I 
108TH CONGRESS 
1ST SESSION H. R. 1863
To declare adequate pain care research, education, and treatment as national 
public health priorities, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
APRIL 29, 2003
Mr. ROGERS of Michigan introduced the following bill; which was referred to 
the Committee on Energy and Commerce, and in addition to the Commit-
tees on Ways and Means, Armed Services, and Veterans’ Affairs, 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 com-
mittee concerned 
A BILL 
To declare adequate pain care research, education, and treat-
ment as national public health priorities, and for other 
purposes.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘National Pain Care Policy Act of 2003’’. 
(b) TABLE OF CONTENTS.—The table of contents of 
this Act is as follows:
Sec. 1. Short title; table of contents.
Sec. 2. White House Conference on Pain Care. 
Sec. 3. National Center for Pain and Palliative Care Research. 
Sec. 4. Pain care education and training. 
Sec. 5. Public awareness campaign on pain management. 
Sec. 6. Pain care initiative in military health care facilities. 
Sec. 7. Pain care standards in Medicare+Choice plans. 
Sec. 8. Pain care standards in TRICARE plans. 
Sec. 9. Annual report on medicare expenditures for pain care services. 
Sec. 10. Pain care initiative in veterans health care facilities.
SEC. 2. WHITE HOUSE CONFERENCE ON PAIN CARE. 
(a) CONVENING.—Not later than June 30, 2004, the 
President shall convene a conference to be known as the 
White House Conference on Pain Care (in this section re-
ferred to as the ‘‘Conference’’). 
(b) PURPOSES.—The purposes of the Conference 
shall be to—
(1) increase the recognition of pain as a signifi-
cant public health problem in the United States; 
(2) assess the adequacy of diagnosis and treat-
ment for primary and secondary pain, including 
acute, chronic, intractable, and end-of-life pain; 
(3) identify barriers to appropriate pain care, 
including—
(A) lack of understanding and education 
among patients, providers, regulators, and 
third-party payors; 
(B) barriers to access to care at the pri-
mary, specialty, and tertiary care levels; and
(C) gaps in basic and clinical research on 
the symptoms and causes of, and potential 
treatments to improve, pain care; and 
(4) establish an agenda for action in both the 
public and private sectors that will reduce such bar-
riers and significantly improve the state of pain care 
research, education, and clinical care in the United 
States by 2010. 
(c) CHAIR.—The Secretary of Health and Human 
Services shall serve as the chair of the Conference. 
(d) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of carrying out this section, there are authorized 
to be appropriated such sums as shall be necessary for 
fiscal year 2004. 
SEC. 3. NATIONAL CENTER FOR PAIN AND PALLIATIVE 
CARE RESEARCH. 
(a) ESTABLISHMENT.—Section 401(b)(2) of the Pub-
lic Health Service Act (42 U.S.C. 281(b)(2)) is amended 
by adding at the end the following: 
‘‘(H) The National Center for Pain and Pallia-
tive Care Research.’’. 
(b) OPERATION.—Part E of title IV of the Public 
Health Service Act (42 U.S.C. 287 et seq.) is amended 
by adding at the end the following:
‘‘Subpart 7—National Center for Pain and Palliative 
Care Research 
‘‘SEC. 485I. ESTABLISHMENT. 
‘‘(a) ESTABLISHMENT.—The Secretary shall estab-
lish within the National Institutes of Health a center to 
be known as the National Center for Pain and Palliative 
Care Research (referred to in this subpart as the ‘Cen-
ter’). 
‘‘(b) DIRECTOR.—The Center shall be headed by a 
Director (referred to in this subpart as the ‘Director of 
the Center’), who shall be appointed by the Director of 
NIH after consultation with experts in the fields of pain 
and palliative care research and treatment. 
‘‘(c) POWERS OF SECRETARY AND DIRECTOR.—For 
purposes of section 405, the Center shall be treated as 
a national research institute. 
‘‘(d) GENERAL PURPOSES.—The general purposes of 
the Center are—
‘‘(1) to improve the quality of life of individuals 
suffering from pain by fostering clinical and basic 
science research into the biology of pain and the 
causes of and effective treatments for pain; 
‘‘(2) to establish a national agenda for con-
ducting and supporting pain and palliative care re-
search in the specific categories described in para-
graphs (3) and (4); 
‘‘(3) to identify, coordinate, and support re-
search, research training, and related activities (in-
cluding the development of new and the refinement 
of existing treatments) with respect to both primary 
and secondary pain, including—
‘‘(A) acute pain; 
‘‘(B) cancer and HIV-related pain, particu-
larly at the end of life; 
‘‘(C) back pain, headache pain, and other 
chronic and intractable pain; and 
‘‘(D) other painful conditions; 
‘‘(4) to identify, coordinate, and support re-
search, research training, and related activities with 
respect to palliative care; 
‘‘(5) to conduct and support pain and palliative 
care research, research training, and related activi-
ties that have been identified as requiring additional, 
special priority as determined appropriate by the Di-
rector of the Center and the Advisory Board estab-
lished under subsection (e);
‘‘(6) to coordinate all pain and palliative care 
research, research training, and related activities
being carried out among the national research insti-
tutes or in any such institute; 
‘‘(7) to ensure the prompt and effective dis-
semination of current and future research results to 
improve patient access to and provider delivery of 
pain and palliative care; 
‘‘(8) to initiate a comprehensive program of col-
laborative interdisciplinary research among schools, 
colleges, and universities, including schools of medi-
cine and osteopathy, schools of pharmacy and phar-
macology, schools of nursing, schools of dentistry, 
schools of physical therapy, schools of occupational 
therapy, and schools of clinical psychology, com-
prehensive health care centers and systems, and spe-
cialized centers of pain research or treatment; and 
‘‘(9) to report not less than annually on the 
state of public and private funding for pain and pal-
liative care research and the adequacy of such fund-
ing, taking into account the specific categories de-
scribed in paragraphs (3) and (4). 
