AMCP Praises House Ways & Means Committee Passage of Measure to Prevent Medicare Part D Drug Abuse


Alexandria, Va., Feb. 27, 2015 — The Academy of Managed Care Pharmacy (AMCP) applauds the House Ways & Means Committee for approving legislation that contains measures to prevent prescription drug abuse under the Medicare Part D program, a step long advocated by AMCP.

Section 12 of the “Protecting the Integrity of Medicare Act” (H.R. 1021), which passed the full committee yesterday, would create a drug management program for a small number of Medicare beneficiaries determined to be at risk of prescription drug misuse or abuse. Starting Jan. 1, 2017, such individuals could be limited to one or more physicians and one or more pharmacies for certain opioids and other schedule II drugs, under the provision.

AMCP has been a leading advocate for legislation that would allow Medicare Part D plans to institute such programs, which have proven successful in the private market and Medicaid. These programs to prevent inappropriate prescriptions from being filled and dispense may be used in conjunction with medication therapy and case management for at-risk Medicare beneficiaries.

“While we will continue to advocate for improvements to this provision, such as widening its scope to include addictive drugs in other scheduled categories, we believe this provision is an important step toward helping to curb the growing problem of opioid abuse,” said AMCP CEO Edith A. Rosato, RPh, IOM.

“Managed care organizations have well-established techniques for preventing the abuse or diversion of opiates or other controlled substances for beneficiaries who have a history or suspicion of inappropriate utilization, diversion or abuse of these agents,” Rosato added. “Plans also include specially trained pharmacists, nurses, and case managers who provide clinical interventions to help beneficiaries better utilize opioids.”

Under Section 12, beneficiaries would still be able to access noncontrolled medications from the prescribers and pharmacies of their choice. Beneficiaries would be removed from the drug management program if it is concluded that they are no longer at risk, according to the provision.

The bipartisan H.R. 1021, which combats Medicare fraud, now goes before the full House. AMCP will continue to support passage of the bill and companion legislation in the Senate.