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CMS Plan to Restrict Sale of Pain Drugs Opposed by AMA

Cheryl Clark, for HealthLeaders Media, March 6, 2012

"We acknowledge that there are instances where multiple prescribers and pharmacies are writing and dispensing medications to the same patient and unaware that the patient is receiving the same drug or similar drugs from other sources. The best way to address that information gap is for the plans to share the information with the other prescribers so that these prescribers can reconcile the patient’s multiple medications and ensure the beneficiary is getting appropriate care."

Madara wrote that CMS should "acknowledge that physicians are best equipped to evaluate the medication needs of their patients and CMS should not promote the adoption of policies that substitute physician clinical judgment with that of (Part D drug plan) sponsors."

CMS, however, said its policy change was in part in response to a report last September from the Government Accountability Office.

That report detailed "egregious overutilization of medications from Part D beneficiaries who were obtaining medications from a minimum of five different prescribers and a maximum of fifty prescribers, with the vast majority of beneficiaries receiving medications from between five and ten providers.

The medications most often identified as being potentially overprescribed were hydrocodone containing products (e.g., Vicodin and Lortab ) followed distantly by oxycodone containing products (e.g., Percocet and Oxycontin)."

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3 comments on "CMS Plan to Restrict Sale of Pain Drugs Opposed by AMA"


rrpostal (12/4/2012 at 4:42 PM)
Oh my. I work for medicare and this is going to swamp us in people screaming for their meds. "Cutting people off" from their relatively safe and regulated medication is not the proper way to combat addiction. People will resort to crime and illicit drugs. The amount of medicare patients on pain meds is astounding, but hardly a huge cost issue, which is what I'd rather they worry about. If someone is going to be getting stoned on opiates, I'd much rather they do it at their pharmacy than the street corner.

RICK (3/7/2012 at 10:46 AM)
CMS = Constant Mental Struggle. Just more proof that CMS stinks.

B S (3/6/2012 at 9:36 AM)
Of course this is all about patient safety - that's why the Government Accountability Office (A financial and budgeting entity) triggered the action.