PCMA Statement on the ‘Protecting the Integrity of Medicare Act’

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New Medicare Part D ‘Lock-In’ Pharmacy Provision Will Help Curb Prescription Drug Fraud, Waste, and Abuse

New legislation introduced today by U.S. House Ways and Means Health Subcommittee Chairman Kevin Brady (R-TX) and Ranking Member Jim McDermott (D-WA) – the Protecting the Integrity of Medicare Act (PIMA) of 2014 – includes a pharmacy “lock-in” provision to help prevent inappropriate prescriptions from crossing the pharmacy counter. The bill recognizes the need to address the prescription drug abuse epidemic, said the Pharmaceutical Care Management Association (PCMA).

“The key to stopping ‘drugstore shopping’ is preventing improper prescriptions from being filled in the first place,” said PCMA President and CEO Mark Merritt. “The creation of a ‘lock-in’ program in Medicare Part D allows health plans and at-risk beneficiaries to choose a pharmacy for the dispensing of frequently abused drugs.”

A recent report by the Health and Human Services Office of Inspector General, “Part D Beneficiaries with Questionable Utilization Patterns for HIV Drugs,” calls for a pharmacy “lock-in” program in Part D. The Centers for Disease Control and Prevention, the Centers for Medicare & Medicaid Services, the Government Accountability Office and the Office of National Drug Control Policy also have called for a “lock-in” program in Medicare. Currently 46 state Medicaid agencies operate “lock-in” programs and 49 states have enacted prescription drug monitoring legislation.

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