Governor Greitens announced Monday a new effort to protect Missourians from opioid addiction by cracking down on providers who over-prescribe powerful drugs. Medicaid providers who refuse to comply with Centers for Disease Control and Prevention guidelines will be held accountable.
Statement from Governor Eric Greitens: “Too often, Missourians seeking real help are getting hooked on dangerous drugs that threaten their lives. We trust doctors to give us sound advice, and most of them do. Family doctors in communities across the state take good care of people and save lives. Still, in every system there are bad actors who put greed, ease, or profit ahead of their mission to help people.
There are prescribers manipulating the system and creating or feeding dangerous habits. Last year, there were more than 1.2 million opioid prescriptions in our Medicaid system alone—sometimes destroying the lives and families of our neighbors.
Today we announced a new initiative that will hold providers in the Medicaid system who prescribe too many opioids, and refuse to change their ways, accountable for their actions. The people who push unnecessary, expensive, and powerful prescriptions to Missourians are ruining lives, and we’re working to stop it. We’re cracking down on this dangerous behavior within the Medicaid system to keep patients safe and protect our communities from the opioid epidemic that threatens so many families.”
The Department of Social Services (DSS), the Department of Mental Health (DMH), and the Department of Health and Senior Services (DHSS) have joined forces to implement national standards for prescribing opioids to chronic pain patients. The departments are working to bring MO HealthNet (Missouri Medicaid) providers who aren’t following Centers for Disease Control and Prevention (CDC) guidelines into compliance when it comes to opioid prescriptions.
In 2017, 10 percent of all MO HealthNet patients received opioids. This means 1.2 million opioid prescriptions were paid for by MO HealthNet, at a cost of more than $10 million. More than 8,000 Medicaid prescribers whose prescribing habits do not adhere to one or more Quality Indicators™ pertinent to the use of an opioid for management of pain have already been identified.
DSS will refer MO HealthNet prescribers who fail to respond within 20 business days from the receipt of the second notification to their respective licensing board and the Bureau of Narcotics and Dangerous Drugs within DHSS.
“In an effort to educate providers and advance evidence-based management of pain, MO HealthNet prescribers who have not adhered to safe opioid prescribing guidelines have received multiple notifications,” said Steve Corsi, Psy.D., Director, DSS. “The Department has a duty to ensure the health and wellbeing of MO HealthNet participants. From this point forward, DSS, DMH, and DHSS are informing prescribers who appear to have prescribing patterns that could be unsafe to address the issue or be referred to the appropriate licensing board. DSS and MO HealthNet are committed to providing consultation, training or assistance in an effort to improve a provider’s compliance with CDC opioid prescription guidelines.”
For some MO HealthNet providers serving patients with opioid use disorder, addressing the issue may mean a referral for services at programs certified by the DMH. “The solution to the opiate epidemic must include modern treatment,” said Mark Stringer, Director, DMH. “That means offering patients FDA-approved medications for opioid use disorder along with counseling and other services.”
“Eighty percent of heroin users indicate they got their start by misusing prescription drugs,” said Randall Williams, M.D., Director, DHSS. “Last year was a pivotal year in Missouri’s campaign to help families affected by the opioid crisis, which is the number one health crisis in America today. Preliminary data indicates that the rapid rise in overdose deaths from 2015-2016 has slowed, but it’s vital that we move forward and ensure that people aren’t initiating therapy with inappropriate amounts of narcotics that will set them on a course for addiction.”
“I want to assure MO HealthNet participants that the majority of MO HealthNet prescribers are compliant with the CDC guidelines for prescribing opioids for chronic pain,” said Dr. Corsi. “Every MO HealthNet participant trusts their health care provider is delivering safe and appropriate care. With the support of DMH and DHSS, the DSS will ensure all MO HealthNet prescribers live up to that expectation.”
Support from Legislators and Stakeholders:
Rep. Holly Rehder (R-148): “Ensuring all prescribers know and are following best practices when it comes to opioids is something the Department has been lax on for too many years. Dr. Corsi and his passion to fight opioid abuse and misuse is a breath of fresh air. This will make a real difference in people’s lives who struggle with addiction.”
Rep. Cody Smith (R-163): “I applaud Director Corsi and the Department for aggressively dealing with bad actors. Opioids have become a public health epidemic and I’m glad to see the Department take this important step.”
Rep. Crystal Quade (D-132): “This year I filed HB 1310 that directs DHSS to promulgate rules that enforce CDC guidelines for opioid prescriptions. I’m pleased our administrative agencies are coming together to educate prescribers who are not complying and taking action, when necessary, to protect Missouri lives.”
Rep. Robert Ross (R-142): “I appreciate the leadership being shown by Dr. Corsi and the Department. It’s about time we started cracking down on bad actors in this state who aren’t following best practices when it comes to prescribing opioids.”
“The Missouri Coalition for Community Behavioral Healthcare, and its 33 behavioral health member agencies, applaud the Governor’s new initiative to use prescribing data combined with education, intervention and enforcement to improve prescribing practices around opioids,” said Brent McGinty, President/CEO, Missouri Coalition for Community Behavioral Healthcare. “We stand ready to do even more as resources become available to provide the treatment needed to respond to this nation’s opioid epidemic.”
“Addressing the state’s opioid crisis will require engagement by all stakeholders,” said Herb B. Kuhn, Missouri Hospital Association President and CEO. “This includes patients, providers and payers.”
“The Missouri League for Nursing is in full support of the state of Missouri’s collaborative effort to ensure the safety of our residents and educate our prescribers in their role in leadership to address this number one health crisis in the United States,” said Peggy Neale-Lewis, RN, CPHQ, President, Missouri League for Nursing.
For additional information please visit https://dss.mo.gov/mhd/providers/opi-program.htm.