Next Steps

The OIG recommends that the following steps be taken by the Centers for Medicare and Medicaid Services to prevent inappropriately prescribed medications and noncompliance with Medicare rules:

• Facilitate access to information necessary to ensure accurate coverage and reimbursement determinations.

• Assess whether survey and certification processes for nursing home licensure offer adequate safeguards against unnecessary antipsychotic medication use in nursing homes.

• Explore alternative methods beyond survey and certification processes to promote compliance with federal standards regarding unnecessary drug use in nursing homes.

• Take appropriate action regarding the claims associated with erroneous payments identified in the OIG sample.