Medicare lock-in program may help rehab opioid addicts

September 1, 2015

Program aims to prevent drug diversion

Ohio Sen. Sherrod Brown recently unveiled new national bipartisan legislation to address prescription drug abuse by putting a stop to “doctor-shopping.”

Related: A health plan tackles opioid addiction

The Stopping Medication Abuse and Protecting Seniors Act Brown is cosponsoring would create a patient review and restriction, or “lock-in” program-similar to drug diversion prevention plans already in Medicaid and commercial plans-that would limit Medicare beneficiaries with a history of drug abuse to seeing one prescriber and one pharmacy.

The creation of the lock-in program would help the estimated 170,000 Medicare beneficiaries who are addicted to opioids and other prescription drugs receive the help they need while saving taxpayer dollars, according to a statement issued by Brown's office.

Brown's drug abuse prevention plan would also encourage insurers, Part D plan sponsors, and healthcare professionals to assist beneficiaries battling addiction in seeking substance abuse treatment. Beneficiaries identified as potentially being at-risk would receive information on local and national resources, such as addiction treatment services and mental health counseling.

Related: New weapons combat opioid addiction

Vivekanadan“Usually drug abusers fill their prescriptions at multiple pharmacies to avoid exposure," explains Frost & Sullivan's Transformational Health Industry Analyst, Aishwarya Vivekanandan. "Physicians and pharmacies do not have the capability to track these multiple orders enabling drug-seeking behavior. The main objective of this bill is to stop ‘drug store shopping’ and ‘physician hopping.’"

Currently, an estimated 2.1 million Americans suffer from substance abuse due to their addiction to prescription opioid pain relievers, according to the National Institute on Drug Abuse (NIDA). According to NIDA, substance abuse costs the U.S. more than $600 billion annually. 

The bill has been referred to the Senate Committee on Finance, which has jurisdiction over Medicare. 

Tracey Walker is content manager for Managed Healthcare Executive.