81_FR_22194 81 FR 22122 - Rezik A. Saqer, M.D.; Decision and Order

81 FR 22122 - Rezik A. Saqer, M.D.; Decision and Order

DEPARTMENT OF JUSTICE
Drug Enforcement Administration

Federal Register Volume 81, Issue 72 (April 14, 2016)

Page Range22122-22128
FR Document2016-08572

Federal Register, Volume 81 Issue 72 (Thursday, April 14, 2016)
[Federal Register Volume 81, Number 72 (Thursday, April 14, 2016)]
[Notices]
[Pages 22122-22128]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2016-08572]


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 DEPARTMENT OF JUSTICE

Drug Enforcement Administration

[Docket No. 16-7]


Rezik A. Saqer, M.D.; Decision and Order

    On October 1, 2015, the Deputy Assistant Administrator, Office of 
Diversion Control, Drug Enforcement Administration, issued an Order to 
Show Cause to Rezik A. Saqer, M.D., (Respondent). The Show Cause Order 
proposed the revocation of Respondent's DEA Certificates of 
Registration BS4072637 and FS1975359, pursuant to which he is 
authorized to dispense controlled substances in schedules II through V, 
as a practitioner, at the respective registered locations of 11037 FM 
1960 West, Suite B1, Houston, Texas, and 3074 College Park Drive, 
Conroe, Texas. Show Cause Order, at 1. The Show Cause Order further 
proposed the denial of any applications to renew or modify either 
registration, as well as the denial of any other application for a DEA 
registration. Id.
    More specifically, the Show Cause Order alleged that ``[e]ffective 
September 28, 2015, the Texas Medical Board issued an Order of 
Temporary Suspension . . . which suspended [Respondent's] medical 
license,'' and therefore, he is currently ``without authority to handle 
controlled substances in Texas, the State in which [he is] registered 
with'' DEA. Id. at 2. The Show Cause Order thus advised Respondent that 
``DEA must revoke [his] registrations based upon [his] lack of 
authority to handle controlled substances in the State of Texas.'' Id. 
(citing 21 U.S.C. 802(21), 823(f), and 824(a)(3)).
    On October 2, 2015, a Diversion Investigator served the Show Cause 
Order by travelling to Respondent's registered location in Houston, and 
leaving it with a medical assistant, who provided a signed receipt for 
the Order. Affidavit of DI, at 1. On November 5, 2015, Respondent, 
through his counsel, requested a hearing on the allegations of the Show 
Cause Order.\1\ The matter was then placed on the docket of the Office 
of Administrative Law Judges, and

[[Page 22123]]

assigned to the Chief Administrative Law Judge (hereinafter, CALJ).
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    \1\ While Respondent's request was untimely, Respondent's 
counsel subsequently filed a motion which established that his 
secretary had attempted to file the hearing request by UPS overnight 
delivery, but had provided an incorrect address. DEA has previously 
held that this type of inadvertence may establish ``good cause'' to 
excuse an untimely hearing request, at least when the party promptly 
moves to rectify the omission. Tony Bui, 75 FR 49979, 49980 (2010).
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    In the same filing which contained his hearing request, Respondent 
also sought a ``brief stay'' of the proceeding, stating that a hearing 
on the Texas Medical Board's (TMB) emergency suspension order was to 
commence on November 19, 2015. Respondent further expressed his 
expectation that ``[o]n or shortly after that date . . . the [TMB] will 
issue an order regarding his challenge to the temporary suspension.'' 
Respondent's Req. for Hrng. and Mot. for Brief Stay of Admin. 
Proceedings, at 1.
    The next day, the CALJ denied Respondent's request for a stay and 
ordered the Government to provide evidence in support of the allegation 
that Respondent lacks state authority and any accompanying motion, no 
later than 2 p.m. on November 23, 2015. CALJ Order, at 2 (Nov. 6, 
2015). The CALJ also ordered that if the Government filed such a 
motion, Respondent's Reply would be due no later than 2 p.m. on 
December 3, 2015. Id.
    On November 18, 2015, the Government filed its Motion for Summary 
Disposition. Therein, the Government argued that it was undisputed that 
Respondent's medical license has been suspended by the State, and while 
Respondent argued that the TMB was to hold a hearing on the suspension, 
whether and when the TMB would lift its order was ``a matter of 
speculation.'' Mot. at 3. The Government thus argued that even where a 
registrant's state authority has been temporarily suspended, revocation 
of his registration is still warranted because the registrant must 
possess authority to handle controlled substances under state law in 
order for the Agency to maintain his registration. Id. at 3-4. As 
support for its Motion, the Government attached the Order of Temporary 
Suspension (Without Notice of Hearing), which was issued to Respondent 
by the TMB's Disciplinary Panel on September 28, 2015.
    On December 3, 2015, Respondent filed its Opposition to the 
Government's Motion. Therein, he argued that both the Controlled 
Substances Act (CSA) and DEA's regulations require that if a registrant 
``requests a hearing, the agency is required to provide such a 
hearing.'' Resp. Opp., at 1 (citing 21 U.S.C. 824(c); 21 CFR 1301.36(d) 
and 1301.37(d)). He also argued that ``[t]here are no provisions in 
DEA's regulations or the CSA that allow for summary disposition whereby 
Respondent's right to a hearing is denied.'' Id. And he argued that 
Title 5 (the Administrative Procedure Act) ``requires an `agency 
hearing' in every case in which a statute requires adjudication to be 
determined on the record,'' and that 5 U.S.C. 554 does not contain ``an 
exception for `summary disposition.' '' Id. at 2.
    Respondent also argued that the Agency's position that the 
possession of state authority is a condition for maintaining a DEA 
registration is based on a misreading of the term ``practitioner,'' id. 
at 3-4, which the CSA defines as meaning ``a physician . . . or other 
person licensed, registered, or otherwise permitted, by the United 
States or the jurisdiction in which he practices to . . . dispense . . 
. a controlled substance in the course of professional practice.'' 21 
U.S.C. 802(21). More specifically, Respondent argued that because the 
definition uses the disjunctive ``or,'' rather than the conjunctive of 
``and,'' this ``clearly signals Congress' intent that a practitioner is 
one who either has state authority or federal authority to prescribe or 
dispense controlled substances.'' Id. at 4. And finally, Respondent 
argued that under 21 U.S.C. 843(a), the Agency ``may revoke a 
registration based on the suspension or revocation of state authority 
to dispense controlled substances, not that it must revoke based on 
those allegations.'' Id. at 5. Respondent then contended that granting 
summary disposition was ``inappropriate'' because he ``intend[ed] to 
present evidence that his registration is consistent with the public 
interest notwithstanding the status of [sic] state license,'' and he 
``is challenging the loss of his state authority and until his rights 
are exhausted, there exists a real prospect that his state authority 
will be reinstated.'' Id.
    Finding that ``no genuine dispute exists over the fact that the 
Respondent lacks state authority to handle controlled substances,'' the 
CALJ concluded that because Respondent lacks such authority, ``Agency 
precedent dictates that he is not entitled to maintain his DEA 
registration.'' Order Granting Govt. Mot. for Summ. Disp., at 9. Noting 
that ``there is no contested factual matter adducible at a hearing that 
would, in the Agency's view, provide authority to allow the Respondent 
to continue to hold his'' registration, the CALJ granted the 
Government's motion for summary disposition and recommended that his 
``registration be revoked'' and that ``any pending applications for 
renewal be denied.'' Id. at 9-10 (bold and capitalization deleted).
    Respondent filed Exceptions to the CALJ's Order and the Government 
filed a Response to Respondent's Exceptions. Thereafter, the record was 
forwarded to me for Final Agency Action. Having considered the record 
including Respondent's Exceptions, I adopt the CALJ's finding that 
Respondent lacks authority under Texas law to handle controlled 
substances, and his conclusion of law that Respondent is not entitled 
to maintain his registration. For reasons explained below, I will also 
adopt the ALJ's recommendation but only with respect to Respondent's 
Certificate of Registration BS4072637. I make the following findings.

Findings of Fact

    Respondent is the holder of DEA Certificate of Registration 
BS4072637, pursuant to which he is authorized to dispense controlled 
substances in schedules II through V, as a practitioner, at the address 
of 11037 FM 1960 West, Suite B1, Houston, Texas. Mot. for Summ. Disp., 
at Attachment 2. Under this registration, Respondent is also authorized 
to treat up to 100 patients as a DATA-waived physician. Id. This 
registration does not expire until February 28, 2018. Id.
    Respondent also previously held DEA Certificate of Registration 
FS1975359, pursuant to which he was authorized to dispense controlled 
substances in schedules II through V, as a practitioner, at the address 
of 3074 College Park Drive, Conroe, Texas. Mot. for. Summ. Disp., at 
Attachment 3. This registration was due to expire on February 29, 2016, 
id., and according to the registration records of this Agency of which 
I take official notice, Respondent has not filed a timely renewal 
application (let alone any application to renew this registration).\2\ 
Accordingly, I find that this registration has expired. See 21 CFR 
1301.36(i).
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    \2\ Under the Administrative Procedure Act (APA), an agency 
``may take official notice of facts at any stage in a proceeding--
even in the final decision.'' U.S. Dept. of Justice, Attorney 
General's Manual on the Administrative Procedure Act 80 (1947) (Wm. 
W. Gaunt & Sons, Inc., Reprint 1979). In accordance with the APA and 
DEA's regulations, Respondent is ``entitled on timely request to an 
opportunity to show to the contrary.'' 5 U.S.C. 556(e); see also 21 
CFR 1316.59(e). To allow Respondent the opportunity to refute the 
facts of which I take official notice, Respondent may file a motion 
for reconsideration within ten calendar days of service of this 
order which shall commence on the date this order is mailed.
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    Respondent is also the holder of Texas Medical License No. K-2282. 
In re Saqer, Order of Temporary Suspension (Without Notice of Hearing), 
at 1 (Tex. Med. Bd. Sept. 28, 2015). However, on September 28, 2015, 
the Disciplinary Panel of the Texas Medical Board entered an Order of 
Temporary Suspension against Respondent's medical license following an 
ex-parte hearing on the Board's Application for

[[Page 22124]]

Temporary Suspension (Without Notice of Hearing). Id. at 4.
    As the basis for the Order, the Panel found that on September 22, 
2015, a search warrant was executed at a pain management clinic owned 
by Respondent, during which DEA agents ``obtained evidence establishing 
that Respondent pre-signed treatment notes, pre-signed prescriptions 
and illegally maintained schedule II controlled substances in his 
personal office.'' Id. at 2. The Panel also found ``that patients of 
[the clinic] were sometimes seen by unlicensed individuals that would 
fill in the records and prescriptions to make it appear that Respondent 
had seen the patient and written the prescription.'' Id. The Panel thus 
found that ``Respondent engaged in illegal activities related to his 
operation of [the clinic], and engaged in the inappropriate 
prescribing, dispensing, or administering of controlled substances, and 
therefore Respondent has committed violations of state and federal law, 
including the Medical Practice Act and Board Rules.'' Id.
    The Panel concluded that ``Respondent's continued practice of 
medicine, including improper and illegal activities related to his 
operation of a pain management clinic, and including the method and 
manner in which controlled substances were prescribed and maintained, 
poses a continuing threat to public welfare.'' Id. Based on these 
findings, the Panel found ``a continuing threat to the public health, 
safety, or welfare that requires immediate effect of this Order of 
Temporary Suspension on the date rendered.'' Id. And after setting 
forth its legal conclusions that Respondent violated multiple 
provisions of the Medical Practice Act, the Panel ordered that 
Respondent's medical license be suspended. Id. at 3-4.
    On November 19, 2015, the Disciplinary Panel conducted a hearing at 
which Respondent appeared and was represented by counsel. In re Saqer, 
Order of Temporary Suspension (With Notice of Hearing), at 1 (Tex. Med. 
Bd. Nov. 19, 2015). However, following the hearing, the Board made the 
same factual findings and legal conclusions as it had at the ex parte 
proceeding, see id. at 1-4, and it again ordered the temporary 
suspension of Respondent's medical license. Id. According to the online 
records of the Texas Medical Board, the suspension remains in effect. I 
therefore find that Respondent is currently without authority to 
dispense controlled substances in Texas, the State in which he is 
engages in professional practice and holds his DEA registration.

