[Federal Register Volume 86, Number 32 (Friday, February 19, 2021)]
[Notices]
[Pages 10354-10357]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2021-03360]
[[Page 10354]]
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DEPARTMENT OF JUSTICE
Drug Enforcement Administration
Ibrahim Al-Qawaqneh, D.D.S.; Decision and Order
On November 20, 2018, the Assistant Administrator, Diversion
Control Division, Drug Enforcement Administration (hereinafter, DEA or
Government), issued an Order to Show Cause to Ibrahim Al-Qawaqneh,
D.D.S. (hereinafter, Respondent), of Anaheim, California.
Administrative Law Judge Exhibit (ALJX) 1 (Order to Show Cause
(hereinafter, OSC)), at 1. The OSC proposes the revocation of
Respondent's Certificate of Registration No. BA6641472 and denial of
any pending application to renew \1\ such registration pursuant to 21
U.S.C. 824(a)(5).
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\1\ The OSC also proposed denial of any pending application to
modify a DEA registration. Because there is no evidence in the
record of a pending application to modify a DEA registration, and
because the Government made no arguments regarding the factors in 21
U.S.C. 823(f), I will not address this proposal herein.
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I. Procedural History
The OSC alleged that on July 2, 2014, Respondent ``entered a plea
of nolo contendere in the Superior Court of California, County of
Orange, to a charge of Offering Unlawful Medi-Cal Remuneration, a
felony. . . .'' OSC, at 1. The OSC further alleged that as a result of
Respondent's conviction, on September 30, 2015, the United States
Department of Health and Human Services, Office of Inspector General
(hereinafter, HHS/OIG), notified Respondent ``of [his] mandatory
exclusion from participation in all Federal health care programs for a
minimum period of five years pursuant to 42 U.S.C. 1320a-7(a)''
(hereinafter, Exclusion Letter); and that ``[m]andatory exclusion from
Medicare is an independent ground for revoking a DEA registration
pursuant to 21 U.S.C. 824(a)(5).'' OSC, at 2.
The OSC notified Respondent of the right to either request a
hearing on the allegations or submit a written statement in lieu of
exercising the right to a hearing, the procedures for electing each
option, and the consequences for failing to elect either option. Id. at
2 (citing 21 CFR 1301.43). The OSC also notified Respondent of the
opportunity to submit a corrective action plan. OSC, at 3 (citing 21
U.S.C. 824(c)(2)(C)).
By letter dated December 21, 2018, Respondent timely requested a
hearing.\2\ ALJX 2 (Request for Hearing), at 1. The matter was placed
on the docket of the Office of Administrative Law Judges and was
assigned to Administrative Law Judge Charles Wm. Dorman (hereinafter,
the ALJ). On December 28, 2018, the ALJ established a schedule for the
filing of prehearing statements. ALJX 3 (Order for Prehearing
Statements), at 1. The Government filed its prehearing statement timely
on January 14, 2019. ALJX 5 (Government's Prehearing Statement), at 1.
Respondent twice missed the deadline for filing his prehearing
statement and was granted two extensions. ALJX 6 (Order Rescheduling
Prehearing Conference and Order to Respondent to File Prehearing
Statement and to Show Good Cause Why Case should not be Terminated);
ALJX 7 (Prehearing Ruling). Respondent filed his prehearing statement
within the extended deadline on February 26, 2019, and supplemented the
prehearing statement on March 7, 2019. ALJX 8 (Resp Prehearing), ALJX
10 (Resp Supp Prehearing).
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\2\ I find that service of the OSC was proper. See ALJX 4
(Government's Notice Regarding Service of Order to Show Cause and
Position on Motion for Termination of Proceedings), Attachment 2
(Form DEA-12 (8-02) ``Receipt for Cash or Other Items,'' dated
November 27, 2018).
