Copyright: 2003 The Courier-Journal
Contact: cjletter@courier-journal.com
Website: http://www.courier-journal.com/
Details: http://www.mapinc.org/media/97
Author: Tom Loftus, The Courier-Journal
Bookmark: http://www.mapinc.org/oxycontin.htm (Oxycontin/Oxycodone)

DOCTORS' GROUP IS BIG LOBBYIST

Paducah-based Society Seeking Drug Database

FRANKFORT, Ky. -- A Paducah-based doctors' group that is lobbying Congress
for a national prescription-tracking program to combat drug abuse has
become a major source of political contributions in Kentucky.

Since January 1999, the group's president and founder, Dr. Laxmaiah
Manchikanti, and others affiliated with his American Society of
Interventional Pain Physicians have made $1.1 million in political
contributions. That is twice the contributions made during the same period
by the Kentucky Medical Association's powerful political action committee.

Of the $1.1 million, more than $390,000 went to Kentucky Congress members,
and $47,500 went to the state's two political parties.

Manchikanti, 56, and his wife alone have given $285,000 to various
candidates and political committees, campaign finance records show. The
largest beneficiary was Manchikanti's own congressman, 1st District
Republican Rep. Ed Whitfield, who has received $155,800 from the group and
its members and who spoke at the society's meeting this month in Washington.

Earlier this month, Whitfield also filed the prescription-tracking bill
sought by the society, whose 2,310 members from around the country include
doctors who specialize in treating people with chronic pain.

Manchikanti said the group's contributions reflect the members' belief that
they need to be aggressive in enhancing their specialty in the medical
community. "Most of our issues are fair and balanced, and we mostly focus
on patient access rather than our pocketbooks," he said.

The group's tracking bill, which Whitfield also filed last year but which
didn't pass, would create a nationwide electronic system similar to
Kentucky's monitoring program that keeps a record of prescriptions of
controlled drugs filled in the state. Supporters of a national program say
the goal is to help prevent abuse of medications, such as the powerful
painkiller OxyContin, by tracking where prescriptions are filled and
catching people who cross state lines to avoid the state tracking systems.

The second-largest share of the group's contributions, $111,100, has gone
to the political committees of 6th District Republican Rep. Ernie Fletcher
- - including at least $63,850 this year for Fletcher's campaign for governor.

REPUBLICAN Sen. Jim Bunning has received $44,750; Democratic 4th District
Rep. Ken Lucas, $34,500; Republican 3rd District Rep. Anne Northup,
$21,500; Republican 2nd District Rep. Ron Lewis, $11,500; and Republican
Sen. Mitch McConnell, $11,000.

The group's members and political action committee also have contributed to
members of Congress from other states. But they have given nothing to one
Kentuckian in the House - Republican Rep. Harold "Hal" Rogers, whose 5th
District in Eastern Kentucky has a big prescription drug abuse problem. He
opposes Whitfield's bill.

Rogers has been the delegation's most active member on the issue. He favors
building up a program he initiated three years ago - the Harold Rogers
Prescription Drug Monitoring Program - in which states apply for federal
grants to create or improve their own electronic networks or regional
networks with neighboring states for tracking prescriptions.

"It's needless duplication and needless cost," Rogers said of the approach
in Whitfield's bill. "It would create a huge new federal bureaucracy that
would replace state systems that are working."

Rogers said he has never sought or been offered political contributions
from Manchikanti's group.

Whitfield said a national tracking system is needed to catch people who
doctor-shop - move from doctor to doctor and cross state lines to acquire
prescription drugs illegally. That has been a problem in Eastern Kentucky,
with people crossing into bordering states to get the same prescription
filled multiple times.

"We have a more comprehensive approach," Whitfield said. "Whether we can
make an effective system without being unmanageable and bureaucratic, I
don't know. Our goal is to do it."

Manchikanti said prescription abuse is a problem for doctors as well as the
public. "Doctors are getting into trouble, and we are not able to provide
proper care not knowing what is happening to the patient," he said.

Manchikanti is medical director of the Pain Management Center of Paducah.
He is a registered Democrat, and Gov. Paul Patton appointed him to the
Kentucky Board of Medical Licensure last year.

MANCHIKANTI founded the society in 1998. Since its inception, the group has
lobbied for various changes in federal law and regulations to allow, or
increase, Medicare reimbursement for pain treatment procedures used by
doctors at outpatient surgery clinics, where its members practice.

