[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[S. 3008 Introduced in Senate (IS)]
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115th CONGRESS
2d Session
S. 3008
To direct the Secretary of Health and Human Services to conduct a study
and submit to Congress a report containing recommendation on how to
improve the use of non-opioid treatments for acute and chronic pain
management for individuals entitled to benefits under part A or
enrolled under part B of the Medicare program, and for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
June 6, 2018
Mr. Young (for himself and Mr. Donnelly) introduced the following bill;
which was read twice and referred to the Committee on Finance
_______________________________________________________________________
A BILL
To direct the Secretary of Health and Human Services to conduct a study
and submit to Congress a report containing recommendation on how to
improve the use of non-opioid treatments for acute and chronic pain
management for individuals entitled to benefits under part A or
enrolled under part B of the Medicare program, 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 ``Dr. Todd Graham Pain Management
Improvement Act of 2018''.
SEC. 2. PAIN MANAGEMENT STUDY.
(a) In General.--Not later than 1 year after the date of enactment
of this Act, the Secretary of Health and Human Services (referred to in
this section as the ``Secretary'') shall conduct a study and submit to
the Committee on Ways and Means and the Committee on Energy and
Commerce of the House of Representatives and the Committee on Finance
of the Senate a report containing recommendations on whether and how
reimbursement to providers and suppliers of services, coverage, and
coding policies related to the use of multi-disciplinary, evidence-
based, non-opioid treatments for acute and chronic pain management for
individuals entitled to benefits under part A or enrolled under part B
of title XVIII of the Social Security Act should be revised. The
Secretary shall make such report available on the public website of the
Centers for Medicare & Medicaid Services.
(b) Consultation.--In developing the report described in subsection
(a), the Secretary shall consult with--
(1) relevant agencies within the Department of Health and
Human Services;
(2) licensed and practicing osteopathic and allopathic
physicians, physician assistants, nurse practitioners,
dentists, and pharmacists;
(3) hospitals and other medical facilities, including acute
care hospitals, cancer hospitals, psychiatric hospitals,
hospital emergency departments, facilities furnishing urgent
care services, ambulatory surgical centers, and post-acute care
and long-term care facilities (such as skilled nursing
facilities, inpatient rehabilitation facilities, long-term care
hospitals, and home health agencies);
(4) substance abuse and mental health professional
organizations;
(5) pain management professional organizations and advocacy
entities, including individuals who personally suffer chronic
pain;
(6) medical professional organizations and medical
specialty organizations;
(7) licensed health care providers who furnish alternative
pain management services;
(8) organizations with expertise in the development of
innovative medical technologies for pain management;
(9) beneficiary advocacy organizations; and
(10) other organizations with expertise in the assessment,
diagnosis, treatment, and management of pain, as determined
appropriate by the Secretary.
(c) Contents.--The report described in subsection (a) shall include
the following:
(1) The recommendations described in subsection (d).
(2) The impact analysis described in subsection (e).
(3) An assessment of pain management guidance published by
the Federal Government that may be relevant to coverage
determinations or other coverage requirements under title XVIII
of the Social Security Act.
(4) Recommendations for updating, including expanding, the
``CDC Guideline for Prescribing Opioids for Chronic Pain--
United States, 2016'' published in March 2016 by the Centers
for Disease Control and Prevention, including for purposes of
management of pain. Such recommendations shall--
(A) consider incorporating relevant elements of the
``Va/DoD Clinical Practice Guideline for Opioid Therapy
for Chronic Pain'' published in February 2017 by the
Department of Veterans Affairs and Department of
Defense, including adoption of elements of the
Department of Defense and Veterans Administration pain
rating scale; and
(B) include recommendations on how the ``CDC
Guideline for Prescribing Opioids for Chronic Pain--
United States, 2016'', as so updated, could be adopted
by health care providers across clinical settings.
(5) An evaluation of the following:
(A) Barriers inhibiting individuals entitled to
benefits under part A or enrolled under part B of such
title from accessing treatments and technologies
described in subparagraphs (A) through (C) of paragraph
(6).
(B) Potential legislative and administrative
changes under such title to improve individuals' access
to items and services currently covered under such
title and used for the treatment of pain, such as
cognitive behavioral interventions, physical therapy,
occupational therapy, physical medicine, biofeedback
therapy, and chiropractic therapy, and other pain
treatments services furnished in a hospital or post-
acute care setting.
(C) Costs and benefits associated with potential
expansion of coverage under such title to include items
and services not covered under such title that may be
used for the treatment of pain, such as acupuncture,
therapeutic massage, and items and services furnished
by integrated pain management programs.
(6) An analysis on reimbursement, coverage, and coding
policies (including DRG classification, CPT, HCPCS, NDC, and
other applicable codes) under title XVIII of the Social
Security Act with respect to the following:
(A) Non-opioid based treatments and technologies
for chronic or acute pain, including such treatments
that are covered, not covered, or have limited coverage
under such title.
(B) Non-opioid based treatments and technologies
that monitor substance use withdrawal and prevent
overdoses of opioids.
(C) Non-opioid based treatments and technologies
that treat substance use disorders.
(D) Items and services furnished by practitioners
through a multi-disciplinary treatment model for pain
management.
(E) Medical devices, non-opioid based drugs, and
other therapies (including interventional and
integrative pain therapies) approved or cleared by the
Food and Drug Administration for the treatment of pain.
(F) Items and services furnished to beneficiaries
with psychiatric disorders, substance use disorders, or
who are at risk of suicide, or have comorbidities and
require consultation or management of pain with one or
more specialists in pain management, mental health, or
addiction treatment.
(d) Recommendations.--The recommendations described in this
subsection are, with respect to individuals entitled to benefits under
part A or enrolled under part B of title XVIII of the Social Security
Act, legislative and administrative recommendations on the following:
(1) Options for additional coverage of pain management
therapies without the use of opioids, including interventional
pain therapies, and options to augment opioid therapy with
other clinical and complementary, integrative health services
to minimize the risk of substance use disorder, including in a
hospital setting.
(2) Options for coverage and reimbursement modifications of
medical devices and non-opioid based pharmacological and non-
pharmacological therapies (including interventional and
integrative pain therapies) approved or cleared by the Food and
Drug Administration for the treatment of pain as an alternative
or augment to opioid therapy.
(3) Treatment strategies for beneficiaries with psychiatric
disorders, substance use disorders, or who are at risk of
suicide, and treatment strategies to address health disparities
related to opioid use and opioid abuse treatment.
(4) Treatment strategies for beneficiaries with
comorbidities who require a consultation or comanagement of
pain with one or more specialists in pain management, mental
health, or addiction treatment, including in a hospital
setting.
(5) Coadministration of opioids and other drugs,
particularly benzodiazepines.
(6) Appropriate case management for beneficiaries who
transition between inpatient and outpatient hospital settings,
or between opioid therapy to non-opioid therapy, which may
include the use of care transition plans.
(7) Outreach activities designed to educate providers of
services and suppliers under the Medicare program and
individuals entitled to benefits under part A or under part B
of such title on alternative, non-opioid therapies to manage
and treat acute and chronic pain.
(8) Creation of a beneficiary education tool on
alternatives to opioids for chronic pain management.
(e) Impact Analysis.--The impact analysis described in this
subsection consists of an analysis of any potential effects
implementing the recommendations described in subsection (d) would
have--
(1) on expenditures under the Medicare program; and
(2) on preventing or reducing opioid addiction for
individuals receiving benefits under the Medicare program.
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