I
106TH CONGRESS
1ST SESSION
H. R. 2188
To amend the Public Health Service Act to provide for a public response
to the public health crisis of pain, and for other purposes.
IN THE HOUSE OF REPRESENTATIVES
JUNE 14, 1999
Ms. HOOLEY of Oregon (for herself, Mr. GREENWOOD, Mr. LEVIN, Mrs.
JOHNSON of Connecticut, and Mrs. MALONEY of New York) introduced
the following bill; which was referred to the Committee on Commerce,
and in addition to the Committee on Ways and Means, for a period to
be subsequently determined by the Speaker, in each case for consider-
ation of such provisions as fall within the jurisdiction of the committee
concerned
A BILL
To amend the Public Health Service Act to provide for
a public response to the public health crisis of pain,
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
‘‘Conquering Pain Act of 1999’’.
(b) TABLE OF CONTENTS.—The table of contents for
this Act is as follows:
Sec. 1. Short title.
Sec. 2. Findings.
Sec. 3. Definitions.
TITLE I—EMERGENCY RESPONSE TO THE PUBLIC HEALTH
CRISIS OF PAIN
Sec. 101. Guidelines for the treatment of pain.
Sec. 102. Patient expectations to have pain and symptom management.
Sec. 103. Quality improvement projects.
Sec. 104. Pain coverage quality evaluation and information.
Sec. 105. Surgeon General’s report.
TITLE II—DEVELOPING COMMUNITY RESOURCES
Sec. 201. Family support networks in pain and symptom management.
TITLE III—REIMBURSEMENT BARRIERS
Sec. 301. Reimbursement barriers report.
Sec. 302. Insurance coverage of pain and symptom management.
TITLE IV—IMPROVING FEDERAL COORDINATION OF POLICY,
RESEARCH, AND INFORMATION
Sec. 401. Advisory Committee on Pain and Symptom Management.
Sec. 402. Institutes of Medicine report on controlled substance regulation and
the use of pain medications.
Sec. 403. Conference on pain research and care.
TITLE V—DEMONSTRATION PROJECTS
Sec. 501. Provider performance standards for improvement in pain and symp-
tom management.
SEC. 2. FINDINGS.
Congress finds that—
(1) pain is often left untreated or under-treated
especially among older patients, African Americans,
and children;
(2) chronic pain is a public health problem af-
fecting at least 50,000,000 Americans through some
form of persisting or recurring symptom;
(3) 40 to 50 percent of patients experience
moderate to severe pain at least half the time in
their last days of life;
(4) 70 to 80 percent of cancer patients experi-
ence significant pain during their illness;
(5) despite the best intentions of physicians,
nurses, pharmacists, and other health care profes-
sionals, pain is often under-treated because of the
inadequate training of physicians in pain manage-
ment;
(6) despite the best intentions of physicians,
nurses, pharmacists, and other health care profes-
sionals, pain and symptom management is often
suboptimal because the health care system has fo-
cused on cure of disease rather than the manage-
ment of a patient’s pain and other symptoms;
(7) the technology and scientific basis to ade-
quately manage most pain is known;
(8) pain should be considered the fifth vital
sign; and
(9) coordination of Federal efforts is needed to
improve access to high quality effective pain and
symptom management in order to assure the needs
of chronic pain patients and those who are termi-
nally ill are met.
SEC. 3. DEFINITIONS.
In this Act: