[Congressional Record Volume 164, Number 102 (Tuesday, June 19, 2018)]
[House]
[Pages H5256-H5258]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




 PROVIDING RELIABLE OPTIONS FOR PATIENTS AND EDUCATIONAL RESOURCES ACT 
                                OF 2018

  Mr. CURBELO of Florida. Mr. Speaker, I move to suspend the rules and 
pass the bill (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, as 
amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 5775

       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

[[Page H5257]]

       ``(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)(aa) 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.
       ``(bb) The Secretary shall not include on the Hospital 
     Compare Internet website any measures based on the questions 
     appearing on the Hospital Consumer Assessment of Healthcare 
     Providers and Systems survey in 2018 about communication by 
     hospital staff with an individual about such individual's 
     pain.''.
       (b) Restriction on Use of 2018 Pain Questions in the 
     Hospital Value-based Purchasing Program.--Section 
     1886(o)(2)(B) of the Social Security Act (42 U.S.C. 
     1395ww(o)(2)(B)) is amended by adding at the end the 
     following new clause:
       ``(iii) HCAHPS pain questions.--The Secretary may not 
     include under subparagraph (A) a measure that is based on the 
     questions appearing on the Hospital Consumer Assessment of 
     Healthcare Providers and Systems survey in 2018 about 
     communication by hospital staff with an individual about the 
     individual's pain.''.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Florida (Mr. Curbelo) and the gentlewoman from California (Ms. Judy 
Chu) each will control 20 minutes.
  The Chair recognizes the gentleman from Florida.


                             General Leave

  Mr. CURBELO of Florida. Mr. Speaker, I ask unanimous consent that all 
Members may have 5 legislative days within which to revise and extend 
their remarks and include extraneous material on H.R. 5775, currently 
under consideration.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Florida?
  There was no objection.
  Mr. CURBELO of Florida. Mr. Speaker, I yield myself such time as I 
may consume.
  Mr. Speaker, I stand today in strong support of H.R. 5775, the 
Providing Reliable Options for Patients and Educational Resources Act, 
or the PROPER Act.
  This is a bipartisan bill centered on increasing educational 
resources for Medicare beneficiaries and improving pain-related 
questions contained in patient satisfaction surveys.
  H.R. 5775, introduced by my colleagues Erik Paulsen, Ron Kind, Brian 
Fitzpatrick, Bruce Poliquin, and Conor Lamb, contain several bills to 
combat the opioid crisis, including H.R. 5686, the Medicare CHOICE Act; 
H.R. 5714, the Education for Disposal of Unused Opioids Act; and H.R. 
5719, the Reduce Overprescribing Opioids in Treatment, or ROOT Act.
  Unfortunately, my home State of Florida has seen a dramatic increase 
in opioid-related overdose deaths in the past several years. Every 
year, thousands of Floridians become addicted and lose their lives to 
opioid addiction.
  Effective alternatives to opioids, such as physical therapy and 
medical devices exist, and in most instances are covered by Medicare.
  However, many seniors and providers simply aren't aware of the 
coverage options. Education is a key tool for seniors to make informed 
decisions about their healthcare.
  For this reason, the Ways and Means Committee sprang into action and 
passed H.R. 5775 unanimously. This bill contains provisions authored by 
my colleagues Erik Paulsen and Ron Kind to inform seniors about 
alternative nonaddictive pain management therapies covered by Medicare.
  This bill also includes a provision led by my colleagues Diane Black, 
Joe Crowley, Richard Hudson, and Raul Ruiz to educate seniors on safe 
disposal of unused controlled substances.
  Lastly, this bill includes another provision led by Diane Black and  
Tom O'Halleran requiring the Secretary of Health and Human Services to 
remove all pain-related questions contained in Medicare's hospital 
patient surveys unless the individual experiencing the pain is also 
informed about the risks associated with the use of opioids and given 
information on nonopioid alternatives for the treatment of pain.
  Madam Speaker, I want to thank my colleagues for their strong 
bipartisan work. This bill will make a difference in addressing the 
opioid epidemic that continues to devastate many Americans and their 
families.
  Madam Speaker, I reserve the balance of my time.
                                         House of Representatives,


                                  Committee on Ways and Means,

                                     Washington, DC, June 8, 2018.
     Hon. Greg Walden,
     Chairman, Committee on Energy and Commerce,
     Washington, DC.
       Dear Chairman Walden: I write to you regarding several 
     opioid bills the Committee on Ways and Means ordered 
     favorably reported to address the opioid epidemic. The 
     following bills were also referred to the Committee on Energy 
     and Commerce.
       I ask that the Committee on Energy and Commerce waive 
     formal consideration of the following bills so that they may 
     proceed expeditiously to the House Floor:
       H.R. 5774, Combatting Opioid Abuse for Care in Hospitals 
     (COACH) Act;
       H.R. 5775, Providing Reliable Options for Patients and 
     Educations Resources (PROPER) Act;
       H.R. 5776, Medicare and Opioid Safe Treatment (MOST) Act;
       H.R. 5773, Preventing Addition for Susceptible Seniors 
     (PASS) Act;
       H.R. 5676, Stop Excessive Narcotics in our Retirement 
     (SENIOR) Communities Protection Act; and
       H.R. 5723, Expanding Oversight of Opioid Prescribing and 
     Payment Act.
       I acknowledge that by waiving formal consideration of the 
     bills, the Committee on Energy and Commerce is in no way 
     waiving its jurisdiction over the subject matter contained in 
     those provisions of the bills that fall within your Rule X 
     jurisdiction. I would support your effort to seek appointment 
     of an appropriate number of conferees on any House-Senate 
     conference involving this legislation.
       I will include a copy of our letters in the Congressional 
     Record during consideration of this legislation on the House 
     floor.
           Sincerely,
                                                      Kevin Brady,
                                                         Chairman.

