OIG and Senator Grassley Join CANHR in Condemning Misuse of Antipsychotic Drugs in Nursing Homes, Urge CMS to “Wake Up and Do its Job”

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.

The report has generated a great deal of media attention, including national reports from CBS Evening News and the New York Times.

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:

OIG Report: Medicare Atypical Antipsychotic Drug Claims for Elderly Nursing Home Residents

May 9, 2001 letter from Inspector General Daniel R. Levinson

Grassley says report on use of anti-psychotic drugs is an outrage

May 9, 2011 letter from Senators Grassley and Kohl

CBS Evening News: Gov’t finds nursing homes misuse antipsychotics

New York Times: Antipsychotic Drugs Called Hazardous for the Elderly

California Watch – Audit: Common psychiatric meds can be deadly for elderly


About achicotel

Anthony Chicotel is a staff attorney for CANHR. His areas of expertise include the rights of long-term care residents, nursing home litigation, health care decision-making, and conservatorships.
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