[Federal Register Volume 61, Number 61 (Thursday, March 28, 1996)]
[Notices]
[Pages 13876-13878]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 96-7498]



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DEPARTMENT OF JUSTICE

Drug Enforcement Administration
[Docket No. 95-7]


Stanley Karpo, D.P.M.; Revocation of Registration

    On September 19, 1994, the Deputy Assistant Administrator, Office 
of Diversion Control, (then titled Director, Office of Diversion 
Control), Drug Enforcement Administration (DEA), issued an Order to 
Show Cause to Stanley Karpo, D.P.M., (Respondent) of Norristown, 
Pennsylvania, notifying him of an opportunity to show cause as to why 
DEA should not revoke his DEA Certificate of Registration, AK5172515, 
under 21 U.S.C. 824(a), and deny any pending applications for renewal 
of such registration as a practitioner under 21 U.S.C. 823(f), as being 
inconsistent with the public interest. Specifically, in relevant part, 
the Order to Show Cause alleged that the Respondent had been excluded 
from participation in a program pursuant to 42 U.S.C. 1320a-7(a), as 
evidenced by, but not limited to, the following:

    (a) Between 1986 and 1989, [the Respondent] submitted 219 
fraudulent claims for $32,317.00, to Medicare for medical services 
not provided.
    (b) On July 22, 1991, in the Court of Common Pleas for 
Montgomery County, Pennsylvania, [the Respondent] pled guilty to 23 
counts of Medicaid fraud, and two counts of theft by deception. On 
October 15, 1991, [the Respondent was] sentenced to a period

[[Page 13877]]
of incarceration of between 8-23 months; court costs and fines; two 
years supervised probation; and ordered to pay restitution to the 
Pennsylvania Department of Public Welfare.
    (c) On March 6, 1992, [the Respondent was] notified by the 
Department of Health and Human Services of [his] eight-year 
mandatory exclusion from participation in the Medicare program 
pursuant to 42 U.S.C. 1320a-7(a).

    While this matter was pending, the Respondent filed a request for 
modification of his DEA Certificate of Registration to reflect his 
change of address from Norristown, Pennsylvania, to Hollywood, Florida. 
On November 3, 1994, the Deputy Assistant Administrator, Office of 
Diversion Control, issued another Order to Show Cause to the Respondent 
at his Hollywood, Florida address, notifying him of an opportunity to 
show cause as to why DEA should not only revoke his DEA Certificate of 
Registration as stated in the earlier show cause order, but also to 
deny his request for modification under 21 U.S.C. 823(f), for the same 
reasons as stated in the earlier show cause order.
    By letter dated November 25, 1994, the Respondent, representing 
himself, requested a hearing, and following prehearing procedures, a 
hearing was scheduled before Judge Paul A. Tenney, for October 11, 
1995. However, by letter dated October 5, 1995, the Respondent notified 
Judge Tenney that he had elected not to contest this matter. By order 
dated October 10, 1995, Judge Tenney determined that the Respondent's 
letter was a withdrawal of his request for a hearing, and he cancelled 
the hearing scheduled for October 11. Judge Tenney also recommended 
that this case ``be disposed of by a decision based upon the 
investigative record.'' By letter dated October 18, 1995, Judge Tenney 
transmitted the record of these proceedings to the Deputy 
Administrator.
    The Deputy Administrator agrees with Judge Tenney's determination 
that the Respondent's letter dated October 5, 1995, was a withdrawal of 
his request for a hearing. Accordingly, the Deputy Administrator now 
enters his final order in this matter without a hearing and based on 
the investigative file and the prehearing matters submitted by the 
parties pursuant to 21 CFR 1301.54(e) and 1301.57.
    The Deputy Administrator finds that the parties have stipulated 
before Judge Tenney, and nothing filed by the Respondent indicates his 
intention to withdraw from this stipulation, as follows:

    (1) On July 22, 1991, in the Court of Common Pleas for 
Montgomery County, Pennsylvania, [the] Respondent pled guilty to 
twenty-three counts of Medicaid fraud and two counts of theft by 
deception. On October 15, 1991, [the] Respondent was sentenced to a 
period of incarceration between 8-23 months; court costs and fines; 
two years supervised probation; and ordered to pay restitution to 
the Pennsylvania Department of Public Welfare.
    (2) On [March 6, 1992, the] Respondent was notified by the 
Department of Health and Human Services of his eight-year exclusion 
from participation in the Medicare Program pursuant to 42 U.S.C. 
[1320]a-7a. This action is currently under appeal.

