H. R. 6—109 
under section 1899, the quality reporting requirements for 
inpatient hospitals under section 1886(b)(3)(B)(viii), and 
the hospital value-based purchasing program under section 
1886(o). 
‘‘(3) CONSIDERATION OF MEASURES BY SECRETARY.—The Sec-
retary shall consider— 
‘‘(A) using opioid and opioid use disorder measures 
(including measures used under the Merit-Based Incentive 
Payment System under section 1848(q), measures rec-
ommended under paragraph (2)(C), and other such meas-
ures identified by the Secretary) in alternative payment 
models under section 1833(z)(3)(C) and in the shared 
savings program under section 1899; and 
‘‘(B) using opioid measures described in subparagraph 
(A), as applicable, in the quality reporting requirements 
for inpatient hospitals under section 1886(b)(3)(B)(viii), and 
in the hospital value-based purchasing program under sec-
tion 1886(o). 
‘‘(4) PRIORITIZATION OF MEASURE DEVELOPMENT.—The Sec-
retary shall prioritize for measure development the gaps in 
quality measures identified under paragraph (2)(B). 
‘‘(5) PRIORITIZATION OF MEASURE ENDORSEMENT.—The Sec-
retary— 
‘‘(A) during the period beginning on the date of the 
enactment of this subsection and ending on December 31, 
2023, shall prioritize the endorsement of measures relating 
to opioids and opioid use disorders by the entity with 
a contract under subsection (a) of section 1890 in connection 
with endorsement of measures described in subsection 
(b)(2) of such section; and 
‘‘(B) on and after January 1, 2024, may prioritize the 
endorsement of such measures by such entity.’’. 
SEC. 6094. TECHNICAL EXPERT PANEL ON REDUCING SURGICAL SET-
TING OPIOID USE; DATA COLLECTION ON PERIOPERATIVE 
OPIOID USE. 
(a) TECHNICAL EXPERT PANEL ON REDUCING SURGICAL SETTING 
OPIOID USE.— 
(1) IN GENERAL.—Not later than 6 months after the date 
of the enactment of this Act, the Secretary of Health and 
Human Services shall convene a technical expert panel, 
including medical and surgical specialty societies and hospital 
organizations, to provide recommendations on reducing opioid 
use in the inpatient and outpatient surgical settings and on 
best practices for pain management, including with respect 
to the following: 
(A) Approaches that limit patient exposure to opioids 
during the perioperative period, including pre-surgical and 
post-surgical injections, and that identify such patients 
at risk of opioid use disorder pre-operation. 
(B) Shared decision making with patients and families 
on pain management, including a review of payment to 
ensure payment under the Medicare program under title 
XVIII of the Social Security Act accounts for time spent 
on shared decision making. 
(C) Education on the safe use, storage, and disposal 
of opioids.
H. R. 6—110 
(D) Prevention of opioid misuse and abuse after dis-
charge. 
(E) Development of a clinical algorithm to identify 
and treat at-risk, opiate-tolerant patients and reduce reli-
ance on opioids for acute pain during the perioperative 
period. 
(2) REPORT.—Not later than 1 year after the date of the 
enactment of this Act, the Secretary shall submit to Congress 
and make public a report containing the recommendations 
developed under paragraph (1) and an action plan for broader 
implementation of pain management protocols that limit the 
use of opioids in the perioperative setting and upon discharge 
from such setting. 
(b) DATA COLLECTION
ON PERIOPERATIVE OPIOID USE.—Not 
later than 1 year after the date of the enactment of this Act, 
the Secretary of Health and Human Services shall submit to Con-
gress a report that contains the following: 
(1) The diagnosis-related group codes identified by the Sec-
retary as having the highest volume of surgeries. 
(2) With respect to each of such diagnosis-related group 
codes so identified, a determination by the Secretary of the 
data that is both available and reported on opioid use following 
such surgeries, such as with respect to— 
(A) surgical volumes, practices, and opioid prescribing 
patterns; 
(B) opioid consumption, including— 
(i) perioperative days of therapy; 
(ii) average daily dose at the hospital, including 
dosage greater than 90 milligram morphine equivalent; 
(iii) post-discharge prescriptions and other com-
bination drugs that are used before intervention and 
after intervention; 
(iv) quantity and duration of opioid prescription 
at discharge; and 
(v) quantity consumed and number of refills; 
(C) regional anesthesia and analgesia practices, 
including pre-surgical and post-surgical injections; 
(D) naloxone reversal; 
(E) post-operative respiratory failure; 
(F) information about storage and disposal; and 
(G) such other information as the Secretary may 
specify. 