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On February 28, 2019, the ALJ issued a prehearing ruling that,
among other things, set out four agreed upon stipulations and
established schedules for the remaining prehearing activities and for
the hearing. ALJX 9 (Second Prehearing Ruling). The hearing in this
matter took place in Los Angeles, California, and spanned two days. See
ALJX 11 (Ruling Regarding Hearing Location); ALJX 12 (Notice of
Hearing); and Transcript of Proceedings in the Matter of Ibrahim Al-
Qawaqneh, D.D.S. (hereinafter, Tr.). The Government filed a posthearing
brief, but Respondent did not. ALJX 16 (Government's Proposed Findings
of Fact, Conclusions of Law and Argument (hereinafter, Govt
Posthearing)). The ALJ's Recommended Rulings, Findings of Fact,
Conclusions of Law, and Decision (hereinafter, RD) is dated June 21,
2019. See RD. According to the ALJ, neither party filed exceptions to
the RD and the deadline for doing so has passed. See Transmittal Letter
from the ALJ, dated July 15, 2019. I have reviewed and agree with the
procedural rulings of the ALJ during the administration of the hearing.
Having considered the record in its entirety, I agree with the ALJ
and find that the Government established ``that HHS mandatorily
excluded [Respondent] from Federal health care programs based on a
program-related conviction.'' RD, at 17. I also agree with the ALJ that
the Respondent failed to accept responsibility for his misconduct, and
that revocation is the appropriate sanction. See RD, at 28. I make the
following findings of fact.
II. Findings of Fact
A. Respondent's DEA Registration
The parties stipulated that Respondent is registered with the DEA
``as a dentist practitioner in Schedules II-V \3\ under DEA
registration number BA6641472 at 1719 W. Romneya Drive, Anaheim,
California 92801.'' ALJX 9, at 1; Government Exhibit (hereinafter, GX)
1 (Controlled Substance Registration Certificate); and GX 2 (Certified
Registration History of Respondent). According to Agency records,
Respondent did not submit a renewal application and his registration
expired on June 30, 2020.\4\ See also GX 1, GX 2.
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\3\ As the ALJ noted in his decision, the Respondent is actually
only registered in Schedules II-III. RD, at 6; GX 1; GX 2.
\4\ The fact that a respondent allows his registration to expire
during the pendency of an OSC does not impact my jurisdiction or
prerogative under the Controlled Substances Act (hereinafter, CSA)
to adjudicate the OSC to finality. Jeffrey D. Olsen, M.D., 84 FR
68474 (2019).
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B. Government's Case
The Government's documentary evidence consisted primarily of
records from the Superior Court of California, County of Orange,
regarding Respondent's conviction; documents regarding the Dental Board
of California's accusation against and settlement with Respondent; and
the HHS/OIG exclusion letter notifying Respondent of his Medicare and
Medicaid exclusion. See GX 1-6. Additionally, the Government called the
Diversion Investigator (hereinafter DI) as a witness both in the
Government's case-in-chief and in rebuttal. Tr. 15-20, 82-86.
DI testified regarding his professional background and about his
involvement in the investigation into Respondent. Tr. 17-18. DI
testified that he obtained the HHS/OIG exclusion letter regarding
Respondent's five-year minimum exclusion from Medicare and Medicaid as
part of his investigation. Id. at 18. He also testified that DEA has
not received any information that the five-year minimum exclusion HHS/
OIG imposed on Respondent has been modified, lifted, or otherwise
rescinded. Id. at 18-19. On rebuttal, DI testified that he searched the
Controlled Substance Utilization Review and Evaluation System for the
18 months prior to his testimony (approximately November 2017 to May 7,
2019) and found just one controlled substance prescription issued by
Respondent. Id. at 84-85. Having read and analyzed all of the record
[[Page 10355]]
evidence, I agree with the ALJ that DI's testimony was straightforward
and professional, and I likewise ``give his testimony full credit.''
RD, at 3.
