RECORDS SHOW SENATOR INTERCEDED FOR DOCTOR

Dr. Frank B. Fisher, the Shasta County physician recently charged with Medi-
Cal fraud and three counts of murder for allegedly over- prescribing
narcotic painkillers, had a powerful ally in his corner just as he was
facing intense scrutiny from the state attorney general's office -- former
state Sen. Leroy Greene.

Greene, a Carmichael Democrat who served 24 years in the Legislature and now
sits on the state commission that negotiates contracts for the Medi-Cal
health care program, wrote two letters trying to persuade state regulators
to allow Fisher to prescribe more narcotic painkillers than the doctor was
being allotted.

Greene also appeared with Fisher at a meeting with state regulators, where
he made the same argument, court documents show. That meeting was requested
by Shasta Pharmacy, where most of Fisher's prescriptions were filled.
Shasta's owners have also been charged with murder and Medi-Cal fraud.

Greene is a noted authority on medical issues and wrote the 1990 Intractable
Pain Treatment Act that essentially leaves it up to doctors to determine how
much pain medication is too much.

He said Monday that he doesn't recall Fisher or writing letters for him, but
that he would go to bat for a doctor who had many patients in chronic pain
and needed to prescribe more drugs than state regulators allowed.

At the time Greene wrote to the state Department of Justice on Sept. 24,
1997 and again the following September, Fisher was telling state regulators
he needed more than the 100 "triplicate" prescription forms he was allotted.
Doctors must use those forms to prescribe the types of painkillers, such as
Percocet and Vicodin, that Fisher was recommending for many of his patients.

"Dr. Fisher has a number of chronic pain patients who need large quantities
of medications," Greene wrote in 1997, at Fisher's request. The letter was
sent to Robert Stillman, a program technician with the state Department of
Justice who reviews doctors' requests for triplicate forms.

"Since the patients are so numerous and are entitled to the medication and
the doctor is entitled to prescribe it, it would seem reasonable to relieve
needless suffering by pain patients."

About 10 days after the letter was sent, the state Department of Justice
increased Fisher's monthly forms allocation from 100 to 200, according to
Chris Bucher, Stillman's boss.

Fisher, being held in the Shasta County jail on $15 million bail, has said
he prescribed as many as 4,500 pills to one person in one day because he had
to conserve the 100 forms he was allowed each month.

On Sept. 17, 1998, Greene wrote to Stillman again, less than a month after
Bucher's office received Fisher's request for 400 triplicate forms a month.

"As I understand it," Greene's letter said, "while no one is telling Dr.
Fisher that he cannot get the extra (prescription) pads, time is passing and
patients who are entitled to the medication which the doctor is legally
prescribing are going without their needed medication while he awaits
additional triplicate pads.

"There is too much needless suffering by pain patients because of what
appear to be simply bureaucratic slowdowns," Greene's letter continued. "Is
there some way that this process can be expedited so Dr. Fisher and other
doctors who treat this very vulnerable population will be able to adequately
treat their patients."

Stillman declined comment when asked about the letters Monday. Greene said
he had no idea Fisher was suspected of any wrongdoing. But Greene questioned
the validity of the state's case.

"There are far more cases around where doctors under-prescribe than
over-prescribe," Greene said. "What is the advantage to the doctor in
over-prescribing? He's not going to get any money out of that. If he
under-prescribes, no one challenges him. Not the (state) Medical Board, not
the insurance companies."

Fisher, Greene said, had a large number of patients in "high levels of pain.
Since the prescription book only covers 100 patients, if you have 300 I see
nothing wrong with trying to get him more forms so his patients don't
suffer."

The charges against Fisher and the pharmacy owners allege that the doctor, a
1981 graduate of the Harvard Medical School, received kickbacks from the
pharmacy for steering so much business its way.

"I assume Senator Greene had the wool pulled over his eyes and was not quite
aware of what Dr. Fisher was doing," said Gary Binkerd, the deputy attorney
general prosecuting the case. "He surely could not have been aware of what
type of practice this was."

Fisher is due in court this afternoon to say how he pleads to the charges
and to ask that his bond to be lowered.