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News | Dec. 7, 2023

Press Release: Audit of Defense Health Agency Controls to Monitor Opioid Prescription Compliance with Federal and DoD Opioid Safety Standards (DODIG-2024-036)

Inspector General Robert P. Storch announced today that the Department of Defense Office of Inspector General released the “Audit of Defense Health Agency Controls to Monitor Opioid Prescription Compliance with Federal and DoD Opioid Safety Standards.” The audit examined whether the Defense Health Agency had controls to monitor opioid prescriptions and ensure compliance with Federal and DoD opioid safety recommendations and requirements.

The audit found that although the DHA implemented policies and programs to monitor opioid prescriptions, providers failed to adhere to Federal and DoD opioid safety recommendations and requirements, and beneficiaries were not adequately monitored through established DHA programs. The audit also determined that DHA lacked effective controls to consistently implement Federal opioid safety recommendations and DHA opioid safety policies and programs to monitor at-risk beneficiaries.

“Opioid addiction impacts people from all walks of life, including military service members and their families being treated by the DHA,” said IG Storch. “It is paramount that providers prescribe opioids within safety guidelines and that the DHA monitor provider-compliance with those guidelines to ensure patients are receiving the appropriate medications for their conditions.” 

The DoD OIG did not receive adequate medical documentation to support whether the DHA and providers followed or met Federal and DoD opioid safety recommendations and requirements for more than half of the beneficiaries in our sample.  The DHA did not have an effective process for requesting and obtaining beneficiary medical documentation for at-risk beneficiaries. As a result, the DHA does not have insight into whether tens of thousands of potentially at-risk beneficiaries need additional medical assistance, leaving those individuals at increased risk of being overprescribed opioids. This situation heightens the risk of unintentional or intentional drug diversion on prescriptions, leading to opioid misuse, addiction, overdose incidents, or even death. Overprescribing remains a significant health and safety concern for beneficiaries, and poses a potential readiness issue for the DoD.

The DoD OIG made eight recommendations including that the DHA Director develop and implement procedures to review compliance with its opioid safety policies and programs. The DoD OIG further recommended that the DHA coordinate with the TRICARE Pharmacy contractor to ensure the adequacy of algorithms used to identify at-risk beneficiaries. The report describes actions that the DHA is taking steps to act on the DoD OIG’s recommendations, and DoD OIG will continue to monitor DHA’s progress toward full implementation of all recommendations in this report.