Providing Reliable Options for Patients and Educational Resources Act of 2018

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. Short title This Act may be cited as the Providing Reliable Options for Patients and Educational Resources Act of 2018 PROPER Act of 2018 2. Requiring Medicare Advantage plans and part D prescription drug plans to include information on risks associated with opioids and coverage of nonpharmacological therapies and nonopioid medications or devices used to treat pain Section 1860D–4(a)(1) of the Social Security Act ( 42 U.S.C. 1395w–104(a)(1) (1) in subparagraph (A), by inserting , subject to subparagraph (C), including (2) in subparagraph (B), by adding at the end the following new clause: (vi) For plan year 2021 and each subsequent plan year, subject to subparagraph (C), with respect to the treatment of pain— (I) the risks associated with prolonged opioid use; and (II) coverage of nonpharmacological therapies, devices, and nonopioid medications— (aa) in the case of an MA-PD plan under part C, under such plan; and (bb) in the case of a prescription drug plan, under such plan and under parts A and B. ; and (3) by adding at the end the following new subparagraph: (C) Targeted provision of information A PDP sponsor of a prescription drug plan may, in lieu of disclosing the information described in subparagraph (B)(vi) to each enrollee under the plan, disclose such information through mail or electronic communications to a subset of enrollees under the plan, such as enrollees who have been prescribed an opioid in the previous two-year period. . 3. Requiring Medicare Advantage plans and prescription drug plans to provide information on the safe disposal of prescription drugs (a) Medicare Advantage Section 1852 of the Social Security Act ( 42 U.S.C. 1395w–22 (n) Provision of information relating to the safe disposal of certain prescription drugs (1) In general In the case of an individual enrolled under an MA or MA-PD plan who is furnished an in-home health risk assessment on or after January 1, 2021, such plan shall ensure that such assessment includes information on the safe disposal of prescription drugs that are controlled substances that meets the criteria established under paragraph (2). Such information shall include information on drug takeback programs that meet such requirements determined appropriate by the Secretary and information on in-home disposal. (2) Criteria The Secretary shall, through rulemaking, establish criteria the Secretary determines appropriate with respect to information provided to an individual to ensure that such information sufficiently educates such individual on the safe disposal of prescription drugs that are controlled substances. . (b) Prescription drug plans Section 1860D–4(c)(2)(B) of the Social Security Act ( 42 U.S.C. 1395w–104(c)(2)(B) (1) by striking may include elements that promote (2) by redesignating clauses (i) through (iii) as subclauses (I) through (III) and adjusting the margins accordingly; (3) by inserting before subclause (I), as so redesignated, the following new clause: (i) may include elements that promote— ; (4) in subclause (III), as so redesignated, by striking the period at the end and inserting ; and (5) by adding at the end the following new clause: (ii) with respect to plan years beginning on or after January 1, 2021, shall provide for— (I) the provision of information to the enrollee on the safe disposal of prescription drugs that are controlled substances that meets the criteria established under section 1852(n)(2), including information on drug takeback programs that meet such requirements determined appropriate by the Secretary and information on in-home disposal; and (II) cost-effective means by which an enrollee may so safely dispose of such drugs. . 4. Revising measures used under the Hospital Consumer Assessment of Healthcare Providers and Systems survey relating to pain management (a) Restriction on the use of pain questions in HCAHPS Section 1886(b)(3)(B)(viii) of the Social Security Act ( 42 U.S.C. 1395ww(b)(3)(B)(viii) (XII) (aa) With respect to a Hospital Consumer Assessment of Healthcare Providers and Systems survey (or a successor survey) conducted on or after January 1, 2019, such survey may not include questions about communication by hospital staff with an individual about such individual’s pain unless such questions take into account, as applicable, whether an individual experiencing pain was informed about risks associated with the use of opioids and about non-opioid alternatives for the treatment of pain. (bb) The Secretary shall not include on the Hospital Compare Internet website any measures based on the questions appearing on the Hospital Consumer Assessment of Healthcare Providers and Systems survey in 2018 about communication by hospital staff with an individual about such individual’s pain. . (b) Restriction on use of 2018 pain questions in the hospital value-based purchasing program Section 1886(o)(2)(B) of the Social Security Act ( 42 U.S.C. 1395ww(o)(2)(B) (iii) HCAHPS pain questions The Secretary may not include under subparagraph (A) a measure that is based on the questions appearing on the Hospital Consumer Assessment of Healthcare Providers and Systems survey in 2018 about communication by hospital staff with an individual about the individual’s pain. . June 19, 2018 Reported from the Committee on Ways and Means June 19, 2018 Committee on Energy and Commerce

Summary: Providing Reliable Options for Patients and Educational Resources Act of 2018 or the PROPER Act of 2018 (Sec. 2) This bill requires Medicare and Medicare Advantage (MA) prescription drug plan (PDP) sponsors to annually disclose information to enrollees about: (1) the risks of prolonged opioid use; and (2) the plan's coverage of nonpharmacological therapies, devices, and non-opioid medications. PDP sponsors may limit disclosure to a subset of enrollees (such as those who were prescribed an opioid in the previous two-year period). (Sec. 3) The bill also requires Medicare medication therapy management programs and MA in-home health risk assessments to include information about the safe disposal of prescription drugs. (Sec. 4) The bill prohibits inclusion of pain management questions in certain health care system surveys, unless the questions address the risks of opioid use and the availability of non-opioid alternatives.