Watchdog Report Finds Over-Prescription Of Opioids For Some Medicaid Patients

A report from a federal oversight agency shows that over 4,000 patients in the Ohio Valley received high amounts of opioids in 2018 through Medicaid. The agency is encouraging states to enforce prescription drug monitoring programs and sharing data with Medicaid agencies.

The Office of Inspector General for the Department of Health and Human Services focused the report on six Appalachian states in support of their partnership with law enforcement agencies who are in the Appalachian Regional Prescription Opioid Strike Force.

Patients are considered at serious risk if they’ve received an extreme amount of opioids, which is defined as 32 tablets or more of 5 milligram Percocet every day for a year.

If patients appear to be doctor shopping which means receiving high amounts of opioids from multiple prescribers and pharmacies, they are also considered at serious risk.

The report found five prescribers in Kentucky and 13 in Ohio have questionable prescribing patterns.

Hilary Slover served as a team leader for the study. She says the oversight agency is concerned with the potential impacts COVID-19 maybe having on treatment and opioid prescribing.

“During this time some Medicaid programs have relaxed rules and suspended safeguards like the requirement for face to face visits with prescribers to receive opioid prescriptions,” Slover said. “In addition, patients may be experiencing reduced access to in person treatment and recovery support. ”

COVID-19 could have a greater effect on patients with an opioid use disorder because the virus attacks the lungs. According to the report, respiratory disease is known to increase the risk of fatal overdose.

Slover says the IG’s Office will release reviews that will assess the trends and challenges of opioid prescribing during the COVID-19 pandemic at a later date.