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Senate Watchdog Targets High-Prescribing Medicaid Docs

Sen. Charles Grassley, R-Iowa, wants to know why an Ohio doctor wrote 54 prescriptions per weekday for the antipsychotic Abilify, while the biggest prescriber of Seroquel wrote an average nine prescriptions per hour.

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Sen. Charles Grassley (Benjamin J. Myers/WDCPIX)

An influential U.S. senator is grilling officials in nearly three-dozen states, demanding to know how they are cracking down on physicians who prescribe massive amounts of potentially dangerous prescription drugs.

Iowa Republican Charles Grassley sent letters to 34 states Monday asking what steps they had taken to investigate doctors whose prescribing of antipsychotics, anti-anxiety drugs and painkillers to Medicaid patients far exceeds that of their peers.

The request is a follow-up to a 2010 letter Grassley sent all states that requested statistics on top prescribers of these drugs.

“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.”

ProPublica reported in November that Florida allowed at least three physicians to keep treating and prescribing drugs to the poor amid clear signs of possible misconduct. One doctor kept prescribing narcotic pain pills to Medicaid patients for more than a year after he was arrested and charged in 2010 with trafficking in them.

A number of the top-prescribing Medicaid doctors around the country are listed in our 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.

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.

His letter to Ohio 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 that those prescriptions, state officials reported to Grassley.

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. When Ohio submitted the data to Grassley last year, it did not identify the doctors by name or license number.

“After an extensive review of prescribing habits of the serial prescribers of pain and mental-health drugs in Ohio, I have concerns about the oversight and enforcement of Medicaid abuse in your state,” he wrote. “While I am sensitive to the concerns of misinterpretation of the data you provided, the numbers themselves are quite shocking.”

Grassley’s letter to Maine cites a physician who wrote 1,867 prescriptions for the powerful painkiller OxyContin in 2009, nearly double the second-highest prescriber. The doctor also wrote 1,723 prescriptions for another painkiller, Roxicodone, nearly three times as many as the next highest prescriber.

Calls to officials in Ohio and Maine have not been returned.

Update Feb. 6, 2012: A spokesman for Ohio’s Medicaid program now says the information the state submitted to Grassley in 2010 may have been misleading. The data for its top prescribers of Abilify and Seroquel did not reflect the prescriptions of a single physician, according to Benjamin Johnson of the Ohio Department of Job and Family Services. Instead, they were aggregations of prescriptions written by a group of providers. During 2008 and 2009, pharmacists attributed prescriptions to a generic provider code if they were unsure of a physician’s individual code, Johnson says. Hospitals were also included among the state’s highest prescribers, and Ohio plans to send Grassley a new list of its highest-prescribing physicians, Johnson says.

In his letters to the 34 states, Grassley asked that officials 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.

Grassley is sending letters to 12 other states that never provided him data, as requested, on their top Medicaid prescribers. Four other states will not receive follow-up letters because the senator felt their initial responses to his 2010 letter were adequate.

ProPublica reported in November that since Grassley’s initial letter requesting the data in 2010, Louisiana, Arizona, Oklahoma and New York have kicked some high-prescribing physicians out of Medicaid. California has temporarily suspended or placed restrictions on 15 to 20 doctors in the past two years for prescribing disproportionately high volumes of painkillers and antipsychotics to Medicaid patients.

But Grassley said more needs to be done.

“When a doctor writes more prescriptions than seems humanly possible, it makes sense to ask questions,” he said in a statement to ProPublica. The statement noted that some states never responded to his original letter in 2010.

“If state and federal taxpayers are being cheated because of inappropriate prescriptions,” Grassley said, “the state and federal governments have to get to the bottom of it and stop it.”

Margaret Wilde

Jan. 24, 2012, 2:32 p.m.

Surely some of these high-prescribing doctors should have their prescribing rights curbed or even curtailed.

Thank goodness Charles Grassley draws attention to these abuses.

Barry Schmittou

Jan. 24, 2012, 4:01 p.m.

I pray readers will contact Senator Grassley at .(JavaScript must be enabled to view this email address) and ask him to immediately investigate MetLife, AIG and Other Insurance Companies That Are Rigging Bids To Increase Sales of Health and Workers’ Comp Policies While At the Exact Same Time They Have Doctors Who Are Ignoring Life Threatening Medical Conditions Including Multiple Sclerosis, Cancer and Cardiac Conditions of Many Patients and Destroying the Lives of Thousands of Injured and Disabled Americans, and Injured War Zone Contractors as Seen in Section Three of :

http://www.stopdeadlycorporatecrimes.blogspot.com

The crimes ar so bad four Professors wrote this about the destruction of lives : Professor Joseph Belth from Indiana University wrote :

“They’ve turned Erisa on its head,”  “It was supposed to protect employees, and it’s being used to protect insurers.”

