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      house Committees
      House Committee on Energy and Commerce
      Health
      House Committee on Ways and Means
    IntroducedOctober 30th, 2013

Bill Details

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Title

Medicare Part D Patient Safety and Drug Abuse Prevention Act of 2013

Official Title

To amend title XVIII of the Social Security Act to provide for a PDP safety program to prevent fraud and abuse in the dispensing of controlled substances under part D of the Medicare program, and for other purposes.

Summary

Medicare Part D Patient Safety and Drug Abuse Prevention Act of 2013 - Amends part D (Voluntary Prescription Drug Benefit Program) of title XVIII (Medicare) of the Social Security Act (SSA) to establish a safe pharmacy access program under which a prescription drug plan (PDP) sponsor (or a Medicare Advantage (MA) organization offering an MA-PD plan) shall have in place procedures designed to prevent fraud and abuse in the dispensing of certain controlled substances under Medicare part D. Allows a PDP sponsor to suspend payments and clean claim notifications to a pharmacy pending an investigation of a credible allegation of fraud against the pharmacy, unless the Secretary determines there is a good cause not to suspend payments. Directs the Secretary of Health and Human Services (HHS), under contracts entered into under the Medicare integrity program with Medicare drug integrity contractors (MEDICs), to authorize such MEDICs to obtain prescription and medical records directly from entities such as pharmacies, PDPs, and physicians. Requires a MEDIC to acknowledge receipt of a PDP sponsor referral of information for investigation, report back to the sponsor the investigation results within 45 days, and share them with appropriate agencies. Requires electronic transmission (e-prescribing) of prescriptions for certain covered Medicare part D controlled substances.

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