MEDI-CAL FRAUD: Physician, Pharmacists Accused in Opiate Overprescription Case
Preliminary hearings begin today in what the San Francisco Chronicle calls "the most dramatic confrontation in recent memory between law enforcement and a physician involving the use of narcotics for control of chronic pain." State prosecutors want to prove guilty a Shasta County physician and two Redding pharmacy owners accused of three murders and six additional deaths in an opiate painkiller "drug- selling scheme designed to defraud" Medi-Cal (Hall, 4/28). The three defendants are being charged "in connection with more than $2 million in allegedly illegal Medi-Cal billings," the AP/San Diego Daily Transcript reports. Dr. Frank Fisher, a graduate of Harvard Medical School, is accused of prescribing OxyContin -- a slow-release form of morphine -- in doses so high "that a patient following the doctor's orders could wind up dead." Stephen and Madeline Miller, owners of the pharmacies where most of the prescriptions were filled, are accused of accepting kickbacks from the doctor. All three have been in the Shasta County jail since their February 18 arrest, in lieu of multimillion-dollar bail amounts (4/27). The Chronicle reports that records indicate Dr. Fisher was by far the highest prescriber of OxyContin in the state -- 46% of all prescriptions filled bore his signature. Dr. Ann Murphy, medical director of Shasta Community Health Center, testified that Fisher prescribed "too much medicine, too freely, in a reckless way," thereby "setting [patients] up for a fall."
In Their Defense
The Chronicle reports that Patrick Hallinan, the "prominent San Francisco attorney" representing Fisher, dismissed the murder allegations as "ridiculous," noting that five of the nine alleged victims were not even Fisher's patients when they died. In addition, according to medical experts, "there is no set upper limit on dosages of opiate painkillers," whose most dangerous side effects are said to "diminish as patients grow tolerant."
Some fear the case will make it harder for patients with chronic pain to find "doctors willing to treat them, considering the stigma attached to narcotic use." Ben Moulton, executive director of Boston-based American Society of Law, Medicine and Ethics, said, "Any such kind of criminal prosecution has a chilling effect." The hearing in Shasta County Superior Court is expected to last three weeks. Additional charges related to the case may be forthcoming, according to sources (4/28).