Title: PROPER Act of 2018
Policy area: Health

Summary:
Providing Reliable Options for Patients and Educational Resources Act of 2018 or the PROPER Act of 2018
This bill requires Medicare and Medicare Advantage (MA) prescription drug plan (PDP) sponsors to annually disclose information to enrollees about: (1) the risks of prolonged opioid use; and (2) the plan's coverage of nonpharmacological therapies, devices, and non-opioid medications. PDP sponsors may limit disclosure to a subset of enrollees (such as those who were prescribed an opioid in the previous two-year period).
The bill also requires Medicare medication therapy management programs and MA in-home health risk assessments to include information about the safe disposal of prescription drugs.
The bill prohibits inclusion of pain management questions in certain health care system surveys, unless the questions address the risks of opioid use and the availability of non-opioid alternatives.


[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5775 Introduced in House (IH)]

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115th CONGRESS
  2d Session
                                H. R. 5775

  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.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                              May 11, 2018

    Mr. Paulsen (for himself, Mr. Poliquin, Mr. Kind, and Mr. Lamb) 
 introduced 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 Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Providing Reliable Options 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 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 
        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 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 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 two-year period.''.

SEC. 3. REQUIRING MEDICARE ADVANTAGE PLANS AND PRESCRIPTION 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 Disposal 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 substances 
        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 disposal.
            ``(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 
        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 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.''.

SEC. 4. REVISING MEASURES USED UNDER THE HOSPITAL CONSUMER ASSESSMENT 
              OF HEALTHCARE PROVIDERS AND SYSTEMS SURVEY RELATING 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 amended by adding at the end the following 
new subclause:
    ``(XII) With respect to a Hospital Consumer Assessment of 
Healthcare Providers and Systems survey (or a successor survey) 
conducted on or after January 1, 2019, such survey may not include 
questions about communication 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 informed 
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:
                            ``(iii) For fiscal year 2019.--For value-
                        based incentive payments made with respect to 
                        discharges occurring during fiscal year 2019, 
                        the Secretary shall ensure that measures 
                        selected under subparagraph (A) do not include 
                        a measure based on questions about 
                        communication by hospital staff with an 
                        individual about such individual's pain 
                        included in the Hospital Consumer Assessment of 
                        Healthcare Providers and Systems survey.''.
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