Richard M. Fleming; Denial of Hearing on Application for Termination of Debarment, 12686-12688 [2023-04003]

Download as PDF 12686 Federal Register / Vol. 88, No. 39 / Tuesday, February 28, 2023 / Notices proposed collection(s) summarized in this notice, please access the CMS PRA website by copying and pasting the following web address into your web browser: https://www.cms.gov/ Regulations-and-Guidance/Legislation/ PaperworkReductionActof1995/PRAListing. DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [Document Identifier: CMS–10716] Agency Information Collection Activities: Proposed Collection; Comment Request Centers for Medicare & Medicaid Services, Health and Human Services (HHS). ACTION: Notice. AGENCY: The Centers for Medicare & Medicaid Services (CMS) is announcing an opportunity for the public to comment on CMS’ intention to collect information from the public. Under the Paperwork Reduction Act of 1995 (PRA), federal agencies are required to publish notice in the Federal Register concerning each proposed collection of information (including each proposed extension or reinstatement of an existing collection of information) and to allow 60 days for public comment on the proposed action. Interested persons are invited to send comments regarding our burden estimates or any other aspect of this collection of information, including the necessity and utility of the proposed information collection for the proper performance of the agency’s functions, the accuracy of the estimated burden, ways to enhance the quality, utility, and clarity of the information to be collected, and the use of automated collection techniques or other forms of information technology to minimize the information collection burden. DATES: Comments must be received by May 1, 2023. ADDRESSES: When commenting, please reference the document identifier or OMB control number. To be assured consideration, comments and recommendations must be submitted in any one of the following ways: 1. Electronically. You may send your comments electronically to https:// www.regulations.gov. Follow the instructions for ‘‘Comment or Submission’’ or ‘‘More Search Options’’ to find the information collection document(s) that are accepting comments. 2. By regular mail. You may mail written comments to the following address: CMS, Office of Strategic Operations and Regulatory Affairs, Division of Regulations Development, Attention: Document Identifier/OMB Control Number: , Room C4–26–05, 7500 Security Boulevard, Baltimore, Maryland 21244–1850. To obtain copies of a supporting statement and any related forms for the ddrumheller on DSK120RN23PROD with NOTICES SUMMARY: VerDate Sep<11>2014 18:37 Feb 27, 2023 Jkt 259001 FOR FURTHER INFORMATION CONTACT: William N. Parham at (410) 786–4669. SUPPLEMENTARY INFORMATION: Contents This notice sets out a summary of the use and burden associated with the following information collections. More detailed information can be found in each collection’s supporting statement and associated materials (see ADDRESSES). CMS–10716 Applicable Integrated Plan Coverage Decision Letter Under the PRA (44 U.S.C. 3501– 3520), federal agencies must obtain approval from the Office of Management and Budget (OMB) for each collection of information they conduct or sponsor. The term ‘‘collection of information’’ is defined in 44 U.S.C. 3502(3) and 5 CFR 1320.3(c) and includes agency requests or requirements that members of the public submit reports, keep records, or provide information to a third party. Section 3506(c)(2)(A) of the PRA requires federal agencies to publish a 60-day notice in the Federal Register concerning each proposed collection of information, including each proposed extension or reinstatement of an existing collection of information, before submitting the collection to OMB for approval. To comply with this requirement, CMS is publishing this notice. Information Collection 1. Type of Information Collection Request: Revision of a currently approved collection; Title of Information Collection: Applicable Integrated Plan Coverage Decision Letter; Use: Sections 1859(f)(8) of the Act require development of unified grievance and appeals processes for D–SNPs, to the extent feasible. We finalized the implementation of this regulation for integrated organization