WA: Ferry County Hospital District Agrees to Pay $15,000 Penalty

Ferry County Hospital District Agrees to Pay $15,000 Penalty and Implement Corrective Actions to Address Improper Opioid Dispensing Practices at Republic Pharmacy

The Ferry County Hospital District agreed to pay a $15,000 Controlled Substances Act penalty and to institute corrective actions in regards to opioid prescribing practices at Republic Drug Store, a pharmacy in Republic, Washington, that Ferry County Hospital District purchased in January 2021 and has continued to operate since that time.

To protect the public, the Controlled Substances Act and its implementing regulations place legal responsibilities on medical professionals to ensure that opioid medications and other controlled substances are prescribed, dispensed, and used for medically-appropriate purposes and in a safe manner.  The responsibility for the proper prescribing and dispensing of controlled substances is upon the prescribing practitioner, but a corresponding responsibility rests with the pharmacist who fills the prescription to ensure that prescriptions are legitimate, safe, and medically appropriate.  This responsibility includes addressing and resolving “red flags”, that is, indications that a particular prescription may be unsafe or medically inappropriate, by obtaining additional information before filling the prescription.

In the settlement announced Friday, Ferry County Hospital District admitted that, between October 2017 and November 2021, Republic Drug Store and its pharmacists and employees did not always appropriately exercise their corresponding responsibility in filling prescriptions for opioids and other controlled substances. Ferry County Hospital District admitted that Republic Drug Store filled prescriptions that contained “red flags”, i.e., indications of possible fraud, drug-seeking, lack of medical necessity, potential for abuse or health risk, or potential for drug diversion into the community, without appropriately resolving those red flags prior to dispensing.  Ferry County Hospital District further admitted that these red flags included: (1) numerous patients for whom Republic Drug Store filled prescriptions for a dangerous and medically-inappropriate combination of drugs known as the “holy trinity” (an opioid, a benzodiazepine, and a muscle relaxant taken in tandem), as well as other dangerous combinations; (2) high doses of opioids, including patients prescribed opioid doses far in excess of guidelines promulgated by the Centers for Disease Control (CDC); (3) fraudulent prescriptions purportedly issued by physicians who were no longer practicing medicine or who had their licenses suspended or revoked; (4) early refill prescriptions that Republic Drug Store filled with no explanation of why the patient had exhausted the prior month’s supply more than a week early; and (5) prescriptions written by naturopathic doctors who did not have the medical authority to prescribe controlled substances. 

“DEA’s core mission is to protect Americans and we need our partners in the healthcare community to help us by following the rules.  When they do not, we hold them accountable, not to punish, but to encourage their cooperation and ensure that they are doing their part to keep people safe,” said David F. Reames, Special Agent in Charge, DEA Seattle Field Division. “We deeply appreciate our partnership with the United States Attorney’s Office in the Eastern District of Washington, without whom this success would not have been possible.”

“Pharmacies, such as Republic Drug, play a critical role in keeping our communities safe and strong,” said U.S. Attorney Waldref.  “Pharmacies serve a vital gatekeeper function in keeping our residents safe and healthy, preventing the diversion of dangerous drugs, and combatting addiction.  I’m grateful that Ferry County Hospital District accepted responsibility and has entered into a robust agreement with the Drug Enforcement Administration (DEA) to ensure that it complies with its gatekeeper function and obligations going forward.”

In addition to the $15,000 civil penalty, Ferry County Hospital District has entered into a Memorandum of Agreement (MOA) with the DEA concerning Republic Drug Store.  Under the MOA, Republic Drug Store agreed to resolve all “red flag” prescriptions prior to dispensing any controlled substances.  Republic Drug Store is also required to conduct quarterly physical inventory audits and provide those to the DEA.  These audits must be performed by a team that includes a licensed pharmacist.  Additionally, Republic Drug Store is required to provide training for its employees on how to detect and prevent filling of fraudulent or medically inappropriate prescriptions.  Finally, Republic Drug Store further agreed to review and update its controlled substance policies and procedures to ensure compliance with the Controlled Substances Act going forward.

“This resolution would not have been possible without the exceptional investigative work by DEA Seattle Field Division’s Diversion Group, and I am grateful for our longstanding and continuing partnership,” stated U.S. Attorney Waldref.  “We are committed to working hand-in-glove with DEA Diversion Group and our law enforcement partners to protect our communities and public health and safety.”

The settlement was the result of a joint investigation conducted by the U.S. Attorney’s Office for the Eastern District of Washington and DEA’s Seattle Field Division, Diversion Group. Assistant United States Attorneys Dan Fruchter and Tyler H.L. Tornabene handled this matter on behalf of the United States.

Press Release