DOJ unveils fraud unit targeting opioid prescribers, distributors

Attorney General Jeff Sessions on Wednesday announced the Department of Justice (DOJ) is piloting a new unit that will mine health care fraud data to combat the illicit distribution of prescription opioids.

Reduce opioid misuse and abuse with our new report

Sessions unveiled the Opioid Fraud and Abuse Detection Unit in a speech at the Columbus Police Academy in Ohio. He said the unit, which will be part of DOJ's criminal division, will analyze opioid-related health care fraud data to provide information on:

• "Regional hot spots" for opioid misuse;
• The average age of patients receiving opioid prescriptions;
• The number of a doctor's patients who died within 60 days of receiving an opioid prescription;
• Which pharmacies dispense large amounts of opioids; and
• Which physicians write opioid prescriptions at higher than average rates.

Learn the 8 steps for deploying clinical pharmacists

DOJ under the pilot program will select 12 assistant U.S. attorneys to investigate and prosecute health-care fraud cases in 12 areas:

1. District of Nevada;
2. District of Maryland;
3. Eastern District of California;
4. Eastern District of Kentucky;
5. Eastern District of Michigan;
6. Eastern District of Tennessee;
7. Middle District of Florida;
8. Middle District of North Carolina;
9. Northern District of Alabama;
10. Southern District of Ohio;
11. Southern District of West Virginia; and
12. Western District of Pennsylvania.

He said those prosecutors will serve three-year terms, during which they will focus on health care fraud cases involving pill mill schemes, as well as the unlawful distribution of prescription opioids.

"These prosecutors, working with FBI, [Drug Enforcement Agency], HHS, as well as our state and local partners, will help us target and prosecute these doctors, pharmacies, and medical providers who are furthering this epidemic to line their pockets," Sessions said.

Reaction

In an email response, Patrice Harris, chair of the American Medical Association's Opioids Task Force, said, "The AMA strongly supports public health efforts to end the nation's opioid epidemic" and has "zero tolerance for pill mills or other illegitimate activity."

However, Harris added, "[W]e urge caution in deploying law enforcement approaches that could have unintended consequences in increasing stigma and decreasing access to care. As the nation's opioid epidemic shifts from one driven by prescription opioids to one now largely fueled by heroin and lethal synthetic opioids such as illicit fentanyl and carfentanil, we should rely on evidence-based treatments. We must not let our patients suffer" (Lynch, Reuters, 8/2; Wilber, Wall Street Journal, 8/2; DOJ release, 8/2).

Reduce opioid misuse and abuse with our new report

Opioid misuse and abuse is one of the most pressing public health issues in the U.S., and hospitals and health systems are on the front lines. Currently, most health systems focus their opioid management efforts on select medical specialties.

This report outlines three imperatives to guide hospitals and health systems in their efforts to reduce the impact of inappropriate opioid prescribing and misuse.

Read the Report