[[Page H5258]]

     
                                  ____
                                         House of Representatives,


                             Committee on Energy and Commerce,

                                     Washington, DC, June 8, 2018.
     Hon. Kevin Brady,
     Chairman, Committee on Ways and Means,
     Washington, DC.
       Dear Chairman Brady: Thank you for your letter regarding 
     the following bills, which were also referred to the 
     Committee on Energy and Commerce:
       H.R. 5774, Combatting Opioid Abuse for Care in Hospitals 
     (COACH) Act;
       H.R. 5775, Providing Reliable Options for Patients and 
     Educations Resources (PROPER) Act;
       H.R. 5776, Medicare and Opioid Safe Treatment (MOST) Act;
       H.R. 5773, Preventing Addition for Susceptible Seniors 
     (PASS) Act;
       H.R. 5676, Stop Excessive Narcotics in our Retirement 
     (SENIOR) Communities Protection Act; and
       H.R. 5723, Expanding Oversight of Opioid Prescribing and 
     Payment Act.
       I wanted to notify you that the Committee will forgo action 
     on these bills so that they may proceed expeditiously to the 
     House floor.
       I appreciate your acknowledgment that by forgoing formal 
     consideration of these bills, the Committee on Energy and 
     Commerce is in no way waiving its jurisdiction over the 
     subject matter contained in those provisions of the bills 
     that fall within its Rule X jurisdiction. I also appreciate 
     your offer to support the Committee's request for the 
     appointment of conferees in the event of a House-Senate 
     conference involving this legislation.
       Thank you for your assistance on this matter.
           Sincerely,
                                                      Greg Walden,
                                                         Chairman.

  Ms. JUDY CHU of California. Madam Speaker, I yield myself such time 
as I may consume.
  Madam Speaker, I offer my support of H.R. 5775, the PROPER Act. This 
bill, introduced by my colleagues Representatives Paulsen and Kind, 
would require Medicare Advantage and Medicare part D plans to provide 
information to beneficiaries on the risks associated with prolonged 
opioid use, as well as coverage information about alternatives, like 
nonpharmacological therapies, devices, and nonopioid medications.
  It is important to ensure that our providers in hospitals and 
outpatient settings have up-to-date and accurate information about 
opioid use. But it is equally critical that this information is 
provided to beneficiaries.
  Additionally, providing information on coverage of alternative 
therapies could help beneficiaries who may want to try a nonopioid pain 
management therapy to do so, thus avoiding a prescription where it may 
not be necessary.
  This bill also requires that by January 1, 2019, all pain-related 
questions be removed from the hospital consumer assessment of 
healthcare providers and systems survey, with some exceptions.
  If hospitals are graded on how much pain patients are feeling, they 
likely would seek to minimize the patient's pain through pain 
management drugs like opioids.
  In order to properly address this crisis in the Medicare program, we 
must ensure that beneficiaries have the information necessary to make 
informed decisions about their pain management plan.
  Madam Speaker, just as we are working to improve provider education, 
we must not leave our Medicare beneficiaries behind.
  I support this bill because it would ensure that Medicare Advantage 
and Medicare part D plans provide their beneficiaries with information 
on the risks of prolonged opioid use, as well as information about 
coverage for alternatives for pain management.
  Earlier in this debate, I mentioned a woman who testified that 
although she was experiencing severe back pain, she did not want to 
risk taking addictive pain medication and instead turned to 
acupuncture. It worked for her, and she told me that because of her 
acupuncture treatment, she was able to live pain free.
  Now, this is not to say that every alternative will work for every 
patient, but we should give patients the ability to choose their own 
pain management therapy. I believe H.R. 5775 is an important step 
toward this goal.
  Madam Speaker, I urge my colleagues to support this bill, and I yield 
back the balance of my time.
  Mr. CURBELO of Florida. Madam Speaker, the PROPER Act will bring much 
needed education to our seniors.
  This bill was brought through the committee process in a bipartisan 
fashion, and now on the floor I strongly urge my colleagues on both 
sides of the aisle to vote in favor of H.R. 5775, the PROPER Act.
  This is another example of how Republicans and Democrats can come 
together, can work together, to help struggling families in our 
country, and in this case seniors, who should be aware of all the 
different options that are available to them for pain treatment and 
should certainly be aware of the many risks associated with opioid use.
  Madam Speaker, I am grateful to all my colleagues and to committee 
staff for all their work on this legislation, and I strongly encourage 
everyone to support it, and I yield back the balance of my time.
  The SPEAKER pro tempore (Ms. Tenney). The question is on the motion 
offered by the gentleman from Florida (Mr. Curbelo) that the House 
suspend the rules and pass the bill, H.R. 5775, as amended.
  The question was taken; and (two-thirds being in the affirmative) the 
rules were suspended and the bill, as amended, was passed.
  A motion to reconsider was laid on the table.

                          ____________________