, his Opposition states that he believes his appeal has
merit on the ground that the prosecution ``failed to present sufficient
evidence at trial to sustain his convictions.'' Id. The Opposition
further states that Dr. Jones's counsel intends to ``outline the
relevant issues in that appeal at his [DEA] hearing.'' Id. Respondent's
Opposition reiterates the substance of the testimony that is contained
in his Prehearing Statement concerning his appeal pending before the
Fifth Circuit, but adds for the first time that the DEA proceeding
should be ``deferred until after the Fifth Circuit resolves the
appeal.'' Id.
Analysis
Under DEA precedent, ``it is well-settled that when no question of
material fact is involved, a plenary, adversary administrative
proceeding involving evidence and cross-examination of witnesses is not
obligatory.'' Michael G. Dolin, M.D., 65 FR 5661, 5662 (2000). This
precedent is based on the principle that ``Congress did not intend
administrative agencies to perform meaningless tasks.'' Sandra J.S.
Tyner, M.D., 63 FR 56223, 56223 (1998). `` `[C]ommon sense suggests the
futility of hearings where there is no factual dispute of substance.'
'' Richard Jay Blackburn, D.O., 82 FR 18669, 18672 (2017) (quoting Veg-
Mix, Inc. v. U.S. Dep't of Agric., 832 F.2d 601, 607 (D.C. Cir. 1987)).
The central inquiry when deciding a motion for summary disposition is
whether there is ``a genuine issue for trial.'' Anderson v. Liberty
Lobby, Inc., 477 U.S. 242, 249 (1986).
The ``party moving for summary disposition `must show, with
materials of appropriate evidentiary quality, that every state of facts
is excluded save that which entitles [it] to relief.' '' Bio Diagnostic
Int'l, 78 FR 39327, 39328-29 (2013). The underlying facts are ``
`viewed in the light most favorable to the' '' non-moving party.
Matsushita Elec. Indus. Co., Ltd. v. Zenith Radio Corp., 475 U.S. 574,
587 (1986) (quoting United States v. Diebold, Inc., 369 U.S. 654, 655
(1962)). Once the moving party satisfies its burden to show that there
is no genuine dispute of material fact, the non-movant is tasked with
presenting `` `competent evidence that could be presented at trial
showing that there is a genuine dispute as to a material fact.' ''
William J. O'Brien, III, D.O., 82 FR 46527, 46529 (2017) (quoting 10B
Charles Allen Wright, et al., Federal Practice and Procedure Civ. Sec.
2727.2 (4th ed. April 2017)).
``A fact is `material' if it `might affect the outcome of the suit
under the governing law.' '' Bazan v. Hidalgo Cty., 246 F.3d 481, 489
(5th Cir. 2001) (emphasis in original) (quoting Liberty Lobby, Inc.,
477 U.S. at 248). To be considered material, a fact must be ``outcome
determinative.'' Int'l Shortstop, Inc. v. Rally's, Inc., 939 F.2d 1257,
1264 (5th Cir. 1991). In other words, a material fact is a fact that
has the potential to affect the outcome of the case. Failure to present
material evidence that could impact the outcome of the case is fatal to
the non-moving party. William J. O'Brien, III, D.O., 82 FR at 46529. An
issue is genuine if the evidence resolving the issue is sufficient to
support a ruling in favor of the party opposing summary judgment.
Prof'l Managers, Inc. v. Fawer, Brian, Hardy & Zatzkis, 799 F.2d 218,
222 (5th Cir. 1986). An issue must be ``real and substantial'' to be
considered genuine. Bazan, 246 F.3d at 489.
The Administrative Record contains ``reliable and probative
evidence'' to support the conclusion that there is no genuine issue of
material fact requiring an adversarial hearing. Richard Jay Blackburn,
D.O., 82 FR at 18672-73. To begin, at the prehearing conference, the
Government and Respondent entered into all the relevant factual
stipulations necessary to establish a prima facie case for sanction
under 21 U.S.C. 824(a)(5). Specifically, the Parties stipulated that
Dr. Jones was convicted of federal offenses involving health care fraud
in the United States District Court for the Eastern District of
Louisiana (``District Court'') (Stip. 2); that as a result of his
convictions the HHS/OIG mandatorily excluded Dr. Jones from
participating in Medicare, Medicaid, and all federal health care
programs for ten years beginning on April 18, 2019 (Stip. 3); that
reinstatement in federal health care programs is not automatic (Stip.
