Commit to Opioid Medical Prescriber Accountability and Safety for Seniors Act or the COMPASS 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 numbers currently included on claims for covered drugs) to identify outlier prescribers; and (3) annually notify identified outlier prescribers of their status and provide them with resources on proper prescribing methods. The CMS may also identify and notify outlier prescribers based on co-prescriptions of covered drugs that have adverse effects when used in combination with opioids.
[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5716 Introduced in House (IH)]
<DOC>
115th CONGRESS
2d Session
H. R. 5716
To amend title XVIII of the Social Security Act to require the
Secretary of Health and Human Services to provide notifications under
the Medicare program to outlier prescribers of opioids.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
May 9, 2018
Mr. Roskam (for himself, Mr. Larson of Connecticut, Mrs. Brooks of
Indiana, and Mr. Welch) introduced the following bill; which was
referred to the Committee on Energy and Commerce, and in addition to
the Committee on Ways and Means, for a period to be subsequently
determined by the Speaker, in each case for consideration of such
provisions as fall within the jurisdiction of the committee concerned
_______________________________________________________________________
A BILL
To amend title XVIII of the Social Security Act to require the
Secretary of Health and Human Services to provide notifications under
the Medicare program to outlier prescribers of opioids.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Commit to Opioid Medical Prescriber
Accountability and Safety for Seniors Act'' or the ``COMPASS Act''.
SEC. 2. MEDICARE NOTIFICATIONS TO OUTLIER PRESCRIBERS OF OPIOIDS.
Section 1860D-4(c)(4) of the Social Security Act (42 U.S.C. 1395w-
104(c)(4)) is amended by adding at the end the following new paragraph:
``(D) Outlier prescriber notification.--
``(i) Notification.--Beginning not later
than two years after the date of the enactment
of this subparagraph, the Secretary shall, in
the case of a prescriber identified by the
Secretary under clause (ii) to be an outlier
prescriber of opioids, provide, subject to
clause (iv), an annual notification to such
prescriber that such prescriber has been so
identified and that includes resources on
proper prescribing methods and other
information specified in accordance with clause
(iii).
``(ii) Identification of outlier
prescribers of opioids.--
``(I) In general.--The Secretary
shall, subject to subclause (III),
using the valid prescriber National
Provider Identifiers included pursuant
to subparagraph (A) on claims for
covered part D drugs for part D
eligible individuals enrolled in
prescription drug plans under this part
or MA-PD plans under part C and based
on the threshold established under
subclause (II), conduct an analysis to
identify prescribers that are outlier
opioid prescribers for a period
specified by the Secretary.
``(II) Establishment of
threshold.--For purposes of subclause
(I) and subject to subclause (III), the
Secretary shall, after consultation
with stakeholders, establish a
threshold, based on prescriber
specialty and geographic area, for
identifying whether a prescriber in a
specialty and geographic area is an
outlier prescriber of opioids as
compared to other prescribers of
opioids within such specialty and area.
``(III) Exclusions.--The Secretary
may exclude the following individuals
and prescribers from the analysis under
this clause:
``(aa) Individuals
receiving hospice services.
``(bb) Individuals with a
cancer diagnosis.
``(cc) Prescribers who are
the subject of an investigation
by the Centers for Medicare &
Medicaid Services or the Office
of Inspector General of the
Department of Health and Human
Services.
``(iii) Contents of notification.--The
Secretary shall, based on input from
stakeholders, specify the resources and other
information to be included in notifications
provided under clause (i).
``(iv) Modifications and expansions.--
``(I) Frequency.--Beginning 5 years
after the date of the enactment of this
subparagraph, the Secretary may change
the frequency of the notifications
described in clause (i) based on
stakeholder input.
``(II) Expansion to other
prescriptions.--The Secretary may
expand notifications under this
subparagraph to include identifications
and notifications with respect to
concurrent prescriptions of covered
Part D drugs used in combination with
opioids that are considered to have
adverse side effects when so used in
such combination, as determined by the
Secretary.
``(v) Opioids defined.--For purposes of
this subparagraph, the term `opioids' has such
meaning as specified by the Secretary through
program instruction or otherwise.''.
<all>
Introduced in House
Introduced in House
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Committee Consideration and Mark-up Session Held.
Ordered to be Reported by Voice Vote.
Referred to the Subcommittee on Health.
Reported by the Committee on Energy and Commerce. H. Rept. 115-740, Part I.
Reported by the Committee on Energy and Commerce. H. Rept. 115-740, Part I.
Committee on Ways and Means discharged.
Committee on Ways and Means discharged.
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Placed on the Union Calendar, Calendar No. 574.