Washington – Sen. Chuck Grassley of Iowa and Sen. Dianne Feinstein of California are exploring whether patient satisfaction surveys linked to Medicare payments encourage opioid pain reliever abuse, already a national epidemic. The senators wrote to the federal agency in charge of Medicare payments on agency practices in this area.
“There is growing anecdotal evidence that these surveys may be having the unintended effect of encouraging practitioners to prescribe (opioid pain relievers) unnecessarily and improperly, which can ultimately harm patients and further contribute to the United States’ prescription (opioid pain relievers) epidemic,” Grassley and Feinstein wrote to Administrator Marilyn Tavenner of the Centers for Medicare and Medicaid Services.
Some practitioners have reported that they have prescribed opioids for the specific purpose of improving their patient satisfaction survey scores, Grassley and Feinstein wrote. The senators cited the examples of a South Carolina doctor who reportedly cited his low patient satisfaction scores as the reason why he prescribed Dilaudid, a powerful pain killer commonly used to treat cancer pain, to treat a patient’s toothache. Almost half the members of the South Carolina Medical Association have admitted to prescribing opioids in response to patient survey scores. One hospital with low satisfaction scores even went so far as to offer Vicodin “goody bags” to patients discharged from its emergency room in an effort to improve its scores, Grassley and Feinstein wrote.
The senators asked the agency to explain in writing what, if anything, it is doing to address the impact of patient surveys on the improper prescribing of opioid pain relievers. In addition, Grassley and Feinstein expressed interest in learning whether there are any opportunities for physicians to explain any relevant medical reasons for refusing to prescribe opioid pain relievers to patients who have reported low satisfaction scores concerning their pain management.
Grassley is co-chairman and Feinstein is chairman of the Senate Caucus on International Narcotics Control. The senators regularly weigh in together on domestic drug problems.
The text of the Grassley-Feinstein letter to CMS is available here.###