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Legalease
Legalease, Lawyer
Category: Criminal Law
Satisfied Customers: 14461
Experience:  13 years experience in criminal law, BA in criminal justice
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How do I know if I am being investigated for Doctor Shopping?

Resolved Question:

How do I know if I am being investigated for Doctor Shopping? I just received a certified letter from one doctor who discharged me and a letter from my primary physician stating in so many words. I am trying to figure out if I did something wrong and unknowingly. Am I going to jail?
Submitted: 1 year ago.
Category: Criminal Law
Expert:  P. Simmons replied 1 year ago.
Thanks for the chance to assist on this matter. I am an attorney with over 12 years experience in criminal law.

Can you tell me, which state are you in?
Customer: replied 1 year ago.


PA and MD

Expert:  P. Simmons replied 1 year ago.
Thank you

While some states have specific laws against "doctor shopping", (for example, NV has a law that makes it illegal to "doctor shop") neither PA nor MD have specific "doctor shopping laws". That said, if there is evidence that you are using fraud to obtain medication, that could be charged in both MD and PA.

Health care providers and pharmacies have a legal duty to report the issuance of controlled substances to the State Bureau of Narcotics and Dangerous Drugs Control which is probably where the doctor was looking when they decided to terminate the doctor patient relationship.

You have the right to seek medical treatment for a medical condition. What you cannot do is to lie to get access to more medication. If there is evidence you are lying to obtain access to controlled substances that can be charged criminally.

But the thing is, such fraud can be tough to prove...the would have to prove you were lying to the doctors to obtain the drugs. Again, that can be difficult for law enforcement to prove.

How would you know if you are being investigated? If you are contacted by law enforcement and questioned. If that happens, you may want to invoke your Constitutional rights and remain silent.

Customer: replied 1 year ago.


I was seeing my primary doctor and already on medication for two buldged disks in my lower back then he i was in an accident and have two buldged disks in my neck which I was also recieving medication for this issue as when I asked my primary doctor to see me the day I had my accident he refused to take auto claims in which the one doctor is on my auto insurrance and my primary on my medical in which I was already recieving medication. they are saying i am not allowed to receive medication for both as I did not speak to my primary doctor about my pain doctor on auto claim as he said they do not do auto claims. So i thought i was to keep them seperate and did not disclose to either about my issue. I thought i was doing the right thing as i had a different claim number for the accident doctor and health on my medical. am I going to jail and loose my job and be arressted. how will i know if there is a warrant for my arrest i am very confused.

Expert:  P. Simmons replied 1 year ago.
What you describe does not sound like a crime. And, frankly, I doubt the police would even investigate this

If they do, then you should certainly invoke your right to remain silent...but as I mention, what you describe is not a crime so I doubt the police even take the case

Customer: replied 1 year ago.


They are saying since I got narcotics from both doctors for the past year that the letter said narcotic seeking i have been on both medications for a year and was ready to have neck surgery until they found cancer in my thyroid and my surgery date is for this week and I am worried they are going to come and arrest me at my job or at my house. Will they put out a warrant for my arrest. I did not know i was doing anything wrong i thought i had confidentiality not telling the doctor about the other since they are from differnt sources: lower back injury from 15 years ago which is what my primary doctor was seeing me for then my car accident that injured my neck and two buldged disks as the MRI shows and again have to have surgery. I no longer have a doctor and on one will probably take me now. what do i do about finding another doctor do i go to a pain type of clinic they stopped my medication and I have depression and was doing better as i was able to do more things without pain. is this confidential?

Expert:  P. Simmons replied 1 year ago.
Again, what you describe is not a crime...so I doubt they will put a warrant out for your arrest.

I understand you are scared, but what you describe is not a crime, so I do not see you being arrested.
Customer: replied 1 year ago.


Sorry to keep bothering you. But i did a research online and i saw these doctor shopping laws. I was taking both medications from each doctor for year and it came up as doctor shopping. Will this information come up on my background check I get for my job every couple of years? Just trying to understand what to expect. I have no primary doctor or any doctors anymore should i tell the new doctor when i find one about this?

Expert:  P. Simmons replied 1 year ago.
It will not come up for a background check unless you are charged criminally. And as I mention, while some states have specific doctor shopping laws, neither PA nor MD does...that is why I doubt you will be charged with a crime.

In the unlikely event you are charged, you should keep quiet and seek the help of a local attorney.

But I doubt that you are charged

Customer: replied 1 year ago.

You have been great in helping me understand the issue at hand. If they decide to investigate how long will this take? Should i expect someone to contact me from the law months from now? How do I move forward with finding a doctor for my neck issue in which I am to have surgery just see the surgeon and move forward?

