Opioids in Medicaid: Review of Extreme Use and Overprescribing in the Appalachian Region

Opioid abuse and overdose deaths remain at crisis levels in the United States and the Appalachian region. In 2017, opioids were involved in nearly 48,000 overdose deaths nation-wide, and the opioid overdose death rate was 72 percent higher in Appalachian counties than non-Appalachian counties. These issues are of particular concern for Medicaid beneficiaries, who are more likely to have chronic conditions and comorbidities that require pain relief, especially those beneficiaries who qualify through a disability. Consistent with previous OIG work in Medicaid and Medicare Part D, we will identify beneficiaries who received extreme amounts of opioids through Medicaid, beneficiaries who appear to be doctor or pharmacy shopping, and prescribers associated with these beneficiaries.

Announced or Revised	Agency	Title	Component	Report Number(s)	Expected Issue Date (FY)
August 2019	Centers for Medicare & Medicaid Services	Opioids in Medicaid: Review of Extreme Use and Overprescribing in the Appalachian Region	Office of Evaluation and Inspections	OEI-05-19-00410	FY 2021