[Pages H5258-H5261]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

PREVENTING ADDICTION FOR SUSCEPTIBLE SENIORS ACT OF 2018

Mr. ROSKAM. Madam Speaker, I move to suspend the rules and pass the
bill (H.R. 5773) to amend title XVIII of the Social Security Act to
require Medicare prescription drug plans to establish drug management
programs for at-risk beneficiaries, require electronic prior
authorization for covered part D drugs, and to provide for other
program integrity measures under parts C and D of the Medicare program,
as amended.
The Clerk read the title of the bill.
The text of the bill is as follows:

H.R. 5773

Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

This Act may be cited as the ``Preventing Addiction for
Susceptible Seniors Act of 2018'' or the ``PASS Act of
2018''.

SEC. 2. ELECTRONIC PRIOR AUTHORIZATION FOR COVERED PART D
DRUGS.

(a) Inclusion in Electronic Prescription Program.--Section
1860D-4(e)(2) of the Social Security Act (42 U.S.C. 1395w-
104(e)(2)) is amended by adding at the end the following new
subparagraph:
``(E) Electronic prior authorization.--
``(i) In general.--Not later than January 1, 2021, the
program shall provide for the secure electronic transmission
of--

``(I) a prior authorization request from the prescribing
health care professional for coverage of a covered part D
drug for a part D eligible individual enrolled in a part D
plan (as defined in section 1860D-23(a)(5)) to the PDP
sponsor or Medicare Advantage organization offering such
plan; and
``(II) a response, in accordance with this subparagraph,
from such PDP sponsor or Medicare Advantage organization,
respectively, to such professional.

``(ii) Electronic transmission.--

``(I) Exclusions.--For purposes of this subparagraph, a
facsimile, a proprietary payer portal that does not meet
standards specified by the Secretary, or an electronic form
shall not be treated as an electronic transmission described
in clause (i).
``(II) Standards.--In order to be treated, for purposes of
this subparagraph, as an electronic transmission described in
clause (i), such transmission shall comply with technical
standards adopted by the Secretary in consultation with the
National Council for Prescription Drug Programs, other
standard setting organizations determined appropriate by the
Secretary, and stakeholders including PDP sponsors, Medicare
Advantage organizations, health care professionals, and
health information technology software vendors.
``(III) Application.--Notwithstanding any other provision
of law, for purposes of this subparagraph, the Secretary may
require the use of such standards adopted under subclause
(II) in lieu of any other applicable standards for an
electronic transmission described in clause (i) for a covered
part D drug for a part D eligible individual.''.

(b) Sense of Congress Regarding Electronic Prior
Authorization.--It is the sense of the Congress that--
(1) there should be increased use of electronic prior
authorizations for coverage of covered part D drugs for part
D eligible individuals enrolled in prescription drug plans
under part D of title XVIII of the Social Security Act and
MA-PD plans under part C of such title to reduce access
delays by resolving coverage issues before prescriptions for
such drugs are transmitted; and
(2) greater priority should be placed on increasing the
adoption of use of such electronic prior authorizations among
prescribers of such drugs, pharmacies, PDP sponsors, and
Medicare Advantage organizations.

[[Page H5259]]

SEC. 3. PROGRAM INTEGRITY TRANSPARENCY MEASURES UNDER
MEDICARE PARTS C AND D.

