Notice2025-19611
Enyibuaku Uzoaga, M.D.; Decision and Order
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Published
October 21, 2025
Issuing agencies
Justice DepartmentDrug Enforcement Administration
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<title>Federal Register, Volume 90 Issue 201 (Tuesday, October 21, 2025)</title>
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[Federal Register Volume 90, Number 201 (Tuesday, October 21, 2025)]
[Notices]
[Pages 48432-48435]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2025-19611]
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DEPARTMENT OF JUSTICE
Drug Enforcement Administration
[Docket No. 25-37]
Enyibuaku Uzoaga, M.D.; Decision and Order
On March 26, 2025, the Drug Enforcement Administration (DEA or
Government) issued an Order to Show Cause (OSC) to Enyibuaku Uzoaga,
M.D., of Houston, Texas (Applicant). OSC, at 1, 3. The OSC proposed the
denial of Applicant's application for a DEA Certificate of
Registration, Control No. W24000817C, alleging that Applicant has been
excluded from participation in Medicare, Medicaid, and all federal
health care programs pursuant to 42 U.S.C. 1320a-7(a). Id. at 1 (citing
21 U.S.C. 824(a)(5)).
A hearing was held before DEA Administrative Law Judge (ALJ) Paul
E. Soeffing, who, on June 25, 2025, issued his Recommended Rulings,
Findings of Fact, Conclusions of Law, and Decision (RD). The RD
recommended that Applicant's application for registration be denied.
RD, at 19. Applicant filed exceptions to the RD which are addressed
herein. Having reviewed the entire record, the Agency adopts and hereby
incorporates by reference the entirety of the ALJ's rulings,
credibility findings,\1\ findings of fact, conclusions of law,
sanctions analysis, and recommended sanctions in the RD, and clarifies
and expands upon portions thereof herein.
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\1\ The Agency adopts the ALJ's summary of the witnesses'
testimonies as well as the ALJ's assessment of the witnesses'
credibility. RD, at 3-7. The Agency agrees with the ALJ that the
testimony from the DEA Diversion Investigator, which was primarily
focused on the introduction of the Government's documentary evidence
and the Diversion Investigator's contact with the case, was
generally consistent and genuine without indication of any animosity
towards Applicant, and therefore was credible and warranted
significant weight. Id. at 4. The Agency agrees with the ALJ that
the testimony from the DEA Group Supervisor, which was primarily
focused on rebutting Applicant's testimony regarding the Memorandum
of Agreement, also was generally consistent and genuine without
indication of any animosity towards Applicant, and therefore was
credible and warranted significant weight. Id. at 6. Finally, the
Agency agrees with the ALJ's credibility determination regarding the
testimony from Applicant, which was primarily focused on her
background, her desire to regain a DEA registration, her health care
fraud conviction, her exclusion from all federal health care
programs, and her interactions with DEA regarding the potential
Memorandum of Agreement. Id. at 7. As described by the ALJ, in her
testimony, Applicant attempted to minimize her responsibility
regarding her role in the health care fraud and attempted to shift
the blame to others. Id. Even so, as the ALJ described, Applicant's
testimony regarding the underlying facts of the case was otherwise
generally consistent and credible. Id. The Agency therefore agrees
with the ALJ that Applicant's testimony warrants general weight
except where it differs from the corroborated testimony of other
witnesses, in which case it warrants less weight. Id.
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I. Applicable Law
Pursuant to 21 U.S.C. 824(a)(5), the Agency \2\ is authorized to
suspend or revoke a registration upon finding that the registrant ``has
been excluded (or directed to be excluded) from participation in a
program pursuant to section 1320a-7(a) of Title 42.'' The Agency has
consistently held that it may
[[Page 48433]]
also deny an application upon finding that an applicant has been
excluded from a federal health care program.\3\ Mark Agresti, M.D., 90
FR 30098, 30099 (2025); Samirkumar Shah, M.D., 89 FR 71931, 71933
(2024); Arvinder Singh, M.D., 81 FR 8247, 8248 (2016).
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\2\ The Controlled Substances Act (CSA) delegates power to the
Attorney General, who has delegated it to the Administrator of the
DEA (the Agency) by 28 CFR 0.100.
