State puts lid on overprescribing doctors
By Andrew Conte
Published: Saturday, March 17, 2012
Pennsylvania has investigated and removed some doctors who were among the top prescribers of painkillers and mental health drugs for Medicaid patients, officials said in a letter made public on Friday.
Five doctors were disqualified from participating in the program; four had their licenses suspended; two were referred to prosecutors for review; and one is under investigation, the state Department of Public Welfare told U.S. Senate investigators.
The state reported its actions in a Feb. 27 letter to Sen. Charles Grassley, R-Iowa, who has been investigating abuses nationwide of medicines such as the anti-depressant Xanax. Pennsylvania initially provided information about the top 10 prescribers of eight antipsychotic, painkiller or anti-anxiety drugs to Grassley in 2010.
"We are seeing that certain states, including Pennsylvania, are reporting that they or the state medical board has taken action against medical providers, and that's good news," said Jill Gerber, Grassley's spokeswoman.
The state welfare department said it sent intervention letters to 51 other doctors, showing their patients' drug histories. The state said its program encourages doctors to discontinue unnecessary prescriptions, reduce drug quantities or switch to other treatments.
State officials declined to identify any doctors.
"Our administration is dedicated to rooting out all waste, abuse and fraud in our programs and services," spokeswoman Donna Kirker Morgan said in a statement.
"Although the senator's questions are an interesting snapshot of antipsychotic drug utilization in the Medicaid system, the questions do not delve into important facts and backgrounds about patients and their current needs for such drugs and the circumstances for such prescriptions."
Top prescribers continue to dispense many of the drugs at a high cost for taxpayers, the state's response shows. Along with its letter, public welfare reported the top 10 prescribers for eight drugs, showing the number of prescriptions each doctor wrote and the dollar value of them.
One doctor last year gave out 6,950 prescriptions for Xanax — or more than 19 every day — at a cost of nearly $70,500. The year before, another doctor wrote 1,864 prescriptions for Seroquel, an antidepression and schizophrenia drug that can cost up to $12 per tablet. The Seroquel prescriptions cost taxpayers more than $1 million.
The state attorney general's office could not immediately provide details about whether any of the public welfare referrals resulted in prosecution. "We aggressively pursue provider fraud, which diverts limited taxpayer resources from Medicaid recipients with legitimate needs," spokesman Nils Hagen-Frederiksen said.
The state's response to Grassley was made public yesterday when the agency responded to a Right-to-Know Request filed by Ken Kramer, an investigator for Citizens Commission on Human Rights International, a group that investigates and exposes psychiatric abuse.
"It's very good to see Pennsylvania taking action," Kramer, 55, of Clearwater, Fla., said in an email to the Tribune-Review. "There is no debate on this: Patients are overdrugged, Medicaid is overbilled and taxpayers are overburdened -- all caused by the bogus prescribing of psychiatrists."
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