,,ii #aaeth ,,congress #b;d ,session ,s4 #bije ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,may #bb1 #bjah ,mr4 ,toomey 7for himself and ,mrs4 ,mc,caskill7 introduced the following bill2 which was read twice and referred to the ,committee on ,finance ,a ,,bill ,to amend title ,,xviii of the ,social ,security ,act to provide for certain program integrity transparency measures under ,medicare parts ,c and ,d4 #a4 ,short title ,this ,act may be cited as the ,strengthening ,partnerships to ,prevent ,opioid ,abuse ,act of #bjah4 #b4 ,program integrity transparency measures under ,medicare parts ,c and ,d 7a7 ,in general ,section #ahei of the ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#bh7 is amended by adding at the end the following new subsection3 7i7 ,program integrity transparency measures 7#a7 ,program integrity portal 7,a7 ,in general ,not later than #b years after the date of the enactment of this subsection1 the ,secretary shall1 after consultation with stakeholders1 establish a secure ,internet website portal that would allow a secure path for communication between the ,secretary1 ,,ma plans under this part1 prescription drug plans under part ,d1 and an eligible entity with a contract under section #ahic 7such as a ,medicare drug integrity contractor or any successor entity to a ,medicare drug integrity contractor71 in accordance with subsection 7j77#c7 of such section1 for the purpose of enabling through such portal-- 7i7 the referral by such plans of suspicious activities of a provider of services 7including a prescriber7 or supplier related to fraud1 waste1 and abuse for initiating or assisting investigations conducted by the eligible entity2 and 7ii7 data sharing among such ,,ma plans1 prescription drug plans1 and the ,secretary 7including with respect to information for activities under section #ahic7;j774 7,b7 ,required uses of portal ,the ,secretary shall disseminate the following information to ,,ma plans under this part and prescription drug plans under part ,d through the secure ,internet website portal established under subparagraph 7,a73 7i7 ,providers of services and suppliers that have been referred pursuant to subparagraph 7,a77i7 during the previous #ab-month period4 7ii7 ,providers of services and suppliers who are the subject of an active exclusion under section #aabh or who are subject to a suspension of payment under this title pursuant to section #ahfb7o7 or otherwise4 7iii7 ,providers of services and suppliers who are the subject of an active revocation of participation under this title1 including for not satisfying conditions of participation4 7iv7 ,in the case of such a plan that makes a referral under subparagraph 7,a77i7 through the portal with respect to suspicious activities of a provider of services 7including a prescriber7 or supplier1 if such provider 7or prescriber7 or supplier has been the subject of an administrative action under this title or title ,,xi with respect to similar activities1 a notification to such plan of such action so taken4 7,c7 ,rulemaking ,for purposes of this paragraph1 the ,secretary shall1 through rulemaking1 specify what constitutes substantiated fraud1 waste1 and abuse1 using guidance such as what is provided in the ,medicare ,program ,integrity ,manual #d4g4a4 7#b7 ,quarterly reports ,beginning not later than #b years after the date of the enactment of this subsection1 the ,secretary shall make available to ,,ma plans under this part and prescription drug plans under part ,d in a timely manner 7but no less frequently than quarterly7 and using information submitted to an entity described in paragraph 7#a7 through the portal described in such paragraph or pursuant to section #ahic1 information on fraud1 waste1 and abuse schemes and trends in identifying suspicious activity4 ,information included in each such report shall-- 7,a7 include administrative actions1 pertinent information related to opioid overprescribing1 and other data determined appropriate by the ,secretary in consultation with stakeholders2 and 7,b7 be anonymized information submitted by plans without identifying the source of such information4 7#c7 ,clarification ,nothing in this subsection shall preclude referrals to the ,inspector ,general of the ,department of ,health and ,human ,services or other law enforcement entities4 4 7b7 ,contract requirement ,to communicate plan corrective actions against opioids over-prescribers ,section #aheg7;e77#d77;,c7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#bg7;e77#d77;,c77 is amended by adding at the end the following new paragraph3 7#e7 ,communicating plan corrective actions against opioids over-prescribers 7,a7 ,in general ,beginning with plan years beginning on or after ,january #a1 #bjba1 a contract under this section with an ,,ma organization shall require the organization to submit to the ,secretary1 through the process established under subparagraph 7,b71 information on credible evidence of suspected fraud and other actions taken by such plans related to inappropriate prescribing of opioids4 7,b7 ,process ,not later than ,january #a1 #bjba1 the ,secretary shall1 in consultation with stakeholders1 establish a process under which ,,ma plans and prescription drug plans shall submit to the ,secretary information described in subparagraph 7,a74 7,c7 ,regulations ,for purposes of this paragraph1 including as applied under section #ahfj;,d-#ab7;b77#c77;,d71 the ,secretary shall1 pursuant to rulemaking-- 7i7 specify a definition for the term inappropriate prescribing of opioids and a method for determining if a provider of services prescribes such a high volume2 and 7ii7 establish the process described in subparagraph 7,b7 and the types of information that may be submitted through such process4 4 7c7 ,reference under part ,d to program integrity transparency measures ,section #ahfj;,d-#d of the ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#ajd7 is amended by adding at the end the following new subsection3 7m7 ,program integrity transparency measures ,for program integrity transparency measures applied with respect to prescription drug plan and ,,ma plans1 see section #ahei7;i74 4