83_FR_61906 83 FR 61675 - Steve Fanto, M.D.; Decision and Order

83 FR 61675 - Steve Fanto, M.D.; Decision and Order

DEPARTMENT OF JUSTICE
Drug Enforcement Administration

Federal Register Volume 83, Issue 231 (November 30, 2018)

Page Range61675-61678
FR Document2018-26046

Federal Register, Volume 83 Issue 231 (Friday, November 30, 2018)
[Federal Register Volume 83, Number 231 (Friday, November 30, 2018)]
[Notices]
[Pages 61675-61678]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2018-26046]


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DEPARTMENT OF JUSTICE

Drug Enforcement Administration

[Docket No. 2018-27]


Steve Fanto, M.D.; Decision and Order

    On April 4, 2018, the Assistant Administrator, Diversion Control 
Division, Drug Enforcement Administration (hereinafter, DEA or 
Government), issued an Order to Show Cause to Steve Fanto, M.D. 
(hereinafter, Respondent), of Scottsdale, Arizona. Order to Show Cause 
(hereinafter, OSC), at 1. The OSC proposes the revocation of 
Respondent's Certificate of Registration (hereinafter, COR) on the 
ground that he is without authority to handle controlled substances in 
Arizona, the State in which he is registered with the DEA. Id. The OSC 
cites the operative statutory provisions that spell out the 
requirements for registration upon which the DEA alleges that 
Respondent is deficient, and the DEA's alleged authority to revoke his 
registration. 21 U.S.C. 823(f) and 824(a)(3). Id. at 1-2.

Jurisdiction

    This Agency has jurisdiction to decide this case based upon the OSC 
allegation that Respondent holds a DEA Certificate of Registration (No. 
BF3649312) at the registered address of 7320 Deer Valley Road, J100, 
Scottsdale, Arizona 85255. Id. at 1. That registration authorizes 
Respondent, as a practitioner, to dispense controlled substances in 
schedules II through V. Although Respondent's COR reflects an 
expiration date of September 30, 2017, the OSC alleges that 
Respondent's COR is current by virtue of his having submitted a timely 
application for renewal of this COR on September 21, 2017. Id.

[[Page 61676]]

Substantive Ground for Revocation of COR Alleged in OSC

    The substantive ground for the proceeding, as alleged in the OSC, 
is that Respondent is ``prohibited from practicing medicine in the 
state in which . . . [he is] registered with the DEA.'' Id. at 2. 
Specifically, the OSC alleges that, according to Arizona Medical Board 
(hereinafter, AMB) records, Respondent ``engaged in medical practices 
(including the prescribing of controlled substances) that constitute[ ] 
`significant deviations from the standard of care.' '' Id. at 1, 
quoting AMB Interim Consent Agreement for Practice Restriction 
(hereinafter, Interim Consent Agreement) (ellipse omitted). As a 
result, according to the OSC, Respondent entered into an Interim 
Consent Agreement whereby he is ``prohibited from engaging in the 
practice of medicine in the State of Arizona'' until he applies to the 
AMB and receives permission to do so. Id. at 1-2. Registrant signed the 
Interim Consent Agreement on July 11, 2017. Id. at 1. The OSC states 
that since Respondent is not licensed to dispense controlled substances 
in Arizona, his DEA COR must be revoked pursuant to 21 U.S.C. 823(f) 
and 824(a)(3). Id. at 2.
    The OSC notified Respondent of his right to request a hearing on 
the allegations or to submit a written statement if he chooses to waive 
his right to a hearing. Id. at 2. The OSC explained the procedures for 
electing each option, the consequences for failing to elect one of 
those options, and the regulations that govern the rules for responding 
to the OSC (21 CFR 1301.43). Id. at 2. The OSC also notified Respondent 
of the opportunity to submit a corrective action plan, the specific 
procedures for filing a corrective action plan, and the statutory 
provision that governs such a plan. Id. at 2-3 (citing 21 U.S.C. 
824(c)(2)(C)).

Adequacy of Service

    In his April 30, 2018, Request for Extension/Hearing, Respondent 
acknowledged receipt of the OSC ``on or after April 4, 2018.'' \1\ 
Request for Extension/Hearing, at 1. Since the OSC was issued on April 
4, 2018 and Respondent admitted receiving the OSC ``on or after April 
4, 2018,'' I find that the Government's service of the OSC was legally 
sufficient and that Respondent's request for a hearing was timely. OSC, 
at 1; Request for Extension/Hearing, at 1.
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    \1\ Respondent's April 30, 2018, Request for Extension/Hearing 
is stamped ``received'' by the Office of Administrative Law Judges 
on May 1, 2018.
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Respondent's Request for Extension of Time

    Respondent argued in his Request for Extension/Hearing that he 
should be allowed an extension of time to request a hearing ``pending 
the resolution of . . . [AMB] actions regarding his Arizona medical 
license.'' Request for Extension/Hearing, at 1. The gravamen of his 
argument is that an extension should be allowed, because if Respondent 
is successful before the AMB, his medical license will be returned to 
him. Id. The request for extension asked in the alternative for a 
hearing if the request for extension of time is not granted.

CALJ Denial of Request for Extension of Time

    The Office of Administrative Law Judges put the matter on the 
docket and assigned it to the Chief Administrative Law Judge, John J. 
Mulrooney, II (hereinafter, CALJ). On May 4, 2018, the CALJ denied the 
request for an extension of time, stating that ``[a]n extension of time 
that has the potential to exist in perpetuity, at least on the present 
record, will not serve the interests of justice.'' Order Denying the 
Respondent's Request for Extension and Directing the Filing of 
Government Evidence of Lack of State Authority Allegation and Briefing 
Schedule dated May 4, 2018 (hereinafter, Order Denying Extension), at 
2. In the Order Denying Extension, the CALJ ordered the DEA to file 
evidence in support of its allegation that Respondent lacks State 
authority to handle controlled substances. Id. The CALJ further 
established a briefing schedule for any Government motion for summary 
disposition based upon its allegation that Respondent lacks State 
authority to handle controlled substances. Id.

Government Motion for Summary Disposition

    On May 16, 2018, the Government filed a motion for summary 
disposition. The motion by the Government alleged, in pertinent part, 
that Respondent lacks authority to handle controlled substances in 
Arizona and, therefore, pursuant to 21 U.S.C. 823(f) and 824(a)(3), 
Respondent's DEA COR should be revoked. Government's Motion for Summary 
Disposition and Argument in Support of Finding that Respondent Lacks 
State Authorization to Handle Controlled Substances (hereinafter, 
Summary Disposition Motion), at 4.