(a) In General.--Section 1859 of the Social Security Act
(42 U.S.C. 1395w-28) is amended by adding at the end the
following new subsection:
``(i) Program Integrity Transparency Measures.--
``(1) Program integrity portal.--
``(A) In general.--Not later than two years after the date
of the enactment of this subsection, the Secretary shall,
after consultation with stakeholders, establish a secure
Internet website portal (or other successor technology) that
would allow a secure path for communication between the
Secretary, MA plans under this part, prescription drug plans
under part D, and an eligible entity with a contract under
section 1893 (such as a Medicare drug integrity contractor or
an entity responsible for carrying out program integrity
activities under this part and part D) for the purpose of
enabling through such portal (or other successor
technology)--
``(i) the referral by such plans of substantiated fraud,
waste, and abuse for initiating or assisting investigations
conducted by the eligible entity; and
``(ii) data sharing among such MA plans, prescription drug
plans, and the Secretary.
``(B) Required uses of portal.--The Secretary shall
disseminate the following information to MA plans under this
part and prescription drug plans under part D through the
secure Internet website portal (or other successor
technology) established under subparagraph (A):
``(i) Providers of services and suppliers that have been
referred pursuant to subparagraph (A)(i) during the previous
12-month period.
``(ii) Providers of services and suppliers who are the
subject of an active exclusion under section 1128 or who are
subject to a suspension of payment under this title pursuant
to section 1862(o) or otherwise.
``(iii) Providers of services and suppliers who are the
subject of an active revocation of participation under this
title, including for not satisfying conditions of
participation.
``(iv) In the case of such a plan that makes a referral
under subparagraph (A)(i) through the portal (or other
successor technology) with respect to activities of
substantiated fraud, waste, or abuse of a provider of
services or supplier, if such provider or supplier has been
the subject of an administrative action under this title or
title XI with respect to similar activities, a notification
to such plan of such action so taken.
``(C) Rulemaking.--For purposes of this paragraph, the
Secretary shall, through rulemaking, specify what constitutes
substantiated fraud, waste, and abuse, using guidance such as
what is provided in the Medicare Program Integrity Manual
4.7.1. In carrying out this subsection, a fraud hotline tip
(as defined by the Secretary) without further evidence shall
not be treated as sufficient evidence for substantiated
fraud, waste, or abuse
``(D) HIPAA compliant information only.--For purposes of
this subsection, communications may only occur if the
communications are permitted under the Federal regulations
(concerning the privacy of individually identifiable health
information) promulgated under section 264(c) of the Health
Insurance Portability and Accountability Act of 1996.
``(2) Quarterly reports.--Beginning two years after the
date of enactment of this subsection, the Secretary shall
make available to MA plans under this part and prescription
drug plans under part D in a timely manner (but no less
frequently than quarterly) and using information submitted to
an entity described in paragraph (1) through the portal (or
other successor technology) described in such paragraph or
pursuant to section 1893, information on fraud, waste, and
abuse schemes and trends in identifying suspicious activity.
Information included in each such report shall--
``(A) include administrative actions, pertinent information
related to opioid overprescribing, and other data determined
appropriate by the Secretary in consultation with
stakeholders; and
``(B) be anonymized information submitted by plans without
identifying the source of such information.
``(3) Clarification.--Nothing in this subsection shall be
construed as precluding or otherwise affecting referrals
described in subparagraph (A) that may otherwise be made to
law enforcement entities or to the Secretary.''.
(b) Contract Requirement to Communicate Plan Corrective
Actions Against Opioid Over-prescribers.--Section 1857(e) of
the Social Security Act (42 U.S.C. 1395w-27(e)) is amended by
adding at the end the following new paragraph:
``(5) Communicating plan corrective actions against opioids
over-prescribers.--
``(A) In general.--Beginning with plan years beginning on
or after January 1, 2021, a contract under this section with
an MA organization shall require the organization to submit
to the Secretary, through the process established under
subparagraph (B), information on the investigations and other
actions taken by such plans related to providers of services
who prescribe a high volume of opioids.
``(B) Process.--Not later than January 1, 2021, the
Secretary shall, in consultation with stakeholders, establish
a process under which MA plans and prescription drug plans
shall submit to the Secretary information described in
subparagraph (A).
``(C) Regulations.--For purposes of this paragraph,
including as applied under section 1860D-12(b)(3)(D), the
Secretary shall, pursuant to rulemaking--
``(i) specify a definition for the term `high volume of
opioids' and a method for determining if a provider of
services prescribes such a high volume; and
``(ii) establish the process described in subparagraph (B)
and the types of information that shall be submitted through
such process.''.
(c) Reference Under Part D to Program Integrity
Transparency Measures.--Section 1860D-4 of the Social
Security Act (42 U.S.C. 1395w-104) is amended by adding at
the end the following new subsection:
``(m) Program Integrity Transparency Measures.--For program
integrity transparency measures applied with respect to
prescription drug plan and MA plans, see section 1859(i).''.

SEC. 4. EXPANDING ELIGIBILITY FOR MEDICATION THERAPY
MANAGEMENT PROGRAMS UNDER PART D.