determinations at § 422.631, effective January 1, 2021. This rule requires applicable integrated plans to send an enrollee a written notice of any adverse decision on an integrated organization determination using a notice that is written in plain language and contains the information detailed at § 422.631(d)(1)(iii). Applicable integrated plans as defined at § 422.561 are required to PO 00000 Frm 00040 Fmt 4703 Sfmt 4703 issue form CMS–10716 when a request for either a medical service or payment is denied in whole or in part after considering both the Medicare or Medicaid benefit. Applicable integrated plans issue this form to enrollees when the plan reduces, stops, suspends, or denies, in whole or in part, a request for a service or item (including a Part B drug) or a request for payment of a service or item (including a Part B drug) that the enrollee has already received. The form provides the enrollee with information regarding their right to an appeal of the applicable integrated plan’s decision and the enrollee will use the instructions to navigate the appeal process. Form Number: CMS–10716 (OMB control number: 0938–1386); Frequency: Occasionally; Affected Public: Private sector (Business or other for-profits); Number of Respondents: 112; Total Annual Responses: 24,716; Total Annual Hours: 4,120. (For policy questions regarding this collection contact Kristi Sugarman Coats at 415– 744–3629.) Dated: February 23, 2023. William N. Parham, III, Director, Paperwork Reduction Staff, Office of Strategic Operations and Regulatory Affairs. [FR Doc. 2023–04068 Filed 2–27–23; 8:45 am] BILLING CODE 4120–01–P DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA–2013–N–0333] Richard M. Fleming; Denial of Hearing on Application for Termination of Debarment AGENCY: Food and Drug Administration, HHS. ACTION: Notice. The Food and Drug Administration (FDA or the Agency) is denying Dr. Richard M. Fleming’s (Dr. Fleming’s) request for a hearing and denying his application for termination of debarment under the Federal Food, Drug, and Cosmetic Act (FD&C Act). Dr. Fleming has failed to file information and analyses sufficient to create a basis for a hearing concerning this action. DATES: This order is applicable February 28, 2023. ADDRESSES: You may be submit comments at any time as follows: SUMMARY: Electronic Submissions Submit electronic comments in the following way: E:\FR\FM\28FEN1.SGM 28FEN1 Federal Register / Vol. 88, No. 39 / Tuesday, February 28, 2023 / Notices ddrumheller on DSK120RN23PROD with NOTICES • Federal eRulemaking Portal: https://www.regulations.gov. Follow the instructions for submitting comments. Comments submitted electronically, including attachments, to https:// www.regulations.gov will be posted to the docket unchanged. Because your comment will be made public, you are solely responsible for ensuring that your comment does not include any confidential information that you or a third party may not wish to be posted, such as medical information, your or anyone else’s Social Security number, or confidential business information, such as a manufacturing process. Please note that if you include your name, contact information, or other information that identifies you in the body of your comments, that information will be posted on https://www.regulations.gov. • If you want to submit a comment with confidential information that you do not wish to be made available to the public, submit the comment as a written/paper submission and in the manner detailed (see ‘‘Written/Paper Submissions’’ and ‘‘Instructions’’). Written/Paper Submissions • Mail/Hand Delivery/Courier (for written/paper submissions): Dockets Management Staff (HFA–305), Food and Drug Administration, 5630 Fishers Lane, Rm. 1061, Rockville, MD 20852. • For written/paper comments submitted to the Dockets Management Staff, FDA will post your comment, as well as any attachments, except for information submitted, marked and identified, as confidential, if submitted as detailed in ‘‘Instructions.’’ Instructions: All submissions received must include the Docket No. FDA– 2013–N–0333 for ‘‘Richard M. Fleming; Denial of Hearing on Application for Termination of Debarment.’’ Received comments will be placed in the docket and, except for those submitted as ‘‘Confidential Submissions,’’ publicly viewable at https://www.regulations.gov or at the Dockets Management Staff between 9 a.m. and 4 p.m., Monday through Friday, 240–402–7500. • Confidential Submissions—To submit a comment with confidential information that you do not wish to be made publicly available, submit your comments only as a written/paper submission. You should submit two copies total. One copy will include the information you claim to be confidential with a heading or cover note that states ‘‘THIS DOCUMENT CONTAINS CONFIDENTIAL INFORMATION.’’ The Agency will review this copy, including the claimed confidential information, in its consideration of comments. The second copy, which will have the VerDate Sep<11>2014 18:37 Feb 27, 2023 Jkt 259001 claimed confidential information redacted/blacked out, will be available for public viewing and posted on https://www.regulations.gov. Submit both copies to the Dockets Management Staff. If you do not wish your name and contact information to be made publicly available, you can provide this information on the cover sheet and not in the body of your comments and you must identify this information as ‘‘confidential.’’ Any information marked as ‘‘confidential’’ will not be disclosed except in accordance with 21 CFR 10.20 and other applicable disclosure law. For more information about FDA’s posting of comments to public dockets, see 80 FR 56469, September 18, 2015, or access the information at: https:// www.govinfo.gov/content/pkg/FR-201509-18/pdf/2015-23389.pdf. Docket: For access to the docket, go to https://www.regulations.gov and insert the docket number, found in brackets in the heading of this document, into the ‘‘Search’’ box and follow the prompts and/or go to the Dockets Management Staff, 5630 Fishers Lane, Rm. 1061, Rockville, MD 20852, 240–402–7500. Publicly available submissions may be seen in the docket. FOR FURTHER INFORMATION CONTACT: Rachael Vieder Linowes, Office of Scientific Integrity, Food and Drug Administration, 10903 New Hampshire Ave., Bldg. 1, Rm. 4206, Silver Spring, MD 20993, 240–402–5931. SUPPLEMENTARY INFORMATION: I. Background On April 24, 2009, Dr. Fleming, the president of, and sole physician at, Fleming Heart and Health Institute, P.C. (FHHI), pled guilty to one felony count of healthcare fraud, in violation of 18 U.S.C. 1347 and 2, and one felony count of mail fraud, in violation of 18 U.S.C. 1341 and 2. On August 20, 2009, the U.S. District Court for the District of Nebraska entered a judgment of conviction against Dr. Fleming on these counts and sentenced Dr. Fleming to 5 years of probation. In pleading guilty to those offenses, Dr. Fleming admitted that his convictions stemmed from two separate actions. Dr. Fleming, through his practice at FHHI, performed various imaging studies and submitted reimbursement claims to Medicare and Medicaid. Dr. Fleming’s felony healthcare fraud related to the submission of a reimbursement claim. Dr. Fleming admitted to knowingly executing and attempting to execute a scheme to defraud Medicare and Medicaid healthcare benefit programs in connection with the delivery of and payment for healthcare benefits, items, PO 00000 Frm 00041 Fmt 4703 Sfmt 4703 12687 and services, namely by submitting payment claims for tomographic myocardial perfusion imaging studies that he did not actually perform. Dr. Fleming’s felony mail fraud violation related to money paid to him to conduct a clinical study of a soy chip food product for the purpose of evaluating health benefits. As Dr. Fleming admitted during his guilty plea, he received approximately $35,000 for conducting a clinical trial, but he fabricated data for certain subjects. By letter dated November 18, 2013, pursuant to section 306(b)(2)(B)(ii)(I) of the FD&C Act (21 U.S.C. 335a(b)(2)(B)(ii)(I)), FDA’s Office of Regulatory Affairs (ORA) notified Dr. Fleming of its proposal to debar him for 10 years based on those convictions. On September 28, 2018, FDA debarred Dr. Fleming for 10 years from providing services in any capacity to a person with an approved or pending drug product application. Following that debarment, Dr. Fleming made various submissions from September 2018 to October 2018, which FDA construed as a petition for reconsideration and denied on November 28, 2018. On March 15, 2022, Dr. Fleming