June 29, 2010

Doctor Shopping in Florida---2009 Legislation

Last year, in an effort to limit the number of people who go to multiple doctors to obtain prescriptions for the same type of pain medication, the Florida legislature enacted a new law that make is a felony for a person to go to more than one doctor to obtain identical medication before a refill is allowed for the first prescription. Florida was one of the last state's in the country to enact such a law.

People's names, whether paying in cash or by insurance, credit card or otherwise, are entered into a data bank that "cross references" the person's name with the narcotics they purchase. If a person's name shows that he or she got Lortab's for instance from pharmacy A on June 4, 2010 using a prescription from Dr. Jones, and then again filled a prescription from Pharmacy B for Lortabs on June 15, 2010 using a prescription from Dr. Smith, law enforecment authorities are notified by the computer system that monitors these purchases and there exists a high probability that law enforcement will attempt to interview and subsequently arrest the person who appears to be doctor shopping. Law enforcement officers may ask the doctor 'Were you aware that your patient was also seeing Dr. Smith and receiving a prescription for Lortabs (or xanax, valium, oxycodone, percoset, hydrocodone (generic Lortabs), etc. prior to the date of the next refill allowed by your prescription. Of course the doctor is not aware of this and the police can then obtain a warrant for the "doctor shopper's' arrest on felony charges. Many narcotic type prescription drugs however require a face to face meeting with the doctor on a montly basis in order for the doctor to refill the prescription. The doctor shoppers in these cases see multiple doctors and go to multiple pharmacies to have their scripts refilled. Florida is also one of the few states that allow these pain clinics to dispense medication also!

The policy behind the legislation is supposedly reducing the number of deaths caused by overdosing on drugs. This is a noble purpose, we don't want people to kill themselves by overdosing of course. The secondary purpose of the bill is to put the "pain pill mills" located primarily in South Florida out of business. From what I understand Broward county has the most pain clinics per capita in the State of Florida, and, perhaps, in the nation.

The federal government has been "cracking down" on these clinics. In the last five years in the Pensacola Division of the Northern District of Florida we have had approximtely seven doctors prosecuted in Federal Court through FBI investigations; four of these prosecutions have resulted in these doctors recieving 25+ years to life in federal prison. There is a documentary called the Oxycontin Express that portrays these clinics as preying on addicted people. These doctors are primarily interested in making money very quicking and usually in cash. According to the documentary doctors in Florida are prescribing powerful pain medications at five times the national average. See http://current.com/shows/vanguard/91183979_the-oxycontin-express.htm

Doctors being "pushers" of drugs is the topic of another article written in this blog.

What law enforcement does not seem to comprehend is that the majority of people who are addicts who obtain pain drugs through these clinics are truly sick people; they come from all walks of life and many began there spiral down to the hell of severe drug addiction because of a chronic injury. It just doesn't seem like the problem we have as a society is
never going to be solved if the government doesn't take a more rehabilative approach than a punitve approach in these cases. People do not learn how to get off while in prison. The 12 step recovery programs say that alcohol or drug abuse is merely a symptom of underlying causes. Efforts must be made to help people who have not learned to cope with the ups and downs of life without escaping their pain or stress without drugs or alcohol. Most recovery experts really don't distinguish between alcohol and drugs. It's just that we as a society have chosen to legalize and tax alcohol.

But the purpose of this little article was only to let people know that doctor shopping for pain pills is now a serious crime that can result in a prison sentence. Please read the article below on the outrageously severe penalties for possession of Lortabs and hydrocodone with a prescription.

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June 27, 2010

Florida Sexual Offenses

Similar fact evidence is offered in a lot of sex cases in Florida and, of course, is most times, horribly damning to our clients.

In Florida we have statutory, Fla. Stat. 90.404(2), and case law, Williams v. State, 110 So. 2d 654 (Fla. 1959), that allows the state to introduce evidence of prior similar sexual wrongdoing (other crimes, wrongs or acts) in a new case involving sexual offenses. There need be no conviction. In fact, even if former charges are dismissed, the underlying facts may be admissible. Pomeranz v. State, 703 So. 2d 465, 469 (Fla. 1997).

The state must give the defense "notice" of the use of such crimes at least 10 days before trial. (Much like federal rule 404(b) evidence). If the evidence is admitted the Court, if requested, must instruct the jury on the limited purpose for which the evidence was received immediately prior to when the evidence is admitted at trial and provide a limiting instruction in it's final instructions to the jury.

In Florida, we also have "reverse similar fact evidence where a defendant can offer evidence that another person committed the crime. State v. Savino, 567 So. 2d 892 (Fla. 1990). No notice requirement is required of the defense; however, because of our liberal discovery rules and procedural right to take discovery depositions in felony cases in Florida, the documents and/or names or witnesses intended to prove the "reverse similar fact evidence" must be disclosed to the prosecution. Depending on the facts of the case and how you strategical plan your defense, the prosecution may not learn of such defense prior to trial. However, the same admissibility standards apply to the defense's introduction of this evidence as it does to the State so there must be a proffer to show similarity of the evidence and it's relevancy. Because "reverse similar fact evidence" has a lower potential for prejudice to the State than standard similar fact evidence has to the defendant, the trial court has somewhat less discretion toe exclude reverse similar fact evidence offered by the defense. Palazzolo v. State, 754 So. 2d 731, 739-40 (Fla. 2d DCA 2000).

If objected to prior to trial by way of motion in limine or motion to exclude, a hearing must be held and the judge must not only find the similar fact evidence is relevant, he or she must also find its probative value is substantially outweighed by its unduly prejudicial nature. When the prejudicial nature of the evidence is outweighed by the undue prejudice the evidence creates, it is inadmissible. McLean v. State, 934 So. 2d 1248 (Fla. 2006). If the court finds that the evidence is relevant only to prove propensity or bad character it's inadmissible. However, in Florida, the rule of admissibility of evidence of other crimes, wrongs or acts in a child molestation case have been "relaxed." So, prior sexual acts of the defendant are admissible even though their sole purpose is to prove propensity to commit sex crimes - the rule of admissibility in a sex case becomes is the similar fact evidence to the matter for which it is being introduced? The amendment to the preexisting statute excluding prior act evidence if it only goes to show "propensity" has withstood constitutional challenge in a sex case.

The standard of proof for admissibility in Florida for "similar fact evidence" is by "clear and convincing evidence." The similar fact evidence must be stated with the same specificity as that is required of the allegations in the indictment or information.

If the presentation of the similar fact evidence becomes the "feature" of the present trial, the evidence will also be inadmissible. Ashley v. State, 265 So. 2d 685,693(Fla. 1972). Sometimes the evidence in the present case is so weak that the similar fact evidence may become the "feature" of the case at trial, and, if so, it should be ruled inadmissible. Also, if the similar fact evidence confuses or misleads the jury, or is cumulative, it may be ruled inadmissible.

Similar fact evidence generally is an extremely difficult hurdle to overcome if it is not excluded. However, sometimes the similar fact evidence is so weak or incredulous that, if admitted, it creates the appearance that the State is willing to do anything to bolster a weak case that should not have been filed on in the first place. However, for the most part, every possible effort to keep the evidence from being admitted must be made.

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