“The most important federal insurance regulation of the past generation is ERISA,” says Tom Baker, deputy dean of the University of Pennsylvania Law School in Philadelphia. “If ever a law backfired for the public, ERISA is the perfect example.”

John Marshall Law School Professor Mark Debofsky wrote:

“empirical evidence is now available that shows insurers operating under ERISA have systematically engaged in the wrongful denial of claims. Cases of abusive benefit denials involving other disability insurers abound.

“MetLife and its henchmen” is an exact quote written by U.S. District Judge Richard Enslen in a Disability case linked later.

WFAA - TV in Dallas wrote this about Workers Comp :

“a remarkable number of Texans committed suicide because they could no longer endure the pain caused by their injuries and they had been repeatedly turned down for worker’s comp care. Some insurance companies send peer review doctors medical files “stripped” of records important to the possible approval of workers’ comp claims.”

** During the time period of the suicides AIG rigged billions of dollars in bids to increase sales of Workers Comp policies; No one was prosecuted by the Bush administration !!!!

I have repeatedly provided the evidence seen on the website to Directors’ of the Obama administration, and his DOL Directors wrote me a letter from Washington in December of 2010 telling me it is their top priority to stop violations, but they have done nothing !!

Identical crimes are also being committed against severely injured War Zone Contractors.For more details please see Section Three of :

http://www.stopdeadlycorporatecrimes.blogspot.com

Look guys, this is due to one and only one issue, and it is the ROOT issue for them all: campaign bribes!!! The buy a “hands off” policy here, and taxpayers-funded subsides elsewhere. Isn’t our free-for-all market great?

Jack Lohman
http://MoneyedPoliticians.net

It’s worse than you know! Here in NH, last year, more people died from drug & alcohol overdoses, than in car crashes…1/2 of the drug deaths were “legal” prescription drugs. In addition to blatantly FRAUDULENT billing, these psych drugs are killing people, at taxpayers expense, and the drug companies are profiting. Yes, it is far more the Repub-tards than the Demis, but the Demis are in the same bed.
Psychiatry and “Pharma” are YOUR TAX DOLLARS AT WASTE!

Barry, get a job and stop living off my dime! Stop trying to add all your medical diseases to your workers comp claim.

Stephanie Palmer

Jan. 24, 2012, 5:53 p.m.

I have no love for Grassley, but people are crazy to take all of these goofy new drugs. It makes no sense to me why people don’t even question the doctors about prescriptions. You should ask the pharmacist before you take anything.  These new drugs are mighty nasty.

Christina Marlowe

Jan. 24, 2012, 6:03 p.m.

To Senator Grassley and every other government flunkie/hacks:

You yourselves enjoy full, lifetime health care along with endless other benefits, all on the taxpayers dime, right as you continually fight to deny your own constituents, your own fellow citizens, the very entitlements that which you yourselves benefit. How dare you people. And to this I say:

I propose a simple and straightforward bit of legislation to be given to the citizens of the United States as a REFERENDUM vote:

Retract entirely every last health care benefit that these hypocritical parasites in our miserably failing government enjoy on OUR, the taxpayers’, hard-earned dime. Then these corrupt, meanspirited and unconscionable government HUMPS would all have to do just as WE ALL MUST DO: buy filthy, grossly inflated, anti-American, inhumane for-profit health care “insurance,” (one of the biggest SCAMS in history) that covers nothing at all just when you need coverage most; and then, when one of these filthy, horrible Republicans or “Blue-Dog” Democrats gets sick and is denied coverage, let the insurance company CEO immediately and unceremoniously pull the plug.

Christina Marlowe

Jan. 24, 2012, 6:11 p.m.

Alan Simpson, Republican Senator from Wyoming, Co-Chair of Obama’s deficit commission, calls senior citizens the Greediest Generation as he compared “Social Security” to a Milk Cow with 310 million teats.  August, 2010.

Here’s a response in a letter from a unknown fellow in Montana.

