H.R. 5676House115th Congress (2017-2019)Passed House

SENIOR Communities Protection Act of 2018

Introduced May 3, 2018

AI-Generated Summary

Updated April 15, 2026 at 9:39 PM UTC

The Senior Communities Protection Act of 2018 changes the Social Security Act so that Medicare prescription drug plans and Medicare Advantage Prescription Drug (MA‑PD) plans can stop paying pharmacies while a credible fraud investigation is under way. The rule is meant to protect Medicare funds from suspected pharmacy fraud, especially in senior living settings, and it takes effect for plan years beginning on or after January 1 2020.

Key Provisions

  • Adds a new paragraph allowing Medicare prescription drug plans (PDPs) and MA‑PD plans to suspend payments to a pharmacy when there are credible fraud allegations.
  • Specifies that the existing post‑payment review authority of PDP sponsors remains unchanged.
  • Extends the suspension authority to MA‑PD plans by referencing the new PDP provision.
  • Clarifies that a fraud‑hotline tip alone does not constitute a "credible allegation of fraud" without additional evidence.
  • Sets the effective date of these changes to plan years starting on or after January 1 2020.

Legislative Activity

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14 earlier actions
SenateIntro Referral Latest Action

Received in the Senate and Read twice and referred to the Committee on Finance.

June 20, 2018

View full timeline
HouseIntro Referral

Introduced in House

May 3, 2018

HouseIntro Referral

Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.

May 3, 2018

HouseCommittee

Referred to the Subcommittee on Health.

May 16, 2018

HouseCommittee

Committee Consideration and Mark-up Session Held.

May 16, 2018

HouseCommittee

Ordered to be Reported (Amended) by Voice Vote.

May 16, 2018

HouseCommittee

Reported (Amended) by the Committee on Ways and Means. H. Rept. 115-759, Part I.

June 19, 2018

HouseFloor

Mr. Roskam moved to suspend the rules and pass the bill, as amended.

June 19, 2018 • 4:21 PM

HouseFloor

Considered under suspension of the rules. (consideration: CR H5261-5264)

June 19, 2018 • 4:22 PM

HouseFloor

DEBATE - The House proceeded with forty minutes of debate on H.R. 5676.

June 19, 2018 • 4:22 PM

HouseFloor

At the conclusion of debate, the Yeas and Nays were demanded and ordered. Pursuant to the provisions of clause 8, rule XX, the Chair announced that further proceedings on the motion would be postponed.

June 19, 2018 • 4:36 PM

HouseFloor

Considered as unfinished business. (consideration: CR H5272)

June 19, 2018 • 6:59 PM

HouseFloor

Passed/agreed to in House: On motion to suspend the rules and pass the bill, as amended Agreed to by the Yeas and Nays: (2/3 required): 356 - 3 (Roll no. 270).(text: CR H5261-5262)

June 19, 2018 • 7:06 PM

HouseFloor

On motion to suspend the rules and pass the bill, as amended Agreed to by the Yeas and Nays: (2/3 required): 356 - 3 (Roll no. 270). (text: CR H5261-5262)

June 19, 2018 • 7:06 PM

HouseFloor

Motion to reconsider laid on the table Agreed to without objection.

June 19, 2018 • 7:06 PM

SenateIntro Referral

Received in the Senate and Read twice and referred to the Committee on Finance.

June 20, 2018

Floor Debate

14 members

What members said about H.R. 5676 on the floor

8 Republicans6 Democrats
Judy Chu
Rep. Judy ChuD-CA-27 · Jun 19, 2018

Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, according to the Centers for Disease Control and Prevention, more than 42,000 Americans died from opioid-related drug overdoses in…

Peter J. Roskam
Rep. Peter J. RoskamR-IL-6 · Jun 19, 2018

Mr. Speaker, I move to suspend the rules and pass the bill (H.R. 5676) to amend title XVIII of the Social Security Act to authorize the suspension of payments by Medicare prescription drug plans and…

Jackie Walorski
Rep. Jackie WalorskiR-IN-2 · Jun 19, 2018

Mr. Speaker, I move to suspend the rules and pass the bill (H.R. 6110) to amend title XVIII of the Social Security Act to provide for the review and adjustment of payments under the Medicare…

Peter J. Roskam
Rep. Peter J. RoskamR-IL-6 · Jun 19, 2018

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…

Carlos Curbelo
Rep. Carlos CurbeloR-FL-26 · Jun 19, 2018

Mr. Speaker, I move to suspend the rules and pass the bill (H.R. 5775) to amend title XVIII of the Social Security Act to require Medicare Advantage plans and part D prescription drug plans to…

Show 8 more
Peter J. Roskam
Rep. Peter J. RoskamR-IL-6 · Jun 19, 2018

Mr. Speaker, I move to suspend the rules and pass the bill (H.R. 5723) to require the Medicare Payment Advisory Commission to report on opioid payment, adverse incentives, and data under the Medicare…

Jackie Walorski
Rep. Jackie WalorskiR-IN-2 · Jun 19, 2018

Mr. Speaker, I move to suspend the rules and pass the bill (H.R. 5774) to require the Secretary of Health and Human Services to develop guidance on pain management and opioid use disorder prevention…

Thomas MacArthur
Rep. Thomas MacArthurR-NJ-3 · Jun 19, 2018

Mr. Speaker, I thank my friend for yielding. As co-chair of the Bipartisan Heroin Task Force, I have spent a lot of my time working on this opioid crisis. Congress must do everything we can to ensure…

Judy Chu
Rep. Judy ChuD-CA-27 · Jun 19, 2018

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…

Claudia Tenney
Rep. Claudia TenneyR-NY-22 · Jun 19, 2018

Mr. Speaker, I want to thank the gentleman for yielding so much time to me in favor of this legislation that I coauthored with my colleague, Ms. DelBene, on this bipartisan piece, H.R. 5723, the…

