,,ii #aaeth ,,congress #b;d ,session ,s4 #bibj ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,may #bb1 #bjah ,mrs4 ,mc,caskill 7for herself and ,mr4 ,toomey7 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 impose certain requirements under the ,medicare program with respect to outlier prescribers of opioids4 #a4 ,short title ,this ,act may be cited as the ,commit to ,opioid ,medical ,prescriber ,accountability and ,safety for ,seniors ,act of #bjah4 #b4 ,medicare requirements with respect to outlier prescribers of opioids ,section #ahfj;,d-#d7;c77#d7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#ajd7;c77#d77 is amended by adding at the end the following new subparagraph3 7,d7 ,notification and additional requirements with respect to outlier prescribers of opioids 7i7 ,notification ,not later than ,january #a1 #bjba1 the ,secretary shall1 in the case of a prescriber identified by the ,secretary under clause 7ii7 to be an outlier prescriber of opioids1 provide1 subject to clause 7iv71 an annual notification to such prescriber 7during the period in which such provider maintains such identification7 that such prescriber has been so identified and including such resources on proper prescribing methods and such other information as specified in accordance with clause 7iii74 7ii7 ,identification of outlier prescribers of opioids 7,i7 ,in general ,the ,secretary shall1 subject to subclause 7,,iii71 using the valid prescriber ,national ,provider ,identifiers included pursuant to subparagraph 7,a7 on claims for covered part ,d drugs for part ,d eligible individuals enrolled in prescription drug plans under this part and ,,ma-,,pd plans under part ,c and based on the thresholds established under subclause 7,,ii71 identify prescribers that are outlier opioids prescribers for a period of time specified by the ,secretary4 7,,ii7 ,establishment of thresholds ,for purposes of subclause 7,i7 and subject to subclause 7,,iii71 the ,secretary shall1 after consultation with stakeholders1 establish thresholds1 based on prescriber specialty and1 as determined appropriate by the ,secretary1 geographic area1 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 area4 7,,iii7 ,exclusions ,the following shall not be included in the process for identifying outlier prescribers of opioids under this clause3 7aa7 ,claims for covered part ,d drugs for part ,d eligible individuals who are receiving hospice care under this title4 7bb7 ,claims for covered part ,d drugs for part ,d eligible individuals who are receiving oncology services under this title4 7cc7 ,prescribers who are the subject of an investigation by the ,centers for ,medicare ,medicaid ,services or the ,office of the ,inspector ,general of the ,department of ,health and ,human ,services4 7iii7 ,contents of notification ,the ,secretary shall include the following information in the notifications provided under clause 7i73 7,i7 ,information on how such prescriber compares to other prescribers within the same specialty and1 if determined appropriate by the ,secretary1 geographic area4 7,,ii7 ,information on opioid prescribing guidelines1 based on input from stakeholders1 that may include the ,centers for ,disease ,control and ,prevention guidelines for prescribing opioids for chronic pain and guidelines developed by physician organizations4 7,,iii7 ,other information determined appropriate by the ,secretary4 7iv7 ,modifications and expansions 7,i7 ,frequency ,beginning #e years after the date of the enactment of this subparagraph1 the ,secretary may change the frequency of the notifications described in clause 7i7 based on stakeholder input and changes in opioid prescribing utilization and trends4 7,,ii7 ,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 combination4 7v7 ,additional requirements for persistent outlier prescribers ,in the case of a prescriber who the ,secretary determines is persistently identified under clause 7ii7 as an outlier prescriber of opioids1 the following shall apply3 7,i7 ,the ,secretary shall connect such prescriber with an entity that provides technical or educational resources on opioid prescribing guidelines 7such as the guidelines described in clause 7iii77,,ii771 which may include a quality improvement organization under part ,b of title ,,xi1 as available and appropriate4 7,,ii7 ,such prescriber may be required to enroll in the program under this title under section #ahff7;j7 if such prescriber is not otherwise required to enroll4 ,the ,secretary shall determine the length of the period for which such prescriber is required to maintain such enrollment4 7,,iii7 ,not less frequently than annually 7and in a form and manner determined appropriate by the ,secretary71 the ,secretary shall communicate information on such prescribers to sponsors of a prescription drug plan and ,medicare ,advantage organizations offering an ,,ma-,,pd plan4 7vi7 ,public availability of information ,the ,secretary shall make aggregate information under this subparagraph available on the ,internet website of the ,centers for ,medicare ,medicaid ,services4 ,such information shall be in a form and manner determined appropriate by the ,secretary and shall not identify any specific prescriber4 ,in carrying out this clause1 the ,secretary shall consult with interested stakeholders4 7vii7 ,opioids defined ,for purposes of this subparagraph1 the term opioids has such meaning as specified by the ,secretary4 7viii7 ,other activities ,nothing in this subparagraph shall preclude the ,secretary from conducting activities that provide prescribers with information as to how they compare to other prescribers that are in addition to the activities under this subparagraph1 including activities that were being conducted as of the date of the enactment of this subparagraph4 4