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Medicare Takes Closer Look at Controlled Substances Prescription

Prescription pain medication is an important medication for many Medicare beneficiaries. Pain medications such as narcotics and stimulants can help countless beneficiaries who are in chronic pain with pain management. These substances are known as Schedule 2 controlled substances. And while they are helpful for many, they also come with the potential for abuse and harm, which is why it’s important that doctors use discretion when prescribing them.

However, data show that some Medicare doctors are prescribing these substances at an alarming rate. According to ProPublica, Medicare prescriptions of Schedule 2 substances in 2012 were “up 9 percent over 2011, compared to a 5 percent increase in Medicare prescriptions overall. Even taking into account an increase in the number of Medicare enrollees, the prescribing rate rose slightly for these drugs.”

After ProPublica reporting in 2013 showed that “Medicare did not proactively analyze its prescribing data or take action against providers whose patterns were troubling,” Medicare is starting to take a closer look at patterns of controlled substances prescription.

More than half of the top 20 prescribers of these substances were the recipients of disciplinary actions by state medical boards or were charged with criminal activity. An investigation revealed that the top precriber wrote more than 14,000 prescriptions for Schedule 2 substances in 2012, and would prescribe them without an exam while taking money under the table. His controlled substances certificate was suspended by the medical board of Alabama, and he later surrendered his medical license.

Medicare has also sent out 760 letters to doctors who are outliers in terms of the amount of Schedule 2 prescriptions they’ve written compared to other doctors in the specialty and state. It is not presumed that the recipients of these letters are violating protocol. The goal is to cause them to reevaluate their prescription habits.

This isn’t to say that Medicare isn’t letting illegal activity go. “Medicare also has sent information on 71 prescribers for possible investigation to the inspector general of the U.S. Department of Health and Human Services, and on one doctor to a state medical board,” according to ProPublica.

Medicare controlled substances

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