Discussion

Respondent's Contention That DEA Cannot Use Summary Disposition to 
Adjudicate This Matter

    As explained above, in his Opposition to the Government's Motion, 
Respondent contends that because he requested a hearing, under the 
Agency's regulation, the Agency was required to provide him with a 
hearing. Opp. at 1-3. He further contends that there are no provisions 
in either the CSA or the Agency's regulations that allow for summary 
disposition, thereby denying him his right to a hearing. Id. at 2-3.
    However, numerous courts, including the Supreme Court, have held 
that even where a statute directs an agency to provide a party with a 
hearing, the agency can nonetheless resolve the matter on summary 
disposition when there are no material facts in dispute. See, e.g., 
Veg-Mix, Inc. v. Department of Agriculture, 832 F.2d 601, 607 (D.C. 
Cir. 1987). As the DC Circuit explained in Veg-Mix, ``[c]ommon sense 
suggests the futility of hearings where there is no factual dispute of 
substance.'' Id. \3\ See also NLRB v. International Ass'n of Bridge, 
Structural and Ornamental Ironworkers, 549 F.2d 634, 639 (9th Cir. 
1977) (`` `It is settled law that when no fact question is involved or 
the facts are agreed, a plenary, adversary administrative proceeding 
involving evidence, cross-examination of witnesses, etc., is not 
obligatory, even though a pertinent statute prescribes a hearing. In 
such situations, the rationale is that Congress does not intend 
administrative agencies to perform meaningless tasks.' '') (quoting 
United States v. Consolidated Mines & Smelting Co., Ltd., 455 F.2d 432, 
453 (9th Cir. 1971)).\4\ Cf. Weinberger v. Hynson, Westcott and 
Dunning, Inc., 412 U.S. 609, 620-22 (1973) (upholding agency's 
authority to dispense with a formal hearing where applicant has not 
provided any evidence that it meets statutory standards).
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    \3\ While Respondent noted that the Agency's rules regarding the 
conduct of hearings do not include a provision which expressly 
authorizes the use of summary disposition, this Agency has used 
summary disposition to resolve proceedings based on a registrant's 
loss of his/her state authority for nearly 40 years. See, e.g., 
Alfred Tennyson Smurthwaite, N.D., 43 FR 11873 (1978). There are 
hundreds of such cases reported in the Federal Register. Contrary to 
Respondent's contention that the Agency cannot rely on summary 
disposition in the absence of a regulation which expressly allows 
for it, ``[i]t is well established that agencies are free to 
announce and develop rules in an adjudicatory setting.'' Puerto Rico 
Aqueduct and Sewer Auth. v. EPA, 35 F.3d 600 607 (1st Cir. 1994) 
(citing NLRB v. Bell Aerospace Co., 416 U.S. 267, 294 (1974)).
    \4\ See also Travers v. Shalala, 20 F.3d 993, 998 (9th Cir. 
1994) (quoting Consolidated Mines, 455 F.2d at 453).
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    Notably, while Respondent was given the opportunity to demonstrate 
the existence of a factual dispute as to whether he retains state 
authority, he could not do so, as even after he was allowed to appear 
before the Board and challenge the temporary suspension of his license, 
the Board re-imposed the suspension. However, even in the absence of a 
disputed material fact, Respondent contends that ``summary disposition 
[was] inappropriate,'' because he ``intend[ed] to present evidence that 
his registration is consistent with the public interest notwithstanding 
the status of [his] state license.'' Opp. at 5. The short answer to 
this argument is that even if Respondent could show that his 
registration is consistent with the public interest, his lack of state 
authority precludes his continued registration under the CSA, and it is 
the Government and not Respondent who decides what ground or grounds to 
pursue when seeking the revocation of his registration.

Respondent's Challenge to the Agency's Authority To Revoke His 
Registration

    Respondent nonetheless maintains that the Agency's rule that a 
practitioner's loss of his ``state authority is an automatic bar to 
maintaining a DEA registration'' is based ``on a misreading of the 
CSA.'' Resp. Exceptions, at 1-2. In his Exceptions, Respondent contends 
that ``[f]or proceedings seeking the revocation of a DEA registration, 
the [A]gency derives its authority from 21 U.S.C. 824, not 21 U.S.C. 
823, and 21 U.S.C. 824 does not support the [A]gency's position that it 
must revoke a DEA registration in all instances where a registrant 
lacks state authority.'' Id. at 2.
    To be sure, section 824(a) states, in relevant part, that ``[a] 
registration pursuant to section 823 of this title to manufacture, 
distribute, or dispense a controlled substance or list I chemical may 
be suspended or revoked . . . upon a finding that the registrant . . . 
has had his State license or registration suspended, revoked, or denied 
by competent State authority and is no longer authorized by State law 
to engage in the manufacturing, distribution or dispensing of 
controlled substances or list I chemicals.'' 21 U.S.C. 824(a)(3). Thus, 
Respondent is correct that section 824 grants the Attorney General 
discretion and does not mandate the revocation of a ``registration in 
all instances where a registrant lacks state authority.'' Resp. 
Exceptions, at 2.
    Indeed, in Bio-Diagnostic International, 78 FR 39327 (2013), a

[[Page 22125]]

case involving a list I chemical distributor which did not possess 
state authority, the Agency held that granting summary disposition to 
the Government on this basis was improper because neither the provision 
setting forth the standards for the registration of list I 
distributors, nor the definition of a distributor, requires that a 
distributor possess state authority in order to be registered.\5\ While 
Bio-Diagnostic involved an application, in a footnote, the decision 
explained that while ``section 824(a)(3) authorizes revocation where a 
registrant `has had [its] State license suspended, revoked, or denied 
by competent state authority and is no longer authorized by State law 
to engage in the manufacturing [or] distribution of . . . list I 
chemicals[,]' [this] does not mean that revocation is warranted in all 
instances.'' Id. at 39330 n.6. Continuing, the decision explained that 
``[t]his provision grants the Agency discretionary authority to impose 
an appropriate sanction; the failure to consider factors such as the 
egregiousness of the misconduct and mitigating factors in imposing the 
sanction would render the sanction arbitrary and capricious.'' Id.
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    \5\ The decision did note, however, that where a list I 
distributor was required to obtain state authority and had not done 
so, this could be considered under the public interest factor which 
examines ``compliance by the applicant with applicable Federal, 
State and local law.'' 78 FR at 39330-31 (quoting 21 U.S.C. 
823(h)(2)).
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    Respondent is not, however, a List I chemical distributor. Rather, 
he is a practitioner, and by contrast to the CSA's provisions 
applicable to list I distributors, both the CSA's definition of the 
term ``practitioner'' and the registration provision applicable to 
practitioners make clear that a practitioner must be currently 
authorized to dispense controlled substances by the State in which he 
practices in order to obtain and maintain a registration.
    As for the registration provision applicable to practitioners, it 
provides, in relevant part, that: ``[t]he Attorney General shall 
register practitioners . . . to dispense . . . controlled substances . 
. . if the applicant is authorized to dispense . . . controlled 
substances under the laws of the State in which he practices.'' 21 
U.S.C. 823(f). As the Supreme Court explained in United States v. 
Moore, 423 U.S. 122, 140-41 (1975), ``[r]egistration of physicians and 
other practitioners is mandatory if the applicant is authorized to 
dispense drugs . . . under the law of the State in which he practices. 
[21 U.S.C.] Sec.  823(f). In the case of a physician, this scheme 
contemplates that he is authorized by the State to practice medicine 
and to dispense drugs in connection with his professional practice.'' 
\6\
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    \6\ While in 1984 Congress granted the Attorney General 
authority to deny a registration on public interest grounds, the 
provision did not alter the CSA's requirement that a practitioner 
must be ``authorized by the State to practice medicine'' and 
dispense drugs in order to be registered.
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    Thus, the CSA defines ``[t]he term `practitioner' [to] mean[] a 
physician . . . or other person licensed, registered, or otherwise 
permitted, by the United States or the jurisdiction in which he 
practices to . . . dispense . . . a controlled substance in the course 
of professional practice.'' 21 U.S.C. 802(21). As noted above, in his 
Opposition, Respondent argued that ``[t]he use of the disjunctive `or' 
clearly signals Congress' intent that a practitioner is one who either 
has state authority or federal authority to prescribe or dispense 
controlled substances[,]'' and that ``[h]ad Congress required that a 
practitioner maintain both state and federal authority to handle 
controlled substances, it would have used the word `and.''' Resp. Opp. 
at 4. Continuing, Respondent argued that ``[w]hile it is not entirely 
clear why Congress took this approach . . . the clear statutory 
language'' refutes the Government's argument that ``a lack of state 
licensure [is] an automatic bar to maintaining a DEA registration.'' 
Id.
    Respondent is mistaken. As for why Congress used the disjunctive 
rather than the conjunctive in defining the term practitioner, 
notwithstanding the absence of any relevant discussion in the CSA's 
legislative history, there is an explanation. While the overwhelming 
majority of practitioners who practice medicine (or dentistry and 
veterinary medicine) are subject to regulation by the State in which 
they practice their professions, multiple federal Departments and 
Agencies (e.g., the Department of Defense, Veterans Administration, 
Bureau of Prisons, United States Public Health Service, and Indian 
Health Service) employ practitioners. However, by virtue of the 
Supremacy Clause, these health-care professionals are not subject to 
regulation by the State in which the federal facility is located as 
long they confine their practice to the facility. See Taylor v. United 
States, 821 F.2d 1428, 1431 (9th Cir. 1987) (noting that under the 
Supremacy Clause, a State ``lacks power to require licensing of federal 
health care providers and physicians'' and that ``[t]he United States 
has essentially deemed [an] Army [h]ospital and its staff fit to 
provide health care services''); United States v. Composite State Bd. 
of Med. Exmn'rs, 656 F.2d 131, 135 n.4 (5th Cir. 1981) (citing Sperry 
v. Florida ex rel. Florida Bar, 373 U.S. 379 (1963) (``A State may not 
enforce licensing requirements that, though valid in the absence of 
federal regulation, give the state's licensing board a virtual power of 
review over the federal determination that a person is qualified to 
perform certain functions.'').
    Thus, Congress used the word ``or'' only to distinguish between 
those practitioners who practice at federal facilities and are subject 
to the licensing requirements of the United States,\7\ and the vast 
majority of practitioners who are subject to the licensing requirements 
of the State in which they practice their profession. And while the 
Agency has exempted from ``[t]he requirement of registration . . . any 
official of'' the military, the Public Health Service, or Bureau of 
Prisons who is authorized to prescribe, dispense, or administer, but 
not to procure or purchase, controlled substances in the course of his/
her official duties,'' 21 CFR 1301.23(a), these practitioners otherwise 
remain subject to the Act. See, e.g., 21 U.S.C. 829(a) (``Except when 
dispensed directly by a practitioner, other than a pharmacist, to an 
ultimate user, no controlled substance in schedule II, which is a 
prescription drug as determined under the [FDCA], may be dispensed 
without the written prescription of a practitioner, except [for] in 
emergency situations, as prescribed by . . . regulation . . . .''); 21 
CFR 1306.04(a) (``A prescription for a controlled substance to be 
effective must be issued for a legitimate medical purpose by an 
individual practitioner acting in the usual course of his professional 
practice.'').
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    \7\ As a general matter, federal entities that employ physicians 
require only that the physician hold a medical license in one of the 
50 States. See U.S. Public Health Service, Job Requirements 
(available at www.usphs.gov/profession/physician/requirements.aspx) 
(requiring that a physician have a``[c]urrent, unrestricted, and 
valid medical license to practice in one of the 50 states; 
Washington, DC; Commonwealth of Puerto Rico; U.S. Virgin Islands; or 
Guam''; Indian Health Service, Indian Health Manual, Part 3-
1.4(C)(5) (``Members of the medical staff and others who must apply 
for clinical privileges must hold an active and unrestricted State 
license, certification, or registration, as applicable, to practice 
in their professional field.''); VA Careers (available at 
www.vacareers.va.gov/careers/physicians/credentially.asp) (``At VA, 
only one active, unrestricted state license is required to practice 
in every VA facility across all 50 States, the District of Columbia, 
and U.S. Territories.'').
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    Respondent further asserts that ``[h]ad Congress required that a 
practitioner maintain both state and federal authority to handle 
controlled substances, it would have used the word `and.''' Resp. Opp. 
at 4. Were this the case, any practitioner who is no longer

