Heavy opioid use among beneficiaries and questionable opioid prescribing practices poses an issue for Medicare, according to a new report from the HHS Office of Inspector General.
In the report, which assesses Medicare Part D data for 2016, the OIG determined "[t]he extreme use of opioids and apparent doctor shopping described in this study put beneficiaries at risk and may indicate that opioids are being prescribed for medically unnecessary purposes and then diverted for resale or recreational use."
Here are five things to know.
1. One–third of Medicare beneficiaries were prescribed opioids in 2016.
2. More than 500,000 beneficiaries received high amounts of opioids in 2016. The report defined high amounts of opioids as an average morphine equivalent dose of 120 milligrams a day for at least three months.
3. The report identified nearly 90,000 Medicare Part D beneficiares at serious risk of opioid misuse or overdose. Among them, 69,563 received extreme amounts of opioids — defined as a daily average MED greater than 240 milligrams — and 22,308 appeared to be shopping for physicians as they received opioids from four or more prescribers and used four or more pharmacies.
4. About 400 prescribers displayed questionable prescribing practices. Among them, 264 ordered opioids for numerous beneficiaries seeking opioids from many physicians.
5. The OIG report found one Texas physician wrote 1,199 opioid prescriptions for 103 beneficiaries. In 2016, this physician gave one patient 24 opioid prescriptions, each valid for an eight-month period. The prescriptions included three opioid medications — oxycodone, morphine and hydrocodone-acetaminophen.
To read the full report, click here.
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