Sec. 4. Improving activities of Medicare Drug Integrity Contractors (MEDICs)
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Section 1893 of the Social Security Act ( 42 U.S.C. 1395ddd ) is amended by adding at the end the following new subsection: Under contracts entered into under this section (each in this subsection referred to as a MEDIC contract ) with Medicare drug integrity contractors (each in this subsection referred to as a MEDIC ), the Secretary shall authorize MEDICs to directly obtain prescription and medical records from entities such as pharmacies, PDP and physicians. If a PDP sponsor refers information to a MEDIC for investigation, under the MEDIC contract the MEDIC must acknowledge receipt of the referral and must report back to the sponsor the result of the MEDIC’s investigation within 45 days of the date of the referral and share such results with appropriate agencies, such as law enforcement officials and State licensing authority.
In order to assess the performance of MEDICs, the Secretary shall develop a uniform reporting criteria for the annual reporting of the results of investigations by MEDICs to the Secretary and to Congress. Each such annual report shall include information on the number of referrals for investigation made to a MEDIC, the average time required for investigation, the results of the investigation, and the number of results that were referred to the Inspector General of the Department of Health and Human Services and to State licensing officials for further investigations. .
The amendment made by subsection
(a)shall take effect on the date of the enactment of this Act and shall apply as quickly as possible to MEDIC contracts, including MEDIC contracts entered into before such date of enactment.
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Sec. 4
Improving activities of Medicare Drug Integrity Contractors (MEDICs)
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