Bill Aims to Tackle Prescription Drug Abuse in Medicare Participants

A New Jersey congressman announced this week he will introduce legislation aimed at reducing prescription drug abuse among Medicare participants. Frank Pallone, Jr., is proposing to increase the requirements for verifying the validity of prescriptions before Medicare pays for the drugs.

Pallone, the ranking member of the House Energy and Commerce Subcommittee on Health, is focusing on Medicare Part D, the prescription drug portion of the program, reports. He hopes the bill will help catch doctors who are writing inappropriate prescriptions, and stop patients from collecting too many prescriptions.

Medicare contracts with private insurance companies to provide prescription drug coverage to enrolled patients. Under the measure, Medicare would not pay for a prescription for a drug on the controlled substances list until these companies verify that it was written by an authorized doctor.

The companies also would be required to have drug utilization programs, which would restrict access if there was credible evidence that a patient was abusing or diverting drugs.

“Prescription drug abuse is an epidemic,” Pallone said in a statement. “Millions of Americans benefit from Medicare’s drug coverage program each year, which is why it’s imperative that checks are in place to prevent fraud and abuse as well as to protect patients. We cannot allow Medicare’s prescription drug program to be compromised at taxpayer expense. My bill, the Part D Prescription Drug Integrity Act of 2013, will strengthen the Medicare law to help address potential factors contributing to prescription drug abuse.”

Last month, the Department of Health and Human Services’ Inspector General issued a report that found Medicare paid for prescriptions for drugs, including controlled substances such as oxycodone, written by professionals including massage therapists, home health aides and veterinarians, who were not authorized to do so.