Medicare Painkiller Abuse Prompts Crackdown


Never before have we seen such a heightened interest in the Federal response to the abuse of pain meds to people enrolled in Medicare

WASHINGTON (Reuters) – Health authorities are directing Medicare prescription drug plans to withhold payments for popular painkillers when they suspect patient abuse, part of a wider effort to combat fraud.

The Department of Health and Human Services noted evidence of “doctor shopping,” when patients approach several doctors to get multiple prescriptions of addictive painkillers like OxyContin and Percocet. It also encouraged doctors to issue prescriptions for such drugs that provide a supply of 30 days or less.

The Government Accountability Office found that in 2008 some 170,000 people in Medicare, the federal health insurance for the elderly, received prescriptions from five or more doctors for drugs that are frequently abused.

They incurred about $148 million in prescription drug costs, much of which was paid for by the government.

Painkillers including OxyContin, made by Purdue Pharma, and Percocet, from Endo Pharmaceuticals Holdings Inc, represent the fifth most-filled class of prescription drugs in Medicare, according to the Centers for Medicare and Medicaid Services.

Abuse of painkillers is also responsible for more deaths than illegal drugs like cocaine and heroin combined.

Nearly 15,000 Americans died from a record number of overdoses of prescription painkillers in 2008, the Centers for Disease Control and Prevention said last month.

The CDC estimated that as of last year, 12 million Americans were using prescription opioid or narcotic pain relievers.

HHS said the government has recovered almost $3 billion resulting from healthcare fraud this year.

(Reporting by Alina Selyukh, editing by Carol Bishopric)


Posted in Medical Cost Containment, OMCA, Workers’ Compensation