C. Respondent's Case
Respondent's documentary evidence consisted of Respondent's resume
and a list of continuing dental education courses that Respondent has
recently taken. Respondent's Exhibits (hereinafter RX), 1-2. Respondent
testified on his own behalf and presented no other testimony in support
of his case. Respondent testified regarding his professional
background, experience, and education; and regarding his dental
practice. Tr. 22-28, 38, 52-54. Respondent testified that he has had
his dental practice for over twenty years, and that he has never had
any malpractice claims filed against him, DEA has not expressed any
concerns regarding his prescribing practices, and that the matters at
issue in this case resulted in the only time the Respondent was ever
called before the Dental Board of California (hereinafter, Board).\5\
Id. at 22-23, 37-38, 42. Respondent also testified that, although he
does not often prescribe controlled substances, he needs his DEA
registration to be able to provide quality care to his patients.\6\ Id.
at 24-26. Respondent testified that he might prescribe controlled
substances three or four times a month,\7\ but that 95 percent of his
prescriptions are for non-controlled substances. Id. at 52-53.
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\5\ Due to the conviction, on January 13, 2017, the Dental Board
of California (hereinafter, Board) filed an accusation against
Respondent. GX 5 (Accusation from the Board, dated January 13,
2017), at 1. The parties stipulated that Respondent and the Board
agreed, ``inter alia, that Respondent's dental license would be
revoked; however, the revocation was stayed, and Respondent's dental
license was placed on probation for three years subject to several
terms and conditions.'' ALJX 9, at 2; RD, at 6; see also GX 6 (Board
Decision and Stipulated Settlement and Disciplinary Order). In the
settlement, Respondent ``admit[ted] the truth of each and every
charge and allegation in [the Board's] Accusation.'' GX 6, at 3.
\6\ The Government argued that Respondent's registration should
be revoked because he ``has not demonstrated a need for a DEA
[registration] in order to continue his practice of dentistry.''
ALJX 16, at 19; RD, at 26. The ALJ assessed and rejected this
argument, and I agree. RD, at 26-27. Respondent's need for a
registration is not relevant to my determination of whether or not
Respondent can be entrusted with a registration. See infra IV.
\7\ The ALJ found that this testimony was rebutted by DI's
testimony that Respondent had issued only one controlled substance
prescription in the year and a half prior to the hearing. RD, at 4;
and see supra II.B. Thus, the ALJ did not find Respondent's
testimony on this issue to be credible. RD, at 4.
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Respondent also testified regarding the event that led to his
criminal conviction. See infra II.D. He testified that in December
2013, an undercover agent from the Medi-Cal fraud department going by
the name of Mr. Gonzales came to Respondent's dental office to talk to
him. Tr. 28-29; RD, at 9, GX 5, at 5. According to Respondent, Mr.
Gonzales informed Respondent that he did ``marketing'' and that he
could bring Respondent a lot of medical patients for $90-$120 per
patient. Tr. 29; RD, at 9. Respondent stated, ``I told [Mr. Gonzales],
that's a lot. I wouldn't do that. And I won't pay more than $80.'' \8\
Tr. 29. Respondent stated, ``I did tell [Mr. Gonzales] that is illegal
. . . like paying per patient. And I was telling him . . . it's legal
to do marketing if you get paid like, an hourly or salary but not per
patient. That's the law.'' Id. at 29. Respondent testified that his
conversation with Mr. Gonzales lasted approximately fifteen minutes.
Id. at 30; RD, at 9. Respondent admitted that during the conversation
he offered Mr. Gonzales: $20 for patients who had their teeth cleaned;
$40 for patients who had sealants put on their teeth; $50 for patients
for who received three to four fillings; and $100 for patients who
received six or more fillings. Tr. 75-78; GX 5, at 5; RD, at 9. In
addition, Respondent warned Mr. Gonzales not to tell anyone about
getting paid for bringing patients. Tr. at 75-78.
