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Over the years, an Alabama pain management doctor built a reputation for prescribing large quantities of opioid medications out of his Huntsville office, and his patients included many workers’ compensation claimants. In 2012, he prescribed over 12.3 million pills, many of which authorities say should have never been prescribed. Additionally, it was determined that he defrauded Medicare and private insurers out of at least $9.5 million.
In October 2016, the doctor pleaded guilty to illegally writing prescriptions, and to health care fraud. Prior to his arrest, he was once considered the nation’s most prolific Medicare prescriber of opioid painkillers. Now, he will spend the next 15 years in federal prison and has to pay $6.7 million in restitution to Medicare and Blue Cross Blue Shield of Alabama.
It’s no secret that “pill mills” have long been a problem in Alabama. A 2013 study by the Centers for Disease Control and Prevention found that Alabama was among the top 20 states nationally in the number of prescription drug overdoses. In response to that report, the Alabama Legislature passed The Alabama Pain Management Act and made changes to the laws that pertain to the Alabama Department of Public Health’s Prescription Drug Monitoring Program.
My Two Cents
The Prescription Drug Monitoring Program includes a database where doctors can determine what prescription drugs a patient has had filled by other doctors. It can be a very useful tool for doctors to identify patients that are “doctor shopping” to obtain prescription painkillers. Only doctors can access the database, and they cannot share the information that they obtain. However, it is a good idea for claims professionals to insist that the physicians they select to treat claimants review the database, at least on suspect claims.
About the Author
This article was written by Charley M. Drummond, Esq. of Fish Nelson & Holden, LLC. Fish Nelson & Holden is a law firm located in Birmingham, Alabama dedicated to representing employers, self-insured employers, and insurance carriers in workers’ compensation cases and related liability matters. Drummond and his firm are members of The National Workers’ Compensation Defense Network (NWCDN). The NWCDN is a national and Canadian network of reputable law firms organized to provide employers and insurers access to the highest quality representation in workers’ compensation and related employer liability fields. If you have questions about this article or Alabama workers’ compensation issues in general, please feel free to contact the author firstname.lastname@example.org or (205) 332-3414.