Jason Simcakoski PROMISE Act

Bill: 114-hr-4063
Sponsor: Rep. Bilirakis, Gus M. [R-FL-12]
Introduced: 2015-11-18 in the House
Policy area: Armed Forces and National Security
Subjects: Accounting and auditing
Advisory bodies
Alternative treatments
Congressional oversight
Department of Veterans Affairs
Drug therapy
Drug trafficking and controlled substances
Drug, alcohol, tobacco use
Government studies and investigations
Health care quality
Health facilities and institutions
Health information and medical records
Health personnel
Health promotion and preventive care
Home and outpatient care
Hospital care
Licensing and registrations
Medical education
Medical ethics
Medical tests and diagnostic methods
Mental health
Military medicine
Prescription drugs
Veterans' medical care

Summary:
action_date: 2015-11-18
text: 

Promoting Responsible Opioid Management and Incorporating Scientific Expertise Act or the Jason Simcakoski PROMISE Act

 
This bill directs the Department of Veterans Affairs (VA) and the Department of Defense (DOD) to jointly update the VA/DOD Clinical Practice Guideline for Management of Opioid Therapy for Chronic Pain, including guidelines regarding: 
 
 
prescribing opioids for outpatient treatment of chronic, non-cancer pain; 
 
contraindications for opioid therapy; 
 
treatment of patients with post-traumatic stress disorder, psychiatric disorders, or a history of substance abuse or addiction; 
 
case management for patients transitioning between inpatient and outpatient health care and between DOD and non-DOD health care; 
 
routine and random urine drug tests to help prevent substance abuse; and 
 
options to augment opioid therapy with other clinical and complementary and integrative health services to minimize opioid dependence. 
 
 
The VA shall: 
 
 
expand the opioid safety initiative to include all VA medical facilities, including providing employees with pain management training, and establishment of pain management teams; 
 
track and monitor opioid use, including through the use of state program information; 
 
increase the availability of Food and Drug Administration-approved opioid receptor antagonists; 
 
modify the computerized patient record system to ensure that any health care provider that accesses a veteran's record will be immediately notified whether the veteran is receiving opioid therapy and has a history of substance use disorder or opioid abuse; 
 
 establish standard protocols for the designation of pain management teams at each VA medical facility;
 
 carry out a pilot program to assess the feasibility of using wellness programs to complement pain management and related health care services to veterans; 
 
 carry out a program of internal audits to improve health care services to veterans and their families; and 
 
provide to the medical board of each state in which a VA health care provider is licensed information about such provider's medical license violations.
 
 
The Creating Options for Veterans' Expedited Recovery Commission is established to examine the evidence-based therapy treatment model used by the VA for treating mental health conditions of veterans and the potential benefits of incorporating complementary alternative treatments available in non-VA facilities. 
 
The Government Accountability Office shall report to Congress on the VA's opioid safety initiative and patient advocacy program. 
 
The VA shall request from the medical board of each state in which a prospective health care provider has a medical license information on: (1) medical license violations during the past 20 years, and (2) any settlement agreements for a medical-related disciplinary charge. 

action_date: 2016-05-10
text: 

Promoting Responsible Opioid Management and Incorporating Scientific Expertise Act or the Jason Simcakoski PROMISE Act

 
(Sec. 2) This bill directs the Department Veterans Affairs (VA) to expand its Opioid Safety Initiative to include all VA medical facilities. 
 
The VA shall establish guidance that each VA health care provider, before initiating opioid therapy, use the VA Opioid Therapy Risk Report tool, which shall include: (1) information from state prescription drug monitoring programs; and (2) a patient's most recent information in order to assess the risk for adverse outcomes of opioid therapy, including the concurrent use of controlled substances such as benzodiazepines. 
 
The VA shall establish enhanced standards for the use of routine and random urine drug tests before and during opioid therapy to help prevent substance abuse, dependence, and diversion, including that: (1) tests occur at least once each year; and (2) health care providers use the test results to tailor pain therapy, safeguards, and risk management strategies for each patient. 
 