\3\ A statutory basis to deny an application pursuant to section
823 is also a basis to revoke or suspend a registration pursuant to
section 824, and vice versa, because doing ``otherwise would mean
that all applications would have to be granted only to be revoked
the next day . . . .'' Robert Wayne Locklear, M.D., 86 FR 33738,
33744-45 (2021) (collecting cases).
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II. Findings of Fact
The following facts are undisputed.\4\ On November 3, 2015,
Applicant was convicted of one count of conspiracy to commit health
care fraud in violation of 18 U.S.C. 1347, 1349 and six counts of
health care fraud in violation of 18 U.S.C. 2, 1347.\5\ RD, at 2;
Government Exhibit (GX) 4, at 6-22; GX 5, 1-2. On March 24. 2016,
Applicant was sentenced to 42 months of incarceration on each count, to
be served concurrently, and ordered to pay restitution in the amount of
$389,294.99.\6\ RD, at 2; GX 6, at 3, 6. Based on Applicant's
conviction, the U.S. Department of Health and Human Services, Office of
Inspector General (HHS/OIG), excluded Applicant, effective August 18,
2016, from participation in Medicare, Medicaid, and all federal health
care programs pursuant to 42 U.S.C. 1320a-7(a) for a minimum period of
fifteen years.\7\ RD, at 2; GX 8, at 1-2. On June 21, 2017, the
fifteen-year exclusion was affirmed. RD, at 2; GX 10, at 1, 9.\8\
Accordingly, the Agency finds more than substantial record evidence \9\
that Applicant has been, and continues to be, excluded from
participation in Medicare, Medicaid, and all federal health care
programs pursuant to 42 U.S.C. 1320a-7(a).
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\4\ According to the CSA, ``[f]indings of fact by the [DEA
Administrator], if supported by substantial evidence, shall be
conclusive.'' 21 U.S.C. 877. Here, where Applicant has stipulated to
all of the material facts, the record evidence exceeds the
``substantial evidence'' standard of 21 U.S.C. 877; it is unrebutted
evidence.
\5\ Applicant stipulated to this fact. See ALJ Exhibit 16, at 3
(Stipulation 4).
\6\ Applicant stipulated to this fact. See ALJ Exhibit 16, at 3
(Stipulation 5).
\7\ Applicant stipulated to this fact. See ALJ Exhibit 16, at 3
(Stipulation 6).
\8\ Applicant stipulated to this fact. See ALJ Exhibit 16, at 3
(Stipulation 7).
\9\ Where Applicant has stipulated to a fact, the Agency exceeds
the ``substantial record evidence'' standard. See supra n.4.
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III. Discussion
The Agency agrees with the ALJ and finds substantial record
evidence that Applicant has been, and remains, mandatorily excluded
from federal health care programs pursuant to 42 U.S.C. 1320a-7(a),\10\
and Applicant has admitted to the same. RD, at 11-12; GX 8, at 1-2; GX
10, at 1, 9; ALJ Exhibit 16, at 3 (Stipulations 6-7). Accordingly, the
Agency finds that substantial record evidence establishes the
Government's prima facie case for denying Applicant's application under
21 U.S.C. 824(a)(5), that Applicant did not rebut that prima facie
case, and that there is substantial record evidence supporting the
denial of Applicant's application.\11\
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\10\ The Agency has consistently held that it may deny an
application under 21 U.S.C. 824(a)(5) even if the conviction
underlying the exclusion does not relate to controlled substances.
See, e.g., Phong H. Tran, M.D., 90 FR 14383, 14384 n.10 (2025)
(collecting cases).
\11\ Pursuant to 21 U.S.C. 823(g)(1), ``[t]he Attorney General
shall register practitioners . . . to dispense . . . controlled
substances . . . if the applicant is authorized to dispense . . .
controlled substances under the laws of the State in which he
practices.'' 21 U.S.C. 823(g)(1). This regulation further provides
that an application for a practitioner's registration may be denied
upon a determination that ``the issuance of such registration . . .
would be inconsistent with the public interest'' and requires
consideration of five factors in making such a determination. Id. In
both her post-hearing brief and her Exceptions, Applicant argues
that analysis of the five public interest factors of 21 U.S.C.
