TN won't release names of doctors who write most prescriptions - comments spot on

[Guest guest]

http://www.tennessean.com/article/20101201/NEWS01/12010355/TN-won-t-release-name\

s-of-doctors-who-write-most-prescriptions

TN won't release names of doctors who write most prescriptions

Senator targets overprescribers of costly drugs

By Gee • THE TENNESSEAN • December 1, 2010

A powerful U.S. senator is turning a spotlight on doctors who

overprescribe commonly abused

medications, but he has found a challenge in getting the names of the

doctors from some states,

including Tennessee.

Still, the data that Tennessee sent from its TennCare program shows that

some doctors prescribe far

more than others of the costly medications — and taxpayers foot the bill.

U.S. Sen. Grassley, R-Iowa, believes overprescribing is

contributing to the growth in

taxpayer dollars spent on health-care programs such as Medicaid, which

cost states and the federal

government $317 billion annually.

Grassley asked states to provide a list of the top 10 prescribers of

eight antipsychotic and pain

medications. Tennessee is one of a handful of states that chose not to

provide information that could

identify the individual doctors in its response to Grassley.

According to the lists submitted by TennCare Director Darin Gordon to

Grassley and the Senate

Finance Committee in May, one Tennessee doctor wrote 2,060 prescriptions

for three of the

antipsychotic medications last year. TennCare covered more than $990,000

of the cost of that

doctor's prescriptions, which went to 763 distinct patients. Fourteen

Tennessee doctors wrote more

than 1,000 prescriptions last year for the drugs Grassley asked about,

an analysis of the lists

showed.

As it responded to Grassley's request, TennCare also took its own look

at the top prescribers,

spokeswoman Gunderson said. She said the bureau looked at the

physicians' specialties to see

whether the prescriptions matched their scope of practice. An

unspecified number that warranted

further investigation were forwarded to TennCare's Provider Fraud Task

Force.

The task force hasn't identified any instances of fraud or inappropriate

prescribing that it would turn

over to the Tennessee Bureau of Investigation, Gunderson said. Two

doctors on the lists, however,

have since had their medical licenses suspended and been sanctioned so

that they can no longer

participate in Medicare or Medicaid programs, including TennCare, which

administers the Medicaid

program in Tennessee. TennCare would not reveal the two doctors' names,

so The Tennessean could

not investigate the specific reasons that the state health department

suspended their licenses.

Overall, Tennessee's top prescribers did not exhibit the types of high

numbers that have particularly

troubled Grassley.

In other states, doctors have been found to write tens of thousands of

prescriptions for the drugs.

One Florida doctor wrote 96,685 prescriptions for mental-health drugs in

a 21-month period.

More scrutiny urged

In an October letter to Health and Human Services Secretary Kathleen

Sebelius, Grassley said that,

while the information on top prescribers doesn't prove illegal activity,

it does warrant further scrutiny.

" This may be because a particular physician has a specific expertise or

patient population, " Grassley

wrote, " but it might also suggest overutilization or even health-care

fraud. "

Grassley asked for information on the drugs Abilify, Geodon, Seroquel,

Zyprexa, Risperdal, OxyContin,

Roxicodone and Xanax. In the letter to Sebelius, he noted the big gaps

between the top prescribers of

certain medications and the 10th-highest prescribers of the same drugs.

In Tennessee, for example,

the doctor who prescribed the most Risperdal, a mental-health

medication, wrote 1,481 prescriptions

for the drug. The 10th doctor on the list wrote 851.

" The trend is found again and again across the states, " Grassley wrote,

" suggesting that top

prescribers stand out not only against other providers in their state,

but against the very top

prescribers in those states. "

Tennessee, along with eight other states, chose not to provide its top

prescribers' names or prescriber

numbers.

In his letter to Grassley, Gordon wrote that he worried " identifying

these providers could lead to

severe consequences stemming from faulty conclusions. "

" We don't want to see a provider unjustly accused of improper care, "

Gunderson said. " The second you

start putting that out, people begin drawing their own conclusions. "

Not all states respond

According to Jill Gerber, a spokeswoman for Grassley, five states

provided doctors' names, 24

turned over prescriber identifiers that can be used to identify doctors

and nine, such as Tennessee,

assigned doctors a random number that cannot be used to identify them.

Alabama declined to provide

any information at all, and 11 states haven't responded yet.

, a former investigator in the Pennsylvania Office of the

Inspector General turned

prominent pharmaceutical industry whistle-blower, said he's troubled

that states would withhold names.

" It absolutely should be public. These are taxpayer dollars being spent

on behalf of our most

vulnerable citizens, " said.

