Indianapolis Star

by John Russell

Indiana doctors who write thousands of prescriptions a year for drugs covered by publicly funded Medicaid and Medicare programs are coming under federal scrutiny.

U.S. Sen. Charles Grassley of Iowa has launched an investigation into doctors here and around the country who are top prescribers for drugs billed to the federal program, citing concerns that expensive medications are being overprescribed.
Several states, including Indiana, have already responded with lists of top prescribers.

Grassley said that some physicians are writing tens of thousands of prescriptions for costly drugs. He cited a doctor in Florida who wrote 96,685 prescriptions for mental health drugs in a 21-month period.

No Indiana doctor came close to that amount, according to a list sent to Grassley’s office by the Indiana Family & Social Services Administration. The agency compiled a list of top prescribers overall in 2008 and top prescribers for certain psychiatric medications in 2008 and 2009, including Zyprexa, Geodon, Risperdal and Abilify.

According to the list, the top overall prescriber in Indiana is Dr. Daniel Kinsey, a psychiatrist in Goshen. He wrote 2,894 prescriptions in 2008, which resulted in $791,289 in medication charges to the state.

The next highest was Dr. Melinda Weekly, a psychiatrist in Bloomington, who wrote 2,456 prescriptions in 2008, resulting in charges to Indiana of $1.16 million.

Other states have also compiled lists. In Texas, one doctor authorized 13,596 prescriptions for anxiety drug Xanax in 2008, and increased it to 14,170, according to a letter Grassley recently sent to the U.S. Department of Health and Human Services.

In Connecticut, one doctor ranked consistently as the top prescription writer across a full range of pharmaceuticals, Grassley said, writing 5,945 prescriptions in 2008 and 7,459 in 2009 for seven medications.

“I want to be clear that none of the information provided suggests any illegal or wrongful behavior,” Grassley wrote. “It merely demonstrates that across pharmaceutical brands and categories, as well as across states, there are very often providers that prescribe certain drugs at significantly higher rates than their peers.”

He continued: “This may be because a particular physician has a specific expertise or patient population, but it might also suggest overutilization or even health care fraud.”

Grassley, who is a top member of the Senate Finance Committee, urged federal authorities to look into the matter.

“The trend is found again and again across the states, suggesting that top prescribers stand out not only against other providers in their state, but against the very top prescribers in those states,” he said.