US Congress House Bill 4876 (Prior Session Legislation)

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Spectrum: Slight Partisan Bill (Republican 3-1)
Status: Introduced on March 23 2016 - 25% progression, died in committee
Action: 2016-03-29 - Referred to the Subcommittee on Health.
Pending: House Subcommittee on Health Committee
Text: Latest bill text (Introduced) [PDF]

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.

Medicare Prescription Drug Abuse Prevention Act of 2016

Rep. Patrick Meehan [R-PA]

Rep. Richard Neal [D-MA]

Rep. Tom Reed [R-NY]

Rep. Patrick Tiberi [R-OH]

Date	Chamber	Action
2016-03-29	House	Referred to the Subcommittee on Health.
2016-03-25	House	Referred to the Subcommittee on Health.
2016-03-23	House	Referred to House Ways and Means
2016-03-23	House	Referred to House Energy and Commerce
2016-03-23	House	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.
2016-03-23	House	Introduced in House

SB524 (Related) 2016-07-22 - Became Public Law No: 114-198. (TXT | PDF)
SB1913 (Related) 2015-07-30 - Read twice and referred to the Committee on Finance.

Type	Source
Summary	https://www.congress.gov/bill/114th-congress/house-bill/4876/all-info
Text	https://www.congress.gov/114/bills/hr4876/BILLS-114hr4876ih.pdf