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State snubs feds in doctor probe

State snubs feds in doctor probe


outh Dakota is one of 10 states that failed to provide complete information to a U.S. senator who is trying to identify doctors who prescribe excessive amounts of mental health and pain medications.

State Medicaid Director Larry Iverson also refused to release that information to the media.

Instead of identifying doctors by name, or provider numbers, the state used letter codes that had no consistency from year to year, making it impossible to identify doctors who might be over-prescribing psychotropic or addictive medicines including Oxycontin and Xanax.

Without a way to track patterns from one year to the next, the information provided by the state was largely useless.

U.S. Sen. Charles Grassley, R-Iowa, a ranking member of the Senate Finance Committee, asked every state to provide a list of its top 10 prescribers for mental health and pain medications.

He launched the inquiry after hearing about a Florida doctor who wrote 96,685 prescriptions for mental health drugs within a two-year period. The goal is to determine whether proper oversight exists for Medicare/Medi- caid practices.

South Dakota should have assisted that effort to protect public safety.

Doctors who overprescribe potentially dangerous medications need to be identified for the safety of their patients, their loved ones and the public, all of whom are put at risk when addictions develop or illegal trafficking in prescription medicines results.

Iverson said his office has practices in place to detect fraud and over-prescribing, including a drug utilization program that reviews the prescription patterns of doctors. Therefore, he should understand the federal government's desire to do the same thing.

The public isn't likely to complain about too much oversight.

Even with the incomplete information provided by South Dakota, Grassley identified an unnamed South Dakota doctor who wrote 898 prescriptions for Risperdal in 2009, compared with the other top 9 who ranged from 133-441 prescriptions.

That doesn't necessarily mean any abuse took place.

Certain specialists or doctors working in certain medical facilities would prescribe more of these medications as part of a normal practice. But there's no way of knowing that without oversight.

The 10 states that refused to fully cooperate cited a desire to protect doctor confidentiality. Perhaps they're confusing that with the necessity of protecting patient confidentiality.

It's more important to protect patient safety - and to expose potential fraud with taxpayer dollars - than it is to protect doctors.

Another reason the state limited its information, according to Iverson, was that the state didn't know how it would be used.

That makes no difference whatsoever. The federal government has every right to examine prescription practices in the federal Medicare and Medicaid programs.

South Dakota would better serve the public by providing the requested information to Grassley.

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