Judy Chu
Rep. Judy ChuD-CA-27 · Jun 19, 2018

Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, I am pleased to support H.R. 5723, the Expanding Oversight of Opioid Prescribing and Payment Act. As I mentioned earlier, 80…

Judy Chu
Rep. Judy ChuD-CA-27 · Jun 19, 2018

Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, I am pleased to support H.R. 5676, the SENIOR Communities Protection Act. The Affordable Care Act granted the Department of Health…

Judy Chu
Rep. Judy ChuD-CA-27 · Jun 19, 2018

Madam Speaker, I yield myself such time as I may consume. Madam Speaker, I offer my support of H.R. 5775, the PROPER Act. This bill, introduced by my colleagues Representatives Paulsen and Kind,…

Show 9 more
Judy Chu
Rep. Judy ChuD-CA-27 · Jun 19, 2018

Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, I offer my support for H.R. 5774, the COACH Act, which was introduced by Congress Members DelBene and Curbelo. This bill focuses…

Mike Kelly
Rep. Mike KellyR-PA-3 · Jun 19, 2018

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…

James B. Renacci
Rep. James B. RenacciR-OH-16 · Jun 19, 2018

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…

Earl Blumenauer
Rep. Earl BlumenauerD-OR-3 · Jun 21, 2018

Mr. Speaker, had I been present for the vote on H.R. 5687--the SOUND Disposal and Packaging Act (Roll Call No. 269), I would have voted ``aye.'' This bill would require the Federal Food, Drug, and…

David E. Price
Rep. David E. PriceD-NC-4 · Jun 20, 2018

Mr. Speaker, due to adverse weather and numerous flight delays and cancellations in North Carolina, I was unable to vote yesterday during Roll Call 269, the motion to suspend the rules and pass as…

Gene Green
Rep. Gene GreenD-TX-29 · Jun 20, 2018

Mr. Speaker, I was unable to vote on Tuesday, June 19, 2018, due to cancellations and delays to my scheduled return flights to Washington. If I had been able to vote, I would have voted as follows:…

Terri A. Sewell
Rep. Terri A. SewellD-AL-7 · Jun 19, 2018

Mr. Speaker, during the votes held on June 19, 2018, I was inescapably detained and away handling important matters related to my District and the State of Alabama. If I had been present I would have…

Al Green
Rep. Al GreenD-TX-9 · Jun 21, 2018

Mr. Speaker, on Tuesday, June 19, 2018, I missed votes. Had I been present, I would have voted in the following manner: on H.R. 5687--SOUND Disposal and Packaging Act, I would have voted ``YES'' on…

John R. Moolenaar
Rep. John R. MoolenaarR-MI-4 · Jun 19, 2018

Mr. Speaker, I was unavoidably detained. Had I been present, I would have voted ``yea'' on rollcall No. 270.

Bill Text

3 versions available

Reading Mode
Latest
Referred in SenateIssued June 20, 2018

IIB

115th CONGRESS

2d Session

H. R. 5676

IN THE SENATE OF THE UNITED STATES

June 20, 2018

Received; read twice and referred to the Committee on Finance

AN ACT

To amend title XVIII of the Social Security Act to authorize the suspension of payments by Medicare prescription drug plans and MA–PD plans pending investigations of credible allegations of fraud by pharmacies.

1.

Short title

This Act may be cited as the Stop Excessive Narcotics in our Retirement Communities Protection Act of 2018 or the SENIOR Communities Protection Act of 2018.

2.

Suspension of payments by Medicare prescription drug plans and MA–PD plans pending investigations of credible allegations of fraud by pharmacies

(a)

In general

Section 1860D–12(b) of the Social Security Act (42 U.S.C. 1395w–112(b)) is amended by adding at the end the following new paragraph:

(7)

Suspension of payments pending investigation of credible allegations of fraud by pharmacies

(A)

In general

The provisions of section 1862(o) shall apply with respect to a PDP sponsor with a contract under this part, a pharmacy, and payments to such pharmacy under this part in the same manner as such provisions apply with respect to the Secretary, a provider of services or supplier, and payments to such provider of services or supplier under this title.

(B)

Rule of construction

Nothing in this paragraph shall be construed as limiting the authority of a PDP sponsor to conduct postpayment review.

.

(b)

Application to MA–PD plans

Section 1857(f)(3) of the Social Security Act (42 U.S.C. 1395w–27(f)(3)) is amended by adding at the end the following new subparagraph:

(D)

Suspension of payments pending investigation of credible allegations of fraud by pharmacies

Section 1860D–12(b)(7).

.

(c)

Conforming amendment

Section 1862(o)(3) of the Social Security Act (42 U.S.C. 1395y(o)(3)) is amended by inserting , section 1860D–12(b)(7) (including as applied pursuant to section 1857(f)(3)(D)), after this subsection.

(d)

Clarification relating to credible allegation of fraud

Section 1862(o) of the Social Security Act (42 U.S.C. 1395y(o)) is amended by adding at the end the following new paragraph:

(4)

Credible allegation of fraud

In carrying out this subsection, section 1860D–12(b)(7) (including as applied pursuant to section 1857(f)(3)(D)), and section 1903(i)(2)(C), a fraud hotline tip (as defined by the Secretary) without further evidence shall not be treated as sufficient evidence for a credible allegation of fraud.

.

(e)

Effective date

The amendments made by this section shall apply with respect to plan years beginning on or after January 1, 2020.

Passed the House of Representatives June 19, 2018.

Karen L. Haas,

Clerk