" I can't see any rationale for secrecy regarding the information

Grassley asked for. "

While he doesn't have any specific knowledge of wrongdoing in Tennessee,

said he suspects

many top prescribers have inappropriate relationships with

pharmaceutical companies, such

as pushing the drugs of companies that pay them for services such as

speaking engagements. He said

that the more secret things are kept, " the more open and ripe the

situation is for fraud and abuse. "

According to a ProPublica investigation into the influence

pharmaceutical companies have on patient

care, 43 doctors received more than $200,000 since 2009 from the seven

companies that disclose

payments for promotional work. Five of the doctors were from Tennessee,

more than any other state.

Tennessee is the 17th-largest state by population.

Gerber said Grassley's investigation is pending while he waits for a

response to his October letter to

Sebelius asking what steps the Department of Health and Human Services

is taking to prevent the overuse

of prescription drugs. He requested a response by Dec. 3. Gerber said

Grassley has not yet come out

with a position on whether top prescribers should be identified by name.

" He's pushed for transparency in many other areas of the health-care

system, " Gerber said, " so as this

inquiry moves forward and HHS joins the conversation, data availability

is certainly one of the

topics on the table. "

Contact Gee at 726-5982 or bgee@....

[Guest guest]

http://www.tennessean.com/article/20101201/NEWS01/12010355/TN-won-t-release-name\

s-of-doctors-who-write-most-prescriptions

TN won't release names of doctors who write most prescriptions

Senator targets overprescribers of costly drugs

By Gee • THE TENNESSEAN • December 1, 2010

A powerful U.S. senator is turning a spotlight on doctors who

overprescribe commonly abused

medications, but he has found a challenge in getting the names of the

doctors from some states,

including Tennessee.

Still, the data that Tennessee sent from its TennCare program shows that

some doctors prescribe far

more than others of the costly medications — and taxpayers foot the bill.

U.S. Sen. Grassley, R-Iowa, believes overprescribing is

contributing to the growth in

taxpayer dollars spent on health-care programs such as Medicaid, which

cost states and the federal

government $317 billion annually.

Grassley asked states to provide a list of the top 10 prescribers of

eight antipsychotic and pain

medications. Tennessee is one of a handful of states that chose not to

provide information that could

identify the individual doctors in its response to Grassley.

According to the lists submitted by TennCare Director Darin Gordon to

Grassley and the Senate

Finance Committee in May, one Tennessee doctor wrote 2,060 prescriptions

for three of the

antipsychotic medications last year. TennCare covered more than $990,000

of the cost of that

doctor's prescriptions, which went to 763 distinct patients. Fourteen

Tennessee doctors wrote more

than 1,000 prescriptions last year for the drugs Grassley asked about,

an analysis of the lists

showed.

As it responded to Grassley's request, TennCare also took its own look

at the top prescribers,

spokeswoman Gunderson said. She said the bureau looked at the

physicians' specialties to see

whether the prescriptions matched their scope of practice. An

unspecified number that warranted

further investigation were forwarded to TennCare's Provider Fraud Task

Force.

The task force hasn't identified any instances of fraud or inappropriate

prescribing that it would turn

over to the Tennessee Bureau of Investigation, Gunderson said. Two

doctors on the lists, however,

have since had their medical licenses suspended and been sanctioned so

that they can no longer

participate in Medicare or Medicaid programs, including TennCare, which

administers the Medicaid

program in Tennessee. TennCare would not reveal the two doctors' names,

so The Tennessean could

not investigate the specific reasons that the state health department

suspended their licenses.

Overall, Tennessee's top prescribers did not exhibit the types of high

numbers that have particularly

troubled Grassley.

In other states, doctors have been found to write tens of thousands of

prescriptions for the drugs.

One Florida doctor wrote 96,685 prescriptions for mental-health drugs in

a 21-month period.

More scrutiny urged

In an October letter to Health and Human Services Secretary Kathleen

Sebelius, Grassley said that,

while the information on top prescribers doesn't prove illegal activity,

it does warrant further scrutiny.

" This may be because a particular physician has a specific expertise or

patient population, " Grassley

wrote, " but it might also suggest overutilization or even health-care

fraud. "

Grassley asked for information on the drugs Abilify, Geodon, Seroquel,

Zyprexa, Risperdal, OxyContin,

Roxicodone and Xanax. In the letter to Sebelius, he noted the big gaps

between the top prescribers of

certain medications and the 10th-highest prescribers of the same drugs.

In Tennessee, for example,

the doctor who prescribed the most Risperdal, a mental-health

medication, wrote 1,481 prescriptions

for the drug. The 10th doctor on the list wrote 851.

