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GAO: CMS Needs More Data to Manage Medicare Opioid Risks
Health Payer Intelligence January 23, 2018
The Government Accountability Office (GAO) told CMS to collect more overprescribing data from payers and providers to identify potential Medicare beneficiary opioid risks.
The Government Accountability Office (GAO) has recommended that CMS should collect additional data on Medicare beneficiary opioid risks, including the number of beneficiaries with high-dose opioid prescriptions, the number of providers that overprescribe opioids, and available health plan data on overprescribing indicators.
CMS effectively identified over 33,000 beneficiaries at risk for opioid overutilization, but the current criteria CMS uses to detect possible opioid abuse may miss risk indicators described within CDC guidelines, GAO asserts.
“We found that CMS does not identify providers who may be inappropriately prescribing large amounts of opioids separately from other drugs, and does...
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