New tool tracks prescribers' practices

The Centers for Medicare & Medicaid Services (CMS) has done little to prevent unsafe prescribing patterns for patients on Medicaid Part D, and to reduce questionable prescribing practices, according to an analysis by ProPublica, an independent newsroom that performs investigative journalism in the public interest.

ProPublica analyzed four years of Medicare prescription records--2007 through 2010--and co-published results with the Washington Post. The analysis makes public the prescribing practices of identified providers, and a new tool, called Prescriber Checkup, allows the public to search for providers by name.

The analysis revealed a widespread pattern of prescribing of drugs that are potentially harmful, disorienting or addictive for older Americans, determining that little has been done in the way of prevention.

The data show that 1.1 billion claims were filed in 2010, with just 70 providers each responsible for more than 50,000 prescriptions and refills, which equals about 137 a day.

The FDA has warned against prescribing antipsychotic medications for dementia patients, citing increased risk of death. Despite the warning, in 2010, nearly 340 providers each wrote more than 1,000 antipsychotic prescriptions for patients ages 65 and older. The analysis also found that providers routinely prescribed drugs that had been pulled from foreign markets for safety reasons.

ProPublica recommended several changes, including periodic scrutiny of the data for those who frequently prescribe potentially harmful drugs; requiring private insurers in Part D to report suspicious activity; sharing prescribing data with state medical boards; and seeking congressional authority to bar those who have been indicted or convicted in connection with Part D prescribing habits.