Senate Finance Committee Chairman Orrin Hatch, along with 10 of his Republican Committee colleagues, recently called on the Department of Health and Human Services (HHS) to increase safeguards against opioid fraud. In the letter, the senators request information about HHS’ measures to prevent opioid abuse among Medicare Part D providers and beneficiaries.
The letter requests details regarding the HHS Office of Inspector General’s (OIG) report issued last July, which found that one in three Medicare Part D beneficiaries received a prescription opioid in 2016 – as many as 500,000 of those beneficiaries were receiving high amounts of opioids and nearly 90,000 beneficiaries were deemed to be at serious risk. The report also identified roughly 400 prescribers with questionable opioid prescription patterns for those beneficiaries at serious risk.
The senators requested additional information of HHS regarding the OIG’s findings, including information on the most prevalent opioid related fraud schemes identified in the report; prevention efforts HHS intends to undertake in the wake of these findings; along with a request for specific congressional recommendations as to additional authority that may be needed to protect beneficiaries and prevent fraud and abuse of opioids. The senators also request further detail regarding the 400 prescribers with questionable opioid prescription patterns and the subsequent actions HHS intends to take to follow-up with these prescribers.
Finally, the lawmakers request increased engagement of HHS with the Committee to address the epidemic, including a discussion of potential regulatory and/or legislative actions in this vein. Specifically, the letter request that “HHS officials engage with the Committee on policy options including, but not limited to, review of Medicare and Medicaid payment incentives related to treatment of pain and addiction.”
The Committee’s letter came in conjunction with the recent Senate Health, Education, Labor and Pensions (HELP) hearing on the opioid epidemic at which a number of HHS officials testified, including Scott Gottlieb, MD, Commissioner of the FDA.
During the hearing, the HHS members noted that five-point Opioid Strategy the Agency has implemented, which provides the overarching framework to leverage the expertise and resources of HHS agencies in a strategic and coordinated manner. The comprehensive Opioid Strategy aims to:
- Improve access to prevention, treatment, and recovery support services to prevent the health, social, and economic consequences associated with opioid addiction and to enable individuals to achieve long-term recovery;
- Target the availability and distribution of overdose-reversing drugs to ensure the broad provision of these drugs to people likely to experience or respond to an overdose, with a particular focus on targeting high-risk populations;
- Strengthen public health data reporting and collection to improve the timeliness and specificity of data and to inform a real-time public health response as the epidemic evolves;
- Support cutting-edge research that advances our understanding of pain and addiction, leads to the development of new treatments, and identifies effective public health interventions to reduce opioid-related health harms; and
- Advance the practice of pain management to enable access to high-quality, evidence based pain care that reduces the burden of pain for individuals, families, and society while also reducing the inappropriate use of opioids and opioid-related harms.