A recent case involving a Maryland veterinarian whose receptionist forged prescriptions is a reminder that controlled substance risks do not always come from outside the clinic. Here is what to check.
A report out of Maryland last week caught my attention. According to the story, a former receptionist at a veterinary hospital used the veterinarian's credentials to forge prescriptions for opioids, in some cases using the names of dogs that had already passed away to obtain the drugs. Seventy-eight prescriptions, allegedly written by someone who was never a veterinarian, all under one doctor's name.
I read stories like that one and think about the practice owners I work with. Nobody imagines it will happen in their clinic. But the uncomfortable truth is that your DEA number and your signature are only as protected as the systems and people around them, and a case like this is a reminder worth taking seriously.
To be clear up front: this is not legal advice, and the steps DEA and your state board require are theirs to confirm. If something like this ever touches your practice, loop in your attorney early. What I can speak to is the insurance side, and the questions I would ask before a problem ever surfaces.
Who can reach your DEA number and signature
Think about everyone in your practice who can touch a prescription. Front desk staff who handle refill requests. Technicians who prepare medications for your review. Anyone with a login to your practice management software who can queue a prescription under your name.
Federal rules make your DEA registration yours alone. A registration authorizes you, at your registered address, and it cannot be transferred to anyone else. That means the responsibility for what is dispensed under your registration sits with you, even when someone else pressed the button.
That is worth reviewing your safeguards against. Not everyone needs access to controlled substance prescribing. Individual logins rather than shared ones make it possible to show who did what. Periodically reviewing your own prescription records, rather than assuming they are accurate, catches discrepancies earlier.
Check your state prescription monitoring program
Every state operates a prescription monitoring program that tracks controlled substance prescriptions. Most veterinarians I talk with have never logged into theirs. It is worth doing.
If someone were writing prescriptions under your name, your state's program would likely show it. Reviewing your own records there takes a few minutes, and if you ever do find a prescription you did not write, you will want to know sooner rather than later, both for your patients and for your own protection with the state board and the DEA.
When a pharmacist calls to verify
In the Maryland case, part of what eventually surfaced the problem was the pattern of prescriptions reaching pharmacies. Pharmacists call to verify prescriptions more often than practice owners realize, especially for controlled substances.
Make sure those calls reach you or someone you have specifically designated, and that the callback number they use is one you control. If verification calls are being handled casually, by whoever happens to answer the phone, a forged prescription can pass a phone check without the pharmacist ever speaking to the doctor whose name is on it.
Questions to ask about your coverage
If an employee forged prescriptions under your name, several kinds of damage could follow, and they land on different coverages. These are the questions I would want answered before anything happens.
First, license defense. A state board investigation into your DEA registration or your prescribing record is not a malpractice claim, and your professional liability policy may or may not include coverage for the cost of responding to it. Ask whether your policy includes a license defense provision, what its limit is, and whether it applies to investigations, not just formal disciplinary action. This is also the moment to understand what veterinary malpractice insurance actually covers and, just as important, what veterinary practice insurance does not cover.
Second, employee dishonesty or crime coverage. If a member of your staff stole from you, whether that is diverted inventory, forged prescriptions that cost you money, or fraud committed against your practice, crime coverage is the part of your program that may respond. Many practice policies include it at a modest limit or not at all, and it is worth knowing which applies to yours.
Third, cyber. If the prescriptions were created through your practice management system, the question of whether someone accessed records or systems they should not have is a cyber question. If an investigation involves your software, your records, or your network, cyber coverage and the breach response resources that come with it may matter.
A short closing thought
Cases like the one in Maryland are rare. The systems that would catch one early are not expensive, and most of them are already within reach of your practice today. If you want to talk through how your policy would respond to a situation like this, or what questions to ask at your next renewal, I am happy to help. You can reach me at jeremyajones.com/contact.
Enjoying this article? Get Jeremy's latest posts delivered to your inbox.