4); and that Dr. Jones is currently excluded from participating in
federal health care programs (Stip. 5). PHR, at 1-2. Lastly, Respondent
stipulated to the admissibility of the Government's exhibits (Stip. 6).
Id. at 2.
The Government attached evidence to its Motion for Summary
Disposition corroborating the factual stipulations. Specifically, the
Government attached a notarized Certification of Registration History
(Exh. 1); a copy of the judgment entered by the District Court against
Dr. Jones (Exh. 2); a copy of the HHS/OIG exclusion letter (Exh. 3);
and a printout from the HHS/OIG website (Exh. 4).
The notarized Certification of Registration History, dated June 24,
2019, is signed by the Associate Chief of DEA's Registration and
Program Support Section. Gov't Summ. Disp., Exh. 1, at 1. The
Certification states that Dr. Jones is registered with the DEA as a
practitioner-DW/30 to handle controlled substances in Schedules 2-5
under COR No. BJ5665281 and that DEA last approved the renewal of this
registration on November 29, 2018. Id.
[[Page 20730]]
The Certification further states that this registration expires on
December 31, 2021, and that it is currently under active pending
status. Id. The Certification additionally states that this
registration number is the only DEA registration associated with Dr.
Jones. Id.
The Government's next exhibit is the judgment entered by the
District Court against Dr. Jones on September 25, 2018. The District
Court's judgment form shows that Dr. Jones was found guilty of one
count of conspiracy to commit health care fraud (18 U.S.C. 1349); one
count of conspiracy to pay and receive illegal health care kickbacks
(18 U.S.C. 371); and seven counts of health care fraud (18 U.S.C.
1347). Gov't Summ. Disp., Exh. 2, at 1. The judgment further ordered
Dr. Jones to pay $347,525 in restitution to Medicare, and sentenced him
to serve three years in prison followed by two years of supervised
release. Id. at 2-3, 6.
Next, the Government attached a copy of the HHS/OIG exclusion
letter, dated March 29, 2019. That letter shows that as a result of Dr.
Jones's convictions, HHS excluded him from participating in Medicare,
Medicaid, and all federal health care programs for ten years. Gov't
Summ. Disp., Exh. 3, at 1. The letter explains that Dr. Jones's ten-
year exclusion would become effective twenty days from the date of the
letter. Id. The letter further explains that Dr. Jones's exclusion is
based on his conviction of a program-related crime. Id.; 42 U.S.C.
1320a-7(a)(1). In addition, the letter explains that reinstatement in
federal health care programs is not automatic. Id. at 3. Lastly, the
Government attached a printout from the HHS/OIG website, which shows
that Dr. Jones has been excluded from federal health care programs
since April 18, 2019, for a program-related conviction. Gov't Summ.
Disp., Exh. 4, at 1.
The four exhibits attached to the Government's Motion are the same
exhibits the Government identified in its prehearing statement. See
Gov't PHS, at 3 (describing each of the Government's four exhibits
intended for use at the hearing). Respondent stipulated to the
information that is contained in each of those exhibits (Stips. 2-5) as
well as the admissibility of those exhibits if they were offered at
trial (Stip. 6). Based on the Government's exhibits and the Parties'
factual stipulations to the contents of those exhibits, as well as
their admissibility, I find that the Administrative Record contains
``reliable and probative evidence'' that Dr. Jones is currently
excluded from Medicare, Medicaid, and all federal health care programs
pursuant to a program-related conviction. Richard Jay Blackburn, D.O.,
82 FR at 18672-73. The Administrative Record further establishes that
Dr. Jones's ten-year exclusion from all federal health care programs is
the result of his convictions related to health care fraud. The
Administrative Record also shows that Dr. Jones's exclusion began on
April 18, 2019. And based on the Parties' factual stipulations,
Respondent does not dispute that he was convicted of fraud-related
crimes and then excluded by HHS/OIG from all federal health care
programs.
To meet its burden for sanction under 21 U.S.C. 824(a)(5), the
Government must show that Respondent is excluded from participating in
Medicare, Medicaid, and all federal health care programs under one of
the four bases for mandatory exclusion in 42 U.S.C. 1320a-7(a).
Mandatory exclusion from a federal health care program under 42 U.S.C.
1320a-7(a) serves as an independent basis for revoking a DEA
registration. 21 U.S.C. 824(a)(5); Terese, Inc., d/b/a Peach Orchard
Drugs, 76 FR 46843, 46847 (2011); Dinorah Drug Store, Inc., 61 FR
15972, 15973 (1996).