applied for termination of debarment pursuant to section 306(d)(1) of the FD&C Act. Absent a conviction reversal, FDA may grant an application to terminate debarment pursuant to section 306(b)(2)(B) only when ‘‘termination serves the interests of justice and adequately protects the integrity of the drug approval process’’ (see section 306(d)(3)(B)). By letter dated July 12, 2022, ORA offered Dr. Fleming an opportunity for a hearing under 21 CFR part 12 on a proposal to deny his application for termination of debarment. In the letter, ORA stated that, considering all the favorable and unfavorable information in light of the remedial public health purposes underlying debarment, terminating Dr. Fleming’s debarment would not best serve the interests of justice and would not adequately protect the integrity of the drug approval process. Under the authority delegated by the Commissioner of Food and Drugs, the Chief Scientist has considered Dr. Fleming’s request for a hearing. Hearings are granted only if there is a genuine and substantial issue of fact. Hearings will not be granted on issues of policy or law, on mere allegations, denials, or general descriptions of positions and contentions, or on data and information insufficient to justify the factual determination urged (see § 12.24(b) (21 CFR 12.24(b))). E:\FR\FM\28FEN1.SGM 28FEN1 12688 Federal Register / Vol. 88, No. 39 / Tuesday, February 28, 2023 / Notices ddrumheller on DSK120RN23PROD with NOTICES The Chief Scientist has considered Dr. Fleming’s arguments, as well as the proposal to deny Dr. Fleming’s application for termination of debarment and concludes that there is no genuine and substantial issue of fact requiring a hearing. Further, the Chief Scientist finds that Dr. Fleming’s application does not satisfy the grounds for terminating debarment. II. Arguments In his response to ORA’s proposal to deny his request for termination, Dr. Fleming concedes that the convictions underlying his debarment pursuant to section 306(b)(2)(B)(ii)(I) of the FD&C Act have not been reversed. FDA could therefore only terminate his debarment under section 306(d)(3)(B) if the Agency determined that such termination would serve the interests of justice and adequately protect the integrity of the drug approval process. In the application to terminate his debarment, Dr. Fleming presented three reasons for terminating his debarment: (1) that he was effectively debarred in the period between when he was convicted of the two felony offenses on which his debarment was based and when FDA finalized his debarment; (2) that he has taken training courses related to billing and ethics; and (3) that he has taken steps to prevent future mistakes in billing and collecting data. In proposing to deny Dr. Fleming’s application to terminate his debarment, ORA weighed the seriousness and nature of the offenses that led to his debarment, including his culpability, against his statements regarding other mitigating factors. After accounting for his assertions that he had effectively been debarred since his original convictions, ORA found that Dr. Fleming had not established that terminating his debarment would serve the interests of justice or adequately protect the integrity of the drug approval process. In his request for a hearing on ORA’s proposal, Dr. Fleming repeats some of the arguments from his application for termination of debarment and provides some additional context related to his own views on drug regulation, the criminal justice system, and other ethical considerations. He further clarifies some of the corrective actions he has implemented with respect to patient billing. As a preliminary matter, the Chief Scientist notes Dr. Fleming’s request in his application for termination of debarment that FDA consider the time starting from when he was convicted in 2009 as ‘‘time served.’’ Dr. Fleming contended that, because he was VerDate Sep<11>2014 18:37 Feb 27, 2023 Jkt 259001 convicted in 2009, ‘‘the effective period of debarment has been 12+ years.’’ While Dr. Fleming does not renew this argument in his request for a hearing on ORA’s proposal, the timing of when he was convicted, when ORA proposed his debarment, and when FDA finalized his debarment is not in dispute. Notwithstanding his arguments to the contrary, FDA did not debar Dr. Fleming until the Agency issued the final order debarring him in September 2018. Neither his convictions nor ORA’s proposal to debar him started his debarment period pursuant to the Agency’s authority under section 306(b)(2)(B)(ii)(I) of the FD&C Act. He thus cannot now argue that his ultimate debarment in September 2018 had any effect whatsoever on him before that time. The Chief Scientist therefore agrees with ORA that terminating his debarment on that basis would not serve the interests of justice or adequately protect the integrity of the drug approval process. The Chief Scientist further agrees with ORA that Dr. Fleming has not shown that terminating his debarment would serve the interests of justice or adequately protect the drug approval process—even in light of the additional assertions and arguments proffered in support of his hearing request on ORA’s proposal. Both offenses underlying his debarment are felony fraud convictions related to the regulation of drugs. As noted in ORA’s proposal to deny Dr. Fleming’s application for termination, the pattern of fraudulent conduct on which his convictions were based calls into question his ability to comply with the FD&C Act and indicates that he poses a threat to the drug approval process if he were allowed to participate in it. In light of the conduct underlying the convictions on which Dr. Fleming’s debarment was based, his assertions that he has taken some courses and adopted corrective measures relative to billing patients and collecting data do not come close to showing that terminating his debarment would serve the interests of justice and adequately protect the drug approval process in the sense contemplated by section 306(d)(3)(B)(ii). Dr. Fleming has thus presented no material factual dispute for a hearing on ORA’s proposal to deny the application to terminate his debarment. III. Conclusion Therefore, the Chief Scientist, under authority delegated to her, denies Dr. Fleming’s application for termination of debarment under section 306(d) of the FD&C Act. A hearing on this request is not necessary because there are no PO 00000 Frm 00042 Fmt 4703 Sfmt 4703 genuine and substantial issues of fact (see § 12.24(b)). Any person with an approved or pending drug product application who knowingly uses the services of Dr. Fleming, in any capacity during his period of debarment, will be subject to civil money penalties (section 307(a)(6) of the FD&C Act (21 U.S.C. 335b(a)(6))). If Dr. Fleming provides services in any capacity to a person with an approved or pending drug product application, he will be subject to civil money penalties (section 307(a)(7) of the FD&C Act). In addition, FDA will not accept or review any abbreviated new drug applications submitted by or with the assistance of Dr. Fleming during his period of debarment (section 306(c)(1)(B) of the FD&C Act). Dated: February 22, 2023. Namandje´ N. Bumpus, Chief Scientist. [FR Doc. 2023–04003 Filed 2–27–23; 8:45 am] BILLING CODE 4164–01–P DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Office of the Secretary; Notice of Meeting Pursuant to section 10(a) of the Federal Advisory Committee Act, as amended, notice is hereby given of a meeting of the Interagency Autism Coordinating Committee. The meeting will be open to the public for virtual viewing via NIH Videocast. Advanced registration is recommended. Individuals who plan to attend the meeting virtually and need special assistance or other reasonable accommodations to virtually view the meeting should notify the Contact Person listed below at least seven (7) business days in advance of the meeting. The open session can be accessed from the NIH Videocast website (https://videocast.nih.gov/). Name of Committee: Interagency Autism Coordinating Committee. Date: April 4, 2023. Time: 10:00 a.m. to 5:00 p.m. Meeting Access: https://videocast.nih.gov/ watch=49068. Agenda: To discuss business, updates, and issues related to ASD research and services activities. Cost: The meeting is free and open to the public. Registration: A registration web link will be posted on the IACC website (www.iacc.hhs.gov) prior to the meeting. Preregistration is recommended. Deadlines: Written/Virtual Public Comment Due Date: Wednesday, March 22, E:\FR\FM\28FEN1.SGM 28FEN1