Section 1860D-4(c)(2)(A)(ii) of the Social Security Act (42
U.S.C. 1395w-104(c)(2)(A)(ii)) is amended--
(1) by redesignating subclauses (I) through (III) as items
(aa) through (cc), respectively, and adjusting the margins
accordingly;
(2) by striking ``are part D eligible individuals who--''
and inserting ``are the following:

``(I) Part D eligible individuals who--''; and

(3) by adding at the end the following new subclause:

``(II) Beginning January 1, 2021, at-risk beneficiaries for
prescription drug abuse (as defined in paragraph (5)(C)).''.

SEC. 5. MEDICARE NOTIFICATIONS TO OUTLIER PRESCRIBERS OF
OPIOIDS.

Section 1860D-4(c)(4) of the Social Security Act (42 U.S.C.
1395w-104(c)(4)) is amended by adding at the end the
following new subparagraph:
``(D) Outlier prescriber notification.--
``(i) Notification.--Beginning not later than two years
after the date of the enactment of this subparagraph, the
Secretary shall, in the case of a prescriber identified by
the Secretary under clause (ii) to be an outlier prescriber
of opioids, provide, subject to clause (iv), an annual
notification to such prescriber that such prescriber has been
so identified and that includes resources on proper
prescribing methods and other information specified in
accordance with clause (iii).
``(ii) Identification of outlier prescribers of opioids.--

``(I) In general.--The Secretary shall, subject to
subclause (III), using the valid prescriber National Provider
Identifiers included pursuant to subparagraph (A) on claims
for covered part D drugs for part D eligible individuals
enrolled in prescription drug plans under this part or MA-PD
plans under part C and based on the threshold established
under subclause (II), conduct an analysis to identify
prescribers that are outlier opioid prescribers for a period
specified by the Secretary.
``(II) Establishment of threshold.--For purposes of
subclause (I) and subject to subclause (III), the Secretary
shall, after consultation with stakeholders, establish a
threshold, based on prescriber specialty and geographic area,
for identifying whether a prescriber in a specialty and
geographic area is an outlier prescriber of opioids as
compared to other prescribers of opioids within such
specialty and area.
``(III) Exclusions.--The Secretary may exclude the
following individuals and prescribers from the analysis under
this clause:

``(aa) Individuals receiving hospice services.
``(bb) Individuals with a cancer diagnosis.
``(cc) Prescribers who are the subject of an investigation
by the Centers for Medicare & Medicaid Services or the Office
of Inspector General of the Department of Health and Human
Services.
``(iii) Contents of notification.--The Secretary shall,
based on input from stakeholders, specify the resources and
other information to be included in notifications provided
under clause (i).
``(iv) Modifications and expansions.--

``(I) Frequency.--Beginning 5 years after the date of the
enactment of this subparagraph, the Secretary may change the
frequency of the notifications described in clause (i) based
on stakeholder input.
``(II) Expansion to other prescriptions.--The Secretary may
expand notifications under this subparagraph to include
identifications and notifications with respect to concurrent
prescriptions of covered Part D drugs used in combination
with opioids that are considered to have adverse side effects
when so used in such combination, as determined by the
Secretary.

``(v) Opioids defined.--For purposes of this subparagraph,
the term `opioids' has such meaning as specified by the
Secretary through program instruction or otherwise.''.

SEC. 6. NO ADDITIONAL FUNDS AUTHORIZED.

No additional funds are authorized to be appropriated to
carry out the requirements of this Act and the amendments
made by this Act. Such requirements shall be carried out
using amounts otherwise authorized to be appropriated.

The SPEAKER pro tempore. Pursuant to the rule, the gentleman from
Illinois (Mr. Roskam) and the gentlewoman from California (Ms. Judy
Chu) each will control 20 minutes.

[[Page H5260]]

The Chair recognizes the gentleman from Illinois.

