NB20-16: The Role of Fraud and Abuse Perpetrators in DI and SSI Application and Enrollment Rates

News media accounts point to “pill mill” doctors who fueled the opioid crisis by helping their clients obtain Medicaid coverage to finance opioids for patient use and distribution, using the Supplemental Security Income (SSI) program as a gateway to Medicaid (Quinones, 2015, McGreal 2018, Meier 2018). Since SSI receipt provides immediate access to Medicaid benefits, which pays for prescription opioids, pill mill doctors may provide false medical evidence in support of applications to increase sales. Despite anecdotal evidence, it is unknown whether the growing number of providers involved in opioid-linked fraud and abuse are also contributing medical evidence in support of disability applications (Dyer 2018, Office of the Inspector General 2016, Rothberg and Stith 2018).
In this study, we will use new Social Security Administration data on treating providers listed on Disability Insurance (DI) and SSI applications to quantify the extent to which healthcare providers engaged in Medicare and Medicaid fraud and abuse directly contribute to new applications and benefit receipt. We will consider the contribution of all fraud and abuse perpetrators as well as those specifically involved in inappropriate prescription drug distribution to better understand the role of opioid prescribing in possible growth in the DI and SSI roles. We will ultimately produce a research manuscript reporting the results of this study.