This week saw the “largest health care fraud takedown operation” in the nation’s history, according to U.S. Attorney General Jeff Sessions. Over 400 people – nearly 60 of whom are licensed physicians or nurse practitioners – have been charged with health care fraud costing American taxpayers $1.3 billion. 120 of those charged stand accused of crimes involving the sale, transfer and use of opioid prescriptions.
The DOJ’s recent actions were focused on addressing the ongoing opioid addiction crisis – and may portend stronger actions in the future. Sessions said, “We believe there are a lot more cases that need to be brought.”
The operation began with online surveys to identify medical professionals who were writing an excessive number of prescriptions. The Los Angeles Times reported the arrest of 77 people in Florida who engaged in various forms of chicanery that included convincing addicts to come to Palm Beach, bribing them with various perks such as casino trips and gift cards. In addition, 17 were arrested in Southern California for schemes that included writing unnecessary prescriptions for oxycodone.
This is only the tip of the proverbial iceberg, unfortunately. According to a recent government report, one-third of all patients receiving benefits through Medicare Part D were prescribed opioid pain relievers. Approximately 500,000 of those patients were given “high amounts of opioids.” The report also states that some 400 doctors “had questionable opioid prescribing patterns for beneficiaries are serious risk .”
Charles Rosenberg of the Drug Enforcement Administration points out that 80% of all heroin addicts start out by taking prescription pain medication. He adds, “most of the people who start on prescription pills get them out of someone’s medicine cabinet, get it ‘legitimately.’”
In a statement to the press, Sessions said, “We would like to see a reduction in the prescription of opioids…the U.S. is by far the highest-prescribing opioid nation in the world; no other nation is close to it.”
Unfortunately, while the government is looking for ways to reduce the demand and supply of opioids on one hand, it is threatening to take away access from low-income patients with the other. Prior to implementation of the Affordable Care Act, adults living in poverty and struggling with substance abuse issues had limited options, since addiction was not considered a disability under Medicaid.
The Medicaid expansion allowed more addicts to enter treatment programs that included counseling, behavioral therapy and medications. If the so-called “Trumpcare” bill is signed into law, it would roll back those benefits. Although the latest version of the bill includes $45 million to “combat opioid abuse,” it is woefully short of the amount needed to address the crisis in a meaningful and effective way.