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The U.S. Department of Health and Human Services (HHS) announced it will tell Medicare prescription drug plans to withhold payment to pharmacies when they detect signs of suspicious activity related to narcotics and painkillers. The move is aimed at reducing Medicare fraud, Reuters reports.
If an insurance plan suspects fraud, it should withhold payment until it verifies the claim is valid, HHS urges. The department also is calling on doctors to write prescriptions for potentially addictive painkillers in supplies of less than 30 days. According to an HHS news release, the Government Accountability Office found that in 2008 an estimated 170,000 people enrolled in Medicare received prescriptions from five or more doctors for drugs that are often abused, such as OxyContin and Percocet.
Nearly three in 10 people between ages 57 to 85 use at least five prescriptions, according to the Substance Abuse and Mental Health Services Administration (SAMHSA). Between 1997 and 2008, the rate of hospital admissions for conditions related to prescription medications and illicit drug use rose by 96 percent among people ages 65 and 84; for people 85 and older, admissions grew 87 percent. SAMHSA notes medication misuse and abuse can cause a range of harmful side effects, including drug-induced delirium and dementia.
Published
December 2011