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Protecting Seniors Access to Proper Care Act of 2015

H.R. 4062 · 114th Congress · Nov 18, 2015 · Lineage

A BILL

To amend title XVIII of the Social Security Act to remove the enrollment restriction on certain physicians and practitioners prescribing covered outpatient drugs under the Medicare prescription drug program.

Section 1 Short title

This Act may be cited as the “Protecting Seniors Access to Proper Care Act of 2015”.

Sec. 2 Removing duplicative paperwork in permitting certain non-enrolled physicians or practitioners to prescribe covered outpatient drugs under Medicare part D

Section 1860D–4 of the Social Security Act (42 U.S.C. 1395w–103) is amended by adding at the end the following new subsection:

“(m) Removal of enrollment restriction—Nothing in this title or section 6405(c) of the Patient Protection and Affordable Care Act (42 U.S.C. 1395f note) shall be construed as requiring, as a condition of payment by a PDP sponsor for a covered part D drug prescribed by an individual who is a physician or who is a practitioner described in section 1842(b)(18)(C) and authorized under State law to prescribe such drug, that the individual be enrolled under section 1866(j) so long as—

“(1) the individual is not otherwise disqualified from being so enrolled; and

“(2)

“(A) the individual is not a physician described in section 1861(r)(1); or

“(B) the individual is such a physician and the individual’s practice prescribes a low-volume (as determined by the Secretary) of billings for such drugs under this part.”