Audit: State Should Do More To Prevent ‘Doctor Shopping’ For Prescriptions

June 2, 2015

A new audit finds Colorado's Medicaid program isn't doing enough to insure health providers don't over-prescribe drugs or recipients don't "doctor shop" to get prescription drugs. 

The State Auditor found the Department of Health Care Policy and Financing, which oversees Medicaid, needs to improve oversight of the system that provides prescription drugs to Medicaid recipients. 

The audit spotlighted 17 recipients who apparently “doctor shopped” getting more than 40 opioid prescriptions from more than 12 providers through Medicaid in a year. It also identified 492 Medicaid providers whose prescribing patterns indicated potential fraud, waste or abuse.

By next fall a new computer claims system should address some of the problems, said Chris Underwood, health information office director at the Department of Health Care Policy and Financing.

A 2014 study found prescription drug overdoses in Colorado more than doubled between 2000 and 2012.