‘‘(B) includes evaluation and treatment of 
illnesses that frequently accompany serious 
pain, including depression, other mental health 
disorders, sleep disturbance, and substance 
abuse; 
‘‘(C) provides medical and other health 
services through physicians and other practi-
tioners credentialed or experienced in pain med-
icine; 
‘‘(D) provides for referral of patients with 
chronic pain to specialists, and, where appro-
priate, to a comprehensive multidisciplinary 
pain management program; 
‘‘(E) continues treatment for as long as 
treatment is required to maximize the quality of 
life and functional capacity of the patient; and 
‘‘(F) permits physicians and other practi-
tioners experienced or credentialed in pain med-
icine to make clinical decisions with respect to 
the need for and the extent and duration of 
pain care services. 
‘‘(2) DEFINITIONS.—For purposes of this sub-
section— 
‘‘(A) The term ‘chronic pain’ means severe, per-
sistent, or recurrent pain that interferes with the ac-
tivities of daily living, and has not been significantly 
reduced or ameliorated despite reasonable treatment 
efforts for a period of 6 months. 
‘‘(B) The term ‘comprehensive multidisciplinary 
pain management program’ means an inpatient or 
outpatient health care facility or program that— 
‘‘(i) provides at least medical, nursing, 
mental 
health, 
and 
rehabilitation 
services 
through licensed health care professionals; 
‘‘(ii) provides or arranges for the provision 
of inpatient and outpatient hospital and reha-
bilitation facility services, drugs, devices, and 
other items and services required for the treat-
ment of chronic pain; 
‘‘(iii) provides ongoing patient and profes-
sional education for pain management; 
‘‘(iv) is accredited as a comprehensive pain 
management program by an accrediting organi-
zation approved by the Secretary, including the 
Joint Commission on the Accreditation of 
Health Care Organizations or the Rehabilita-
tion Accreditation Commission; and 
‘‘(v) is directed by 1 or more physicians 
credentialed in pain medicine, or, where appro-
priate, dentistry, by a board or boards approved
by the Secretary, which shall include the Amer-
ican Board of Pain Medicine and boards recog-
nized by the American Board of Medical Spe-
cialists. 
‘‘(3) COMPLIANCE.—A contractor may comply with 
the requirements set forth in this subsection by providing 
care through its own network of participating providers, 
or under arrangement with out-of-network providers, but 
in no event may a contractor impose higher costs on its 
enrollees in the form of deductibles, copayments, pre-
miums, or otherwise in the event appropriate pain care 
in accordance with the standards set forth in this sub-
section is provided out of network.’’. 
(b) EFFECTIVE DATE.—The amendment made by 
subsection (a) shall apply to contracts as of January 1, 
2006. 
SEC. 9. ANNUAL REPORT ON MEDICARE EXPENDITURES 
FOR PAIN CARE SERVICES. 
Not later than December 31, 2006, and annually 
thereafter, the Administrator of the Centers for Medicare 
& Medicaid Services shall prepare and submit to the Con-
gress a report on medicare expenditures for pain care dur-
ing the preceding fiscal year. The report shall include the 
following:
(1) An estimate of total payments made under 
part B of the medicare program to physicians spe-
cializing in pain medicine. 
(2) An estimate of payments made under such 
part B to other providers and suppliers for the pro-
vision of pain care items and services. 
(3) An estimate of expenditures made under 
part A of the medicare program for the diagnosis 
and treatment of pain of inpatients, and an estimate 
of the percentage of such care that relates to end- 
of-life care. 
(4) An estimate of expenditures under part C 
of the medicare program for the provision of pain 
care items and services through the Medicare Advan-
tage program. 
(5) An estimate of out-of-pocket expenditures 
by medicare beneficiaries for both prescription and 
nonprescription pain medications not covered by the 
medicare program. 
(6) An analysis of trends in both medicare pro-
gram and medicare beneficiary expenditures for pain 
care items and services.
SEC. 10. PAIN CARE INITIATIVE IN VETERANS HEALTH 
CARE FACILITIES. 
(a) REQUIREMENT.—Subchapter II of chapter 17 of 
title 38, United States Code, is amended by adding at the 
end the following new section: 
‘‘§ 1720F. Pain care 
‘‘The Secretary shall develop and implement a pain 
care initiative in all health care facilities of the Depart-
ment. The initiative shall be designed to ensure that each 
individual receiving treatment in a health care facility 
under the jurisdiction of the Secretary— 
‘‘(1) is assessed for pain at the time of admis-
sion or initial treatment, and periodically thereafter, 
using a professionally recognized pain assessment 
tool or process; and 
‘‘(2) receives appropriate pain care consistent 
with recognized guidelines and practice parameters 
for the diagnosis and treatment of primary and sec-
ondary–pain, including acute, chronic, and intrac-
table pain.’’. 
(b) CLERICAL AMENDMENT.—The table of sections 
at the beginning of such chapter is amended by inserting 
after the item relating to section 1720E the following new 
item: 
‘‘1720F. Pain care.’’.