[[Page 22126]]

authorized to practice medicine by his State (even those who engaged in 
drug dealing) would nonetheless still be allowed to dispense controlled 
substances under their federal registration. The argument is, however, 
refuted by the CSA's definition of the term ``dispense'' to ``mean[ ] 
to deliver a controlled substance to an ultimate user or research 
subject by, or pursuant to the lawful order of, a practitioner, 
including the prescribing and administering of a controlled 
substance.'' 21 U.S.C. 802(10) (emphasis added). Because Respondent is 
required to possess state authority to dispense controlled substances 
in Texas, and by virtue of the Board's Order, no longer holds such 
authority, he cannot issue a ``lawful order'' to deliver a controlled 
substance. And he therefore no longer meets the requirement for being a 
registered practitioner under the Act.
    Respondent further argues that ``had Congress wanted the lack of a 
state license to be an automatic bar to maintaining a DEA registration, 
it would have used the word `shall' '' rather than ``may'' in section 
824. He argues that ``if DEA understood that to be what Congress 
intended the agency could have added lack of state licensure to one of 
the grounds for immediate termination of a DEA registration found in 21 
CFR 1301.52(a). It chose not too [sic], presumably because DEA knew it 
had no such authority.'' Resp. Opp. at 4-5.
    It is not clear, however, why using the word ``shall'' rather than 
``may'' would make any difference, as section 824(a) grants the Agency 
authority to either revoke or suspend. Moreover, were it the case that 
section 824(a) used the word ``shall,'' the Agency would be mandated to 
either suspend or revoke a registration upon making one of the 
enumerated findings, regardless of how persuasive a registrant's 
showing was on issues of remediation where, as in a proceeding brought 
under the public interest authority, such a showing is authorized.
    As this Agency has previously explained, Section 824(a)'s grant of 
authority to suspend or revoke a registration applies across all 
categories of registration, including manufacturers, distributors, 
importers, exporters, narcotic treatment programs, list I distributors, 
and practitioners. And it applies to five different grounds for 
sanctioning a registrant. As the Agency has previously explained, 
``this general grant of authority in imposing a sanction must be 
reconciled with the CSA's specific provisions which mandate that a 
practitioner hold authority under state law in order to obtain and 
maintain a DEA registration.'' James L. Hooper, 76 FR 71371, 71372 
(2011), pet. for rev. denied, Hooper v. Holder, 481 Fed. App'x 826 (4th 
Cir. 2012). See also Gozlon-Peretz v. United States, 498 U.S. 395, 407 
(1991) (``A specific provision controls over one of more general 
application.''); Bloate v. United States, 559 U.S. 196, 207 (2010) 
(``language of a statutory provision, although broad enough to include 
it, will not be held to apply to a matter specifically dealt with in 
another part of the same enactment.' '').
    Thus, in Hooper v. Holder, a physician whose state authority was 
suspended for a period of one year, challenged the revocation of his 
registration, arguing that the Agency ``failed to recognize the 
discretion under Sec.  824(a) to revoke or suspend a registration and 
that it was impermissible for the [Agency] to conclude that the CSA 
requires revocation of a practitioner's DEA registration when the 
practitioner's State license is suspended.'' 481 Fed. App'x, at 826. 
The Fourth Circuit rejected the physician's challenge, explaining:

    We find Hooper's contention unconvincing. Section 824(a) does 
state that the [Agency] may ``suspend or revoke'' a registration, 
but the statute provides for this sanction in five different 
circumstances, only one of which is loss of a State license. Because 
Sec.  823(f) and Sec.  802(21) make clear that a practitioner's 
registration is dependent upon the practitioner having state 
authority to dispense controlled substances, the [Agency's] decision 
to construe Sec.  824(a)(3) as mandating revocation upon suspension 
of a state license is not an unreasonable interpretation of the CSA. 
The [Agency's] decision does not ``read[ ] the suspension option'' 
out of the statute, because that option may still be available for 
the other circumstances enumerated in Sec.  824(a).

Id. \8\ See also Maynard v. DEA, 117 Fed. Appx. 941, 945 (5th Cir. 
2004) (upholding revocation of DEA registration after Texas DPS 
summarily suspended practitioner's controlled substance registration, 
noting that the Agency ``has construed the CSA to require revocation 
when a registrant no longer possesses valid state authority to handle 
controlled substances''; ``We agree with [the] argument that it may 
have been arbitrary and capricious had the DEA failed to revoke [the 
physician's] registration under the circumstances.'').
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    \8\ As for Respondent's contention that if Congress intended 
that lack of a state license should be an automatic bar, the Agency 
could have made this a ground for immediate termination without a 
hearing, the argument ignores that by requiring the Agency to serve 
a Show Cause Order on the registrant, and affording the registrant 
an opportunity to respond, the procedures reduce the risk of an 
erroneous deprivation. See Mathews v. Eldridge, 424 U.S. 319 (1976).
---------------------------------------------------------------------------

    Indeed, DEA has interpreted the CSA in this manner for nearly 40 
years. See Frederick Marsh Blanton, M.D., 43 FR 27616 (1978). In 
Blanton, a physician's state license was suspended for a period of one 
year. Id. at 27616. The Agency nonetheless revoked the physician's 
registration, explaining that ``it is the Administrator's finding and 
conclusion that there is a lawful or statutory basis for the revocation 
of the Respondent's DEA registration. State authorization to dispense 
or otherwise handle controlled substances is a prerequisite to the 
issuance and maintenance of a Federal controlled substances 
registration. The Respondent's registration must, therefore, be 
revoked.'' Id. at 27617 (emphasis added). See also Alfred Tennyson 
Smurthwaite, 43 FR at 11873 (same). Moreover, on various occasions, 
Congress has amended the CSA, including in 1984, when it granted the 
Agency the authority to revoke a practitioner's registration on the 
ground that he had committed acts inconsistent with the public 
interest. See Drug Enforcement Amendments to the Comprehensive Crime 
Control Act of 1984. See P.L. 98-473, Sec.  512, 98 Stat. 1838, 2073 
(1984). Yet it has left the Agency's interpretation intact. See NLRB v. 
Bell Aerospace Co., 416 U.S. 267, 275 (1974).
    The Agency has also long held that revocation is warranted even 
where a practitioner has lost his state authority by virtue of the 
State's use of summary process and the State has yet to provide a 
hearing to challenge the suspension. Bourne Pharmacy, 72 FR 18273, 
18274 (2007); Wingfield Drugs, 52 FR 27070, 27071 (1987). Indeed, as 
this case demonstrates, state proceedings can go on for an extended 
period, and thus, it is not DEA's policy to hold revocation proceedings 
in abeyance while practitioners challenge Board decisions which suspend 
or revoke their state authority.
    Respondent argues, however, that ``the agency's decision [in Odette 
Campbell, 80 FR 41062 2015)] to remand the matter and allow 
administrative proceedings to be conducted by the ALJ (and ultimately 
hold proceedings in abeyance), pending the outcome of state board 
proceedings[,] undermines . . . the agency's notion that it must revoke 
a DEA registration in all instances where a registrant lacks state 
authority, rendering an administrative hearing unnecessary.'' 
Exceptions at 2. Respondent then asserts that ``[w]hile the agency 
conjured up a Due Process

[[Page 22127]]

argument to support its decision in [Campbell], in doing so it 
implicitly held that lack of state authority is not an automatic bar to 
holding a DEA registration.'' Id. Respondent further asserts that 
``[w]hile declaring that Due Process was the basis for this decision, 
the only outcome that could have been reached in that case, if the 
[A]gency followed its own case law, was the revocation of Dr. 
Campbell's DEA registration as the DEA proceedings would not have 
changed the fact that she did not have state authority to handle state 
authority to handle controlled substances.'' Id. at 2-3.
    Respondent's reliance on Campbell is unavailing because he ignores 
critical aspects of the case's procedural history. For one, the case 
began when DEA issued an Order to Show Cause and Immediate Suspension 
of Registration (ISO) to the physician, which was based on allegations 
that she violated various provisions of the Controlled Substances Act. 
80 FR at 41063 n.3. Thereafter, the Texas Medical Board suspended her 
medical license and the Texas Department of Public Safety suspended her 
state controlled substance registration based on the Agency's issuance 
of the ISO. Id. The Government then moved for summary disposition on 
the ground that the physician lacked authority to dispense controlled 
substances under Texas law and the ALJ granted the motion. Id.
    While the matter was under review, the physician submitted a letter 
to the ALJ (which was forwarded to the Administrator), in which she 
asserted that the Medical Board had reinstated her license. Id. After 
the Government responded by letter to the ALJ that the physician was 
still without state authority because her DPS registration had been 
revoked, Respondent submitted a letter to the ALJ asserting that her 
DPS registration could not be reinstated unless her DEA registration 
was reinstated. Id.
    Noting that parties had directed their letters to each other and 
the ALJ, and that neither party had sought relief from her, the former 
Administrator directed the Government to file a properly supported 
motion seeking a final order based on the physician's lack of state 
authority. Id. The Government filed its request, which Respondent 
opposed, arguing that because the DPS's action was based on the 
unsubstantiated allegations of the ISO, it was fundamentally unfair and 
a denial of due process to revoke her DEA registration based on the 
DPS's action. Id.
    On further review, the former Administrator observed that ``it 
appeared that under Texas law and regulations, Respondent was not 
entitled to a hearing before the DPS to challenge either the DPS's 
suspension or the denial of her application for a new registration.'' 
Id. (citing Tex. Health & Safety Code Sec.  481.063(e)(3) & (h); id. 
Sec.  481.066(g); 37 Tex. Admin. Code Sec.  13.272(h)). The 
Administrator then explained that ``if this was so, revoking her [DEA] 
registration based on her lack of state authority would preclude her 
from ever being able to challenge the basis of the Immediate Suspension 
Order.'' Id. The Administrator thus remanded the case, instructing the 
ALJ ``to first determine whether the DPS would provide [the respondent] 
with a hearing on the allegations.'' Id. The Administrator further 
instructed that if the DPS had provided or would provide respondent 
with a hearing, the Government could renew its motion for summary 
disposition. Id. However, if DPS would not provide her with a hearing, 
the ALJ was to conduct a hearing on the allegations of the Show Cause 
Order and ISO. Id.
    In short, there was nothing ``conjured up'' in the Agency's due 
process rationale, which recognized only that due to the vagaries of 
Texas law,\9\ the Agency's litigation strategy might well result in the 
respondent having no meaningful opportunity to challenge the 
allegations which both the Agency and the DPS had relied on in 
suspending their respective registrations. As for Respondent's 
contention that revocation was ``the only outcome that could have been 
reached . . . as the DEA proceedings would not have changed the fact 
that she did not have state authority to handle controlled 
substances,'' Respondent ignores that DPS imposed its suspension based 
solely on the Agency's ISO and that if the physician succeeded in 
challenging the ISO, the basis for the DPS' suspension would no longer 
exist. And Respondent further ignores that in her remand order, the 
Administrator provided that the Government could move for summary 
disposition if it could show that DPS would provide the physician with 
a hearing.\10\
---------------------------------------------------------------------------

    \9\ See Tex. Health & Safety Code Sec.  481.066(g) (State 
Administrative Procedure Act ``does not apply to a . . . suspension 
of a registration for a cause described by Section 481.063 . . . 
(e)(3),'' which includes the suspension of a registration under the 
CSA); 37 Tex. Admin. Code Sec.  13.272(h) (``Under the Act, Sec.  
481.0639(h), the [State Administrative Procedure Act] does not apply 
to a denial, suspension, or revocation of an application for 
registration if the denial is based on a denial or other 
disciplinary action taken by DEA under the Federal Controlled 
Substances Act.'').
    \10\ As for Respondent's assertion that the Administrator's 
decision to hold the Campbell case in abeyance, pending the outcome 
of state board proceedings, ``undermines . . . the [A]gency's notion 
that it must revoke a DEA registration in all instances where a 
registration lacks state authority,'' Exceptions at 2, Respondent 
ignores that at the time the proceeding was held in abeyance, the 
physician (who had been indicted on multiple counts of health care 
fraud) had allowed her registration to expire and had only an 
application pending before the Agency. Moreover, the physician then 
held both a state license and state controlled substance 
registration. See 80 FR at 41063. The case thus does not support 
Respondent's contention.
---------------------------------------------------------------------------

    Accordingly, I reject Respondent's contentions.\11\ Because 
Respondent lacks state authority to dispense controlled substances, he 
is not entitled to maintain his DEA registration. I will therefore 
order that his remaining registration be revoked.
---------------------------------------------------------------------------

