[Federal Register Volume 61, Number 61 (Thursday, March 28, 1996)]
[Notices]
[Pages 13876-13878]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 96-7498]
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DEPARTMENT OF JUSTICE
Drug Enforcement Administration
[Docket No. 95-7]
Stanley Karpo, D.P.M.; Revocation of Registration
On September 19, 1994, the Deputy Assistant Administrator, Office
of Diversion Control, (then titled Director, Office of Diversion
Control), Drug Enforcement Administration (DEA), issued an Order to
Show Cause to Stanley Karpo, D.P.M., (Respondent) of Norristown,
Pennsylvania, notifying him of an opportunity to show cause as to why
DEA should not revoke his DEA Certificate of Registration, AK5172515,
under 21 U.S.C. 824(a), and deny any pending applications for renewal
of such registration as a practitioner under 21 U.S.C. 823(f), as being
inconsistent with the public interest. Specifically, in relevant part,
the Order to Show Cause alleged that the Respondent had been excluded
from participation in a program pursuant to 42 U.S.C. 1320a-7(a), as
evidenced by, but not limited to, the following:
(a) Between 1986 and 1989, [the Respondent] submitted 219
fraudulent claims for $32,317.00, to Medicare for medical services
not provided.
(b) On July 22, 1991, in the Court of Common Pleas for
Montgomery County, Pennsylvania, [the Respondent] pled guilty to 23
counts of Medicaid fraud, and two counts of theft by deception. On
October 15, 1991, [the Respondent was] sentenced to a period
[[Page 13877]]
of incarceration of between 8-23 months; court costs and fines; two
years supervised probation; and ordered to pay restitution to the
Pennsylvania Department of Public Welfare.
(c) On March 6, 1992, [the Respondent was] notified by the
Department of Health and Human Services of [his] eight-year
mandatory exclusion from participation in the Medicare program
pursuant to 42 U.S.C. 1320a-7(a).
While this matter was pending, the Respondent filed a request for
modification of his DEA Certificate of Registration to reflect his
change of address from Norristown, Pennsylvania, to Hollywood, Florida.
On November 3, 1994, the Deputy Assistant Administrator, Office of
Diversion Control, issued another Order to Show Cause to the Respondent
at his Hollywood, Florida address, notifying him of an opportunity to
show cause as to why DEA should not only revoke his DEA Certificate of
Registration as stated in the earlier show cause order, but also to
deny his request for modification under 21 U.S.C. 823(f), for the same
reasons as stated in the earlier show cause order.
By letter dated November 25, 1994, the Respondent, representing
himself, requested a hearing, and following prehearing procedures, a
hearing was scheduled before Judge Paul A. Tenney, for October 11,
1995. However, by letter dated October 5, 1995, the Respondent notified
Judge Tenney that he had elected not to contest this matter. By order
dated October 10, 1995, Judge Tenney determined that the Respondent's
letter was a withdrawal of his request for a hearing, and he cancelled
the hearing scheduled for October 11. Judge Tenney also recommended
that this case ``be disposed of by a decision based upon the
investigative record.'' By letter dated October 18, 1995, Judge Tenney
transmitted the record of these proceedings to the Deputy
Administrator.
The Deputy Administrator agrees with Judge Tenney's determination
that the Respondent's letter dated October 5, 1995, was a withdrawal of
his request for a hearing. Accordingly, the Deputy Administrator now
enters his final order in this matter without a hearing and based on
the investigative file and the prehearing matters submitted by the
parties pursuant to 21 CFR 1301.54(e) and 1301.57.
The Deputy Administrator finds that the parties have stipulated
before Judge Tenney, and nothing filed by the Respondent indicates his
intention to withdraw from this stipulation, as follows:
(1) On July 22, 1991, in the Court of Common Pleas for
Montgomery County, Pennsylvania, [the] Respondent pled guilty to
twenty-three counts of Medicaid fraud and two counts of theft by
deception. On October 15, 1991, [the] Respondent was sentenced to a
period of incarceration between 8-23 months; court costs and fines;
two years supervised probation; and ordered to pay restitution to
the Pennsylvania Department of Public Welfare.
(2) On [March 6, 1992, the] Respondent was notified by the
Department of Health and Human Services of his eight-year exclusion
from participation in the Medicare Program pursuant to 42 U.S.C.
[1320]a-7a. This action is currently under appeal.
Although the parties stipulated that the Respondent appealed the
Medicare exclusion determination, neither party has submitted any
evidence demonstrating that the Medicare exclusion has been revoked or
otherwise altered from the original determination.
The investigate file contains a report indicating that during the
Medicare fraud investigation, investigators from the Pennsylvania
Attorney General's Medicaid Fraud Section interviewed a number of the
Respondent's ex-employees, who had related that the Respondent had
treated patients while under the influence of drugs. One of the ex-
employees stated that she had seen the Respondent take excessive
amounts of Valium during office hours. Valium is a brand name for a
product containing diazepam, a Schedule IV controlled substance.
