Federal Register / Vol. 85, No. 249 / Tuesday, December 29, 2020 / Notices 85667 

According to the New York 

Controlled Substances Act (hereinafter, 

the Act), ‘‘[i]t shall be unlawful for any 

person to manufacture, sell, prescribe, 

distribute, dispense, administer, 

possess, have under his control, 

abandon, or transport a controlled 

substance except as expressly allowed 

by this article.’’ N.Y. Pub. Health Law 

§ 3304 (West 2020). The Act defines 

‘‘practitioner,’’ as ‘‘a physician . . . or 

other person licensed, or otherwise 

permitted to dispense, administer, or 

conduct research with respect to a 

controlled substance in the course of a 

licensed professional practice. . . .’’ Id. 

at § 3302(29). Finally, New York 

regulations state that ‘‘[a] prescription 

for a controlled substance may be issued 

only by a practitioner who is . . . 

authorized to prescribe controlled 

substances pursuant to his licensed 

professional practice . . .’’ N.Y. Comp. 

Codes R. & Regs. Tit. 10, § 80.64 (West 

2020). 

Here, the undisputed evidence in the 

record is that Registrant currently lacks 

authority to practice medicine in New 

York. As already discussed, a physician 

must be a licensed practitioner to 

dispense a controlled substance in New 

York. Thus, because Registrant lacks 

authority to practice medicine in New 

York and, therefore, is not authorized to 

handle controlled substances in New 

York, Registrant is not eligible to 

maintain a DEA registration. 

Accordingly, I will order that 

Registrant’s DEA registration be 

revoked. 

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. BG6075875 issued to 

Irene G. Gurvits, M.D. Further, pursuant 

to 28 CFR 0.100(b) and the authority 

vested in me by 21 U.S.C. 823(f), I 

hereby deny any pending application of 

Irene G. Gurvits, M.D. to renew or 

modify this registration or for any other 

registrations in the State of New York. 

This Order is effective January 28, 2021. 

Timothy J. Shea, 

Acting Administrator. 

[FR Doc. 2020–28683 Filed 12–28–20; 8:45 am] 

BILLING CODE 4410–09–P 

DEPARTMENT OF JUSTICE 

Drug Enforcement Administration 

[Docket No. 18–33] 

Steven M. Kotsonis, M.D.; Order 

On May 3, 2018, the Assistant 

Administrator, Office of Diversion 

Control, Drug Enforcement 

Administration (hereinafter, DEA or 

Government) issued an Order to Show 

Cause (hereinafter, OSC) to Steven M. 

Kotsonis, M.D. (hereinafter, 

Respondent), which sought to revoke 

Respondent’s DEA Certificate of 

Registration FK1584336 and to deny any 

pending applications for renewals or 

modifications of such registration, based 

on its contention that his continued 

registration is inconsistent with the 

public interest. Administrative Law 

Judge Exhibit (ALJX) 1 (OSC). In 

response to the OSC, Respondent 

submitted a timely request for a hearing, 

which was held from August 14–17, 

2018. On October 23, 2018, Chief 

Administrative Law Judge John J. 

Mulrooney, II issued a Recommended 

Rulings, Findings of Fact, Conclusions 

of Law, and Decision of the 

Administrative Law Judge (hereinafter, 

Recommended Decision), which 

recommended that I revoke 

Respondent’s registration and that I 

deny any pending application for 

renewal. Respondent filed Exceptions to 

the Recommended Decision, and the 

record was forwarded to me for final 

Agency action on November 26, 2018. 

After reviewing the record, I learned 

that Respondent had surrendered his 

DEA registration on December 23, 2019. 

I issued an Order on September 25, 

2020, requiring the Government to 

produce documentation of Respondent’s 

surrender of his registration. The Order 

further instructed the parties to file a 

Request for Dismissal ‘‘if it is the intent 

of [the] party to rely on Respondent’s 

voluntary surrender of his registration to 

terminate this proceeding’’ or a brief on 

the issue ‘‘if [the] party opposes the 

dismissal of this proceeding prior to the 

issuance of my Decision on the 

Government’s allegation in the OSC.’’ 

Both parties filed timely responses. 

