Lance's Corner

NYSDOH Highlights Reduced Opioid Prescribing

Jun 27, 2024

Per the notice below, the New York State Department of Health (NYSDOH) is highlighting a significant reduction in opioid prescribing in New York State.

New York State Department of Health Acknowledges Prescribers In New York for Reducing New High-risk Exposures to Opioid Prescriptions

Data to Action Report Shows Prescribers are Making Strides in Reducing Risks for Overdose and Substance Use Disorder

Number of Opioid Prescriptions Filled Reduced by 42.1 Percent From 2013 to 2022

The New York State Department of Health has released a new data report showing opioid prescribing practices are improving in New York State.  The Data to Action Report on Opioid Prescribing in New York State shows that New York State providers continue to make strides in practice improvements and implementing new preventive measures to reduce the risks of overdose and substance use disorder within their communities.

"It is encouraging to see this positive trend of decreased prescribing for prescription opioids.  Often, pain can be treated with anti-inflammatories or other modalities without the risk of dependence on a prescription medication," State Health Commissioner Dr. James McDonald said.  "Opioid use disorder is a public health crisis that requires a collaborative approach to solve. I thank our dedicated medical professionals who prescribe judiciously and balance risk and benefit for their patients."

Overuse and overprescribing of opioids beginning in the 1990s contributed to their misuse and abuse and has had a significant impact on the current state of the opioid crisis today.  Historically, overdose deaths involving opioids in New York State reached an all-time high in 2022 with 5,388 opioid-related overdose deaths that year.  Data outlined in the report shows opioid prescribing practices are improving in New York State.  The number of filled opioid prescriptions declined from more than 9 million in 2013 to under 6 million in 2022—a 42.1 percent decrease over 10 years.  From 2013 to 2022, the age adjusted rate per 1,000 population of opioid prescriptions decreased from 460.3 to 240.8.  Reductions were observed in both New York City and New York State outside of New York City.  More work still needs to be done.  Data found that in 2022, the prescribing rate was twice as high outside of New York City compared to New York City (303.1 per 1,000 versus 152.1 per 1,000, respectively).  State and federal regulators have employed various strategies to address the opioid crisis.  In New York, efforts have included laws to improve monitoring and control of opioid prescriptions.  These strategies include, but are not limited to the following requirements:

  • Consulting the New York State Prescription Monitoring Program Registry before prescribing any schedule II, III, or IV controlled substance.
  • Mandate for electronic prescribing.
  • Limits on initial opioid prescriptions for acute pain.
  • Required written treatment plans for long-term chronic pain opioid use.
  • Mandate for annual prescribing an opioid antagonist when certain risk factors are present.

The Center for Disease Control and Prevention's Clinical Guideline for Prescribing Opioids for Pain issued in 2022, emphasizes reducing risks by promoting nonpharmacologic and nonopioid therapies, prescribing the lowest effective opioid dose and duration, weighing risks and benefits, using immediate-release opioids, and reviewing patient history for opioid use, as well as misuse.  These guidelines were supported by studies indicating that in primary care patients who were prescribed between a 4- and 7-day supply of an opioid analgesic, fewer than one in five required additional opioid prescriptions after completion of the supply provided with the initial fill.  Successful legislation within New York State helped reduce overprescribing of opioids.  New legislation limiting the initial opioid prescribing to a 7-day supply for acute pain was enacted in July 2016.  Following this, the number of episodes when an opioid-naïve patient (a patient that has not received an opioid prescription in the last 45 days) received more than a 7-day supply of an opioid from the initial prescription reduced 74 percent from 2016 to 2022 (974,577 episodes to 255,984, respectively).  The New York State Department of Health offers an Opioid Overdose Prevention Program.  A life-saving law took effect on April 1, 2006, making it legal in New York State for non-medical persons to administer naloxone to another individual to prevent an opioid overdose from becoming fatal.  All registered opioid overdose programs are furnished naloxone (Narcan) by the State Department of Health.  Registration for these programs has continued to grow.  As of June 2024, there are over 1,200 registered programs across New York State with over 5,000 affiliate sites.  For more information on our Opioid Overdose Prevention Program, please visit the Department's dedicated website here.

USDOL Issues Comprehensive Employer Guidance on Long COVID

The United States Department of Labor (USDOL) has issued a comprehensive set of resources that can be accessed below for employers on dealing with Long COVID.

Supporting Employees with Long COVID: A Guide for Employers

The “Supporting Employees with Long COVID” guide from the USDOL-funded Employer Assistance and Resource Network on Disability Inclusion (EARN) and Job Accommodation Network (JAN) addresses the basics of Long COVID, including its intersection with mental health, and common workplace supports for different symptoms.  It also explores employers’ responsibilities to provide reasonable accommodations and answers frequently asked questions about Long COVID and employment, including inquiries related to telework and leave.

Download the guide

Accommodation and Compliance: Long COVID

The Long COVID Accommodation and Compliance webpage from the USDOL-funded Job Accommodation Network (JAN) helps employers and employees understand strategies for supporting workers with Long COVID.  Topics include Long COVID in the context of disability under the Americans with Disabilities Act (ADA), specific accommodation ideas based on limitations or work-related functions, common situations and solutions, and questions to consider when identifying effective accommodations for employees with Long COVID.  Find this and other Long COVID resources from JAN, below:

Long COVID, Disability and Underserved Communities: Recommendations for Employers

The research-to-practice brief “Long COVID, Disability and Underserved Communities” synthesizes an extensive review of documents, literature and data sources, conducted by the USDOL-funded Employer Assistance and Resource Network on Disability Inclusion (EARN) on the impact of Long COVID on employment, with a focus on demographic differences.  It also outlines recommended actions organizations can take to create a supportive and inclusive workplace culture for people with Long COVID, especially those with disabilities who belong to other historically underserved groups.

