Medicare
US Congress 115th Congress
Opioid Screening and Chronic Pain Management Alternatives for Seniors Act [HB-5798]
Opioid Screening and Chronic Pain Management Alternatives for Seniors Act This bill requires the initial examination for new Medicare enrollees to include a review of current opioid prescriptions and an opioid use disorder screening.
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Opioid Workforce Act of 2018 [S.2843]
Opioid Workforce Act of 2018 This bill increases the number of residency positions eligible for graduate medical education payments under Medicare for hospitals that have addiction or pain management programs, with an aggregate increase of 1,000 positions over a five-year period.
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Post-Surgical Injections as an Opioid Alternative Act [HB-5804]
Post-Surgical Injections as an Opioid Alternative Act This bill temporarily freezes Medicare payment at 2016 levels for specified spinal surgery outpatient procedures that are conducted in ambulatory surgical centers.
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Opioid Workforce Act of 2018 [HB-5818]
Opioid Workforce Act of 2018 This bill increases the number of residency positions eligible for graduate medical education payments under Medicare for hospitals that have addiction or pain management programs, with an aggregate increase of 1,000 positions over a five-year period.
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Promoting Quality of Care in Pain Management Act of 2018 [HB-5779]
Promoting Quality of Care in Pain Management Act of 2018 This bill requires the Centers for Medicare & Medicaid Services to convene a technical expert panel to recommend opioid and opioid-use disorder quality measures for possible use in hospital payment and reporting models under Medicare.
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PROPER Act of 2018 Providing Reliable Options for Patients and Educational Resources Act of 2018 [HB-5775]
PROPER Act of 2018 Providing Reliable Options for Patients and Educational Resources Act of 2018 (Sec. 2) This bill requires Medicare and Medicare Advantage (MA) prescription drug plan (PDP) sponsors to annually disclose information to enrollees about: (1) the risks of prolonged opioid use; and (2) the plan's coverage of nonpharmacological therapies, devices, and non-opioid medications. PDP sponsors may limit disclosure to a subset of enrollees (such as those who were prescribed an opioid in the previous two-year period). (Sec. 3) The bill also
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COACH Act of 2018 Combating Opioid Abuse for Care in Hospitals Act of 2018 [HB-5774]
COACH Act of 2018 Combating Opioid Abuse for Care in Hospitals Act of 2018 (Sec. 2) This bill requires the Centers for Medicare & Medicaid Services (CMS) to publish guidance for hospitals on pain management and opioid-use disorder prevention strategies for Medicare beneficiaries. (Sec. 3) The CMS must also convene a technical expert panel to recommend opioid and opioid-use disorder quality measures for possible use in hospital payment and reporting models under Medicare. (Sec. 4) The Department of Health and Human Services must: (1) convene a technical
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PASS Act of 2018 Preventing Addiction for Susceptible Seniors Act of 2018 [HB-5773]
PASS Act of 2018 Preventing Addiction for Susceptible Seniors Act of 2018 (Sec. 2) This bill alters several requirements under the Medicare prescription drug benefit. Specifically, the bill requires electronic prescription programs to enable the secure transmittal of prior authorization requests for covered drugs. (Sec. 3) The bill also requires the Centers for Medicare & Medicaid Services (CMS) to establish a secure online portal to allow: (1) data sharing among the CMS, Medicare prescription drug benefit plans, and Medicare Advantage (MA) plans;
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Promoting Outpatient Access to Non-Opioid Treatments Act [HB-5778]
Promoting Outpatient Access to Non-Opioid Treatments Act This bill requires the Centers for Medicare & Medicaid Services (CMS) to review payments under Medicare for opioid and non-opioid pain management procedures, specifically with respect to ambulatory outpatient surgical procedures and hospital outpatient department services. The CMS must ensure that there are no payment incentives for using opioids instead of non-opioid alternatives and must make revisions accordingly.
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MOST Act Medicare and Opioid Safe Treatment Act [HB-5776]
MOST Act Medicare and Opioid Safe Treatment Act This bill establishes several requirements for the Centers for Medicare & Medicaid Services (CMS), and alters requirements under Medicare and Medicare Advantage, related to pain management and opioid use. For example, the bill requires certified opioid treatment program services to be covered under Medicare. Additionally, among other requirements, the CMS must review payments under Medicare for opioid and non-opioid pain management procedures, specifically with respect to ambulatory outpatient surgical
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Expanding Access to Treatment Act [HB-5769]
Expanding Access to Treatment Act This bill requires payment under Medicare to federally qualified health centers and rural health clinics that have health care practitioners who are newly certified to provide medication-assisted treatment. Specifically, a federally qualified health center or rural health clinic may receive payment for each health care practitioner who becomes certified on or after January 1, 2019, to prescribe or dispense methadone, buprenorphine, or suboxone (medications used to treat opioid-use disorders). The Centers for Medicare
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ROOT Act of 2018 Reduce Overprescribing Opioids in Treatment Act of 2018 [HB-5719]
ROOT Act of 2018 Reduce Overprescribing Opioids in Treatment Act of 2018 This bill prohibits inclusion of pain management questions in a specified health care system survey used by the Centers for Medicare & Medicaid Services, unless the questions address the risks of opioid use and the availability of non-opioid alternatives.
