Brady Anti-fraud Bill Addresses Drug Prescribing Issues for Hospices; Audit and Education Reform and DME F2F Modifications
In recent weeks, the House Ways and Means Health Subcommittee Chairman Kevin Brady (R-TX) and Ranking Member Jim McDermott (D-WA) introduced the Protecting the Integrity of Medicare Act (PIMA) (H.R. 5780). The bill includes a provision that would impose a home health surety bond of not less than $50,000 that is “commensurate with the volume of payments to the home health agency.”
The bill also contains several provisions that would affect hospices and how they may administer certain controlled substances. While it appears that the legislation will not see action prior to the end of this legislative session, it may be a starting point for discussions early next year. Below is a synopsis of those issues:
Part D Enrollees at Risk for Abuse of Opioids, Other Pain Meds would have Limits on Prescribers, Pharmacies for these Drugs, with Exemption for Hospice Enrollees
As part of H.R. 5780, Rep. Brady and his colleagues seek to address concerns about potential “drug seeking” as part of the Medicare program through establishment of a drug management program for at-risk beneficiaries starting January 1, 2017. Under the program, Part D enrollees determined to be at-risk for prescription drug abuse could be limited to one or more physicians and one or more pharmacies for certain opioids and similar drugs. Once a beneficiary has been determined to be not at risk, he or she will be removed from the drug management program.
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