Episode 8; Administrative Law and Federal Oversight

Muhamad Aly Rifai, MD

Welcome folks to our 8th episode of the virtual psychiatrist with my cohost Norm clement, we come to you with this quick episode to talk about legal developments with the practice of Medicine and the administrative law, this will impact every physician out there

Norman Clement

Thank you Dr. Rifai you have been a rock in your fight against administrative overreach and defending you case where the government accused you of fraud, it seems they were the fraudsters !

Muhamad Aly Rifai, MD

well Norm, when we think about administrative law, it’s easy to get lost in its complexity. But really, it all boils down to this: how much control the President has over agencies and the officials within them. Now, recently, the Department of Justice took a bold position—basically saying that the rules shielding Administrative Law Judges, or ALJs, from being removed easily, well, they’re unconstitutional. They're citing concerns about separation of powers. This is all because of the election of President Donald Trump and the New attorney general Pam Bondi

Norman Clement

Wait, so you're saying they want to make it easier to fire judges who sit within these agencies?

Muhamad Aly Rifai, MD

Exactly. The DOJ's conclusion rests heavily on decisions like the Free Enterprise Fund v. PCAOB case. That case set the precedent by arguing that bureaucratic layers protecting executive officers from removal violate the President’s powers under Article 2 of the Constitution. It’s a ripple effect—we’re now seeing these principles applied to ALJs.

Norman Clement

Hmm. So, this isn’t just some technical debate—it seems like it could change how agencies work. How are cases like Axalta Coating Systems or MMJ Biopharma tied into this?

Muhamad Aly Rifai, MD

Good question. Take Axalta Coating Systems v. Federal aviation administration —there, the DOJ explicitly told the court it wouldn't defend the ALJs' protections under 5 United States Code section 7521. Same with MMJ Biopharma Cultivation v Drug Enforcement Administration. They're essentially saying these removal restrictions conflict with what the Constitution allows. Now the courts have to balance this restructuring against how it impacts procedural fairness.

Norman Clement

Okay, but doesn’t this rock the system to its core? I mean, ALJs have been this, like, shield between regular folks and government overreach, right?

Muhamad Aly Rifai, MD

That’s just it. On one side, we argue that ALJs can’t be impartial if they’re constantly worried about job security. On the other, we’re redefining their accountability because, ultimately, they’re still part of the executive branch. The DOJ’s stance shifts the power dynamics significantly—and, in some cases, it might even strengthen the President’s authority over these judges.

Norman Clement

But… doesn’t this just weaken the idea of checks and balances? If ALJs aren’t insulated, if they’re just really extensions of the agencies, where’s the protection?

Muhamad Aly Rifai, MD

True, Norm, and that’s what makes this so contentious. Legal thinkers are questioning whether this move endangers the independent judgment of ALJs. Remember, historically, cases like Free Enterprise Fund have emphasized curtailing extreme bureaucracy, but is this overhaul necessary or an overstep? That’s where we’re at—an inflection point.

Norman Clement

Yeah, it’s like pulling one thread and watching the whole thing unravel. But it sounds like this fight was set in motion a while back and we’re just seeing the fallout now.

Muhamad Aly Rifai, MD

Precisely. These debates are firmly rooted in constitutional inquiries that have been simmering for decades. Decisions from even the mid-20th century touch on the scope of presidential power when it comes to hiring and firing. The DOJ’s latest steps? They’re just a new chapter in this ongoing struggle over administrative control.

Norman Clement

Okay, I’m curious now. You’ve had firsthand battles with administrative practices—so how does all this play into your story, with the DEA in particular?

Muhamad Aly Rifai, MD

That’s a great question, Norm. My case highlights the stakes in these debates. It all began with an undercover operation—a plainclothes officer entered my clinic, posing as a patient. What followed was an attempt to paint my legitimate medical practice as criminal behavior. And yeah, Norm, the DEA wasn’t exactly subtle in its methods.

Norman Clement

Hold up. Are we talking about threats? Coercion? What’d they do?