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Strengthening Partnerships to Prevent Opioid Abuse Act [HB-5715]
Strengthening Partnerships to Prevent Opioid Abuse Act This bill requires the Centers for Medicare & Medicaid Services (CMS) to establish a secure online portal to allow: (1) data sharing among the CMS, Medicare prescription drug benefit plans, and Medicare Advantage (MA) plans; and (2) referrals by such plans of substantiated fraud, waste, or abuse in order to initiate or assist investigations by contracted entities under the Medicare Integrity Program. The CMS must disseminate and report certain collected information to such plans, including information
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PRO Act Perioperative Reduction of Opioids Act [HB-5718]
PRO Act Perioperative Reduction of Opioids Act This bill requires the Department of Health and Human Services (HHS) to convene a technical expert panel to recommend ways to reduce opioid use in surgical settings and best practices for pain management, specifically during the perioperative (pre-operative through post-operative) period. HHS must also report on diagnosis-related group codes that have the highest volume of surgeries and the availability of associated data regarding post-operative opioid use, including prescription patterns and rates
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Dr. Todd Graham Pain Management Improvement Act of 2018 [HB-5722]
Dr. Todd Graham Pain Management Improvement Act of 2018 This bill requires the Centers for Medicare & Medicaid Services to publish a report on whether Medicare payments, coverage, and coding policies for non-opioid pain management treatments should be revised. The report must include an analysis of pain management and prescribing guidelines, access to non-opioid treatments, and the effect of any recommended changes on Medicare and enrollee opioid addiction.
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Expanding Oversight of Opioid Prescribing and Payment Act of 2018 [HB-5723]
Expanding Oversight of Opioid Prescribing and Payment Act of 2018 (Sec. 2) This bill requires the Medicare Payment Advisory Commission to report to Congress on: (1) how Medicare pays for opioid and non-opioid pain management treatments in inpatient and outpatient hospital settings; (2) current incentives for prescribing opioid and non-opioid treatments under Medicare inpatient and outpatient prospective payment systems, along with recommendations to address any identified adverse incentives; and (3) how opioid use is currently tracked and monitored
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COMPASS Act Commit to Opioid Medical Prescriber Accountability and Safety for Seniors Act [HB-5716]
COMPASS Act Commit to Opioid Medical Prescriber Accountability and Safety for Seniors Act This bill requires the Centers for Medicare & Medicaid Services (CMS) to identify outlier prescribers of opioids under the Medicare prescription drug benefit and Medicare Advantage prescription drug plans. Specifically, the CMS must: (1) establish an opioid-prescription threshold for determining whether a prescriber is an outlier compared to other prescribers, based on specialty and geographic area; (2) use National Provider Identifiers (unique provider identification
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EDU Act of 2018 Education for Disposal of Unused Opioids Act of 2018 [HB-5714]
EDU Act of 2018 Education for Disposal of Unused Opioids Act of 2018 This bill requires Medicare medication therapy management programs and Medicare Advantage in-home health risk assessments to include information about the safe disposal of prescription drugs.
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Caring for our Veterans Act of 2017 [S.2193]
Caring for our Veterans Act of 2017 This bill establishes a Veterans Community Care Program to furnish hospital care, medical services, and extended care services to covered veterans through non-Department of Veterans Affairs (VA) health care providers under specified circumstances. This program replaces the Veterans Choice Program. The VA shall develop: (1) an education program for veterans about their VA health care options, (2) processes to ensure safe opioid prescribing practices by non-VA health care providers; and (3) criteria to designate
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HOST Act of 2018 Hospital Opioid Solutions Toolkit Act of 2018 [HB-5699]
HOST Act of 2018 Hospital Opioid Solutions Toolkit Act of 2018 This bill requires the Centers for Medicare & Medicaid Services to publish guidance for hospitals on pain management and opioid-use disorder prevention strategies for Medicare beneficiaries, including best practices for opioid-use disorder screening, education, and monitoring.