" The trend is found again and again across the states, " Grassley wrote,

" suggesting that top

prescribers stand out not only against other providers in their state,

but against the very top

prescribers in those states. "

Tennessee, along with eight other states, chose not to provide its top

prescribers' names or prescriber

numbers.

In his letter to Grassley, Gordon wrote that he worried " identifying

these providers could lead to

severe consequences stemming from faulty conclusions. "

" We don't want to see a provider unjustly accused of improper care, "

Gunderson said. " The second you

start putting that out, people begin drawing their own conclusions. "

Not all states respond

According to Jill Gerber, a spokeswoman for Grassley, five states

provided doctors' names, 24

turned over prescriber identifiers that can be used to identify doctors

and nine, such as Tennessee,

assigned doctors a random number that cannot be used to identify them.

Alabama declined to provide

any information at all, and 11 states haven't responded yet.

, a former investigator in the Pennsylvania Office of the

Inspector General turned

prominent pharmaceutical industry whistle-blower, said he's troubled

that states would withhold names.

" It absolutely should be public. These are taxpayer dollars being spent

on behalf of our most

vulnerable citizens, " said.

" I can't see any rationale for secrecy regarding the information

Grassley asked for. "

While he doesn't have any specific knowledge of wrongdoing in Tennessee,

said he suspects

many top prescribers have inappropriate relationships with

pharmaceutical companies, such

as pushing the drugs of companies that pay them for services such as

speaking engagements. He said

that the more secret things are kept, " the more open and ripe the

situation is for fraud and abuse. "

According to a ProPublica investigation into the influence

pharmaceutical companies have on patient

care, 43 doctors received more than $200,000 since 2009 from the seven

companies that disclose

payments for promotional work. Five of the doctors were from Tennessee,

more than any other state.

Tennessee is the 17th-largest state by population.

Gerber said Grassley's investigation is pending while he waits for a

response to his October letter to

Sebelius asking what steps the Department of Health and Human Services

is taking to prevent the overuse

of prescription drugs. He requested a response by Dec. 3. Gerber said

Grassley has not yet come out

with a position on whether top prescribers should be identified by name.

" He's pushed for transparency in many other areas of the health-care

system, " Gerber said, " so as this

inquiry moves forward and HHS joins the conversation, data availability

is certainly one of the

topics on the table. "

Contact Gee at 726-5982 or bgee@....

[Guest guest]

http://www.tennessean.com/article/20101201/NEWS01/12010355/TN-won-t-release-name\

s-of-doctors-who-write-most-prescriptions

TN won't release names of doctors who write most prescriptions

Senator targets overprescribers of costly drugs

By Gee • THE TENNESSEAN • December 1, 2010

A powerful U.S. senator is turning a spotlight on doctors who

overprescribe commonly abused

medications, but he has found a challenge in getting the names of the

doctors from some states,

including Tennessee.

Still, the data that Tennessee sent from its TennCare program shows that

some doctors prescribe far

more than others of the costly medications — and taxpayers foot the bill.

U.S. Sen. Grassley, R-Iowa, believes overprescribing is

contributing to the growth in

taxpayer dollars spent on health-care programs such as Medicaid, which

cost states and the federal

government $317 billion annually.

Grassley asked states to provide a list of the top 10 prescribers of

eight antipsychotic and pain

medications. Tennessee is one of a handful of states that chose not to

provide information that could

identify the individual doctors in its response to Grassley.

According to the lists submitted by TennCare Director Darin Gordon to

Grassley and the Senate

Finance Committee in May, one Tennessee doctor wrote 2,060 prescriptions

for three of the

antipsychotic medications last year. TennCare covered more than $990,000

of the cost of that

doctor's prescriptions, which went to 763 distinct patients. Fourteen

Tennessee doctors wrote more

than 1,000 prescriptions last year for the drugs Grassley asked about,

an analysis of the lists

showed.

As it responded to Grassley's request, TennCare also took its own look

at the top prescribers,

spokeswoman Gunderson said. She said the bureau looked at the

physicians' specialties to see

whether the prescriptions matched their scope of practice. An

unspecified number that warranted

further investigation were forwarded to TennCare's Provider Fraud Task

Force.

The task force hasn't identified any instances of fraud or inappropriate

prescribing that it would turn

over to the Tennessee Bureau of Investigation, Gunderson said. Two

doctors on the lists, however,

have since had their medical licenses suspended and been sanctioned so

that they can no longer

participate in Medicare or Medicaid programs, including TennCare, which

administers the Medicaid

program in Tennessee. TennCare would not reveal the two doctors' names,

so The Tennessean could

not investigate the specific reasons that the state health department

suspended their licenses.

