I 

115TH CONGRESS 

2D SESSION H. R. 5718 

To provide for a technical expert panel to provide recommendations on reducing opioid use in the surgical setting and on best practices for pain 

management, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

MAY 9, 2018 

Mr. SMITH of Missouri (for himself and Mr. HIGGINS of New York) introduced the following bill; which was 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 

A BILL 

To provide for a technical expert panel to provide recommendations on reducing opioid use in the surgical 

setting and on best practices for pain management, and 

for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Perioperative Reduc5 tion of Opioids Act’’ or the ‘‘PRO Act’’. 


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1 SEC. 2. TECHNICAL EXPERT PANEL ON REDUCING SUR2 GICAL SETTING OPIOID USE; DATA COLLEC3 TION ON PERIOPERATIVE OPIOID USE. 

4 (a) TECHNICAL EXPERT PANEL ON REDUCING SUR5 GICAL SETTING OPIOID USE.— 

6 (1) IN GENERAL.—Not later than 6 months 

7 after the date of the enactment of this Act, the Sec8 retary of Health and Human Services shall convene 

9 a technical expert panel, including medical and sur10 gical specialty societies, to provide recommendations 

11 on reducing opioid use in the inpatient and out12 patient surgical settings and on best practices for 

13 pain management, including with respect to the fol14 lowing: 

15 (A) Approaches that limit patient exposure 

16 to opioids during the perioperative period, in17 cluding pre-surgical and post-surgical injec18 tions. 

19 (B) Shared decisionmaking with patients 

20 and families on pain management, including 

21 recommendations for the development of an 

22 evaluation and management code for purposes 

23 of payment under the Medicare program under 

24 title XVIII of the Social Security Act that 

25 would account for time spent on shared deci26 sionmaking. 


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1 (C) Education on the safe use, storage, 

2 and disposal of opioids. 

3 (D) Prevention of opioid misuse and abuse 

4 after discharge. 

5 (E) Development of a clinical algorithm to 

6 treat opiate tolerant patients and reduce reli7 ance on opiates for acute pain during the 

8 perioperative period. 

9 (2) REPORT.—Not later than 1 year after the 

10 date of the enactment of this Act, the Secretary 

11 shall submit to Congress and make public a report 

12 containing the recommendations developed under 

13 paragraph (1) and recommendations for broader im14 plementation of pain management protocols that 

15 limit the use of opioids in the perioperative setting 

16 and upon discharge from such setting. 

17 (b) DATA COLLECTION ON PERIOPERATIVE OPIOID

18 USE.—Not later than 1 year after the date of the enact19 ment of this Act, the Secretary of Health and Human 

20 Services shall submit to Congress a report that contains 

21 the following: 

22 (1) The diagnosis-related group codes identified 

23 by the Secretary as having the highest volume of 

24 surgeries. 


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1 (2) With respect to each of such diagnosis-re2 lated group codes so identified, a determination by 

3 the Secretary of the data that is both available and 

4 reported on opioid use following such surgeries, such 

5 as with respect to— 

6 (A) surgical volumes, practices, and opioid 

7 prescribing patterns; 

8 (B) opioid consumption, including— 

9 (i) perioperative days of therapy; 

10 (ii) average daily dose at hospital, in11 cluding high dosage greater than 90 milli12 gram morphine equivalent; 

13 (iii) post-discharge prescriptions and 

14 other combination drugs that are used be15 fore intervention and after intervention; 

16 (iv) quantity and duration of opioid 

17 prescription at discharge; and 

18 (v) quantity consumed and number of 

19 refills; 

20 (C) regional anesthesia and analgesia prac21 tices, including pre-surgical and post-surgical 

22 injections; 

23 (D) naloxone reversal; 

24 (E) post-operative respiratory failure; 


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1 (F) information about storage and dis2 posal; and 

3 (G) such other information as the Sec4 retary may specify. 

5 (3) Recommendations for improving data collec6 tion on perioperative opioid use, including an anal7 ysis to identify barriers to collecting, reporting, and 

8 analyzing the data described in paragraph (2), in9 cluding barriers related to technological availability. 

Æ 


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