Respondent's Motion for Extension of Time To File Response

    By motion dated May 25, 2018, Respondent requested an extension of 
time until December 3, 2018 to respond to the Government's motion for 
summary disposition. The essence of Respondent's argument was that the 
AMB ``is expected to have acted on and reinstated . . . [Respondent's] 
authority to practice medicine by such date. Motion for Extension of 
Time to File Response to Government's Motion for Summary Disposition 
and Argument in Support of Finding that Respondent Lacks State 
Authorization to Handle Controlled Substances and Response to 
Government's Motion for Summary Disposition, at 1 (hereinafter, 
Respondent's Motion). Respondent alleged that he entered into the 
Interim Consent Agreement with the AMB, wherein he agreed to be 
prohibited from engaging in the practice of medicine in the State of 
Arizona until he applies to the Board and receives permission to do so, 
``based on coercive assertions'' by the AMB at a time when he was 
unrepresented by counsel. Id. at 2.

CALJ Order Denying Respondent's Request for an Extension and Granting 
the Government's Motion for Summary Disposition

    On May 31, 2018, the CALJ issued an Order (hereinafter, R.D.) 
denying Respondent's request for an extension and granting the 
Government's motion for summary disposition.

Findings of Fact

Respondent's DEA Registration

    Respondent is the holder of DEA Certificate of Registration No. 
BF3649312, pursuant to which he is authorized to dispense controlled 
substances in schedules II through V as a practitioner, at the 
registered address of 7320 Deer Valley Road, J100, Scottsdale, Arizona 
85255. Summary Disposition Motion, Attachment 1, at 1.

The Status of Respondent's State License

    The AMB and Respondent entered into an Interim Consent Agreement. 
Summary Disposition Motion, Attachment 2. The effective date of the 
Interim Consent Agreement is July 12, 2017. Id. at 7, 10. According to 
its terms, Respondent ``elect[ed] to permanently waive any right to a 
hearing and appeal with respect to this Interim Consent Agreement for 
Practice Restriction'' and is ``prohibited from engaging in the 
practice of medicine in the State of Arizona . . . until he applies to 
the . . .

[[Page 61677]]

[AMB] and receives permission to do [so].'' Id. at 1, 7.
    On May 8, 2018, a DEA Diversion Investigator (hereinafter, DI) 
contacted an AMB Investigator who informed the DI that Respondent's 
medical license remains under practice restriction. Summary Disposition 
Motion, Attachment 4, at 2. The DI averred that ``the result of DEA's 
investigation has shown that . . . [Respondent] remains currently 
prohibited from practicing medicine in the State of Arizona.'' Id. at 
3.
    There is no evidence in the record that the AMB lifted the Practice 
Restriction on Respondent's medical license. Further, according to the 
online records of the State of Arizona, of which I take official 
notice, I find that the Interim Consent Agreement is still in effect 
today.\2\ Arizona Medical Board Licensee Search, https://www.azmd.gov 
(last visited November 19, 2018).
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    \2\ Under the Administrative Procedure Act, an agency ``may take 
official notice of facts at any stage in a proceeding--even in the 
final decision.'' United States Department of Justice, Attorney 
General's Manual on the Administrative Procedure Act 80 (1947) (Wm. 
W. Gaunt & Sons, Inc., Reprint 1979). Pursuant to 5 U.S.C. 556(e), 
``[w]hen an agency decision rests on official notice of a material 
fact not appearing in the evidence in the record, a party is 
entitled, on timely request, to an opportunity to show the 
contrary.'' Accordingly, Respondent may dispute my finding by filing 
a properly supported motion for reconsideration within 20 calendar 
days of the date of this Order. Any such motion shall be filed with 
the Office of the Administrator and a copy shall be served on the 
Government; in the event Respondent files a motion, the Government 
shall have 20 calendar days to file a response.
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    Accordingly, based on all of the evidence in the record before me, 
I find that Respondent currently is without authority to practice 
medicine in Arizona, the State in which he is registered.

Discussion

    Pursuant to 21 U.S.C. 824(a)(3), the Attorney General is authorized 
to suspend or revoke a registration issued under section 823 of the 
Controlled Substances Act (hereinafter, CSA), ``upon a finding that the 
registrant . . . has had his State license or registration suspended . 
. . [or] revoked . . . by competent State authority and is no longer 
authorized by State law to engage in the . . . dispensing of controlled 
substances.'' With respect to a practitioner, the DEA has also long 
held that the possession of authority to dispense controlled substances 
under the laws of the State in which a practitioner engages in 
professional practice is a fundamental condition for obtaining and 
maintaining a practitioner's registration. See, e.g., James L. Hooper, 
