U.S. Senator Requests List in Probe of Rising Medicaid Costs
Wyoming’s top 10 Medicaid prescribers of drugs at the center of a U.S. senator’s probe into fraud, waste and abuse in the Medicaid system wrote prescriptions on six antipsychotic drugs totaling $5 million in 2008 and 2009.
The Wyoming Department of Health compiled the data in response to a request from U.S. Senator Charles Grassley of Iowa, ranking Republican on the Senate Finance Committee, which oversees Medicaid and Medicare.
In April the senator requested 2008 and 2009 data from all 50 state Medicaid agencies on the top 10 Medicaid prescribers for each of six antipsychotic and two narcotic drugs in an effort to identify “outlier” doctors who have prescribed certain drugs in much greater quantities than other doctors.
“The overutilization of prescription drugs, whether through drug abuse or outright fraud, plays a significant role in the rising cost of our health care system,” Grassley wrote.
The most glaring example, cited by Grassley in a letter to Health and Human Services Secretary Kathleen Sebelius, was a Florida doctor who wrote 96,685 prescriptions for psychiatric drugs in 21 months, with the cost billed to the state’s Medicaid program.
Because Wyoming’s top Medicaid antipsychotic prescribers are not identified by name in the Department of Health data, it is not possible to track any financial ties they might have with the pharmaceutical companies that make these drugs. Such ties could lead to a higher use of the drugs and a higher cost to the Medicaid program without benefiting patients.