Muhamad Aly Rifai, MD

There was an administrative subpoena—presented under the guise of routine oversight. But its real aim? To fish for evidence they could use in a criminal case against me. And let me be clear—this wasn’t just about procedure. It became deeply personal.

Norman Clement

Man, that’s like bending the rules till they snap. Did they even have real grounds?

Muhamad Aly Rifai, MD

None that held up. The irony is, after years of accusations and my own due diligence to clear my name, a jury outright acquitted me. No criminal wrongdoing, completely innocent. But by then, my reputation had been dragged through the mud, and the emotional toll? That’s something few people understand unless they’re in it.

Norman Clement

Yeah. And don’t get me started on how the media runs with this stuff—it turns everyday professionals into villains overnight. Did you feel that pressure?

Muhamad Aly Rifai, MD

Absolutely. Every headline, every piece of hearsay—it amplifies the public’s perception. But worse than that, it erodes trust. Patients start questioning you, colleagues keep their distance. And the process itself? It’s isolating. There were times I found myself questioning whether the fight was worth it.

Norman Clement

But you fought back. Dude, that’s powerful right there. What kept you in the ring?

Muhamad Aly Rifai, MD

Honestly? The conviction that I hadn’t done what they claimed. My practice serves rural communities—places that lack access to mental health care entirely. I couldn’t walk away, knowing that patients would be left in the lurch because I didn’t see this through.

Norman Clement

So the DEA goes hard after care providers like you… while patients suffer. Makes you wonder what we’re prioritizing as a system, right?

Muhamad Aly Rifai, MD

It’s a question of balance, Norman. The DEA’s mission is critical—no one denies the importance of regulation. But when those regulations overstep—when they target doctors offering legitimate care—it’s the patients who pay the price. The chilling effect spreads across the industry.

Norman Clement

And then we wonder why fewer and fewer docs wanna prescribe certain meds or even work in underserved areas. It's a ripple effect—start with one person like you and the whole system starts cracking at the edges.

Muhamad Aly Rifai, MD

Exactly. And my case reflected a systemic problem. It wasn’t just me. The broader issue is the administrative process itself—how opaque it is, how unchecked, and how it leaves practitioners vulnerable without proper due process safeguards.

Norman Clement

Man… So this isn’t just about you. It’s about fixing the whole damn machine. But let me ask—when the dust settled, how did this change your approach to medicine, or even your sense of justice?

Muhamad Aly Rifai, MD

Well the case of the DEA administrative judges was unique, they were not balanced the DEA wins 100% of the time no justice, no recourse this is why this is very important, removing these judges is very important.

Norman Clement

Looking back now, do you think this fight reshaped how you view the system—or even the role we all play in fixing it?

Muhamad Aly Rifai, MD

Exactly, Norm. My case is just the tip of the iceberg. What it really highlights is the systemic issue in administrative oversight, especially in how the DEA handles its regulatory authority over healthcare providers.

Norman Clement

And by oversight, you mean... overreach?

Muhamad Aly Rifai, MD

In some ways, yes. Regulatory frameworks are necessary—no one disputes that. But when enforcement becomes overly aggressive, not only does it burden professionals like me, it also disrupts patient care. Healthcare providers, especially psychiatrists, can find themselves second-guessing every decision.

Norman Clement

Right, and it’s not just about the docs. The patients are the ones left hanging, you know? Especially the vulnerable ones. You’re serving rural communities, for crying out loud. Who steps in when the system drives doctors out?

Muhamad Aly Rifai, MD

That’s the crux of it. Federal scrutiny, when unchecked, can cause a chilling effect. Doctors hesitate to prescribe certain treatments or even avoid high-risk areas of practice, which leaves patients without options. In psychiatry and addiction medicine, where trust is already frail, this undermines care entirely.

Norman Clement

Yeah, and what gets me is how folks think regulation is black and white—it’s either too little or too much. But isn’t there, I dunno, a middle ground?

