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Published: Wednesday, 10/5/2011

Medicare plan aiding addicts, GAO reports

Abusers feed own habits, sell pills, investigators say

BLADE NEWS SERVICES

WASHINGTON — Medicare's popular prescription program is an easy target for drug abusers seeking to feed their own addictions or sell painkillers for profit, congressional investigators said in a report released yesterday.

The Government Accountability Office found that about 170,000 Medicare recipients each received prescriptions from multiple doctors for 14 frequently abused medications in 2008. Not counting related charges for office visits, the cost to the taxpayer-supported program amounted to $148 million.

Abuse of prescription medications is a fast-growing problem, particularly entrenched among teens and young adults. Sen. Tom Carper (D., Del.), who requested the investigation, said Medicare has a responsibility to not make things any worse.

"We have a moral imperative to make sure the public health system is not used to subsidize and intensify a public health crisis," Senator Carper said at a hearing of the Homeland Security and Government Affairs Committee's subcommittee on federal financial management.

Medicare officials say they face legal limitations in what they can do to stop the abuse, although they recognize the problem and have adopted new strategies to confront it.

The investigation found that drug abusers have little to fear from exploiting Medicare. In one case described in the report, a Medicare beneficiary in Georgia received a 150-day supply of oxycodone in just 27 days by obtaining seven prescriptions from four doctors. Over the course of a year, she received prescriptions for a total of 3,655 pills (a 1,679-day supply) from 58 prescribers, and she filled them at more than 40 pharmacies.

In another case, a California man received prescriptions for a total of 1,397 fentanyl patches and pills (a 1,758-day supply) from 21 prescribers in a year. In a third case, a Texas beneficiary received prescriptions for a total of 4,574 hydrocodone pills (a 994-day supply) from 25 doctors.

Overall, taxpayers pay three-fourths of the cost of the Medicare prescription drug program, which covers some 28 million seniors and disabled people for about $55 billion a year.

All types of insurance plans confront prescription abuse. Narcotics, tranquilizers, stimulants, and sedatives obtained from unwitting doctors can feed a personal addiction or can be resold in a lucrative underground market.

Medicare appears to be hamstrung in confronting it, the report concluded.

Many private insurance plans and state Medicaid programs restrict patients who appear to be abusing drugs so they can get narcotics only from specific doctors and pharmacies.

But Medicare officials told investigators that federal law does not allow the prescription program to limit the access of beneficiaries who appear to be abusing drugs.



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