“Prescription Fraud” & “Doctor Shopping” Laws in California

In California, doctor shopping is defined as trying to obtain controlled substances you do not medically need by giving false information to healthcare providers or by hiding material facts from them. It is a type of prescription fraud prosecuted under Health & Safety Code Section 11173 HS.

Unsurprising, the opioid crisis has sparked an increase in patients lying to doctors – or going to multiple doctors – to get painkillers to feed their addiction.

You can be charged with doctor shopping whether you are fraudulently seeking:

• prescriptions for controlled substances,
• the administration of controlled substances, or
• the controlled substances themselves.

HS 11173 applies only to cases involving controlled substances, which are any drugs listed on the five classification schedules of federal and California drug laws. Examples include:

• Adderall
• Morphine
• Oxycontin
• Ritalin
• Vicodin
• Xanax

You can still be prosecuted under HS 11173 even if your physician realizes you are doctor shopping and refuses to write a prescription for you. All that matters is that you attempted to wrongfully get the drugs.¹

Examples of doctor shopping

• You lie to a doctor about being in chronic pain in order to get Hydrocodone, which you have grown dependent on following a back injury.
• You go to multiple primary care doctors to get the maximum allowed dosage of Ritalin, and you purposely conceal that you are getting the same prescription from other providers.
• You go to the ER lying about being in excruciating pain so that you will get administered Dilaudid.
• You give a false name, address, and other identifying information to a new doctor so that they cannot find your real file, which shows that your old doctor in the same practice refused to prescribe the Oxycontin you are asking for.
• After obtaining prescription Demerol by doctor shopping, you have a change of heart and refuse to pick up the drugs from the pharmacy: You could still be charged merely for obtaining the prescription.

Penalties for doctor shopping

HS 11173 violations are wobblers, which means the prosecutor can charge it as a misdemeanor or a felony depending on;

• the facts of the case, and
• your criminal record.

If you are arrested for doctor shopping, it is important you contact us right away before charges get filed. Through a process called “prefile intervention,” we can contact the prosecutors ahead of time to persuade them to bring misdemeanor rather than felony charges.

In some cases, we may even be able to persuade the D.A. that their evidence is too weak to justify criminal charges, and they may agree to drop the matter altogether.

Note that you cannot get doctor shopping charges dismissed by doing rehab through a drug diversion program or Proposition 36.²

Doctor shopping is becoming more common as more people grow addicted to prescription painkillers.

Defenses to doctor shopping

Here at Shouse Law Group, we have represented literally thousands of people charged with California fraud crimes such as doctor shopping. In our experience, the following three defenses have proven very effective with prosecutors, judges, and juries.

There was no fraud

The key element of doctor shopping is that you knowingly tried to obtain drugs or a prescription through:

• deceit,
• misrepresentation,
• subterfuge, or
• concealment.

Claiming you acted without fraud is a strong defense because prosecutors have no way of knowing what was going on inside your head. For example, perhaps you genuinely forgot you already had a Xanax prescription from your old doctor when you asked your new doctor for a prescription.

Unless prosecutors can prove beyond a reasonable doubt you acted fraudulently, HS 11173 charges cannot stand.

You were entrapped

Undercover police are allowed to trick you, but they are not allowed to pressure you into committing a crime you were not predisposed to commit. If you would never have doctor-shopped but for the police’s pressure, you are an entrapment victim and should not be convicted.

The police performed an illegal search

If police failed to follow Fourth Amendment protocols when searching for evidence in your case, we can file a motion to suppress. This is where we ask the court to disregard all the evidence that the police uncovered through their illegal search (such as drugs).

If the judge agrees and suppresses the unlawfully-obtained evidence, the D.A. may be forced to drop your case for lack of proof.

Prescription fraud by doctors

Medical professionals commit prescription fraud in violation of Health & Safety Code 11153 HS when they knowingly write a prescription for a controlled substance that:

• is not issued for a legitimate medical purpose, and/or
• is not issued in the usual course of their professional practice.⁴

Examples include over-prescribing drugs or running a “pill mill” to sell prescriptions and refills “no questions asked.”

Prescription fraud by doctors carries the same penalties as doctor shopping. Plus, as with doctor shopping, the strongest defense is that the provider lacked criminal intent: For example, perhaps a nurse practitioner wrote an inaccurate prescription out of carelessness instead of on purpose.³

Related charges

• Counterfeiting a prescription pad – HS 11162.5
• Forging or altering a prescription – HS 11368
• Possession of a controlled substance – HS 11350
• Sale or transportation of a controlled substance – HS 11352

Among the most commonly “doctor shopped” drugs are Adderall, Codeine, Morphine, Oxycodone, Valium, Vicodin, and Xanax.

Additional reading

For more in-depth information, refer to the following scholarly articles:

• Health Information Technology and Doctor Shopping: A Systematic Review, Healthcare.
• Prescription Drug Monitoring Programs, a Response to Doctor Shopping: Purpose, Effectiveness, and Directions for Future Research – Issues in Mental Health Nursing.
• Doctor Shopping: A Concept Analysis – Research and Theory for Nursing Practice.
• Doctor Shopping Behavior and the Diversion of Prescription Opioids – Substance Use: Research and Treatment.
• Deception for Drugs: Self-Reported “Doctor Shopping” Among Young Adults – Journal of the American Board of Family Medicine.
• “Doctor and pharmacy shopping”: A fading signal for prescription opioid use monitoring? – Drug and Alcohol Dependence.
• Doctor and Pharmacy Shopping for Controlled Substances – Medical Care.