Prescriber Checkup: Lifting the veil on dangerous prescribing

Federal officials were skeptical two years ago when ProPublica asked them to release a database of prescriptions written in Medicare's landmark drug plan, known as Part D.

The data details the prescribing habits of more than 1 million doctors and other health professionals who treat Medicare patients. The Centers for Medicare and Medicaid Services had never allowed any outsider, let alone journalists, to have access to such records, which include identity codes for individual providers.

In the months that followed, ProPublica reporters argued that freeing this data could help patients assess the prescribing patterns of their health providers. The reporters pointed out that the stringent laws on the confidentiality of medical records were written to protect the privacy of patients, not doctors.

After months of high-level deliberation, CMS, to its credit, agreed to release the records -- and to unveil one of medicine's biggest secrets.

In examining the data, our reporters found powerful indications that Medicare has not done all it could to oversee its drug plan.

Some of our nation's most vulnerable citizens rely on this program -- the elderly and disabled. We found that some doctors were prescribing antipsychotic drugs to large numbers of seniors -- an age group for which such medicines are particularly hazardous. Others were writing unusually high numbers of prescriptions for painkillers and other dangerous drugs. Reporters systematically examined these cases, interviewing the doctors about their prescribing decisions. In some cases, they could explain their conduct. In others, they could not.

They all had one thing in common: None of the doctors whose prescribing habits stood out in our analysis had ever been questioned by Medicare officials. Government overseers, our reporters found, didn't consider it their job to examine these patterns or act upon them.

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Prescriber Checkup: Lifting the veil on dangerous prescribing