Read the brief

Long COVID and Disability Accommodations in the Workplace

The policy brief “Long COVID and Disability Accommodations in the Workplace” explores Long COVID’s impact on the workforce and provides examples of policy actions different states are taking to help affected people remain at work or return when ready.  It was developed by the National Conference of State Legislatures (NCSL) as part of its involvement in USDOL’s State Exchange on Employment and Disability (SEED) initiative.

Download the policy brief

Understanding and Addressing the Workplace Challenges Related to Long COVID

The report “Understanding and Addressing the Workplace Challenges Related to Long COVID” summarizes key themes and takeaways from an ePolicyWorks national online dialogue through which members of the public were invited to share their experiences and insights regarding workplace challenges posed by Long COVID.  The dialogue took place during summer 2022 and was hosted by USDOL and its agencies in collaboration with the Centers for Disease Control and Prevention and the U.S. Surgeon General.

Download the report

Working with Long COVID

The USDOL-published “Working with Long COVID” fact sheet shares strategies for supporting workers with Long COVID, including accommodations for common symptoms and resources for further guidance and assistance with specific situations.

Download the fact sheet

COVID-19: Long-Term Symptoms

This USDOL motion graphic informs workers with Long COVID that they may be entitled to temporary or long-term supports to help them stay on the job or return to work when ready, and shares where they can find related assistance.

Watch the motion graphic

A Personal Story of Long COVID and Disability Disclosure

In the podcast “A Personal Story of Long COVID and Disability Disclosure,” Pam Bingham, senior program manager for Intuit’s Diversity, Equity and Inclusion in Tech team, shares her personal experience of navigating Long COVID symptoms at work.  The segment was produced by the USDOL-funded Partnership on Employment and Accessible Technology (PEAT) as part of its ongoing “Future of Work” podcast series.

Listen to the podcast

HHS OIG Issues Annual Report on State MFCUs

Per the notice below, the Office of the Inspector General (OIG) of the United States Department of Health and Human Services (HHS) has issued its annual report on the performance of state Medicaid Fraud Control Units (MFCUs).

Medicaid Fraud Control Units Fiscal Year 2023 Annual Report (OEI-09-24-00200) 

Medicaid Fraud Control Units (MFCUs) investigate and prosecute Medicaid provider fraud and patient abuse or neglect. OIG is the Federal agency that oversees and annually approves federal funding for MFCUs through a recertification process. This new report analyzed the statistical data on annual case outcomes—such as convictions, civil settlements and judgments, and recoveries—that the 53 MFCUs submitted for Fiscal Year 2023.  New York data is as follows:

Outcomes

  • Investigations1 - 556
  • Indicted/Charged - 9
  • Convictions - 8
  • Civil Settlements/Judgments - 28
  • Recoveries2 - $73,204,518

Resources

  • MFCU Expenditures3 - $55,964,293
  • Staff on Board4 - 257

1Investigations are defined as the total number of open investigations at the end of the fiscal year.

2Recoveries are defined as the amount of money that defendants are required to pay as a result of a settlement, judgment, or prefiling settlement in criminal and civil cases and may not reflect actual collections.  Recoveries may involve cases that include participation by other Federal and State agencies.

3MFCU and Medicaid Expenditures include both State and Federal expenditures.

4Staff on Board is defined as the total number of staff employed by the Unit at the end of the fiscal year.

Read the Full Report

View the Statistical Chart

Engage with the Interactive Map

GAO Issues Report on Medicaid Managed Care Service Denials and Appeal Outcomes

The United States Government Accountability Office (GAO) has issued a report on federal use of state data on Medicaid managed care service denials and appeal outcomes.  GAO found that federal oversight is limited because it doesn't require states to report on Medicaid managed care service denials or appeal outcomes and there has not been much progress on plans to analyze and make the data publicly available.  To read the GAO report on federal use of state data on Medicaid managed care service denials and appeal outcomes, use the first link below.  To read GAO highlights of the report on federal use of state data on Medicaid managed care service denials and appeal outcomes, use the second link below.
https://www.gao.gov/assets/d24106627.pdf  (GAO report on federal use of state data on Medicaid managed care service denials and appeal outcomes)
https://www.gao.gov/assets/d24106627_high.pdf  (GAO highlights on federal use of state data on Medicaid managed care service denials and appeal outcomes)

CMS Issues Latest Medicare Regulatory Activities Update

The Centers for Medicare and Medicaid Services (CMS) has issued its latest update on its regulatory activities in the Medicare program.  While dentistry is only minimally connected to the Medicare program, Medicare drives the majority of health care policies and insurance reimbursement policies throughout the country.  Therefore, it always pays to keep a close eye on what CMS is doing in Medicare.  To read the latest CMS update on its regulatory activities in Medicare, use the link below.
https://www.cms.gov/training-education/medicare-learning-network/newsletter/2024-03-14-mlnc