Controlled Substances:

Medicaid Data May Be Useful for Monitoring Diversion

HRD-88-111: Published: Aug 1, 1988. Publicly Released: Aug 30, 1988.

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In response to a congressional request, GAO assessed the possibility of using Medicaid data to identify health care providers who may be diverting prescription drugs for illegal purposes.

GAO found that states should use data contained in the Medicaid Management Information System (MMIS) to identify health care providers who may be illegally diverting controlled substances, since: (1) states' MMIS often comprise the largest databases on the prescription and dispensing of controlled substances; (2) Medicaid laws allow disclosure of the data; and (3) it would enable law enforcement officials and licensing and regulatory agencies to identify sources of drug diversion.

Recommendation for Executive Action

  1. Status: Closed - Implemented

    Comments: The Department of Health and Human Services (HHS) stated it would disseminate information about successful state actions rather than sponsor a test like the one GAO recommended.

    Recommendation: The Secretary of Health and Human Services, in consultation with the Department of Justice in its role of assisting state and local law enforcement agencies, should take the initiative and test the usefulness and cost of analyzing and providing MMIS controlled substances data to law enforcement, regulatory, and licensing agencies for identifying sources of drug diversion.

    Agency Affected: Department of Health and Human Services


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