Incident 40118

The Drug Enforcement Administration Special Agent in Charge Robert J. Bell of the Chicago Field Division, and the United States Attorney Scott C. Blader announced that Clifford T. Bowe, M.D., a retired Cadott, Wisconsin physician, entered into a settlement agreement to pay $70,000 to resolve civil allegations that he violated the Controlled Substances Act (CSA) relating to his prescribing of controlled substances, including opioids, outside the usual course of professional practice, among other CSA violations.

Dr. Bowe owned and operated Cadott Medical Center (CMC) in Cadott. A majority of his patients went to CMC because they were suffering from opioid use disorder and other addictions. Dr. Bowe had received authorization to treat up to 100 opioid dependent patients for opioid use disorder with medication-assisted treatments, such as the FDA-approved Schedule III drug, buprenorphine (Suboxone). Buprenorphine, a partial opioid agonist, blocks the opiate receptors and reduces an individual’s urges to use opioids. According to the government’s allegations set forth in the settlement agreement, Dr. Bowe not only improperly prescribed buprenorphine along with other potent opioids, but he also counseled patients on how to fill these improper simultaneous prescriptions so as to avoid rejection by pharmacies or insurance payers. Moreover, the government alleged that Dr. Bowe prescribed Schedule II opioids to treat opioid use disorder, which is prohibited by CSA regulations.

According to the settlement agreement, the government alleged that Dr. Bowe also violated the CSA by prescribing emergency Schedule II controlled substances to a family member that failed to meet the regulatory requirements for such prescribing; by providing inaccurate directions for use on controlled substance prescriptions to maneuver-around pharmacies refusing to fill compounded prescriptions or insurance companies denying payment for such prescriptions; and by failing to maintain records regarding the receipt and dispensing of controlled substances, or to maintain an inventory of controlled substances on-hand at CMC. Dr. Bowe denies these allegations.

In enacting the CSA, Congress recognized the importance of preventing the diversion of drugs from legitimate to illegitimate uses. The CSA, in relevant part, deters the illegal distribution, possession, dispensing, and improper use of controlled substances, all of which have contributed significantly to the opioid epidemic over the past two decades. The CSA therefore regulates entities and practitioners that dispense controlled substances by establishing controls over all stages of the chain of distribution of controlled substances in the United States.

“Physicians who prescribe controlled substances, including opioids, outside the usual course of professional practice, abuse their prescription-writing privileges and contribute to the opioid crisis,” said United States Attorney Blader. “Controlled substance prescribing violations, in addition to the critical recordkeeping of controlled substances to ensure the system remains closed, will result in enforcement action in the Western District of Wisconsin.”

“DEA will continue to pursue civil actions against any registrant that violates the Controlled Substances Act by practicing outside of professional medical practice and issuing illegitimate controlled substance prescriptions. The overprescribing of opioids has played a large role in the national opioid addiction crisis that our country currently faces on a daily basis,” said DEA Milwaukee District Office Assistant Special Agent in Charge Paul E. Maxwell, Jr.

According to public records, on February 15, 2012, the Wisconsin Medical Examining Board reprimanded Dr. Bowe for engaging in any practice or conduct that tended to constitute a danger to the health, welfare, or safety of patients or the public, and thus, unprofessional conduct, including the unjustified prescribing of Schedule II and other controlled substances. The Board ordered Dr. Bowe to attend a Comprehensive Pain Board symposium, which he later completed.

In 2017, DEA obtained an Administrative Inspection Warrant to conduct an inspection relating to Dr. Bowe and CMC. According to the settlement, after DEA informed Dr. Bowe of numerous allegations that he failed to comply with relating to the federal controlled substance requirements, Dr. Bowe voluntarily surrendered his DEA Registration Number. Without a DEA registration number, he could no longer prescribe or dispense controlled substances.

In 2016, the State of Wisconsin also opened cases into Dr. Bowe’s prescribing practices that led to the Wisconsin Medical Examining Board’s March 15, 2017 Order. According to the Board’s Order, to resolve the State’s claims, Bowe neither admitted nor denied engaging in unprofessional conduct, rather, he stated that due to his age and limitation on his ability to care for patients, he agreed to resolve the cases by voluntarily and permanently surrendering his Wisconsin license to practice medicine.

The DEA Milwaukee District Office primarily conducted the investigation, along with the United States Attorney’s Office Affirmative Civil Enforcement team. Assistant United States Attorney Leslie Herje represented the government in this matter. The settlement agreement states CSA allegations only; Dr. Bowe denies the allegations, except that he admits that, in violation of federal law, he pre-signed incomplete patient prescriptions on other than the date of issuance and placed them in patient charts.