Providing Reliable Options for Patients and Educational Resources Act of 2018 or the PROPER Act of 2018
(Sec. 2) This bill requires Medicare and Medicare Advantage (MA) prescription drug plan (PDP) sponsors to annually disclose information to enrollees about: (1) the risks of prolonged opioid use; and (2) the plan's coverage of nonpharmacological therapies, devices, and non-opioid medications. PDP sponsors may limit disclosure to a subset of enrollees (such as those who were prescribed an opioid in the previous two-year period).
(Sec. 3) The bill also requires Medicare medication therapy management programs and MA in-home health risk assessments to include information about the safe disposal of prescription drugs.
(Sec. 4) The bill prohibits inclusion of pain management questions in certain health care system surveys, unless the questions address the risks of opioid use and the availability of non-opioid alternatives.
[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5775 Introduced in House (IH)]
<DOC>
115th CONGRESS
2d Session
H. R. 5775
To amend title XVIII of the Social Security Act to require Medicare
Advantage plans and part D prescription drug plans to include
information on the risks associated with opioids, coverage of certain
nonopioid treatments used to treat pain, and on the safe disposal of
prescription drugs, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
May 11, 2018
Mr. Paulsen (for himself, Mr. Poliquin, Mr. Kind, and Mr. Lamb)
introduced the following bill; which was referred to the Committee on
Ways and Means, and in addition to the Committee on Energy and
Commerce, 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
_______________________________________________________________________
A BILL
To amend title XVIII of the Social Security Act to require Medicare
Advantage plans and part D prescription drug plans to include
information on the risks associated with opioids, coverage of certain
nonopioid treatments used to treat pain, and on the safe disposal of
prescription drugs, and for other purposes.
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 ``Providing Reliable Options for
Patients and Educational Resources Act of 2018'' or the ``PROPER Act of
2018''.
SEC. 2. REQUIRING MEDICARE ADVANTAGE PLANS AND PART D PRESCRIPTION DRUG
PLANS TO INCLUDE INFORMATION ON RISKS ASSOCIATED WITH
OPIOIDS AND COVERAGE OF NONPHARMACOLOGICAL THERAPIES AND
NONOPIOID MEDICATIONS OR DEVICES USED TO TREAT PAIN.
Section 1860D-4(a)(1) of the Social Security Act (42 U.S.C. 1395w-
104(a)(1)) is amended--
(1) in subparagraph (A), by inserting ``, subject to
subparagraph (C),'' before ``including'';
(2) in subparagraph (B), by adding at the end the following
new clause:
``(vi) For plan year 2021 and each
subsequent plan year, subject to subparagraph
(C), with respect to the treatment of pain--
``(I) the risks associated with
prolonged opioid use; and
``(II) coverage of
nonpharmacological therapies, devices,
and nonopioid medications--
``(aa) in the case of an
MA-PD plan under part C, under
such plan; and
``(bb) in the case of a
prescription drug plan, under
such plan and under parts A and
B.''; and
(3) by adding at the end the following new subparagraph:
``(C) Targeted provision of information.--A PDP
sponsor of a prescription drug plan may, in lieu of
disclosing the information described in subparagraph
(B)(vi) to each enrollee under the plan, disclose such
information through mail or electronic communications
to a subset of enrollees under the plan, such as
enrollees who have been prescribed an opioid in the
previous two-year period.''.
SEC. 3. REQUIRING MEDICARE ADVANTAGE PLANS AND PRESCRIPTION DRUG PLANS
TO PROVIDE INFORMATION ON THE SAFE DISPOSAL OF
PRESCRIPTION DRUGS.
(a) Medicare Advantage.--Section 1852 of the Social Security Act
(42 U.S.C. 1395w-22) is amended by adding at the end the following new
subsection:
``(n) Provision of Information Relating to the Safe Disposal of
Certain Prescription Drugs.--
``(1) In general.--In the case of an individual enrolled
under an MA or MA-PD plan who is furnished an in-home health
risk assessment on or after January 1, 2021, such plan shall
ensure that such assessment includes information on the safe
disposal of prescription drugs that are controlled substances
that meets the criteria established under paragraph (2). Such
information shall include information on drug takeback programs
that meet such requirements determined appropriate by the
Secretary and information on in-home disposal.