M.D., 76 FR 71,371 (2011), pet. for rev. denied, 481 Fed. Appx. 826 
(4th Cir. 2012); Frederick Marsh Blanton, M.D., 43 FR 27,616, 27,617 
(1978).
    This rule derives from the text of two provisions of the CSA. 
First, Congress defined the term ``practitioner'' to mean ``a physician 
. . . or other person licensed, registered, or otherwise permitted, by 
. . . the jurisdiction in which he practices . . . , to distribute, 
dispense, . . . [or] administer . . . a controlled substance in the 
course of professional practice.'' 21 U.S.C. 802(21). Second, in 
setting the requirements for obtaining a practitioner's registration, 
Congress directed that ``[t]he Attorney General shall register 
practitioners . . . 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). Because Congress has clearly mandated 
that a practitioner possess State authority in order to be deemed a 
practitioner under the CSA, the DEA has held repeatedly that revocation 
of a practitioner's registration is the appropriate sanction whenever 
he is no longer authorized to dispense controlled substances under the 
laws of the State in which he practices. See, e.g., Hooper, supra, 76 
FR at 71,371-72; Sheran Arden Yeates, M.D., 71 FR 39,130, 39,131 
(2006); Dominick A. Ricci, M.D., 58 FR 51,104, 51,105 (1993); Bobby 
Watts, M.D., 53 FR 11,919, 11,920 (1988); Blanton, supra, 43 FR at 
27,617.
    Section 32-1401(22) of the Arizona Revised Statutes, cited in the 
``Interim Consent Agreement for Practice Restriction,'' in pertinent 
part, defines the ``practice of medicine'' as the diagnosis or 
treatment of any and all human diseases, injuries, ailments, 
infirmities, or deformities, whether they be physical or mental, ``by 
any means, methods, devices or instrumentalities.'' Ariz. Rev. Stat. 
Ann. Sec.  32-1401(22) (Westlaw, current through the First Special and 
Second Regular Session of the Fifty-Third Legislature (2018)). 
``Medicine'' means ``allopathic medicine as practiced by the recipient 
of a degree of doctor of medicine.'' Ariz. Rev. Stat. Ann. Sec.  32-
1401(19) (Westlaw, current through the First Special and Second Regular 
Session of the Fifty-Third Legislature (2018)). Under Arizona law, a 
``doctor of medicine'' is a ``natural person holding a license, 
registration or permit to practice medicine pursuant to this chapter.'' 
Ariz. Rev. Stat. Ann. Sec.  32-1401(10) (Westlaw, current through the 
First Special and Second Regular Session of the Fifty-Third Legislature 
(2018)). See also Ariz. Rev. Stat. Ann. Sec.  32-1401(21) (Westlaw, 
current through the First Special and Second Regular Session of the 
Fifty-Third Legislature (2018)) (A physician is a ``doctor of medicine 
who is licensed pursuant to this chapter.''). Further, a physician who 
``wishes to dispense a controlled substance . . . shall be currently 
licensed to practice medicine in Arizona.'' Ariz. Admin. Code Sec.  R4-
16-301 (Westlaw, current through rules published in Arizona 
Administrative Register Volume 24, Issue 43, Oct. 26, 2018). 
``Dispense,'' under Arizona law, means ``the delivery by a doctor of 
medicine of a prescription drug or device to a patient . . . and 
includes the prescribing, administering, packaging, labeling and 
security necessary to prepare and safeguard the drug or device for 
delivery.'' Ariz. Rev. Stat. Ann. Sec.  32-1401(9) (Westlaw, current 
through the First Special and Second Regular Session of the Fifty-Third 
Legislature (2018)).
    As already discussed, the AMB and Respondent entered into an 
``Interim Consent Agreement for Practice Restriction.'' ``Restrict,'' 
in the context of this Interim Consent Agreement, means ``taking a 
disciplinary action that alters the physician's practice or 
professional activities if the board determines that there is evidence 
that the physician is or may be medically incompetent or guilty of 
unprofessional conduct.'' Ariz. Rev. Stat. Ann. Sec.  32-1401(23) 
(Westlaw, current through the First Special and Second Regular Session 
of the Fifty-Third Legislature (2018)).
    The conclusory language in Respondent's Motion that he imprudently 
entered into the Interim Consent Agreement based upon coercive 
assertions by the AMB at a time when he was unrepresented by counsel 
was not accompanied by specific facts indicating what was said that 
Respondent considered coercive. The legitimacy of the claim is 
undermined by the notable fact that Respondent did not submit any 
documentation indicating an effort by Respondent to bring the validity 
of the Interim Consent Agreement before the AMB, which, initially, 
would be the proper forum in which to raise that issue. Regardless, as 
pointed out by the CALJ citing long-standing Agency precedent, the 
controlling question is not the merits of Respondent's claim before the 
AMB, but rather, whether Respondent is currently authorized to handle 
controlled substances in the State of registration. R.D., at 3. In that 
regard, I adopt the following portion of the R.D. and agree with the 
CALJ's denial of Respondent's request for an extension of time/stay of 
proceedings. R.D., at 4.