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\8\ Respondent repeatedly testified that Mr. Gonzales
misunderstood what he had said. He testified that ``[t]he
conversation was in general about just marketing'' and that Mr.
Gonzales put his words together in a way that made it seem like
Respondent was offering to pay for patients. Tr. 78-79. Respondent
testified that what he really meant was: ``when I say I spent $80 on
a patient, like if you put an ad in the newspaper . . . let's say
you spent $1,000, and you got, like, maybe 10 patients or 12
patients, roughly, you're spending about $80 per patient.'' Tr. 30.
At one point, Respondent testified, Mr. Gonzales was ``talking to me
and--and trying to trick my tongue in saying things like, wrong.''
Tr. 69. I agree with the ALJ that ``[i]n comparing [Respondent's]
testimony on direct examination about his conversation with the
undercover agent with the detailed facts contained in Government
Exhibit 5, I do not find it credible that the agent misunderstood
what [Respondent] had said.'' RD, at 5. Ultimately, whether
Respondent intended to get patients from Mr. Gonzales for a fee or
the conversation was in fact a misunderstanding is irrelevant to
determining whether or not Respondent was excluded from
participation in Medicare, Medicaid, or other Federal health care
program. However, the mitigation of his crime is relevant to his
acceptance of responsibility. See infra IV.
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At times, Respondent appeared to accept responsibility for his
actions and acknowledge that what he did was wrong.\9\ Id. at 33, 39,
67-68, 79, 80-81.\10\ However, more frequently, Respondent clearly
denied doing anything wrong. See id. at 29, 31, 68-69, 76-78.
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\9\ Respondent's testimony where he accepted responsibility most
often was in response to a leading question from his attorney. See
Tr. 33, 67-68, 79, 80-81.
\10\ When asked by his attorney what caused his conviction,
Respondent answered ``. . . that talking about--offering someone
money to refer you patients, that's considered a crime.'' Tr. 80.
I did not do anything. It's just like talking to this person.
But I--I felt bad because, you know, this happened to me. And I feel
like, sorry, and it's really, like, you know, the--the judgment on
[sic] the Court with the final decision will affect my life and my
practice and my family, you know. But I never gave him any money. I
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never gave any checks. He brought no patients to me at all.
Id. at 31. Respondent also testified that he was unfairly charged, that
he is innocent, and that the judgment was unfair. Id. at 56, 68. I
agree with the ALJ that ``it is obvious that during [Respondent's]
testimony on direct examination, he was downplaying his criminal
conduct.'' RD, at 5.
Respondent testified that because of his conversation with the
undercover agent he entered a nolo contendere plea in state court to a
misdemeanor charge of offering to pay for patients. Tr. 33, 35; RD, at
9-10. Respondent testified that he was sentenced to informal probation,
to perform 40 hours of community service, and to pay some minimal fees.
Tr. 33, 36-37; RD, at 10. He testified that he has satisfied the terms
of his probation. Tr. 37, 74; RD, at 10.
The ALJ found that Respondent generally presented his testimony in
a clear, candid, and convincing manner, but found that Respondent's
testimony lacked credibility on two points (see supra n.7 and n.8), and
was concerning or evasive on four other points.\11\ RD, at 4-5. I agree
with the ALJ and adopt all of his credibility findings in this matter.
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\11\ (1) Respondent neglected to mention in his testimony that
the Board had revoked his dental license and then stayed the
revocation, but Respondent had stipulated to that fact prior to the
hearing. RD, at 4. (2) Respondent's testimony regarding his
continuing education courses was evasive. RD, at 4-5. (3) Respondent
was reluctant to acknowledge that his agreement with the Board
stated that he was convicted of a felony. RD, at 5. (4) Respondent
claimed to not understand the ALJ's question when the ALJ asked him
why he pled nolo contendere instead of guilty. Id.
