PlainBillCongress, translated.Legislation. Context. Public interest.Read twice and referred to the Committee on Finance.
Congressional Research Service
Version 00 · Introduced in Senate · Jul 30, 2015
Stopping Medication Abuse and Protecting Seniors Act of 2015
This bill amends title XVIII (Medicare) of the Social Security Act to: (1) authorize a Medicare prescription drug plan (PDP) sponsor to establish a drug management program under which the PDP sponsor may limit an at-risk beneficiary’s access to coverage for frequently abused drugs to include only those drugs that are prescribed by selected prescribers and dispensed by selected pharmacies; and (2) require a PDP sponsor to have in place a utilization management tool to prevent drug abuse.
With respect to a drug management program, a PDP sponsor must: (1) provide specified notice to a beneficiary who has been identified by the Centers for Medicare & Medicaid (CMS) as “at-risk” and consequently enrolled in the program; and (2) in selecting prescribers and dispensers, ensure that the beneficiary continues to have reasonable access to drugs. These determinations shall be subject to expedited reconsideration and appeal. A PDP sponsor must review and consider an at-risk beneficiary’s preferences regarding prescriber and pharmacy selection.
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Certain individuals, including those receiving hospice care or residing in a long-term care facility, are exempted from enrollment in a drug management program.
CMS must, for purposes of quality or performance assessments, review and consider complaints received from at-risk beneficiaries regarding lack of access due to their enrollment in a drug management program. In addition, CMS must establish rules and procedures requiring a PDP sponsor to provide specified program data.
People & committees
Sen. Toomey, Patrick [R-PA] · R–PA
Legislative record
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Read twice and referred to the Committee on Finance.
Introduced in Senate
Primary sources
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Source last updated: Jan 20, 2026. Consult Congress.gov for the current record.
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