‘‘(e) ADVISORY COUNCIL.—
‘‘(1) IN GENERAL.—The Center shall have an 
advisory council to be known as the National Pain 
and Palliative Care Research Center Advisory Board 
(in this section referred to as the ‘Advisory Board’).
‘‘(2) MEMBERSHIP.—The Advisory Board shall 
be established and maintained in accordance with 
section 406, except that—
‘‘(A) the appointed voting members shall 
include—
‘‘(i) representatives of the broad range 
of medical, health, and scientific disciplines 
involved in research and treatment related 
to the categories of pain and palliative care 
described in paragraphs (3) and (4) of 
subsection (d), including individuals with 
expertise and training in pain medicine, 
clinical psychology, physical medicine, and 
rehabilitative services (including physical 
therapy and occupational therapy), phar-
macy and pharmacology, nursing, and den-
tistry; and 
‘‘(ii) representatives of painful pa-
tients; and 
‘‘(B) the nonvoting ex officio members 
shall include—
‘‘(i) the Director of the National Can-
cer Institute;
‘‘(ii) the Director of the National In-
stitute of Dental and Craniofacial Re-
search; 
‘‘(iii) the Director of the National In-
stitute of Child Health and Human Devel-
opment; 
‘‘(iv) the Director of the National In-
stitute of Nursing Research; 
‘‘(v) the Director of the National In-
stitute of Allergy and Infectious Diseases; 
‘‘(vi) the Director of the National In-
stitute of Arthritis and Musculoskeletal 
and Skin Diseases; 
‘‘(vii) the Director of the National In-
stitute of Mental Health; 
‘‘(viii) the Director of the National In-
stitute of Neurological Disorders and 
Stroke; 
‘‘(ix) the Director of the National In-
stitute on Drug Abuse; 
‘‘(x) the Director of the National In-
stitute on Disability and Rehabilitation Re-
search;
‘‘(xi) the Director of the National In-
stitute of Biomedical Imaging and Bio-
engineering; and 
‘‘(xii) the Director of the National 
Bioethics Advisory Commission. 
‘‘(3) DUTIES.—The Advisory Board shall ad-
vise, assist, consult with, and make recommenda-
tions to the Director of the Center regarding the 
matters set forth in subsection (d), including coordi-
nation, research, funding, and purposes. 
‘‘(f) ESTABLISHMENT OF REGIONAL PAIN RESEARCH 
CENTERS.—
‘‘(1) ESTABLISHMENT.—To facilitate and en-
hance the research, research training, and related 
activities to be carried out by the Center, the Direc-
tor of NIH, in consultation with the Director of the 
Center and the Advisory Board, shall establish not 
less than 6 regional pain research centers, which 
shall operate as part of the Center. 
‘‘(2) FOCUS AND DISTRIBUTION.—
‘‘(A) FOCUS.—Not less than 4 of the re-
gional centers established under paragraph (1) 
shall have as their primary focus 1 of the cat-
egories of pain described in subparagraphs (A), 
(B), and (C) of subsection (d)(3).
‘‘(B) DISTRIBUTION.—One regional pain 
research center shall be established in each of 
the following regions of the United States (as 
such regions are determined by the Director of 
the Center): 
‘‘(i) The Northeast region. 
‘‘(ii) The Southeast region. 
‘‘(iii) The Midwest region. 
‘‘(iv) The Southwest region. 
‘‘(v) The West region, including Ha-
waii. 
‘‘(vi) The Pacific Northwest region, 
including Alaska. 
‘‘(3) SELECTION.—The regional centers shall be 
selected through a competitive process from among 
institutions and centers of the type described in sub-
section (d)(8). 
‘‘(g) ANNUAL CONSENSUS CONFERENCE ON PAIN 
AND PALLIATIVE CARE RESEARCH.—To assist the Center 
in the establishment and maintenance of a national agen-
da for pain and palliative care research, and to ensure that 
the Center remains abreast of research and clinical devel-
opments in both the public and private sectors, the Direc-
tor of the Center shall convene each year a consensus con-
ference of prominent researchers and clinicians in the field 
of pain and palliative care research and treatment. 
‘‘(h) AUTHORIZATION OF APPROPRIATIONS.—
‘‘(1) IN
GENERAL.—For the purpose of car-
rying out this section, there are authorized to be ap-
propriated $40,000,000 for each of fiscal years 
2004, 2005, and 2006, and such sums as may be 
necessary thereafter. 
‘‘(2) REGIONAL CENTERS.—Of the amount ap-
propriated under paragraph (1) for fiscal year 2005 
and each subsequent fiscal year, not less than 
$1,500,000 shall be made available to each of the re-
gional centers established under subsection (f).’’. 
SEC. 4. PAIN CARE EDUCATION AND TRAINING. 
(a) PAIN AND PALLIATIVE CARE RESEARCH AND 
QUALITY.—Part A of title IX of the Public Health Service 
Act (42 U.S.C. 299 et seq.) is amended by adding at the 
end the following: 
‘‘SEC. 904. PROGRAM FOR PAIN AND PALLIATIVE CARE RE-
SEARCH AND QUALITY. 
‘‘(a) IN GENERAL.—The Director shall carry out a 
program to—
‘‘(1) develop and advance the quality, appro-
priateness, and effectiveness of pain and palliative 
care; and