CMS enlists tracking measures on Medicaid opioid, antipsychotic prescribing to identify cases of misuse

December 21, 2015

CMS will track the use of opioids by adults and antipsychotics among children and adolescents more closely with Medicaid and the Children's Health Insurance Program quality measures, which the APA said will help identify patterns of misuse. However, some experts are concerned the measure could dissuade providers from prescribing multiple antipsychotics when the severity of the case calls for it. The CMS will require Medicaid programs, beginning no later than Dec. 2016, to track the use of opioids at high dosages acquired from four or more providers and pharmacies by beneficiaries who don't have cancer; a move intended to indicate inappropriate prescribing or fragmented care. The CDC reported about 28,600 people died in 2014 from overdoses of prescription painkillers, heroin and other opioids - the highest figure on record and has tripled since 2000.