IB 

Union Calendar No. 594 

115TH CONGRESS 

2D SESSION H. R. 5775 

[Report No. 115–763, Part I] 

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 

JUNE 19, 2018 

Additional sponsors: Mr. FITZPATRICK and Mr. SAM JOHNSON of Texas 

JUNE 19, 2018 

Reported from the Committee on Ways and Means with an amendment 

[Strike out all after the enacting clause and insert the part printed in italic] 

JUNE 19, 2018 

Committee on Energy and Commerce discharged; committed to the Committee 

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

[For text of introduced bill, see copy of bill as introduced on May 11, 2018] 


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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. 


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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 2018’’ 

6 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 pro25 longed 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 enroll20 ees who have been prescribed an opioid in the 

21 previous two-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 So6 cial Security Act (42 U.S.C. 1395w–22) is amended by add7 ing 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 as14 sessment includes information on the safe disposal of 

15 prescription drugs that are controlled substances that 

16 meets the criteria established under paragraph (2). 

17 Such information shall include information on drug 

18 takeback programs that meet such requirements deter19 mined appropriate by the Secretary and information 

20 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 sub2 stances.’’. 

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 redes12 ignated, 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 pro22 vide 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), in3 cluding information on drug takeback 

4 programs that meet such requirements 

5 determined appropriate by the Sec6 retary and information on in-home 

7 disposal; and 

8 ‘‘(II) cost-effective means by which 

9 an enrollee may so safely dispose of 

10 such drugs.’’. 

11 SEC. 4. REVISING MEASURES USED UNDER THE HOSPITAL 

12 CONSUMER ASSESSMENT OF HEALTHCARE 

13 PROVIDERS AND SYSTEMS SURVEY RELATING 

14 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 amended 

18 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, 2019, 

22 such survey may not include questions about communica23 tion by hospital staff with an individual about such indi24 vidual’s pain unless such questions take into account, as 

25 applicable, whether an individual experiencing pain was 


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1 informed about risks associated with the use of opioids and 

2 about non-opioid alternatives for the treatment of pain. 

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

4 Compare Internet website any measures based on the ques5 tions appearing on the Hospital Consumer Assessment of 

6 Healthcare Providers and Systems survey in 2018 about 

7 communication by hospital staff with an individual about 

8 such individual’s pain.’’. 

9 (b) RESTRICTION ON USE OF 2018 PAIN QUESTIONS

10 IN THE HOSPITAL VALUE-BASED PURCHASING PRO11 GRAM.—Section 1886(o)(2)(B) of the Social Security Act 

12 (42 U.S.C. 1395ww(o)(2)(B)) is amended by adding at the 

13 end the following new clause: 

14 ‘‘(iii) HCAHPS PAIN QUESTIONS.— 

15 The Secretary may not include under sub16 paragraph (A) a measure that is based on 

17 the questions appearing on the Hospital 

18 Consumer Assessment of Healthcare Pro19 viders and Systems survey in 2018 about 

20 communication by hospital staff with an 

21 individual about the individual’s pain.’’. 


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Union Calendar No. 594 

115TH CONGRESS 

2D SESSION H. R. 5775 

[Report No. 115–763, Part I] 

A BILL 

To amend title XVIII of the Social Security Act to 

for other purposes. on the safe disposal of prescription drugs, and tain nonopioid treatments used to treat pain, and the risks associated with opioids, coverage of cerprescription drug plans to include information on require Medicare Advantage plans and part D 

JUNE 19, 2018 

Reported from the Committee on Ways and Means with 

J

an amendment 

UNE 19, 2018 

Committee on Energy and Commerce discharged; comState of the Union and ordered to be printed mitted to the Committee of the Whole House on the 


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