CMS Opioid Monitoring System Successful in Part D Recipients

63% of Americans admit they have used an opioid pillpunchthumband over a third of them within the past three years.  Medical experts have declared a public health crisis over the abuse of opioid prescription drugs and heroin with upwards of 74% expressing extreme concern that opioids are being abused and misused.

In response to this issue, CMS implemented a Medicare Part D Overutilization Monitoring System (OMS) in 2013 specifically designed to identify high risk beneficiaries.  Since the program was put into place, they have seen a 26% decrease between the years of 2011 and 2014 in beneficiaries being identified as possible opioid abusers.

Studies show that opioids may not be the most effective long-term pain treatment and that other medicines and therapies can more greatly benefit patients.  CMS will continue to retrieve data from health care providers and pharmacies to identify those who may be receiving too much of these medications in an attempt to reduce the widespread overuse and improve the health of Medicare and Medicaid recipients.

Posted in Industry News, Medicare Advantage/Part D Prescription