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The close companionship of fraud and painkiller abuse

Stories from Pennsylvania, West Virginia and Florida

Insurers pay up to $72.5 billion annually in direct healthcare costs related to non-medical use of prescription painkillers, according to the Centers for Disease Control and Prevention. And opiate abuse paves the way to healthcare fraud as evidenced by news from three states.

Pennsylvania geriatrician John Terry, M.D., for example, was charged with unlawful distribution of controlled substances and healthcare fraud, according to the Westfield Free Press-Courier. Terry reportedly wrote prescriptions for oxycodone and other narcotics for people he knew didn't need the drugs for legitimate medical reasons. Terry also allegedly prescribed painkillers for beneficiaries who weren't his patients knowing Medicare would pick up the tab for the drugs, the Press-Courier added.

"We rely on doctors to be part of the prescription drug abuse solution--not part of the problem," Nick DiGiulio, special agent in charge for the Inspector General's Philadelphia Office, told the newspaper. 

In West Virginia, authorities arrested nine people for alleged involvement in a drug ring that forged prescriptions and paid runners to fill them at pharmacies, WSAZ News reported. Tonya Ramsey reportedly stole a doctor's prescription blank and then shared wrongfully-obtained oxycodone with runners including her daughter, WSAZ noted.

But Florida--the state once called the nation's pill mill capital--is making strides against painkiller addiction through a combination of crackdown efforts, according to The Tampa Tribune.

Oxycodone's main manufacturer, for instance, reformulated the drug in 2010 to make it harder to abuse. Florida law enforcement stepped up raids on pain clinics and sent drug-dealing doctors to prison. The state also passed new laws penalizing over prescribers and requiring pharmacists to use a prescription drug monitoring database, the article noted. 

The results: The number of oxycodone pills shipped to Florida--more than 650 million in 2010--fell to less than 527 million in 2011 and has continued to drop since. And there are now 367 pain statewide pain clinics, less than half the number operating in 2010.         

For more:
- view the CDC feature
- read the Westfield Free Press-Courier article
- see the WSAZ News piece
- here's The Tampa Tribune article

Related Articles:
Forging prescriptions is easy, criminal says
How to work effectively with law enforcement to fight fraud
Prescription abuse prevention saves money and lives
Sharpening the tool of prescription drug monitoring programs
Electronic databases can help fight prescription painkiller abuse