Revised 21st Century Cures Part D “Lock-In” Language “A Significant Step in Right Direction” for LTC Pharmacy Patients, Providers

DATE: May 13, 2015

Washington, DC – The following is a statement from Alan G. Rosenbloom, President of the Senior Care Pharmacy Coalition (SCPC), commenting on newly revised language in the 21st Century Cures draft legislation as it pertains to programs to prevent prescription drug abuse under Medicare Parts C and D (the so-called “lock-in” provision) (Sec 3141):

“The SCPC supports the Committee’s dedication to preventing prescription drug abuse among seniors. We also recognize that Part D beneficiaries who receive care in certain settings already have substantial protections against drug abuse. We urge Congress, if it proceeds with programs to prevent drug abuse under Medicare, to recognize that these settings should be exempt from the “lock-in” provision. The SCPC believes that beneficiaries in skilled nursing facilities and other long-term care settings like assisted living already have sufficient protections and should be exempted.

“In our view, the new Medicare Part D ‘lock-in’ language is a significant step in the right direction. The revamped provision recognizes there are certain beneficiaries who should not be exempt from the provision because they already are protected from potential drug abuse.

“Specifically, the new language codifies that hospice patients are exempt, allows the Secretary of Health and Human Services (HHS) to create exemptions for other categories of individuals, and references a long term care facility resident as an example.

“We commend the Energy and Commerce Committee for recognizing and acting on the need to build in exemption language. The bill can and should be further strengthened by making clear that beneficiaries in skilled nursing facilities and other long-term care settings are exempt by legislation rather than subsequent administrative rule.

“We look forward to working with the Committee on an ongoing basis to optimize the language in a manner that ensures long term care patients are able to receive needed medications when and where needed, and that appropriately addresses the problem of drug abuse and diversion among seniors.”

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