Legislature should curb TennCare's spread of opioids

Johnson City Press • Mar 17, 2018 at 8:00 AM

State Sen. Frank Niceley's bill to prohibit TennCare from providing coverage for any drug containing oxycodone has run afoul of federal law. But that should not be the end of it.

Niceley should take that as a challenge and search for other ways to prevent, or at the least dramatically reduce, the amount of opioids that are being paid for through Tennessee's Medicaid program and which are killing people by the hundreds.

Perhaps Nicely was merely trying to make a point in proposing that TennCare not fund any opioids. There are legitimate needs for pain medication for many on TennCare, and the state’s fiscal review committee found that, as written, Nicely's bill violated federal law and would jeopardize federal rebates to the state’s Medicaid program to the tune of some $250.3 million.

A TennCare spokesperson said the bill would be in violation of federal statute and would put TennCare at risk of losing its full federal rebate. Can't have that. But we also can't continue with TennCare as part of the problem of opioid abuse. It needs to be part of the conversation about fighting the epidemic of opioid abuse.

For 2016, TennCare paid for more than $40 million in opioids. Area prosecutors point out that TennCare pays for dispensing a lot of narcotics with “copays maybe as low as $3,” Sullivan County District Attorney General Barry Staubus stressed. District Attorney General Dan Armstrong said of opioids: “You can sell them for $30 a pill and get 20 pills for your own habit.”

The prosecutors say that increased DUIs are not due to alcohol, but drugs. Said one, "The last four homicides in my district have been drug related. You look at everything we do, it stems from the drug epidemic.”

TennCare provides health care for approximately 1.4 million Tennesseans and operates with an annual budget of approximately $11.8 billion. TennCare members are primarily low-income pregnant women, children and individuals who are elderly or have a disability. It covers approximately 20 percent of the state’s population, 50 percent of the state’s births and 50 percent of the state’s children.

The federal government funds about 65 percent of the program, with the state paying for the remainder. Without doubt, a percentage of the opioids that TennCare provides are being used by addicts, being sold on the street, and causing overdose deaths. Surely our lawmakers can, with input from all involved, find a way to better control the flow of opioids through TennCare.

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