Table I.
GAO Recommended Measures for the Prevention and Detection of Fraud Related to Prescription Opioids
| • Implementation of data sharing and system control measures to identify fraudulent enrollments or claims |
| • Screening of prescribers and pharmacies against the federal debarment list |
| • Drug utilization reviews to identify over-utilization, drug-drug interaction, or therapeutic duplication |
| • Prior authorization for medications considered at high risk of fraud or abuse |
| • Increased use of state prescription drug monitoring programs |
| • Checks of vital records to ensure that the beneficiary is alive |
| • Increased use of the restricted participant program (pharmacy or health care provider lock-ins) |
| • Aggressive investigation and prosecution of individuals involved in fraud |