Once the Government meets its burden, the issue becomes which
sanction should DEA impose in light of considerations concerning
acceptance of responsibility, mitigation, egregiousness, and
deterrence. Jeffrey Stein, M.D., 84 FR 46968, 46972 (2019). To resolve
this issue, the DEA considers whether the respondent ``has presented
`sufficient mitigating evidence to assure the Administrator that [he]
can be trusted with the responsibility carried by' '' a DEA
registration. Id. (alteration in original) (quoting Samuel S. Jackson,
D.D.S., 72 FR 23848, 23853 (2007)); see also Kwan Bo Jin, M.D., 77 FR
35021, 35023-25 (2012) (concluding the Government ``met its burden of
proving its Section 824(a)(5) claim'' and then considering the five
public interest factors to determine whether respondent met his burden
``to show that . . . granting him a COR would not be contrary to the
public interest.''). The material issues in this case are, therefore,
quite simple: Is Dr. Jones excluded under 42 U.S.C. 1320a-7(a), and, if
so, does the evidentiary record support the Government's requested
sanction?
As discussed above, there is no dispute that Dr. Jones is currently
excluded from all federal health care programs under 42 U.S.C. 1320a-
7(a)(1). There is no dispute because Dr. Jones does not contest the
fact that HHS/OIG excluded him from eligibility to participate in all
federal health care programs for ten years beginning on April 18, 2019.
Stips. 3, 5. Thus, to defeat the Government's Motion, Dr. Jones must
present `` `competent evidence that could be presented at trial' ''
relevant to the issue of which sanction should DEA impose. William J.
O'Brien, III, D.O., 82 FR at 46529 (quoting 10B Charles Allen Wright,
et al., Federal Practice and Procedure Civ. Sec. 2727.2 (4th ed. April
2017)). In other words, to raise an issue of material fact, Dr. Jones
would need to present evidence relevant to acceptance of
responsibility, mitigation, egregiousness, or deterrence. Jeffrey
Stein, M.D., 84 FR at 46972. He has failed to do so.
Instead, Dr. Jones responded to the Government's Motion with the
same proposed evidence he raised in his Prehearing Statement. And
despite the fact that Dr. Jones was allowed to file a prehearing
statement after the original deadline for doing so, and despite my
advice to him at the prehearing conference concerning the level of
detail that his prehearing statement should contain, Dr. Jones filed a
prehearing statement with only a single sentence of proposed testimony.
That single sentence previewed that Dr. Jones would testify that he
appealed his criminal sentence to the Fifth Circuit and he believes his
conviction will be overturned.\1\ Resp't PHS, at 3. Dr. Jones's
Prehearing Statement noticed only one exhibit: A copy of the certified
notice of his appeal to the Fifth Circuit. Id. In his Opposition to the
Government's Motion, Dr. Jones states that he appealed his conviction
to the Fifth Circuit and that he believes his appeal has merit.\2\
Resp't Opposition, at 1. Dr. Jones's Opposition further previews that
his counsel intends to ``outline'' at the DEA hearing the issues he has
appealed to the Fifth Circuit.\3\ Id.
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\1\ Notwithstanding the irrelevance of this proposed testimony,
it is unclear how an appeal of his sentence would affect the
underlying conviction.
\2\ Again, notwithstanding the irrelevance of this statement,
the basis for this belief is unclear.
\3\ Again, notwithstanding the irrelevance of his appeal, it is
unclear how Respondent's counsel intends to ``outline'' the issues
of that appeal at the hearing since he failed to disclose in his
prehearing statement, or his Opposition, what issues he intends to
``outline.''
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Dr. Jones's appeal of his conviction has no bearing on the issues
relevant to this case. First, the appeal of his conviction does not
change the fact that beginning on April 18, 2019, HHS/OIG excluded him
from federal health care programs for ten years. Furthermore, Dr.
Jones's pending appeal does not change the fact that he is currently
excluded
[[Page 20731]]
from all federal health care programs for a program-related conviction
under 42 U.S.C. 1320a-7(a)(1). Because it is Dr. Jones's mandatory
exclusion and not his underlying conviction that forms the basis for
sanction in this case, his appeal of the conviction is not a relevant
consideration. Second, the appeal does not bear in any way on the issue
of whether Dr. Jones can be trusted with handling controlled substances
during his ten-year exclusion. In other words, the existence of a
pending appeal is not mitigating evidence that is probative of Dr.
Jones's ability to responsibly discharge the duties of a DEA registrant
and to comply with controlled substance laws. Third, whether Dr.
