New Jersey doctors have been bilking Medicaid by wrongfully handing out drugs for prescription painkillers and in some cases serving as a front for the Russian mob — showing the need for stricter oversight, according to a report by the State Commission of Investigation (SCI) released yesterday.
The authors of the report, “Scenes from an Epidemic,” recommended that the state adopt explicit standards based on national models for how doctors should prescribe powerful pain treatments.
The New Jersey State Board of Medical Examiners hasn’t picked up on key elements of the national model, including explicit definitions of terms like “acute pain” and “substance abuse,” which will help in setting formal standards of practice for doctors, a step that the report recommended.
The often-gripping report described a series of schemes pursued by doctors across the state, including cases in which associates of Russian crime figures used Passaic doctor Joseph W. Dituro as a front to receive Medicaid payments and prescription narcotics.
The scheme initially had homeless Medicaid and Medicare patients from the Newark streets transported to the mob-owned clinic, where Dituro would prescribe unnecessary pain medications and diagnoses, and then bill the government, according to the SCI. Dituro, who was well-compensated, would later turn over the payments to the clinic’s mob owners, said the report. The scheme escalated over several years, and the clinic got a well-earned reputation as a place where drug addicts could get bogus prescriptions.
“Would-patients in search of scripts often arrived drunk or high, and drug paraphernalia, including crack-cocaine vials and hypodermic needles, regularly turned up in the center’s restrooms,” according to a section of the report. The mob owners eventually had to hire a bouncer to bring order to the clinic, according to the report — which reads like a magazine article or best-seller.
The report also indicates that the use of prescription narcotics is contributing to a growing problem with heroin addiction among young people.
In addition to suggesting stricter prescription standards, the commission recommended a series of other steps.
These include tougher financial and criminal penalties for doctors who improperly prescribe drugs, which would run from $10,000 for a first offense to $20,000 for subsequent offenses. The report also said many regulators and law enforcement officials contend that the Board of Medical Examiners’ improper prescription enforcement has been “weak and infrequent.”
In addition, the commission recommended creating a statewide opioid strike force
solely devoted to identifying, investigating, and prosecuting illegal sources and distribution of prescription pills, as well as giving state officials the authority to gather information about doctors’ business relationships when they apply to renew their licenses.
Other recommendations include: making it easier for law-enforcement to access a prescription-monitoring program that collects and analyzes statewide data on dangerous controlled substances and human growth hormones; embedding security markers on prescription forms; lowering the legal threshold for charging people with criminal heroin possession with intent to distribute; and criminalizing the use of secret “traps,” compartments in vehicles used to store illegal drugs.
The report also recommended establishing stronger regulations for prepaid cell phones, including requiring that service providers gather subscriber information, such as name, address, date of birth, and assigned serial numbers and phone listings.
Legislators from both parties released statements that called for further action in the wake of the report.
Sen. Joseph F. Vitale (D-Middlesex) said legislators should take a closer look at existing drug laws to determine whether they should be made more stringent.
“We need to crack down on doctors who illicitly prescribe these drugs with tougher penalties, we should review the effectiveness of the prescription-monitoring program, we should consider uniform standards for prescription forms and practice, and we need more oversight of medical practices to identify those that act as fronts for illicit prescription drug sales,” Vitale said. “They are essentially drug dealers with medical licenses.”
Assembly members Mary Pat Angelini (R-Monmouth) and David W. Wolfe (R-Ocean) reiterated their support for a bill they introduced in June, A-4220, that includes a provision designed to encourage more doctors to participate in the state prescription-monitoring program.
“The instances of prescriptive drug abuse are increasing at an alarming rate, especially when they are diverted from the intended recipient and sold to those who are vulnerable,” Angelini said. “When combined with the price of acquiring heroin at roughly the same cost of cigarettes, we need to make better use of the PMP to assess and curtail the illegal pipeline which is a lucrative source of revenue for those who prey on the addiction potential of these controlled substances.”
The SCI is an independent agency established in 1968 whose mission is to expose organized crime, public corruption, and waste and to recommend reforms.