IIB 

115TH CONGRESS 

2D SESSION H. R. 5775 

IN THE SENATE OF THE UNITED STATES 

JUNE 20, 2018 

Received; read twice and referred to the Committee on Finance 

AN ACT 

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. 


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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 ‘‘Providing Reliable Op5 tions for Patients and Educational Resources Act of 

6 2018’’ or the ‘‘PROPER Act of 2018’’. 

7 SEC. 2. REQUIRING MEDICARE ADVANTAGE PLANS AND 

8 PART D PRESCRIPTION DRUG PLANS TO IN9 CLUDE INFORMATION ON RISKS ASSOCIATED 

10 WITH OPIOIDS AND COVERAGE OF NON11 PHARMACOLOGICAL THERAPIES AND 

12 NONOPIOID MEDICATIONS OR DEVICES USED 

13 TO TREAT PAIN. 

14 Section 1860D–4(a)(1) of the Social Security Act (42 

15 U.S.C. 1395w–104(a)(1)) is amended— 

16 (1) in subparagraph (A), by inserting ‘‘, subject 

17 to subparagraph (C),’’ before ‘‘including’’; 

18 (2) in subparagraph (B), by adding at the end 

19 the following new clause: 

20 ‘‘(vi) For plan year 2021 and each 

21 subsequent plan year, subject to subpara22 graph (C), with respect to the treatment of 

23 pain— 

24 ‘‘(I) the risks associated with 

25 prolonged opioid use; and 


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1 ‘‘(II) coverage of nonpharma2 cological therapies, devices, and 

3 nonopioid medications— 

4 ‘‘(aa) in the case of an MA5 PD plan under part C, under 

6 such plan; and 

7 ‘‘(bb) in the case of a pre8 scription drug plan, under such 

9 plan and under parts A and B.’’; 

10 and 

11 (3) by adding at the end the following new sub12 paragraph: 

13 ‘‘(C) TARGETED PROVISION OF INFORMA14 TION.—A PDP sponsor of a prescription drug 

15 plan may, in lieu of disclosing the information 

16 described in subparagraph (B)(vi) to each en17 rollee under the plan, disclose such information 

18 through mail or electronic communications to a 

19 subset of enrollees under the plan, such as en20 rollees who have been prescribed an opioid in 

21 the previous 2-year period.’’. 


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1 SEC. 3. REQUIRING MEDICARE ADVANTAGE PLANS AND 

2 PRESCRIPTION DRUG PLANS TO PROVIDE IN3 FORMATION ON THE SAFE DISPOSAL OF PRE4 SCRIPTION DRUGS. 

5 (a) MEDICARE ADVANTAGE.—Section 1852 of the 

6 Social Security Act (42 U.S.C. 1395w–22) is amended by 

7 adding at the end the following new subsection: 

8 ‘‘(n) PROVISION OF INFORMATION RELATING TO THE

9 SAFE DISPOSAL OF CERTAIN PRESCRIPTION DRUGS.— 

10 ‘‘(1) IN GENERAL.—In the case of an individual 

11 enrolled under an MA or MA-PD plan who is fur12 nished an in-home health risk assessment on or after 

13 January 1, 2021, such plan shall ensure that such 

14 assessment includes information on the safe disposal 

15 of prescription drugs that are controlled substances 

16 that meets the criteria established under paragraph 

17 (2). Such information shall include information on 

18 drug takeback programs that meet such require19 ments determined appropriate by the Secretary and 

20 information on in-home disposal. 

21 ‘‘(2) CRITERIA.—The Secretary shall, through 

22 rulemaking, establish criteria the Secretary deter23 mines appropriate with respect to information pro24 vided to an individual to ensure that such informa25 tion sufficiently educates such individual on the safe 


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1 disposal of prescription drugs that are controlled 

2 substances.’’. 

3 (b) PRESCRIPTION DRUG PLANS.—Section 1860D– 

4 4(c)(2)(B) of the Social Security Act (42 U.S.C. 1395w– 

5 104(c)(2)(B)) is amended— 

6 (1) by striking ‘‘may include elements that pro7 mote’’; 

8 (2) by redesignating clauses (i) through (iii) as 

9 subclauses (I) through (III) and adjusting the mar10 gins accordingly; 

11 (3) by inserting before subclause (I), as so re12 designated, the following new clause: 

13 ‘‘(i) may include elements that pro14 mote—’’; 

15 (4) in subclause (III), as so redesignated, by 

16 striking the period at the end and inserting ‘‘; and’’; 

17 and 

18 (5) by adding at the end the following new 

19 clause: 

20 ‘‘(ii) with respect to plan years begin21 ning on or after January 1, 2021, shall 

22 provide for— 

23 ‘‘(I) the provision of information 

24 to the enrollee on the safe disposal of 

25 prescription drugs that are controlled 


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1 substances that meets the criteria es2 tablished under section 1852(n)(2), 

3 including information on drug 

4 takeback programs that meet such re5 quirements determined appropriate by 

6 the Secretary and information on in7 home disposal; and 

8 ‘‘(II) cost-effective means by 

9 which an enrollee may so safely dis10 pose of such drugs.’’. 

11 SEC. 4. REVISING MEASURES USED UNDER THE HOSPITAL 

12 CONSUMER ASSESSMENT OF HEALTHCARE 

13 PROVIDERS AND SYSTEMS SURVEY RELAT14 ING TO PAIN MANAGEMENT. 

15 (a) RESTRICTION ON THE USE OF PAIN QUESTIONS

16 IN HCAHPS.—Section 1886(b)(3)(B)(viii) of the Social 

17 Security Act (42 U.S.C. 1395ww(b)(3)(B)(viii)) is amend18 ed by adding at the end the following new subclause: 

19 ‘‘(XII)(aa) With respect to a Hospital Consumer As20 sessment of Healthcare Providers and Systems survey (or 

21 a successor survey) conducted on or after January 1, 

22 2019, such survey may not include questions about com23 munication by hospital staff with an individual about such 

24 individual’s pain unless such questions take into account, 

25 as applicable, whether an individual experiencing pain was 


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1 informed about risks associated with the use of opioids 

2 and about non-opioid alternatives for the treatment of 

3 pain. 

4 ‘‘(bb) The Secretary shall not include on the Hospital 

5 Compare Internet website any measures based on the 

6 questions appearing on the Hospital Consumer Assess7 ment of Healthcare Providers and Systems survey in 2018 

8 about communication by hospital staff with an individual 

9 about such individual’s pain.’’. 

10 (b) RESTRICTION ON USE OF 2018 PAIN QUESTIONS

11 IN THE HOSPITAL VALUE-BASED PURCHASING PRO12 GRAM.—Section 1886(o)(2)(B) of the Social Security Act 

13 (42 U.S.C. 1395ww(o)(2)(B)) is amended by adding at the 

14 end the following new clause: 

15 ‘‘(iii) HCAHPS PAIN QUESTIONS.— 

16 The Secretary may not include under sub17 paragraph (A) a measure that is based on 

18 the questions appearing on the Hospital 

19 Consumer Assessment of Healthcare Pro20 viders and Systems survey in 2018 about 


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1 communication by hospital staff with an 

2 individual about the individual’s pain.’’. 

Passed the House of Representatives June 19, 2018. 

Attest: KAREN L. HAAS, 

Clerk. 


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