General Leave

Mr. ROSKAM. Madam Speaker, I ask unanimous consent that all Members
may have 5 legislative days within which to revise and extend their
remarks and include extraneous material on H.R. 5773, currently under
consideration.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from Illinois?
There was no objection.
Mr. ROSKAM. Madam Speaker, I yield myself such time as I may consume.
Madam Speaker, I stand in strong support of H.R. 5773, a bipartisan
bill centered on curbing opioid overuse by increasing program integrity
efforts and increasing resources for beneficiaries to help ensure that
they are properly adhering to their prescribed pain medications.
My home State of Illinois is experiencing a notable increase in
opioid-related overdose deaths. According to the Illinois Department of
Public Health, there has been a 44.3 percent increase in drug overdoses
from 2013 to 2016. This staggering statistic is not limited to my
district alone. This crisis has affected all of our districts, and for
some, the four walls of our own homes.
For this reason, Congress is taking action today to continue our work
to deliver solutions to the opioid epidemic that is plaguing far too
many American families.
H.R. 5773, which I have introduced with my colleagues Representatives
Knight, Sewell, and Sinema, packages several previously introduced
bills.
Specifically, H.R. 5773 includes policies under my bill H.R. 5716,
the Commit to Opioid Medical Prescriber Accountability and Safety for
Seniors Act, otherwise known as the COMPASS Act, introduced with
Representative Larson, that ensures prescribers are notified of their
opioid prescribing patterns to help educate them on proper prescribing.
Second, the bill includes H.R. 4841, the Standardizing Electronic
Prior Authorization for Safe Prescribing Act, led by Representatives
Schweikert and Mike Thompson, to standardize electronic prior
authorization to reduce physician burden and ensure medically necessary
access to drugs, like opioids, that have dangerous side effects and
high risk of abuse.
And third, this bill contains policies from H.R. 5715, the
Strengthening Partnerships to Prevent Opioid Abuse Act, led by
Representatives Renacci and Sewell that will establish a portal to
better facilitate communication between plan sponsors and the Medicare
program to prevent opioid overuse and overprescribing.
And finally, the bill contains policies from H.R. 5684, the
Protecting Seniors from Opioid Abuse Act, championed by my colleagues
Mr. Kelly of Pennsylvania and Mr. Thompson of California, which expands
Medication Therapy Management services to those who are at risk of
opioid overuse.
Madam Speaker, I look forward to working with my colleagues to
advance policies like all the bills we have today that will further
prevent opioid overuse and overprescribing, and I reserve the balance
of my time.

House of Representatives,

Committee on Ways and Means,

Washington, DC, June 8, 2018.
Hon. Greg Walden,
Chairman, Committee on Energy and Commerce,
Washington, DC.
Dear Chairman Walden: I write to you regarding several
opioid bills the Committee on Ways and Means ordered
favorably reported to address the opioid epidemic. The
following bills were also referred to the Committee on Energy
and Commerce.
I ask that the Committee on Energy and Commerce waive
formal consideration of the following bills so that they may
proceed expeditiously to the House Floor:
H.R. 5774, Combatting Opioid Abuse for Care in Hospitals
(COACH) Act;
H.R. 5775, Providing Reliable Options for Patients and
Educations Resources (PROPER) Act;
H.R. 5776, Medicare and Opioid Safe Treatment (MOST) Act;
H.R. 5773, Preventing Addiction for Susceptible Seniors
(PASS) Act;
H.R. 5676, Stop Excessive Narcotics in our Retirement
(SENIOR) Communities Protection Act; and
H.R. 5723, Expanding Oversight of Opioid Prescribing and
Payment Act.
I acknowledge that by waiving formal consideration of the
bills, the Committee on Energy and Commerce is in no way
waiving its jurisdiction over the subject matter contained in
those provisions of the bills that fall within your Rule X
jurisdiction. I would support your effort to seek appointment
of an appropriate number of conferees on any House-Senate
conference involving this legislation.
I will include a copy of our letters in the Congressional
Record during consideration of this legislation on the House
floor.
Sincerely,
Kevin Brady,
Chairman.
____

House of Representatives,

Committee on Energy and Commerce,

Washington, DC, June 8, 2018.
Hon. Kevin Brady,
Chairman, Committee on Ways and Means,
Washington, DC.
Dear Chairman Brady: Thank you for your letter regarding
the following bills, which were also referred to the
Committee on Energy and Commerce:
H.R. 5774, Combatting Opioid Abuse for Care in Hospitals
(COACH) Act;
H.R. 5775, Providing Reliable Options for Patients and
Educations Resources (PROPER) Act;
H.R. 5776, Medicare and Opioid Safe Treatment (MOST) Act;
H.R. 5773, Preventing Addiction for Susceptible Seniors
(PASS) Act;
H.R. 5676, Stop Excessive Narcotics in our Retirement
(SENIOR) Communities Protection Act; and
H.R. 5723, Expanding Oversight of Opioid Prescribing and
Payment Act.
I wanted to notify you that the Committee will forgo action
on these bills so that they may proceed expeditiously to the
House floor.
I appreciate your acknowledgment that by forgoing formal
consideration of these bills, the Committee on Energy and
Commerce is in no way waiving its jurisdiction over the
subject matter contained in those provisions of the bills
that fall within its Rule X jurisdiction. I also appreciate
your offer to support the Committee's request for the
appointment of conferees in the event of a House-Senate
conference involving this legislation.
Thank you for your assistance on this matter.
Sincerely,
Greg Walden,
Chairman.