Overall, Tennessee's top prescribers did not exhibit the types of high

numbers that have particularly

troubled Grassley.

In other states, doctors have been found to write tens of thousands of

prescriptions for the drugs.

One Florida doctor wrote 96,685 prescriptions for mental-health drugs in

a 21-month period.

More scrutiny urged

In an October letter to Health and Human Services Secretary Kathleen

Sebelius, Grassley said that,

while the information on top prescribers doesn't prove illegal activity,

it does warrant further scrutiny.

" This may be because a particular physician has a specific expertise or

patient population, " Grassley

wrote, " but it might also suggest overutilization or even health-care

fraud. "

Grassley asked for information on the drugs Abilify, Geodon, Seroquel,

Zyprexa, Risperdal, OxyContin,

Roxicodone and Xanax. In the letter to Sebelius, he noted the big gaps

between the top prescribers of

certain medications and the 10th-highest prescribers of the same drugs.

In Tennessee, for example,

the doctor who prescribed the most Risperdal, a mental-health

medication, wrote 1,481 prescriptions

for the drug. The 10th doctor on the list wrote 851.

" The trend is found again and again across the states, " Grassley wrote,

" suggesting that top

prescribers stand out not only against other providers in their state,

but against the very top

prescribers in those states. "

Tennessee, along with eight other states, chose not to provide its top

prescribers' names or prescriber

numbers.

In his letter to Grassley, Gordon wrote that he worried " identifying

these providers could lead to

severe consequences stemming from faulty conclusions. "

" We don't want to see a provider unjustly accused of improper care, "

Gunderson said. " The second you

start putting that out, people begin drawing their own conclusions. "

Not all states respond

According to Jill Gerber, a spokeswoman for Grassley, five states

provided doctors' names, 24

turned over prescriber identifiers that can be used to identify doctors

and nine, such as Tennessee,

assigned doctors a random number that cannot be used to identify them.

Alabama declined to provide

any information at all, and 11 states haven't responded yet.

, a former investigator in the Pennsylvania Office of the

Inspector General turned

prominent pharmaceutical industry whistle-blower, said he's troubled

that states would withhold names.

" It absolutely should be public. These are taxpayer dollars being spent

on behalf of our most

vulnerable citizens, " said.

" I can't see any rationale for secrecy regarding the information

Grassley asked for. "

While he doesn't have any specific knowledge of wrongdoing in Tennessee,

said he suspects

many top prescribers have inappropriate relationships with

pharmaceutical companies, such

as pushing the drugs of companies that pay them for services such as

speaking engagements. He said

that the more secret things are kept, " the more open and ripe the

situation is for fraud and abuse. "

According to a ProPublica investigation into the influence

pharmaceutical companies have on patient

care, 43 doctors received more than $200,000 since 2009 from the seven

companies that disclose

payments for promotional work. Five of the doctors were from Tennessee,

more than any other state.

Tennessee is the 17th-largest state by population.

Gerber said Grassley's investigation is pending while he waits for a

response to his October letter to

Sebelius asking what steps the Department of Health and Human Services

is taking to prevent the overuse

of prescription drugs. He requested a response by Dec. 3. Gerber said

Grassley has not yet come out

with a position on whether top prescribers should be identified by name.

" He's pushed for transparency in many other areas of the health-care

system, " Gerber said, " so as this

inquiry moves forward and HHS joins the conversation, data availability

is certainly one of the

topics on the table. "

Contact Gee at 726-5982 or bgee@....

[Guest guest]

http://www.tennessean.com/article/20101201/NEWS01/12010355/TN-won-t-release-name\

s-of-doctors-who-write-most-prescriptions

TN won't release names of doctors who write most prescriptions

Senator targets overprescribers of costly drugs

By Gee • THE TENNESSEAN • December 1, 2010

A powerful U.S. senator is turning a spotlight on doctors who

overprescribe commonly abused

medications, but he has found a challenge in getting the names of the

doctors from some states,

including Tennessee.

Still, the data that Tennessee sent from its TennCare program shows that

some doctors prescribe far

more than others of the costly medications — and taxpayers foot the bill.

U.S. Sen. Grassley, R-Iowa, believes overprescribing is

contributing to the growth in

taxpayer dollars spent on health-care programs such as Medicaid, which

cost states and the federal

government $317 billion annually.

Grassley asked states to provide a list of the top 10 prescribers of

eight antipsychotic and pain

medications. Tennessee is one of a handful of states that chose not to

provide information that could

identify the individual doctors in its response to Grassley.

