“The IHS hospitals we reviewed did not always follow the Indian Health Manual when prescribing and dispensing opioids. Specifically, through our patient record review, we found that hospitals did not always review the course of patient treatment and causes of pain within required timeframes, perform the
required urine drug screenings within recommended time intervals, review patient health records before filling a prescription from a non-IHS provider, and maintain pain management documents to support that provider responsibilities had been performed. We also found that these IHS hospitals did not fully use the States’ prescription drug monitoring programs when prescribing or dispensing opioids.”