H.R. 5715

Strengthening Partnerships to Prevent Opioid Abuse Act

This bill requires the Centers for Medicare & Medicaid Services (CMS) to establish a secure online portal to allow: (1) data sharing among the CMS, Medicare prescription drug benefit plans, and Medicare Advantage (MA) plans; and (2) referrals by such plans of substantiated fraud, waste, or abuse in order to initiate or assist investigations by contracted entities under the Medicare Integrity Program. The CMS must disseminate and report certain collected information to such plans, including information regarding providers that were referred through the portal and trends in identifying suspicious activity.

Additionally, for plan years beginning on or after January 1, 2021, MA organizations must submit information to the CMS regarding investigations or other actions taken by MA plans against providers that prescribe high volumes of opioids (as determined by the CMS).