Respondent filed a Request for 

Dismissal on October 15, 2020. As 

grounds for the dismissal, Respondent 

stated that, ‘‘upon DEA request, he 

voluntarily surrendered his DEA 

registration on December 23, 2019.’’ 

Respondent Request for Dismissal. 

The Government submitted a 

response to my September 25 Order on 

October 23, 2020 (hereinafter, the 

Government Response). As required by 

my September 25 Order, the 

Government submitted a copy of the 

Voluntary Surrender of Controlled 

Substances Privileges form, DEA–104, 

signed by Respondent surrendering DEA 

Registration No. FK1584336. The 

Government stated that Respondent 

voluntarily surrendered his DEA 

registration following a guilty plea to 

felony criminal drug charges in a 

criminal matter concurrent to the 

instant matter. Government Response at 

2. The Government Response neither 

requested that I dismiss this matter nor 

that I file a final Decision on the 

allegations it made in the OSC. Rather, 

the Government provided legal 

arguments regarding why Respondent’s 

voluntary surrender of his registration 

did not preclude me from issuing a final 

Decision. Id. at 2–3. The Government 

then concluded its Response stating that 

I ‘‘should issue whatever order is 

appropriate in light of the 

administrative record presented.’’ Id. at 

3. 

Based upon my review of the parties’ 

submissions, the record, and public 

documents from Respondent’s criminal 

case, I am granting Respondent’s 

Request for Dismissal. 

Facts 

Respondent was registered with DEA 

as a practitioner in schedules II through 

V under Certificate of Registration No. 

FK1584336, at the registered address of 

347 Park Ave., Pewaukee, Wisconsin 

53702. OSC at 1. In its OSC, the 

Government contended that 

Respondent’s registration was 

inconsistent with the public interest and 

should be revoked because Respondent 

failed to comply with applicable federal 

law relating to controlled substances. Id. 

at 1–2. Specifically, the OSC alleged 

that Respondent issued prescriptions for 

controlled substances outside the usual 

course of professional practice and not 

for a legitimate medical purpose, in 

violation of 21 CFR 1306.04(a). Id. at 2. 

On December 23, 2019, Respondent 

voluntarily surrendered his DEA 

registration. Government Response, 

Attachment 1 (DEA Form 104 signed by 

Respondent). In his surrender form, 

Respondent affirmed that he was 

voluntarily surrendering his registration 

for cause ‘‘[i]n view of [his] alleged 

failure to comply with the Federal 

requirements pertaining to controlled 

substances.’’ Id. Respondent also 

acknowledged that submitting the form 

to DEA would result in the immediate 

termination of his registration. Id. 

The Government stated in its 

Response that Respondent surrendered 

his DEA registration ‘‘following a guilty 

plea to felony criminal drug charges in 

[a] concurrent criminal matter.’’ 


KHAMMOND on DSKJM1Z7X2PROD with NOTICES
85668 Federal Register / Vol. 85, No. 249 / Tuesday, December 29, 2020 / Notices 

1 I am taking official notice of the docket and two 

documents from Respondent’s criminal matter, the 

Plea Agreement and the Judgment. Kotsonis, No. 

2:16–cr–92. 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 of 

finding of fact within fifteen 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 fifteen calendar days to file a response. Any 

such motion and response may be filed and served 

by email (dea.addo.attorneys@dea.usdoj.gov). 

2Respondent admitted that the facts in 

Attachment A are true and ‘‘establish his guilt 

beyond a reasonable doubt.’’ Plea Agreement, at 2, 

Kotsonis, No. 2:16–cr–92. 

3Oxycodone is a schedule II controlled 

substance. 21 CFR 1308.12(1). 

Government Response, at 1–2. 

According to the publicly available 

records from the Respondent’s 

concurrent criminal matter, U.S. v. 

Steven M. Kotsonis, No. 2:16–CR–92 

(E.D. Wis. filed July 21, 2016), 

Respondent was criminally indicted on 

June 21, 2016, on twenty counts alleging 

violations of the Controlled Substances 

Act, specifically 21 U.S.C. 841(a)(1), 

(b)(1)(C), and 846.1 Respondent pled 

guilty to one count, Count 17, of the 

indictment for ‘‘dispensing unlawfully a 

controlled substance outside a 

professional medical practice and not 

for a legitimate medical purpose’’ in 

violation of 21 U.S.C. 841(a)(1) and 

(b)(1)(C). Judgment, at 1, Kotsonis, No. 