Hey Alan, let’s get a few things straight…

1. As a career politician, you have been on the public dole for FIFTY YEARS.

2. I have been paying Social Security taxes for 48 YEARS (since I was 15 years old. I am now 63).

3. My Social Security payments, and those of millions of other Americans, were safely tucked away in an interest bearing account for decades until you political pukes decided to raid the account and give OUR money to a bunch of zero ambition losers in return for votes, thus bankrupting the system and turning Social Security into aPonzi scheme that would have made Bernie Madoff proud.

4. Recently, just like Lucy & Charlie Brown, you and your ilk pulled the proverbial football away from millions of American seniors nearing retirement and moved the goalposts for full retirement from age 65 to age 67.  NOW, you and your shill commission is proposing to move the goalposts YET AGAIN.

5. I, and millions of other Americans, have been paying into Medicare from Day One, and now you morons propose to change the rules of the game. Why? Because you idiots mismanaged other parts of the economy to such an extent that you need to steal money from Medicare to pay the bills.

6. I, and millions of other Americans, have been paying income taxes our entire lives, and now you propose to increase our taxes yet again. Why? Because you incompetent bastards spent our money so profligately that you just kept on spending even after you ran out of money. Now, you come to the American taxpayers and say you need more to pay off YOUR debt.
~~~~~~~~~~~~~~~~~~
To add insult to injury, you label us “greedy” for calling “bullshit” on your incompetence. Well, Captain Bullshit, I have a few questions for YOU.

1. How much money have you earned from the American taxpayers during your pathetic 50-year political career?

2. At what age did you retire from your pathetic political career, and how much are you receiving in annual retirement benefits from the American taxpayers?

3. How much do you pay for YOUR government provided health insurance?

4.  What cuts in YOUR retirement and healthcare benefits are you proposing in your disgusting deficit reduction proposal, or, as usual, have you exempted yourself and your political cronies?

It is you, Captain Bullshit, and your political co-conspirators who are “greedy”. It is you and they who have bankrupted America and stolen the American dream from millions of loyal, patriotic taxpayers.  And for what?  Votes.  That’s right, sir.  You and yours have bankrupted America for the sole purpose of advancing your pathetic political careers.  You know it, we know it, and you know that we know it.

And you can take that to the bank, you miserable son of a bitch.”

Marcy Bernstein

Jan. 24, 2012, 6:18 p.m.

What we need in this country is DIRECT DEMOCRACY like they have in Switzerland.  Where the people vote for what they want, and tell the Representatives what to do.  Just like when we all sent e-mails and
stopped the Government from shutting down the internet.

If you are interested Google “DIRECT DEMOCRACY.”

Christina Marlowe

Jan. 24, 2012, 6:20 p.m.

And to “Barry,”

Those WAR MONGERING RACKETEERS/PROFITEERS deserve everything they get by endlessly INVADING countries all over the world and RAPING their people.  HEALTH CARE?!?!?  NOT ON MY DIME.
Let Cheney, Bush, Rumsfeld, et al, and Halliburton and the WAR DEPARTMENT pay their FILTHY BILLS.  This, AMERICA, is precisely and exactly the filthy CRIMINAL Industrial War Complex that Eisenhower had WARNED about all along.

WAKE THE HELL UP!!!!!!!!!!!!!

Christina Marlowe

Jan. 24, 2012, 6:32 p.m.

Marcy,

It’s all too little, too late.  The Corporate Takeover of our government is complete.  We let it happen, believing and then voting for these criminals and sociopaths.  In my view, full-Scale Revolution is the ONLY thing left at this point.  These people who run this wretched little show are bought and paid for, just as a common street whore.

I’ll leave you with a few prescient quotes from a few notables:

“I see in the near future a crisis approaching that unnerves me and causes me to tremble for the safety of my country. . .Corporations have been enthroned and an era of corruption in high places will follow, and the money power of the country will endeavor to prolong its reign by working upon the prejudices of the people until all wealth is aggregated in a few hands and the Republic is destroyed.”

~ Abraham Lincoln, Nov. 21, 1864


‘I believe that banking institutions are more dangerous to our liberties than standing armies. If the American people ever allow private banks to control the issue of their currency, first by inflation, then by deflation, the banks and corporations that will grow up around the banks will deprive the people of all property until their children wake-up homeless on the continent their fathers conquered..’”
 
~ Thomas Jefferson, 1802

“There are plenty of ugly things about wealth and its possessors in the present age, and I suppose there have been in all ages. There are many rich people who so utterly lack patriotism, or show such sordid and selfish traits of character, or lead such mean and vacuous lives, that all right-minded men must look upon them with angry contempt…

