; 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)). . 6065. 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 2 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