    \11\ Respondent also points to a provision of the DEA 
Pharmacist's Manual, which allows an entity to obtain a registration 
for a pharmacy it is acquiring prior to the State's issuance of a 
pharmacy license for that location. Opp. at 5. Respondent asserts 
that ``[w]hile the Agency is permitted to interpret its regulations, 
it is not free to contradict its long-standing policy that a state 
license is not a prerequisite to obtaining a DEA registration when 
doing so is simply a convenient litigation position designed to 
prevent a registrant from proving that the underlying state action 
was erroneous.'' Id. at 5-6.
    However, the Pharmacist's Manual makes clear that provision 
applies only ``[i]f the registrant acquiring the pharmacy owns at 
least one other pharmacy licensed in the same state as the pharmacy 
being transferred,'' and that while the registrant may take 
possession of the controlled substances, ``the registrant may not 
dispense controlled substances until the pharmacy haw been issued a 
valid state pharmacy license.'' DEA, Pharmacists Manual, at 10 
(2010) (emphasis added). This policy exists because some States will 
not grant a pharmacy license to the acquiring pharmacy until DEA 
issues it a registration. However, the period in which the 
registrant is without the state license for the acquired pharmacy is 
typically of short duration.
    As for Respondent's assertion that the Agency's position ``is 
simply a convenient litigation position designed to prevent a 
registrant from proving that the underlying state action was 
erroneous,'' not only is this refuted by nearly 40 years of 
precedent (and hundreds of cases), the Agency has also made clear in 
multiple cases that a challenge to a state board proceeding must be 
litigated in the forums provided by the State. See Kamal Tiwari, 76 
FR 71604, 71606 (2011) (collecting cases); see also George S. Heath, 
51 FR 26610 (1986).
---------------------------------------------------------------------------

Order

    Pursuant to the authority vested in me by 21 U.S.C. 824(a)(3) and 
823(f), as well as 28 CFR 0.100(b), I order that DEA Certificate of 
Registration BS4072637 issued to Rezik A. Saqer, M.D., be, and it 
hereby is, revoked. I further order that any application by Rezik A. 
Saqer, M.D., for registration in the State of Texas, be, and it hereby 
is, denied. This Order is effective immediately.\12\
---------------------------------------------------------------------------

    \12\ For the same reasons which led the Texas Board to order the 
emergency suspension of Respondent's medical license, I conclude 
that the public interest necessitates that this Order be effective 
immediately. 21 CFR 1316.67.


[[Page 22128]]


---------------------------------------------------------------------------

    Dated: April 5, 2016.
Chuck Rosenberg,
Acting Administrator.
[FR Doc. 2016-08572 Filed 4-13-16; 8:45 am]
BILLING CODE 4410-09-P



                                                  22122                              Federal Register / Vol. 81, No. 72 / Thursday, April 14, 2016 / Notices

                                                  certain basic classes of controlled                        issuance of the proposed registration in                  DEPARTMENT OF JUSTICE
                                                  substances. The Drug Enforcement                           accordance with 21 CFR 1301.33(a) on
                                                  Administration (DEA) grants Stepan                         or before June 13, 2016.                                  Drug Enforcement Administration
                                                  Company registration as a manufacturer
                                                                                                             ADDRESSES:   Written comments should                      [Docket No. 16–7]
                                                  of those controlled substances.
                                                  SUPPLEMENTARY INFORMATION: By notice
                                                                                                             be sent to: Drug Enforcement
                                                                                                             Administration, Attention: DEA Federal                    Rezik A. Saqer, M.D.; Decision and
                                                  dated April 14, 2015, and published in                                                                               Order
                                                  the Federal Register on April 22, 2015,                    Register Representative/ODW, 8701
                                                  80 FR 22555, Stepan Company, Natural                       Morrissette Drive, Springfield, Virginia                     On October 1, 2015, the Deputy
                                                  Products Department, 100 W. Hunter                         22152.                                                    Assistant Administrator, Office of
                                                  Avenue, Maywood, New Jersey 07607                                                                                    Diversion Control, Drug Enforcement
                                                                                                             SUPPLEMENTARY INFORMATION:      The                       Administration, issued an Order to
                                                  applied to be registered as a
                                                                                                             Attorney General has delegated her                        Show Cause to Rezik A. Saqer, M.D.,
                                                  manufacturer of certain basic classes of
                                                  controlled substances. No comments or                      authority under the Controlled                            (Respondent). The Show Cause Order
                                                  objections were submitted for this                         Substances Act to the Administrator of                    proposed the revocation of
                                                  notice.                                                    the Drug Enforcement Administration                       Respondent’s DEA Certificates of
                                                     The DEA has considered the factors in                   (DEA), 28 CFR 0.100(b). Authority to                      Registration BS4072637 and FS1975359,
                                                  21 U.S.C. 823(a) and determined that                       exercise all necessary functions with                     pursuant to which he is authorized to
                                                  the registration of Stepan Company to                      respect to the promulgation and                           dispense controlled substances in
                                                  manufacture the basic classes of                           implementation of 21 CFR part 1301,                       schedules II through V, as a practitioner,
                                                  controlled substances is consistent with                   incident to the registration of                           at the respective registered locations of
                                                  the public interest and with United                        manufacturers, distributors, dispensers,                  11037 FM 1960 West, Suite B1,
                                                  States obligations under international                     importers, and exporters of controlled                    Houston, Texas, and 3074 College Park
                                                  treaties, conventions, or protocols in                     substances (other than final orders in                    Drive, Conroe, Texas. Show Cause
                                                  effect on May 1, 1971. The DEA                             connection with suspension, denial, or                    Order, at 1. The Show Cause Order
                                                  investigated the company’s maintenance                     revocation of registration) has been                      further proposed the denial of any
                                                  of effective controls against diversion by                 redelegated to the Deputy Assistant                       applications to renew or modify either
                                                  inspecting and testing the company’s                       Administrator of the DEA Office of                        registration, as well as the denial of any
                                                  physical security systems, verifying the                   Diversion Control (‘‘Deputy Assistant                     other application for a DEA registration.
                                                  company’s compliance with state and                        Administrator’’) pursuant to section 7 of                 Id.
                                                  local laws, and reviewing the company’s                    28 CFR part 0, appendix to subpart R.                        More specifically, the Show Cause
                                                  background and history.                                                                                              Order alleged that ‘‘[e]ffective
                                                     Therefore, pursuant to 21 U.S.C.                          In accordance with 21 CFR                               September 28, 2015, the Texas Medical
                                                  823(a), and in accordance with 21 CFR                      1301.33(a), this is notice that on January                Board issued an Order of Temporary
                                                  1301.33, the above-named company is                        13, 2016, Patheon API Manufacturing,                      Suspension . . . which suspended
                                                  granted registration as a bulk                             Inc., 309 Delaware Street, Building                       [Respondent’s] medical license,’’ and
                                                  manufacturer of the following basic                        1106, Greenville, South Carolina 29605                    therefore, he is currently ‘‘without
                                                  classes of controlled substances:                          applied to be registered as a bulk                        authority to handle controlled
                                                                                                             manufacturer of the following basic                       substances in Texas, the State in which
                                                          Controlled substance                   Schedule    classes of controlled substances:                         [he is] registered with’’ DEA. Id. at 2.
                                                                                                                                                                       The Show Cause Order thus advised
                                                  Cocaine (9041) .............................   II
                                                  Ecgonine (9180) ...........................    II
                                                                                                                     Controlled substance                   Schedule   Respondent that ‘‘DEA must revoke [his]
                                                                                                                                                                       registrations based upon [his] lack of
                                                                                                             Marihuana (7360) .........................    I           authority to handle controlled
                                                    The company plans to manufacture
                                                                                                             Tetrahydrocannabinols (7370) .....            I           substances in the State of Texas.’’ Id.
                                                  the listed controlled substances in bulk                   Noroxymorphone (9668) ..............          II
                                                  for distribution to its customers.                                                                                   (citing 21 U.S.C. 802(21), 823(f), and
                                                                                                                                                                       824(a)(3)).
                                                    Dated: April 4, 2016
                                                                                                               The company plans to manufacture                           On October 2, 2015, a Diversion
                                                  Louis J. Milione,                                                                                                    Investigator served the Show Cause
                                                                                                             the above-listed controlled substances
                                                  Deputy Assistant Administrator.                            as Active Pharmaceutical Ingredients                      Order by travelling to Respondent’s
                                                  [FR Doc. 2016–08576 Filed 4–13–16; 8:45 am]                (API) for clinical trials.                                registered location in Houston, and
                                                  BILLING CODE 4410–09–P
                                                                                                               In reference to drug codes 7360                         leaving it with a medical assistant, who
                                                                                                                                                                       provided a signed receipt for the Order.
                                                                                                             (marihuana), and 7370 (THC), the
                                                                                                                                                                       Affidavit of DI, at 1. On November 5,
                                                  DEPARTMENT OF JUSTICE                                      company plans to bulk manufacture
                                                                                                                                                                       2015, Respondent, through his counsel,
                                                                                                             these drugs as synthetics. No other                       requested a hearing on the allegations of
                                                  Drug Enforcement Administration                            activities for these drug codes are                       the Show Cause Order.1 The matter was
                                                  [Docket No. DEA–392]                                       authorized for this registration.                         then placed on the docket of the Office
                                                                                                               Dated: March 29, 2016.                                  of Administrative Law Judges, and
                                                  Bulk Manufacturer of Controlled
                                                                                                             Louis J. Milione,
                                                  Substances Application: Patheon API                                                                                    1 While Respondent’s request was untimely,
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                                                  Manufacturing, Inc.                                        Deputy Assistant Administrator.
                                                                                                                                                                       Respondent’s counsel subsequently filed a motion
                                                                                                             [FR Doc. 2016–08569 Filed 4–13–16; 8:45 am]               which established that his secretary had attempted
                                                  ACTION:    Notice of application.                          BILLING CODE 4410–09–P                                    to file the hearing request by UPS overnight
                                                                                                                                                                       delivery, but had provided an incorrect address.
                                                  DATES:  Registered bulk manufacturers of                                                                             DEA has previously held that this type of
                                                                                                                                                                       inadvertence may establish ‘‘good cause’’ to excuse
                                                  the affected basic classes, and                                                                                      an untimely hearing request, at least when the party
                                                  applicants therefore, may file written                                                                               promptly moves to rectify the omission. Tony Bui,
                                                  comments on or objections to the                                                                                     75 FR 49979, 49980 (2010).



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                                                                                Federal Register / Vol. 81, No. 72 / Thursday, April 14, 2016 / Notices                                                   22123