823(g)(1) does not demonstrate that granting her application for
registration would be inconsistent with the public interest (note:
Applicant appears to cite in error to 21 U.S.C. 823(f), which
pertains to distributors of controlled substances in Schedules III-
V). Applicant's Proposed Findings of Fact and Conclusions of Law, at
4-9; Applicant's Exceptions, at 3-6. However, in the current matter,
it is undisputed that Applicant holds a valid state medical license
and is authorized to dispense controlled substances in Texas.
Moreover, because the Government has not alleged that Applicant's
registration is inconsistent with the public interest under 21
U.S.C. 823(g)(1), and although the Agency has considered 21 U.S.C.
823(g)(1), the Agency will not analyze Applicant's application under
the five public interest factors, in accordance with prior agency
decisions. See Shah, 89 FR at 71933; Daniel R. Nevarre, M.D., 87 FR
3340, 3341-42 (2022).
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IV. Sanction
Where, as here, the Government has met its prima facie burden of
showing that Applicant's application for registration should be denied,
the burden shifts to Applicant to show why she can be entrusted with a
registration. Morall v. Drug Enf't Admin., 412 F.3d. 165, 174 (D.C.
Cir. 2005); Jones Total Health Care Pharmacy, LLC v. Drug Enf't Admin.,
881 F.3d 823, 830 (11th Cir. 2018); Garrett Howard Smith, M.D., 83 FR
18882, 18904 (2018). The issue of trust is necessarily a fact-dependent
determination based on the circumstances presented by the individual
registrant. Jeffrey Stein, M.D., 84 FR 46968, 46972 (2019); see also
Jones Total Health Care Pharmacy, 881 F.3d at 833. Moreover, as past
performance is the best predictor of future performance, the Agency has
required that a registrant who has committed acts inconsistent with the
public interest must accept responsibility for those acts and
demonstrate that he or she will not engage in future misconduct. See
Jones Total Health Care Pharmacy, 881 F.3d at 833; ALRA Labs, Inc. v.
Drug Enf't Admin., 54 F.3d 450, 452 (7th Cir. 1995). The Agency
requires a registrant's unequivocal acceptance of responsibility. Janet
S. Pettyjohn, D.O., 89 FR 82639, 82641 (2024); Mohammed Asgar, M.D., 83
FR 29569, 29573 (2018); see also Jones Total Health Care Pharmacy, 881
F.3d at 830-31. In addition, a registrant's candor during the
investigation and hearing is an important factor in determining
acceptance of responsibility and the appropriate sanction. See Jones
Total Health Care Pharmacy, 881 F.3d at 830-31; Hoxie v. Drug Enf't
Admin., 419 F.3d 477, 483-84 (6th Cir. 2005). Further, the Agency has
found that the egregiousness and extent of the misconduct are
significant factors in determining the appropriate sanction. See Jones
Total Health Care Pharmacy, 881 F.3d at 833 n.4, 834. The Agency also
considers the need to deter similar acts by a registrant and by the
community of registrants. Jeffrey Stein, M.D., 84 FR at 46972-73.
Here, although Applicant testified that she ``[l]earned [her]
lesson,'' is ``incredibly sorry,'' and takes ``full responsibility,''
the Agency agrees with the ALJ that Applicant failed to unequivocally
accept responsibility for her misconduct. RD, at 6, 17; Tr. 67, 68,
106-07, 118-19. Instead, Applicant repeatedly emphasized that she had
``trusted the wrong people'' and placed the blame on the therapy
company and billing company that she had contracted with. RD, at 6, 15-
16; Tr. 66, 97, 121-22.
Applicant asserted that she had no knowledge of the fraud and
``unbeknownst to [her], the therapy company and the biller had connived
to submit false claims,'' including by billing for services under her
provider number and billing for hundreds of tests when only one was
performed. RD, at 6, 15-16; Tr. 66-67, 97, 99, 105, 107. According to
Applicant, she was ``too busy doing a lot of hospital work at that time
and also seeing patients in the clinic'' and she ``had no reason to
suspect anybody. [She] believed that everyone was doing what they were
supposed to do.'' RD, at 15; Tr. 122-23; see Bernadette U. Iguh, M.D.,
87 FR 56709, 56711 (2022) (``Respondent's emphasis on her ignorance as
the cause
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of her misconduct . . . serve[s] to downplay the extent to which her
own actions and decisions were harmful.'').
