With half of nursing homes audited in a new process admitting to misdiagnosing schizophrenia patients, the Centers for Medicare & Medicaid Services is extending its drive to reduce the use of certain drugs intended to treat schizophrenia, psychosis and other behavioral health conditions.
Last January, CMS announced it would review diagnoses among the nursing home population because it had observed a rise in rates of schizophrenia, which is most commonly diagnosed when a person is in their 20s. Regulators said they suspected that some diagnoses were unfounded and potentially being given to mask dependence on medications to treat symptoms of other diseases or disorders.
While CMS did not release information about how it chose its audit targets, two clinical and compliance experts with Zimmet Health Services Group said even a single diagnosis could qualify a provider for additional review. Still, the audits appeared to focus on a group of facilities that diagnosed patients most often.