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HR 4876 114th Congress House Health Administrative law and regulatory procedures Congressional oversight Consumer affairs Department of Health and Human Services Drug trafficking and controlled substances Drug, alcohol, tobacco use Fraud offenses and financial crimes Government studies and investigations Health care coverage and access Health information and medical records Health technology, devices, supplies Medicare Performance measurement Prescription drugs

Medicare Prescription Drug Abuse Prevention Act of 2016

Introduced: March 23, 2016 See on congress.gov
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This bill died when the 114th Congress ended
It never became law before the 114th Congress (2015–2016) adjourned, and bills don't carry over to the next Congress. It would have to be reintroduced. You can still save it for reference, but it won't receive updates.
 Everywhere this bill has been 4 steps
Introduced
In committee
Reported out
Passed House
Passed Senate
To President
Became law
Mar 29, 2016
Referred to the Subcommittee on Health.
Mar 25, 2016
Referred to the Subcommittee on Health.
Mar 23, 2016
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.
Mar 23, 2016
Introduced in House
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 Plain-English summary Congressional Research Service

Medicare Prescription Drug Abuse Prevention Act of 2016

This bill amends title XVIII (Medicare) of the Social Security Act to: (1) authorize a Medicare prescription drug plan (PDP) sponsor to establish a drug management program under which the PDP sponsor may limit an at-risk beneficiary's access to coverage for frequently abused drugs to include only those drugs that are prescribed by selected prescribers and dispensed by selected pharmacies; and (2) require a PDP sponsor to have in place a utilization management tool to prevent drug abuse.

With respect to a drug management program, a PDP sponsor must: (1) provide specified notice to a beneficiary who has been identified by the Centers for Medicare & Medicaid (CMS) as "at-risk" and consequently enrolled in the program; and (2) in selecting prescribers and dispensers, ensure that the beneficiary continues to have reasonable access to drugs. These determinations shall be subject to expedited reconsideration and appeal. A PDP sponsor must review and consider an at-risk beneficiary's preferences regarding prescriber and pharmacy selection.

Certain individuals, including those receiving hospice care or residing in a long-term care facility, are exempted from enrollment in a drug management program.

CMS must, for purposes of quality or performance assessments, review and consider complaints received from at-risk beneficiaries regarding lack of access due to their enrollment in a drug management program. In addition, CMS must establish rules and procedures requiring a PDP sponsor to provide specified program data.

What's happening now March 29, 2016

Referred to the Subcommittee on Health.

 Related & companion bills 2
  • S 524 Related bill Comprehensive Addiction and Recovery Act of 2016
  • S 1913 Related bill Stopping Medication Abuse and Protecting Seniors Act of 2015
 Bill text 1 version

Source documents hosted by congress.gov.

 Committees of jurisdiction 4
 Cosponsors 1
All 1 Democratic 1
D
Neal, Richard E.
Massachusetts · Mar 23, 2016
Cite this page click to expand
APA
U.S. Congress. (2026). H.R. 4876: Medicare Prescription Drug Abuse Prevention Act of 2016. 114th Congress. Open America. https://openamerica.io/bill/114-HR-4876/
MLA
"H.R. 4876: Medicare Prescription Drug Abuse Prevention Act of 2016." 114th Congress, 2026, Open America, https://openamerica.io/bill/114-HR-4876/.
Bluebook (legal)
H.R. 4876, 114th Cong. (2026), https://openamerica.io/bill/114-HR-4876/.
Markdown link
[H.R. 4876: Medicare Prescription Drug Abuse Prevention Act of 2016](https://openamerica.io/bill/114-HR-4876/)
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