Michigan’s Medicaid chief is denying allegations of wrongdoing in a response to a state administrative complaint that alleged he violated his medical duties by overprescribing opioids, among other offenses.
Dr. David Neff, who is responsible for overseeing the state’s Medicaid program, was accused in a May administrative complaint by the Department of Licensing and Regulatory Affairs (LARA) of failing to sufficiently screen patients before prescribing powerful opioid painkillers. The complaint also alleged the he offered doses high enough to pose “significant” addiction risks, among other accusations of negligence.
Neff denies the allegations and asked for the complaint to be “dismissed in its entirety,” according to the response from his attorney obtained by the Michigan Advance through a Freedom of Information Act request.
The alleged violations in question occurred at Neff’s part-time private medical practice in Okemos, where he cares for about 85 patients. His response states that the accusations have “negatively impacted” his full-time employment with the Department of Health and Human Services “without a showing of good cause.”
Neff has been placed on paid administrative leave while the outcome of the complaint is pending. He continues to earn a salary of $194,184.
The Medicaid chief’s attorney, Timothy Dardas of Hackney Grover, alleges that Neff’s “conduct does not constitute a violation of a general duty, consisting of negligence or failure to exercise due care, including negligent delegation to or supervision of employees or other individuals.” He goes on to write in a response dated May 31, “In fact, [Neff] acted appropriately to avoid creating greater harm than good by simply discontinuing opioids, discharging or abandoning patients with life altering pain.”
“Most importantly he upheld his personal and professional commitment to the patients he promised not to abandon,” Dardas wrote.
Neff has been praised by Michigan medical associations in the past for his work in fighting opioid addiction.
LARA alleged that Neff prescribed pain patches containing a synthetic opioid called fentanyl to a patient who removed them, potentially leading the painkillers to sale on the street.
The agency also alleged that Neff failed to monitor patients who had a risk of drug abuse, didn’t include a reason in another patient’s file for increasing a painkiller dose, and failed to indicate in yet another patient’s file why his or her dosage was decreased. He also is accused of improperly using a state opioid tracking database, along with prescribing higher-than-recommended opioid doses.
The complaint pointed to his lack of urine screening to assess drug addiction risks.
But urine tests do not necessarily reduce the risk of addiction, can be misinterpreted, can stigmatize patients and “irreparably fracture the physician-patient relationship,” Neff’s attorney wrote in the response.
Neff also denies improperly using the state opioid database, and called many of the allegations “gross overgeneralization[s].”
The response says that Neff “has responsibly cared for the majority of these patients for the last 21-37 years, during which dramatically different standards of care have come and gone… most of these patients have been seen since the 1980s. Seven of the ten patients reviewed were suffering from cancer quality pain, but were not dying of cancer.”
The response argued that for many of his patients, “non-opioid treatments had been exhausted.”
In addition to asking that the complaint be dismissed, his attorney has requested a “compliance conference.”