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The Herald-Dispatch
Editorial: Senator asks good questions about prescription drugs

He is a U.S. senator from another state, but we think Charles Grassley of Iowa is asking the right questions about a topic that affects our region in a big way.

Recently, Grassley studied Medicare and Medicaid prescription rates from doctors around the country, and found several instances of doctors with very high prescription rates. Among the findings were:
A Miami doctor who wrote nearly 97,000 prescriptions in 18 months for mental health drugs for Medicaid patients.

An Ohio physician who wrote about 102,000 prescriptions in two years.
A Texas doctor who wrote 14,170 prescriptions for the anti-anxiety drug Xanax in one year.

To help with the math, 102,000 prescriptions in two years is about 135 a day with no weekends off and no vacation. These guys are pretty busy, and the taxpayer is footing the bill.

\”The federal government has an obligation to figure out what\’s going on here,\” said Grassley, who is a Republican ranking member of the Senate Finance Committee, which oversees Medicare and Medicaid. \”These programs can\’t spare a dollar for prescription drugs that aren\’t properly prescribed. The conclusion might be that there isn\’t any fraud, but it\’s important to reach a conclusion one way or the other and fix whatever is broken.\”

Moreover, as we know in our region, the flood of prescription drugs is now one of the biggest components of the nation\’s drug abuse problem. Local law enforcement has made cases against some pill-mill type operations, but those cases take years and huge amounts of manpower.

What is the federal government doing to look at this from a \”top-down\” vantage point — especially when the prescriptions are being paid for by Medicare or Medicaid?

Apparently not as much as it could.

Grassley\’s investigation shows the government does not investigate doctors who prescribe suspiciously high rates of drugs for fraud. Those cases may be referred for \”medical review,\” but critics say that accomplishes little.

Meanwhile, the Medicare and Medicaid fraud problem is estimated at $60 billion to $90 billion a year.

Grassley has written to Department of Health and Human Services Secretary Kathleen Sebelius for an explanation on how contractors are monitored, and he wrote to several state agencies, including West Virginia\’s Department of Health and Human Services.

While these agencies place a priority on making sure patients get the care they need, it also makes sense to recognize their unique position in identifying fraud and preventing prescription drugs from entering the black market.

We think Grassley is asking the right questions.