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Prescription Monitoring Considered 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 opiods. 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 opiods. Graphic: The Pew Charitable Trusts
December 7, 2015

RICHMOND, 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 opiods.

But Cynthia Reilly, director of the Prescription Drug Abuse Project with The Pew Charitable Trusts, says nearly a quarter million seniors took a potentially unsafe dose for ninety 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. They then designate a given prescriber and pharmacy for these patients," says Reilly.

Reilly says more than anything, prescription monitoring is aimed at reducing accidental overdose deaths. She says 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," says Reilly. "Patients may not know when a prescription is duplicative or additive in a way that is potentially harmful."

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

"You may see some concern from other stakeholders, but we know from experience that the programs are structured and they need to be structured in a way that ensures continued access for those patients," she says.

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.

Dan Heyman, Public News Service - VA