I 

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. 

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


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Providing Reliable Op3 tions for Patients and Educational Resources Act of 

4 2018’’ or the ‘‘PROPER Act of 2018’’. 

5 SEC. 2. REQUIRING MEDICARE ADVANTAGE PLANS AND 

6 PART D PRESCRIPTION DRUG PLANS TO IN7 CLUDE INFORMATION ON RISKS ASSOCIATED 

8 WITH OPIOIDS AND COVERAGE OF NON9 PHARMACOLOGICAL THERAPIES AND 

10 NONOPIOID MEDICATIONS OR DEVICES USED 

11 TO TREAT PAIN. 

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

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

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

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

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

17 the following new clause: 

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

19 subsequent plan year, subject to subpara20 graph (C), with respect to the treatment of 

21 pain— 

22 ‘‘(I) the risks associated with 

23 prolonged opioid use; and 

24 ‘‘(II) coverage of nonpharma25 cological therapies, devices, and 

26 nonopioid medications— 


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1 ‘‘(aa) in the case of an MA– 

2 PD plan under part C, under 

3 such plan; and 

4 ‘‘(bb) in the case of a pre5 scription drug plan, under such 

6 plan and under parts A and B.’’; 

7 and 

8 (3) by adding at the end the following new sub9 paragraph: 

10 ‘‘(C) TARGETED PROVISION OF INFORMA11 TION.—A PDP sponsor of a prescription drug 

12 plan may, in lieu of disclosing the information 

13 described in subparagraph (B)(vi) to each en14 rollee under the plan, disclose such information 

15 through mail or electronic communications to a 

16 subset of enrollees under the plan, such as en17 rollees who have been prescribed an opioid in 

18 the previous two-year period.’’. 

19 SEC. 3. REQUIRING MEDICARE ADVANTAGE PLANS AND 

20 PRESCRIPTION DRUG PLANS TO PROVIDE IN21 FORMATION ON THE SAFE DISPOSAL OF PRE22 SCRIPTION DRUGS. 

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

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

25 adding at the end the following new subsection: 


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

2 SAFE DISPOSAL OF CERTAIN PRESCRIPTION DRUGS.— 

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

4 enrolled under an MA or MA–PD plan who is fur5 nished an in-home health risk assessment on or after 

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

7 assessment includes information on the safe disposal 

8 of prescription drugs that are controlled substances 

9 that meets the criteria established under paragraph 

10 (2). Such information shall include information on 

11 drug takeback programs that meet such require12 ments determined appropriate by the Secretary and 

13 information on in-home disposal. 

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

15 rulemaking, establish criteria the Secretary deter16 mines appropriate with respect to information pro17 vided to an individual to ensure that such informa18 tion sufficiently educates such individual on the safe 

19 disposal of prescription drugs that are controlled 

20 substances.’’. 

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

22 4(c)(2)(B) of the Social Security Act (42 U.S.C. 1395w– 

23 104(c)(2)(B)) is amended— 

24 (1) by striking ‘‘may include elements that pro25 mote’’; 


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

2 subclauses (I) through (III) and adjusting the mar3 gins accordingly; 

4 (3) by inserting before subclause (I), as so re5 designated, the following new clause: 

6 ‘‘(i) may include elements that pro7 mote—’’; 

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

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

10 and 

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

12 clause: 

13 ‘‘(ii) with respect to plan years begin14 ning on or after January 1, 2021, shall 

15 provide for— 

16 ‘‘(I) the provision of information 

17 to the enrollee on the safe disposal of 

18 prescription drugs that are controlled 

19 substances that meets the criteria es20 tablished under section 1852(n)(2), 

21 including information on drug 

22 takeback programs that meet such re23 quirements determined appropriate by 

24 the Secretary and information on in25 home disposal; and 


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1 ‘‘(II) cost-effective means by 

2 which an enrollee may so safely dis3 pose of such drugs.’’. 

4 SEC. 4. REVISING MEASURES USED UNDER THE HOSPITAL 

5 CONSUMER ASSESSMENT OF HEALTHCARE 

6 PROVIDERS AND SYSTEMS SURVEY RELAT7 ING TO PAIN MANAGEMENT. 

8 (a) RESTRICTION ON THE USE OF PAIN QUESTIONS

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

10 Security Act (42 U.S.C. 1395ww(b)(3)(B)(viii)) is amend11 ed by adding at the end the following new subclause: 

12 ‘‘(XII) With respect to a Hospital Consumer Assess13 ment of Healthcare Providers and Systems survey (or a 

14 successor survey) conducted on or after January 1, 2019, 

15 such survey may not include questions about communica16 tion by hospital staff with an individual about such indi17 vidual’s pain unless such questions take into account, as 

18 applicable, whether an individual experiencing pain was in19 formed about risks associated with the use of opioids and 

20 about non-opioid alternatives for the treatment of pain.’’. 

21 (b) RESTRICTION ON USE OF PAIN QUESTIONS IN

22 THE HOSPITAL VALUE-BASED PURCHASING PROGRAM

23 FOR FISCAL YEAR 2019.—Section 1886(o)(2)(B) is 

24 amended by adding at the end the following new clause: 


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1 ‘‘(iii) FOR FISCAL YEAR 2019.—For 

2 value-based incentive payments made with 

3 respect to discharges occurring during fis4 cal year 2019, the Secretary shall ensure 

5 that measures selected under subparagraph 

6 (A) do not include a measure based on 

7 questions about communication by hospital 

8 staff with an individual about such individ9 ual’s pain included in the Hospital Con10 sumer Assessment of Healthcare Providers 

11 and Systems survey.’’. 

Æ 


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