(3) Recommendations for improving data collection on 
perioperative opioid use, including an analysis to identify and 
reduce barriers to collecting, reporting, and analyzing the data 
described in paragraph (2), including barriers related to techno-
logical availability. 
SEC. 6095. REQUIRING THE POSTING AND PERIODIC UPDATE OF 
OPIOID PRESCRIBING GUIDANCE FOR MEDICARE BENE-
FICIARIES. 
(a) IN GENERAL.—Not later than 180 days after the date of 
the enactment of this Act, the Secretary of Health and Human 
Services (in this section referred to as the ‘‘Secretary’’) shall post 
on the public website of the Centers for Medicare & Medicaid 
Services all guidance published by the Department of Health and
H. R. 6—111 
Human Services on or after January 1, 2016, relating to the pre-
scribing of opioids and applicable to opioid prescriptions for individ-
uals entitled to benefits under part A of title XVIII of the Social 
Security Act (42 U.S.C. 1395c et seq.) or enrolled under part B 
of such title of such Act (42 U.S.C. 1395j et seq.). 
(b) UPDATE OF GUIDANCE.— 
(1) PERIODIC UPDATE.—The Secretary shall, in consultation 
with the entities specified in paragraph (2), periodically (as 
determined appropriate by the Secretary) update guidance 
described in subsection (a) and revise the posting of such guid-
ance on the website described in such subsection. 
(2) CONSULTATION.—The entities specified in this para-
graph are the following: 
(A) Medical professional organizations. 
(B) Providers and suppliers of services (as such terms 
are defined in section 1861 of the Social Security Act (42 
U.S.C. 1395x)). 
(C) Health care consumers or groups representing such 
consumers. 
(D) Other entities determined appropriate by the Sec-
retary. 
Subtitle K—Providing Reliable Options for 
Patients and Educational Resources 
SEC. 6101. SHORT TITLE. 
This subtitle may be cited as the ‘‘Providing Reliable Options 
for Patients and Educational Resources Act of 2018’’ or the 
‘‘PROPER Act of 2018’’. 
SEC. 6102. REQUIRING MEDICARE ADVANTAGE PLANS AND PART D 
PRESCRIPTION DRUG PLANS TO INCLUDE INFORMATION 
ON RISKS ASSOCIATED WITH OPIOIDS AND COVERAGE 
OF NONPHARMACOLOGICAL 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 subpara-
graph (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 subparagraph (C), with respect to the 
treatment of pain— 
‘‘(I) the risks associated with prolonged opioid 
use; and 
‘‘(II) coverage of nonpharmacological 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 prescription drug 
plan, under such plan and under parts A and 
B.’’; and 
(3) by adding at the end the following new subparagraph: 
‘‘(C) TARGETED PROVISION OF INFORMATION.—A PDP 
sponsor of a prescription drug plan may, in lieu of disclosing
H. R. 6—112 
the information described in subparagraph (B)(vi) to each 
enrollee under the plan, disclose such information through 
mail or electronic communications to a subset of enrollees 
under the plan, such as enrollees who have been prescribed 
an opioid in the previous 2-year period.’’. 
SEC. 6103. REQUIRING MEDICARE ADVANTAGE PLANS AND PRESCRIP-
TION DRUG PLANS TO PROVIDE INFORMATION ON THE 
SAFE DISPOSAL OF PRESCRIPTION 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 DIS-
POSAL OF CERTAIN PRESCRIPTION DRUGS.— 
‘‘(1) IN GENERAL.—In the case of an individual enrolled 
under an MA or MA–PD plan who is furnished 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 sub-
stances that meets the criteria established under paragraph 
(2). Such information shall include information on drug 
takeback programs that meet such requirements determined 
appropriate by the Secretary and information on in-home dis-
posal. 
‘‘(2) CRITERIA.—The Secretary shall, through rulemaking, 
establish criteria the Secretary determines appropriate with 
respect to information provided to an individual to ensure that 
such information sufficiently educates such individual on the 
safe 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 promote’’; 
(2) by redesignating clauses (i) through (iii) as subclauses 
(I) through (III) and adjusting the margins accordingly; 
(3) by inserting before subclause (I), as so redesignated, 
the following new clause: 
‘‘(i) may include elements that promote—’’; 
(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 beginning 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 
established under section 1852(n)(2), including 
information on drug takeback programs that meet 
such requirements determined appropriate by the 
Secretary and information on in-home disposal; 
and 
‘‘(II) cost-effective means by which an enrollee 
may so safely dispose of such drugs.’’.