Applicant also repeatedly asserted that ``there was no direct
evidence'' connecting her to the fraud. RD, at 6, 15; Tr. 67, 97, 103.
Applicant testified that her office manager was the one who wrote all
the checks to the biller, that the biller kept all of the submitted
claims, and that the biller testified at trial that Applicant had had
no knowledge of the fraud that was going on. RD, at 6; Tr. 102. In line
with her placing the blame on others and emphasizing her ignorance,
Applicant's categorical denial here of any direct connection to the
fraud demonstrates a marked unwillingness to unequivocally accept
responsibility.
Finally, as noted by the ALJ, Applicant failed to acknowledge the
harm done to her patients by her betraying their trust, as well as the
unnecessary medical tests that her patients underwent because of the
fraud. RD, at 14-15, 16; \12\ see Iguh, M.D., 87 FR at 56711
(``Respondent's emphasis on her ignorance . . . in tandem with
Respondent's lack of emphasis on the damages she caused, both serve to
downplay the extent to which her own actions and decisions were
harmful.'').
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\12\ In her Exceptions, Applicant argued that she introduced the
potential Memorandum of Agreement (MOA) ``to show that she was
qualified for [a] DEA [registration]'' because DEA offered her a
registration ``inspite [sic.] of her 2016 conviction and exclusion[,
which] NEGATES the relief sought by the DEA.'' Exceptions, at 2-3.
The Agency disagrees. Had the MOA been signed, Applicant would not
be able to handle Schedule II controlled substances and would be
under additional restrictions. RD, at 4; Tr. 46. Therefore, the MOA,
to the extent it is relevant, suggests that DEA, absent agreed upon
restrictions (and there was no agreement), did not trust Applicant
with a registration, consistent with the Agency's findings herein.
Applicant further objects to the ALJ's finding that ``because no
agreement was reached, [the] MOA is immaterial in this case.''
Exceptions at 3. To the extent that the circumstances and
communications surrounding the MOA were relevant, they would further
suggest to the Agency that Applicant had not unequivocally accepted
responsibility for her actions. According to the Diversion I,
Applicant wanted ``full and clear DEA registration without any
restrictions.'' RD, at 4; Tr. 46. The DEA Group Supervisor testified
that Applicant did not think she needed an MOA and instead wanted a
DEA registration with no restrictions and for all schedules. RD, at
5; Tr. 128, 129, 133-34, 136. Applicant testified she was not
willing to agree to two years of supervision, RD, at 7; Tr. 74-75,
79-80, 88; Applicant Exhibit (RX) 4, at 7; but that she thought
``anything from 90 days to six months [was] fair'' for her to be
under probation. RD, at 7; Tr. 88-89. Ultimately, the MOA and the
communications surrounding it are immaterial as, even without it,
the Agency would find that Applicant had not demonstrated her
unequivocal acceptance of responsibility.
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Accordingly, the Agency finds that Applicant did not unequivocally
accept responsibility for her actions.\13\ When a registrant fails to
make the threshold showing of acceptance of responsibility, the Agency
need not address the registrant's remedial measures. Ajay S. Ahuja,
M.D., 84 FR 5479, 5498 n.33 (2019) (citing Jones Total Health Care
Pharmacy, L.L.C., & SND Health Care, L.L.C., 81 FR 79188, 79202-03
(2016)); Daniel A. Glick, D.D.S., 80 FR 74800, 74801, 74810 (2015).\14\
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\13\ In her Exceptions, Applicant cited to evidence of her
testimony accepting ``her full responsibility,'' Exceptions, at 1,
but as discussed herein, the Agency finds that Applicant's
acceptance of responsibility was not unequivocal.
\14\ Applicant did provide examples of certain remedial measures
and the Agency has considered them. Applicant testified that since
she has returned to practice, she renders all billing, therapy, and
services in-house under her direct supervision. RD, at 6; Tr. 68.
Applicant also testified that she has a compliance program in place
and is following all rules and regulations. RD, at 6; Tr. 68; see
also RD, at 7; Tr. 80-83; Exceptions at 1-2. Applicant also noted
that in 2022, after completing a remedial course, she regained her
full, unrestricted medical license. RD, at 6; Tr. 69-70; GX 3.
