Sen. Brown: Crack Down on Medicaid Prescription Drug Fraud by Preventing "Doctor Shopping" and "Pharmacy Hopping"

Brown Calls for Establishment of “Medicaid Lock-In” Program, Which Would Prevent Convicted Prescription Drug Abusers from Acquiring Excess Prescription Drugs – for Illegal Resale or Abuse – By Visiting Multiple Doctors, Pharmacies

WASHINGTON, D.C. - U.S. Sen. Sherrod Brown (D-OH) today urged the Office of Ohio Health Plans to continue with plans to establish a Medicaid “lock-in” Program for the State of Ohio which would crack down on the fraudulent use of Medicaid cards to obtain and fill prescriptions for addictive pain medications.  A Medicaid lock-in program would prevent prescription drug abusers from acquiring excess prescription drugs – which they may abuse or illegally-re-sell – by barring them from visiting multiple doctors and pharmacies.

“Ohio taxpayers should not be footing the bill for drug abuse and diversion,” Brown said. “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. We have an obligation to crack down on deadly prescription drug abuse. Implementing a Medicaid lock-in program is certainly not the whole answer – the vast majority of Medicaid beneficiaries use their Medicaid card appropriately and there are plenty of other avenues for illegal drug use – but it will help stop those few Medicaid enrollees who have been misusing their Medicaid cards from continuing this costly and dangerous practice. Ohio’s Medicaid program will not finance criminal activity or feed drug addiction.”

Following meetings with community leaders throughout southern Ohio, Sen. Brown wrote to then-Governor Ted Strickland 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.
Prescription drug abuse is an epidemic in Ohio. 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. 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).

Sen. 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 Agency, 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.

Brown is working to combat the growing problem of prescription drug abuse and Medicaid fraud in Ohio on all fronts. Earlier this year, Sen. Brown wrote to President Obama in support of the President's proposals to combat Medicaid prescription drug fraud and joined a bipartisan group of Senators in introducing legislation to reauthorize the National All Schedules Prescription Electronic Drug Reporting (NASPER) Act, which helps support monitoring programs to prevent individuals from filling multiple controlled substance prescriptions.


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