Medicare Prescription Drug Abuse Prevention Act of 2016

Summary

Medicare Prescription Drug Abuse Prevention Act of 2016 This bill amends title XVIII (Medicare) of the Social Security Act to: (1) authorize a Medicare prescription drug plan (PDP) sponsor to establish a drug management program under which the PDP sponsor may limit an at-risk beneficiary's access to coverage for frequently abused drugs to include only those drugs that are prescribed by selected prescribers and dispensed by selected pharmacies; and (2) require a PDP sponsor to have in place a utilization management tool to prevent drug abuse. With respect to a drug management program, a PDP sponsor must: (1) provide specified notice to a beneficiary who has been identified by the Centers for Medicare & Medicaid (CMS) as "at-risk" and consequently enrolled in the program; and (2) in selecting prescribers and dispensers, ensure that the beneficiary continues to have reasonable access to drugs. These determinations shall be subject to expedited reconsideration and appeal. A PDP sponsor must review and consider an at-risk beneficiary's preferences regarding prescriber and pharmacy selection. Certain individuals, including those receiving hospice care or residing in a long-term care facility, are exempted from enrollment in a drug management program. CMS must, for purposes of quality or performance assessments, review and consider complaints received from at-risk beneficiaries regarding lack of access due to their enrollment in a drug management program. In addition, CMS must establish rules and procedures requiring a PDP sponsor to provide specified program data.

This text is taken from the official record. PoliticalRepo does not editorialize.

Timeline

1. 23 March 2016

   Introduced

   Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.

   Source: IntroReferral

2. 23 March 2016

   Introduced

   Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.

   Source: IntroReferral

3. 23 March 2016

   Introduced

   Introduced in House

   Source: IntroReferral

4. 23 March 2016

   Introduced

   Introduced in House

   Source: IntroReferral

5. 25 March 2016

   Referred

   Referred to the Subcommittee on Health.

   Source: Committee

6. 29 March 2016

   Referred

   Referred to the Subcommittee on Health.

   Source: Committee

Votes

No vote records are attached yet.

Versions

• Introduced in House · 23 March 2016 · Download file

Documents

3 official files

• Introduced in House (text)

  Introduced in House · EN · 23 March 2016

  ViewDownloadOpen at official source

• Introduced in House (PDF)

  Introduced in House · EN · 23 March 2016

  ViewDownloadOpen at official source

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• Introduced in House

  summary · EN · 23 March 2016

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  Leesvertaling

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  Vertaal document

  Documentvertaling op verzoek met downloadbare PDF (logo + link naar de officiële bron). Het bronbestand blijft leidend.

Sponsors

• Rep. Meehan, Patrick [R-PA-7] · R · Sponsor
• Rep. Neal, Richard E. [D-MA-1] · D · Sponsor
• Rep. Reed, Tom [R-NY-23] · R · Cosponsor
• Rep. Tiberi, Patrick J. [R-OH-12] · R · Cosponsor
• · hswm00 · Standing
• · hsif00 · Standing

Related records

• related to → Comprehensive Addiction and Recovery Act of 2016
• related to → Stopping Medication Abuse and Protecting Seniors Act of 2015