[[Page 61678]]


Where a registrant has lost state authority to handle controlled 
substances, the Agency has repeatedly taken the position that 
``revocation is warranted even where a practitioner's state 
authority has been summarily suspended and the State has yet to 
provide the practitioner with a hearing to challenge the State's 
action and at which he . . . may ultimately prevail.'' Kamal Tiwari, 
M.D., 76 FR 71604, 71606 (2011) (citations omitted); see also Anne 
Lazar Thorn, M.D., 62 FR 12847, 12848 (1997) (``[T]he controlling 
question is not whether a practitioner's license to practice 
medicine in the state is suspended or revoked; rather, it is whether 
the Respondent is currently authorized to handle controlled 
substances in the [state of registration].''). Even when the 
Respondent is actively engaged in appealing a state decision, the 
Agency has noted that ``[i]t is not DEA's policy to stay 
[administrative] proceedings . . . while registrants litigate in 
other forums.'' Newcare Home Health Servs., 72 FR 42126, 42127 n.2 
(2007). Agency precedent has consistently affirmed recommended 
decisions where a respondent's request for a stay due to state 
medical board proceedings were denied by the Administrative Law 
Judge. See, e.g., Irwin August, D.O., 81 FR 3158, 3159 (2016); Pedro 
E. Lopez, M.D., 80 FR 46324, 46325-26 (2015). The Agency has stated 
in recent final orders that a stay in administrative enforcement 
proceedings is ``unlikely to ever be justified'' due to ancillary 
proceedings involving the Respondent. Grider Drug #1 & Grider Drug 
#2, 77 FR 44070, 44104 n.97 (2012).
    Even if the Agency's precedent were not fixed firmly against the 
granting of such a delay in principle, the Respondent here is unable 
to point to a reliably fixed date where state proceedings would 
reasonably be concluded. The Respondent's Motion includes a 
Declaration from the Respondent's counsel (Respondent's Board 
Counsel) in his Arizona Board proceedings. . . . [Respondent's 
Motion,] Attachment 1. In the Respondent's Board Counsel's 
declaration, the decisional timeframe is couched in the following 
tenuous terms:
    As for when the [Arizona Board] might take action, my best guess 
is that it will be at its August 20, 2018 meeting, although I would 
not be surprised if [the Respondent's] matter is not heard until the 
October 22 meeting, which is the next regularly scheduled meeting of 
the [Arizona Board].

Id. at 2-3 (emphasis supplied). The Respondent's Board Counsel 
further explained that the state process involves the actions and 
recommendations of an internal committee, and avers that he and the 
Respondent ``are hopeful that [the internal committee] will make 
those recommendations and share them with us in the not-too-distant 
future and if that occurs then the matter should be heard at the 
August 20 meeting.'' Id. at 3 (emphasis supplied). While the candor 
of the Respondent's Board Counsel is commendable, the language 
strikes as too aspirational and amorphous to be particularly 
supportive of the delay sought by the Respondent here--even if the 
Agency's precedent were not squarely opposed to the relief--which it 
is.

R.D., at 3-4.
    It is undisputed that Respondent is not currently authorized to 
practice medicine in Arizona due to the Interim Consent Agreement. 
Thus, according to Arizona law, Respondent does not have authority to 
handle controlled substances in Arizona, the State in which he is 
registered with the DEA. As already discussed, the practice restriction 
on Respondent's medical license is currently in effect. DEA has ``long 
and consistently interpreted the CSA as mandating the possession of 
authority under state law to handle controlled substances as a 
fundamental condition for obtaining and maintaining a registration.'' 
Hooper, supra, 76 FR at 71,371. That is the controlling question. 
Thorn, supra, 62 FR at 12,848. The CSA has consistently been 
interpreted to mean that ``DEA does not have statutory authority . . . 
to maintain a registration if the registrant is without state authority 
to handle controlled substances in the state in which he practices.'' 
Yeates, supra, 71 FR at 39,131. As succinctly explained by the CALJ, 
``The DEA has long held that possession of authority under state law to 
dispense controlled substances is not only a prerequisite to obtaining 
a DEA registration, but also an essential condition for maintaining 
it.'' R.D., at 5 (citations omitted). I agree with the CALJ's 
conclusion that ``as a matter of law, a DEA registration may not be 
granted or maintained where an applicant/registrant no longer falls 
within the CSA's definition of a practitioner.'' Id. Very simply, since 
Respondent is not authorized to handle controlled substances in 
Arizona, he is not eligible for a DEA registration. As such, I will 
order that Respondent's DEA registration be revoked.

