Rule debate highlights shortcomings in Idaho’s prescription tracking program

By Melissa Davlin, Idaho Reports

A new rule designed to prevent Medicaid participants from abusing opioid prescriptions sparked debate in House Health and Welfare on Friday, and in the process highlighted issues with the state’s prescription tracking system.

The rule, presented by Medicaid program manager Tiffany Kinzler, would prevent Medicaid recipients from paying cash for controlled substance prescriptions.

The idea behind the rule: Medicaid participants who have obtained prescriptions through legitimate means wouldn’t normally be paying for their prescriptions in the first place, explained Tami Eide of the Idaho Medicaid Pharmacy Program.

Rep. Sue Chew, D-Boise and the only pharmacist on the committee, said it raises red flags when someone with a Medicaid card ends up paying for a pain killer prescription.

Rep. John Vander Woude, R-Nampa, expressed concern that the state’s prescription tracking program wasn’t catching abuse. That system, Eide replied, is imperfect.

Most pharmacies don’t have access to look at that,” she told the committee. Chew agreed.

“Our system to try to mitigate (abuse) electronically, it’s getting there, but it doesn’t work that great,” Chew said.

Matt Wimmer, Administrator for the Division of Medicaid, told the committee that the prescription tracking system helps when physicians use it — but not everyone does.

We don’t have a legal requirement that you must (update it) all the time,” Wimmer said.

Ultimately, the committee voted to adopt the rule, with Vander Woude joining Reps. Bryan Zollinger, John Green, Chad Christensen and Marc Gibbs in voting no.

After the meeting. Chew explained that the current rule mandates that pharmacists and physicians register with the prescription tracking system, but nothing forces them to actually participate and update the tracker.

That’s why we’ve got a dilemma,” Chew said. “If we had a magic wand, we’d mandate that all pharmacists look on those things before they dispense.” The problem? “In this state, no one likes mandates.”

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