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house Bill H.R. 6110

Dr. Todd Graham Pain Management, Treatment, and Recovery Act of 2018

Bill Details

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Title

Dr. Todd Graham Pain Management, Treatment, and Recovery Act of 2018

Official Title

To amend title XVIII of the Social Security Act to provide for the review and adjustment of payments under the Medicare outpatient prospective payment system to avoid financial incentives to use opioids instead of non-opioid alternative treatments, and for other purposes.

Summary

Dr. Todd Graham Pain Management, Treatment, and Recovery Act of 2018 This bill establishes several requirements for the Centers for Medicare & Medicaid Services (CMS), and alters requirements under Medicare and Medicare Advantage (MA), related to pain management and opioid use. Among other requirements, the CMS must review payments under Medicare for opioid and non-opioid pain management procedures, specifically with respect to ambulatory outpatient surgical procedures and hospital outpatient department services. The CMS must ensure that there are no payment incentives for using opioids instead of non-opioid alternatives and must make revisions accordingly. The bill also requires payment under Medicare to federally qualified health centers and rural health clinics that have health care practitioners who are newly certified to provide medication-assisted treatment (e.g., buprenorphine). The bill also authorizes the suspension of payments to a pharmacy under the Medicare prescription drug benefit and MA prescription drug plans pending the investigation of a credible allegation of fraud by the pharmacy.

bill Progress

  • Not enacted
    The President has not signed this bill
  • The senate has not voted
      senate Committees
      Committee on Finance
  • The house Passed June 19th, 2018
    Passed by Voice Vote
      house Committees
      Committee on Energy and Commerce
      Committee on Ways and Means
      Health
    IntroducedJune 14th, 2018
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    Suzanne's Opinion Against
    ···
    12/19/2020
    A pharmacy should not arbitrarily decide if a physician, or other clinician, be investigated for fraud. In what free time (?), and with no terms of what constitutes fraud by the prescriber? The other issue with this bill is it has no mentioned, board-certified, pain management specialist recommended in it for wording, who could speak on behalf of chronic and intractacle pain patients; to review the wording of the proposed treatment reimbursement. By not including those who treat long-term pain, or those that experience intractacle/chronic/acute pain in this bill proposal, then the wording regarding OPD treatment for pain, or not, should be removed. Treatment of pain actually allows for patients to access the other "tools in the toolbox" (i.e., massage, physical therapy, etc.) proposed. These services will not always be available to everyone (rural, poor, areas with low concentrations of alternatives), and therefore is the definition of biased care, or care only available to the elite and upper middle class; due to time and resources. It would cost the government much less - if people with actual pain could be treated properly, in order to continue working - instead of having to remove themselves from society due to social misunderstanding of physical pain and its undertreatment (or lack of treatment; as seen with the VA in the last 4-5 years, which has resulted in massive veteran suicides).
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