According to the lists submitted by TennCare Director Darin Gordon to

Grassley and the Senate

Finance Committee in May, one Tennessee doctor wrote 2,060 prescriptions

for three of the

antipsychotic medications last year. TennCare covered more than $990,000

of the cost of that

doctor's prescriptions, which went to 763 distinct patients. Fourteen

Tennessee doctors wrote more

than 1,000 prescriptions last year for the drugs Grassley asked about,

an analysis of the lists

showed.

As it responded to Grassley's request, TennCare also took its own look

at the top prescribers,

spokeswoman Gunderson said. She said the bureau looked at the

physicians' specialties to see

whether the prescriptions matched their scope of practice. An

unspecified number that warranted

further investigation were forwarded to TennCare's Provider Fraud Task

Force.

The task force hasn't identified any instances of fraud or inappropriate

prescribing that it would turn

over to the Tennessee Bureau of Investigation, Gunderson said. Two

doctors on the lists, however,

have since had their medical licenses suspended and been sanctioned so

that they can no longer

participate in Medicare or Medicaid programs, including TennCare, which

administers the Medicaid

program in Tennessee. TennCare would not reveal the two doctors' names,

so The Tennessean could

not investigate the specific reasons that the state health department

suspended their licenses.

Overall, Tennessee's top prescribers did not exhibit the types of high

numbers that have particularly

troubled Grassley.

In other states, doctors have been found to write tens of thousands of

prescriptions for the drugs.

One Florida doctor wrote 96,685 prescriptions for mental-health drugs in

a 21-month period.

More scrutiny urged

In an October letter to Health and Human Services Secretary Kathleen

Sebelius, Grassley said that,

while the information on top prescribers doesn't prove illegal activity,

it does warrant further scrutiny.

" This may be because a particular physician has a specific expertise or

patient population, " Grassley

wrote, " but it might also suggest overutilization or even health-care

fraud. "

Grassley asked for information on the drugs Abilify, Geodon, Seroquel,

Zyprexa, Risperdal, OxyContin,

Roxicodone and Xanax. In the letter to Sebelius, he noted the big gaps

between the top prescribers of

certain medications and the 10th-highest prescribers of the same drugs.

In Tennessee, for example,

the doctor who prescribed the most Risperdal, a mental-health

medication, wrote 1,481 prescriptions

for the drug. The 10th doctor on the list wrote 851.

" The trend is found again and again across the states, " Grassley wrote,

" suggesting that top

prescribers stand out not only against other providers in their state,

but against the very top

prescribers in those states. "

Tennessee, along with eight other states, chose not to provide its top

prescribers' names or prescriber

numbers.

In his letter to Grassley, Gordon wrote that he worried " identifying

these providers could lead to

severe consequences stemming from faulty conclusions. "

" We don't want to see a provider unjustly accused of improper care, "

Gunderson said. " The second you

start putting that out, people begin drawing their own conclusions. "

Not all states respond

According to Jill Gerber, a spokeswoman for Grassley, five states

provided doctors' names, 24

turned over prescriber identifiers that can be used to identify doctors

and nine, such as Tennessee,

assigned doctors a random number that cannot be used to identify them.

Alabama declined to provide

any information at all, and 11 states haven't responded yet.

, a former investigator in the Pennsylvania Office of the

Inspector General turned

prominent pharmaceutical industry whistle-blower, said he's troubled

that states would withhold names.

" It absolutely should be public. These are taxpayer dollars being spent

on behalf of our most

vulnerable citizens, " said.

" I can't see any rationale for secrecy regarding the information

Grassley asked for. "

While he doesn't have any specific knowledge of wrongdoing in Tennessee,

said he suspects

many top prescribers have inappropriate relationships with

pharmaceutical companies, such

as pushing the drugs of companies that pay them for services such as

speaking engagements. He said

that the more secret things are kept, " the more open and ripe the

situation is for fraud and abuse. "

According to a ProPublica investigation into the influence

pharmaceutical companies have on patient

care, 43 doctors received more than $200,000 since 2009 from the seven

companies that disclose

payments for promotional work. Five of the doctors were from Tennessee,

more than any other state.

Tennessee is the 17th-largest state by population.

Gerber said Grassley's investigation is pending while he waits for a

response to his October letter to

Sebelius asking what steps the Department of Health and Human Services

is taking to prevent the overuse

of prescription drugs. He requested a response by Dec. 3. Gerber said

Grassley has not yet come out

with a position on whether top prescribers should be identified by name.

" He's pushed for transparency in many other areas of the health-care

system, " Gerber said, " so as this

inquiry moves forward and HHS joins the conversation, data availability

is certainly one of the

topics on the table. "

Contact Gee at 726-5982 or bgee@....