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Congress Considering Prescription Monitoring for Medicare

Congress is looking at prescription monitoring for Medicare because studies are showing a large number of the program's patients are taking dangerous levels of opioids. Graphic: The Pew Charitable Trusts.
Congress is looking at prescription monitoring for Medicare because studies are showing a large number of the program's patients are taking dangerous levels of opioids. Graphic: The Pew Charitable Trusts.
December 7, 2015

CHARLESTON, W.Va. – Congress is considering giving Medicare the power to monitor for excess use of pain medicines.

Currently Medicare part D administrators don't have the authority to watch for signs that a patient might be intentionally or accidentally abusing opioids.

But Cynthia Reilly, director of the Prescription Drug Abuse Project at The Pew Charitable Trusts, says nearly a quarter million seniors took a potentially unsafe dose for 90 or more consecutive days in 2011.

She says the House, Senate and White House are all looking at a plan that would flag warning signs.

"A large number of prescribers, or a large number of pharmacies, large quantities,” she states. “They then designate a given prescriber and pharmacy for these patients."

The Centers for Disease Control and Prevention says more than 16,000 Americans die from painkiller overdoses annually.

Reilly says prescription monitoring is becoming an increasingly common way to address what is a growing problem.

She says more than anything, prescription monitoring is aimed at reducing accidental overdose deaths. And she adds there is some evidence of doctor shopping and patients seeking more of the pills than they need.

But Reilly stresses that the patients and the doctors may not even know they are doing anything wrong.

"Oftentimes prescribers don't know that their patients are visiting multiple prescribers,” she points out. “Patients may not know when a prescription is duplicative or additive in a way that is potentially harmful."

Reilly says the programs have to be careful to not keep pain medicines from the patients who need them.

But according to Sam Hickman, executive director of the West Virginia Chapter of the National Association of Social Workers, this could be an opportunity to move health care away from its dependence on strong medicines that are sometimes too easy to get.

He says the state's health care system is gradually shifting to other kinds of therapies that help people stay well.

"That may not involve pain medication,” he stresses. “Whether it's through wellness and exercise activities or dealing with behavioral and mental health problems that contribute to perceptions of pain."


Dan Heyman, Public News Service - WV