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D. Respondent's Exclusion
The evidence in the record demonstrates that on July 2, 2014,
Respondent signed a Superior Court of California, County of Orange,
General Misdemeanor \12\ Guilty Plea Form
[[Page 10356]]
(hereinafter, Plea Agreement). GX 3, at 1. In the Plea Agreement,
Respondent plead nolo contendere to the charge of violating Welfare and
Institution Code 14107.2(b) offering unlawful Medi-Cal remuneration. GX
3, at 1; Tr. 33; GX 5, at 5. Upon his conviction, Respondent's
sentencing terms stated: ``imposition . . . of sentence is suspended 3
years''; ``[i]nformal PROBATION as to Count(s) 1''; and ``[p]robation
to termination . . . upon 18 months no violation.'' GX 3, at 4-5.
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\12\ There is evidence in the record that Respondent plead nolo
contendere to and was convicted of a felony, not a misdemeanor. See
GX 5, at 5; Resp Prehearing, at 2; Resp Supp Prehearing, at 2. The
testimony at the hearing, however, clarified that Respondent was
originally charged with a felony violation, but ultimately plead
nolo contendere to and was convicted of a misdemeanor. Tr. 19, 35.
Ultimately whether he was convicted of a felony or a misdemeanor is
irrelevant to determining whether or not Respondent was excluded
from participation in Medicare, Medicaid, or other Federal health
care program, which is the grounds for revocation under the
Controlled Substances Act, and the record evidence clearly
demonstrates that he was so excluded.
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The parties stipulated that on September 30, 2015, Respondent was
notified by HHS/OIG of his mandatory exclusion from participation in
all federal health care programs for a minimum period of five years
pursuant to 42 U.S.C. 1320a-7(a). ALJX 9, at 2; GX 4 (hereinafter,
Exclusion Letter), at 1. The Exclusion Letter stated, ``[t]his
exclusion is due to your conviction . . . in the Superior Court of
California, County of Orange, of a criminal offense related to the
delivery of an item or service under the Medicare or a State health
care program, including the performance of management or administrative
services relating to the delivery of items or services, under any such
program.'' GX 4, at 1. The Exclusion Letter stated that the exclusion
would become effective twenty days from the date of the letter, and
notified Respondent of his appeal rights. Id.
Accordingly, I find that the HHS/OIG excluded Respondent from
Medicare, Medicaid, and all federal health care programs under 42
U.S.C. 1320a-7(a) for a minimum of five years effective twenty days
after September 30, 2015, based on Respondent's conviction.
III. Discussion
Under Section 824(a) of the Controlled Substances Act (hereinafter,
CSA), a registration ``may be suspended or revoked'' upon a finding of
one or more of five grounds. 21 U.S.C. 824. The ground in 21 U.S.C.
824(a)(5) requires that the registrant ``has been excluded (or directed
to be excluded) from participation in a program pursuant to section
1320a-7(a) of Title 42.'' Id. 42 U.S.C. 1320a-7(a) provides a list of
four predicate offenses for which exclusion from Medicare, Medicaid,
and federal health care programs is mandatory and sets out mandatory
timeframes for such exclusion. Id. The undisputed record evidence
demonstrates that HHS/OIG mandatorily excluded Respondent. GX 4, ALJX
9, at 2; RD, at 6.
Each subsection of Section 824(a) provides an independent and
adequate ground to impose a sanction on a registrant. Arnold E.
Feldman, M.D., 82 FR 39614, 39617 (2017)); see also Gilbert L.
Franklin, D.D.S., 57 FR 3441 (1992) (``[M]andatory exclusion from
participation in the Medicare program constitutes an independent ground
for revocation pursuant to 21 U.S.C. [Sec. ] 824(a)(5).'').
