Medicare drug abuse rising

Congressional investigators have issued a new report in which they say that Medicare is subsidizing drug abuse for thousands of beneficiaries. They say these individuals shop around for doctors who will fill prescriptions for large quantities of painkilling medication and other narcotics in excess of amounts that any patient could safely use.

LOS ANGELES, CA (Catholic Online) - The report has been issued by the Government Accountability Office. The report states that Medicare officials have been slow to acknowledge and act on this abuse. The report was presented during a Senate hearing on Tuesday.

In the report, Gregory D. Kutz, the director of forensic audits and special investigations at the accounting office said, "Our analysis found that 170,000 Medicare beneficiaries receive prescriptions from five or more medical practitioners." He said that the report looks at 14 types of drugs that are frequently abused.

The most commonly abused medications were obtained through Part D of Medicare which provides coverage for prescription drugs. Among the drugs most commonly abused by Medicare beneficiaries are powerful painkillers such oxycodones and hydrocodones. Brand names for some of these pills include OxyContin and Percocet.

The report described some cases in which the abuse is quite stark. In one case a Medicare beneficiary in Georgia was able to obtain a 150 day supply of oxycodone in less than a month by obtaining seven prescriptions from four doctors. This woman was able to receive over the course of a year prescriptions for a total of 3,655 oxycodone pills which is equivalent to a five-year supply from 15 different prescribers and she had been filled at more than 40 pharmacies.

In another similar case a man in California obtained prescriptions for a total of 1,397 fentanyl  patches and pills, a supply of more than five years. He obtained these from 21 different prescribers. 

Stu study says that physicians were unaware they were facilitating drug abuse. Many patients seek appointments with multiple doctors to get their prescriptions and doctors are entirely unaware that they have seen another physician for same condition and have already been given a prescription.

The report suggests that changes be made including limiting patients who abuse prescription drugs to using only one prescriber and one pharmacy.

However, Medicare officials said they are reluctant to make that change. Although they acknowledge the overuse of drugs by some beneficiaries they said they did not want to jeopardize patient access to care.

In a statement they said, "High utilization of pain medications is not necessarily an indication of abuse, but could be an indication of poorly coordinated care in the treatment of pain symptoms."
Jonathan D. Blum, deputy administrator of the centers for Medicare and Medicaid services noted that prescriptions for painkilling medications, particularly opiates, had increased sharply.

According to Blum, Medicare drug plans provided nearly 57 million opiate prescriptions last year, up from 46 million in 2007, which is an increase of 24 percent.

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Blum said that greater use of electronic health records and transmitting electronic prescriptions to drugstores could help reduce fraud and abuse by making it easier to keep track of patients' medication histories. Additionally, he suggested that insurers could increase their review of claims to identify patterns of what he called, "Gross overuse or inappropriate or medically unnecessary care."   

Unfortunately experts have noted that even if an insurer finds that a patient is misusing their prescription drug coverage, it may not stop the abuser from obtaining additional supplies of drugs. Patients can simply sign-up with the new insurer.

It is unknown if the report will form the basis of any actual reforms or changes in the law at this time.

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