Order

    Pursuant to 28 CFR 0.100(b) and the authority thus vested in me by 
21 U.S.C. 824(a), I order that DEA Certificate of Registration No. 
BF3649312 issued to Steve Fanto, M.D., be, and it hereby is, revoked. 
Pursuant to 28 CFR 0.100(b) and the authority thus vested in me by 21 
U.S.C. 823(f), I further order that any pending application of Steve 
Fanto, M.D., to renew or modify this registration, as well as any other 
pending application by him for registration in the State of Arizona, 
be, and it hereby is, denied. This order is effective December 31, 
2018.

    Dated: November 19, 2018.
Uttam Dhillon,
Acting Administrator.
[FR Doc. 2018-26046 Filed 11-29-18; 8:45 am]
 BILLING CODE 4410-09-P



                                                                          Federal Register / Vol. 83, No. 231 / Friday, November 30, 2018 / Notices                                                61675

                                                Issued: November 26, 2018.                            —Evaluate whether the proposed                        7.5 hours, which is equal to 75 (# of
                                              Lisa Barton,                                             collection of information is necessary               respondents) * 1 (# of responses per
                                              Secretary to the Commission.                             for the proper performance of the                    respondents) * .1 (6 minutes).
                                              [FR Doc. 2018–26020 Filed 11–29–18; 8:45 am]             functions of the agency, including                   If additional information is required
                                              BILLING CODE 7020–02–P
                                                                                                       whether the information will have                    contact: Melody Braswell, Department
                                                                                                       practical utility;                                   Clearance Officer, United States
                                                                                                      —Evaluate the accuracy of the agency’s                Department of Justice, Justice
                                                                                                       estimate of the burden of the                        Management Division, Policy and
                                              DEPARTMENT OF JUSTICE                                    proposed collection of information,                  Planning Staff, Two Constitution
                                                                                                       including the validity of the                        Square, 145 N Street NE, 3E.405A,
                                              Bureau of Alcohol, Tobacco, Firearms
                                                                                                       methodology and assumptions used;                    Washington, DC 20530.
                                              and Explosives                                          —Evaluate whether and if so how the
                                                                                                       quality, utility, and clarity of the                   Dated: November 26, 2018.
                                              [OMB Number 1140–NEW]
                                                                                                       information to be collected can be                   Melody Braswell,
                                              Agency Information Collection                            enhanced; and                                        Department Clearance Officer for PRA, U.S.
                                              Activities; Proposed eCollection                        —Minimize the burden of the collection                Department of Justice.
                                              eComments Requested; Forensic                            of information on those who are to                   [FR Doc. 2018–25988 Filed 11–29–18; 8:45 am]
                                              Firearm Training Request for Non-ATF                     respond, including through the use of                BILLING CODE 4410–14–P
                                              Employees—ATF Form 7110.15                               appropriate automated, electronic,
                                                                                                       mechanical, or other technological
                                              AGENCY:  Bureau of Alcohol, Tobacco,                     collection techniques or other forms                 DEPARTMENT OF JUSTICE
                                              Firearms and Explosives, Department of                   of information technology, e.g.,
                                              Justice.                                                 permitting electronic submission of                  Drug Enforcement Administration
                                              ACTION: 30-Day notice.                                   responses.
                                                                                                                                                            [Docket No. 2018–27]
                                              SUMMARY:   The Department of Justice                       Overview of this information
                                              (DOJ), Bureau of Alcohol, Tobacco,                      collection:                                           Steve Fanto, M.D.; Decision and Order
                                              Firearms and Explosives (ATF), will                        (1) Type of Information Collection:
                                              submit the following information                        New Collection.                                          On April 4, 2018, the Assistant
                                              collection request to the Office of                        (2) The Title of the Form/Collection:              Administrator, Diversion Control
                                              Management and Budget (OMB) for                         Forensic Firearm Training Request for                 Division, Drug Enforcement
                                              review and approval in accordance with                  Non-ATF Employees.                                    Administration (hereinafter, DEA or
                                              the Paperwork Reduction Act of 1995.                       (3) The agency form number, if any,                Government), issued an Order to Show
                                                                                                      and the applicable component of the                   Cause to Steve Fanto, M.D. (hereinafter,
                                              DATES: The proposed information
                                                                                                      Department sponsoring the collection:                 Respondent), of Scottsdale, Arizona.
                                              collection was previously published in                                                                        Order to Show Cause (hereinafter, OSC),
                                                                                                         Form number: ATF Form 7110.15.
                                              the Federal Register, on September 21,                                                                        at 1. The OSC proposes the revocation
                                                                                                         Component: Bureau of Alcohol,
                                              2018, allowing for a 60-day comment                                                                           of Respondent’s Certificate of
                                                                                                      Tobacco, Firearms and Explosives, U.S.
                                              period. Comments are encouraged and                                                                           Registration (hereinafter, COR) on the
                                                                                                      Department of Justice.
                                              will be accepted for an additional 30                      (4) Affected public who will be asked              ground that he is without authority to
                                              days until December 31, 2018.                           or required to respond, as well as a brief            handle controlled substances in
                                              FOR FURTHER INFORMATION CONTACT: If                     abstract:                                             Arizona, the State in which he is
                                              you have additional comments,                              Primary: Federal Government.                       registered with the DEA. Id. The OSC
                                              particularly with respect to the                           Other: State, Local, or Tribal                     cites the operative statutory provisions
                                              estimated public burden or associated                   Government.                                           that spell out the requirements for
                                              response time, have suggestions, need a                    Abstract: The Forensic Firearm                     registration upon which the DEA alleges
                                              copy of the proposed information                        Training Request for Non-ATF                          that Respondent is deficient, and the
                                              collection instrument with instructions,                Employees (ATF F 7110.15) will be used                DEA’s alleged authority to revoke his
                                              or desire any other additional                          to obtain information from Federal,                   registration. 21 U.S.C. 823(f) and
                                              information, please contact: Sheila                     State and local, and international law                824(a)(3). Id. at 1–2.
                                              Hopkins, National Laboratory Center                     enforcement personnel to register,
                                              either by mail at 6000 Ammendale                                                                              Jurisdiction
                                                                                                      obtain course information, and/or
                                              Road, Ammendale, MD 20705, by email                     evaluate ATF forensic firearms                           This Agency has jurisdiction to
                                              at Sheila.hopkins@atf.gov, or by                        investigative techniques training. The                decide this case based upon the OSC
                                              telephone at 202–648–6061. Written                      information collected on the form will                allegation that Respondent holds a DEA
                                              comments and/or suggestions can also                    assist ATF to determine the applicant’s               Certificate of Registration (No.
                                              be directed to the Office of Management                 eligibility to attend this training.                  BF3649312) at the registered address of
                                              and Budget, Office of Information and                      (5) An estimate of the total number of             7320 Deer Valley Road, J100, Scottsdale,
                                              Regulatory Affairs, Attention                           respondents and the amount of time                    Arizona 85255. Id. at 1. That registration
                                              Department of Justice Desk Officer,                     estimated for an average respondent to                authorizes Respondent, as a
                                              Washington, DC 20503 or sent to OIRA_                   respond: An estimated 75 respondents                  practitioner, to dispense controlled
                                              submissions@omb.eop.gov.                                will utilize the form associated with this            substances in schedules II through V.
amozie on DSK3GDR082PROD with NOTICES1




                                              SUPPLEMENTARY INFORMATION: Written                      information collection (IC), and it will              Although Respondent’s COR reflects an
                                              comments and suggestions from the                       take each respondent approximately 6                  expiration date of September 30, 2017,
                                              public and affected agencies concerning                 minutes to complete the form.                         the OSC alleges that Respondent’s COR
                                              the proposed collection of information                     (6) An estimate of the total public                is current by virtue of his having
                                              are encouraged. Your comments should                    burden (in hours) associated with the                 submitted a timely application for
                                              address one or more of the following                    collection: The estimated annual public               renewal of this COR on September 21,
                                              four points:                                            burden associated with this collection is             2017. Id.


