Doctor Shopping and Prescription Fraud - California Health and Safety Code § 11173
Doctor shopping is now common in California as prescription drug addiction has grown widespread. In basic terms, doctor shopping involves visiting several medical health care professionals or pharmacies to obtain multiple prescriptions for controlled substances. It's a form of prescription fraud describer under California Health & Safety Code Section 11173.
Just as a medical professional can commit prescription fraud by over-prescribing medication or selling prescriptions through a “pill mill,” so too can patients be charged for the act of “doctor shopping,” i.e. seeking multiple prescriptions or prescriptions which are not medically necessary by providing fraudulent statements of concealing important facts from a medical professional.
California Health and Safety Code § 11173 provides for criminal penalties for patients who, through fraud, deceit, misrepresentation, or subterfuge obtain, or attempt to obtain, a prescription from a medical professional for a controlled substance such as a painkiller. Concealment of a material fact, meaning a fact which is important to the doctor’s determination of whether or not to issue a prescription, is also considered fraud and can be punished under Section 11173.
To give readers useful information about doctor shopping and prescription fraud under Health and Safety Code § 11173, our California criminal defense attorneys are providing an overview below.
Definition of Doctor Shopping Prescription Fraud
California Health and Safety Code § 11173 defines the crime of prescription fraud as:
Nobody shall obtain, attempt to obtain controlled substances, or procure a prescription for controlled substances by fraud, deceit, misrepresentation, or by concealment of a material fact.
In other words, Health & Safety Code 11173 criminalizes any of the following acts:
- Obtain or make an attempt to obtain a controlled substance;
- Procure or make an attempt to procure the administration of a controlled substance; or
- Procure or make an attempt to procure a prescription for a controlled substance.
It should be noted you can still commit this form of prescription fraud even in a situation where no prescription was actually involved.
It should also be noted you can be convicted of California Health & Safety Code 11173 prescription fraud even in a situation where you never actually obtained a drug or a prescription for a drug. It’s only required that you made an attempt to obtain a drug or prescription.
You can also commit HS 11173 prescription fraud if you give a false name or false address in connection with prescriptions for a controlled substance.
The most common prescription drugs involved in prescription fraud case include Vicodin, Xanax, Valium, Morphine, Oxycodone, Adderall, among others.
Common Examples of Health & Safety Code 11173
In the simplest scenario, a drug-addicted individual might set up an appointment with a doctor under the false pretense they are suffering from chronic pain or has recently suffered a significant injury. In fact, the patient simply wants to obtain a prescription for a powerful painkiller such as an opioid substance because they are addicted to that substance.
The act of making the false statement to the medical professional about the need for pain management is in of itself a crime, even if the doctor discovers the fraud and refuses to provide the prescription.
As stated above, it is important to note, therefore, that the individual in question does not need to actually obtain medication, or even obtain the prescription for that medication, in order to be prosecuted under Health and Safety Code § 11173.
A second and also common scenario is “doctor shopping.” In this scenario, the defendant might be a legitimate patient in need of pain medication, for example.
However, although they legitimately received an initial prescription from one doctor for a powerful painkiller, the defendant then becomes addicted and begins setting up appointments with multiple other doctors to receive additional prescriptions for the same or related drugs.
Critically, the defendant fails to mention to the subsequent doctors that they are already under the care of another physician who has already provided a prescription for painkillers. This conduct is also considered prescription fraud and would be prosecuted under Section 11173.
Penalties for Health & Safety Code 11173
A violation of Health and Safety Code § 11173 for doctor shopping or other prescription fraud by a patient is a “wobbler,” under California law, meaning it can be prosecuted as either a felony or a misdemeanor depending on the defendant’s background, the circumstances of the case, etc.
The decision whether to file a misdemeanor or a felony-level charge under Section 11173 is left to the discretion of the filing prosecutor, typically a Deputy District Attorney.
Prefiling intervention in suspected doctor shopping cases is therefore critical as the presentation of a strong defense position before court can sometimes sway the filing deputy to proceed with a misdemeanor rather than a felony. The potential punishment associated with a Section 11173 depends on whether a felony or a misdemeanor is charged.
Misdemeanor-level prosecutions for doctor shopping carry a potential punishment of one year in the county jail. Felonies, on the other hand, carry a potential punishment of 16 months, 2 years, or 3 years in the California state prison.
Related California Offenses for HS 11173
Health & Safety Code 11350 – Possession of Controlled Substance
Health & Safety Code 11352 – Sale of Transportation of Controlled Substance
Health & Safety Code 11353 – Prescribing Drugs Without Legitimate Purpose
Health & Safety Code 11368 – Forging or Altering a Prescription
Fighting HS 11173 Prescription Fraud Charges
Our Los Angeles criminal defense lawyers can use a variety of strategies to defend you against prescription fraud charges. We need to first closely examine the details in order to determine an appropriate plan to obtain the best possible outcome on your case. The most common defense includes:
Lack of Fraudulent Intent
As with many fraud crimes, the most common defense to a Health and Safety Code § 11173 prosecution is that the defendant lacked fraudulent intent. Consider again the two scenarios listed above and keep in mind that the defendant must have deployed fraud, deceit, subterfuge, etc. in order to be convicted.
In the case of the drug addict who seeks pain pills, it is obvious that fraud was deployed as they lied about being in chronic pain or suffering an injury justifying a prescription for painkillers.
However, if the defendant had simply told the doctor they wanted a prescription and the doctor failed to exercise due diligence, the doctor might be guilty of a crime or face licensure consequences, but the defendant’s actions should not result in a conviction under Section 11173.
In the second scenario, if the defendant had been forthright about seeing other doctors and having obtained prescriptions in the past, the onus would again be on the doctor not to provide a second prescription. The critical element in both cases is the making of false statements with the fraudulent intent to obtain the prescription.
A doctor shopping or other prescription fraud case against a patient is a serious crime under California law. Our experienced criminal defense attorneys can counsel you in the prefiling stage as well as in court to help you obtain the best possible outcome. If you or a family member are facing a charge under Health and Safety Code § 11173, contact our office to explore your options. We serve clients throughout Southern California, including the greater Los Angeles area.
The criminal defense law firm of Eisner Gorin LLP is located at 1875 Century Park E #705, Los Angeles, CA 90067 and 14401 Sylvan St #112 Van Nuys, CA 91401. Call us at (310) 328-3776 to review your case.