                                                  assigned to the Chief Administrative                    hearing’ in every case in which a statute             me for Final Agency Action. Having
                                                  Law Judge (hereinafter, CALJ).                          requires adjudication to be determined                considered the record including
                                                     In the same filing which contained his               on the record,’’ and that 5 U.S.C. 554                Respondent’s Exceptions, I adopt the
                                                  hearing request, Respondent also sought                 does not contain ‘‘an exception for                   CALJ’s finding that Respondent lacks
                                                  a ‘‘brief stay’’ of the proceeding, stating             ‘summary disposition.’ ’’ Id. at 2.                   authority under Texas law to handle
                                                  that a hearing on the Texas Medical                        Respondent also argued that the                    controlled substances, and his
                                                  Board’s (TMB) emergency suspension                      Agency’s position that the possession of              conclusion of law that Respondent is
                                                  order was to commence on November                       state authority is a condition for                    not entitled to maintain his registration.
                                                  19, 2015. Respondent further expressed                  maintaining a DEA registration is based               For reasons explained below, I will also
                                                  his expectation that ‘‘[o]n or shortly                  on a misreading of the term                           adopt the ALJ’s recommendation but
                                                  after that date . . . the [TMB] will issue              ‘‘practitioner,’’ id. at 3–4, which the               only with respect to Respondent’s
                                                  an order regarding his challenge to the                 CSA defines as meaning ‘‘a physician                  Certificate of Registration BS4072637. I
                                                  temporary suspension.’’ Respondent’s                    . . . or other person licensed, registered,           make the following findings.
                                                  Req. for Hrng. and Mot. for Brief Stay of               or otherwise permitted, by the United
                                                  Admin. Proceedings, at 1.                               States or the jurisdiction in which he                Findings of Fact
                                                     The next day, the CALJ denied                        practices to . . . dispense . . . a                      Respondent is the holder of DEA
                                                  Respondent’s request for a stay and                     controlled substance in the course of                 Certificate of Registration BS4072637,
                                                  ordered the Government to provide                       professional practice.’’ 21 U.S.C.                    pursuant to which he is authorized to
                                                  evidence in support of the allegation                   802(21). More specifically, Respondent                dispense controlled substances in
                                                  that Respondent lacks state authority                   argued that because the definition uses               schedules II through V, as a practitioner,
                                                  and any accompanying motion, no later                   the disjunctive ‘‘or,’’ rather than the               at the address of 11037 FM 1960 West,
                                                  than 2 p.m. on November 23, 2015.                       conjunctive of ‘‘and,’’ this ‘‘clearly                Suite B1, Houston, Texas. Mot. for
                                                  CALJ Order, at 2 (Nov. 6, 2015). The                    signals Congress’ intent that a                       Summ. Disp., at Attachment 2. Under
                                                  CALJ also ordered that if the                           practitioner is one who either has state              this registration, Respondent is also
                                                  Government filed such a motion,                         authority or federal authority to                     authorized to treat up to 100 patients as
                                                  Respondent’s Reply would be due no                      prescribe or dispense controlled                      a DATA-waived physician. Id. This
                                                  later than 2 p.m. on December 3, 2015.                  substances.’’ Id. at 4. And finally,                  registration does not expire until
                                                  Id.                                                     Respondent argued that under 21 U.S.C.                February 28, 2018. Id.
                                                     On November 18, 2015, the                            843(a), the Agency ‘‘may revoke a                        Respondent also previously held DEA
                                                  Government filed its Motion for                         registration based on the suspension or               Certificate of Registration FS1975359,
                                                  Summary Disposition. Therein, the                       revocation of state authority to dispense             pursuant to which he was authorized to
                                                  Government argued that it was                           controlled substances, not that it must               dispense controlled substances in
                                                  undisputed that Respondent’s medical                    revoke based on those allegations.’’ Id.              schedules II through V, as a practitioner,
                                                  license has been suspended by the State,                at 5. Respondent then contended that                  at the address of 3074 College Park
                                                  and while Respondent argued that the                    granting summary disposition was                      Drive, Conroe, Texas. Mot. for. Summ.
                                                  TMB was to hold a hearing on the                        ‘‘inappropriate’’ because he ‘‘intend[ed]             Disp., at Attachment 3. This registration
                                                  suspension, whether and when the TMB                    to present evidence that his registration             was due to expire on February 29, 2016,
                                                  would lift its order was ‘‘a matter of                  is consistent with the public interest                id., and according to the registration
                                                  speculation.’’ Mot. at 3. The                           notwithstanding the status of [sic] state             records of this Agency of which I take
                                                  Government thus argued that even                        license,’’ and he ‘‘is challenging the loss           official notice, Respondent has not filed
                                                  where a registrant’s state authority has                of his state authority and until his rights           a timely renewal application (let alone
                                                  been temporarily suspended, revocation                  are exhausted, there exists a real                    any application to renew this
                                                  of his registration is still warranted                  prospect that his state authority will be             registration).2 Accordingly, I find that
                                                  because the registrant must possess                     reinstated.’’ Id.                                     this registration has expired. See 21 CFR
                                                  authority to handle controlled                             Finding that ‘‘no genuine dispute                  1301.36(i).
                                                  substances under state law in order for                 exists over the fact that the Respondent                 Respondent is also the holder of
                                                  the Agency to maintain his registration.                lacks state authority to handle                       Texas Medical License No. K–2282. In
                                                  Id. at 3–4. As support for its Motion, the              controlled substances,’’ the CALJ                     re Saqer, Order of Temporary
                                                  Government attached the Order of                        concluded that because Respondent                     Suspension (Without Notice of Hearing),
                                                  Temporary Suspension (Without Notice                    lacks such authority, ‘‘Agency precedent              at 1 (Tex. Med. Bd. Sept. 28, 2015).
                                                  of Hearing), which was issued to                        dictates that he is not entitled to                   However, on September 28, 2015, the
                                                  Respondent by the TMB’s Disciplinary                    maintain his DEA registration.’’ Order                Disciplinary Panel of the Texas Medical
                                                  Panel on September 28, 2015.                            Granting Govt. Mot. for Summ. Disp., at               Board entered an Order of Temporary
                                                     On December 3, 2015, Respondent                      9. Noting that ‘‘there is no contested                Suspension against Respondent’s
                                                  filed its Opposition to the Government’s                factual matter adducible at a hearing                 medical license following an ex-parte
                                                  Motion. Therein, he argued that both the                that would, in the Agency’s view,                     hearing on the Board’s Application for
                                                  Controlled Substances Act (CSA) and                     provide authority to allow the
                                                  DEA’s regulations require that if a                     Respondent to continue to hold his’’                     2 Under the Administrative Procedure Act (APA),

                                                  registrant ‘‘requests a hearing, the                                                                          an agency ‘‘may take official notice of facts at any
                                                                                                          registration, the CALJ granted the                    stage in a proceeding—even in the final decision.’’
                                                  agency is required to provide such a                    Government’s motion for summary                       U.S. Dept. of Justice, Attorney General’s Manual on
                                                  hearing.’’ Resp. Opp., at 1 (citing 21                  disposition and recommended that his                  the Administrative Procedure Act 80 (1947) (Wm.
mstockstill on DSK4VPTVN1PROD with NOTICES




                                                  U.S.C. 824(c); 21 CFR 1301.36(d) and                    ‘‘registration be revoked’’ and that ‘‘any            W. Gaunt & Sons, Inc., Reprint 1979). In accordance
                                                                                                                                                                with the APA and DEA’s regulations, Respondent
                                                  1301.37(d)). He also argued that ‘‘[t]here              pending applications for renewal be                   is ‘‘entitled on timely request to an opportunity to
                                                  are no provisions in DEA’s regulations                  denied.’’ Id. at 9–10 (bold and                       show to the contrary.’’ 5 U.S.C. 556(e); see also 21
                                                  or the CSA that allow for summary                       capitalization deleted).                              CFR 1316.59(e). To allow Respondent the
                                                  disposition whereby Respondent’s right                     Respondent filed Exceptions to the                 opportunity to refute the facts of which I take
                                                                                                                                                                official notice, Respondent may file a motion for
                                                  to a hearing is denied.’’ Id. And he                    CALJ’s Order and the Government filed                 reconsideration within ten calendar days of service
                                                  argued that Title 5 (the Administrative                 a Response to Respondent’s Exceptions.                of this order which shall commence on the date this
                                                  Procedure Act) ‘‘requires an ‘agency                    Thereafter, the record was forwarded to               order is mailed.



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                                                  22124                         Federal Register / Vol. 81, No. 72 / Thursday, April 14, 2016 / Notices

                                                  Temporary Suspension (Without Notice                    Discussion                                                  provided any evidence that it meets
                                                  of Hearing). Id. at 4.                                                                                              statutory standards).
                                                                                                          Respondent’s Contention That DEA                               Notably, while Respondent was given
                                                     As the basis for the Order, the Panel
                                                                                                          Cannot Use Summary Disposition to                           the opportunity to demonstrate the
                                                  found that on September 22, 2015, a
                                                                                                          Adjudicate This Matter                                      existence of a factual dispute as to
                                                  search warrant was executed at a pain
                                                  management clinic owned by                                 As explained above, in his Opposition                    whether he retains state authority, he
                                                  Respondent, during which DEA agents                                                                                 could not do so, as even after he was
                                                                                                          to the Government’s Motion,
                                                  ‘‘obtained evidence establishing that                                                                               allowed to appear before the Board and
                                                                                                          Respondent contends that because he
                                                  Respondent pre-signed treatment notes,                                                                              challenge the temporary suspension of
                                                                                                          requested a hearing, under the Agency’s
                                                  pre-signed prescriptions and illegally                                                                              his license, the Board re-imposed the
                                                                                                          regulation, the Agency was required to
                                                  maintained schedule II controlled                                                                                   suspension. However, even in the
                                                                                                          provide him with a hearing. Opp. at 1–
                                                  substances in his personal office.’’ Id. at                                                                         absence of a disputed material fact,
                                                                                                          3. He further contends that there are no                    Respondent contends that ‘‘summary
                                                  2. The Panel also found ‘‘that patients                 provisions in either the CSA or the
                                                  of [the clinic] were sometimes seen by                                                                              disposition [was] inappropriate,’’
                                                                                                          Agency’s regulations that allow for                         because he ‘‘intend[ed] to present
                                                  unlicensed individuals that would fill                  summary disposition, thereby denying
                                                  in the records and prescriptions to make                                                                            evidence that his registration is
                                                                                                          him his right to a hearing. Id. at 2–3.                     consistent with the public interest
                                                  it appear that Respondent had seen the
                                                  patient and written the prescription.’’                    However, numerous courts, including                      notwithstanding the status of [his] state
                                                  Id. The Panel thus found that                           the Supreme Court, have held that even                      license.’’ Opp. at 5. The short answer to
                                                  ‘‘Respondent engaged in illegal                         where a statute directs an agency to                        this argument is that even if Respondent
                                                  activities related to his operation of [the             provide a party with a hearing, the                         could show that his registration is
                                                  clinic], and engaged in the                             agency can nonetheless resolve the                          consistent with the public interest, his
                                                  inappropriate prescribing, dispensing,                  matter on summary disposition when                          lack of state authority precludes his
                                                  or administering of controlled                          there are no material facts in dispute.                     continued registration under the CSA,
                                                  substances, and therefore Respondent                    See, e.g., Veg-Mix, Inc. v. Department of                   and it is the Government and not
                                                  has committed violations of state and                   Agriculture, 832 F.2d 601, 607 (D.C. Cir.                   Respondent who decides what ground
                                                  federal law, including the Medical                      1987). As the DC Circuit explained in                       or grounds to pursue when seeking the
                                                  Practice Act and Board Rules.’’ Id.                     Veg-Mix, ‘‘[c]ommon sense suggests the                      revocation of his registration.
                                                     The Panel concluded that                             futility of hearings where there is no                      Respondent’s Challenge to the Agency’s
                                                  ‘‘Respondent’s continued practice of                    factual dispute of substance.’’ Id. 3 See                   Authority To Revoke His Registration
                                                  medicine, including improper and                        also NLRB v. International Ass’n of
                                                                                                          Bridge, Structural and Ornamental                              Respondent nonetheless maintains
                                                  illegal activities related to his operation                                                                         that the Agency’s rule that a
                                                  of a pain management clinic, and                        Ironworkers, 549 F.2d 634, 639 (9th Cir.
                                                                                                          1977) (‘‘ ‘It is settled law that when no                   practitioner’s loss of his ‘‘state authority
                                                  including the method and manner in                                                                                  is an automatic bar to maintaining a
                                                  which controlled substances were                        fact question is involved or the facts are
                                                                                                          agreed, a plenary, adversary                                DEA registration’’ is based ‘‘on a
                                                  prescribed and maintained, poses a                                                                                  misreading of the CSA.’’ Resp.
                                                  continuing threat to public welfare.’’ Id.              administrative proceeding involving
                                                                                                          evidence, cross-examination of                              Exceptions, at 1–2. In his Exceptions,
                                                  Based on these findings, the Panel                                                                                  Respondent contends that ‘‘[f]or
                                                  found ‘‘a continuing threat to the public               witnesses, etc., is not obligatory, even
                                                                                                          though a pertinent statute prescribes a                     proceedings seeking the revocation of a
                                                  health, safety, or welfare that requires                                                                            DEA registration, the [A]gency derives
                                                  immediate effect of this Order of                       hearing. In such situations, the rationale
                                                                                                          is that Congress does not intend                            its authority from 21 U.S.C. 824, not 21
                                                  Temporary Suspension on the date                                                                                    U.S.C. 823, and 21 U.S.C. 824 does not
                                                  rendered.’’ Id. And after setting forth its             administrative agencies to perform
                                                                                                          meaningless tasks.’ ’’) (quoting United                     support the [A]gency’s position that it
                                                  legal conclusions that Respondent                                                                                   must revoke a DEA registration in all
                                                  violated multiple provisions of the                     States v. Consolidated Mines & Smelting
                                                                                                          Co., Ltd., 455 F.2d 432, 453 (9th Cir.                      instances where a registrant lacks state
                                                  Medical Practice Act, the Panel ordered                                                                             authority.’’ Id. at 2.
                                                  that Respondent’s medical license be                    1971)).4 Cf. Weinberger v. Hynson,
                                                                                                                                                                         To be sure, section 824(a) states, in
                                                  suspended. Id. at 3–4.                                  Westcott and Dunning, Inc., 412 U.S.
                                                                                                                                                                      relevant part, that ‘‘[a] registration
                                                     On November 19, 2015, the                            609, 620–22 (1973) (upholding agency’s
                                                                                                                                                                      pursuant to section 823 of this title to
                                                  Disciplinary Panel conducted a hearing                  authority to dispense with a formal
                                                                                                                                                                      manufacture, distribute, or dispense a
                                                  at which Respondent appeared and was                    hearing where applicant has not
                                                                                                                                                                      controlled substance or list I chemical
                                                  represented by counsel. In re Saqer,                                                                                may be suspended or revoked . . . upon
                                                                                                             3 While Respondent noted that the Agency’s rules
                                                  Order of Temporary Suspension (With                                                                                 a finding that the registrant . . . has had
                                                                                                          regarding the conduct of hearings do not include a
                                                  Notice of Hearing), at 1 (Tex. Med. Bd.                 provision which expressly authorizes the use of             his State license or registration
                                                  Nov. 19, 2015). However, following the                  summary disposition, this Agency has used                   suspended, revoked, or denied by
                                                  hearing, the Board made the same                        summary disposition to resolve proceedings based            competent State authority and is no
                                                  factual findings and legal conclusions as               on a registrant’s loss of his/her state authority for
                                                                                                          nearly 40 years. See, e.g., Alfred Tennyson
                                                                                                                                                                      longer authorized by State law to engage
                                                  it had at the ex parte proceeding, see id.              Smurthwaite, N.D., 43 FR 11873 (1978). There are            in the manufacturing, distribution or
                                                  at 1–4, and it again ordered the                        hundreds of such cases reported in the Federal              dispensing of controlled substances or
                                                  temporary suspension of Respondent’s                    Register. Contrary to Respondent’s contention that          list I chemicals.’’ 21 U.S.C. 824(a)(3).
                                                                                                          the Agency cannot rely on summary disposition in
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                                                  medical license. Id. According to the                                                                               Thus, Respondent is correct that section
                                                                                                          the absence of a regulation which expressly allows
                                                  online records of the Texas Medical                     for it, ‘‘[i]t is well established that agencies are free   824 grants the Attorney General
                                                  Board, the suspension remains in effect.                to announce and develop rules in an adjudicatory            discretion and does not mandate the
                                                  I therefore find that Respondent is                     setting.’’ Puerto Rico Aqueduct and Sewer Auth. v.          revocation of a ‘‘registration in all
                                                  currently without authority to dispense                 EPA, 35 F.3d 600 607 (1st Cir. 1994) (citing NLRB
                                                                                                          v. Bell Aerospace Co., 416 U.S. 267, 294 (1974)).
                                                                                                                                                                      instances where a registrant lacks state
                                                  controlled substances in Texas, the State                  4 See also Travers v. Shalala, 20 F.3d 993, 998          authority.’’ Resp. Exceptions, at 2.
                                                  in which he is engages in professional                  (9th Cir. 1994) (quoting Consolidated Mines, 455               Indeed, in Bio-Diagnostic
                                                  practice and holds his DEA registration.                F.2d at 453).                                               International, 78 FR 39327 (2013), a


