Pallone to Introduce Bill to Prevent Medicare Prescription Drug Abuse and Fraud

Washington, DC – Today, Congressman Frank Pallone, Jr. (NJ-06), Ranking Member of the House Energy and Commerce Subcommittee on Health announced that he is set to introduce legislation to address new reports of inappropriate payments for prescriptions of controlled substances in Medicare’s Part D program.

“Prescription drug abuse is an epidemic,” said Pallone. “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.”

Under Medicare Part D, the Centers for Medicare and Medicaid Services (CMS) contracts with private insurance companies, known as plan sponsors, to provide prescription drug coverage to beneficiaries who choose to enroll. Pallone’s bill would require plan sponsors to verify that a prescription for a drug on the Controlled Substances list was made by an authorized physician before paying for the drug. Under the current law, such a requirement does not exist.

The bill would also require plan sponsors to have drug utilization programs in place that would restrict access if there was credible evidence of beneficiaries abusing or diverting drugs. Most state Medicaid programs have utilization programs, but similar guidelines are not in place for most Part D beneficiaries. In addition, the bill will provide the Secretary of Health and Human Services (HHS) new tools to prevent the payment of claims by fraudulent prescribers or pharmacies.

Pallone wrote his bill on the heels of a HHS Office of Inspector General’s report released last month, which found that Medicare is paying for prescription drugs prescribed by unauthorized individuals including massage therapists, athletic trainers, social workers and interpreters. Given that tens of thousands of these drugs were controlled substances, the study’s findings raise questions about patient safety because of the potential for prescription drug abuse.

Prescription drug abuse has emerged as a serious and growing problem. According to the Centers for Disease Control and Prevention, more than 20,000 deaths occur each year due to the misuse and abuse of prescription drugs and one in 20 Americans say they have used prescription painkillers for non-medical reasons in the last year.

Congressman Frank Pallone's Statement on Supreme Court Ruling to Uphold the Affordable Care Act

FOR IMMEDIATE RELEASE:

Thursday, June 28, 2012

WASHINGTON, D.C.—Congressman Frank Pallone, Jr. (NJ-06), Senior Democrat on the U.S. House Energy and Commerce Committee’s Health Subcommittee and a primary author of Affordable Care Act released the following statement upon the U.S. Supreme Court ruling to uphold the landmark law:

“Today is a great day for the American people.  The Supreme Court’s decision to uphold the Affordable Care Act (ACA) reaffirms our nation’s commitment to make sure that all Americans have access to quality affordable health care and health insurance. 

“For the millions of Americans who have gone without health insurance, the seniors who have struggled due to inadequate coverage, the women, children and young adults that have been denied coverage for preexisting conditions, the Court’s ruling is not only a victory, but a validation that they deserve to have the most basic of human needs met—access to health care.

“The ACA addressed so many of the gaps in the American health care system from closing the Medicare Part D ‘donut hole,’ to stopping the practice of denying those with preexisting conditions insurance coverage, to claiming womanhood as a preexisting health condition, to allowing young adults to stay on their parents’ coverage.  This law has changed the way our country manages and delivers all phases of our health care system and I am proud to have been a part of its creation and prouder still today to learn of the Court’s decision to uphold its constitutionality.” 

Congressma​n Pallone to Discuss Affordable Care Act with Seniors at Greenbriar Senior Community

FOR IMMEDIATE RELEASE

Marlboro, NJ—Congressman Frank Pallone, Jr. (NJ-06), Senior Democrat on the House Energy and Commerce Health Subcommittee and one of the principal authors of the Patient Protection and Affordable Care Act, will visit Greenbriar Senior Community in Marlboro, NJ on Thursday, March 15 at 10:00 a.m. to mark the upcoming second anniversary of the health reform law and highlight the benefits and savings the law provides seniors.


 The U.S. Supreme Court will begin three days of Affordable Care Act oral arguments on March 26. Pallone will discus how New Jersey’s seniors have benefited form the Affordable Care Act and what is at stake if the law is struck down by the Supreme Court. Thanks to the law, seniors now receive a 50% discount on prescription drugs when they fall into the Medicare Part D ‘donut hole’ coverage gap. In New Jersey, seniors on Medicare saved more than $95 million on prescription drugs in 2011. And, almost a million New Jersey seniors have taken advantage of the free preventative health services now covered under Medicare, such as colonoscopies and mammograms.


Congressman Pallone will also discuss other issues of concern to seniors such as Social Security and the economy.