To reduce the cost of providing federally funded prescription drugs by eliminating fraudulent payments and prohibiting coverage of Viagra for child molesters and rapists and for drugs intended to induce abortion.

SA 3556. Mr. COBURN submitted an amendment intended to be proposed by
him to the bill H.R. 4872, to provide for reconciliation pursuant to
Title II of the concurrent resolution on the budget for fiscal year
2010 (S. Con. Res. 13); which was ordered to lie on the table; as
follows:

At the end of subtitle D of title I, add the following:

SEC. 1306. REDUCING HEALTH CARE COSTS BY ELIMINATING PAYMENTS
FOR FRAUDULENT CLAIMS AND PROHIBITING COVERAGE
FOR ABORTION DRUGS AND ERECTILE DYSFUNCTION
DRUGS FOR RAPISTS AND CHILD MOLESTERS.

(a) Eliminating Fraudulent Payments for Prescription
Drugs.--The Secretary shall establish a fraud prevention
system and issue guidance to--
(1) prevent the processing of claims of prescribing
providers and dispensing pharmacies debarred from Federal
contracts or excluded from the Medicare program under title
XVIII of the Social Security Act (42 U.S.C. 1395 et seq.) or
the Medicaid program under title XIX of such Act (42 U.S.C.
1396 et seq.);
(2) ensure that drug utilization reviews and restricted
recipient program requirements adequately identify and
prevent doctor shopping and other abuses of controlled
substances;
(3) develop a claims processing system to identify
duplicate enrollments and deaths of Medicaid beneficiaries
and prevent the approval of fraudulent claims; and
(4) develop a claims processing systems to identify deaths
of Medicaid providers and prevent the approval of fraudulent
claims filed using the identity of such providers.
(b) Prohibiting Coverage of Certain Prescription Drugs.--
(1) In general.--Health programs administered by the
Federal Government and American Health Benefit Exchanges (as
described in section 1311 of the Patient Protection and
Affordable Care Act) shall not provide coverage or
reimbursement for--
(A) prescription drugs to treat erectile dysfunction for
individuals convicted of child molestation, rape, or other
forms of sexual assault; or
(B) drugs prescribed with the intent of inducing an
abortion for reasons other than as described in paragraph
(2).
(2) Exceptions.--The limitation under paragraph (1)(B)
shall not apply to an abortion--
(A) in the case where a woman suffers from a physical
disorder, physical injury, or physical illness that would, as
certified by a physician, place the woman in danger of death
unless an abortion is performed, including a life-endangering
physical condition caused by or arising from the pregnancy
itself; or
(B) if the pregnancy is the result of an act of forcible
rape or incest.
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