The VA shall use the Interdisciplinary Chronic Pain Management Training Team Program to provide education and training on pain management and safe opioid prescribing practices for managing patients with chronic pain.
 
In carrying out the VA Opioid Safety Initiative, each VA medical facility shall designate a pain management team of health care professionals to coordinate pain management therapy for patients experiencing acute and chronic pain that is non-cancer related. 
 
The VA shall establish standard protocols for the designation of pain management teams at each VA medical facility. Each protocol shall ensure that any health care provider without expertise in prescribing analgesics, or who has not completed the required education and training, does not prescribe opioids unless such health care provider: 
 
 
consults with a provider who has pain management expertise or who is on the pain management team; and 
 
refers the patient to the pain management team for subsequent prescriptions and therapy. 
 
 
In carrying out the Opioid Safety Initiative and the Opioid Therapy Risk Report tool, the VA shall: 
 
 
ensure access by VA health care providers to information on controlled substances, including opioids and benzodiazepines, prescribed to veterans who receive care outside the VA through a state prescription drug monitoring program; 
 
include such information in the Opioid Therapy Risk Report; and 
 
require VA health care providers to provide to a state's prescription drug monitoring program information on prescriptions of controlled substances received by veterans in that state. 
 
 
The VA shall report to Congress with respect to improving the VA Opioid Therapy Risk Report tool to allow for improved real-time tracking and access to data on: (1) key clinical indicators regarding the totality of veterans' opioid use, (2) concurrent prescribing by VA health care providers of opioids in different health care settings, and (3) mail-order prescriptions of opioids prescribed to veterans under VA-administered laws.
 
The VA shall: 
 
 
maximize the availability to veterans of Food and Drug Administration (FDA)-approved opioid receptor antagonists, including naloxone; 
 
equip each VA pharmacy with such antagonists for outpatient use; and 
 
expand the Overdose Education and Naloxone Distribution program to ensure that all veterans in receipt of VA health care who are at risk of opioid overdose may access such antagonists and training on the proper administration of such antagonists. 
 
 
The VA shall include in the Opioid Therapy Risk Report tool: 
 
 
information on the most recent time the tool was accessed by a VA health care provider with respect to a veteran and the results of such veteran's most recent urine drug test; and 
 
the ability of VA health care providers to determine whether a health care provider prescribed opioids to a veteran without checking tool information. 
 
 
The VA shall modify its computerized patient record system to ensure that any health care provider that accesses a veteran's record will be immediately notified about whether the veteran: (1) is receiving opioid therapy and has a history of substance use disorder or prior instances of overdose, (2) has a history of opioid abuse, or (3) is at risk of becoming an opioid abuser.
 
(Sec. 3) The VA and the Department of Defense (DOD) shall ensure that the VA/DOD Pain Management Working Group includes a focus on: 
 
 
opioid prescribing practices;
 
 management of acute and chronic pain, including related training for health care providers; 
 
 complementary and integrative health and complementary alternative medicines; 
 
 concurrent use of opioids and prescription drugs to treat mental health disorders, including benzodiazepines; 
 
 prescribing opioids to treat mental health disorders; 
 
 coordination in coverage of and consistent access to medications prescribed for patients transitioning from DOD to VA health care; and 
 
 identification and treatment of substance use disorders.
 
 
The VA and DOD shall ensure that such working group: (1) coordinates with other relevant working groups, (2) consults with other relevant federal agencies, and (3) and consults with VA and DOD regarding any proposed updates to the VA/DOD Clinical Practice Guideline for Management of Opioid Therapy for Chronic Pain. 
 
The VA and DOD shall update the VA/DOD Clinical Practice Guideline for Management of Opioid Therapy for Chronic Pain. Matters to be included in such update are prescribed. 
 
