Ky. ranks 8th in the number of high-prescribing Medicare physicians for powerful narcotic painkillers and stimulants

Kentucky ranks eighth in Medicare physicians who are considered “high prescribers” of Schedule 2 medications, drugs that have the highest potential for abuse like oxycodone, fentanyl, morphine and Ritalin, according to an analysis of Medicare data analyzed by ProPublica, Laura Ungar reports for The Courier-Journal. About 1,000 Kentuckians die each year from drug overdoses.

Medicare’s drug program, Part D, covers about 38 million seniors and disabled and pays for more than one of every four prescriptions dispensed in this country, Charles Ornstein and Ryann Grochowski Jones report for ProPublica, a non-profit investigative news organization.

Further analysis by The Courier-Journal found that Kentucky doctors prescribed narcotic painkillers to a “much larger percentage of their elderly and disabled patients” compared to other states, and that Kentucky had 11 of the 269 prescribers who wrote more than 3,000 prescriptions for Schedule II drugs under the program, Ungar reports.

“One in five doctors who wrote at least 3,000 prescriptions for Schedule 2 drugs have faced some kind of sanction or investigation, according to the ProPublica analysis,” Ornstein and Jones write.

Kentucky’s top prescribers, those with the largest numbers of Medicare patients who received at least one prescription for a narcotic painkiller in 2012, include three pain doctors, an adult-medicine physician and an internal-medicine doctor, Ungar reports.

In 2012, 12 of Medicare’s top 20 prescribers of Schedule 2 drugs faced disciplinary actions by their state medical boards, Ornstein and Jones report. In Kentucky, only one of its top prescribers, Dr. Gregory Mick, a Lexington adult-medicine physician, has been disciplined by the Kentucky Board of Medical Licensure, which ordered him to stop prescribing controlled substances, Ungar reports.

The other four top prescribers told Ungar that “they are practicing good medicine and have legitimate reasons for having more than 1,000 Medicare patients each who received at least one narcotic painkiller prescription.”

Beginning in mid-2015, Medicare will have the authority to kick doctors out of the program if they prescribe in abusive ways, Ornstein and Jones report. Medicare sent letters to 760 high prescribers in September “in hopes that they will examine their prescribing and make changes.”

ProPublica obtained the data under the Freedom of Information Act to update its online Prescriber Checkup tool with the most recent numbers available and shared it with The Courier-Journal and other Gannett Co. news organizations. A Courier-Journal reporter further analyzed the information about Kentucky doctors.