New GAO Report Recommends Implementation of National Lock-In Program as Outlined in Brown’s STOP Act


WASHINGTON, D.C. – Following a new investigation released this week on prescription drug fraud and abuse, U.S. Sen. Sherrod Brown (D-OH) ramped up his call to crack down on the fraudulent use of Medicare cards to obtain and fill prescriptions for addictive pain medications. A new Government Accountability Office (GAO) investigation shows a sharp increase in pain medication prescriptions for Medicare beneficiaries—increasing 24 percent from 2007-2010—and calls for implementation of a lock-in program as proposed by Brown’s legislation. 

“As today’s report shows, abuse of prescription drugs is the fastest growing drug problem in the nation,” Brown said. “It’s unacceptable that American taxpayers are left footing the bill for this criminal activity. That’s why I introduced the STOP Act, to combat this epidemic and draw a hard line against criminals, fraud, and abuse.”

The GAO report also found that 170,000 Medicare beneficiaries received prescriptions from five or more physicians. At a counseling center in Portsmouth earlier this month, Brown outlined his efforts to crack down on this type of “doctor shopping,” and “pharmacy hopping” in Medicare and Medicaid. 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 system by attempting to acquire multiple prescriptions and filling them at multiple pharmacies – undermining taxpayers and efforts to combat prescription drug abuse.

Brown’s bill, the Stop Trafficking of Pills Act (STOP Act), would require national adoption of a Medicaid Lock-In program and directs the Secretary of Health and Human Services (HHS) to establish a similar program in Medicare. Lock-In programs prevent convicted prescription drug abusers and high-risk patients from visiting multiple doctors and pharmacies to obtain and fill prescriptions.  This enables the close monitoring needed to prevent high-risk patients from personally abusing or selling opioids on the taxpayers’ dime. In May, Brown appeared before a Senate committee to discuss Ohio’s prescription drug epidemic and to call for the implementation of a Federal Medicaid Lock-In program.

The Prescription Drug Epidemic in Ohio

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.

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 combat 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’s Work to Combat Prescription Drug Abuse

Brown is working to combat the growing problem of prescription drug abuse and Medicaid fraud in Ohio on all fronts. Following a verbal agreement to work together to combat prescription drug abuse in Ohio, Brown sent a letter 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.