In January of 2019, the National Safety Council released a study with an alarming result: Since 2017, the odds of dying by accidental opioid overdose have exceeded the odds of dying in a car accident. With the opioid crisis raging, the first line of defense may now be healthcare providers, especially rural ones, who treat patients on a daily basis.
On Wednesday, April 3rd, 2019, Attorney Lisa English Hinkle and Compliance Specialist Gina Riddell provided an overview of how rural healthcare providers can fight back, outlining a detailed plan of attack for rural health clinics and other providers. A key takeaway from the webinar is that there are three main ways in which rural health providers can fight the opioid epidemic:
Add Behavioral Health Services
Under 907 KAR 1:082, treatment for mental health disorders, substance use disorders and co-occurring mental health and substance use disorders are covered, and in the Medicare Benefit Policy Manual, RHC and FQHC visits are defined not only as a medical visit but as a mental health visit as well. In addition to medical problems, a patient may have behavioral health issues contributing to the same or different issues. These problems can be identified and a comprehensive care plan developed using a team approach. In other words, adding behavioral health services may result in another revenue stream for a rural healthcare practice and patients can be treated for medical and behavioral health in the same familiar environment without stigma.
Learn, Train and Use Best Prescribing Practices
Legitimate prescriptions remain the number one source of diverted opioids, but up to 43 percent of physicians do not ask about controlled prescription drug abuse when taking a patient’s health history, only 19 percent of physicians have received any medical school training in identifying prescription drug diversion, and only 40 percent of physicians have received any training to identify drug abuse and addiction. Physicians and Nurse Practitioners should prescribe for legitimate medical reasons, document history and physical examination, screen for substance use disorders, use proper techniques, and use electronic prescriptions where possible. Alternatively, medical providers should avoid the following: prescribing at intervals inconsistent with legitimate medical treatment, prescribing large quantities of controlled prescription drugs, issuing prescriptions for dangerous combinations of medications, and prescribing controlled substances when there is no relationship between the medication and the condition being treated. Practitioners should only prescribe in a manner consistent with the KBML and KBN’s directives.
Create a Comprehensive Compliance Plan
Compliance cannot be stressed enough – failure to understand, appreciate and comply with healthcare laws and regulations can lead to penalties such as hefty fines, bans on participation in federal healthcare programs, and even jail time! Efforts to combat the opioid crisis are expanding across agencies and as a result, healthcare providers who submit claims to federal healthcare programs for opioid prescriptions have become the focus of false claims investigations as well as DEA investigations. These efforts increasingly include investigations under the False Claims Act and administrative actions, in addition to the criminal charges. The federal government, principally the US Department of Justice (DOJ), the US Department of Health and Human Services Office of Inspector General (OIG) and CMS along with state agencies are coordinating their efforts and expanding focus on prescribers and healthcare providers who submit claims to federal healthcare programs for opioid prescriptions, as well as drug treatment and laboratory services.
Click here to listen the video.