On August 2, 2017, ​ the U.S. Department of Justice announced the formation of an Opioid Fraud and Abuse Detection Unit, which will focus on opioid-related healthcare fraud. Attorney General Jeff Sessions said the unit will have a data analytics team that can identify providers who prescribe opioids at a higher rate than their peers, as well as the number of a doctor's patients who died within 60 days of a prescription. It will also target pharmacies that dispense a disproportionate amount of opioid prescriptions. “With these new resources, we will be better positioned to identify, prosecute, and convict some of the individuals contributing to these tens of thousands of deaths a year," Sessions said. “The Department is determined to attack this opioid epidemic, and I believe these resources will make a difference." Meanwhile, the President's Commission on Combatting Drug Addiction and the Opioid Crisis said it is time to declare the opioid crisis a national emergency, in a draft interim report. The commission was created by an executive order on March 29, 2017, with the goal of studying ways to combat and treat drug addiction. The commission called the declaration of a national emergency its "first and most urgent recommendation." This declaration would give the executive branch the power to take “bold steps and would force Congress to focus on funding and empowering the Executive Branch even further to deal with this loss of life." Recommendations proposed by the commission include rapidly increased access to treatment facilities; mandatory prescriber education; immediate establishment and funding of federal incentives to enhance access to medication-assisted treatment; development of model legislation that will allow for deployment of the overdose reversal agent naloxone; prioritized development of fentanyl-detection sensors; and enhanced data sharing among prescription drug monitoring programs.

HRC Recommends: Various federal and state agencies, armed with greater and more sophisticated technology and resources, are working with increased coordination to identify and prevent fraud and abuse in the provision of healthcare services. Focus on issues related to the ongoing opioid crisis has increased. Healthcare providers should be familiar with legal and regulatory requirements and implement effective, proactive compliance programs. For successful compliance, active participation across the entire organization is required, including involvement of medical and administrative staff, as well as collaboration and support from risk management and oversight by the governing board. By applying risk management approaches to compliance, risk managers can ensure that the organization promptly and thoroughly investigates reports of potential violations, takes steps to rectify noncompliance, and periodically evaluates its compliance program to ensure that it is up to date and effective.