Last week, Dr. Ernesto Lopez, from Long Island, New York, alongside his assistant and nurse practitioner were all arrested for a familiar scheme; they’re accused of operating several locations of their practices as pill mills. All three face 20 years in prison for writing what authorities say were millions of dollars worth of fake prescriptions for fentanyl patches and oxycodone pills, two very powerful and addictive drugs meant only for severe pain.

They’re certainly not the first pill mill that New York, like many states, has put out of business. Pill mills, a term used by police and district attorney to describe fake clinics that operate in a way that distributes drugs to addicted persons and drug dealers in local communities, are a very common part of the opiate crisis. In this particular case, police say that Lopez charged $200 to $300 in cash for patient visits, where he did minimal examinations and then prescribed them opiates in massive quantities. Audra Baker, an assistant for Lopez’sat two of his clinics, then advised these “patients” to pass the pills or patches on to a drug dealer, who would then resell the drugs on the street, according to the charging documents.

The charges, say prosecutors, essentially amount to a “diversion scheme.” This term refers to doctors that charge cash for “doctor visits” that involve little or no actual physical examination. It’s a common way for fraud to occur within the medical industry. Since 2015, Lopez wrote more than 8,000 oxycodone and 1,700 fentanyl patch prescriptions. These cash transactions helped him allegedly collect $2 million in fees, prosecutors say. That’s a lot of deadly drugs to make it onto the street, where drug dealers can fetch $20 to $30 for an Oxycontin pill alone.

This isn’t the first pill mill to be busted in New York City and it won’t be the last. Unfortunately, as soon as one closes up shop another crooked doctor seems willing to fill the void. In fact, on February 5, the DEA and NYPD brought down what’s been described as the largest pill mill in the northeast. The string of medical clinics called Astramed sold prescriptions for 5.5 million Oxycodone pills with a street value of half a billion dollars, and the pills were distributed as far and wide as Florida.

But it doesn’t have to be that way. What’s the solution to diversion schemes like this? Recommendations from experts include something as simple as accountability. While government agencies seem to love the idea of a database of Oxycontin and other opioid prescriptions, there still hasn’t been an effective national database implemented. While some states, such as Colorado, have implemented voluntary reporting, few of them are forcing doctors to write down each and every prescription for Oxycontin or fentanyl they decide to write.

The only people who know how many narcotic prescriptions one doctor is prescribing are the manufacturers themselves. While some states are suing pharm companies for ignoring prescribing disparities and over-assuring doctors that their products are safe, it seems like a simple solution would be for the drug companies to monitors suspicious over-prescribing doctors, and notify the DEA themselves. It’s baffling as to why they haven’t bothered to do this yet and points to severe negligence that only these many pharmaceutical lawsuits may be able to solve.