United States Alleges that the Pharmacist and Pharmacy Ignored Red Flags Indicating Prescriptions Were Not Legitimate, Including Filling Controlled Substances Prescriptions for Over 300 Patients that Traveled More than 180 Miles to the Pharmacy
Per the Office of the U.S. Attorney, District of Maryland: – U.S. District Judge Peter J. Messitte approved the United States’ consent decree with Abtin Youssefi-Rashti, a Montgomery County based pharmacist, and Upton Care Pharmacy, Inc. (“Upton Care”), resolving the United States’ civil allegations that Youssefi-Rashti and Upton Care violated the Controlled Substances Act (“CSA”) in illegally dispensing controlled substances. Under the consent decree, in addition to paying a $100,000 civil monetary penalty, Youssefi-Rashti agrees to surrender his pharmacist’s license to the Maryland Board of Pharmacy and not to reapply for three years. Additionally, Upton Care agreed to voluntarily surrender its DEA registration to dispense controlled substances for cause.
“Under the Controlled Substances Act, pharmacists have a responsibility to ensure the legitimacy of the prescriptions they fill,” said U.S. Attorney Erek L. Barron. “The U.S. Attorney’s Office intends to use all tools at its disposal—criminal and civil—to hold responsible those at every step in the supply chain who violate the CSA and fan the flames of the present opioid epidemic.”
Special Agent in Charge Jarod A. Forget stated, “Pharmacists have a crucial role in correctly dispensing controlled substances, safeguarding patients and preventing drug diversion. It’s essential to pay attention to warning signs to prevent the opioid epidemic from getting worse. DEA is dedicated to investigating those who ignore the signs and to ensuring the community is safe.”
The government alleges that between 2018 and when Upton Care closed its doors in 2022, Youssefi-Rashti and Upton Care knowingly filled fraudulent prescriptions for controlled substances, ignoring red flags indicating that the prescriptions were not legitimate. For example, the government alleges that Youssefi-Rashti dispensed controlled substances to more than 300 people that traveled more than 180 miles from their homes to Upton Care. Additionally, Youssefi-Rashti dispensed prescriptions for both opioids and stimulants—a dangerous and potentially lethal combination—to the same patient concurrently. Youssefi-Rashti also regularly filled prescriptions for controlled substances that were paid for with cash even though the patient had insurance available to pay for the patient’s prescriptions. Although the Centers for Disease Control and Prevention generally recommends that primary care clinicians should avoid daily dosages of opioids over 90 morphine milligram equivalents (“MME”), Youssefi-Rashti routinely dispensed prescriptions to patients causing their MME levels to be many times that amount—and upwards of 1800 daily MME. The government alleges that Upton Care is liable for these deficiencies.
As part of the Consent Decree, Youssefi-Rashti and Upton Care are required to identify certain red flags—including when filling a prescription would cause the patient to take more than 90 daily MME; and when the patient pays in cash despite having insurance available to pay for the prescription. Before filling prescriptions bearing those red flags, the consent decree requires Youssefi-Rashti and Upton Care to document in detail any indications of abuse or diversion and the steps they took to ensure that the prescription was valid and was issued for a legitimate medical purpose, and that the prescription would not be abused or diverted for illegitimate purposes. Additionally, under the consent decree, Youssefi-Rashti and Upton Care are prohibited from filling certain prescriptions, including a combination of an opioid and a stimulant, and prescriptions for buprenorphine without naloxone without reliable documentation from the prescriber that the patient is pregnant, a nursing mother, or has had an actual adverse reaction to naloxone.
Under the consent decree, if the DEA determines that Youssefi-Rashti or Upton Care have violated any provision of the consent decree or if Youssefi-Rashti or Upton Care do not implement the corrective action the DEA orders, the DEA can order Youssefi-Rashti and Upton Care to cease ordering, distributing, or dispensing controlled substances immediately.
The consent decree is not an admission of liability by Youssefi-Rashti or Upton Care, nor a concession by the United States that its claims are not well founded.
The Court’s approval of this consent decree should remind pharmacists and pharmacies of their corresponding responsibility to confirm the legitimacy of the prescriptions that they fill and that that the Department of Justice intends to use all tools at its disposal—both criminal and civil—to combat the controlled substances epidemic which continues to plague our country, including here in Maryland.