Physicians GAO interviewed generally found prescription drug monitoring programs (PDMPs) to be useful in preventing drug misuse and potentially dangerous drug prescribing. PDMPs are state-operated electronic databases that track prescriptions patients receive for opioids or other medications that are at risk of being misused. Most of the 31 physicians GAO interviewed said PDMP information helped

Genetic counselors and medical geneticists are two groups who typically work together to provide genetic services, such as genetic testing and counseling. Genetic counselors have at least a master's degree in genetic counseling and assess individuals or families with or at risk for genetic conditions, and provide counseling and education on test results. Medical geneticists are typically physicia

Hospice care helps patients who are terminally ill maintain their quality of life. Most patients get hospice care at home, which typically includes use of controlled substances, including opioids such as oxycodone, to provide pain relief. When hospice patients die at home, they often leave behind unused controlled substances, which can be diverted and misused by anyone with access to them. The Su

Medication-assisted treatment (MAT)—which combines behavioral therapy and the use of certain medications, such as buprenorphine—has been shown to be effective at reducing the misuse of or addiction to opioids and increasing treatment retention. The federal government has identified expanding access to MAT as important for reducing opioid use disorders and overdoses, and has taken action to in

Medicare's hospice benefit provides palliative care to beneficiaries with terminal illnesses and a life expectancy of 6 months or less. GAO's review of 2017 data from the Centers for Medicare & Medicaid Services (CMS) found that for-profit and non-profit hospices had, on average, similar scores on CMS's current quality measures that indicate hospice performance in areas such as pain assessment an

The Department of Veterans Affairs (VA) needs to take action to ensure its health care providers have the appropriate qualifications and clinical abilities to deliver high quality, safe care to veterans, as GAO recommended in its February 2019 and November 2017 reports. Specifically, GAO found the following: (1) VA medical centers took action against some providers who did not meet VA licensure r

Individuals may access investigational drugs—those not yet approved for marketing in the United States by the Food and Drug Administration (FDA)—by participating in clinical trials conducted by drug manufacturers to test drug effectiveness and safety. FDA has ongoing efforts to help manufacturers identify the circumstances under which they could broaden clinical trial eligibility criteria to

The Food and Drug Administration (FDA), Drug Enforcement Administration (DEA), and Environmental Protection Agency (EPA) recommend that patients dispose of unused presciption opioids by bringing them to DEA-registered collection sites or a DEA take-back event, or using mail-back programs. As of April 2019, 70 percent of the U.S. population lived less than 5 miles from permanent collection sites,

The 2018 Bipartisan Budget Act (BBA) defined longitudinal comprehensive care planning (LCCP) as services involving an interdisciplinary team of providers who develop and communicate a care plan to Medicare beneficiaries diagnosed with a serious or life-threatening illness. GAO identified at least 58 billing codes in Medicare's physician fee schedule that could be used by providers to bill for ser

GAO found that Veterans Health Administration (VHA) facilities responded in various ways to adverse-action information from the National Practitioner Data Bank (NPDB) for the 57 providers reviewed, and in some cases overlooked or were not aware of adverse action. (1) In some cases, providers had administrative or other nondisqualifying adverse actions reported in the NPDB, but VHA facilities dete