Prescription Fraud by Medical Professionals – California HSC 11153

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Defense for Medical Professionals Facing Drug Charges in Los Angeles

A prescription fraud charge under health and safety code 11153 is categorically different from a patient-level prescription fraud case. When a licensed medical professional is charged under this statute the consequences reach every dimension of their life simultaneously — criminal prosecution, mandatory licensing board referral, DEA registration revocation, and in many cases civil liability. Physicians, nurse practitioners, dentists, and other prescribers who face these charges need a Los Angeles prescription fraud attorney who understands both the criminal defense and the professional licensing dimensions of what they are facing. At The Law Offices of Arash Hashemi our criminal defense attorney has spent over 20 years defending clients against serious drug and fraud charges throughout Los Angeles County. Attorney Hashemi will personally review the prescription records the prosecution is relying on, analyze the medical justification for the prescribing conduct, and explain every defense available in your case. Contact our office today at (310) 448-1529 for a free confidential consultation.

Prescription Fraud by Medical Professionals Under California Law

California Health and Safety Code 11153 makes it a crime for a physician or other person authorized to prescribe controlled substances to prescribe a controlled substance that is not in good faith for a legitimate medical purpose and in the usual course of their professional practice. The statute targets prescribers rather than patients and it is the primary vehicle prosecutors use when investigating pill mills, overprescribing schemes, and cases where a licensed professional is alleged to have issued prescriptions outside the bounds of legitimate medical practice.

The good faith standard is what defines the line between aggressive but legitimate prescribing and criminal conduct under 11153 hs. A physician who prescribes controlled substances in good faith based on a genuine clinical assessment of the patient’s condition and needs is not criminally liable even when the prescribing pattern appears high volume or unconventional. The criminal liability arises when the prescribing had no legitimate medical basis and was issued for the prescriber’s financial gain or to facilitate drug diversion.

How These Cases Are Built Against Medical Professionals

Prescription fraud investigations targeting medical professionals in California are typically initiated through CURES data analysis, insurance fraud investigations, patient complaints, or referrals from the Medical Board of California. Law enforcement uses CURES prescription monitoring records to identify prescribing patterns that deviate significantly from community standards, search warrants to obtain patient files and billing records, undercover patient visits, and in some cases confidential informants who were patients at the practice.

By the time a physician or other prescriber is charged under health and safety code 11153 law enforcement has typically assembled months of prescription records, patient files, billing documentation, and in larger investigations recorded interactions with undercover patients. The investigation record is reviewed in full by our criminal defense attorney from the first consultation because understanding the complete scope of the alleged conduct and the evidence behind each alleged fraudulent prescription is essential to building an effective defense.

Elements of an HSC 11153 Charge

To secure a conviction the prosecution must prove beyond a reasonable doubt:

  • The defendant was a physician or other person authorized to prescribe controlled substances
  • The defendant prescribed a controlled substance to a patient
  • The prescription was not issued in good faith for a legitimate medical purpose
  • The prescription was not issued in the usual course of professional practice

The good faith and legitimate medical purpose elements are where virtually every 11153 hs defense is built. The prosecution must establish not only that the prescription was outside normal practice but that the defendant knew it lacked legitimate medical justification. When the defendant conducted a clinical examination, documented a medical history, and made a professional judgment that the controlled substance was appropriate for the patient the good faith defense is directly applicable even when other physicians might have prescribed differently.

Penalties for Prescription Fraud Under HSC 11153

The penalties for prescription fraud in California under this statute are serious and the criminal sentence is only part of what a convicted medical professional faces. A conviction under 11153 hs is a felony carrying 16 months, 2 years, or 3 years in state prison and fines up to $10,000. There is no misdemeanor option under this specific statute.

Beyond the criminal sentence a conviction triggers mandatory reporting to the Medical Board of California or the applicable licensing authority which initiates its own disciplinary proceedings. A felony drug conviction results in automatic DEA registration revocation eliminating the prescriber’s ability to prescribe controlled substances regardless of whether their medical license is separately revoked. For physicians employed by hospitals or health systems a conviction results in immediate termination and the loss of hospital privileges. For non-citizens a felony conviction triggers mandatory deportation proceedings.

The professional consequences of a conviction under health and safety code 11153 are in most cases more permanently damaging than the criminal sentence itself. A physician who has spent decades building a practice loses everything — the license, the DEA registration, the hospital privileges, and the professional reputation — the moment a conviction is entered.

Legal Defenses Against HSC 11153 Charges

The Prescriptions Were Issued in Good Faith

The most direct defense to a charge under this statute is establishing that the defendant genuinely believed the prescriptions were medically justified based on the clinical information available at the time. Our Los Angeles prescription fraud attorney works with independent medical experts to analyze each prescription at issue against the patient’s documented medical history, the clinical examination findings, and the standard of care applicable to the specific patient population. When the prescribing was consistent with a good faith clinical judgment the criminal intent required for a conviction cannot be established.

The Prescribing Was Within the Standard of Care

Pain management, addiction medicine, and other specialties that regularly involve controlled substance prescribing operate under standards that differ significantly from general practice. What appears to be overprescribing to a law enforcement agent or a general practitioner may be entirely consistent with the standard of care in a specialized practice. Our criminal defense attorney presents independent expert testimony from practitioners in the relevant specialty to establish that the prescribing conduct was within the applicable standard of care and therefore not outside the usual course of professional practice as required for a conviction.

The Investigation Was Constitutionally Defective

Search warrants executed at medical practices must comply with all constitutional requirements and must particularly describe the records and items to be seized. Patient records are subject to specific privacy protections under HIPAA and California law that affect how they can be obtained and used as evidence. When the search warrant was overbroad, when HIPAA procedures were not followed, or when the investigation relied on unlawfully obtained records our criminal defense attorney challenges the admissibility of that evidence through suppression motions filed at the earliest stage of the proceedings.

The Conduct Was Not Knowing or Intentional

Prescription fraud in California requires knowing and intentional conduct. When a prescriber relied on false information provided by a patient, when the prescriber was deceived about the patient’s medical history or prior prescriptions, or when the prescribing decision was based on a genuine clinical error rather than intentional fraud the knowledge and intent elements cannot be established. Our criminal defense attorney investigates the patient relationships behind each alleged fraudulent prescription and presents evidence of good faith reliance on patient representations when the facts support it.

Contact a Los Angeles Prescription Fraud Attorney Today

Attorney Arash Hashemi has defended clients against prescription fraud and serious drug charges throughout Los Angeles County for over 20 years. When you contact our office he will review the complete prescription record and investigation the prosecution is relying on, retain independent medical experts to analyze the good faith and standard of care issues specific to your practice, evaluate every constitutional challenge to the search and investigation, and give you an honest assessment of every defense available in your case. You work directly with Attorney Hashemi at every stage from the first consultation through resolution. Contact our office today for a free confidential consultation.

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We are conveniently located in the Westside Towers serving clients facing prescription fraud and serious drug charges across Los Angeles, Beverly Hills, Santa Monica, the San Fernando Valley, Long Beach, and all surrounding communities. Your defense starts the moment you call.