                                         VerDate Sep<11>2014   17:00 Nov 29, 2018   Jkt 247001   PO 00000   Frm 00077   Fmt 4703   Sfmt 4703   E:\FR\FM\30NON1.SGM   30NON1


                                              61676                       Federal Register / Vol. 83, No. 231 / Friday, November 30, 2018 / Notices

                                              Substantive Ground for Revocation of                    timely. OSC, at 1; Request for                        Respondent’s Motion for Extension of
                                              COR Alleged in OSC                                      Extension/Hearing, at 1.                              Time To File Response
                                                 The substantive ground for the                       Respondent’s Request for Extension of                    By motion dated May 25, 2018,
                                              proceeding, as alleged in the OSC, is                   Time                                                  Respondent requested an extension of
                                              that Respondent is ‘‘prohibited from                                                                          time until December 3, 2018 to respond
                                                                                                         Respondent argued in his Request for
                                              practicing medicine in the state in                                                                           to the Government’s motion for
                                                                                                      Extension/Hearing that he should be
                                              which . . . [he is] registered with the                                                                       summary disposition. The essence of
                                                                                                      allowed an extension of time to request
                                              DEA.’’ Id. at 2. Specifically, the OSC                                                                        Respondent’s argument was that the
                                                                                                      a hearing ‘‘pending the resolution of
                                              alleges that, according to Arizona                                                                            AMB ‘‘is expected to have acted on and
                                                                                                      . . . [AMB] actions regarding his
                                              Medical Board (hereinafter, AMB)                                                                              reinstated . . . [Respondent’s] authority
                                                                                                      Arizona medical license.’’ Request for
                                              records, Respondent ‘‘engaged in                                                                              to practice medicine by such date.
                                                                                                      Extension/Hearing, at 1. The gravamen
                                              medical practices (including the                                                                              Motion for Extension of Time to File
                                                                                                      of his argument is that an extension
                                              prescribing of controlled substances)                                                                         Response to Government’s Motion for
                                                                                                      should be allowed, because if
                                              that constitute[ ] ‘significant deviations                                                                    Summary Disposition and Argument in
                                                                                                      Respondent is successful before the
                                              from the standard of care.’ ’’ Id. at 1,                                                                      Support of Finding that Respondent
                                                                                                      AMB, his medical license will be
                                              quoting AMB Interim Consent                                                                                   Lacks State Authorization to Handle
                                                                                                      returned to him. Id. The request for
                                              Agreement for Practice Restriction                                                                            Controlled Substances and Response to
                                                                                                      extension asked in the alternative for a
                                              (hereinafter, Interim Consent                                                                                 Government’s Motion for Summary
                                                                                                      hearing if the request for extension of
                                              Agreement) (ellipse omitted). As a                                                                            Disposition, at 1 (hereinafter,
                                                                                                      time is not granted.
                                              result, according to the OSC,                                                                                 Respondent’s Motion). Respondent
                                              Respondent entered into an Interim                      CALJ Denial of Request for Extension of               alleged that he entered into the Interim
                                              Consent Agreement whereby he is                         Time                                                  Consent Agreement with the AMB,
                                              ‘‘prohibited from engaging in the                                                                             wherein he agreed to be prohibited from
                                              practice of medicine in the State of                       The Office of Administrative Law                   engaging in the practice of medicine in
                                              Arizona’’ until he applies to the AMB                   Judges put the matter on the docket and               the State of Arizona until he applies to
                                              and receives permission to do so. Id. at                assigned it to the Chief Administrative               the Board and receives permission to do
                                              1–2. Registrant signed the Interim                      Law Judge, John J. Mulrooney, II                      so, ‘‘based on coercive assertions’’ by
                                              Consent Agreement on July 11, 2017. Id.                 (hereinafter, CALJ). On May 4, 2018, the              the AMB at a time when he was
                                              at 1. The OSC states that since                         CALJ denied the request for an                        unrepresented by counsel. Id. at 2.
                                              Respondent is not licensed to dispense                  extension of time, stating that ‘‘[a]n
                                                                                                      extension of time that has the potential              CALJ Order Denying Respondent’s
                                              controlled substances in Arizona, his
                                                                                                      to exist in perpetuity, at least on the               Request for an Extension and Granting
                                              DEA COR must be revoked pursuant to
                                                                                                      present record, will not serve the                    the Government’s Motion for Summary
                                              21 U.S.C. 823(f) and 824(a)(3). Id. at 2.
                                                                                                      interests of justice.’’ Order Denying the             Disposition
                                                 The OSC notified Respondent of his
                                                                                                      Respondent’s Request for Extension and
                                              right to request a hearing on the                                                                               On May 31, 2018, the CALJ issued an
                                                                                                      Directing the Filing of Government
                                              allegations or to submit a written                                                                            Order (hereinafter, R.D.) denying
                                                                                                      Evidence of Lack of State Authority
                                              statement if he chooses to waive his                                                                          Respondent’s request for an extension
                                                                                                      Allegation and Briefing Schedule dated
                                              right to a hearing. Id. at 2. The OSC                                                                         and granting the Government’s motion
                                                                                                      May 4, 2018 (hereinafter, Order Denying
                                              explained the procedures for electing                                                                         for summary disposition.
                                                                                                      Extension), at 2. In the Order Denying
                                              each option, the consequences for                                                                             Findings of Fact
                                                                                                      Extension, the CALJ ordered the DEA to
                                              failing to elect one of those options, and
                                                                                                      file evidence in support of its allegation
                                              the regulations that govern the rules for                                                                     Respondent’s DEA Registration
                                                                                                      that Respondent lacks State authority to
                                              responding to the OSC (21 CFR
                                                                                                      handle controlled substances. Id. The                   Respondent is the holder of DEA
                                              1301.43). Id. at 2. The OSC also notified
                                                                                                      CALJ further established a briefing                   Certificate of Registration No.
                                              Respondent of the opportunity to
                                                                                                      schedule for any Government motion for                BF3649312, pursuant to which he is
                                              submit a corrective action plan, the
                                                                                                      summary disposition based upon its                    authorized to dispense controlled
                                              specific procedures for filing a
                                                                                                      allegation that Respondent lacks State                substances in schedules II through V as
                                              corrective action plan, and the statutory
                                                                                                      authority to handle controlled                        a practitioner, at the registered address
                                              provision that governs such a plan. Id.
                                                                                                      substances. Id.                                       of 7320 Deer Valley Road, J100,
                                              at 2–3 (citing 21 U.S.C. 824(c)(2)(C)).
                                                                                                                                                            Scottsdale, Arizona 85255. Summary
                                                                                                      Government Motion for Summary
                                              Adequacy of Service                                                                                           Disposition Motion, Attachment 1, at 1.
                                                                                                      Disposition
                                                 In his April 30, 2018, Request for                                                                         The Status of Respondent’s State
                                                                                                         On May 16, 2018, the Government                    License
                                              Extension/Hearing, Respondent
                                                                                                      filed a motion for summary disposition.
                                              acknowledged receipt of the OSC ‘‘on or
                                                                                                      The motion by the Government alleged,                    The AMB and Respondent entered
                                              after April 4, 2018.’’ 1 Request for
                                                                                                      in pertinent part, that Respondent lacks              into an Interim Consent Agreement.
                                              Extension/Hearing, at 1. Since the OSC
                                                                                                      authority to handle controlled                        Summary Disposition Motion,
                                              was issued on April 4, 2018 and
                                                                                                      substances in Arizona and, therefore,                 Attachment 2. The effective date of the
                                              Respondent admitted receiving the OSC
                                                                                                      pursuant to 21 U.S.C. 823(f) and                      Interim Consent Agreement is July 12,
                                              ‘‘on or after April 4, 2018,’’ I find that
                                                                                                      824(a)(3), Respondent’s DEA COR                       2017. Id. at 7, 10. According to its terms,
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                                              the Government’s service of the OSC
                                                                                                      should be revoked. Government’s                       Respondent ‘‘elect[ed] to permanently
                                              was legally sufficient and that
                                                                                                      Motion for Summary Disposition and                    waive any right to a hearing and appeal
                                              Respondent’s request for a hearing was
                                                                                                      Argument in Support of Finding that                   with respect to this Interim Consent
                                                1 Respondent’s April 30, 2018, Request for
                                                                                                      Respondent Lacks State Authorization                  Agreement for Practice Restriction’’ and
                                              Extension/Hearing is stamped ‘‘received’’ by the
                                                                                                      to Handle Controlled Substances                       is ‘‘prohibited from engaging in the
                                              Office of Administrative Law Judges on May 1,           (hereinafter, Summary Disposition                     practice of medicine in the State of
                                              2018.                                                   Motion), at 4.                                        Arizona . . . until he applies to the . . .