2:16–cr–92. 

Attachment A of the Plea Agreement, 

which I have attached to this Order, 

provides a narrative of the factual basis 

for Respondent’s guilty plea.2 Plea 

Agreement, at 13–15, Kotsonis, No. 

2:16–cr–92. In brief summary, 

Respondent admitted that the clinic he 

co-owned, and at which he was the 

exclusive health care provider, only 

accepted cash, that individuals payed 

$200 to $350 in cash to obtain a 

prescription, that ‘‘[p]rescriptions were 

written for large quantities of 

Oxycodone, particularly Oxycodone 30 

mg (average of 150–180 tablets per 

month), along with other narcotic 

medications commonly prescribed for 

pain relief such as amphetamine and 

morphine,’’ 3 and that ‘‘[i]ndividuals 

frequently obtaine[ed] prescriptions at 

[his clinic] without being examined or 

having their vitals (height, weight, blood 

pressure) taken during the visit.’’ Id. at 

13. Respondent also admitted to signing 

controlled substance prescriptions 

prepared by his office manager, who 

was not a licensed health care provider, 

without examining the patients or 

reviewing the patients’ files. Id. at 13 

and 15. In regard to the specific count 

to which Respondent pled guilty, Count 

17 of the indictment, Respondent 

admitted that on January 31, 2013, he 

signed a prescription for 90 tablets of 

Oxycodone 30 mg for ‘‘Patient D’’ that 

the clinic’s office manager prepared and 

that he did so without seeing Patient D. 

Id. at 14. When Patient D was 

interviewed regarding Respondent’s 

clinic, she stated that, despite having 

visited the clinic and received 

prescriptions for Oxycodone on four 

prior occasions, ‘‘she did not see 

[Respondent], did not have vitals taken, 

did not receive any type of medical 

exam, and did not submit a urine 

screening.’’ Id. at 13. 

Discussion 

DEA regulations promulgated 

pursuant to the authority delegated by 

the Controlled Substances Act (CSA) 

provide that ‘‘the registration of any 

person . . . shall terminate, without any 

further action by the Administration, if 

and when such person . . . surrenders 

a registration.’’ 21 CFR 1301.52. As 

Respondent surrendered his DEA 

registration on December 23, 2019, 

pursuant to the regulation, his 

registration terminated on the day of his 

surrender, and Respondent is no longer 

authorized to dispense controlled 

substances under federal law. 

The termination of Respondent’s 

registration, however, does not 

automatically terminate this proceeding. 

Although factually distinct from 

registrations terminated through a 

voluntary surrender, DEA has issued 

final decisions revoking registrations 

subsequent to their expirations, and the 

legal reasoning for the Agency’s ability 

to issue decisions in those matters is 

applicable here. As my predecessor 

explained in Jeffrey Olsen, M.D., in 

which he ordered the revocation of an 

expired registration, ‘‘mootness does not 

play the same role in administrative 

agency adjudications as it plays in 

Article III court proceedings’’ and 

‘‘ ‘[t]he agency, with like effect as in the 

case of other orders, and in its sound 

discretion, may issue a declaratory order 

to terminate a controversy or remove 

uncertainty.’ ’’ 84 FR 68,474, 68,478 

(2019) (quoting Tennessee Gas Pipeline 

v. Federal Power Comm’n, 606 F.2d 

1373, 1380 (D.C. Cir. 1979); 5 U.S.C. 

554(e)); see also Climax Molybdenum 

Co. v. Sec’y of Labor, Mine Safety and 

Health Admin., 703 F.2d 447, 451 (10th 

Cir. 1983) (‘‘At the outset, we note that 

an administrative agency is not bound 

by the constitutional requirement of a 

‘case or controversy’ that limits the 

authority of [A]rticle III courts to rule on 

moot issues.’’). DEA is therefore not 

precluded from issuing a final decision 

revoking a registration that was 

voluntarily surrendered even though 

that registration is terminated. 

As my predecessor identified in 

Olsen, 

[F]inal adjudications are particularly helpful 

in supporting the purposes of the CSA and 

my responsibilities to enforce the CSA 

because nothing in the CSA prohibits an 

individual or an entity from applying for a 

registration even when there is a history of 

being denied a registration, or a history of 

having a registration suspended or revoked. 