Further, this Agency has concluded repeatedly that the underlying
crime requiring exclusion from federal health care programs under
Section 1320a-7(a) of Title 42 does not require a nexus to controlled
substances in order to be used as a ground for revocation or suspension
of a registration. Narciso Reyes, M.D., 83 FR 61678, 61681 (2018); KK
Pharmacy, 64 FR at 49510 (collecting cases); Melvin N. Seglin, M.D., 63
FR 70431, 70433 (1998); Stanley Dubin, D.D.S., 61 FR 60727, 60728
(1996). In this case, HHS/OIG excluded Respondent due to his conviction
in state court related to the delivery of an item or service under a
state health care program, including the performance of management or
administrative services relating to the delivery of items or services
such as offering unlawful Medi-Cal remuneration. GX 4, at 1. ``There
does not need to be a nexus to controlled substances to make a
connection between the activity that caused the mandatory exclusion and
the potential for abuse of a DEA registration.'' Jeffrey Stein, M.D.,
84 FR 46968, 46972 (2019). Here, the crime of illegal remuneration does
not have a nexus to controlled substances; however the crime occurred
in the context of Respondent's medical practice, and Respondent knew
that paying per patient was illegal. Respondent's knowing deceit and
failure to credibly accept responsibility, as discussed below, weigh
against my ability to entrust Respondent with a registration and in
favor of revocation.
IV. Sanction
There is no dispute in the record that Respondent is mandatorily
excluded pursuant to Section 1320a-7(a) of Title 42 and, therefore, the
Government has met its prima facie burden of showing that a ground for
the revocation or suspension of Respondent's registration exists. GX 4,
ALJX 9, at 2; RD, at 6. Now, the burden shifts to the Respondent to
show why he can be entrusted with a registration. Garrett Howard Smith,
M.D., 83 FR 18882, 18910 (2018) (collecting cases).
The CSA authorizes the Attorney General to ``promulgate and enforce
any rules, regulations, and procedures which he may deem necessary and
appropriate for the efficient execution of his functions under this
subchapter.'' 21 U.S.C. 871(b). This authority specifically relates
``to `registration' and `control,' and `for the efficient execution of
his functions' under the statute.'' Gonzales v. Oregon, 546 U.S. 243,
259 (2006). A clear purpose of this authority is to ``bar[ ] doctors
from using their prescription-writing powers as a means to engage in
illicit drug dealing and trafficking.'' Id. at 270.
In efficiently executing the revocation and suspension authority
delegated to me under the CSA for the aforementioned purposes, I review
the evidence and arguments Respondent submitted to determine whether or
not he has presented ``sufficient mitigating evidence to assure the
Administrator that he can be trusted with the responsibility carried by
such a registration.'' Samuel S. Jackson, D.D.S., 72 FR 23848, 23853
(2007) (quoting Leo R. Miller, M.D., 53 FR 21931, 21932 (1988)). ``
`Moreover, because ``past performance is the best predictor of future
performance,'' ALRA Labs, Inc. v. DEA, 54 F.3d 450, 452 (7th Cir.
1995), [the Agency] has repeatedly held that where a registrant has
committed acts inconsistent with the public interest, the registrant
must accept responsibility for [the registrant's] actions and
demonstrate that [registrant] will not engage in future misconduct.' ''
Jayam Krishna-Iyer, 74 FR 459, 463 (2009) (quoting Medicine Shoppe, 73
FR 364, 387 (2008)); see also Jackson, 72 FR at 23853; John H.
Kennnedy, M.D., 71 FR 35705, 35709 (2006); Prince George Daniels,
D.D.S., 60 FR 62884, 62887 (1995).
While there are places in Respondent's testimony where he claims to
accept responsibility,\13\ I agree with the ALJ's statement that
``[Respondent's] acceptance of responsibility was, at best,
equivocal.'' RD, at 23. Ultimately I agree with the ALJ's finding
``that [Respondent] has not accepted responsibility for offering to pay
for patients.'' Id. Respondent testified repeatedly that he believed
that he did not do anything wrong--he was just talking to a person. Tr.
