The Senate is actually working on a real solution to a real problem where technical experts are being listened to, bi-partisan coalitions have been formed with Senators from opposing parties seeking to find ways to solve a common problem.
Someone please pass me the smelling salts as this is actual good news:
From the Pittsburgh Post Gazette:
The bill was introduced by Sens. Pat Toomey, R-Pa., and Rob Portman, R-Ohio. Sens. As primary co-sponsors, Bob Casey, D-Pa., and Sherrod Brown, D-Ohio, also have been shepherding it through Congress….
As part of an effort to prevent opioid abuse, lawmakers are teeing up legislation that would limit Medicare Part D beneficiaries to a single pharmacy and a single provider for narcotics….
The GAO estimates that 170,000 Medicare enrollees have engaged in doctor shopping, where they go to multiple doctors who then typically unknowingly write duplicative prescriptions that are then filled at multiple pharmacies for the very same painkiller,” Mr. Toomey said. “It’s an easy way for people to find commercial-scale quantities of opioids which they can then sell on the black market.”
Medicaid has a lock-in program which limits individuals who are identified through claims and prescription data as engaging in doctor shopping behavior. The criteria varies by state. In mine, it is seeing enough doctors to organize a pick-up basketball game and filling those prescriptions at several pharmacies that trigger the red flag. The idea behind lock-in is that it forces an individual who has been doctor shopping to choose a single provider who sees on their medical records that this person has a history of opioid seeking behavior. The single pharmacy restriction allows a pharmacist to see the same faces and act as a backstop when usage becomes an outlier which would suggest significant diversion.
As long as there is a reasonable national criteria for what constitutes opioid seeking behavior in the Medicare population, this bill makes a good amount of sense to reduce but not eliminate a pressing national problem.
This is a win. The challenge is getting this bill to President Obama’s desk without it being tied up in half a dozen other pieces of legislation which contain unrelated poison pills.