Senate Finance Makes Opioid Fraud Scheme Inquiry

Republicans on the Senate Finance Committee have written to the U.S. Department of Health and Human Services (HHS) requesting additional information on the health care fraud takedown that resulted in the identification of $1.3 billion in false billings and 412 charges of participation in fraud schemes related to improper opioid related diversion and abuse. The lawmakers also ask for details on what the Department is doing to combat opioid fraud and abuse in the Medicare Part D program. They request that the Department engage with the Committee on policy options to review Medicare and Medicaid payment initiatives related to the treatment of pain and addiction. 

GAO Releases NAS Report

The Government Accountability Office (GAO) released a new report on neonatal abstinence syndrome (NAS) last week. The report was mandated as part of the Comprehensive Addiction and Recovery Act (CARA). The number of babies born with NAS has increased nearly five-fold between 2000 and 2012 as a result of the opioid epidemic. The GAO examined efforts to treat NAS babies and their mothers under the Medicaid program, citing data that more than 80 percent of NAS cases are paid for through the Medicaid program. The report includes the best clinical practices used to care for infants with NAS and the available data on outcomes. The U.S. Department of Health and Human Services (HHS) released a plan in May of this year to address NAS, and the GAO recommends that the Department develop a more concrete timeline for implementing the HHS strategy. HHS agreed but cited that adequate funding is necessary to implement the recommendations. In related news, the National Institutes of Health (NIH) announced that it would be funding a new study on how best to treat and manage babies born with opioid withdrawal syndrome. The study will be conducted by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) in collaboration with the NIH’s Environmental Influences on Child Health Outcomes Program. 

Upcoming Congressional Hearings and Meetings

House Energy and Commerce Oversight and Investigations Subcommittee hearing on “Examining How Covered Entities Utilize the 340B Pricing Program;” 10:00 a.m., 2123 Rayburn Bldg.; October 11

House Energy and Commerce Health Subcommittee “Member Day” on Effort to Combat the Opioid Crisis; 10:15 a.m., 2322 Rayburn Bldg.; October 11

Senate Health, Education, Labor, and Pensions Committee hearing “The Cost of Prescription Drugs: How the Drug Delivery System Affects What Patients Pay, Part II;” 10:00 a.m., 430 Dirksen Bldg.; October 17

Recently Introduced Health Legislation

S.1905 (introduced by Sen. Debbie Stabenow): A bill to increase the number of States that may conduct Medicaid demonstration programs to improve access to community mental health services; Finance

H.R.3919 (introduced by Rep. Diane Black): To streamline the employer reporting process and strengthen the eligibility verification process for the premium assistance tax credit and cost-sharing subsidy; Ways and Means, Energy and Commerce

H.R.3920 (introduced by Rep. Jackie Walorkski): To establish a Medicare demonstration program on the use of thirdparty interest-free payment arrangements to reduce Medicare hospital part A bad debt claims; Ways and Means, Energy and Commerce

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