Customer: replied 1 year ago.


So based on your expertise and knowledge i will not be charged (especially since my primary doctor was in MD and my pain doctor for my accident was in PA).?

Expert:  P. Simmons replied 1 year ago.
Based on my experience and what you describe I doubt you will face charges in either state...again, neither state has specific doctor shopping laws.

For the future, find a single doctor and work with them exclusively. That will prevent any problems with perception.
Customer: replied 1 year ago.


Hello, I just have one more question. Will the certified letter from both doctors in which one states them discharging me be placed in my medical record/s and be pulled whenever I sign any HIPPA agreements?


 

Expert:  Legalease replied 1 year ago.

*When done reviewing my answer, please press a rating button BELOW THIS ANSWER BOX in order to rate my answer and pay me for my time.

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Hello there

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I am a different expert at Just Answer -- my colleague has stepped away and asked me to pick up this question for him because I have considerable experience in this area.

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First, I want you to take a deep breath and RELAX. It seems that you are very stressed out and upset over this situation and being under that stress does not help your medical situation and your pain level in any shape, manner or form. You are not going to be charged with a crime in this situation -- I can virtually guarantee it. WHat happened here was an unfortunate mistake on your part and you were not given the chance by the doctors involved to explain what happened and why it happened. Doctor shopping is a different thing entirely than what happened here to you -- doctor shopping is a criminal matter only when it gets to the point where a patient visits a bunch of different doctors at the same time or at almost the same time in order to just get pain medication. Typically, these cases are charged when the patient gets up to about 6 or 7 doctors at the same time or in a very short period of time from each other and all of the doctors write out pain medication for the patient. Your situation does not rise to that level at all -- and your doctors are not going to involve the police and take time out of their own practices in order to go to court against you -- it simply will not and would not happen in a case such as yours that you described above (it is up to the doctors whether or not to prosecute and send the matter to the local police and if they had done that you would have heard from the police by now).

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My own husband has been in this unfortunate situation several times over the last 20 years. He had 2 back surgeries, 2 hand surgeries and he continues to work in construction where he suffers 6 or 7 accidents every year that land him in the emergency room. My husband has been dropped by 3 doctors in 20 years because there are some doctors who would rather just dump a patient than determine what is really wrong with the patient and work with the patient to alleviate their pain -- and each time he has been dropped he received certified letters and then simply found another doctor. In each case, the doctor dropped my husband because they claimed he visited the emergency room too much -- even though the injuries have all been legitimate because of being in the construction business (for example, he has had a concussion, fallen from a ladder and had a shard of metal land in his eye in the last 8 months alone). Unfortunately, it is the doctors right to drop a patient when the doctor does not want to have to deal with the DEA regarding writing out any prescription pain medication and most doctors I have dealt with will drop a patient in a moment rather than speak with the DEA and explain to the DEA why the patient has had so many injuries and why the patent must have pain medications prescribed. It really is sad to say it, but we are living in a day and age when a person suffering from debilitating pain cannot get adequate pain relief because the doctors are all afraid of the DEA and so long as doctors have the right to drop a patient for any reason or no reason, we will see more and more of this happening every day.

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So, as my colleague said, doctor shopping is not a crime in the states you mentioned. However, what you did does not even rise to the level of doctor shopping -- you simply violated the internal policy of the doctor's offices that they will dump any patient who receives a pain prescription from more than one doctor at the same time -- without even giving the doctor the chance to explain. The certified letters will not appear in your medical records (or show up regarding any future HIPPA agreements), and the last entries of these two doctors will most likely either not explain why you no longer see the doctor or will simply state that the relationship was terminated without stating who terminated the relationship. You should start looking for another doctor and my suggestion is that you find one doctor to treat you for everything and simply tell the doctor that you did not have a good fit with the prior doctor if any questions are asked -- and then you should not bring anything up with the new doctor unless you are asked any direct questions about the prior situation and what happened to end the relationship. In my husband's case, he was never asked any questions and when he provided proof of the prior doctors treatment and prescriptions then the new doctor pretty much followed the same treatment.

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Please let me know if you have more questions. If not, can you please press the 3rd, 4th or 5th smile face underneath THIS ANSWER BOX (BELOW) so I will be paid for my time. I am paid nothing unless you press a positive rating BELOW -- pressing a positive rating will NOT cost you any additional money -- it simply acts as a trigger to Just Answer to pay me for my time.

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THANK YOU

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MARY

Legalease, Lawyer
Category: Criminal Law
Satisfied Customers: 14461
Experience: 13 years experience in criminal law, BA in criminal justice
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