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                                                                                 Federal Register / Vol. 81, No. 72 / Thursday, April 14, 2016 / Notices                                                       22125

                                                  case involving a list I chemical                        the State to practice medicine and to                  131, 135 n.4 (5th Cir. 1981) (citing
                                                  distributor which did not possess state                 dispense drugs in connection with his                  Sperry v. Florida ex rel. Florida Bar, 373
                                                  authority, the Agency held that granting                professional practice.’’ 6                             U.S. 379 (1963) (‘‘A State may not
                                                  summary disposition to the Government                      Thus, the CSA defines ‘‘[t]he term                  enforce licensing requirements that,
                                                  on this basis was improper because                      ‘practitioner’ [to] mean[] a physician                 though valid in the absence of federal
                                                  neither the provision setting forth the                 . . . or other person licensed, registered,            regulation, give the state’s licensing
                                                  standards for the registration of list I                or otherwise permitted, by the United                  board a virtual power of review over the
                                                  distributors, nor the definition of a                   States or the jurisdiction in which he                 federal determination that a person is
                                                  distributor, requires that a distributor                practices to . . . dispense . . . a                    qualified to perform certain
                                                  possess state authority in order to be                  controlled substance in the course of                  functions.’’).
                                                  registered.5 While Bio-Diagnostic                       professional practice.’’ 21 U.S.C.                        Thus, Congress used the word ‘‘or’’
                                                  involved an application, in a footnote,                 802(21). As noted above, in his                        only to distinguish between those
                                                  the decision explained that while                       Opposition, Respondent argued that                     practitioners who practice at federal
                                                  ‘‘section 824(a)(3) authorizes revocation               ‘‘[t]he use of the disjunctive ‘or’ clearly            facilities and are subject to the licensing
                                                  where a registrant ‘has had [its] State                 signals Congress’ intent that a                        requirements of the United States,7 and
                                                  license suspended, revoked, or denied                   practitioner is one who either has state               the vast majority of practitioners who
                                                  by competent state authority and is no                  authority or federal authority to                      are subject to the licensing requirements
                                                  longer authorized by State law to engage                prescribe or dispense controlled                       of the State in which they practice their
                                                  in the manufacturing [or] distribution of               substances[,]’’ and that ‘‘[h]ad Congress              profession. And while the Agency has
                                                  . . . list I chemicals[,]’ [this] does not              required that a practitioner maintain                  exempted from ‘‘[t]he requirement of
                                                  mean that revocation is warranted in all                both state and federal authority to                    registration . . . any official of’’ the
                                                  instances.’’ Id. at 39330 n.6. Continuing,              handle controlled substances, it would                 military, the Public Health Service, or
                                                  the decision explained that ‘‘[t]his                    have used the word ‘and.’’’ Resp. Opp.                 Bureau of Prisons who is authorized to
                                                  provision grants the Agency                             at 4. Continuing, Respondent argued                    prescribe, dispense, or administer, but
                                                  discretionary authority to impose an                    that ‘‘[w]hile it is not entirely clear why            not to procure or purchase, controlled
                                                  appropriate sanction; the failure to                    Congress took this approach . . . the                  substances in the course of his/her
                                                  consider factors such as the                            clear statutory language’’ refutes the                 official duties,’’ 21 CFR 1301.23(a),
                                                  egregiousness of the misconduct and                     Government’s argument that ‘‘a lack of                 these practitioners otherwise remain
                                                  mitigating factors in imposing the                      state licensure [is] an automatic bar to               subject to the Act. See, e.g., 21 U.S.C.
                                                  sanction would render the sanction                      maintaining a DEA registration.’’ Id.                  829(a) (‘‘Except when dispensed
                                                  arbitrary and capricious.’’ Id.                            Respondent is mistaken. As for why                  directly by a practitioner, other than a
                                                     Respondent is not, however, a List I                 Congress used the disjunctive rather                   pharmacist, to an ultimate user, no
                                                  chemical distributor. Rather, he is a                   than the conjunctive in defining the                   controlled substance in schedule II,
                                                  practitioner, and by contrast to the                    term practitioner, notwithstanding the                 which is a prescription drug as
                                                  CSA’s provisions applicable to list I                   absence of any relevant discussion in                  determined under the [FDCA], may be
                                                  distributors, both the CSA’s definition                 the CSA’s legislative history, there is an             dispensed without the written
                                                  of the term ‘‘practitioner’’ and the                    explanation. While the overwhelming                    prescription of a practitioner, except
                                                  registration provision applicable to                    majority of practitioners who practice                 [for] in emergency situations, as
                                                  practitioners make clear that a                         medicine (or dentistry and veterinary                  prescribed by . . . regulation . . . .’’);
                                                  practitioner must be currently                          medicine) are subject to regulation by                 21 CFR 1306.04(a) (‘‘A prescription for
                                                  authorized to dispense controlled                       the State in which they practice their                 a controlled substance to be effective
                                                  substances by the State in which he                     professions, multiple federal                          must be issued for a legitimate medical
                                                  practices in order to obtain and                        Departments and Agencies (e.g., the                    purpose by an individual practitioner
                                                  maintain a registration.                                Department of Defense, Veterans                        acting in the usual course of his
                                                     As for the registration provision                    Administration, Bureau of Prisons,                     professional practice.’’).
                                                  applicable to practitioners, it provides,               United States Public Health Service, and                  Respondent further asserts that ‘‘[h]ad
                                                  in relevant part, that: ‘‘[t]he Attorney                Indian Health Service) employ                          Congress required that a practitioner
                                                  General shall register practitioners . . .              practitioners. However, by virtue of the               maintain both state and federal
                                                  to dispense . . . controlled substances                 Supremacy Clause, these health-care                    authority to handle controlled
                                                  . . . if the applicant is authorized to                 professionals are not subject to                       substances, it would have used the word
                                                  dispense . . . controlled substances                    regulation by the State in which the                   ‘and.’’’ Resp. Opp. at 4. Were this the
                                                  under the laws of the State in which he                 federal facility is located as long they               case, any practitioner who is no longer
                                                  practices.’’ 21 U.S.C. 823(f). As the                   confine their practice to the facility. See
                                                  Supreme Court explained in United                       Taylor v. United States, 821 F.2d 1428,                   7 As a general matter, federal entities that employ

                                                                                                          1431 (9th Cir. 1987) (noting that under                physicians require only that the physician hold a
                                                  States v. Moore, 423 U.S. 122, 140–41                                                                          medical license in one of the 50 States. See U.S.
                                                  (1975), ‘‘[r]egistration of physicians and              the Supremacy Clause, a State ‘‘lacks                  Public Health Service, Job Requirements (available
                                                  other practitioners is mandatory if the                 power to require licensing of federal                  at www.usphs.gov/profession/physician/
                                                  applicant is authorized to dispense                     health care providers and physicians’’                 requirements.aspx) (requiring that a physician have
                                                                                                          and that ‘‘[t]he United States has                     a‘‘[c]urrent, unrestricted, and valid medical license
                                                  drugs . . . under the law of the State in                                                                      to practice in one of the 50 states; Washington, DC;
                                                  which he practices. [21 U.S.C.] § 823(f).               essentially deemed [an] Army [h]ospital                Commonwealth of Puerto Rico; U.S. Virgin Islands;
                                                  In the case of a physician, this scheme                 and its staff fit to provide health care               or Guam’’; Indian Health Service, Indian Health
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                                                                                                          services’’); United States v. Composite                Manual, Part 3–1.4(C)(5) (‘‘Members of the medical
                                                  contemplates that he is authorized by                                                                          staff and others who must apply for clinical
                                                                                                          State Bd. of Med. Exmn’rs, 656 F.2d                    privileges must hold an active and unrestricted
                                                     5 The decision did note, however, that where a
                                                                                                                                                                 State license, certification, or registration, as
                                                  list I distributor was required to obtain state            6 While in 1984 Congress granted the Attorney
                                                                                                                                                                 applicable, to practice in their professional field.’’);
                                                  authority and had not done so, this could be            General authority to deny a registration on public     VA Careers (available at www.vacareers.va.gov/
                                                  considered under the public interest factor which       interest grounds, the provision did not alter the      careers/physicians/credentially.asp) (‘‘At VA, only
                                                  examines ‘‘compliance by the applicant with             CSA’s requirement that a practitioner must be          one active, unrestricted state license is required to
                                                  applicable Federal, State and local law.’’ 78 FR at     ‘‘authorized by the State to practice medicine’’ and   practice in every VA facility across all 50 States, the
                                                  39330–31 (quoting 21 U.S.C. 823(h)(2)).                 dispense drugs in order to be registered.              District of Columbia, and U.S. Territories.’’).



