It’s no secret that the country is in the midst of an opioid crisis, with multiple states reeling from addiction and overdoses. Law enforcement has had its hands full trying to stem the flow of illegal opioids, but more help may be on the way, courtesy of the federal government. A July 13 health-care fraud “takedown,” orchestrated by the Department of Justice, led to charges against 412 individuals, and 120 of the cases involved opioids.
At the same time, the HHS Office of Inspector General released a data brief estimating that 500,000 Medicare Part D beneficiaries received high doses of opioids in 2016. The brief also said 90,000 Part D beneficiaries were at a high risk of opioid overdose.
Kerry Harvey, a health-care attorney with Dickinson Wright in Lexington, Ky., told me the over-prescription of opioids has fueled the current crisis. Harvey, who served as the U.S. attorney for the Eastern District of Kentucky from 2010 until 2017, said he expects increasingly aggressive law enforcement focused on opioid abuse.
“The OIG data brief sounds a needed warning, and providers should be on notice that scrutiny of prescribing practices is increasing and enforcement action will,” Harvey said.
The OIG is likely to devote more resources to cracking down on the opioid crisis, Harvey said, following a trend begun at the Department of Justice several years ago.
Roughly 400 providers were identified as having questionable opioid prescribing patterns for at-risk beneficiaries, according to the OIG data brief. Some of the providers prescribed high amounts of opioids for patients, while others prescribed opioids for patients who appeared to be engaged in “doctor shopping.” Doctor shopping occurs when patients visit several different physicians to fill multiple opioid prescriptions.
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