Doctors' prescriptions raise suspicions of Medicaid fraud

  • Article by: JEREMY OLSON , Star Tribune
  • Updated: February 29, 2012 - 11:27 PM

Minnesota officials are reporting a handful of doctors to the state medical board for potential disciplinary action because of the amount of addictive painkillers and potent psychotropic drugs they have prescribed.

Minnesota officials are reporting a handful of doctors to the state medical board for potential disciplinary action because of the amount of addictive painkillers and potent psychotropic drugs they have prescribed.

In a Feb. 13 letter to U.S. Sen. Charles Grassley, R-Iowa, the Department of Human Services said it has reported two doctors for excessive prescriptions and was "in the process of reporting others."

The letter was an update to Grassley, a member of the Senate Judiciary Committee who has been investigating whether doctors are bilking the Medicaid system by writing too many prescriptions or are prescribing certain medications more often because of financial ties to drug manufacturers.

In a letter dated Jan. 23, Grassley informed the department that he had "concerns about the oversight and enforcement of Medicaid abuse in your state." One doctor, for example, had prescribed three times more of the addictive painkiller OxyContin to Medicaid fee-for-service patients in 2009 than any of his colleagues.

Grassley said he knew of other "outlier" doctors that year who prescribed excessive levels of Roxicodone, another narcotic painkiller, and antipsychotic drugs. He acknowledged that there can be legitimate reasons why some doctors are frequent prescribers: Some might work with large numbers of Medicaid patients or they might direct mental-health units with many patients who need medication.

Grassley's conclusions were based on 2009 data provided by Minnesota last year regarding the state's Medicaid program, which provides health benefits for poor, elderly and disabled residents.

In its latest correspondence, the state provided Grassley with 2010 and 2011 prescribing data, which show similar patterns.

One doctor, for example, issued 906 prescriptions for the antipsychotic drug Seroquel to patients on the fee-for-service Medicaid program in 2010. The next closest prescriber issued 609 prescriptions. That top doctor, psychiatrist Roger A. Johnson of Roseville, does not appear on the 2011 prescribing list, though. In March last year, the Minnesota Board of Medical Practice disciplined Johnson and forbade him from prescribing psychiatric drugs.

Disciplinary action

State officials offered the disciplinary actions as an example of continuing efforts in Minnesota to curb inappropriate prescriptions. The state is also in the final stages of creating a consult service intended to discourage doctors from issuing questionable prescriptions of antipsychotics and other drugs to children.

"We share your concern about overprescribing and abuse of these drug categories and continue to look for ways to better monitor and control the use of these therapeutically useful yet extremely dangerous prescription drugs," wrote David Godfrey, Minnesota's Medicaid director, in the February letter to Grassley.

The two doctors mentioned in the letter as being referred to the state medical board for disciplinary action are Sheftel Cohen and Spaulding Everett. Everett's medical license was suspended by the board last October. Cohen, of Brooklyn Park, surrendered his medical license in March 2011 after the board found evidence that he was prescribing "excess quantities of narcotics."

The Department of Human Services learned of the doctors' activities by monitoring Medicaid patients and noticing some who were receiving questionable levels of prescription drugs, said spokeswoman Karen Smigielski.

Jeremy Olson • 612-673-7744

  • get related content delivered to your inbox

  • manage my email subscriptions

ADVERTISEMENT

Connect with twitterConnect with facebookConnect with Google+Connect with PinterestConnect with PinterestConnect with RssfeedConnect with email newsletters

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

 
Close