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 Advan-
tage plans and part D prescription drug plans to include information 
on the risks associated with opioids, coverage of certain nonopioid treat-
ments 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) intro-
duced 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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Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Providing Reliable Op-
tions for Patients and Educational Resources Act of 2018’’ 
or the ‘‘PROPER Act of 2018’’. 
SEC. 2. REQUIRING MEDICARE ADVANTAGE PLANS AND 
PART D PRESCRIPTION DRUG PLANS TO IN-
CLUDE INFORMATION ON RISKS ASSOCIATED 
WITH OPIOIDS AND COVERAGE OF NON-
PHARMACOLOGICAL 
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)) is amended— 
(1) in subparagraph (A), by inserting ‘‘, subject 
to subparagraph (C),’’ before ‘‘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 subpara-
graph (C), with respect to the treatment of 
pain— 
‘‘(I) the risks associated with pro-
longed opioid use; and 
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‘‘(II) coverage of nonpharma-
cological 
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 pre-
scription drug plan, under such 
plan and under parts A and B.’’; 
and 
(3) by adding at the end the following new sub-
paragraph: 
‘‘(C) TARGETED
PROVISION
OF
INFORMA-
TION.—A PDP sponsor of a prescription drug 
plan may, in lieu of disclosing the information 
described in subparagraph (B)(vi) to each en-
rollee under the plan, disclose such information 
through mail or electronic communications to a 
subset of enrollees under the plan, such as enroll-
ees who have been prescribed an opioid in the 
previous two-year period.’’. 
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SEC. 3. REQUIRING MEDICARE ADVANTAGE PLANS AND 
PRESCRIPTION DRUG PLANS TO PROVIDE IN-
FORMATION ON THE SAFE DISPOSAL OF PRE-
SCRIPTION DRUGS. 
(a) MEDICARE ADVANTAGE.—Section 1852 of the So-
cial Security Act (42 U.S.C. 1395w–22) is amended by add-
ing at the end the following new subsection: 
‘‘(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 fur-
nished an in-home health risk assessment on or after 
January 1, 2021, such plan shall ensure that such as-
sessment 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 deter-
mined appropriate by the Secretary and information 
on in-home disposal. 
‘‘(2) CRITERIA.—The Secretary shall, through 
rulemaking, establish criteria the Secretary deter-
mines appropriate with respect to information pro-
vided to an individual to ensure that such informa-
tion sufficiently educates such individual on the safe 
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disposal of prescription drugs that are controlled sub-
stances.’’. 
(b) PRESCRIPTION DRUG PLANS.—Section 1860D– 
4(c)(2)(B) of the Social Security Act (42 U.S.C. 1395w– 
104(c)(2)(B)) is amended— 
(1) by striking ‘‘may include elements that pro-
mote’’; 
(2) by redesignating clauses (i) through (iii) as 
subclauses (I) through (III) and adjusting the mar-
gins accordingly; 
(3) by inserting before subclause (I), as so redes-
ignated, the following new clause: 
‘‘(i) may include elements that pro-
mote—’’; 
(4) in subclause (III), as so redesignated, by 
striking the period at the end and inserting ‘‘; and’’; 
and 
(5) by adding at the end the following new 
clause: 
‘‘(ii) with respect to plan years begin-
ning on or after January 1, 2021, shall pro-
vide for— 
‘‘(I) the provision of information 
to the enrollee on the safe disposal of 
prescription drugs that are controlled 
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substances that meets the criteria es-
tablished under section 1852(n)(2), in-
cluding information on drug takeback 
programs that meet such requirements 
determined appropriate by the Sec-
retary and information on in-home 
disposal; and 
‘‘(II) cost-effective means by which 
an enrollee may so safely dispose of 
such drugs.’’. 
SEC. 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)) is amended 
by adding at the end the following new subclause: 
‘‘(XII)(aa) With respect to a Hospital Consumer As-
sessment of Healthcare Providers and Systems survey (or 
a successor survey) conducted on or after January 1, 2019, 
such survey may not include questions about communica-
tion by hospital staff with an individual about such indi-
vidual’s pain unless such questions take into account, as 
applicable, whether an individual experiencing pain was 
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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 ques-
tions 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
PRO-
GRAM.—Section 1886(o)(2)(B) of the Social Security Act 
(42 U.S.C. 1395ww(o)(2)(B)) is amended by adding at the 
end the following new clause: 
‘‘(iii) HCAHPS PAIN
QUESTIONS.— 
The Secretary may not include under sub-
paragraph (A) a measure that is based on 
the questions appearing on the Hospital 
Consumer Assessment of Healthcare Pro-
viders and Systems survey in 2018 about 
communication by hospital staff with an 
individual about the individual’s pain.’’. 
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