Senator wants mental health med investigation

by Anne Zieger on October 26, 2010

At present, both Medicare and Medicaid pay for very high volumes of psychiatric drugs for their beneficiaries. But is this a form of abuse, or just a response to the realities of the patients who have these benefits? Sen. Charles Grassley (R-IA), whose career has focused healthcare system regulation for some time, would like federal agencies to find out.

There seems to be little question that some questionable prescribing is going on. For example, observers note that in some cases, it’s common practice to sedate agitated senile patients with antipsychotics not approved for the purpose.

And in some cases, individual physicians are prescribing particularly high levels of such drugs, including  one Miami MD who wrote almost 97,000 such prescriptions in 18 months and an Ohio doctor who wrote about 102,000 mental health scripts in two years.

“The federal government has an obligation to figure out what’s going on here. The taxpayers are footing the bill, and Medicare and Medicaid are already strained to the limit,” Grassley told the Associated Press.

Right now, doctors don’t face punishment or fraud accusations when their mental health prescribing patterns stand out sharply from their peers. If they’re prescribing particularly high levels of a drug, they’re referred for medical review or education, Grassley’s investigation notes.

The really touchy area in this discussion is Medicaid prescribing, given that Medicaid budgets are straining to cover mental health drugs — particularly blockbusters like Seroquel.

Rage though he might, however,¬†Grassley hasn’t made any specific allegations of fradulent practices state Medicaid agencies or federal enforcers should pursue.

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