Agencies

[Federal Register Volume 88, Number 39 (Tuesday, February 28, 2023)]
[Notices]
[Pages 12686-12688]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2023-04003]


-----------------------------------------------------------------------

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Food and Drug Administration

[Docket No. FDA-2013-N-0333]


Richard M. Fleming; Denial of Hearing on Application for 
Termination of Debarment

AGENCY: Food and Drug Administration, HHS.

ACTION: Notice.

-----------------------------------------------------------------------

SUMMARY: The Food and Drug Administration (FDA or the Agency) is 
denying Dr. Richard M. Fleming's (Dr. Fleming's) request for a hearing 
and denying his application for termination of debarment under the 
Federal Food, Drug, and Cosmetic Act (FD&C Act). Dr. Fleming has failed 
to file information and analyses sufficient to create a basis for a 
hearing concerning this action.

DATES: This order is applicable February 28, 2023.

ADDRESSES: You may be submit comments at any time as follows:

Electronic Submissions

    Submit electronic comments in the following way:

[[Page 12687]]

     Federal eRulemaking Portal: https://www.regulations.gov. 
Follow the instructions for submitting comments. Comments submitted 
electronically, including attachments, to https://www.regulations.gov 
will be posted to the docket unchanged. Because your comment will be 
made public, you are solely responsible for ensuring that your comment 
does not include any confidential information that you or a third party 
may not wish to be posted, such as medical information, your or anyone 
else's Social Security number, or confidential business information, 
such as a manufacturing process. Please note that if you include your 
name, contact information, or other information that identifies you in 
the body of your comments, that information will be posted on https://www.regulations.gov.
     If you want to submit a comment with confidential 
information that you do not wish to be made available to the public, 
submit the comment as a written/paper submission and in the manner 
detailed (see ``Written/Paper Submissions'' and ``Instructions'').

Written/Paper Submissions

     Mail/Hand Delivery/Courier (for written/paper 
submissions): Dockets Management Staff (HFA-305), Food and Drug 
Administration, 5630 Fishers Lane, Rm. 1061, Rockville, MD 20852.
     For written/paper comments submitted to the Dockets 
Management Staff, FDA will post your comment, as well as any 
attachments, except for information submitted, marked and identified, 
as confidential, if submitted as detailed in ``Instructions.''
    Instructions: All submissions received must include the Docket No. 
FDA-2013-N-0333 for ``Richard M. Fleming; Denial of Hearing on 
Application for Termination of Debarment.'' Received comments will be 
placed in the docket and, except for those submitted as ``Confidential 
Submissions,'' publicly viewable at https://www.regulations.gov or at 
the Dockets Management Staff between 9 a.m. and 4 p.m., Monday through 
Friday, 240-402-7500.
     Confidential Submissions--To submit a comment with 
confidential information that you do not wish to be made publicly 
available, submit your comments only as a written/paper submission. You 
should submit two copies total. One copy will include the information 
you claim to be confidential with a heading or cover note that states 
``THIS DOCUMENT CONTAINS CONFIDENTIAL INFORMATION.'' The Agency will 
review this copy, including the claimed confidential information, in 
its consideration of comments. The second copy, which will have the 
claimed confidential information redacted/blacked out, will be 
available for public viewing and posted on https://www.regulations.gov. 
Submit both copies to the Dockets Management Staff. If you do not wish 
your name and contact information to be made publicly available, you 
can provide this information on the cover sheet and not in the body of 
your comments and you must identify this information as 
``confidential.'' Any information marked as ``confidential'' will not 
be disclosed except in accordance with 21 CFR 10.20 and other 
applicable disclosure law. For more information about FDA's posting of 
comments to public dockets, see 80 FR 56469, September 18, 2015, or 
access the information at: https://www.govinfo.gov/content/pkg/FR-2015-09-18/pdf/2015-23389.pdf.
    Docket: For access to the docket, go to https://www.regulations.gov 
and insert the docket number, found in brackets in the heading of this 
document, into the ``Search'' box and follow the prompts and/or go to 
the Dockets Management Staff, 5630 Fishers Lane, Rm. 1061, Rockville, 
MD 20852, 240-402-7500. Publicly available submissions may be seen in 
the docket.

FOR FURTHER INFORMATION CONTACT: Rachael Vieder Linowes, Office of 
Scientific Integrity, Food and Drug Administration, 10903 New Hampshire 
Ave., Bldg. 1, Rm. 4206, Silver Spring, MD 20993, 240-402-5931.

SUPPLEMENTARY INFORMATION: 