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                                                  22126                         Federal Register / Vol. 81, No. 72 / Thursday, April 14, 2016 / Notices

                                                  authorized to practice medicine by his                  obtain and maintain a DEA                              the DEA failed to revoke [the
                                                  State (even those who engaged in drug                   registration.’’ James L. Hooper, 76 FR                 physician’s] registration under the
                                                  dealing) would nonetheless still be                     71371, 71372 (2011), pet. for rev.                     circumstances.’’).
                                                  allowed to dispense controlled                          denied, Hooper v. Holder, 481 Fed.                        Indeed, DEA has interpreted the CSA
                                                  substances under their federal                          App’x 826 (4th Cir. 2012). See also                    in this manner for nearly 40 years. See
                                                  registration. The argument is, however,                 Gozlon-Peretz v. United States, 498 U.S.               Frederick Marsh Blanton, M.D., 43 FR
                                                  refuted by the CSA’s definition of the                  395, 407 (1991) (‘‘A specific provision                27616 (1978). In Blanton, a physician’s
                                                  term ‘‘dispense’’ to ‘‘mean[ ] to deliver a             controls over one of more general                      state license was suspended for a period
                                                  controlled substance to an ultimate user                application.’’); Bloate v. United States,              of one year. Id. at 27616. The Agency
                                                  or research subject by, or pursuant to                  559 U.S. 196, 207 (2010) (‘‘language of                nonetheless revoked the physician’s
                                                  the lawful order of, a practitioner,                    a statutory provision, although broad                  registration, explaining that ‘‘it is the
                                                  including the prescribing and                           enough to include it, will not be held to              Administrator’s finding and conclusion
                                                  administering of a controlled                           apply to a matter specifically dealt with              that there is a lawful or statutory basis
                                                  substance.’’ 21 U.S.C. 802(10) (emphasis                in another part of the same                            for the revocation of the Respondent’s
                                                  added). Because Respondent is required                  enactment.’ ’’).                                       DEA registration. State authorization to
                                                  to possess state authority to dispense                     Thus, in Hooper v. Holder, a                        dispense or otherwise handle controlled
                                                  controlled substances in Texas, and by                  physician whose state authority was                    substances is a prerequisite to the
                                                  virtue of the Board’s Order, no longer                  suspended for a period of one year,                    issuance and maintenance of a Federal
                                                  holds such authority, he cannot issue a                 challenged the revocation of his                       controlled substances registration. The
                                                  ‘‘lawful order’’ to deliver a controlled                registration, arguing that the Agency                  Respondent’s registration must,
                                                  substance. And he therefore no longer                   ‘‘failed to recognize the discretion under             therefore, be revoked.’’ Id. at 27617
                                                  meets the requirement for being a                       § 824(a) to revoke or suspend a                        (emphasis added). See also Alfred
                                                  registered practitioner under the Act.                  registration and that it was                           Tennyson Smurthwaite, 43 FR at 11873
                                                     Respondent further argues that ‘‘had                 impermissible for the [Agency] to                      (same). Moreover, on various occasions,
                                                  Congress wanted the lack of a state                     conclude that the CSA requires                         Congress has amended the CSA,
                                                  license to be an automatic bar to                       revocation of a practitioner’s DEA                     including in 1984, when it granted the
                                                  maintaining a DEA registration, it would                registration when the practitioner’s                   Agency the authority to revoke a
                                                  have used the word ‘shall’ ’’ rather than               State license is suspended.’’ 481 Fed.                 practitioner’s registration on the ground
                                                  ‘‘may’’ in section 824. He argues that ‘‘if             App’x, at 826. The Fourth Circuit                      that he had committed acts inconsistent
                                                  DEA understood that to be what                          rejected the physician’s challenge,                    with the public interest. See Drug
                                                  Congress intended the agency could                      explaining:                                            Enforcement Amendments to the
                                                  have added lack of state licensure to one                 We find Hooper’s contention                          Comprehensive Crime Control Act of
                                                  of the grounds for immediate                            unconvincing. Section 824(a) does state that           1984. See P.L. 98–473, § 512, 98 Stat.
                                                  termination of a DEA registration found                 the [Agency] may ‘‘suspend or revoke’’ a               1838, 2073 (1984). Yet it has left the
                                                  in 21 CFR 1301.52(a). It chose not too                  registration, but the statute provides for this        Agency’s interpretation intact. See
                                                  [sic], presumably because DEA knew it                   sanction in five different circumstances, only         NLRB v. Bell Aerospace Co., 416 U.S.
                                                  had no such authority.’’ Resp. Opp. at                  one of which is loss of a State license.               267, 275 (1974).
                                                  4–5.                                                    Because § 823(f) and § 802(21) make clear                 The Agency has also long held that
                                                                                                          that a practitioner’s registration is dependent
                                                     It is not clear, however, why using the                                                                     revocation is warranted even where a
                                                                                                          upon the practitioner having state authority
                                                  word ‘‘shall’’ rather than ‘‘may’’ would                to dispense controlled substances, the                 practitioner has lost his state authority
                                                  make any difference, as section 824(a)                  [Agency’s] decision to construe § 824(a)(3) as         by virtue of the State’s use of summary
                                                  grants the Agency authority to either                   mandating revocation upon suspension of a              process and the State has yet to provide
                                                  revoke or suspend. Moreover, were it                    state license is not an unreasonable                   a hearing to challenge the suspension.
                                                  the case that section 824(a) used the                   interpretation of the CSA. The [Agency’s]              Bourne Pharmacy, 72 FR 18273, 18274
                                                  word ‘‘shall,’’ the Agency would be                     decision does not ‘‘read[ ] the suspension             (2007); Wingfield Drugs, 52 FR 27070,
                                                  mandated to either suspend or revoke a                  option’’ out of the statute, because that              27071 (1987). Indeed, as this case
                                                                                                          option may still be available for the other
                                                  registration upon making one of the                                                                            demonstrates, state proceedings can go
                                                                                                          circumstances enumerated in § 824(a).
                                                  enumerated findings, regardless of how                                                                         on for an extended period, and thus, it
                                                  persuasive a registrant’s showing was on                Id. 8 See also Maynard v. DEA, 117 Fed.                is not DEA’s policy to hold revocation
                                                  issues of remediation where, as in a                    Appx. 941, 945 (5th Cir. 2004)                         proceedings in abeyance while
                                                  proceeding brought under the public                     (upholding revocation of DEA                           practitioners challenge Board decisions
                                                  interest authority, such a showing is                   registration after Texas DPS summarily                 which suspend or revoke their state
                                                  authorized.                                             suspended practitioner’s controlled                    authority.
                                                     As this Agency has previously                        substance registration, noting that the                   Respondent argues, however, that
                                                  explained, Section 824(a)’s grant of                    Agency ‘‘has construed the CSA to                      ‘‘the agency’s decision [in Odette
                                                  authority to suspend or revoke a                        require revocation when a registrant no                Campbell, 80 FR 41062 2015)] to
                                                  registration applies across all categories              longer possesses valid state authority to              remand the matter and allow
                                                  of registration, including manufacturers,               handle controlled substances’’; ‘‘We                   administrative proceedings to be
                                                  distributors, importers, exporters,                     agree with [the] argument that it may                  conducted by the ALJ (and ultimately
                                                  narcotic treatment programs, list I                     have been arbitrary and capricious had                 hold proceedings in abeyance), pending
                                                  distributors, and practitioners. And it                                                                        the outcome of state board
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                                                                                                             8 As for Respondent’s contention that if Congress
                                                  applies to five different grounds for                                                                          proceedings[,] undermines . . . the
                                                                                                          intended that lack of a state license should be an
                                                  sanctioning a registrant. As the Agency                 automatic bar, the Agency could have made this a
                                                                                                                                                                 agency’s notion that it must revoke a
                                                  has previously explained, ‘‘this general                ground for immediate termination without a             DEA registration in all instances where
                                                  grant of authority in imposing a                        hearing, the argument ignores that by requiring the    a registrant lacks state authority,
                                                  sanction must be reconciled with the                    Agency to serve a Show Cause Order on the              rendering an administrative hearing
                                                                                                          registrant, and affording the registrant an
                                                  CSA’s specific provisions which                         opportunity to respond, the procedures reduce the
                                                                                                                                                                 unnecessary.’’ Exceptions at 2.
                                                  mandate that a practitioner hold                        risk of an erroneous deprivation. See Mathews v.       Respondent then asserts that ‘‘[w]hile
                                                  authority under state law in order to                   Eldridge, 424 U.S. 319 (1976).                         the agency conjured up a Due Process


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                                                                                Federal Register / Vol. 81, No. 72 / Thursday, April 14, 2016 / Notices                                                         22127

                                                  argument to support its decision in                     appeared that under Texas law and                          Accordingly, I reject Respondent’s
                                                  [Campbell], in doing so it implicitly                   regulations, Respondent was not                          contentions.11 Because Respondent
                                                  held that lack of state authority is not an             entitled to a hearing before the DPS to                  lacks state authority to dispense
                                                  automatic bar to holding a DEA                          challenge either the DPS’s suspension or                 controlled substances, he is not entitled
                                                  registration.’’ Id. Respondent further                  the denial of her application for a new                  to maintain his DEA registration. I will
                                                  asserts that ‘‘[w]hile declaring that Due               registration.’’ Id. (citing Tex. Health &                therefore order that his remaining
                                                  Process was the basis for this decision,                Safety Code § 481.063(e)(3) & (h); id.                   registration be revoked.
                                                  the only outcome that could have been                   § 481.066(g); 37 Tex. Admin. Code
                                                  reached in that case, if the [A]gency                   § 13.272(h)). The Administrator then                     Order
                                                  followed its own case law, was the                      explained that ‘‘if this was so, revoking                  Pursuant to the authority vested in me
                                                  revocation of Dr. Campbell’s DEA                        her [DEA] registration based on her lack                 by 21 U.S.C. 824(a)(3) and 823(f), as
                                                  registration as the DEA proceedings                     of state authority would preclude her                    well as 28 CFR 0.100(b), I order that
                                                  would not have changed the fact that                    from ever being able to challenge the                    DEA Certificate of Registration
                                                  she did not have state authority to                     basis of the Immediate Suspension                        BS4072637 issued to Rezik A. Saqer,
                                                  handle state authority to handle                        Order.’’ Id. The Administrator thus                      M.D., be, and it hereby is, revoked. I
                                                  controlled substances.’’ Id. at 2–3.                    remanded the case, instructing the ALJ                   further order that any application by
                                                     Respondent’s reliance on Campbell is                 ‘‘to first determine whether the DPS                     Rezik A. Saqer, M.D., for registration in
                                                  unavailing because he ignores critical                  would provide [the respondent] with a                    the State of Texas, be, and it hereby is,
                                                  aspects of the case’s procedural history.               hearing on the allegations.’’ Id. The                    denied. This Order is effective
                                                  For one, the case began when DEA                        Administrator further instructed that if                 immediately.12
                                                  issued an Order to Show Cause and                       the DPS had provided or would provide
                                                  Immediate Suspension of Registration                    respondent with a hearing, the                           in abeyance, pending the outcome of state board
                                                  (ISO) to the physician, which was based                 Government could renew its motion for                    proceedings, ‘‘undermines . . . the [A]gency’s
                                                  on allegations that she violated various                summary disposition. Id. However, if                     notion that it must revoke a DEA registration in all
                                                  provisions of the Controlled Substances                 DPS would not provide her with a                         instances where a registration lacks state authority,’’
                                                  Act. 80 FR at 41063 n.3. Thereafter, the                                                                         Exceptions at 2, Respondent ignores that at the time
                                                                                                          hearing, the ALJ was to conduct a                        the proceeding was held in abeyance, the physician
                                                  Texas Medical Board suspended her                       hearing on the allegations of the Show                   (who had been indicted on multiple counts of
                                                  medical license and the Texas                           Cause Order and ISO. Id.                                 health care fraud) had allowed her registration to
                                                  Department of Public Safety suspended                      In short, there was nothing ‘‘conjured                expire and had only an application pending before
                                                  her state controlled substance                                                                                   the Agency. Moreover, the physician then held both
                                                                                                          up’’ in the Agency’s due process                         a state license and state controlled substance
                                                  registration based on the Agency’s                      rationale, which recognized only that                    registration. See 80 FR at 41063. The case thus does
                                                  issuance of the ISO. Id. The Government                 due to the vagaries of Texas law,9 the                   not support Respondent’s contention.
                                                  then moved for summary disposition on                   Agency’s litigation strategy might well                     11 Respondent also points to a provision of the

