States Go After High-Prescribing Doctors

States Go After High-Prescribing Doctors

April 18th, 2012 // 12:52 pm @ jmpickett

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If this sounds familiar, it is because we are keeping tabs on the steps that states are taking to monitor doctors who write large numbers of prescriptions for particular drugs that are paid for by Medicaid programs. Why? For the past two years, US Senator Chuck Grassley has pressed all 50 states to provide data on these doctors amid reports that some meds – widely used antipsychotics and the OxyContin painkiller – have sometimes been prescribed at unusually high rates.

The reason for the inquiry was to determine whether the drugs are overprescribed and, consequently, costing taxpayers unnecessarily. The effort was also part of a wide-ranging probe that Grassley has pursued over the last few years into the financial relationships between physicians and the pharmaceutical industry over concerns that such ties may unduly influence medical research and practice.

Initially, some states refused to comply with his demands. More recently, though, results have been coming in and there are increasing signs that some states are taking action against doctors who have been identified as high prescribers. Among the states that were recently reported to have begun to take steps – such as terminating Medicaid contracts or reviewing licenses – are Minnesota, Oregon and Florida.

Yet another batch of states is now disclosing their responses. For instance, in Maine and Colorado, no prescribers faced any action, but both states maintain they are ramping up education efforts (see this and this). But Delaware Health & Human Services recently wrote Grassley that “some form of administrative action” was taken against 12 percent of the top prescribers of antipsychotics and painkillers (read the letter). Meanwhile, Vermont referred one prescriber to its Medical Practice Board and Connecticut suspended the license of one doctor (see here and here).

And in California, a spokesman for the Department of Healthcare Services tells us that temporary suspensions or restrictions were placed on 15 to 20 doctors in the past two years for prescribing disproportionately high volumes of painkillers and antipsychotics to Medicaid patients. “These are internal sanctions placed on providers that affect their participation in the Medi-Cal program,” he wrote us. At the same time, the department wrote Grassley that four providers were referred to the Medical Board of California (look here).

“While the responses from the states are still being received, many states are still reporting a selection of top ten providers that are prescribing at rates double or triple that of their peers,” Grassley said in a statement last month about the ongoing probe. “While some of these outliers are legitimate providers working in high-volume practices, such as mental hospitals, many cannot be explained away.”