~Theodore Roosevelt

The death-knell of the republic had rung as soon as the active power became lodged in the hands of those who sought, not to do justice to all citizens, rich and poor alike, but to stand for one special class and for its interests as opposed to the interests of others.

- Theodore Roosevelt


“When fascism comes to America, it will be wrapped in the flag and carrying a cross.”
 

~ Sinclair Lewis


IT IS OVER!!!!!!!!

Every time I see Senator Chuck Grassley giving someone a stearn look for the camera I have to laugh.  He and Democratic Senator Max Baucus are two of the biggest phonies and bagmen for the health care industry in the U.S. Senate.  I personally responded to so many of his pseudo-inquisitions into Medicare that I had a template file in Word Perfect to punch in each new batch of questions (and sometimes the answers to the last batch worked for the new ones).  This is the same guy who was yelling about Medicare “death panels” and “killing grandma” when he was running scared from the local tea party kooks during his 2010 re-election campaign.  He of all people knows how Medicare really works and what is in the Affordable Care Act.  If he was any good he could have improved something, somewhere, but the only thing he ever accomplished was staying in the Senate for decades.

Barry Schmittou

Jan. 26, 2012, 9:22 a.m.

To Barb and Christina,

Obviously you have not read the evidence I’ve posted. The quotes from the Professors seen above are in reference to the Health Care laws that are supposed to protect Americans. The following quotes from WFAA are in regards to injured workers in America :

WFAA - TV in Dallas wrote this about Workers Comp :

“a remarkable number of Texans committed suicide because they could no longer endure the pain caused by their injuries and they had been repeatedly turned down for worker’s comp care. Some insurance companies send peer review doctors medical files “stripped” of records important to the possible approval of workers’ comp claims.”

Every quote from the numerous Judges seen at http://www.deadlyorganizedcrimes.blogspot.com is in regards to disabled Americans, including Judge Enslen writing “MetLife and it’s henchmen”

Barb and Christina cannot provide a good explain as to how ignoring brain lesions and MS, a foot a new mother broke in five places, and cancer and cardiac conditions is okay for MetLife’s doctors

There are many lives being destroyed, and I am trying to help stop that. I am only responding to Barb and Christina because their comments are misleading and show no compassion for very sick and dying patients. I will not respond to them again, the evidence i’ve posted on the websites proves their comments are misleading. I don’t know what their motivation is.

I appreciate the commenters who have thanked me in the past. ProPublica’s T Christian Miller thanked me for helping to get Marc Munro to contact him.

I am sure some of the commenters who attack me while ignoring the overwhelming evidence are either affiliated with MetLife or the other deadly corporations, or supporters of the Obama and/or Bush administrations that have both allowed numeorous corporate crimes, including Wachovia laundering #378 billion and no one was prosecuted by Obama, as seen at http://www.stopdeadlycorporatecrimes.blogspot.com

Kuddoes to Senator Grassley for his watch dog work.  These aberrations of treatment serve to drive up clinical costs as well as taxpayer costs.  These kind of Doctors force ethical Doctors to carry higher malpractice insurance and those costs do get passed on.  It serves to corrupt clinical responses to patients complaining of pain.  Doctors are so averse to prescribing pain medication that when patients complain of pain they don’t listen to the symptoms, but deny narcotics.  I suffered with rheumatoid arthritis for over 25 years and it wasn’t until I was unable to walk that I was finally diagnosed.  Narcotics are not what got me feeling better.  Narcotics are a useful tool for responsible Doctors to dispense in a responsible way to appropriate patients.  There is no room for drug dealing doctors in medicine.

So, are these Dr.s writing prescriptions on the internet and then getting kickbacks?  What is suspected?

I am no fan of Medicaid or the drug industry but this article is little more than a catchy sound bite.

Most low income adults can’t get Medicaid unless they are disabled, seniors or kids (not adults). So this is a specialized population and numbers would not compare to any “average”.

There’s no sources for this in the article. That’s pretty shooty reporting. I’m very disappointed.

This article is part of an ongoing investigation:
Dollars for Doctors

Dollars for Doctors: How Industry Money Reaches Physicians

ProPublica is tracking the financial ties between doctors and medical companies.

The Story So Far

ProPublica is investigating the financial ties between the medical community and the drug and device industry. In October 2010, ProPublica compiled the list of payments that drug companies make to physicians and built a publicly searchable database so that patients could look up their doctors.

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