WASHINGTON, DC – Last year, Ohio’s Medicaid program spent $820 million on prescription medicines. While most prescription pain medicines are used as prescribed, some criminals are defrauding the Medicaid system by attempting to acquire multiple prescriptions and filling them at multiple pharmacies – undermining taxpayers and efforts to combat prescription drug abuse. Today, U.S. Sen. Sherrod Brown (D-OH) announced a plan to combat prescription drug abuse by targeting doctor-shopping and pharmacy-hopping. Brown unveiled new legislation that would crack down on the fraudulent use of Medicaid cards to obtain and fill prescriptions for addictive pain medications.
“When criminals defraud the Medicaid system to fuel prescription abuse, it’s a one-two punch to the stomach of Ohio taxpayers,” Brown said. “Prescription drug abuse must be treated like the epidemic it is – and that means drawing a hard line against criminals, fraud, and abuse. Ohio taxpayers should not be footing the bill for drug abuse and diversion, but when drug abusers or dealers use their Medicaid cards to visit multiple doctors or pharmacies, they’re feeding their addiction – or illegal drug business – on the taxpayer’s dime. That’s why I’m working to establish a Medicaid lock-in program to help stop those Medicaid enrollees who have been misusing their Medicaid cards from continuing this costly and dangerous practice. The doc-shoppers and pharmacy hoppers are on notice: Ohio taxpayers will not finance criminal activity or feed drug addiction.”
During a news conference call, Brown outlined how a Medicaid lock-in program would prevent prescription drug abusers from acquiring excess prescription drugs–which they may abuse or illegally-resell– by barring them from visiting multiple doctors and pharmacies.
Prescription drug abuse is an epidemic in Ohio. Ohio is second only to Florida in the number of Oxycodone prescriptions filled and Ohio’s death rate due to unintentional drug poisoning increased more than 350 percent from 1999 to 2008. In 2007, unintentional drug poisoning became the leading cause of accidental death in Ohio, surpassing motor vehicle crashes and suicide for the first time on record. Prescription pain medications, such as oxycodone, morphine, and methadone, are largely responsible for increasing numbers of overdoses and deaths in Ohio.
An investigation by the nonpartisan Government Accountability Office (GAO), which audited the Medicaid programs of the five largest states, found 65,000 cases in which Medicaid beneficiaries visited six or more doctors and up to 46 different pharmacies to acquire prescriptions. This same GAO report found approximately 1,800 prescriptions written for dead patients and 1,200 prescriptions "written" by dead physicians. The problem is particularly striking in Ohio, where from January to June 2010, there were more than 927,000 purchases of Oxycodone products—second only to Florida.
Today, Brown announced the introduction of the Stop Trafficking of Pills Act (STOP Act). This bill would require national adoption of Medicaid Lock-In programs, which are already used in nearly 20 states. South Carolina’s Medicaid lock-in pilot program targeted high-use beneficiaries and spurred a 43 percent decrease in the total number of prescription pain medications. Medicaid lock-in programs can be effective by limiting the doctors from which a high-risk patient can receive prescriptions, as well as the pharmacies from which the patient can obtain medicines. This enables the kind of close monitoring needed to prevent high-risk patients from personally abusing or selling opioids.
Community leaders in southern Ohio and rural counties across the state have expressed concerns about the increasing problems with drug abuse and often attribute the rise in abuse to drug diversion (the unlawful channeling of regulated drugs from medical sources to the illicit marketplace of pain medications), doctor shopping (using multiple prescribers), and pill mills (doctors, pharmacies or illegal pain clinics that prescribe and dispense prescription drugs inappropriately or for non-medical reasons or personal financial gain).
Both the Strickland and Kasich Administrations in Ohio have advocated for thorough and comprehensive approaches to combating prescription drug abuse. Governor Strickland established a task force that produced strong recommendations for combating this issue, and Attorney General Mike DeWine has announced several initiatives aimed at cracking down on the “pill mills” that offer easy – and illegal – access to prescription pain medications.
Brown is working to combat the growing problem of prescription drug abuse and Medicaid fraud in Ohio on all fronts. Earlier this year, Brown wrote to the Kasich Administration about establishing a Medicaid “lock-in” program, which would enable the Office of Ohio Health Plans to better monitor and control access to prescription drugs that are subject to abuse and trafficking. Brown also wrote to the Drug Enforcement Administration, requesting additional federal efforts in cracking down on “pill mills” across Ohio.
Following a verbal agreement to work together to combat prescription drug abuse in Ohio, Brown sent a letter today to U.S. Attorney General Eric Holder urging him to establish two Ohio-based tactical diversion squads to help the state crack down on ‘pill mills’ and prescription drug-related crimes. While there are currently 37 operational tactical diversion squads nationwide, none are based in Ohio. At a March 2011 hearing of the U.S. Senate Appropriations Subcommittee on Commerce, Justice, Science, and Related Agencies, Brown urged Holder to work with Ohio’s law enforcement agencies to establish tactical diversion squads in the state.
Last year, Brown joined a bipartisan group of Senators in introducing legislation to reauthorize the National All Schedules Prescription Electronic Drug Reporting (NASPER) Act, a prescription drug monitoring program critical to combating the abuse of prescription drugs. Sen. Brown has also joined his colleagues in introducing legislation that would prevent teenagers from gaining access to discarded prescription drugs by permitting individuals and long-term care facilities to deliver unused drugs for safe disposal and by expanding drug “take-back” programs.
Brown’s office convened a first-of-its-kind roundtable in March 2010 that brought together federal officials from the U.S. Department of Justice, Drug Enforcement Administration Centers for Medicare and Medicaid Services, state officials from the Attorney General's office, Department of Health, and Department of Jobs and Family Services, and community leaders to discuss the issue of drug abuse in southern Ohio.