Jones's appeal will be successful and, if so, whether HHS/OIG will
reinstate his eligibility to participate in federal health care
programs, is pure speculation. Even if his appeal is successful, and
his convictions are erased, it is speculative at this time to predict
whether and when HHS/OIG will reinstate Dr. Jones's eligibility to
participate in federal health care programs. And ``unsupported
speculation [is] not sufficient to defeat a motion for summary
judgment.'' Brown v. City of Houston, 337 F.3d 539, 541 (5th Cir.
2003).
Rather than respond to the Government's Motion with probative
evidence that bears on the issue of whether he can be trusted to handle
controlled substances, Dr. Jones has collaterally attacked the criminal
proceedings underlying his mandatory exclusion. A respondent cannot use
DEA proceedings to collaterally attack proceedings litigated in another
forum. Kristen Lee Raines, A.P.R.N., 81 FR 14890, 14891-92 (2016); see
also Hicham K. Riba, D.D.S., 73 FR 75773, 75774 (2008) (same); Brenton
D. Glisson, M.D., 72 FR 54296, 54297 (2007) (same). There is a proper
forum for Dr. Jones to litigate his criminal convictions, and the DEA
is not that forum. In addition, there is a proper forum to litigate his
mandatory exclusion, and the procedures for doing so are provided on
page 4 of the HHS/OIG exclusion letter in a section titled, ``How to
Appeal Your Exclusion.'' Gov't Summ. Disp., Exh. 3, at 4. Dr. Jones may
disagree with his conviction and exclusion, but a DEA proceeding is not
the proper place to voice that disagreement.
In sum, the Administrative Record contains substantial, undisputed
evidence to establish a prima facie case for sanction under 21 U.S.C.
824(a)(5). Specifically, the evidence proves that Dr. Jones is
currently excluded from Medicare, Medicaid, and all federal health care
programs under 42 U.S.C. 1320a-7(a)(1) pursuant to a program-related
conviction involving fraudulent activity. Dr. Jones's exclusion from
federal health care programs under 42 U.S.C. 1320a-7(a)(1) is an
independent basis for sanction under 21 U.S.C. 824(a)(5). Furthermore,
the evidence that Dr. Jones has presented in response to the
Government's Motion fails to raise a genuine issue of material fact
necessitating an adversarial hearing. The only evidence Dr. Jones has
presented concerns a pending appeal and pure speculation about the
appeal's chance of success. The evidence of Dr. Jones's appeal bears no
relevance to the issue of whether Dr. Jones can be trusted with a DEA
Certificate of Registration in light of the fact that the Government
has satisfied its burden for sanction under 21 U.S.C. 824(a)(5).
Because Dr. Jones's pending appeal cannot affect `` `the outcome of
[this case] under the governing law,' '' it is not a material fact, and
therefore, it is insufficient to defeat the Government's Motion. Bazan,
246 F.3d at 489 (quoting Liberty Lobby, Inc., 477 U.S. at 248).
Accordingly, the Government's Motion for Summary Disposition is
granted, and the scheduled hearing in this matter is, therefore,
cancelled.
With respect to Dr. Jones's request in his Opposition to stay these
proceedings until the resolution of his appeal, that request is denied.
Dr. Jones cites no case law to support the proposition that he is
entitled to a stay of these proceedings pending his appeal.
Furthermore, staying this case pending Dr. Jones's appeal would
significantly diverge from well-established DEA precedent. [See Grider
Drug #1 & Grider Drug #2, 77 FR 44070, 44104 n.97 (2012); see also
Newcare Home Health Servs., 72 FR 42126, 42127 (2007).] *B
Dr. Jones has not pointed to any legal authority, and provided no legal
argument, to justify diverging from DEA's consistent precedent against
granting stays pending the outcome of other proceedings, *[and as noted
herein, the outcome of his appeal does not directly affect this
proceeding.]
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\*B\ Omitted parts of citation for clarity.
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Sanction
Once the Government makes a prima facie case for sanction, the
burden shifts to the respondent to demonstrate that despite the proven
allegations, maintaining his DEA registration would not be inconsistent
with the public interest. Kwan Bo Jin, M.D., 77 FR at 35023. This would
require the respondent to credibly accept responsibility for his
misconduct or point to evidence mitigating the gravity of his offense.
Id. at 35026. Here, because the Administrative Record establishes a
prima facie case for sanction, the next question is ``whether
revocation . . . is the appropriate sanction in light of the facts''
and Respondent's evidence. Samuel Arnold, D.D.S., 63 FR at 8688.
