IB 

Union Calendar No. 574 

115TH CONGRESS 

2D SESSION H. R. 5716 

[Report No. 115–740, Part I] 

To amend title XVIII of the Social Security Act to require the Secretary 

of Health and Human Services to provide notifications under the Medicare program to outlier prescribers of opioids. 

IN THE HOUSE OF REPRESENTATIVES 

MAY 9, 2018 

Mr. ROSKAM (for himself, Mr. LARSON of Connecticut, Mrs. BROOKS of Indiana, and Mr. WELCH) 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 

JUNE 12, 2018 

Additional sponsors: Mrs. BLACKBURN and Mr. WALDEN

JUNE 12, 2018 

Reported from the Committee on Energy and Commerce 

JUNE 12, 2018 

The Committee on Ways and Means discharged; committed to the Committee 

of the Whole House on the State of the Union and ordered to be printed 


pbinns on DSK79D2C42PROD with BILLS
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•HR 5716 RH

A BILL 

To amend title XVIII of the Social Security Act to require 

the Secretary of Health and Human Services to provide 

notifications under the Medicare program to outlier prescribers of opioids. 


pbinns on DSK79D2C42PROD with BILLS
3 

•HR 5716 RH

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 ‘‘Commit to Opioid 

5 Medical Prescriber Accountability and Safety for Seniors 

6 Act’’ or the ‘‘COMPASS Act’’. 

7 SEC. 2. MEDICARE NOTIFICATIONS TO OUTLIER PRE8 SCRIBERS OF OPIOIDS. 

9 Section 1860D–4(c)(4) of the Social Security Act (42 

10 U.S.C. 1395w–104(c)(4)) is amended by adding at the end 

11 the following new paragraph: 

12 ‘‘(D) OUTLIER PRESCRIBER NOTIFICA13 TION.— 

14 ‘‘(i) NOTIFICATION.—Beginning not 

15 later than two years after the date of the 

16 enactment of this subparagraph, the Sec17 retary shall, in the case of a prescriber 

18 identified by the Secretary under clause 

19 (ii) to be an outlier prescriber of opioids, 

20 provide, subject to clause (iv), an annual 

21 notification to such prescriber that such 

22 prescriber has been so identified and that 

23 includes resources on proper prescribing 

24 methods and other information specified in 

25 accordance with clause (iii). 


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•HR 5716 RH

1 ‘‘(ii) IDENTIFICATION OF OUTLIER

2 PRESCRIBERS OF OPIOIDS.— 

3 ‘‘(I) IN GENERAL.—The Sec4 retary shall, subject to subclause (III), 

5 using the valid prescriber National 

6 Provider Identifiers included pursuant 

7 to subparagraph (A) on claims for 

8 covered part D drugs for part D eligi9 ble individuals enrolled in prescription 

10 drug plans under this part or MA–PD 

11 plans under part C and based on the 

12 threshold established under subclause 

13 (II), conduct an analysis to identify 

14 prescribers that are outlier opioid pre15 scribers for a period specified by the 

16 Secretary. 

17 ‘‘(II) ESTABLISHMENT OF

18 THRESHOLD.—For purposes of sub19 clause (I) and subject to subclause 

20 (III), the Secretary shall, after con21 sultation with stakeholders, establish 

22 a threshold, based on prescriber spe23 cialty and geographic area, for identi24 fying whether a prescriber in a spe25 cialty and geographic area is an 


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•HR 5716 RH

1 outlier prescriber of opioids as com2 pared to other prescribers of opioids 

3 within such specialty and area. 

4 ‘‘(III) EXCLUSIONS.—The Sec5 retary may exclude the following indi6 viduals and prescribers from the anal7 ysis under this clause: 

8 ‘‘(aa) Individuals receiving 

9 hospice services. 

10 ‘‘(bb) Individuals with a 

11 cancer diagnosis. 

12 ‘‘(cc) Prescribers who are 

13 the subject of an investigation by 

14 the Centers for Medicare & Med15 icaid Services or the Office of In16 spector General of the Depart17 ment of Health and Human 

18 Services. 

19 ‘‘(iii) CONTENTS OF NOTIFICATION.— 

20 The Secretary shall, based on input from 

21 stakeholders, specify the resources and 

22 other information to be included in notifi23 cations provided under clause (i). 

24 ‘‘(iv) MODIFICATIONS AND EXPAN25 SIONS.— 


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•HR 5716 RH

1 ‘‘(I) FREQUENCY.—Beginning 5 

2 years after the date of the enactment 

3 of this subparagraph, the Secretary 

4 may change the frequency of the noti5 fications described in clause (i) based 

6 on stakeholder input. 

7 ‘‘(II) EXPANSION TO OTHER

8 PRESCRIPTIONS.—The Secretary may 

9 expand notifications under this sub10 paragraph to include identifications 

11 and notifications with respect to con12 current prescriptions of covered Part 

13 D drugs used in combination with 

14 opioids that are considered to have 

15 adverse side effects when so used in 

16 such combination, as determined by 

17 the Secretary. 

18 ‘‘(v) OPIOIDS DEFINED.—For pur19 poses of this subparagraph, the term 

20 ‘opioids’ has such meaning as specified by 

21 the Secretary through program instruction 

22 or otherwise.’’. 


pbinns on DSK79D2C42PROD with BILLS

pbinns on DSK79D2C42PROD with BILLS
Union Calendar No. 574 

115TH CONGRESS 

2D SESSION H. R. 5716 

[Report No. 115–740, Part I] 

A BILL 

To amend title XVIII of the Social Security Act to 

care program to outlier prescribers of opioids. Services to provide notifications under the Medirequire the Secretary of Health and Human 

JUNE 12, 2018 

Reported from the Committee on Energy and Commerce 

JUNE 12, 2018 

The Committee on Ways and Means discharged; comState of the Union and ordered to be printed mitted to the Committee of the Whole House on the 


pbinns on DSK79D2C42PROD with BILLS