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Opioids in Medicaid: Concerns about Extreme Use and Questionable Prescribing in Selected States

Opioid abuse and overdose deaths are at crisis levels in the United States, with more than 33,000 Americans dying from opioids in 2015. These issues are of particular concern for Medicaid beneficiaries because they are more likely to have chronic conditions and comorbidities that require pain relief. Especially affected are beneficiaries who qualify through a disability. We will identify beneficiaries who received extreme amounts of opioids through Medicaid and those cases that appear to involve doctor shopping or pharmacy shopping, as well as prescribers associated with these beneficiaries. This review will provide baseline data about beneficiaries receiving extreme amounts of opioids and prescribers with questionable patterns for opioids in Medicaid.

Announced or Revised Agency Title Component Report Number(s) Expected Issue Date (FY)
November 2017 Centers for Medicare & Medicaid Services Opioids in Medicaid: Concerns about Extreme Use and Questionable Prescribing in Selected States Office of Evaluation and Inspections OEI-05-18-00010 2018

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