As such, having a final, official record of 

allegations, evidence, and the 

Administrator’s decisions regarding those 

allegations and evidence, assists and 

supports future interactions between the 

Agency and the registrant or applicant. 

84 FR at 68,479. As additionally noted 

in Olsen, ‘‘a final adjudication is a 

public record of the Agency’s 

expectations for current and prospective 

members of that community.’’ Id. Final 

adjudications also provide continuing 

education for all DEA personnel and 

help coordinate law enforcement efforts. 

Id. Finally, final adjudications inform 

stakeholders, such as legislators and the 

public, about the Agency’s work and 

allows them to provide feedback to the 

Agency, thereby helping shape how the 

Agency carries out its responsibilities 

under the CSA. Id. 

Since Olsen was decided, the Agency 

has universally issued final 

adjudications in cases where a 

registration expired while a proceeding 

to revoke the registration was pending 

before the Administrator. See, e.g., 

Salvatore Cavaliere, D.O., 85 FR 45,657 

(2020); Jaime C. David, M.D., 85 FR 

10,462 (2020); Jeanne E. Germeil, M.D., 

85 FR 73,786 (2020). I recognize, 

however, that a voluntary surrender for 

cause of a registration that is executed 

while the matter is pending before the 

Administrator can be distinct from the 

expiration of a registration, depending 

on the circumstances particular to a 

matter, and that the aforementioned 

benefits obtained by a final Agency 

adjudication could be diminished by 

those circumstances. I also recognize 

that the voluntary surrender for cause is 

an essential tool in preserving Agency 

enforcement resources and in 

preventing the misuse of a registration 

during the pending enforcement action. 

However, it would be contrary to my 

duties under the CSA to allow the 

usurpation of the Agency’s enforcement 

mission by permitting the unilateral 


KHAMMOND on DSKJM1Z7X2PROD with NOTICES
Federal Register / Vol. 85, No. 249 / Tuesday, December 29, 2020 / Notices 85669 

execution of a voluntary surrender for 

cause by a registrant after the registrant 

has availed himself of the hearing 

process and, particularly where he 

obtained an unfavorable 

recommendation from an 

Administrative Law Judge; and 

therefore, I find that it is most 

reasonable to assess whether to 

adjudicate particular matters to finality 

based on the particular circumstances 

presented by the matters. 

Based on my evaluation of the record 

in this matter, I have decided that the 

benefits to issuing a final adjudication 

in this matter are diminished by the 

particular circumstances, and as such, I 

am dismissing this matter. Here, 

Respondent voluntarily surrendered his 

registration for cause concurrent with 

his guilty plea to a felony, thereby 

acknowledging that the surrender was 

‘‘[i]n view of [his] alleged failure to 

comply with the Federal requirements 

pertaining to controlled substances.’’ 

Government Response, Attach. 1. The 

Judgment from Respondent’s concurrent 

criminal case provides a record of 

Respondent’s criminal violation of the 

CSA for issuing a prescription for a 

controlled substance outside the usual 

course of professional practice and 

without a legitimate medical purpose, 

and the Plea Agreement provides an 

official record of the details of 

Respondent’s criminal violation. I find 

that these records provide many of the 

same benefits that a final Decision 

would provide in this matter—they will 

assist and support any future 

interactions between the Agency and 

Respondent including by providing the 

Agency with facts that may be relevant 

should Respondent re-apply for a 

registration in the future; they provide 

a public record regarding the Agency’s 

expectations of registrants; they inform 

stakeholders about the Agency’s work; 

and they enable me to allocate Agency 

resources efficiently and effectively. 

Accordingly, I find that it is in the 

Agency’s interest to dismiss this matter 

without my issuing a final Decision on 

the Government’s request to revoke 

Respondent’s registration, and I will 

grant Respondent’s Request for 

Dismissal. 

My decision to dismiss this matter 

should not be interpreted as applying 

unilaterally to all matters seeking 

revocation of a registration in which a 

registrant surrenders their license while 

the matter is pending before me. The 

Agency expends considerable resources 

investigating and adjudicating these 

matters, not every matter will have such 

a robust record absent a final 

adjudication, and each matter is unique. 

