Providing Reliable Options for Patients and Educational Resources Act of 2018

Summary: 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. 

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 2-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)(aa) 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.
    ``(bb) The Secretary shall not include on the Hospital Compare 
Internet website any measures based on the questions appearing on the 
Hospital Consumer Assessment of Healthcare Providers and Systems survey 
in 2018 about communication by hospital staff with an individual about 
such individual's pain.''.
    (b) Restriction on Use of 2018 Pain Questions in the Hospital 
Value-based Purchasing Program.--Section 1886(o)(2)(B) of the Social 
Security Act (42 U.S.C. 1395ww(o)(2)(B)) is amended by adding at the 
end the following new clause:
                            ``(iii) HCAHPS pain questions.--The 
                        Secretary may not include under subparagraph 
                        (A) a measure that is based on the questions 
                        appearing on the Hospital Consumer Assessment 
                        of Healthcare Providers and Systems survey in 
                        2018 about


              

                         communication by hospital staff with an 
                        individual about the individual's pain.''.

            Passed the House of Representatives June 19, 2018.

            Attest:

                                                 KAREN L. HAAS,

                                                                 Clerk.