Ms. JUDY CHU of California. Madam Speaker, I yield myself such time
as I may consume.
Madam Speaker, I am pleased to support H.R. 5773, the PASS Act,
introduced by Congress Members Sewell and Roskam.
This bill focuses on policies to help Medicare plans prevent opioid
use in the Medicare program without limiting access to needed
medications for our seniors.
First, H.R. 5773 requires that Medicare prescription drug plans
establish mandatory lock-in programs for seniors who are at risk of
opioid overuse.

{time} 1615

These programs curb fraud, abuse, and misuse of prescribed
medications, while at the same time ensuring that seniors who have
legitimate need of these medications can access them.
For example, these controls prevent doctor and pharmacy shopping and
will prevent duplicative and medically inappropriate drug therapies
that can lead to prescription drug abuse. This bill would also require
that any beneficiaries who are at risk for opioid overuse be eligible
for the benefits provided under the Medication Therapy Management
Program.
This program helps patients understand all of their medications and
how they are working together. It allows a pharmacist or other health
professional to give beneficiaries a comprehensive review of all of
their medications and talk to them about any interactions, risks, or
side effects.
This bill would also include a provision introduced by
Representatives Mike Thompson and David Schweikert that would
streamline the electronic prior authorization system, which is meant to
ensure that certain drugs are covered by an insurer before the drug is
dispensed.
The PASS Act also includes a provision introduced by Representatives
Sewell and Renacci which streamlines communications between the Center
for Medicare and Medicaid Services and Medicare part C and D plans
regarding program integrity.
Finally, H.R. 5773 would direct the Secretary of the Department of
Health and Human Services to annually notify Medicare part D
prescribers who are identified as outlier prescribers compared to their
colleagues in their specialty and region. This has certain exclusions,
for example, patients receiving hospice care, but will be used to help
prescribers, who may not realize

[[Page H5261]]

