Investigating the Illegal Prescriber Jennifer Carpenter
Disclosure
Nothing to Disclose
Learning Objective #1
The student will explain how to identify the “Illegal Prescriber”
Identifying the Illegal Prescriber Number of patients “treated” each day Length of patient visit Prescriptions written for the same type/quantity of controlled substances Traveling distance of patients
Identifying the Illegal Prescriber (cont’d) Physical examination conducted Lack of Physical examination Type of examination conducted Diagnostic Tests/Results Prescriptions being filled same pharmacy for all patients Prescription written for cash only
Identifying the Illegal Prescriber (cont’d) Illegal activity in the parking lot – drug trafficking, drug use Examples of cases investigated: RX for cash RX for other drugs RX for money RX for sex
Identifying the Illegal Prescriber (cont’d) How does Law Enforcement become aware of the “Illegal Prescriber?” - Local Pharmacists - Nearby business owners - Citizens
Other Fraud Medicaid/Insurance Fraud - Billing for drug tests - Billing for services not rendered - Patients filling prescriptions using MedicaidCards
Learning Objective #2
The student will describe the Steps to take to prevent becoming the “Illegal Prescriber�
Prevent Becoming The Illegal Prescriber Conduct random pill counts Utilize Prescription Monitoring Program Conduct Drug Test Pain Management Contracts Awareness of the parking lot/areas around the office
New Kentucky Laws Definition of Pain Management Facility Majority of patients at facility are provided treatment for pain that include controlled substances Primary practice is treatment of pain Facility advertises for any type of pain management services
New Kentucky Laws (cont’d) Must be physician owned facility Physician must be present at least 50% of the time patients are present Physician must hold a current certification in pain management Shall accept private health insurance Violation: Class A Misdemeanor
New Kentucky Laws (cont’d) Prior to the initial prescribing of any Schedule II Controlled Substance or a Schedule III Controlled Substance containing Hydrocodone to a patient, a practitioner must: –Obtain medical history, preform examination –Register with KASPER –Request KASPER on patient
New Kentucky Laws (cont’d) Unless another cause of death is clearly established, coroner or medical examiner shall take a blood sample and have it tested for the presence of controlled substances If cause of death is determined a drug overdose, it must be reported to: –Vital Statistics and Kentucky State Police –Licensing Board of person that prescribed medication
Learning Objective #3
The student will review how Law Enforcement and Health Care Professionals Collaborate Together to combat the Prescription Drug Diversion Epidemic
Law Enforcement/Health Care Collaboration Educate Health Care Professionals regarding drug seeking behaviors Seek out a Law Enforcement contact in the area to communicate with regarding issues that arise
Law Enforcement/Health Care Collaboration (cont’d) Report lost/stolen prescription blanks If allowed by State Law, review own prescription monitoring program report periodically Report employee/former employee that may have been “diverting” prescriptions Report negative drug screens Report to Law Enforcement when PMP Reports show “suspicious behavior”
Prosecution Most Illegal Prescribers are prosecuted in the Federal System –Asset Forfeiture –Seizures –Sentencing Guidelines
NADDI National Association of Drug Diversion Investigators The National Association of Drug Diversion Investigators (NADDI) is a non-profit organization that facilitates cooperation between law enforcement, healthcare professionals, state regulatory agencies and pharmaceutical manufacturers in the prevention and investigation of prescription drug diversion
NADDI (cont’d) www.naddi.org www.guardyourmeds.org
23rd Annual NADDI Conference November 13-16, 2012 Collaborating to End Abuse, Diversion and Counterfeiting of Prescription Medicines by Increasing Awareness and Education Millennium Maxwell House Hotel-Nashville 2025 Rosa L Parks Blvd Nashville, TN 37228
Questions?
Jennifer Carpenter 502-330-9947