An interventional pain physician is a specialist who first injects a
patient with a small amount of medication to identify the source of pain,
and then uses a variety of treatments to relieve the pain, Manchikanti
said. They typically prescribe fewer painkillers than other pain doctors,
he said, and don't use pain medicine as the main treatment.

Manchikanti said only about 10 of his 2,200 active patients are on OxyContin.

The political contributions made by Manchikanti and his associates are
significant, even on a national scale, said Tony Raymond, co-founder of
Political Money Line, a campaign finance and lobby research organization.

"With that amount of money a group like this can accomplish what they want
in making their positions known to key members of Congress," Raymond said.

The amounts are "humongous and excessive," said Richard Beliles, director
of the political watchdog group Common Cause of Kentucky. "It causes me a
lot of pain to see one person give and raise so much. It surely gives this
guy power and access far beyond that of the average citizen, or even the
average contributor."

But Whitfield said he finds nothing wrong with accepting special interest
contributions "because our government is about special interests. It's
about people who have interest in the government."

Fletcher, who is a doctor, said Manchikanti's group is "interested in good
government and somebody who shares their belief and wants to make sure we
improve health care, and we address the problem of their profession. And
it's natural, as a physician, that they've been very supportive of me. ...
We're glad to have their support."

Outside Kentucky, the biggest contributions from the group have gone to
Reps. Frank Pallone, D-New Jersey, and Bart Stupak, D-Michigan, who
co-sponsored Whitfield's bill last year. Pallone received at least $75,285;
Stupak at least $72,750. The group also has given $58,750 to the National
Republican Senatorial Committee.

Manchikanti said he has been the organizer and host of many fund-raisers
for candidates.

WHEN ASKED about state and federal records that show he and his wife have
made more than 150 contributions totaling more than $280,000 since 1999, he
said, "Wow. Now you are depressing me. I don't even count those things."

Adding contributions of other family members, the total rises to more than
$410,675. Adding the contributions of other doctors and employees of the
Paducah clinic raises the total to more than $560,000.

The group has been active this year in raising money for next year's
campaigns by Whitfield and Bunning. On March21, its members and PAC gave
$57,000 to Whitfield's re-election campaign. On April28, Bunning's
re-election committee received $42,250.

And during a two-week period between June30 and July10, 41 people
affiliated with the group and its PAC contributed $37,350 to Fletcher's
gubernatorial campaign. During the same period, Manchikanti, his wife and
the PAC each gave $5,000 - a total of $15,000 - to the Kentucky Republican
Party, which is independently raising funds to promote the election of
Fletcher and the party's ticket in November.

Asked why he went beyond Kentucky to raise money for Fletcher's campaign
for governor, Manchikanti said, "He is in the Congress. He helped us with
our issues before. He already has access to all these people. They all know
him. He came to our annual meeting and spoke there. So people are very
familiar with him."

Manchikanti said he held the April fund-raiser for Bunning to try to win
his support for the drug-tracking bill.

Bunning said in a statement released by his office that he appreciates the
support and agrees with the group's goal of improving prescription drug
monitoring. However, he said he would like to allow time for Rogers'
approach to work "before we head off in a new direction with a different
program altogether."

Since 1999, KASPER - the Kentucky All-Schedule Prescription Electronic
Reporting system - has collected information on every controlled substance
sold in Kentucky's 2,100 pharmacies. A doctor considering writing a
prescription can check a patient's prescription record, as can a
law-enforcement agency conducting an investigation.

Manchikanti said a national monitoring system like Kentucky's would let him
check a single source for the prescriptions a patient has had filled
recently. He said the state's tracking system works well but cannot give
him data for prescriptions filled in another state.

But Rogers said a national database would cost at least $50million to
create and "tens of millions per year" to operate. He said that the grant
program "is working and growing as we speak," and that future grants will
allow states to link with a neighboring state's database.

Danna Drosz, former manager of the state Department of Public Health's Drug
Enforcement Branch and now a consultant to Kentucky's drug tracking system,
agrees with Rogers.

"The concept of a national database sounds good and sounds simple," Drosz
said. "But my experience with national databases is that the data is not
current and you don't get it very quickly. I fail to see what in this would
be different."