Recommendation
Congress should prohibit Centers for Medicare and Medicaid Services from processing Medicaid claims involving opioids that are missing key information.
Details
Medicaid data historically has been incomplete, inaccurate, and out of date, making it inadequate for comprehensive analysis. To remedy this, the Centers for Medicare and Medicaid Services (CMS) began requiring states to submit data to its system on a monthly basis. However, some states do not include important data like National Provider Identifiers (NPIs), diagnosis codes, and unique patient identifiers, which would help identify when providers are overprescribing opioids. Congress should pass a law prohibiting CMS from processing Medicaid claims involving opioids if they are missing this information.
Keep reading:
▪ Joshua New, “How Data Can Help in the Fight Against the Opioid Epidemic in the United States” (Center for Data Innovation, November 2019), https://www.datainnovation.org/2019/11/how-data-can-help-in-the-fight-against-the-opioid-epidemic-in-the-united-states.