Pubdate: Sat, 13 Dec 2003
Source: Sun-Sentinel (Fort Lauderdale, FL)
Copyright: 2003 Sun-Sentinel Company
Contact:  http://www.sun-sentinel.com/
Details: http://www.mapinc.org/media/159
Author: Mark Hollis

FLORIDA HEATS UP WAR ON DRUG FRAUD

TALLAHASSEE - Facing a grim spate of deaths in Florida due to prescription 
drug abuse, top state officials on Friday announced they are forming a task 
force to develop new fraud-fighting strategies.

"Lives are being lost," said state Attorney General Charlie Crist. "We have 
to do what we can to make sure this new era of drug dealing discontinues."

Crist, and a half dozen health, law enforcement and drug policy advisers to 
Gov. Jeb Bush, said the task force will explore short-term and long-range 
plans for tackling Medicaid fraud, shutting down a black market of 
prescription drugs, ending addicts' "doctor shopping" for powerful 
painkillers and clamping down on illegal Internet sales of pharmaceuticals.

The idea, officials said, is to take a broad approach to the prescription 
drug crisis responsible for the estimated five deaths each day in Florida 
and which is contributing to a costly abuse of the government health care 
system for the poor.

"It's about taking the bad guys down to protect the good guys," said John 
Agwunobi, secretary of the state's Department of Health.

Aides to the governor say they have ideas for legislative actions, 
including tougher penalties for doctors who overprescribe the medications 
and pharmacists who fill them, to take advantage of Medicaid reimbursements.

They also are reissuing a call for a new prescription-tracking database, 
financed with $2 million from a state settlement with Purdue Pharma, the 
maker of OxyContin and other highly abused pain relievers. The database 
would allow regulators to track and monitor potential Medicaid abusers.

Tougher Penalties

Harsher penalties and the drug registry are initial proposals that state 
officials and legislators have offered in response to a South Florida 
Sun-Sentinel series "Drugging the Poor" that found that the state has 
failed to curb the costly abuse of pain-relief patches, sleeping pills, 
tranquilizers and other narcotics covered under the state's Medicaid 
program for low-income Floridians.

The Orlando Sentinel also conducted an investigation in October that looked 
at deaths in Florida due to oxycodone, a key ingredient in OxyContin.

State leaders are meeting with groups such as the Florida Medical 
Association, which represents more than half the state's doctors, to 
encourage them to voluntarily upgrade health care workers' training to 
improve the detection and treatment of prescription drug abuse.

Additionally, the officials are talking to Florida medical examiners and 
state prosecutors about how their investigations of drug deaths should 
change. And another goal is to improve the communication between health 
investigators and law enforcement officials.

"Medical examiners are able to identify when a number of overdose deaths 
can be tied to a single doctor. That will become a trigger to pass that 
information in a timely fashion [to law enforcement]" said Jim McDonough, 
director of Bush's Office Drug Control Policy.

In its four-part series, the Sun-Sentinel found fewer than three percent of 
the state's medical professionals prescribed more than two-thirds of the 
narcotics and other dangerous drugs dispensed to Medicaid patients in the 
past three years. These drugs cost taxpayers more than $346 million, helped 
feed a black market of drugs and may have contributed to cases of fatal 
overdoses.

Many of the doctors who handed out the most Medicaid prescriptions, the 
investigation found, also are linked to multiple drug-related deaths, or 
have histories of professional misconduct and even, in a few cases, 
criminal arrests.

The series identified millions of dollars in suspect pharmacy billings for 
drugs such as painkillers and sedatives, including claims paid using the 
billing numbers of doctors who were dead or ineligible to write prescriptions.

Despite the problems in the state outlined in the special report, McDonough 
said Friday that Florida leaders have been working to address prescription 
drug abuse problems for some time and may be leading other states in 
controlling them.

"I believe Florida is ahead of the game," he said. "We've been looking at 
this for a couple of years."

But Crist acknowledged more needs to be done.

"Law enforcement has done an extraordinary job of stopping the flow of 
illegal drugs, but this flow of legal drugs for illicit purposes is 
something we are scratching at the surface of, and we want to do everything 
we can to stop it," Crist said.

The task force that will study and monitor new drug-abuse strategies has 
not yet been named, but leaders said it will likely include: Crist, 
Agwunobi, Agency for Health Care Administration Secretary Dr. Rhonda Medows 
and Florida Department of Law Enforcement Secretary Guy Tunnell.

McDonough said public interest in the prescription drug abuse has 
heightened as a result of radio talk show host Rush Limbaugh's admission in 
October of having been addicted to painkillers. The governor has also made 
the issue a priority after his 26-year-old daughter, Noelle, completed a 
drug rehabilitation program. She was arrested last year after posing as a 
doctor to call in a phony prescription for an anti-anxiety medication.

Emerging Interest

Both the increased public interest and stepped-up efforts in state 
government, McDonough said, may also encourage medical regulatory boards to 
boost their efforts to take the crimes more seriously. Health officials 
said that an indication of the emerging interest is the disciplinary action 
taken last week by the Florida Board of Medicine against eight health 
workers, including Fort Lauderdale physician William A. Morris III.

Morris received a $20,000 fine and was ordered to do 50 hours of community 
service after he was found to have been prescribing drugs over the Internet 
for seven months, earning up to $8,000 profit.

Maureen Doherty, a spokeswoman for the Department of Health, said doctors 
are not allowed to prescribe medicines to anyone they have not already 
examined in person. Violation of the rule is now a misdemeanor and is 
identified as "below the standard of care." Health officials want the 
Legislature next spring to make the practice a felony.
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MAP posted-by: Perry Stripling