(2) ELEMENTS.—The report submitted under 
paragraph (1) shall include the following: 
(A) Recommendations on such improve-
ments to the Opioid Safety Initiative of the De-
partment as the Comptroller General considers 
appropriate. 
(B) Information with respect to— 
(i) deaths resulting from sentinel 
events involving veterans prescribed opioids 
by a health care provider of the Depart-
ment; 
(ii) overall prescription rates and pre-
scriptions indications of opioids to treat 
non-cancer, non-palliative, and non-hospice 
care patients; 
(iii) the prescription rates and pre-
scriptions indications of benzodiazepines 
and opioids concomitantly by health care 
providers of the Department; 
(iv) the practice by health care pro-
viders of the Department of prescribing 
opioids to treat patients without any pain, 
including to treat patients with mental 
health disorders other than opioid use dis-
order; and
(v) the effectiveness of opioid therapy 
for patients receiving such therapy, includ-
ing the effectiveness of long-term opioid 
therapy. 
(C) An evaluation of processes of the De-
partment in place to oversee opioid use among 
veterans, including procedures to identify and 
remedy potential over-prescribing of opioids by 
health care providers of the Department. 
(D) An assessment of the implementation 
by the Secretary of the VA/DOD Clinical Prac-
tice Guideline for Management of Opioid Ther-
apy for Chronic Pain. 
(b) QUARTERLY PROGRESS REPORT ON IMPLEMEN-
TATION
OF
COMPTROLLER
GENERAL
RECOMMENDA-
TIONS.—Not later than 2 years after the date of the enact-
ment of this Act, and not later than 30 days after the 
end of each quarter thereafter, the Secretary of Veterans 
Affairs shall submit to the Committee on Veterans’ Affairs 
of the Senate and the Committee on Veterans’ Affairs of 
the House of Representatives a progress report detailing 
the actions by the Secretary during the period covered by 
the report to address any outstanding findings and rec-
ommendations by the Comptroller General of the United
States under subsection (a) with respect to the Veterans 
Health Administration. 
(c) ANNUAL REVIEW OF PRESCRIPTION RATES.— 
Not later than 1 year after the date of the enactment of 
this Act, and not less frequently than annually for the fol-
lowing 5 years, the Secretary shall submit to the Com-
mittee on Veterans’ Affairs of the Senate and the Com-
mittee on Veterans’ Affairs of the House of Representa-
tives a report, with respect to each medical facility of the 
Department of Veterans Affairs, to collect and review in-
formation on opioids prescribed by health care providers 
at the facility to treat non-cancer, non-palliative, and non- 
hospice care patients that contains, for the 1-year period 
preceding the submission of the report, the following: 
(1) The number of patients and the percentage 
of the patient population of the Department who 
were prescribed benzodiazepines and opioids concur-
rently by a health care provider of the Department. 
(2) The number of patients and the percentage 
of the patient population of the Department without 
any pain who were prescribed opioids by a health 
care provider of the Department, including those 
who were prescribed benzodiazepines and opioids 
concurrently.
(3) The number of non-cancer, non-palliative, 
and non-hospice care patients and the percentage of 
such patients who were treated with opioids by a 
health care provider of the Department on an inpa-
tient-basis and who also received prescription opioids 
by mail from the Department while being treated on 
an inpatient-basis. 
(4) The number of non-cancer, non-palliative, 
and non-hospice care patients and the percentage of 
such patients who were prescribed opioids concur-
rently by a health care provider of the Department 
and a health care provider that is not health care 
provider of the Department. 
(5) With respect to each medical facility of the 
Department, information on opioids prescribed by 
health care providers at the facility to treat non-can-
cer, non-palliative, and non-hospice care patients, in-
cluding information on— 
(A) the prescription rate at which each 
health care provider at the facility prescribed 
benzodiazepines and opioids concurrently to 
such patients and the aggregate such prescrip-
tion rate for all health care providers at the fa-
cility;
(B) the prescription rate at which each 
health care provider at the facility prescribed 
benzodiazepines or opioids to such patients to 
treat conditions for which benzodiazepines or 
opioids are not approved treatment and the ag-
gregate such prescription rate for all health 
care providers at the facility; 
(C) the prescription rate at which each 
health care provider at the facility prescribed or 
dispensed mail-order prescriptions of opioids to 
such patients while such patients were being 
treated with opioids on an inpatient-basis and 
the aggregate of such prescription rate for all 
health care providers at the facility; and 
(D) the prescription rate at which each 
health care provider at the facility prescribed 
opioids to such patients who were also concur-
rently prescribed opioids by a health care pro-
vider that is not a health care provider of the 
Department and the aggregate of such prescrip-
tion rates for all health care providers at the fa-
cility. 
(6) With respect to each medical facility of the 
Department, the number of times a pharmacist at 
the facility overrode a critical drug interaction warn-
ing with respect to an interaction between opioids 
and another medication before dispensing such medi-
cation to a veteran. 
(d) INVESTIGATION OF PRESCRIPTION RATES.—If 
the Secretary determines that a prescription rate with re-
spect to a health care provider or medical facility of the 
Department conflicts with or is otherwise inconsistent 
with the standards of appropriate and safe care, the Sec-
retary shall— 
(1) immediately notify the Committee on Vet-
erans’ Affairs of the Senate and the Committee on 
Veterans’ Affairs of the House of Representatives of 
such determination, including information relating to 
such determination, prescription rate, and health 
care provider or medical facility, as the case may be; 
and 
(2) through the Office of the Medical Inspector 
of the Veterans Health Administration, conduct a 
full investigation of the health care provider or med-
ical facility, as the case may be. 
(e) PRESCRIPTION RATE DEFINED.—In this section, 
the term ‘‘prescription rate’’ means, with respect to a 
health care provider or medical facility of the Department, 
each of the following:
‘‘SEC. 705. LIMITATION ON AWARDS AND BONUSES PAID TO 
EMPLOYEES OF DEPARTMENT OF VETERANS 
AFFAIRS. 
‘‘The Secretary of Veterans Affairs shall ensure that 
the aggregate amount of awards and bonuses paid by the 
Secretary in a fiscal year under chapter 45 or 53 of title 
5, United States Code, or any other awards or bonuses 
authorized under such title or title 38, United States 
Code, does not exceed the following amounts: 
‘‘(1) With respect to each of fiscal years 2017 
through 2021, $230,000,000. 
‘‘(2) With respect to each of fiscal years 2022 
through 2024, $360,000,000.’’. 
Passed the House of Representatives May 10, 2016. 
Attest: 
Clerk.
114TH CONGRESS 
2D SESSION 
H. R. 4063 
AN ACT 
To improve the use by the Secretary of Veterans 
Affairs of opioids in treating veterans, and for 
other purposes.