Revoking a registration on the ground that the registrant has been
mandatorily excluded from federal health care programs is
discretionary. Dinorah Drug Store, Inc., 61 FR at 15973. Since
revocation is a matter of discretion, the DEA has advised that the
public interest factors outlined in 21 U.S.C. 823(f) may be consulted
in determining the appropriate sanction, although the ALJ is not
obligated to analyze them. Id.; see, e.g., Johnnie Melvin Turner, M.D.,
67 FR at 71203-04 (revoking registration based on mandatory exclusion
without conducting public interest inquiry). It is not required that
the underlying misconduct involved controlled substances, but that can
be a relevant consideration.\4\ Dinorah Drug Store, Inc., 61 FR at
15974.
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\4\ DEA has reiterated its well-established precedent in
numerous final orders that the underlying conviction that led to
mandatory exclusion does not need to involve controlled substances
to support sanction. See, e.g., Jeffrey Stein, M.D., 84 FR 46968,
46971 (2019); Mohammed Asgar, M.D., 83 FR 29569, 29571 (2018);
Narciso A. Reyes, M.D., 83 FR 61678, 61681 (2018); Richard Hauser,
M.D., 83 FR 26308, 26310 (2018); Orlando Ortega-Ortiz, M.D., 70 FR
15122, 15123 (2005); Juan Pillot-Costas, M.D., 69 FR 62084, 62085
(2004); Daniel Ortiz-Vargas, M.D., 69 FR 62095, 62095-96 (2004); KK
Pharmacy, 64 FR 49507, 49510 (1999); Melvin N. Seglin, M.D., 63 FR
70431, 70433 (1998); Anibal P. Herrera, M.D., 61 FR 65075, 65078
(1996); Stanley Dubin, D.D.S., 61 FR 60727, 60728 (1996); Richard M.
Koenig, M.D., 60 FR 65069, 65071 (1995); George D. Osafo, M.D., 58
FR 37508, 37509 (1993); Nelson Ramirez-Gonzalez, M.D., 58 FR 52787,
52788 (1993); Gilbert L. Franklin, D.D.S., 57 FR 3441, 3441 (1992).
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*C The Administrator has explained that because DEA
employs roughly 1,625 individuals to regulate over 1.8 million
registrants, the Administration relies heavily on a registrant's
honesty and integrity ``to complete its mission of preventing diversion
within such a large regulated population.'' Jeffrey Stein, M.D., 84 FR
at 46974. Because DEA depends on the integrity of those it entrusts
with controlled substance privileges, it takes a close look at a
registrant's fraudulent activity. See Nelson Ramirez-Gonzalez, M.D., 58
FR 52787, 52788 (1993) (noting fraudulent activity ``casts doubt upon
[a registrant's] integrity''). Although a registrant's fraud may not
involve controlled substances, fraudulent activity indicates that a
registrant ``place[s] monetary gain above the welfare of his patients,
and in so doing,
[[Page 20732]]
endanger[s] the public health and safety.'' George D. Osafo, M.D., 58
FR 37508, 37509 (1993).
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\*C\ Omitted sentence for clarity.
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The Government's evidence does not provide details concerning Dr.
Jones's criminal misconduct; however, the District Court's judgment
offers sufficient information to find that Dr. Jones committed
fraudulent activity related to medical services. Dr. Jones was
convicted of seven counts of violating 18 U.S.C. 1347 (``Health care
fraud''). Gov't Summ. Disp., Exh. 2, at 1. The elements of this statute
require proof that an individual knowingly or willfully executed a
scheme ``to defraud any health care benefit program,'' or ``to obtain,
by means of false or fraudulent pretenses, representations, or
promises, any of the money or property owned by, or under the custody
or control of, any health care benefit program.'' 18 U.S.C. 1347(a).
Dr. Jones was further convicted of one count of violating 18 U.S.C. 371
(``Conspiracy to commit offense or to defraud United States''), which
subjects persons who conspire ``to commit any offense against the
United States, or to defraud the United States,'' to a maximum prison
sentence of five years, or to payment of a fine, or both. The District
Court's judgment specifies that Dr. Jones's violation of 18 U.S.C. 371
involved conspiracy to pay and receive illegal health care kickbacks.