that they are an outlier, to reevaluate their practices and make
adjustments before any harm is done.
I encourage my colleagues to support this legislation, and I reserve
the balance of my time.
Mr. ROSKAM. Madam Speaker, I yield 3 minutes to the gentleman from
Pennsylvania (Mr. Kelly).
Mr. KELLY of Pennsylvania. Madam Speaker, I thank Mr. Roskam so much
for his time.
Madam Speaker, this opioid epidemic is killing 116 people of all ages
every day, and it is horribly impacting western Pennsylvania's families
and communities. There isn't a silver bullet to end the suffering. It
is going to take communities working together to treat addiction and
find lasting methods of prevention.
I am proud of the work that we have done in the people's House to put
forward quality, bipartisan solutions to provide better alternatives
and treatment for all Americans.
I want to thank Chairman Roskam for including my legislation, H.R.
5684, the Protecting Seniors from Opioid Abuse Act, into this package.
This bipartisan bill with my colleagues, Mr. Thompson, Mrs. McMorris
Rodgers, and Mr. Doyle, will help at-risk seniors manage their
medications and avoid prescription drug abuse. This bill gives seniors
who are at risk for prescription abuse access to the Medication Therapy
Management Program. This successful program allows seniors to sit down
with a pharmacist or other health professional and receive expert
advice on how to best manage their prescriptions.
I think for most of us, when you go to pick up your prescriptions,
oftentimes you are asked: Do you want us to sit down and go over this
with you? Oftentimes, there is a line behind you. Or they say: You can
just check the box here and go ahead and pick up your prescription.
That is not the answer to what we are trying to do.
With the Medication Therapy Management Program, we actually sit down
with the seniors and explain the interaction between some of the drugs
that they are taking and some of the drugs that have been prescribed
for them. So it is critical that they have access to this information.
The Center for Medicare and Medicaid Services has already confirmed
that this approach works. To reduce opioid overuse and to avoid
dangerous drug interactions, expanding access to medication therapy
management for at-risk beneficiaries will ensure that these serious
drugs are used properly before it is too late.
This epidemic is devastating our Nation's communities and our
families. I hope that we continue to work together as a unified
Congress to fight this deadly crisis. I appreciate the chairman's time,
and I urge support of this bill.
Ms. JUDY CHU of California. Madam Speaker, I yield myself the balance
of my time.
Our country is truly facing a crisis when it comes to opioids, and
the Medicare population isn't immune from this. We must be careful in
our approach and ensure that the policies we enact in Congress don't
leave out those who have a legitimate medical need for these
medications, like those with cancer, those in hospice, or those with
genetic conditions like sickle cell disease.
H.R. 5773 is a modest step in the right direction, and I look forward
to continuing to work with my colleagues on ways to address the opioid
crisis within the Medicare program.
Madam Speaker, I urge my colleagues to support this bill, and I yield
back the balance of my time.
Mr. ROSKAM. Madam Speaker, I yield myself the balance of my time.
Madam Speaker, I have spent a lot of time, as I know we all have,
listening to my own constituency, the west and northwest suburbs of
Chicago. I have listened to physicians, police chiefs, educators,
caregivers, and others, and I have heard a common theme, and the common
theme is: We need legislation that encourages the use of alternative
treatments, that increases provider education and assists with
detection of those who are at risk. The Preventing Addiction for
Susceptible Seniors, PASS Act, will help do this.
I would like to thank my colleagues on the Ways and Means Committee
for working together in a bipartisan effort by recognizing this crisis
and coming together in offering this solution. I would also like to
thank our colleagues on the Energy and Commerce Committee for their
commitment to working on this, particularly my counterpart who chairs
the Health Subcommittee, Dr. Burgess, and Chairman Walden as well.
This bill was brought through the committee process in a bipartisan
fashion, and now, on the floor, I strongly urge my colleagues on both
sides of the aisle to vote in favor of H.R. 5773, the PASS Act, to
prevent overuse and overprescribing in the Medicare program.
Mr. Speaker, I yield back the balance of my time.
Mr. RENACCI. Mr. Speaker, I rise today in support of H.R. 5773, which
includes a bill I introduced called the Strengthening Partnerships to
Prevent Opioid Abuse Act.
My home state of Ohio has been at the center of the opioid epidemic
for years. Too many Ohio families have had their lives shattered by
this crisis. The most recent statistics show that nearly 5,200 people
died from an opioid overdose in 2017. In my district, multiple counties
have seen sharp increases in overdoses and their largest number of
annual deaths ever. While Ohio is only the 7th largest state by
population, it ranks second in opioid deaths per-capita.
Unlike other drug epidemics, the opioid epidemic is well-known for
its prevalence among older populations. This should be no surprise. In
fact, one out of every three Medicare beneficiaries is prescribed
opioids each year, and 500,000 beneficiaries were prescribed amounts
that are considered dangerous according to the CDC. I find it deeply
troubling that a program meant to help seniors with their medications
may be an avenue to addiction for some.
My bipartisan bill would create an online information-sharing system
through which the Medicare program can partner with Medicare Advantage
and Part D drug plans to identify cases in which seniors are being
overprescribed and providers are engaging in fraud, waste, and abuse.
Currently, neither of these parties knows exactly what the others are
doing, which hampers each's ability to adequately address the opioid
epidemic and issues related to overprescribing and drug diversion.
By strengthening the partnerships between these actors and requiring
information from plan sponsors on the actions they take against
providers who are overprescribing or engaging in fraud and abuse, we
will be better poised to prevent addiction among America's seniors.
On behalf of the more than 7,000 Ohioans who have died of
prescription opioid overdoses since 2006, and the hundreds of thousands
of Medicare beneficiaries being overprescribed today, I encourage my
colleagues to support H.R. 5773 and help us combat this devastating
epidemic.
The SPEAKER pro tempore (Mr. Francis Rooney of Florida). The question
is on the motion offered by the gentleman from Illinois (Mr. Roskam)
that the House suspend the rules and pass the bill, H.R. 5773, as
amended.
The question was taken; and (two-thirds being in the affirmative) the
rules were suspended and the bill, as amended, was passed.
The title of the bill was amended so as to read: ``A bill to amend
title XVIII of the Social Security Act to require electronic prior
authorization for covered part D drugs and to provide for other program
integrity measures under parts C and D of the Medicare program.''.
A motion to reconsider was laid on the table.

____________________