    Although the parties stipulated that the Respondent appealed the 
Medicare exclusion determination, neither party has submitted any 
evidence demonstrating that the Medicare exclusion has been revoked or 
otherwise altered from the original determination.
    The investigate file contains a report indicating that during the 
Medicare fraud investigation, investigators from the Pennsylvania 
Attorney General's Medicaid Fraud Section interviewed a number of the 
Respondent's ex-employees, who had related that the Respondent had 
treated patients while under the influence of drugs. One of the ex-
employees stated that she had seen the Respondent take excessive 
amounts of Valium during office hours. Valium is a brand name for a 
product containing diazepam, a Schedule IV controlled substance. 
Another ex-employee related that the Respondent had inhaled cocaine at 
his office desk. A number of the Respondent's patients also indicated 
that they believed he was under the influence of some drug when he 
treated them.
    On April 16, 1993, pursuant to a consent agreement between the 
Respondent and the State's prosecuting attorney, the Commonwealth of 
Pennsylvania Department of State Bureau of Professional and 
Occupational Affairs (Bureau) ordered the Respondent's license to 
practice podiatry suspended for a period of one year. However, this 
suspension was stayed in favor of a period of active suspension for 
twenty-one days, and a three-year period of probation, with specified 
terms and conditions. One of the terms of probation was that the 
Respondent remain enrolled in, and successfully participate in, ``the 
Impaired Professional Program for the duration of his probation, unless 
earlier released from participation by the Impaired Professional 
Program Consultant.'' In his prehearing statement, the Respondent 
indicated that he was participating in such a program, which included 
weekly meetings, random monthly substance abuse laboratory screenings, 
and psychological evaluations.
    Pursuant to 21 U.S.C. 823(f) and 824(a)(4), the Deputy 
Administrator may revoke a DEA Certificate of Registration and deny any 
pending application for such registration, if he determines that the 
continued registration would be inconsistent with the public interest. 
Section 823(f) requires that the following factors be considered:
    (1) The recommendation of the appropriate State licensing board or 
professional disciplinary authority.
    (2) The applicant's experience in dispensing, or conducting 
research with respect to controlled substances.
    (3) The applicant's conviction record under Federal or State laws 
relating to the manufacture, distribution, or dispensing of controlled 
substances.
    (4) Compliance with applicable State, Federal, or local laws 
relating to contolled substances.
    (5) Such other conduct which may threaten the public health or 
safety.
    These factors are to be considered in the disjunctive; the Deputy 
Administrator may rely on any one or a combination of factors and may 
give each factor the weight he deems appropriate in determining whether 
a registration should be revoked or a pending application for 
registration denied. See Henry J. Schwarz, Jr., M.D., Docket No. 88-42, 
54 FR 16422 (1989).
    In addition, 21 U.S.C. 824(a)(5) specifies that a DEA registration 
may be revoked or suspended if the registrant ``has been excluded * * * 
from participation in a program pursuant to [42 U.S.C. 1320a-7(a)].'' 
Here, the record demonstrates that the Respondent has been so excluded. 
Although the Respondent asserted that this decision was under appeal, 
nothing was presented reversing or otherwise altering his Medicare 
program exclusion. The DEA has previously determined that such an 
exclusion constitutes grounds for revoking a Respondent's DEA 
Certificate of Registration. See Richard M. Koenig, M.D., Docket No. 
94-32, 60 FR 65069 (1995); Joseph A. Zadrozny, M.D., 60 FR 14304 
(1995).
    Next, as to the public interest issue, factors one and five are 
relevant in determining whether the Respondent's continued registration 
would be inconsistent with the public interest. Specifically, as to 
factor one, ``[t]he recommendation of the appropriate state licensing 
board,'' in April of 1993, the Bureau, pursuant to a consent agreement, 
actively suspended the Respondent's license to practice podiatry for 
twenty-one days and placed

[[Page 13878]]
it on probation for three years. The Bureau ordered the Respondent to 
participate in an Impaired Professional Program for the duration of his 
probation. Although the facts concerning the Respondent's alleged acts 
of substance abuse are not adequately developed for specific findings 
based upon the record before the Deputy Administrator, it is 
significant that the Bureau, after reviewing the investigative record 
before it, ordered the Respondent to participate in an Impaired 
Professional Program for the duration of the Respondent's three-year 
probation.
    Further, as to factor five, ``[s]uch other conduct which may 
threaten the public health or safety,'' the Respondent's conduct of 
submitting false invoices placed into question his trustworthiness and 
credibility. Such lack of trustworthiness causes concern as to the 
Respondent's future conduct if entrusted with protecting the public 
interest in administering controlled substances.
    Except for the Respondent's general statement in his prehearing 
submission that he continues to participate in the Impaired 
Professional Program, the Respondent has not submitted any other 
information of his rehabilitative efforts. Given the egregious nature 
of the Respondent's conduct in intentionally filing false documents 
with the State and his resulting exclusion from the Medicare Program, 
the Deputy Administrator finds that the public interest is best served 
by revoking the Respondent's DEA Certificate of Registration and 
denying any pending registration application at the present time. See 
Sokoloff v. Saxbe, 501 F.2d 571, 576 (2d Cir. 1974) (stating that 
``permanent revocation'' of a DEA Certificate of Registration may be 
``unduly harsh'').
    Accordingly, the Deputy Administrator of the Drug Enforcement 
Administration, pursuant to the authority vested in him by 21 U.S.C. 
823 and 824, and 28 CFR 0.100(b) and 0.104, hereby orders that DEA 
Certificate of Registration AK5172515, issued to Stanley Karpo, D.P.M., 
be, and it hereby is, revoked, and any pending application, or request 
for modification of this registration, submitted by the Respondent is 
denied. This order is effective April 29, 1996.

    Dated March 22, 1996.
Stephen H. Greene,
Deputy Administrator.
[FR Doc. 96-7498 Filed 3-27-96; 8:45 am]
BILLING CODE 4410-09-M