However, without an unequivocal acceptance of responsibility,
Applicant's remedial measures are insufficient for the Agency to
determine that Applicant can be trusted with a registration. See
Lewisville Medical Pharmacy, 87 FR 59456, 59460 n.16 (2022); Brenton
D. Wynn, M.D., 87 FR 24228, 24261 (2022); Michael T. Harris, M.D.,
87 FR 30276, 30278-79 (2022).
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The Agency further agrees with the ALJ that Applicant's actions in
the underlying criminal conduct are egregious such that denial of her
application for registration is appropriate. RD, at 19. The Agency has
found that ``defrauding health care programs is egregious,'' in and of
itself. Gilbert Y. Kim, D.D.S., 87 FR 21139, 21145 (2022); Samirkumar
Shah, M.D., 89 FR at 71934. Furthermore, Applicant's mandatory
exclusion period was set and affirmed at fifteen years. GX 8, at 1; GX
10, at 9. This is ten years in excess of the mandatory minimum
prescribed by statute. See 42 U.S.C. 1320a-7(c)(3)(B); see also Jones,
86 FR at 20732 (an exclusion period in excess of the statutory minimum
can be considered on the issue of egregiousness). As noted by the ALJ,
the exclusion letter issued to Applicant from HHS/OIG and the
Departmental Appeals Board Decision explain that Applicant's fraud
included three aggravating factors: (1) Applicant's misconduct caused
or was intended to cause financial loss of more than $5,000 to a
government agency or program; (2) Applicant committed the misconduct
over a period of one year or more; and (3) Applicant's sentence
included incarceration.\15\ RD, at 18; GX 8, at 1-2; GX 10, at 6. When
Applicant appealed her exclusion, the Departmental Appeals Board
Administrative Law Judge found that HHS/OIG had a basis for its
exclusion of Applicant and that the fifteen-year exclusion period was
``reasonable.'' RD, at 18; GX 10, at 9.
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\15\ The ALJ noted: (1) the monetary loss attributed to
Applicant's fraud was more than 75 times the $5,000 threshold; (2)
Applicant's fraud occurred over a period of more than five years;
and (3) Applicant was incarcerated for 42 months. RD, at 18-19; GX
6, at 1-3; GX 7, at 2; GX 8, at 2, GX 10, at 6-7.
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As described supra, the Agency also considers both specific and
general deterrence when determining an appropriate sanction. Daniel A.
Glick, D.D.S., 80 FR at 74810. Regarding both specific and general
deterrence, the Agency agrees with the ALJ that in the current matter,
imposing sanction will `` `deter [Applicant] and the general registrant
community from unethical behavior and deceit, particularly involving
the acceptance of money for unlawful and unethical acts'' because
``[i]t is not difficult to imagine, as the Agency has repeatedly
encountered, this situation repeating itself in the context of
receiving money for controlled substance prescriptions.' '' RD, at 18
(quoting Nicholas P. Roussis, M.D., 86 FR 59190, 59195 (2021)).
In sum, the Agency agrees with the ALJ that Applicant has not
offered any credible evidence on the record to rebut the Government's
prima facie case for denial of her application for registration and
Applicant has not met her burden to demonstrate that she can be
entrusted with the responsibility of registration. RD, at 19.
Accordingly, the Agency will order that Applicant's application for
registration be denied.
Order
Pursuant to 28 CFR 0.100(b) and the authority vested in me by 21
U.S.C. 823(g)(1), I hereby deny the pending application for a DEA
Certificate of Registration, Control No. W24000817C, submitted by
Enyibuaku Uzoaga, M.D., as well as any other pending application of
Enyibuaku Uzoaga, M.D., for additional registration in Texas. This
Order is effective November 20, 2025.
Signing Authority
This document of the Drug Enforcement Administration was signed on
October 9, 2025, by Administrator Terrance Cole. That document with the
original signature and date is maintained by DEA. For administrative
purposes only, and in compliance with requirements of the Office of the
Federal Register, the undersigned DEA Federal Register Liaison Officer
has been authorized to sign and submit the document in electronic
format for publication, as an official document of
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DEA. This administrative process in no way alters the legal effect of
this document upon publication in the Federal Register.
Heather Achbach,
Federal Register Liaison Officer, Drug Enforcement Administration.
[FR Doc. 2025-19611 Filed 10-20-25; 8:45 am]
BILLING CODE 4410-09-P
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