Combating the opioid crisis doesn’t stop at treatment and monitoring use as discussed in LHA’s post on Opioid Use Disorder, but continues with controlling the availability of the drug. According to the CDC, of the 11.4 million people who misused the drug, 53% obtained opioids from a friend or family member, 37.5% received them from a prescription or stealing from a provider and 6% took a more ominous route and obtained them from a dealer or stranger.
For Medicare Part D beneficiaries, 1 in 3 patients received at least one opioid prescription, 76 million prescriptions were covered by Part D and 1 in 10 had opioid prescriptions for 3 months or more. Considering that there are 45 million people with Part D coverage, these statistics give an idea of the potential for fraud and abuse.
The OIG partnered with federal and state law enforcement to take down healthcare fraud with over 600 defendants charged in 2018 for schemes concerning opioid distribution. 165 of which were medical professionals including 32 doctors. One pain management specialist was found guilty for accepting cash in return for writing prescriptions for controlled substances. The specialist was also charged with second-degree manslaughter after one of his patients died from overdose after receiving multiple prescriptions every month for a year. Another physician was found providing pre-signed slips to non-physician staff who later used them to write illegal opioid prescriptions.
For every $1 the OIG spends on fraud investigations, they recover $4. With this return on investment, the crackdown on opioid distribution will continue with the added hope of alleviating the opioid epidemic and saving lives.