I will, therefore, continue to evaluate 

such matters on a case-by-case basis to 

determine if a final adjudication is 

warranted. 

Order 

Pursuant to 28 CFR 0.100(b) and the 

authority vested in me by 21 U.S.C. 824, 

I hereby dismiss the Order to Show 

Cause issued to Steven M. Kotsonis, 

M.D. This Order is effective 

immediately. 

Timothy J. Shea, 

Acting Administrator. 

Attachment A 

This investigation began in 2012 and 

arose in connection with the 

investigation of Dr. Beaver who 

operated Beaver Medical Clinic. In April 

of 2012, Dr. Beaver voluntarily 

surrendered his DEA registration for 

cause based upon allegations of 

improper prescribing of controlled 

substances and Dr. Beaver’s Wisconsin 

medical license was limited to preclude 

him from prescribing controlled 

substances. In May of 2012, Dr. Kotsonis 

began working at Beaver Medical Clinic 

and DEA Investigators met with 

Kotsonis to notify him of DEA’s 

concerns that narcotics prescribed at 

Beaver Medical Clinic were frequently 

being sold by patients. During this 

meeting, Kotsonis acknowledged that 

Moyer, who was the office manager at 

Beaver Medical Clinic at the time, 

sometimes prepared prescriptions for 

him, and he agreed with Investigators 

when they suggested that Kotsonis 

himself should prepare the 

prescriptions. 

Sometime prior to December of 2012, 

Kotsonis relocated his practice to 10721 

W Capitol Drive, Office G103, 

Wauwatosa, Wisconsin, and changed 

the name of the practice to 

Compassionate Care Clinic. Moyer 

continued to work for Kotsonis as the 

officer manager of the Compassionate 

Care Clinic (‘‘Compassionate’’) and also, 

at some point, became the co-owner of 

Compassionate. Moyer is not a licensed 

health care provider and there are no 

other licensed physicians, nurses, or 

other health care providers working at 

Compassionate aside from Kotsonis. 

The investigation of Compassionate 

has revealed that only cash is accepted 

and individuals pay $200 to $350 in 

cash to obtain a prescription. 

Prescriptions are written for large 

quantities of Oxycodone, particularly 

Oxycodone 30mg (average of 150–180 

tablets per month), along with other 

narcotic medications commonly 

prescribed for pain relief such as 

amphetamine and morphine. Moyer 

typically fills out the prescriptions and 

has Kotsonis sign the prescriptions 

without Kotsonis actually seeing the 

individual patient. Individuals 

frequently obtain prescriptions at 

Compassionate without being examined 

or having their vitals (height, weight, 

blood pressure) taken during their visit. 

For example, in January 2013, CS #1 

a/k/a Patient ‘‘D,’’ was interviewed 

regarding Compassionate. CS #1 stated 

that she was brought to Compassionate 

by her friend, who was addicted to 

Oxycodone, and CS #1 was introduced 

to Moyer by her friend as a new patient. 

CS #1 stated that she visited 

Compassionate on approximately 4 

occasions and CS #1’s friend went with 

her on every occasion but one. CS #1’s 

friend paid for the appointment fee and 

in return received a portion of CS #1’s 

pills. CS #1’s friend also brought other 

individuals to Compassionate to obtain 

Oxycodone prescriptions. CS #1 

provided MRI’s regarding back issues 

from 2006 to 2008 to Moyer and was 

accepted as a patient. CS #1 stated that 

she received prescriptions ranging from 

150–210 tablets of Oxycodone 30 mg at 

each of her visits to Compassionate. 

During the visits CS #1 did not see 

Kotsonis, did not have vitals taken, did 

not receive any type of medical exam, 

and did not submit a urine screening. 

CS #1 received prescriptions from 

Moyer, who prepared the prescriptions 

and took the prescriptions to Kotsonis 

for signature. During the visits, Moyer 

asked CS #1 a few questions about pain 

and CS #1 stated she had back pain. CS 

#1 filled out a form regarding pain 

during each visit. On one occasion CS 

#1 and her friend went to a visit early 

and said they were driving to Florida. 