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                                                                            Federal Register / Vol. 83, No. 231 / Friday, November 30, 2018 / Notices                                           61677

                                              [AMB] and receives permission to do                       James L. Hooper, M.D., 76 FR 71,371                  through the First Special and Second
                                              [so].’’ Id. at 1, 7.                                      (2011), pet. for rev. denied, 481 Fed.               Regular Session of the Fifty-Third
                                                 On May 8, 2018, a DEA Diversion                        Appx. 826 (4th Cir. 2012); Frederick                 Legislature (2018)) (A physician is a
                                              Investigator (hereinafter, DI) contacted                  Marsh Blanton, M.D., 43 FR 27,616,                   ‘‘doctor of medicine who is licensed
                                              an AMB Investigator who informed the                      27,617 (1978).                                       pursuant to this chapter.’’). Further, a
                                              DI that Respondent’s medical license                         This rule derives from the text of two            physician who ‘‘wishes to dispense a
                                              remains under practice restriction.                       provisions of the CSA. First, Congress               controlled substance . . . shall be
                                              Summary Disposition Motion,                               defined the term ‘‘practitioner’’ to mean            currently licensed to practice medicine
                                              Attachment 4, at 2. The DI averred that                   ‘‘a physician . . . or other person                  in Arizona.’’ Ariz. Admin. Code § R4–
                                              ‘‘the result of DEA’s investigation has                   licensed, registered, or otherwise                   16–301 (Westlaw, current through rules
                                              shown that . . . [Respondent] remains                     permitted, by . . . the jurisdiction in              published in Arizona Administrative
                                              currently prohibited from practicing                      which he practices . . . , to distribute,            Register Volume 24, Issue 43, Oct. 26,
                                              medicine in the State of Arizona.’’ Id. at                dispense, . . . [or] administer . . . a              2018). ‘‘Dispense,’’ under Arizona law,
                                              3.                                                        controlled substance in the course of                means ‘‘the delivery by a doctor of
                                                 There is no evidence in the record                     professional practice.’’ 21 U.S.C.                   medicine of a prescription drug or
                                              that the AMB lifted the Practice                          802(21). Second, in setting the                      device to a patient . . . and includes the
                                              Restriction on Respondent’s medical                       requirements for obtaining a                         prescribing, administering, packaging,
                                              license. Further, according to the online                 practitioner’s registration, Congress                labeling and security necessary to
                                              records of the State of Arizona, of which                 directed that ‘‘[t]he Attorney General               prepare and safeguard the drug or
                                              I take official notice, I find that the                   shall register practitioners . . . if the            device for delivery.’’ Ariz. Rev. Stat.
                                              Interim Consent Agreement is still in                     applicant is authorized to dispense . . .            Ann. § 32–1401(9) (Westlaw, current
                                              effect today.2 Arizona Medical Board                      controlled substances under the laws of              through the First Special and Second
                                              Licensee Search, https://www.azmd.gov                     the State in which he practices.’’ 21                Regular Session of the Fifty-Third
                                              (last visited November 19, 2018).                         U.S.C. 823(f). Because Congress has                  Legislature (2018)).
                                                 Accordingly, based on all of the                       clearly mandated that a practitioner                    As already discussed, the AMB and
                                              evidence in the record before me, I find                  possess State authority in order to be               Respondent entered into an ‘‘Interim
                                              that Respondent currently is without                      deemed a practitioner under the CSA,                 Consent Agreement for Practice
                                              authority to practice medicine in                         the DEA has held repeatedly that                     Restriction.’’ ‘‘Restrict,’’ in the context
                                              Arizona, the State in which he is                         revocation of a practitioner’s registration          of this Interim Consent Agreement,
                                              registered.                                               is the appropriate sanction whenever he              means ‘‘taking a disciplinary action that
                                                                                                        is no longer authorized to dispense                  alters the physician’s practice or
                                              Discussion                                                controlled substances under the laws of              professional activities if the board
                                                 Pursuant to 21 U.S.C. 824(a)(3), the                   the State in which he practices. See,                determines that there is evidence that
                                              Attorney General is authorized to                         e.g., Hooper, supra, 76 FR at 71,371–72;             the physician is or may be medically
                                              suspend or revoke a registration issued                   Sheran Arden Yeates, M.D., 71 FR                     incompetent or guilty of unprofessional
                                              under section 823 of the Controlled                       39,130, 39,131 (2006); Dominick A.                   conduct.’’ Ariz. Rev. Stat. Ann. § 32–
                                              Substances Act (hereinafter, CSA),                        Ricci, M.D., 58 FR 51,104, 51,105 (1993);            1401(23) (Westlaw, current through the
                                              ‘‘upon a finding that the registrant . . .                Bobby Watts, M.D., 53 FR 11,919, 11,920              First Special and Second Regular
                                              has had his State license or registration                 (1988); Blanton, supra, 43 FR at 27,617.             Session of the Fifty-Third Legislature
                                              suspended . . . [or] revoked . . . by                        Section 32–1401(22) of the Arizona                (2018)).
                                              competent State authority and is no                       Revised Statutes, cited in the ‘‘Interim                The conclusory language in
                                                                                                        Consent Agreement for Practice                       Respondent’s Motion that he
                                              longer authorized by State law to engage
                                                                                                        Restriction,’’ in pertinent part, defines            imprudently entered into the Interim
                                              in the . . . dispensing of controlled
                                                                                                        the ‘‘practice of medicine’’ as the                  Consent Agreement based upon coercive
                                              substances.’’ With respect to a
                                                                                                        diagnosis or treatment of any and all                assertions by the AMB at a time when
                                              practitioner, the DEA has also long held
                                                                                                        human diseases, injuries, ailments,                  he was unrepresented by counsel was
                                              that the possession of authority to
                                                                                                        infirmities, or deformities, whether they            not accompanied by specific facts
                                              dispense controlled substances under
                                                                                                        be physical or mental, ‘‘by any means,               indicating what was said that
                                              the laws of the State in which a
                                                                                                        methods, devices or instrumentalities.’’             Respondent considered coercive. The
                                              practitioner engages in professional
                                                                                                        Ariz. Rev. Stat. Ann. § 32–1401(22)                  legitimacy of the claim is undermined
                                              practice is a fundamental condition for
                                                                                                        (Westlaw, current through the First                  by the notable fact that Respondent did
                                              obtaining and maintaining a                               Special and Second Regular Session of                not submit any documentation
                                              practitioner’s registration. See, e.g.,                   the Fifty-Third Legislature (2018)).                 indicating an effort by Respondent to
                                                2 Under the Administrative Procedure Act, an
                                                                                                        ‘‘Medicine’’ means ‘‘allopathic medicine             bring the validity of the Interim Consent
                                              agency ‘‘may take official notice of facts at any stage   as practiced by the recipient of a degree            Agreement before the AMB, which,
                                              in a proceeding—even in the final decision.’’             of doctor of medicine.’’ Ariz. Rev. Stat.            initially, would be the proper forum in
                                              United States Department of Justice, Attorney             Ann. § 32–1401(19) (Westlaw, current                 which to raise that issue. Regardless, as
                                              General’s Manual on the Administrative Procedure          through the First Special and Second                 pointed out by the CALJ citing long-
                                              Act 80 (1947) (Wm. W. Gaunt & Sons, Inc., Reprint
                                              1979). Pursuant to 5 U.S.C. 556(e), ‘‘[w]hen an           Regular Session of the Fifty-Third                   standing Agency precedent, the
                                              agency decision rests on official notice of a material    Legislature (2018)). Under Arizona law,              controlling question is not the merits of
                                              fact not appearing in the evidence in the record, a       a ‘‘doctor of medicine’’ is a ‘‘natural              Respondent’s claim before the AMB, but
                                              party is entitled, on timely request, to an               person holding a license, registration or            rather, whether Respondent is currently
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                                              opportunity to show the contrary.’’ Accordingly,
                                              Respondent may dispute my finding by filing a
                                                                                                        permit to practice medicine pursuant to              authorized to handle controlled
                                              properly supported motion for reconsideration             this chapter.’’ Ariz. Rev. Stat. Ann. § 32–          substances in the State of registration.
                                              within 20 calendar days of the date of this Order.        1401(10) (Westlaw, current through the               R.D., at 3. In that regard, I adopt the
                                              Any such motion shall be filed with the Office of         First Special and Second Regular                     following portion of the R.D. and agree
                                              the Administrator and a copy shall be served on the
                                              Government; in the event Respondent files a
                                                                                                        Session of the Fifty-Third Legislature               with the CALJ’s denial of Respondent’s
                                              motion, the Government shall have 20 calendar             (2018)). See also Ariz. Rev. Stat. Ann.              request for an extension of time/stay of
                                              days to file a response.                                  § 32–1401(21) (Westlaw, current                      proceedings. R.D., at 4.


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                                              61678                       Federal Register / Vol. 83, No. 231 / Friday, November 30, 2018 / Notices

