FRANKFORT — House Speaker Greg Stumbo demanded Tuesday that the Kentucky Board of Medical Licensure step up its oversight of doctors who prescribe questionable amounts of pain pills.
If he doesn't see improvement soon, Stumbo said, he will try to find another state agency willing to police overprescribing of pain medications such as hydrocodone and oxycodone.
"If the medical licensure board refuses to do its job, then we will try to find some entity in the enforcement community that wishes to do that," Stumbo said after a meeting of the legislature's Program Review and Investigation Committee.
Drug overdoses are the leading cause of death for some age groups in Kentucky, where 16.1 percent of adults ages 18 to 25 have used prescription drugs for non-prescribed purposes, according to federal drug-abuse statistics.
Data show that 6.5 percent of all Kentuckians have abused prescription drugs, compared to the national average of 5 percent.
Stumbo, D-Prestonsburg, said the licensing board specifically requested the ability in 2003 to mine data from the Kentucky All Schedule Prescription Electronic Reporting — a registry known as KASPER that tracks prescriptions for controlled substances — to allow it to more easily target doctors who overprescribed pain medications.
The legislature passed a law in 2003 that would allow the Cabinet for Health and Family Services, which maintains KASPER, to provide geographical data about prescriptions for controlled substances. The licensing board could use that data to determine whether doctors were overprescribing controlled substances in areas that had high prescription rates.
The licensing board has failed to use the data, Stumbo said.
Representatives of the board defended its enforcement record Tuesday.
Lloyd Vest II, the board's general counsel, said the data offered by the Cabinet for Health and Family Services was not specific enough to be meaningful. The cabinet has told the board it does not have the legal authority to further analyze the data, Vest said.
Stumbo countered that the licensing board is the only entity that has the legal authority to further analyze the data to find information about which doctors are prescribing what medications.
In a letter to legislators that Stumbo provided the committee, Dr. Preston Nunnelley, the licensing board's president, said it had conducted KASPER searches only on specific "physicians who are under investigation by the board for improper prescribing practices."
Michael Rodman, an assistant executive director for the board, said he could not provide information Tuesday about how many doctors' licenses have been revoked because they were overprescribing pain medications.
In its 2010 annual report, the board said it initiated actions against 23 medical licenses. As a result, seven licenses were surrendered, five were restricted and seven were suspended; two doctors were placed on probation, and one doctor's license was revoked. However, the information does not say how many of those disciplinary actions involved overprescribing of controlled substances.
Bill Schmidt, the board's executive director, told lawmakers the board does not necessarily have the staffing to conduct the type of data analysis Stumbo is requesting. The board has five investigators to police nearly 10,000 doctors, he said.
If staffing is an issue, the licensing board could raise its assessments and fees on doctors to pay for more investigators, Stumbo said.
The board is funded entirely through licenses and fees and does not receive any money from the state General Fund. It has an annual budget of $2.65 million and 20 staffers.
Representatives of the licensing board agreed to return to the committee in December with more information on how the legislature could change state law to help it root out rogue doctors.
After the meeting, Stumbo said he hoped the licensing board would act quickly. To have the Kentucky State Police or someone other than a doctor review medical files is less than ideal, he said.
"We really need their help on this war on drugs," Stumbo said. "They and only they can really police their profession. Because if a doctor is overprescribing, it's going to take another doctor to go in there and review the cases and review the patient files, and determine whether or not there was an overprescribing trend going on. It's obvious that it's happening."
