by Tony Chicotel, CANHR Staff Attorney
The federal Office of the Inspector General (OIG) within the Department of Health and Human Services has just released a report exposing rampant misuse of antipsychotic drugs in nursing homes, costing taxpayers hundreds of millions of dollars in erroneous Medicare payments. The Inspector General wrote that too many nursing homes eagerly dispense “potentially lethal” antipsychotics in violation of federal regulations intended to protect residents from unnecessary medications.
The report was in response to Senator Charles Grassley’s request to evaluate the quality and cost of atypical antipsychotic drug administration in nursing homes. Senator Grassley stated that the report reveals an “astounding waste of taxpayers’ dollars.”
The OIG report made three major findings regarding the use of atypical antipsychotic drugs:
- 83% of all residents who received atypical antipsychotic drugs paid for by Medicare receive them for an “off-label” use. In addition, 88% of residents on atypical antipsychotics paid for by Medicare are diagnosed with dementia and receive them contrary to an FDA-required Black Box warning label. These staggering numbers reinforce the notion that the vast majority of psychotropic drugs used in nursing homes are given to people for whom they were not clinically intended.
- 22% of Medicare claims for atypical antipsychotics in nursing homes involved at least one indication of unnecessary use. A significant number of administrations are in excessive dose, for excessive duration, or without appropriate indications for use.
- 51% of atypical antipsychotic drug claims for nursing home residents do not comply with Medicare reimbursement criteria. As a result, Medicare paid over $116 million in erroneous claims, just for a six-month period in 2007.
We’re glad that the OIG and Senator Grassley are expressing outrage about the massive misuse of antipsychotic drugs in nursing homes. We join them in demanding that CMS more actively enforce federal regulations to ensure residents are not chemically restrained with deadly unnecessary drugs.
Click on the following to see the OIG Report and its aftermath: