MacArthur’s bill to end pharmacy Medicare fraud included in broad, bipartisan opioid package

A resolution to far-reaching consensus legislation approved by the U.S. House on Sept. 28 to attack the nation’s ongoing opioid crisis includes a bipartisan bill sponsored by U.S. Rep. Tom MacArthur (R-NJ) that would provide more drug protections for America’s senior citizens.

The House on Friday approved, 393-8, a U.S. Senate amendment to the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act, H.R. 6, which would make several changes to state Medicaid programs to address opioid and substance use disorders; would alter Medicare requirements to address opioid use; and would address myriad opioid-related issues, according to the congressional record summary.

The legislative compromise on H.R. 6, finalized earlier last week in a resolution, now heads back to the Senate for a final vote. H.R. 6 is expected to receive Senate approval now that the two chambers have reached agreement on the comprehensive proposal following additional changes the House made to the bill on Sept. 25.

“Republicans and Democrats have come together to pass innovative policies that provide our South Jersey community with real solutions to the opioid crisis,” Rep. MacArthur said on Sept. 28 following House passage of the final H.R. 6. “The bill bolsters local drug treatment, prevention, and enforcement efforts, enhances opioid prescription screening measures, and increases resources for those suffering from addiction.

“All aspects of the opioid crisis are addressed in this legislation, including ways to close loopholes that allow criminals to put drugs on our streets, said MacArthur, co-chair of the Bipartisan Heroin Task Force.

H.R. 6 includes among its 94 related bills the Stop Excessive Narcotics In Our Retirement (SENIOR) Communities Protection Act of 2018, H.R. 5676, a bipartisan proposal Rep. MacArthur introduced on May 3 along with five cosponsors – two Republicans and three Democrats.

MacArthur’s H.R. 5676 would authorize the suspension of payments to a pharmacy under the Medicare prescription drug benefit and Medicare Advantage prescription drug plans pending the investigation of a credible allegation of fraud by the pharmacy, according to the congressional record summary. A fraud hotline tip, without other evidence, may not be considered a credible allegation of fraud, the summary says.

“My bill gives Medicare the ability to protect seniors and stop criminals who are abusing stolen Medicare numbers,” Rep. MacArthur said. “Enforcement of this policy will stop the flow of narcotics in our communities, protect seniors’ Medicare dollars, and support those who need it most.”

H.R. 5676 would permit Medicare Part D to suspend payments to a pharmacy that’s under investigation for fraud or abuse, according to the lawmaker’s office, thereby allowing Medicare to speed up responses to alleged abuse. The House on June 19 approved H.R. 5676, 356-3, and sent it the next day to the Senate.

“I will continue finding ways to make our communities better prepared and more resilient against the opioid epidemic,” said MacArthur. “This crisis is bigger than any one of us, but it is not bigger than all of us together.”

Once the final H.R. 6 package receives Senate approval, which may happen this week, the bill heads to the president’s desk for signature to make it law.