Gov't Summ. Disp., Exh. 2, at 1. The District Court sentenced Dr. Jones
to three years' imprisonment, to be served, if practicable, after the
term of imprisonment of his co-defendant. Id. at 2. The District Court
further imposed two years of supervised release after Dr. Jones serves
his prison term, and ordered him to pay $347,525 to Medicare in
restitution. Id. at 3, 6.
Despite the lack of evidence that Dr. Jones's criminal misconduct
involved controlled substances, the District Court's judgment shows
that Dr. Jones defrauded Medicare of hundreds of thousands of dollars.
This type of criminal misconduct raises serious concerns about Dr.
Jones's integrity and honesty, especially in his dealings with
government agencies, and justifies revocation even if his misconduct
did not involve controlled substances. Anibal P. Herrera, M.D., 61 FR
at 65078; Nelson Ramirez-Gonzalez, M.D., 58 FR at 52788; George D.
Osafo, M.D., 58 FR at 37509; see also Jeffrey Stein, M.D., 84 FR at
46972.
In fact, DEA has previously revoked registrations for misconduct
comparable to Respondent's. See Dan E. Hale, D.O., 69 FR 69402, 69406
(2004) (denying application based on material falsification and
mandatory exclusion which resulted from fraud convictions); Johnnie
Melvin Turner, M.D., 67 FR at 71204 (revocation based on exclusion from
Medicare program after federal fraud conviction); Stanley Dubin,
D.D.S., 61 FR 60727, 60727 (1996) (revocation for exclusion from
federal health care programs after state fraud conviction).
Furthermore, the exclusion letter notes that HHS/OIG deemed Dr.
Jones's criminal misconduct to be egregious enough to warrant an
exclusion period in excess of the statutory minimum. Gov't Summ. Disp.,
Exh. 3, at 1-2. The exclusion letter explains that HHS/OIG excluded Dr.
Jones for ten years instead of the statutory minimum of five years,
because (1) Dr. Jones's fraudulent activity was intended to cause
financial loss to a government agency of more than $50,000; (2) he
committed the fraudulent activity over a period of six years; and (3)
the District Court's sentence included imprisonment. Id. at 2.
The DEA ``carefully consider[s] mitigating evidence provided by the
respondent'' when deciding the appropriate sanction in a Medicare
exclusion case. Jeffrey Stein, M.D., 84 FR at 46970. Dr. Jones,
however, has failed to provide any mitigating evidence for the DEA to
consider. Dr. Jones's failure to present mitigating evidence is the
reason why granting summary disposition in the Government's favor is
appropriate. It is also the reason why, in light of the egregiousness
of his fraudulent activity, revocation is the appropriate sanction.
In the face of Dr. Jones's exclusion, he has not presented any
evidence to convince DEA that it can trust him with the privilege and
responsibility to handle controlled substances. Dr. Jones fraudulently
obtained hundreds of thousands of dollars from a United States
government agency over a period of six years. Based on several
aggravating circumstances, HHS/OIG found Dr. Jones's criminal activity
to be sufficiently egregious to justify imposing a longer exclusion
period than statutorily required. Dr. Jones has not responded with any
indication that he intends to accept responsibility at the DEA hearing
or that he feels remorse for his misconduct. In fact, Dr. Jones pled
not guilty to the criminal charges and his position on appeal is that
the prosecution failed to present enough evidence at trial. Gov't Summ.
Disp., Exh. 2, at 1; Resp't Opposition, at 1. Pleading not guilty and
then attacking the conviction on appeal is inconsistent with a
respondent who accepts responsibility and feels remorse for his
misconduct. Furthermore, Dr. Jones has not presented any mitigation
evidence, to include evidence that he has taken steps to assure DEA
that he will not engage in fraudulent activity in the future. In the
absence of mitigation evidence demonstrating that DEA can entrust Dr.
Jones with a registration, revocation is appropriate.
Recommendation
For these reasons, it is recommended that Dr. Jones's DEA
Certificate of Registration, Number BJ5665281/XJ5665281, be revoked,
and that any of Dr. Jones's applications for renewal or modification of
such registration, and any application by Dr. Jones for any other DEA
registration, be denied.\5\
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\5\ Pursuant to 21 CFR 1316.66, a party may file exceptions to
this Recommended Decision ``[w]ithin twenty days after the date upon
which a party is served a copy of'' this Recommended Decision. * [No
exceptions were timely filed.]
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Dated: September 19, 2019.
Charles Wm. Dorman,
U.S. Administrative Law Judge.
[FR Doc. 2021-08169 Filed 4-20-21; 8:45 am]
BILLING CODE 4410-09-P