I 
115TH CONGRESS 
2D SESSION 
H. R. 5775 
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 
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. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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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 
prolonged opioid use; and 
‘‘(II) coverage of nonpharma-
cological 
therapies, 
devices, 
and 
nonopioid medications— 
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‘‘(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 en-
rollees who have been prescribed an opioid in 
the previous two-year period.’’. 
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 
Social Security Act (42 U.S.C. 1395w–22) is amended by 
adding at the end the following new subsection: 
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‘‘(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 
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 require-
ments determined 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 
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)) is amended— 
(1) by striking ‘‘may include elements that pro-
mote’’; 
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(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 re-
designated, 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 
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 es-
tablished under section 1852(n)(2), 
including 
information 
on 
drug 
takeback programs that meet such re-
quirements determined appropriate by 
the Secretary and information on in- 
home disposal; and 
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‘‘(II) cost-effective means by 
which an enrollee may so safely dis-
pose of such drugs.’’. 
SEC. 4. REVISING MEASURES USED UNDER THE HOSPITAL 
CONSUMER ASSESSMENT OF HEALTHCARE 
PROVIDERS AND SYSTEMS SURVEY RELAT-
ING 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 amend-
ed by adding at the end the following new subclause: 
‘‘(XII) With respect to a Hospital Consumer Assess-
ment 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 in-
formed about risks associated with the use of opioids and 
about non-opioid alternatives for the treatment of pain.’’. 
(b) RESTRICTION ON USE OF PAIN QUESTIONS IN 
THE HOSPITAL VALUE-BASED PURCHASING PROGRAM 
FOR
FISCAL
YEAR
2019.—Section 1886(o)(2)(B) is 
amended by adding at the end the following new clause: 
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