tci Medicare Compliance & Reimbursement - 2018 Issue 9
Benchmarking: Compare Your Opioid Prescription Stats Against Your Peers
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Article Overview
This article explains a Medicare Comparative Billing Report focused on opioid prescribing patterns for Part B providers and how to compare practice-level activity against national benchmarks. It is relevant to clinicians, emergency departments, compliance staff, and coding/billing professionals who monitor prescribing trends, peer comparisons, and payer audit focus areas. The discussion also touches on federal oversight efforts, the role of CMS and related contractors, and broader medication-monitoring topics that may be considered in future reports.
Why This Topic Matters
It helps readers understand what kind of prescribing data Medicare is examining, why peer benchmarking matters, and how reporting trends may signal areas for internal review or compliance attention. It also flags the kinds of opioid-related and medication-monitoring subjects that may appear in future payer analyses.
What You Will Learn
- How Medicare Comparative Billing Reports are used to benchmark opioid prescribing activity.
- What broad categories of opioid-related prescribing data were reviewed for the national comparison.
- Why peer comparisons can matter for practice monitoring and internal compliance review.
- Which federal agencies and contractor programs are involved in these reporting and analysis efforts.
- What general monitoring areas may be the focus of future review activity.
Who Should Read This
- Physicians and other Medicare providers
- Emergency department clinicians
- Billing and coding professionals
- Compliance and audit staff
- Practice managers
- Health system analysts
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