IIB 
115TH CONGRESS 
2D SESSION 
H. R. 5775 
IN THE SENATE OF THE UNITED STATES 
JUNE 20, 2018 
Received; read twice and referred to the Committee on Finance 
AN ACT 
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 
prolonged 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 en-
rollees who have been prescribed an opioid in 
the previous 2-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 
Social Security Act (42 U.S.C. 1395w–22) is amended by 
adding 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 
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 
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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 
‘‘(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)(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 com-
munication 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 
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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 
questions appearing on the Hospital Consumer Assess-
ment 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 
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communication by hospital staff with an 
individual about the individual’s pain.’’. 
Passed the House of Representatives June 19, 2018. 
Attest: 
KAREN L. HAAS, 
Clerk. 
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