The reforms follow an assessment by a Study Group which was tasked by the Attorney General with examining law enforcement drug testing policies, the role physicians may play when these drugs are improperly dispensed, greater insurance and prescription monitoring, and the costs to the public.

According to the report, issued by the Study Group, the legitimate medical uses of steroids, HGH and HCG are limited to a very small number of medical conditions. However, because there was little scrutiny until recently of prescription claims filed by law enforcement officers and others receiving steroids, HGH and HCG, the potential for improper prescribing of these substances was high. In addition, the lack of disciplinary action by regulators against physicians who improperly prescribed these substances and the failure to adequately screen and monitor prescription drugs created a recipe for abuse.

“It is important that we strengthen oversight, regulation and investigation in order to discourage the improper use of steroids throughout New Jersey’s law enforcement community and ensure the public’s confidence,” said Attorney General Dow. “Law enforcement holds a special trust based on its authority and must be held to the highest standard of professionalism. These reforms tighten the safeguards against abuse not only by law enforcement, but by other members of public health plans and doctors who improperly prescribe these substances.”

Brought to you by New Jersey attorneys Garces & Grabler, P.C.

The Attorney General’s reforms address three key issues: misuse of anabolic steroids and human growth hormones, improper prescription of these substances by physicians, and increased health care costs linked to such conduct. Attorney General Dow intends to adopt the following recommendations made in the report.

With regard to users of these medications, the Study Group made several recommendations:

• The Attorney General’s Law Enforcement Drug Testing Policy will be amended to add anabolic steroids to the list of substances tested for under the Policy. Testing of officers will be conducted at the discretion of the law enforcement executive.
• The Drug Testing Policy will also be amended to require officers who test positive for a controlled dangerous substance or steroid to produce a letter from the prescribing physician confirming that the substance is being administered for a medically recognized purpose after appropriate diagnosis and that use of the substance does not render the officer unfit for duty.
• The Attorney General is encouraging local law enforcement to require self-reporting of anabolic steroids or HGH pursuant to her authority to determine fitness for duty.
• Once the Drug Testing Policy has been amended, the Attorney General will issue a memorandum to all law enforcement under her authority advising them of these changes
  and, more generally, about potential criminal and employment penalties that arise from improperly obtaining, possessing or distributing these substances.
• The Attorney General’s office has submitted a recommendation to the Division of Pensions and Benefits that HGH prescriptions and most (approx. 80 percent) of anabolic steroid prescriptions be filled by mail order only by Medco, the State of New Jersey’s prescription benefits manager, to ensure complete fidelity to its new protocols instituted on March 1, 2011.

With regard to physicians, the Study Group recommended the following:

• The Attorney General will convene a working group of investigators, prosecutors and attorneys who handle prescription drug fraud. This working group will meet on a quarterly basis to share information, update counterparts on any new reporting, tips, complaints or information received from informants or defendants seeking plea deals and other “word on the street” information.
• The Attorney General is directing the State Board of Medical Examiners to review current regulations related to anabolic steroids and HGH and to convene a panel of experts to propose amendments that will curtail prescription of HGH for anti-aging purposes.
• As part of the implementation of the Prescription Monitoring Program, in addition to anabolic steroids, which will be tracked along with all Schedule II-V drugs, the Director of the Division of Consumer Affairs, pursuant to statutory authority given to him, will include HGH among the substances the database tracks.
• The Study Group has recommended that the Attorney General call for passage of legislation that will specifically target the unlawful prescription of medications by
  physicians. While state law currently provides for criminal sanction for health care claims fraud and improper dispensing of Schedule III substances, the Attorney General is
  supportive of a bill that would broadly address fraudulent and deceptive practices in this area.

With regard to costs, the Study Group discovered the following:

The Study Group was advised by Medco that the total cost to the state benefit plan for anabolic steroid and HGH prescriptions in 2010 was a little more than $11.2 million, which included about $6.3 million for treatment of roughly 6,000 individuals prescribed anabolic steroids and about $4.9 million for just over 200 patients who received human growth hormone. Prescription of anabolic steroids ranked 45th out of the 172 subcategories of prescriptions filled by Medco, and HGH rated 53rd. The safeguards will discourage improper prescription and dispensing of these substances by health care professionals.

Attorney General Dow stated, “With these reforms in place, users will officially be on notice, prosecutors will be better armed to prosecute abusers, and hopefully health insurers will be better positioned to control the exorbitant costs associated with the misuse of steroids.”

The report notes that the State’s ability to prosecute law enforcement officers for improperly using steroids and billing them to public health plans was hindered in the past by the officers’ ability to claim that they thought what they were doing was proper because doctors were prescribing the substances, pharmacies were dispensing them, and insurers were paying for them. The Study Group concludes that one of the most effective ways to improve the State’s ability to investigate and prosecute abusers is to force them out of the doctor’s office, through the recommended reforms, and relegate them to black market sources. Prosecutors then can avoid defenses centered on the fact that the substances were prescribed by a medical practitioner.

The Attorney General assembled the Study Group following a newspaper series that revealed that members of law enforcement have sought anabolic steroids, HGH and HCG for the purposes of muscle enhancement and/or “lifestyle improvement.”

Attorney General Dow commended the members of the Study Group for their examination and recommendations.

The Study Group includes: First Assistant Attorney General Phillip Kwon, Division of Criminal Justice Director Stephen Taylor, Division of Criminal Justice Deputy Directors Dermot O’Grady and Riza Dagli, Division of Consumer Affairs Director Thomas Calcagni, Middlesex County Prosecutor Bruce Kaplan, Passaic County Prosecutor Camelia Valdes, Mercer County Prosecutor Joseph Bocchini, Hoboken Public Safety Director Angel Alicea, Assistant Attorney General Sharon Joyce, Deputy Attorney General Joseph Fanaroff, and New Jersey Public Employees’ Health Benefit Programs Manager David Pointer.

The Study Group consulted with representatives from the New Jersey State Police Benevolent Association, the State Troopers Fraternal Association of New Jersey, the New Jersey State Association of Chiefs of Police and Medco.

Brought to you by New Jersey attorneys Garces & Grabler, P.C.

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