Supreme Court Ruling Provides Defense for Doctors Facing “Pill Mill” Allegations or Appealing a Sentence or Conviction

Last summer, the U.S. Supreme Court issued a significant ruling in Ruan v. United States that clarified what the Government must prove to convict a doctor accused of running a “pill mill,” which refers to a practice of doctors prescribing opioids and other controlled substances to people who don’t need them, such as drug users or drug dealers.


For decades, the Government had been able to charge doctors as drug dealers based on allegations that the doctor’s prescribing practices were not for a “legitimate medical purpose” or were “outside the usual course of professional medical practice.” In effect, this allowed some doctors to be charged based on negligence.


That changed last summer, when a majority of the Supreme Court held that, when charging a doctor with distributing or prescribing controlled substances unlawfully, the Government must prove beyond a reasonable doubt that the defendant subjectively knew or intended to prescribe controlled substances without a legitimate medical purpose or outside the usual course of ordinary professional medical practice. This is often called the “Good Faith” defense, and it means that the trial judge must instruct the jury that they can only convict the defendant if they find he essentially intended to act like a drug dealer.


This is an important ruling because the standard for convicting doctors of unlawful prescribing practices was so low that innocent doctors were getting charged and convicted. In fact, our firm has represented some of those doctors. The Supreme Court’s decision in Ruan specifically noted that the purpose of criminal laws is not to punish negligence, only intentional wrongdoing.


That said, the Government can still prove that a defendant-doctor acted intentionally and unlawfully through circumstantial evidence—for example, there will likely be sufficient evidence to convict a doctor who only takes cash, doesn’t do any physical exams, doesn’t screen patients, and who prescribes an unusually high number of controlled substances, especially if those drugs are opioids.


In sum, doctors facing allegations of operating a “pill mill” can now be judged on their intentions, not some rigid standard that treats good faith mistakes as serious crimes. In that vein, a doctor’s practice of performing adequate physical exams and screening patients for potential abuse is powerful evidence that the doctor was trying their best, even if they were prescribing an inappropriate number of medications.


Similarly, doctors who have already been convicted of unlawfully prescribing controlled substances may have a basis for vacating their convictions. That’s especially true if the doctor requested, but did not receive, a “good faith” instruction to the jury by the trial court. In many cases, the defendant may be able to show that there was enough evidence of “good faith” prescribing practices that the Government’s evidence was insufficient to prove guilt.


Our firm has a lot of experience handling “pill mill” charges and representing doctors who are falsely accused of acting as drug dealers.


If you or a loved one is facing “pill mill” charges, contact our firm. Our experienced trial lawyers are ready to fight for you and your family.


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