State cuts doctors from Medicaid [The Honolulu Star-Advertiser]
By Rob Perez, The Honolulu Star-Advertiser | |
McClatchy-Tribune Information Services |
The actions against the five physicians came to light in a
Fink oversees
After getting 2008 data showing the top 10 Hawaii prescribers for six antipsychotic medications, a painkiller and an antidepressant, Grassley, a member of the
"While I am sensitive to the concerns of misinterpretation of the data you provided, the numbers themselves are quite shocking," Grassley wrote.
Grassley noted, for instance, that the top prescriber of OxyContin, an addictive painkiller, wrote nearly double the prescriptions prescribed by the second provider on the list and more than four times the 10th prescriber. He also noted that the top prescribers of powerful antipsychotic drugs wrote double or triple the number of prescriptions as others on the lists.
None of the physicians on the lists were identified by name, only by their prescriber identification numbers.
In a written statement to the
"We are mindful that while many prescriptions are therapeutically useful, they also are potentially dangerous and addictive," she wrote. "DHS will continue to be vigilant to protect against fraud and abuse."
Sen.
"We're very aggressive in investigating when these things are flagged," Huff said.
In the nine months he has been with AlohaCare, Huff said he was aware of only one or two cases involving controlled substances that led to internal investigations. If AlohaCare officials find that laws or regulations have been broken, the cases are reported to authorities, he said.
"We take every precaution to guard against abuse and have staff responsible for monitoring all lines of business for potential abuse or fraud," HMSA spokeswoman
Grassley, an
Because of their addictive properties, the painkillers often are abused by patients or are sought for resell on the black market. Some of the antipsychotics have been the focus of investigations in which pharmaceutical companies were accused of illegally promoting the drugs for unapproved uses.
Among other things, the data provided to Grassley showed that the top 10 Hawaii prescribers of Seroquel collectively wrote more than 5,000 prescriptions in 2008 -- the latest year for which statistics were available -- at a cost of nearly
The top prescriber for Zyprexa wrote 581 prescriptions, billing
Some of the doctors showed up on multiple lists. The top Zyprexa prescriber, for instance, also was the top one for Geodon, another antipsychotic, and the second highest for Seroquel.
In his letter last month to Grassley, DHS' Fink wrote that some of the providers on the lists worked in the state Adult Mental Health Division or at one of
In response to Grassley's question about whether providers have been reported to the state medical board, Fink said some -- he didn't specify a number -- have been referred to the
He also noted that 98 percent of prescriptions are processed by managed care organizations and that the state
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