                                              Where a registrant has lost state authority to          R.D., at 3–4.                                         DEPARTMENT OF JUSTICE
                                              handle controlled substances, the Agency has               It is undisputed that Respondent is
                                              repeatedly taken the position that                      not currently authorized to practice                  Drug Enforcement Administration
                                              ‘‘revocation is warranted even where a                  medicine in Arizona due to the Interim
                                              practitioner’s state authority has been                                                                       [Docket No. 18–32]
                                              summarily suspended and the State has yet
                                                                                                      Consent Agreement. Thus, according to
                                              to provide the practitioner with a hearing to           Arizona law, Respondent does not have                 Narciso A. Reyes, M.D.; Decision and
                                              challenge the State’s action and at which he            authority to handle controlled                        Order
                                              . . . may ultimately prevail.’’ Kamal Tiwari,           substances in Arizona, the State in
                                              M.D., 76 FR 71604, 71606 (2011) (citations              which he is registered with the DEA. As                  On April 19, 2018, the Assistant
                                              omitted); see also Anne Lazar Thorn, M.D.,              already discussed, the practice                       Administrator, Diversion Control
                                              62 FR 12847, 12848 (1997) (‘‘[T]he                      restriction on Respondent’s medical                   Division, Drug Enforcement
                                              controlling question is not whether a                   license is currently in effect. DEA has               Administration (hereinafter, DEA or
                                              practitioner’s license to practice medicine in                                                                Government), issued an Order to Show
                                              the state is suspended or revoked; rather, it
                                                                                                      ‘‘long and consistently interpreted the
                                                                                                      CSA as mandating the possession of                    Cause to Narciso A. Reyes, M.D.
                                              is whether the Respondent is currently
                                              authorized to handle controlled substances in           authority under state law to handle                   (hereinafter, Respondent), of Luquillo,
                                              the [state of registration].’’). Even when the          controlled substances as a fundamental                Puerto Rico. Order to Show Cause
                                              Respondent is actively engaged in appealing             condition for obtaining and maintaining               (hereinafter, OSC), at 1. The Show
                                              a state decision, the Agency has noted that             a registration.’’ Hooper, supra, 76 FR at             Cause Order proposes the revocation of
                                              ‘‘[i]t is not DEA’s policy to stay                      71,371. That is the controlling question.             Respondent’s DEA Certificate of
                                              [administrative] proceedings . . . while                Thorn, supra, 62 FR at 12,848. The CSA                Registration on the grounds that he
                                              registrants litigate in other forums.’’ Newcare                                                               materially falsified applications he
                                              Home Health Servs., 72 FR 42126, 42127 n.2              has consistently been interpreted to
                                                                                                      mean that ‘‘DEA does not have statutory               submitted to DEA and that he has been
                                              (2007). Agency precedent has consistently
                                              affirmed recommended decisions where a                  authority . . . to maintain a registration            excluded from participation in a
                                              respondent’s request for a stay due to state            if the registrant is without state                    program pursuant to 42 U.S.C. 1320a–
                                              medical board proceedings were denied by                authority to handle controlled                        7(a). Id. (citing 21 U.S.C. 824(a)(1) and
                                              the Administrative Law Judge. See, e.g., Irwin          substances in the state in which he                   (5)). It also proposes the denial of ‘‘any
                                              August, D.O., 81 FR 3158, 3159 (2016); Pedro            practices.’’ Yeates, supra, 71 FR at                  applications for renewal or modification
                                              E. Lopez, M.D., 80 FR 46324, 46325–26                                                                         of such registration and any
                                              (2015). The Agency has stated in recent final
                                                                                                      39,131. As succinctly explained by the
                                                                                                      CALJ, ‘‘The DEA has long held that                    applications for any other DEA
                                              orders that a stay in administrative                                                                          registration.’’ OSC, at 1 (citing 21 U.S.C.
                                              enforcement proceedings is ‘‘unlikely to ever           possession of authority under state law
                                              be justified’’ due to ancillary proceedings             to dispense controlled substances is not              824(a)(1) and (5)).
                                              involving the Respondent. Grider Drug #1 &              only a prerequisite to obtaining a DEA                   Regarding jurisdiction, the Show
                                              Grider Drug #2, 77 FR 44070, 44104 n.97                 registration, but also an essential                   Cause Order alleges that Respondent
                                              (2012).                                                 condition for maintaining it.’’ R.D., at 5            holds DEA Certificate of Registration
                                                 Even if the Agency’s precedent were not
                                                                                                      (citations omitted). I agree with the                 No. FR4900305 at the registered address
                                              fixed firmly against the granting of such a                                                                   of Calle Fernandez Garcia 306, Luquillo,
                                              delay in principle, the Respondent here is              CALJ’s conclusion that ‘‘as a matter of
                                                                                                      law, a DEA registration may not be                    Puerto Rico 00773, with a mailing
                                              unable to point to a reliably fixed date where                                                                address of P.O. Box 247, Luquillo, PR
                                              state proceedings would reasonably be                   granted or maintained where an
                                              concluded. The Respondent’s Motion                      applicant/registrant no longer falls                  00773. OSC, at 2. This registration, the
                                              includes a Declaration from the Respondent’s            within the CSA’s definition of a                      OSC alleges, authorizes Respondent to
                                              counsel (Respondent’s Board Counsel) in his             practitioner.’’ Id. Very simply, since                dispense controlled substances in
                                              Arizona Board proceedings. . . .                        Respondent is not authorized to handle                schedules II through V as a practitioner.
                                              [Respondent’s Motion,] Attachment 1. In the                                                                   Id. The Show Cause Order alleges that
                                              Respondent’s Board Counsel’s declaration,               controlled substances in Arizona, he is
                                                                                                      not eligible for a DEA registration. As               this registration expires on April 30,
                                              the decisional timeframe is couched in the                                                                    2020. Id.
                                              following tenuous terms:                                such, I will order that Respondent’s
                                                                                                                                                               Regarding the substantive grounds for
                                                 As for when the [Arizona Board] might                DEA registration be revoked.
                                              take action, my best guess is that it will be                                                                 the proceeding, the Show Cause Order
                                              at its August 20, 2018 meeting, although I              Order                                                 alleges that, on October 20, 2009, the
                                              would not be surprised if [the Respondent’s]               Pursuant to 28 CFR 0.100(b) and the                U.S. Department of Health and Human
                                              matter is not heard until the October 22                authority thus vested in me by 21 U.S.C.              Services, Office of Inspector General
                                              meeting, which is the next regularly                    824(a), I order that DEA Certificate of               (hereinafter, HHS/OIG), mandatorily
                                              scheduled meeting of the [Arizona Board].                                                                     excluded Respondent from participating
                                                                                                      Registration No. BF3649312 issued to
                                              Id. at 2–3 (emphasis supplied). The                     Steve Fanto, M.D., be, and it hereby is,              in all Federal health care programs due
                                              Respondent’s Board Counsel further                                                                            to his conviction in U.S. District Court
                                              explained that the state process involves the           revoked. Pursuant to 28 CFR 0.100(b)
                                                                                                      and the authority thus vested in me by                for conspiracy to commit health care
                                              actions and recommendations of an internal
                                                                                                      21 U.S.C. 823(f), I further order that any            fraud. Id. at 2 (citing 42 U.S.C. 1320a–
                                              committee, and avers that he and the
                                              Respondent ‘‘are hopeful that [the internal             pending application of Steve Fanto,                   7(a)(1)). According to the OSC,
                                              committee] will make those                              M.D., to renew or modify this                         Respondent’s ‘‘mandatory exclusion
                                              recommendations and share them with us in               registration, as well as any other                    from Medicare, Medicaid and all
                                              the not-too-distant future and if that occurs           pending application by him for                        Federal health care programs warrants
                                              then the matter should be heard at the                  registration in the State of Arizona, be,             revocation of . . . [his] registration.’’
                                              August 20 meeting.’’ Id. at 3 (emphasis                                                                       OSC, at 2 (citing 21 U.S.C. 824(a)(5)).
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                                              supplied). While the candor of the                      and it hereby is, denied. This order is
                                                                                                      effective December 31, 2018.                             The Show Cause Order further alleges
                                              Respondent’s Board Counsel is                                                                                 that Respondent provided false answers
                                              commendable, the language strikes as too                  Dated: November 19, 2018.
                                              aspirational and amorphous to be
                                                                                                                                                            to two ‘‘yes’’ or ‘‘no’’ liability questions
                                                                                                      Uttam Dhillon,                                        when he applied for a DEA registration
                                              particularly supportive of the delay sought by
                                              the Respondent here—even if the Agency’s                Acting Administrator.                                 on October 16, 2014 and when he filed
                                              precedent were not squarely opposed to the              [FR Doc. 2018–26046 Filed 11–29–18; 8:45 am]          a renewal application on April 17, 2017.
                                              relief—which it is.                                     BILLING CODE 4410–09–P                                OSC, at 2–3. Specifically, the Show


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Document Created: 2018-11-30 04:36:18
Document Modified: 2018-11-30 04:36:18
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 Citation83 FR 61675 

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