Another ex-employee related that the Respondent had inhaled cocaine at
his office desk. A number of the Respondent's patients also indicated
that they believed he was under the influence of some drug when he
treated them.
On April 16, 1993, pursuant to a consent agreement between the
Respondent and the State's prosecuting attorney, the Commonwealth of
Pennsylvania Department of State Bureau of Professional and
Occupational Affairs (Bureau) ordered the Respondent's license to
practice podiatry suspended for a period of one year. However, this
suspension was stayed in favor of a period of active suspension for
twenty-one days, and a three-year period of probation, with specified
terms and conditions. One of the terms of probation was that the
Respondent remain enrolled in, and successfully participate in, ``the
Impaired Professional Program for the duration of his probation, unless
earlier released from participation by the Impaired Professional
Program Consultant.'' In his prehearing statement, the Respondent
indicated that he was participating in such a program, which included
weekly meetings, random monthly substance abuse laboratory screenings,
and psychological evaluations.
Pursuant to 21 U.S.C. 823(f) and 824(a)(4), the Deputy
Administrator may revoke a DEA Certificate of Registration and deny any
pending application for such registration, if he determines that the
continued registration would be inconsistent with the public interest.
Section 823(f) requires that the following factors be considered:
(1) The recommendation of the appropriate State licensing board or
professional disciplinary authority.
(2) The applicant's experience in dispensing, or conducting
research with respect to controlled substances.
(3) The applicant's conviction record under Federal or State laws
relating to the manufacture, distribution, or dispensing of controlled
substances.
(4) Compliance with applicable State, Federal, or local laws
relating to contolled substances.
(5) Such other conduct which may threaten the public health or
safety.
These factors are to be considered in the disjunctive; the Deputy
Administrator may rely on any one or a combination of factors and may
give each factor the weight he deems appropriate in determining whether
a registration should be revoked or a pending application for
registration denied. See Henry J. Schwarz, Jr., M.D., Docket No. 88-42,
54 FR 16422 (1989).
In addition, 21 U.S.C. 824(a)(5) specifies that a DEA registration
may be revoked or suspended if the registrant ``has been excluded * * *
from participation in a program pursuant to [42 U.S.C. 1320a-7(a)].''
Here, the record demonstrates that the Respondent has been so excluded.
Although the Respondent asserted that this decision was under appeal,
nothing was presented reversing or otherwise altering his Medicare
program exclusion. The DEA has previously determined that such an
exclusion constitutes grounds for revoking a Respondent's DEA
Certificate of Registration. See Richard M. Koenig, M.D., Docket No.
94-32, 60 FR 65069 (1995); Joseph A. Zadrozny, M.D., 60 FR 14304
(1995).
Next, as to the public interest issue, factors one and five are
relevant in determining whether the Respondent's continued registration
would be inconsistent with the public interest. Specifically, as to
factor one, ``[t]he recommendation of the appropriate state licensing
board,'' in April of 1993, the Bureau, pursuant to a consent agreement,
actively suspended the Respondent's license to practice podiatry for
twenty-one days and placed
[[Page 13878]]
it on probation for three years. The Bureau ordered the Respondent to
participate in an Impaired Professional Program for the duration of his
probation. Although the facts concerning the Respondent's alleged acts
of substance abuse are not adequately developed for specific findings
based upon the record before the Deputy Administrator, it is
significant that the Bureau, after reviewing the investigative record
before it, ordered the Respondent to participate in an Impaired
Professional Program for the duration of the Respondent's three-year
probation.
Further, as to factor five, ``[s]uch other conduct which may
threaten the public health or safety,'' the Respondent's conduct of
submitting false invoices placed into question his trustworthiness and
credibility. Such lack of trustworthiness causes concern as to the
Respondent's future conduct if entrusted with protecting the public
interest in administering controlled substances.
Except for the Respondent's general statement in his prehearing
submission that he continues to participate in the Impaired
Professional Program, the Respondent has not submitted any other
information of his rehabilitative efforts. Given the egregious nature
of the Respondent's conduct in intentionally filing false documents
with the State and his resulting exclusion from the Medicare Program,
the Deputy Administrator finds that the public interest is best served
by revoking the Respondent's DEA Certificate of Registration and
denying any pending registration application at the present time. See
Sokoloff v. Saxbe, 501 F.2d 571, 576 (2d Cir. 1974) (stating that
``permanent revocation'' of a DEA Certificate of Registration may be
``unduly harsh'').
Accordingly, the Deputy Administrator of the Drug Enforcement
Administration, pursuant to the authority vested in him by 21 U.S.C.
823 and 824, and 28 CFR 0.100(b) and 0.104, hereby orders that DEA
Certificate of Registration AK5172515, issued to Stanley Karpo, D.P.M.,
be, and it hereby is, revoked, and any pending application, or request
for modification of this registration, submitted by the Respondent is
denied. This order is effective April 29, 1996.
Dated March 22, 1996.
Stephen H. Greene,
Deputy Administrator.
[FR Doc. 96-7498 Filed 3-27-96; 8:45 am]
BILLING CODE 4410-09-M
