Combatting the Opioid Epidemic: A Review of Anti-Abuse Efforts in Medicare and Private Health Insurance Systems [open pdf - 426KB]
"The abuse of opioid drugs has become a national health crisis. Sixty percent of the record 47,000 drug overdose deaths in 2014 were attributable to prescription opioids or heroin. Approximately 19,000 of those deaths were due to prescription opioids. Combatting this public health emergency requires a collaborative effort by treatment centers, the health care community, and law enforcement. Those integrated efforts have been the subject of many congressional hearings. The Subcommittee has focused on the significant role that the Centers for Medicare and Medicaid Services (CMS) and private health insurers play in detecting, reporting, and addressing opioid abuse. Specifically, the Subcommittee examined the efforts undertaken by CMS and its main program integrity contractor, the Medicare Drug Integrity Contractor (MEDIC), to address opioid-related fraud and abuse in Medicare Part D-the federal prescription drug coverage program serving nearly 35 million senior citizens and 7 million Social Security disability benefit recipients. In addition, the Subcommittee examined the anti-opioid abuse efforts of six of the nation's largest health insurance companies-both in their commercial insurance business and in their role as Medicare Part D plan sponsors."
Senate Committee on Homeland Security and Governmental Affairs: http://www.hsgac.senate.gov/