I. Background

    On April 24, 2009, Dr. Fleming, the president of, and sole 
physician at, Fleming Heart and Health Institute, P.C. (FHHI), pled 
guilty to one felony count of healthcare fraud, in violation of 18 
U.S.C. 1347 and 2, and one felony count of mail fraud, in violation of 
18 U.S.C. 1341 and 2. On August 20, 2009, the U.S. District Court for 
the District of Nebraska entered a judgment of conviction against Dr. 
Fleming on these counts and sentenced Dr. Fleming to 5 years of 
probation. In pleading guilty to those offenses, Dr. Fleming admitted 
that his convictions stemmed from two separate actions. Dr. Fleming, 
through his practice at FHHI, performed various imaging studies and 
submitted reimbursement claims to Medicare and Medicaid. Dr. Fleming's 
felony healthcare fraud related to the submission of a reimbursement 
claim. Dr. Fleming admitted to knowingly executing and attempting to 
execute a scheme to defraud Medicare and Medicaid healthcare benefit 
programs in connection with the delivery of and payment for healthcare 
benefits, items, and services, namely by submitting payment claims for 
tomographic myocardial perfusion imaging studies that he did not 
actually perform. Dr. Fleming's felony mail fraud violation related to 
money paid to him to conduct a clinical study of a soy chip food 
product for the purpose of evaluating health benefits. As Dr. Fleming 
admitted during his guilty plea, he received approximately $35,000 for 
conducting a clinical trial, but he fabricated data for certain 
subjects.
    By letter dated November 18, 2013, pursuant to section 
306(b)(2)(B)(ii)(I) of the FD&C Act (21 U.S.C. 335a(b)(2)(B)(ii)(I)), 
FDA's Office of Regulatory Affairs (ORA) notified Dr. Fleming of its 
proposal to debar him for 10 years based on those convictions. On 
September 28, 2018, FDA debarred Dr. Fleming for 10 years from 
providing services in any capacity to a person with an approved or 
pending drug product application. Following that debarment, Dr. Fleming 
made various submissions from September 2018 to October 2018, which FDA 
construed as a petition for reconsideration and denied on November 28, 
2018.
    On March 15, 2022, Dr. Fleming applied for termination of debarment 
pursuant to section 306(d)(1) of the FD&C Act. Absent a conviction 
reversal, FDA may grant an application to terminate debarment pursuant 
to section 306(b)(2)(B) only when ``termination serves the interests of 
justice and adequately protects the integrity of the drug approval 
process'' (see section 306(d)(3)(B)).
    By letter dated July 12, 2022, ORA offered Dr. Fleming an 
opportunity for a hearing under 21 CFR part 12 on a proposal to deny 
his application for termination of debarment. In the letter, ORA stated 
that, considering all the favorable and unfavorable information in 
light of the remedial public health purposes underlying debarment, 
terminating Dr. Fleming's debarment would not best serve the interests 
of justice and would not adequately protect the integrity of the drug 
approval process.
    Under the authority delegated by the Commissioner of Food and 
Drugs, the Chief Scientist has considered Dr. Fleming's request for a 
hearing. Hearings are granted only if there is a genuine and 
substantial issue of fact. Hearings will not be granted on issues of 
policy or law, on mere allegations, denials, or general descriptions of 
positions and contentions, or on data and information insufficient to 
justify the factual determination urged (see Sec.  12.24(b) (21 CFR 
12.24(b))).

[[Page 12688]]

    The Chief Scientist has considered Dr. Fleming's arguments, as well 
as the proposal to deny Dr. Fleming's application for termination of 
debarment and concludes that there is no genuine and substantial issue 
of fact requiring a hearing. Further, the Chief Scientist finds that 
Dr. Fleming's application does not satisfy the grounds for terminating 
debarment.