                                                  the ground that the physician lacked                    result in the respondent having no                       DEA Pharmacist’s Manual, which allows an entity
                                                  authority to dispense controlled                                                                                 to obtain a registration for a pharmacy it is
                                                                                                          meaningful opportunity to challenge the                  acquiring prior to the State’s issuance of a
                                                  substances under Texas law and the ALJ                  allegations which both the Agency and                    pharmacy license for that location. Opp. at 5.
                                                  granted the motion. Id.                                 the DPS had relied on in suspending                      Respondent asserts that ‘‘[w]hile the Agency is
                                                     While the matter was under review,                   their respective registrations. As for                   permitted to interpret its regulations, it is not free
                                                  the physician submitted a letter to the                                                                          to contradict its long-standing policy that a state
                                                                                                          Respondent’s contention that revocation                  license is not a prerequisite to obtaining a DEA
                                                  ALJ (which was forwarded to the                         was ‘‘the only outcome that could have                   registration when doing so is simply a convenient
                                                  Administrator), in which she asserted                   been reached . . . as the DEA                            litigation position designed to prevent a registrant
                                                  that the Medical Board had reinstated                   proceedings would not have changed                       from proving that the underlying state action was
                                                  her license. Id. After the Government                   the fact that she did not have state
                                                                                                                                                                   erroneous.’’ Id. at 5–6.
                                                  responded by letter to the ALJ that the                                                                             However, the Pharmacist’s Manual makes clear
                                                                                                          authority to handle controlled                           that provision applies only ‘‘[i]f the registrant
                                                  physician was still without state                       substances,’’ Respondent ignores that                    acquiring the pharmacy owns at least one other
                                                  authority because her DPS registration                  DPS imposed its suspension based                         pharmacy licensed in the same state as the
                                                  had been revoked, Respondent                            solely on the Agency’s ISO and that if                   pharmacy being transferred,’’ and that while the
                                                  submitted a letter to the ALJ asserting                                                                          registrant may take possession of the controlled
                                                                                                          the physician succeeded in challenging                   substances, ‘‘the registrant may not dispense
                                                  that her DPS registration could not be                  the ISO, the basis for the DPS’                          controlled substances until the pharmacy haw been
                                                  reinstated unless her DEA registration                  suspension would no longer exist. And                    issued a valid state pharmacy license.’’ DEA,
                                                  was reinstated. Id.                                     Respondent further ignores that in her                   Pharmacists Manual, at 10 (2010) (emphasis added).
                                                     Noting that parties had directed their                                                                        This policy exists because some States will not
                                                                                                          remand order, the Administrator                          grant a pharmacy license to the acquiring pharmacy
                                                  letters to each other and the ALJ, and
                                                                                                          provided that the Government could                       until DEA issues it a registration. However, the
                                                  that neither party had sought relief from                                                                        period in which the registrant is without the state
                                                                                                          move for summary disposition if it
                                                  her, the former Administrator directed                                                                           license for the acquired pharmacy is typically of
                                                                                                          could show that DPS would provide the
                                                  the Government to file a properly                                                                                short duration.
                                                                                                          physician with a hearing.10                                 As for Respondent’s assertion that the Agency’s
                                                  supported motion seeking a final order
                                                                                                                                                                   position ‘‘is simply a convenient litigation position
                                                  based on the physician’s lack of state                     9 See Tex. Health & Safety Code § 481.066(g)          designed to prevent a registrant from proving that
                                                  authority. Id. The Government filed its                 (State Administrative Procedure Act ‘‘does not           the underlying state action was erroneous,’’ not
                                                  request, which Respondent opposed,                      apply to a . . . suspension of a registration for a      only is this refuted by nearly 40 years of precedent
                                                  arguing that because the DPS’s action                   cause described by Section 481.063 . . . (e)(3),’’       (and hundreds of cases), the Agency has also made
                                                                                                          which includes the suspension of a registration          clear in multiple cases that a challenge to a state
mstockstill on DSK4VPTVN1PROD with NOTICES




                                                  was based on the unsubstantiated                        under the CSA); 37 Tex. Admin. Code § 13.272(h)          board proceeding must be litigated in the forums
                                                  allegations of the ISO, it was                          (‘‘Under the Act, § 481.0639(h), the [State              provided by the State. See Kamal Tiwari, 76 FR
                                                  fundamentally unfair and a denial of                    Administrative Procedure Act] does not apply to a        71604, 71606 (2011) (collecting cases); see also
                                                  due process to revoke her DEA                           denial, suspension, or revocation of an application      George S. Heath, 51 FR 26610 (1986).
                                                                                                          for registration if the denial is based on a denial or      12 For the same reasons which led the Texas
                                                  registration based on the DPS’s action.                 other disciplinary action taken by DEA under the         Board to order the emergency suspension of
                                                  Id.                                                     Federal Controlled Substances Act.’’).                   Respondent’s medical license, I conclude that the
                                                     On further review, the former                           10 As for Respondent’s assertion that the             public interest necessitates that this Order be
                                                  Administrator observed that ‘‘it                        Administrator’s decision to hold the Campbell case       effective immediately. 21 CFR 1316.67.



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                                                  22128                         Federal Register / Vol. 81, No. 72 / Thursday, April 14, 2016 / Notices

                                                    Dated: April 5, 2016.                                 Office/ZP30, Marshall Space Flight                    ADDRESSES:    Objections relating to the
                                                  Chuck Rosenberg,                                        Center, Huntsville, AL 35812, (256)                   prospective license may be submitted to
                                                  Acting Administrator.                                   544–5226. Information about other                     Patent Counsel, NASA Management
                                                  [FR Doc. 2016–08572 Filed 4–13–16; 8:45 am]             NASA inventions available for licensing               Office, Jet Propulsion Laboratory, 4800
                                                  BILLING CODE 4410–09–P
                                                                                                          can be found online at http://                        Oak Grove Drive, M/S 180–800C,
                                                                                                          technology.nasa.gov.                                  Pasadena, CA 91109, (818) 854–7770
                                                                                                                                                                (phone), 818–393–2607 (fax).
                                                                                                          Mark P. Dvorscak,
                                                  NATIONAL AERONAUTICS AND                                                                                      FOR FURTHER INFORMATION CONTACT:
                                                                                                          Agency Counsel for Intellectual Property.
                                                  SPACE ADMINISTRATION                                                                                          Mark Homer, Patent Counsel, NASA
                                                                                                          [FR Doc. 2016–08546 Filed 4–13–16; 8:45 am]
                                                                                                                                                                Management Office, Jet Propulsion
                                                  [Notice (16–027)]                                       BILLING CODE 7510–13–P
                                                                                                                                                                Laboratory, 4800 Oak Grove Drive, M/S
                                                  Notice of Intent To Grant a Partially                                                                         180–800C, Pasadena, CA 91109, (818)
                                                  Exclusive License                                       NATIONAL AERONAUTUICS AND                             854–7770 (phone), 818–393–2607 (fax).
                                                                                                          SPACE ADMINISTRATION                                  Information about other NASA
                                                  AGENCY:   National Aeronautics and                                                                            inventions available for licensing can be
                                                  Space Administration.                                   [Notice (16–028)]                                     found online at http://
                                                  ACTION: Notice of intent to grant a                                                                           technology.nasa.gov
                                                  partially exclusive license.                            Notice of Intent To Grant a Partially
                                                                                                          Exclusive License                                     Mark P. Dvorscak,
                                                  SUMMARY:   This notice is issued in                                                                           Agency Counsel for Intellectual Property.
                                                                                                          AGENCY:  National Aeronautics and
                                                  accordance with 35 U.S.C. 209(e) and 37                                                                       [FR Doc. 2016–08547 Filed 4–13–16; 8:45 am]
                                                                                                          Space Administration.
                                                  CFR 404.7(a)(1)(i). NASA hereby gives                                                                         BILLING CODE 7510–13–P
                                                                                                          ACTION: Notice of intent to grant a
                                                  notice of its intent to grant a partially
                                                  exclusive license in the United States to               partially-exclusive license.
                                                  practice the invention described and                    SUMMARY:   This notice is issued in                   NUCLEAR REGULATORY
                                                  claimed in U.S. Patent Application                      accordance with 35 U.S.C. 209(e) and 37               COMMISSION
                                                  Serial No. 14/196,203 entitled Vibration                CFR 404.7(a)(l)(i). NASA hereby gives
                                                  Damping Circuit Card Assembly to                                                                              [Docket No. 50–382; NRC–2016–0078]
                                                                                                          notice of its intent to grant a partially
                                                  TopLine Corporation, having its                         exclusive license in the United States to             Entergy Operations, Inc.; Waterford
                                                  principal place of business in Irvine,                  practice the invention described and                  Steam Electric Station, Unit 3
                                                  CA. The patent rights in these invention                claimed in U.S. Non-Provisional Patent
                                                  have been assigned to the United States                 Application, Application No. 14/                      AGENCY:  Nuclear Regulatory
                                                  of America as represented by the                        714,756, titled ‘‘Auto-Tracking Antenna               Commission.
                                                  Administrator of the National                           Platform,’’ NASA Case No. DRC–013–                    ACTION: License renewal application;
                                                  Aeronautics and Space Administration.                   031, and any issued patents or                        receipt.
                                                  The prospective partially exclusive                     continuations-in-part resulting
                                                  license will comply with the terms and                  therefrom, to Mobile Antenna Platform                 SUMMARY:   The U.S. Nuclear Regulatory
                                                  conditions of 35 U.S.C. 209 and 37 CFR                  Systems, Inc. having its principal place              Commission (NRC) has received an
                                                  404.7.                                                  of business in Navarre, Florida. Certain              application for the renewal of operating
                                                  DATES: The prospective partially                        patent rights in this invention have been             license NPF–38, which authorizes
                                                  exclusive license may be granted unless,                assigned to the United States of America              Entergy Operations, Inc. (the applicant)
                                                  within fifteen (15) days from the date of               as represented by the Administrator of                to operate the Waterford Steam Electric
                                                  this published notice, NASA receives                    the National Aeronautics and Space                    Station, Unit 3 (Waterford 3). The
                                                  written objections including evidence                   Administration. The prospective                       renewed license would authorize the
                                                  and argument that establish that the                    partially exclusive license will comply               applicant to operate Waterford 3 for an
                                                  grant of the license would not be                       with the terms and conditions of 35                   additional 20-year period beyond the
                                                  consistent with the requirements of 35                  U.S.C. 209 and 37 CFR 404.7.                          period specified in the current license.
                                                  U.S.C. 209 and 37 CFR 404.7.                                                                                  The current operating license for
                                                                                                          DATES: The prospective partially
                                                  Competing applications completed and                                                                          Waterford 3 expires at midnight on
                                                                                                          exclusive license may be granted unless,
                                                  received by NASA within fifteen (15)                                                                          December 18, 2024.
                                                                                                          within fifteen (15) days from the date of
                                                  days of the date of this published notice               this published notice, NASA receives                  DATES: The license renewal application
                                                  will also be treated as objections to the               written objections including evidence                 referenced in this document is available
                                                  grant of the contemplated exclusive                     and argument that establish that the                  on April 14, 2016.
                                                  license.                                                grant of the license would not be                     ADDRESSES: Please refer to Docket ID
                                                     Objections submitted in response to                  consistent with the requirements of 35                NRC–2016–0078 when contacting the
                                                  this notice will not be made available to               U.S.C. 209 and 37 CFR. 404.7.                         NRC about the availability of
                                                  the public for inspection and, to the                   Competing applications completed and                  information regarding this document.
                                                  extent permitted by law, will not be                    received by NASA within fifteen (15)                  You may obtain publicly-available
                                                  released under the Freedom of                           days of the date of this published notice             information related to this document
                                                  Information Act, 5 U.S.C. 552.                          will also be treated as objections to the             using any of the following methods:
                                                  ADDRESSES: Objections relating to the                                                                            • Federal Rulemaking Web site: Go to
mstockstill on DSK4VPTVN1PROD with NOTICES




                                                                                                          grant of the contemplated partially
                                                  prospective license may be submitted to                 exclusive license.                                    http://www.regulations.gov and search
                                                  Mr. James J. Mcgroary, Chief Patent                       Objections submitted in response to                 for Docket ID NRC–2016–0078. Address
                                                  Counsel/LS01, Marshall Space Flight                     this notice will not be made available to             questions about NRC dockets to Carol
                                                  Center, Huntsville, AL 35812, (256)                     the public for inspection and, to the                 Gallagher; telephone: 301–415–3463;
                                                  544–0013.                                               extent permitted by law, will not be                  email: Carol.Gallagher@nrc.gov. For
                                                  FOR FURTHER INFORMATION CONTACT: Mr.                    released under the Freedom of                         technical questions, contact the
                                                  Sammy A. Nabors, Technology Transfer                    Information Act, 5 U.S.C. 552.                        individual listed in the FOR FURTHER


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Document Created: 2018-02-07 13:48:14
Document Modified: 2018-02-07 13:48:14
CategoryRegulatory Information
CollectionFederal Register
sudoc ClassAE 2.7:
GS 4.107:
AE 2.106:
PublisherOffice of the Federal Register, National Archives and Records Administration
SectionNotices
FR Citation81 FR 22122 

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