Moyer asked what they were prescribed 

last time and CS #1 said 180 tablets of 

Oxycodone 30mg. Moyer told CS #1 that 

she would write the prescription for 210 

tablets because of the long drive to 

Florida. Moyer wrote the prescriptions 

out in the waiting room because they 

were already signed by Kotsonis. CS #1 

stated that during the visits she 

witnessed Moyer take the patient signin sheet, write the individuals’ names 

and dates of birth on the prescriptions 

(sometimes written in the waiting room) 

and take the stack of prescriptions to 

Kotsonis’s office for signature. Moyer 

then saw the individuals and wrote the 

quantities on the prescription. The 

waiting room was always full with 

approximately 15 individuals in the 

waiting room and approximately 5 

individuals waiting outside the waiting 

room in the hallway. 

Count Seventeen: On January 31, 

2013, CS #1 and an undercover agent 

(UC #1) visited Compassionate and this 

visit is audio and video recorded. 


KHAMMOND on DSKJM1Z7X2PROD with NOTICES
85670 Federal Register / Vol. 85, No. 249 / Tuesday, December 29, 2020 / Notices 

During the visit, CS #1 filled out a twopage pain form and CS #1 and UC #1 

signed in on the patient sign-in sheet. 

During the visit, Moyer stood next to the 

patient sign-in sheet and wrote down 

names on a prescription pad from the 

sign-in sheet and she asked some of the 

individuals for their date of birth and 

which drug they were prescribed. Moyer 

entered Kotsonis’s office carrying the 

handwritten prescriptions and exited 

minutes later. The individuals were 

provided prescriptions and many did 

not see Kotsonis. During the visit, 

Moyer called CS #1 and UC #1 into her 

office. UC #1 did not see any medical 

equipment in the office. Moyer asked CS 

#1 to tell the truth about her current 

criminal charges. Moyer said she would 

have to cut CS #1 loose but would give 

CS #1 a prescription. Moyer said DEA 

would say what kind of people CS #1 

was hanging out with and then ‘‘bye bye 

clinic, bye bye license, bye bye Dr. 

Steve’s career’’ because DEA would go 

after the doctor. Moyer said if CS #1’s 

criminal charges were dropped she 

could come back to the clinic. Moyer 

said CS #1’s friend (who referred CS #1 

to the clinic) was dumb because he sold 

pills to an undercover cop. Moyer asked 

CS #1 for her name and date of birth and 

wrote CS #1 a prescription for 90 tablets 

of Oxycodone 30mg, which Moyer took 

to Kotsonis to sign. CS #1 paid Moyer 

$200 cash for the visit. Moyer asked CS 

#1 if she knew what people called 

Moyer. CS #1 said no and Moyer 

responded ‘‘The Oxy Czar.’’ ‘‘They call 

me the gestapo because if you screw up 

the world will stop, so don’t screw up.’’ 

Moyer then continued to fill out 

additional prescriptions. 

CS #1 asked Moyer if UC #1 could be 

accepted as a patient and she said 

everyone who came with CS #1 would 

have to be rescreened (because of CS 

#1’s criminal charges). Moyer then 

looked over the MRIs provided by UC 

#1 and said the second MRI looked a 

little better than the first. Moyer said 

she would show the MRIs to the doctor. 

Moyer opened her desk drawer and 

pulled out a handful of prescriptions, 

papers, and cash, then put everything 

back in the drawer and said ‘‘This is a 

nasty little business we’re in.’’ Moyer 

then said ‘‘I own this clinic now, and I 

don’t have to be nice. I don’t have to let 

just anybody in neither. It’s my clinic, 

me and the doctor’s clinic, I don’t have 

to let anybody in. And I won’t, if I think 

they’re a problem. No way, why would 

I? Are you kidding? This is a big 

business here.’’ She told UC #1 that the 

first office visit was $350 and UC #1 

could come alone next time and asked 

him/her to bring prescription records. 

UC #1 was given a longer version of the 

pain form provided to CS #1 earlier in 

the visit to bring back with her to the 

next visit. Moyer exited her office, 

called out CS #1’s name along with five 

other names and said she would get the 

prescriptions signed. Moyer then 

entered Kotsonis’s office and 

approximately four minutes later she 

exited Kotsonis’s office and handed out 

the prescriptions. CS #1 and UC #1 then 

made their next appointment with the 

receptionist. 