``(2) Criteria.--The Secretary shall, through rulemaking,
establish criteria the Secretary determines appropriate with
respect to information provided to an individual to ensure that
such information sufficiently educates such individual on the
safe disposal of prescription drugs that are controlled
substances.''.
(b) Prescription Drug Plans.--Section 1860D-4(c)(2)(B) of the
Social Security Act (42 U.S.C. 1395w-104(c)(2)(B)) is amended--
(1) by striking ``may include elements that promote'';
(2) by redesignating clauses (i) through (iii) as
subclauses (I) through (III) and adjusting the margins
accordingly;
(3) by inserting before subclause (I), as so redesignated,
the following new clause:
``(i) may include elements that promote--
'';
(4) in subclause (III), as so redesignated, by striking the
period at the end and inserting ``; and''; and
(5) by adding at the end the following new clause:
``(ii) with respect to plan years beginning
on or after January 1, 2021, shall provide
for--
``(I) the provision of information
to the enrollee on the safe disposal of
prescription drugs that are controlled
substances that meets the criteria
established under section 1852(n)(2),
including information on drug takeback
programs that meet such requirements
determined appropriate by the Secretary
and information on in-home disposal;
and
``(II) cost-effective means by
which an enrollee may so safely dispose
of such drugs.''.
SEC. 4. REVISING MEASURES USED UNDER THE HOSPITAL CONSUMER ASSESSMENT
OF HEALTHCARE PROVIDERS AND SYSTEMS SURVEY RELATING TO
PAIN MANAGEMENT.
(a) Restriction on the Use of Pain Questions in HCAHPS.--Section
1886(b)(3)(B)(viii) of the Social Security Act (42 U.S.C.
1395ww(b)(3)(B)(viii)) is amended by adding at the end the following
new subclause:
``(XII) With respect to a Hospital Consumer Assessment of
Healthcare Providers and Systems survey (or a successor survey)
conducted on or after January 1, 2019, such survey may not include
questions about communication by hospital staff with an individual
about such individual's pain unless such questions take into account,
as applicable, whether an individual experiencing pain was informed
about risks associated with the use of opioids and about non-opioid
alternatives for the treatment of pain.''.
(b) Restriction on Use of Pain Questions in the Hospital Value-
Based Purchasing Program for Fiscal Year 2019.--Section 1886(o)(2)(B)
is amended by adding at the end the following new clause:
``(iii) For fiscal year 2019.--For value-
based incentive payments made with respect to
discharges occurring during fiscal year 2019,
the Secretary shall ensure that measures
selected under subparagraph (A) do not include
a measure based on questions about
communication by hospital staff with an
individual about such individual's pain
included in the Hospital Consumer Assessment of
Healthcare Providers and Systems survey.''.
<all>
Introduced in House
Introduced in House
Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, 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.
Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, 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.
Committee Consideration and Mark-up Session Held.
Ordered to be Reported (Amended) by Voice Vote.
Referred to the Subcommittee on Health.
Reported (Amended) by the Committee on Ways and Means. H. Rept. 115-763, Part I.
Reported (Amended) by the Committee on Ways and Means. H. Rept. 115-763, Part I.
Committee on Energy and Commerce discharged.
Committee on Energy and Commerce discharged.
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Placed on the Union Calendar, Calendar No. 594.
Mr. Curbelo (FL) moved to suspend the rules and pass the bill, as amended.
Considered under suspension of the rules. (consideration: CR H5256-5258)
DEBATE - The House proceeded with forty minutes of debate on H.R. 5775.
Passed/agreed to in House: On motion to suspend the rules and pass the bill, as amended Agreed to by voice vote.(text: CR H5256-5257)
On motion to suspend the rules and pass the bill, as amended Agreed to by voice vote. (text: CR H5256-5257)
Motion to reconsider laid on the table Agreed to without objection.
Received in the Senate and Read twice and referred to the Committee on Finance.