Alaska Senate weighing a bill to overhaul Medicaid

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The Senate Finance Committee has been weighing a wide-ranging bill to overhaul Medicaid in Alaska. One provision is aimed at curbing the abuse of opioid drugs.

Sen. Peter Micciche speaks on the floor of the Alaska Senate, Feb. 10, 2014. (Photo by Skip Gray/Gavel Alaska)
Sen. Peter Micciche speaks on the floor of the Alaska Senate (Photo by Skip Gray/Gavel Alaska)

Senate Bill 74 would require doctors to check a database before prescribing opioids. The sponsors want to make sure patients aren’t going from doctor to doctor seeking pills. The bill also requires pharmacists to check the Alaska Prescription Database Monitoring Program.

Soldotna Republican Senator Peter Micciche says he became interested in the prescription database when many of his constituents were victims of burglaries. The culprits had addictions.

He attended court-ordered group therapy sessions, so he could better understand the issue.

“These were folks that in some cases, had a very successful path through life, like mine or any other Alaskan, that was diverted to a very unsuccessful path,” said Micciche.

Eagle River Republican Senator Anna MacKinnon supports making doctors check the database.

“Someone is providing access to a variety of opioids,” MacKinnon said. “And then when they can’t get the prescription any longer, they’re turning to heroin, and young men, older women, female, male, are losing their lives.”

But the proposal has drawn concern from doctors groups. While the Alaska State Medical Association supports doctors using the database, it doesn’t support requiring it for every controlled drug.

Association leaders say removing doctors’ discretion would create an unnecessary burden and increase costs.

Emergency doctors have voiced concerns. Doctor Carlton Heine says he agrees with ninety percent of what the legislators want to do.

But he says doctors aren’t solely to blame. He notes that beginning in the 1990s, organizations that accredit hospitals – and federal programs that pay doctors – encouraged doctors to prescribe more pain meds.

“It’s not that we’re trying to do it to create addicts,” said Heine. “There are other situations that are pressuring the behavior that you’re seeing. I do think we need to find some way to identify the providers that are over-prescribing. I think that is a problem, and I get frustrated with that personally, when I see patients coming in, knowing who their provider might be.”

The committee made changes to address some of doctors’ concerns. It provided exemptions from checking the database to doctors whose patients are in emergencies and inpatient settings, and on the day of surgeries.

The Senate Finance Committee could vote on the bill as soon as Monday.