Sec. 101. Requiring valid prescriber National Provider Identifiers on pharmacy claims

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Section 1860D–4(c) of the Social Security Act ( 42 U.S.C. 1395w–104(c) ) is amended by adding at the end the following new paragraph: For plan year 2015 and subsequent plan years, subject to subparagraph (B), the Secretary shall prohibit PDP sponsors of prescription drug plans from paying claims for prescription drugs under this part that do not include a valid prescriber National Provider Identifier. The Secretary shall establish— procedures for determining the validity of prescriber National Provider Identifiers under subparagraph (A); and procedures for transferring to the Inspector General of the Department of Health and Human Services and appropriate law enforcement agencies and other oversight entities information on those National Provider Identifiers and pharmacy claims, including records related to such claims, that the Secretary determines are invalid under clause (i).

Not later than January 1, 2017, the Inspector General of the Department of Health and Human Services shall submit to Congress a report on the effectiveness of the procedures established under subparagraph (B). .

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42 USC 1395w–104(c)

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Sec. 101

Requiring valid prescriber National Provider Identifiers on pharmacy claims

Cite42 USC 1395w–104(c)

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