29, 31, 68-69, 76-78. Respondent also testified that he was unfairly
charged, that he is innocent, and that the judgment was unfair. Tr. 56,
68. Moreover, Respondent made statements that minimized his misconduct,
which weighs against finding that Respondent accepted
[[Page 10357]]
responsibility. See supra II.C; RD, at 21 (citing Arvinder Singh, M.D.,
81 FR 8247, 8249-51 (2016)); Stein, 84 FR 46973. Additionally,
Respondent plead nolo contendere instead of guilty to the charge of
offering unlawful Medi-Cal remuneration. GX 3. ``In general, however, a
plea of nolo contendere is inconsistent with the acceptance of
responsibility.'' RD, at 21 (citing United States v. Gordon, 979 F.
Supp. 337, 342 (E.D. Pa. 1997) (internal citations omitted)). Finding
that a respondent has failed to accept responsibility is warranted
where, as here, the respondent pled nolo contendere and minimized his
role in the crime. See Jeffery M. Freesemann, M.D., 76 FR 60873, 60888
(2011); see also RD, at 22.
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\13\ Respondent, in the opening statement, argued that ``he
certainly has done everything he could try to take responsibility
for this. . . .'' Tr. 14. I disagree.
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Respondent must convince the Administrator that his acceptance of
responsibility and remorse are sufficiently credible to demonstrate
that the misconduct will not recur. Respondent, in his opening
statement, argued that his testimony would show ``his genuine remorse .
. . .'' Tr. 14. But the record indicates that Respondent was not
remorseful for what he did; instead that he regretted the consequences
that flowed from his conviction.\14\ Id. at 31, 39, 68. This lack of
remorse goes hand-in-hand with Respondent's failure to accept
responsibility and further supports the revocation of his registration.
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\14\ For example, Respondent testified ``I really suffered going
through these things--something I didn't do . . . [I] lost most--
most of my patients, lost a lot of PPO insurances. I have to pay a
lot of employees, and so many things for something that happened--
someone faking like, you know, accusing you of doing something, but
there's no 100 percent proof.'' Tr. 68.
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In sanction determinations, the Agency has historically considered
its interest in deterring similar acts, both with respect to the
respondent in a particular case and the community of registrants. See
Joseph Gaudio, M.D., 74 FR 10083, 10095 (2009); Singh, 81 FR at 8248.
In this case, the Respondent knew at the time that he committed the
crime that his actions were illegal--he even told Mr. Gonzales that the
actions were illegal and advised him not to tell anyone. Deterring such
deceit and knowing criminal behavior both in Respondent and the general
registrant community is relevant to ensuring compliance with the CSA.
Although I would not characterize Respondent's underlying crime as
particularly egregious, Respondent has not convinced me that he will
not repeat such deceitful behavior in using his CSA registration.
Respondent has argued, among other things, that he can be entrusted
with a registration because he has seen over 15,000 patients in twenty
years and has never had any issues with prescribing, he has never had a
malpractice complaint, he is very mindful of the opioid crisis, and he
has satisfied the terms of his probation. Tr. 13-14, 37, 74. Even
assuming, arguendo, all of this to be true, Respondent needed to
present evidence of a credible and persuasive acceptance of
responsibility. Respondent has not.
Based on Respondent's failure to accept responsibility for his
criminal misconduct and lack of demonstrated remorse, I cannot find
that Respondent can be entrusted with a DEA registration; and
therefore, I find that revocation is the appropriate sanction
I will therefore order that Respondent's registration be revoked as
contained in the Order below.
Order
Pursuant to 28 CFR 0.100(b) and the authority vested in me by 21
U.S.C. 824(a), I hereby revoke DEA Certificate of Registration No.
BA6641472 issued to Ibrahim Al-Qawaqneh, D.D.S. This Order is effective
March 22, 2021.
D. Christopher Evans,
Acting Administrator.
[FR Doc. 2021-03360 Filed 2-18-21; 8:45 am]
BILLING CODE 4410-09-P