Tag Archives: pain

TennCare’s Top Ten List of Drug Prescribers Reduced by Three

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Three of TennCare’s top 10 prescribers of commonly abused mental health and pain drugs – a physician, a physician’s assistant and an advanced practice nurse — have been blocked from filling prescriptions through the state’s health-care program for the poor and uninsured, reports The Tennessean.
In a 22-page letter and report to a U.S. senator investigating the over-prescribing of prescription drugs in the federal Medicaid program, TennCare Director Darin Gordon outlined the steps under way to cut down on fraud and abuse, including blocking the three prescribers.
“We agree that inappropriate prescribing is a serious problem that can result in patient safety concerns and increased costs to the healthcare system,” Gordon wrote in the March letter to U.S. Sen. Charles Grassley, R-Iowa. “For this reason, TennCare has invested a great deal of effort to develop a multi-faceted approach to ensure that medications are used appropriately within our program.”
The letter came in response to Grassley’s request in January for additional information on how Tennessee monitors and investigates fraud and abuse. Grassley sought answers to a dozen questions after Tennessee reported the top 10 prescribers of eight antipsychotic and pain medications.
…The three (prescribers) are not named in the letter to Grassley, but a TennCare spokeswoman released the names upon request Wednesday.
The three — a physician, a physician’s assistant and an advanced practice nurse — are all from East Tennessee. Dr. Allen R. Foster and nurse Maimoune Wright have faced disciplinary action for over-prescribing drugs, according to the Board of Medical Examiners.
Foster is serving one year in prison after being sentenced last summer for health-care fraud and failure to file tax returns. His license has been revoked. Wright is awaiting federal trial on a charge of conspiracy to distribute prescription drugs. Her license has been suspended.
Wright could not be reached for comment. Her business listing was disconnected, and her home phone number is unlisted. The physician’s assistant named by the state, Thomas Esser, has not been disciplined. His home and business numbers were disconnected

Legislators Referee a Nurses-versus-doctors turf war

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The latest effort by state legislators to referee disputes between various professional groups concerns whether nurse practitioners, physician assistants and the like can give shots of pain medication that involve an injection near the spine…. or whether a specialized, full-fledged doctor must be on hand to supervise.
So the docs have a bill (HB1896) that would make it illegal for less-qualified medical personnel to handle such a procedure. It passed the Senate earlier this year, but stalled in the House and is being studied in the off season. . TNReport and WPLN have write-ups on the turf war.
From WPLN’s Daniel Potter:
Opponents argue it’s a solution without a problem, saying there’s no evidence of harm. Sharon Adkins directs the Tennessee Nurses Association.
“The board of nursing has received no complaints against nurse practitioners who perform these procedures, nor have malpractice insurance rates raised in anyway.”
But that doesn’t mean they’re always doing as good a job as a specialized pain doctor, argues Graf Hilgenhurst, an M.D. who practices in Smyrna.
“There is a small but real risk of doing serious harm to a patient. There is a much greater risk of squandering healthcare dollars and doing no good.”
Tussles like these test the boundaries between doctors and mid-level providers, and could become more common in coming years. That’s as growing patient demand could lead more to physician assistants and nurse practitioners for care.
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House Democratic Caucus Chair Mike Turner says each side is looking out for its own interest.
“We also have to decide ‘Is this a turf battle?’ Because most of the time when we see these bills they’re turf battles. And we have to decide is this a turf battle, or is this actually going to help the people of Tennessee?”
And the role of nurse practitioners and physician assistants is only growing, says Republican Matthew Hill, who chairs the House’s general subcommittee on health.
Hill says the federal healthcare overhaul will make Tennessee more reliant on such midlevel providers to offer all kinds of care. He says that means lawmakers have to make sure they’re well trained for the task.

Governor Defends DIDD Cuts

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By Eric Schelzig, Associated Press
WINCHESTER, Tenn. — Republican Gov. Bill Haslam is defending the decision to cut back home care for people with developmental disabilities despite a federal lawsuit seeking to stop the move to group homes.
Haslam said after a ribbon-cutting event in at Tims Ford State Park on Thursday that the group homes save money while still delivering personalized services.
“We can still maintain a high quality of care for each one of these individuals,” Haslam said.
“I understand the families, and the pain that people feel,” he said. “But again, I think we feel like we can provide a high quality of care in this situation.”
The lawsuit has been filed on behalf of 39 Tennesseans ranging from ages 7 to 52 over the cuts to in-home care services, claiming the move violates the Americans with Disabilities Act.

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