GAO: CMS failed to identify thousands of Medicare beneficiaries at risk for opioid addiction

The U.S. Government Accountability Office called on CMS last week to improve its oversight of opioid use among Medicare Part D beneficiaries after identifying flaws in the agency's monitoring of opioid prescriptions.

CMS estimated 33,223 Medicare recipients were at risk of opioid overutilization based upon its recently revised prescribing guidelines. However, the GAO believes CMS guidelines, which rely on prescription monitoring information from private organizations that implement Medicare drug plans, miss many Medicare patients at-risk for addiction and misuse. The GAO determined more than 727,000 enrollees in Medicare's prescription drug program in 2015 were at risk of opioid addiction or misuse due to opioid prescriptions not aligned with CDC prescribing guidelines, according to a GOA report released on Nov. 6.

"CMS oversees the prescribing of drugs at high risk of abuse through a variety of projects, but does not analyze data specifically on opioids," wrote the authors of the GAO report. "However, GAO found that CMS does not identify providers who may be inappropriately prescribing large amounts of opioids separately from other drugs, and does not require plan sponsors to report actions they take when they identify such providers. As a result, CMS is lacking information that it could use to assess how opioid prescribing patterns are changing over time, and whether its efforts to reduce harm are effective."

To improve CMS' opioid oversight, the GAO recommended the agency gather information on beneficiaries receiving high doses of opioids, identify providers who write high amounts of opioid prescriptions and require plan sponsors to report potentially inappropriate provider prescribing practices.

In 2016, providers prescribed more than 14 million Medicare Part D beneficiaries opioids.

More articles on opioids: 
Chicago unveils memorial of 22,000+ pills to remember opioid overdose victims  
Ohio paramedic overdoses while driving OD patient to hospital 
DEA issues emergency action to crack down on spread of synthetic opioid

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