Investigating Prescription Dollars
ProPublica's Charles Ornstein and Tracy Weber report that Iowa Republican Sen. Charles Grassley is asking 34 states what steps they are taking to investigate doctors who are prescribing antipsychotics, anti-anxiety drugs and painkillers to Medicaid patients at levels far higher than their peers.
For instance, in his letter to Ohio, Grassley notes, "that the top prescriber of the anti-psychotic Abilify wrote 13,825 prescriptions in 2009 - about 54 prescriptions per weekday. Ohio paid $6.7 million for those prescriptions....The biggest prescriber of another anti-psychotic, Seroquel, wrote 18,890 scripts at a cost of $5.7 million. Grassley wrote the tally would amount to nine prescriptions per hour." Grassley went on to explain to Ohio officials that he had concerns about the oversight and enforcement of Medicaid abuse in the state and that the numbers presented to him were "quite shocking."
Grassley has asked state officials to tell him by Feb. 13 what action, if any, "they have taken against top prescribers, whether those doctors are still eligible to bill Medicaid, whether any of the doctors were referred to their state medical boards for investigation, and what systems have been set up to track possibly excessive prescribing, among others."
“These types of drugs have addictive properties, and the potential for fraud and abuse by prescribers and patients is extremely high,” Grassley wrote in Monday’s letters. “When these drugs are prescribed to Medicaid patients, it is the American people who pay the price for over-prescription, abuse, and fraud.”
Grassley, the senior Republican on the Senate Judiciary Committee, has long argued for greater transparency in health care. The painkillers and mental health drugs Grassley is inquiring about are among the top drivers of Medicaid drug spending.
Ornstein and Weber had previously reported that Florida allowed at least three physicians to keep treating and prescribing drugs to the poor amid clear signs of possible misconduct.
A number of the top-prescribing Medicaid doctors around the country are listed in ProPublica's Dollars for Docs database of payments made by 12 pharmaceutical companies to physicians for speaking and consulting Medicaid, jointly funded by the states and federal government, provides health care coverage to about 60 million low-income enrollees.