Muhamad Aly Rifai, MD

There has to be, Norm. Reforming these practices requires balance. Agencies like the DEA need mechanisms that hold providers accountable but also protect their autonomy. Transparency in how these processes happen—that’s crucial. Professionals should have safeguards to ensure due process, plain and simple.

Norman Clement

Speaking of balance, does this litigation push for real change? Or is it just, you know, a Band-Aid while the wound keeps bleeding?

Muhamad Aly Rifai, MD

Ongoing litigation is part of the solution. It forces issues into the legal spotlight, challenging unconstitutional practices. Legislative reform can follow, but what’s most important is reexamining how these systems function day-to-day. Without accountability, the healthcare system crumbles under mistrust.

Norman Clement

Man, it makes you wonder—if these flaws are so glaring, why hasn’t it been fixed already? I mean, are folks just looking the other way?

Muhamad Aly Rifai, MD

Sometimes, it feels that way. But I think it’s also about inertia—these frameworks have existed for decades. Changing them, even when constitutional flaws are obvious, takes immense litigation and political will. Raising awareness, creating momentum—that’s where it begins.

Norman Clement

Well, you’re definitely raising awareness. And let’s be real: this isn’t just about one or two bad cases. This whole conversation makes you think about the fate of the entire medical community.

Muhamad Aly Rifai, MD

It should, Norman. These procedures need reform—not to dilute the DEA’s mission, but to ensure that its reach doesn’t threaten the very professionals tasked with caring for others. And like we’ve seen in my case, until those reforms happen, these battles will keep repeating.

Norman Clement

You know, with everything you’ve shared about the systemic issues and raising awareness, it makes me think—these changes to administrative law judges, they’re not just shaking up the DEA, right?

Muhamad Aly Rifai, MD

You’re spot on, Norm. What’s happening isn’t limited to the DEA. It sets a precedent that could ripple through other agencies, like the Department of Health and Human Services. Take Medicare exclusion proceedings—imagine the same shifts affecting how those cases are handled. We’re talking about redefining fairness across the board.

Norman Clement

Wow, so this could get a lot bigger than most folks realize. But what’s the end goal—for the government, I mean? Is this about efficiency, or is it about control?

Muhamad Aly Rifai, MD

That’s the underlying question. On paper, it’s about aligning with constitutional principles—ensuring the President has clear oversight over executive branch officials. But in practice, Norm, we could see a spiral where vital agencies lose credibility. The reduction in ALJs’ authority could weaken their role as impartial adjudicators and, ultimately, the checks on agency overreach.

Norman Clement

And if that happens—if trust erodes—then who pays the price? It’s not just docs like you, man. It’s the patients at the end of the line.

Muhamad Aly Rifai, MD

Exactly. And that’s where the real danger lies. If healthcare professionals fear unjust persecution—or worse, if the system prioritizes prosecution over patient care—communities, particularly the underserved, will feel the brunt of it. And once that trust is broken, rebuilding it takes generations.

Norman Clement

Yeah, and let’s not forget—the DEA and other agencies have missions that matter. But when tools get misused, the whole system takes a hit. Sounds like we need more than reform… we need accountability.

Muhamad Aly Rifai, MD

Absolutely, Norm. Reform without accountability is just a Band-Aid. Agencies like the DEA need oversight too—systems that ensure transparency while respecting constitutional limits. It’s the only way forward, not just for professionals but for the integrity of the entire healthcare framework.

Norman Clement

Well said, man. I gotta tell you, this conversation has been eye-opening. We started with your story, but really, it’s about the bigger picture—fixing a system that just doesn’t work for anyone right now.

Muhamad Aly Rifai, MD

That’s the hope, Norm. It’s about creating a system that balances enforcement with fairness, ensuring care providers can do their jobs without fear, and most importantly, protecting the communities we serve. On that note, thanks for holding space for this conversation—it’s been incredible.

Norman Clement

Right back at you, my friend. And for everyone listening, take this as a reminder—advocacy doesn’t stop here. The fight for justice is one we’re all part of. and always remember you are within the norms We’ll see you next time.