On July 23, 2013, a search warrant 

was executed at Compassionate Care 

Clinic and Kotsonis’ patient files were 

seized along with other evidence. 

Patient files, computers, Moyer’s 

cellphone and pre-signed prescriptions 

(containing the doctor’s signature only), 

filled out prescriptions without 

signature and ripped up prescriptions 

were recovered from Moyer’s office. 

Agents also recovered a letter from 

Costco refusing to fill Dr. Kotsonis’ 

prescriptions and an Express Scripts 

letter regarding excessive medication 

prescribed to a patient as well as 

prefilled out monthly evaluation notes. 

Agents observed minimal medical 

equipment in the clinic. During the 

execution of the search warrant 

Kotsonis agreed to be interviewed and 

was advised he was not under arrest. 

Kotosnis admitted to allowing Moyer to 

prepare prescriptions that he 

subsequently signs and said she brings 

in prescriptions 3–4 patients at a time 

and that he trusts Moyer’s advice on 

what medication should be prescribed 

and generally agrees with her. Kotsonis 

stated most of the time he verifies what 

prescription the patient is receiving. He 

stated that if Moyer does not bring the 

patient file to his office with the 

prescription to verify he trusts what she 

says the patient is receiving. Kotsonis 

estimated 20–25 patients per day are 

follow up patients and Moyer brings 10– 

12 patient charts to Kotsonis a day and 

Kotsonis actually sees and examines 1– 

2 patients per day. Moyer was also 

interviewed and stated the she and 

Kotsonis discuss patients but he 

determines what to prescribe. She stated 

she writes out prescriptions before the 

patients are seen based upon their last 

prescription but does not write down a 

quantity. 

[FR Doc. 2020–28676 Filed 12–28–20; 8:45 am] 

BILLING CODE P 

DEPARTMENT OF JUSTICE 

Drug Enforcement Administration 

Annamalai Ashokan, M.D.; Decision 

and Order 

On June 1, 2020, the Assistant 

Administrator, Diversion Control 

Division, Drug Enforcement 

Administration (hereinafter, 

Government), issued an Order to Show 

Cause (hereinafter, OSC) to Annamalai 

Ashokan, M.D. (hereinafter, Registrant). 

OSC, at 1. The OSC proposed the 

revocation of Registrant’s Certificate of 

Registration No. BA0859174. Id. It 

alleged that Registrant is without 

‘‘authority to handle controlled 

substances in the State of California, the 

state in which [Registrant is] registered 

with the DEA.’’ Id. at 1–2 (citing 21 

U.S.C. 824(a)(3)). 

Specifically, the OSC alleged that 

Registrant surrendered his medical 

license pursuant to an agreement he 

entered into with the Medical Board of 

California on November 12, 2019, and 

that his license remains surrendered. Id. 

at 1–2. The OSC further alleged that 

because Registrant surrendered his 

medical license, Registrant lacks the 

authority to handle controlled 

substances in the State of California. Id. 

at 2. 

The OSC notified Registrant 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. (citing 

21 CFR 1301.43). The OSC also notified 

Registrant of the opportunity to submit 

a corrective action plan. Id. at 3 (citing 

21 U.S.C. 824(c)(2)(C)). 

On June 4, 2020, a DEA Diversion 

Investigator placed a copy of the OSC 

addressed to the Registrant in his 

‘‘office’s outgoing mail pickup box for 

pickup by DEA mailroom staff that day. 

The letter would have been placed in 

the United States mail by DEA’s 

mailroom staff no later than the 

following day, June 5, 2020.’’ Request 

for Final Agency Action (hereinafter, 

RFAA) Exhibit (hereinafter, RFAAX) 4, 

at 1 (Declaration of Diversion 

Investigator). Registrant’s attorney sent a 

letter, dated July 22, 2020, to the 

Assistant Administrator, Diversion 

Control Division, stating that Registrant 

had surrendered his medical license and 

that ‘‘he hereby waives his right to a 

hearing on this matter.’’ RFAAX 5 

(Letter from Registrant’s Attorney), at 1. 

I find that more than thirty days have 

now passed since the Government 

accomplished service of the OSC. 


KHAMMOND on DSKJM1Z7X2PROD with NOTICES