Investigation: Top Massachusetts Doctors Prescribed Oxycodone 13,000+ Times

Wednesday, May 06, 2015

GoLocalWorcester News Team and Kate Nagle

Twenty five physicians and health professionals in Massachusetts prescribed Oxycodone over 13,000 times in one year under Medicare -- including the leading prescriber whose license was suspended the following year in Rhode Island following patient deaths -- and was arrested in the Commonwealth the following year.

Fathala Mashali, who was was reported to have prescribed Oxycodone under Medicare over 2,500 times in 2012 -- twice the amount of the next doctor and three times the third - was found to have billed Medicare $3.4 million in 2012.

Last month, Boston Business Journal's Jessica Bartlett reported, "Federal prosecutors were at it again this month, accusing a Dover physician with 21 counts of Medicare fraud after having already levied some 23 charges against the same doctor in 2013 and 2014."

SLIDES: See Top Oxycodone Prescribing MA Doctors Under Medicare BELOW

In its report, ProPublica cited the findings that reporter Charles Ornstein said raised flags.

"Medicare had failed to use its own records to flag doctors who prescribed thousands of dangerous, inappropriate or unnecessary," wrote Ornstein.

"Beginning next month, the agency also will compel health providers to enroll in Medicare to order medications for patients in Part D, closing the loophole that has allowed some practitioners to operate with little or no oversight," continued Ornstein. "Medicare Part D is popular among seniors for helping to lower their drug costs. But experts have complained that since Part D began in 2006, Medicare has placed a higher priority on getting prescriptions into patients’ hands than on targeting problem prescribers. The U.S. Department of Health and Human Services’ inspector general has repeatedly called for tighter controls."

Addressing Opiates in MA

First dubbed as a epidemic by the CDC in 2011, the problem has only increased. “Deaths from prescription painkillers have also quadrupled since 1999, killing more than 16,000 people in the U.S. in 2013. Nearly two million Americans, aged 12 or older, either abused or were dependent on opioids in 2013 (the most recent year of full data),” wrote the CDC.

GoLocalWorcester reviewed data collected by the non-profit, media watchdog group, ProPublica who has been collected and organizing federal data. The data collected by ProPublica and reviewed and categorized by GoLocalWorcester comes from new federal reporting requirements impacting the Centers for Medicaid and Medicare (CMS).

In February Governor Baker announced the formation of an Opioid Addiction Working Group, releasing for the first time time, county-level data on the number of prescriptions written for opioids and the number of confirmed opioid-related overdose deaths. The prescription numbers are a result of the Prescription Monitoring Program (PMP), which mandates all opioid prescribers enroll in the program. At its launch, 65% of health professionals required to enroll were , with the remainder expected to sign up by the fall of 2015.

In 2013, Massachusetts witnessed a record 978 overdose deaths with 112 of those in Worcester County.

Worcester County DA Joseph Early said in March that the opiate-abuse problem needs to be attacked from every possible angle, stressing the need for prevention programs, access to treatment and aggressive prosecution of drug dealers and traffickers, and application of the overdose-reversing drug Narcan by police and first-responders has already made a difference, but deaths from heroin and other opioids continue to be high.“

“This is an issue that continues to cause a lot of pain, grief and tragedy,” Early.

Physicians need better training in how to manage pain as well as how to treat addiction to opioids, several experts told a congressional committee.
"[We need] to develop better strategies for the management of chronic pain," said Nora Volkow, MD, director of the National Institute on Drug Abuse, in Bethesda, Md., while testifying Friday at a House Energy & Commerce Oversight and Investigations Subcommittee hearing on government efforts to combat the opioid abuse epidemic. "Physicians are forced -- their patients are suffering, they don't know what to do and give an opioid, even though the evidence does not really show us they're effective for chronic pain, but there are not very many alternatives."

Investigation: Top Massachusetts Doctors Prescribed Oxycodone 13,000+ Times

Related Slideshow: MA Doctors - See Who Prescribed the Most Oxycodone

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