Brown Calls on President Obama to Combat Prescription Drug Abuse and Medicaid Fraud in Ohio

Illegal Reselling of Prescription Drugs is Growing Public Health Problem

WASHINGTON, D.C. – U.S. Sen. Sherrod Brown (D-OH) today wrote to President Obama about the growing problem of prescription drug abuse and Medicaid fraud in Ohio. President Obama introduced proposals to combat Medicaid prescription drug fraud earlier this year and Brown called for increased state and federal collaboration in fighting drug diversion and drug fraud.

“This is not only a matter of crime, it is both a public health and fiscal issue,” wrote Brown in his letter to President Obama.  “In Southern Ohio, there is a disturbing pattern of drug diversion wherein individuals obtain controlled substances using their Medicaid cards and then sell these substances.”

Prescription drug abuse is an epidemic in Ohio. In 2007, unintentional drug poisoning became the leading cause of injury death in Ohio, surpassing motor vehicle crashes and suicide for the first time on record. Prescription opoids, or pain medications, such as oxycodone, morphine, and methadone are largely responsible for overdoses and deaths in Ohio. Many rural counties increasingly cite the use of Medicaid drug fraud as a strategy for drug users and sellers to subsidize their habits. These communities have also seen an increasing number of so-called “pain clinics” that offer a no-questions-asked front for supplying painkillers. 

“In 2009, Adams County with a population of 28,000 people lost 20 individuals from overdoses on prescription medication — typically by Oxycodone,” Adams County Judge Brett Spencer said. “Here in my county for example, one woman- in less than 9 months- received prescriptions for Oxycodone and Hydocodone from 73 different doctors filled at 54 different pharmacies.  The cost to the taxpayer exceeded $34,000.00, with a street value of $248,000.00- translating to $10.00 per milligram.”

The increase in drug activity creates a cascade of negative consequences. Abusers end up in the court system, which places a strain on their families and further strain on the prison systems. More employers find workers with drug felonies or job applicants that cannot pass drug tests, further depressing the local economy.

A full copy of the letter can be found below:

March 8, 2010

President Barack Obama
The White House
1600 Pennsylvania Ave. NW
Washington, DC 20500

Dear President Obama:

I am writing in regard to two Administration proposals that could have a significant bearing on drug diversion, which is a critical and growing problem in Ohio.

I was very pleased to see that your fiscal year 2011 budget – as well as the health reform proposal you released on February 22, 2010 – included a section on Medicaid Prescription Drug Profiling.  This proposed program, which is part of your administration’s new approach to health care fraud and abuse control, would require states to monitor and remediate high-risk prescription drug billing activity.  It would allow the Centers for Medicare and Medicaid Services (CMS), along with other federal agencies, to track prescription drug users and prescribers in an effort to curb over-utilization, saving an estimated $1.6 billion over the next five years.  The prospects for such a program – especially in the area of controlled substances – are promising.

Another promising proposal contained within your recently released budget would support initiatives of the joint Department of Health and Human Services (HHS) and Department of Justice (DOJ) Health Care Fraud Prevention and Enforcement Action Team (HEAT) task force. This joint task force, made up of top level law enforcement and staff from DOJ and HHS, is charged with preventing fraud and enforcing current anti-fraud laws around the country. In 2008, the HEAT task force secured 588 criminal convictions, obtained 337 civil administrative actions against individuals and organizations who were committing Medicare Fraud, and recovered more than a billion dollars in health care fraud monies.

I would like to work with you on establishing dedicated efforts within each of these programs to address the misuse of Medicare and particularly Medicaid coverage to engage in drug diversion. In Southern Ohio, there is a disturbing pattern of drug diversion wherein individuals obtain controlled substances using their Medicaid cards and then sell these substances. This is not only a matter of crime, it is both a public health and fiscal issue. I strongly believe that there should be a special emphasis on stopping this illegal behavior as part of your drug profiling initiative and that the HEAT task force should consider stopping this behavior a top priority.

We also must explore other avenues for combating prescription drug fraud, addressing illegal prescription drug use, and rooting out existing fraud. As you know, the illegal use of controlled substances has become an epidemic across the country and Ohio is no exception, particularly Southern Ohio. A February 7, 2010 article in the Columbus Dispatch reported that Ohio pharmacists filled 2.7 million prescriptions in 2008 for narcotics containing oxycodone (such as OxyContin and Percocet) and 4.8 million prescriptions for medications containing hydrocodone (such as Vicodin). According to statistics from the Substance Abuse and Mental Health Services Administration (SAMHSA), there has been a 141 percent increase in the number of admissions for substance abuse treatment for prescription opioids in Ohio from 1998 to 2006 – from 1,140 in 1998 to 2,746 in 2006. We have also heard from county sheriffs that Ohio jails are increasingly being populated by individuals who have illegally sold or abused these drugs and that the subsequent overcrowding of prisons is a growing problem.

And, most worrisome of all, deaths related to overdoses of prescription drugs have soared in Ohio over the last decade. From 1999 to 2007, Ohio’s death rate due to unintentional drug poisonings increased more than 300 percent, largely due to prescription drug overdoses. In Ohio, there were 327 fatal unintentional drug overdoses in 1999 growing to 1,351 annual deaths in 2007. In 2007, unintentional drug poisoning became the leading cause of injury death in Ohio, surpassing motor vehicle crashes and suicide for the first time on record.

In a region afflicted by growing rates of substance abuse, Southern Ohio is struggling with high unemployment rates and limited resources to address these types of problems.  This has become a public health emergency as well as a drain on scarce federal, state, and local dollars. In order to address these problems, I ask for your help in rooting out the prescription drug fraud that is contributing to the misuse of taxpayer dollars and for your help in addressing the substance abuse problems that are plaguing my state. I have reached out to DOJ, HHS, and the Drug Enforcement Agency (DEA) in order to formulate solutions to these pressing problems, and I appreciate your continued assistance in addressing these important issues burdening Ohio.  Thank you.

Senator Sherrod Brown

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