WASHINGTON, D.C. – A bipartisan bill offered by U.S. Sens. Sherrod Brown (D-OH) and Pat Toomey (R-PA) to prevent wrongful access to opioids and improve patient care for Medicare beneficiaries at-risk for opioid addiction was highlighted during a Senate Finance Committee Hearing on the opioid addiction crisis. The Stopping Medication Abuse and Protecting Seniors Act would implement an effective drug abuse prevention plan already operating in Medicaid and commercial plans in Medicare. The plan identifies beneficiaries with histories of drug abuse in Medicare Part D and Medicare Advantage and locks them into one prescriber and one pharmacy to help manage potential addiction. U.S. Sens. Rob Portman (R-OH) and Tim Kaine (D-VA) are also cosponsors.
“In order to connect Americans struggling with addiction the help they need, we must do a better job of finding them,” said Brown. “And in order to do that, we need to make sure that health care providers have the tools they need to manage patients who are being seriously harmed and may even die from addiction. Our bill would prevent seniors from seeking out prescription drugs from multiple doctors and pharmacies to help them break their addiction while also eliminating fraudulent, unnecessary Medicare prescription payments. By identifying those seniors who may be struggling with addiction – and encouraging insurers, prescription drug plan sponsors, and physicians to do more to connect beneficiaries battling addiction with treatment options – we can do more to coordinate care, help people recover, and improve overall health.”
“This past October, I hosted a field hearing in Western Pennsylvania about the heroin and opioid abuse epidemic,” said Toomey. “I wanted to hear directly from those fighting this terrible problem on the ground and get feedback on our bipartisan bill which will help end the illegal and fraudulent diversion of pain pills, save taxpayers money, and limit the overprescribing of opioids. Since this hearing, the acting administrator of the federal agency responsible for overseeing Medicare has come out in support of our legislation, saying it ‘makes every bit of sense in the world.’ All of us – policy makers, medical professionals, law enforcement officers, family, and friends – must do more to stop opioid abuse and the heroin epidemic raging across the country. We cannot afford to wait. I look forward to working with Senator Brown and my colleagues on both sides of the aisle to treat addiction and save lives.”
In addition to creating a “lock-in” mechanism to curb wrongful access to opioids, the bill would also encourage insurers, Part D plan sponsors, and physicians to assist beneficiaries battling addiction in seeking substance abuse treatment. The bipartisan legislation will save taxpayers between $79 and $115 million over 10 years by eliminating fraudulent and medically unnecessary prescription payments from Medicare.
The Government Accountability Office (GAO) estimates 170,000 Medicare beneficiaries may be battling addiction to pain medication. As the rate of pain medication abuse and overdose continues to rise, this legislation would combat opioid abuse, while also improving the continuity of care, and ensuring patients with true medical needs maintain access to effective pain control. Both the HHS Office of the Inspector General and the Medicare Payment Advisory Commission have suggested Medicare adopt the kind of drug abuse prevention tool authorized by the legislation.
During the hearing, Allan Coukell, the Senior Director of Health Programs for the Pew Charitable Trusts, weighed in on the importance of this legislation.
“This legislation achieves an appropriate balance in allowing identification of doctor shopping and at-risk patients, and providing access to effective pain management,” said Coukell in his testimony. “We thank Senators Toomey, Brown, Portman and Kaine for introducing this legislation, as well as the many cosponsors of the legislation who sit on this Committee. We urge the Senate to help address the nation’s prescription drug abuse epidemic by passing the Stopping Medication Abuse and Protecting Seniors Act of 2015, which would expand use of patient review and restriction (PRR) to ensure that these programs can be used to prevent prescription drug abuse in Medicare.”
The Stopping Medication Abuse and Protecting Seniors Act would:
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