II. Arguments

    In his response to ORA's proposal to deny his request for 
termination, Dr. Fleming concedes that the convictions underlying his 
debarment pursuant to section 306(b)(2)(B)(ii)(I) of the FD&C Act have 
not been reversed. FDA could therefore only terminate his debarment 
under section 306(d)(3)(B) if the Agency determined that such 
termination would serve the interests of justice and adequately protect 
the integrity of the drug approval process. In the application to 
terminate his debarment, Dr. Fleming presented three reasons for 
terminating his debarment: (1) that he was effectively debarred in the 
period between when he was convicted of the two felony offenses on 
which his debarment was based and when FDA finalized his debarment; (2) 
that he has taken training courses related to billing and ethics; and 
(3) that he has taken steps to prevent future mistakes in billing and 
collecting data.
    In proposing to deny Dr. Fleming's application to terminate his 
debarment, ORA weighed the seriousness and nature of the offenses that 
led to his debarment, including his culpability, against his statements 
regarding other mitigating factors. After accounting for his assertions 
that he had effectively been debarred since his original convictions, 
ORA found that Dr. Fleming had not established that terminating his 
debarment would serve the interests of justice or adequately protect 
the integrity of the drug approval process. In his request for a 
hearing on ORA's proposal, Dr. Fleming repeats some of the arguments 
from his application for termination of debarment and provides some 
additional context related to his own views on drug regulation, the 
criminal justice system, and other ethical considerations. He further 
clarifies some of the corrective actions he has implemented with 
respect to patient billing.
    As a preliminary matter, the Chief Scientist notes Dr. Fleming's 
request in his application for termination of debarment that FDA 
consider the time starting from when he was convicted in 2009 as ``time 
served.'' Dr. Fleming contended that, because he was convicted in 2009, 
``the effective period of debarment has been 12+ years.'' While Dr. 
Fleming does not renew this argument in his request for a hearing on 
ORA's proposal, the timing of when he was convicted, when ORA proposed 
his debarment, and when FDA finalized his debarment is not in dispute. 
Notwithstanding his arguments to the contrary, FDA did not debar Dr. 
Fleming until the Agency issued the final order debarring him in 
September 2018. Neither his convictions nor ORA's proposal to debar him 
started his debarment period pursuant to the Agency's authority under 
section 306(b)(2)(B)(ii)(I) of the FD&C Act. He thus cannot now argue 
that his ultimate debarment in September 2018 had any effect whatsoever 
on him before that time. The Chief Scientist therefore agrees with ORA 
that terminating his debarment on that basis would not serve the 
interests of justice or adequately protect the integrity of the drug 
approval process.
    The Chief Scientist further agrees with ORA that Dr. Fleming has 
not shown that terminating his debarment would serve the interests of 
justice or adequately protect the drug approval process--even in light 
of the additional assertions and arguments proffered in support of his 
hearing request on ORA's proposal. Both offenses underlying his 
debarment are felony fraud convictions related to the regulation of 
drugs. As noted in ORA's proposal to deny Dr. Fleming's application for 
termination, the pattern of fraudulent conduct on which his convictions 
were based calls into question his ability to comply with the FD&C Act 
and indicates that he poses a threat to the drug approval process if he 
were allowed to participate in it. In light of the conduct underlying 
the convictions on which Dr. Fleming's debarment was based, his 
assertions that he has taken some courses and adopted corrective 
measures relative to billing patients and collecting data do not come 
close to showing that terminating his debarment would serve the 
interests of justice and adequately protect the drug approval process 
in the sense contemplated by section 306(d)(3)(B)(ii). Dr. Fleming has 
thus presented no material factual dispute for a hearing on ORA's 
proposal to deny the application to terminate his debarment.

III. Conclusion

    Therefore, the Chief Scientist, under authority delegated to her, 
denies Dr. Fleming's application for termination of debarment under 
section 306(d) of the FD&C Act. A hearing on this request is not 
necessary because there are no genuine and substantial issues of fact 
(see Sec.  12.24(b)).
    Any person with an approved or pending drug product application who 
knowingly uses the services of Dr. Fleming, in any capacity during his 
period of debarment, will be subject to civil money penalties (section 
307(a)(6) of the FD&C Act (21 U.S.C. 335b(a)(6))). If Dr. Fleming 
provides services in any capacity to a person with an approved or 
pending drug product application, he will be subject to civil money 
penalties (section 307(a)(7) of the FD&C Act). In addition, FDA will 
not accept or review any abbreviated new drug applications submitted by 
or with the assistance of Dr. Fleming during his period of debarment 
(section 306(c)(1)(B) of the FD&C Act).

    Dated: February 22, 2023.
Namandj[eacute] N. Bumpus,
Chief Scientist.
[FR Doc. 2023-04003 Filed 2-27-23; 8:45 am]
 BILLING CODE 4164-01-P
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.