In the Matter of Mireille Lalanne, M.D., 78 Fed. Reg. 47,750 (August 6, 2013) Dr. Lalanne is a physician who, sometime before November 2008, became involved in an organized crime scheme.  Her role?  Dr. Lalanne provided controlled substance prescriptions to different syndicates for illegal distribution.  In November 2008, Dr. Lalanne was indicted by a Kentucky grand jury on five felony counts relating to her controlled substance prescribing practices.  In the months that followed, Dr. Lalanne was arrested and charged with prescribing large quantities of OxyContin and methadone to individuals she knew were distributing the drugs to others.  As a condition of being released on bond, Dr. Lalanne surrendered her DEA registration. In January 2010, Dr. Lalanne entered an Alford plea to a misdemeanor count of facilitation of trafficking in a controlled substance in the first degree.  By entering into the Alford plea, Dr. Lalanne did not admit guilt, but she acknowledged that the evidence against her strongly indicated guilt and that her best interests were served by a guilty plea.  All remaining criminal charges against Dr. Lalanne were dismissed. Three days after entering the Alford plea, Dr. Lalanne submitted an online application for a new DEA registration.  Not surprisingly, DEA issued an Order to Show Cause proposing the denial of Dr. Lalanne’s application. After the administrative hearing took place, DEA issued a final order denying Dr. Lalanne’s application.  The Administrator found that Dr. Lalanne’s criminal conviction was relevant under factor three of the public interest analysis, stating that “[i]nasmuch as the federal definition of “dispense” under the CSA includes prescribing, and knowingly prescribing controlled substances to the facilitated traffickers defined [Dr. Lalanne’s] culpability under state law, it is clear that she was convicted of a state crime relating to the dispensing of controlled substances.”  The Administrator also found that Dr. Lalanne’s past prescribing practices implicated factors two (experience in dispensing controlled substances), four (compliance with federal and state law relating to controlled substances), and five (other conduct which may threaten public health and safety).  Put simply, Dr. Lalanne’s prescribing practices were found to be woefully inadequate.  Finally, the Administrator found that Dr. Lalanne failed to accept responsibility for her actions (she continually maintained her innocence in the face of the criminal conviction), persuasively express remorse for her conduct, or present evidence that could reasonably support a finding that she could be entrusted with a DEA registration. This final order also addressed the use of hearsay in DEA administrative proceedings.  While acknowledging the general admissibility of hearsay in DEA administrative proceedings, the Administrator reiterated what has recently been stated in other final orders: that hearsay may only constitute substantial evidence if other factors are present to indicate that the hearsay is sufficiently reliable.  The factors to determine whether the hearsay is sufficiently reliable may vary among jurisdictions, and it is the obligation of the proponent offering the hearsay statement to show that the hearsay “possesses sufficient indicia of reliability to be deemed substantial evidence.”