Proposed Medicare rules would tighten CMS oversight of nursing home prescriptions

In light of reports that Medicare Part D prescribing practices are endangering seniors — many of them in long-term care facilities — the Centers for Medicare & Medicaid Services has issued a proposed rule that would give the agency more power to oversee and control the prescription drug program.

To date, CMS has taken a limited role in overseeing Part D, saying that this is the responsibility of the private health plans that administer it. This has led to some problematic prescribers doling out potentially harmful medications to seniors for years, according to investigative journalism organization ProPublica.

Some of the seniors most at risk reside in skilled nursing facilities and other long-term care settings, according to a high-profile report published last year by ProPublica and The Washington Post. The article focused on some of the most prolific Part D prescribers in the nation, such as Adolphus Ray Lewis. Even after admitting responsibility for the death of a nursing home resident given excessive doses of painkillers, Lewis went on to account for the fifth-highest number of Medicare prescription claims in the country in 2010.

Miami psychiatrist Enrique Casuso was another doctor investigated. He prescribed more antipsychotic medications to Medicare beneficiaries than any other physician in the nation in 2010, and many of those seniors had dementia and were living in facilities, according to ProPublica.

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Proposed Medicare rules would tighten CMS oversight of nursing home prescriptions