(Sec. 4) The Government Accountability Office shall, within two years, report to Congress on: (1) the VA Opioid Safety Initiative, and (2) opioid prescribing practices of VA health care providers. Such report shall include: 
 
 
improvements to the Opioid Safety Initiative; 
 
information regarding VA-prescribed opioid-related deaths, overall opioid prescription rates for non-cancer, non-palliative, and non-hospice care patients, concomitant opioid and benzodiazepine prescription rates, the prescription of opioids to patients without any pain (including non-opioid mental health disorders); 
 
 the effectiveness of opioid therapy; and 
 
 evaluations of the VA's oversight processes regarding veterans' opioid use and of its implementation of the VA/DOD Guideline for Management of Opioid Therapy. 
 
 
The VA shall: (1) report to Congress for five years regarding the prescription of opioids at each VA facility to treat non-cancer, non-palliative, and non-hospice care patients; and (2) notify Congress and conduct an investigation through the Office of the Medical Inspector if the VA determines that a prescription rate is inconsistent with safe care standards. 
 
(Sec. 5) VA disclosure of certain information to a state controlled substance monitoring program in order to prevent misuse of prescription medicines by a veteran or dependent is made mandatory.
 
(Sec. 6) The Veterans Access, Choice, and Accountability Act of 2014 is amended to reduce the aggregate amount of awards and bonuses that may be paid by the VA in each of FY2017-FY2021 to $230 million.


Legislative actions:
action_date: 2016-05-11
text: Received in the Senate and Read twice and referred to the Committee on Veterans' Affairs.
action_date: 2016-05-10
text: The title of the measure was amended. Agreed to without objection.
action_date: 2016-05-10
text: Motion to reconsider laid on the table Agreed to without objection.
action_date: 2016-05-10
text: On motion to suspend the rules and pass the bill, as amended Agreed to by voice vote. (text: CR H2166-2169)
action_date: 2016-05-10
text: Passed/agreed to in House: On motion to suspend the rules and pass the bill, as amended Agreed to by voice vote.(text: CR H2166-2169)
action_date: 2016-05-10
text: DEBATE - The House proceeded with forty minutes of debate on H.R. 4063.
action_date: 2016-05-10
text: Considered under suspension of the rules. (consideration: CR H2166-2172)
action_date: 2016-05-10
text: Mr. Miller (FL) moved to suspend the rules and pass the bill, as amended.
action_date: 2016-05-10
text: Placed on the Union Calendar, Calendar No. 422.
action_date: 2016-05-10
text: Committee on Armed Services discharged.
action_date: 2016-05-10
text: Committee on Armed Services discharged.
action_date: 2016-05-10
text: Reported (Amended) by the Committee on Veterans' Affairs. H. Rept. 114-546, Part I.
action_date: 2016-05-10
text: Reported (Amended) by the Committee on Veterans' Affairs. H. Rept. 114-546, Part I.
action_date: 2016-02-25
text: Ordered to be Reported in the Nature of a Substitute (Amended) by Voice Vote.
action_date: 2016-02-25
text: Committee Consideration and Mark-up Session Held.
action_date: 2016-02-25
text: Subcommittee on Health Discharged.
action_date: 2015-12-03
text: Referred to the Subcommittee on Health.
action_date: 2015-12-01
text: Sponsor introductory remarks on measure. (CR H8656)
action_date: 2015-11-30
text: Referred to the Subcommittee on Military Personnel.
action_date: 2015-11-18
text: Referred to the Committee on Veterans' Affairs, and in addition to the Committee on Armed Services, 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.
action_date: 2015-11-18
text: Referred to the Committee on Veterans' Affairs, and in addition to the Committee on Armed Services, 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.
action_date: 2015-11-18
text: Referred to the Committee on Veterans' Affairs, and in addition to the Committee on Armed Services, 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.
action_date: 2015-11-18
text: Introduced in House
action_date: 2015-11-18
text: Introduced in House