[Congressional Record (Bound Edition), Volume 162 (2016), Part 2]
[House]
[Pages 1667-1668]
[From the U.S. Government Publishing Office, www.gpo.gov]




              PRESCRIPTION DRUG EPIDEMIC IN WEST VIRGINIA

  The SPEAKER pro tempore. The Chair recognizes the gentleman from West 
Virginia (Mr. Mooney) for 5 minutes.
  Mr. MOONEY of West Virginia. Mr. Speaker, every morning, countless 
West Virginians wake up fearing that they lost a loved one to drugs the 
night before; and every morning, far too many West Virginians find this 
fear has come true.
  The prescription drug abuse epidemic in our State is a tragedy that 
we cannot afford to ignore. It ravages our communities, rips families 
apart, stunts the development of our youth, and further ruptures our 
State's already ailing economy.
  Overuse of prescription pain medication is one of the leading causes 
of opioid addiction. When a patient has more narcotic pain medication 
than they need after a medical event, this excess medication can fall 
into the wrong hands; and a narcotic pain medication in the wrong hands 
often leads to addiction. In fact, the National Institute on Drug Abuse 
has found that 1 in 15 people who take nonmedical prescription pain 
relievers will try heroin.
  Last year, the number of fatal overdoses from prescription 
painkillers increased by 16 percent and, from heroin, 28 percent in the 
United States. In West Virginia, the story is even worse. According to 
a recent study by the Trust for America's Health, the Mountain State 
has the highest rate of overdose deaths in the entire United States.
  This issue is above party politics. It is a plague that all Americans 
must come together to solve. That is why, yesterday, I introduced H.R. 
4499, the Promoting Responsible Opioid Prescribing Act. This bipartisan 
bill strikes a harmful provision of ObamaCare that places unnecessary 
pressure on doctors and hospitals to prescribe narcotic pain medicine.
  This concern was brought to my attention while meeting with doctors 
and other healthcare professional workers in Charleston, West Virginia, 
who are active in our State's medical society. In other words, this was 
their idea. I thank them for bringing this to my attention, and I 
encourage others to bring any ideas to help fight back against the 
opium epidemic to your local Congressman.
  In 2006, the Centers for Medicare and Medicaid Services, CMS, and the 
Department of Health and Human Services developed a survey called the 
Hospital Consumer Assessment of Healthcare Providers and Systems, 
pronounced ``H-caps,'' for short. HCAHPS is a standardized survey used 
to measure patient perspectives and satisfaction on the care they 
receive in hospital settings.
  At first, hospitals used this survey on an optional basis. However, 
when ObamaCare became law in 2010, it put in place ``pay for 
performance'' provisions that use these survey results as a factor in 
calculating Medicare reimbursement rates for physicians and hospitals 
on quality measures.
  This provision of ObamaCare was intended to save money and to force 
improvements on hospital performance. However, it has led to unintended 
consequences in the area of pain management.
  The HCAHPS survey contains three questions on pain management:
  One, during this hospital stay, did you need medicine for pain?
  Two, during this hospital stay, how often was your pain well-
controlled?
  Three, during this hospital stay, how often did the hospital staff do 
everything they could to help you with your pain?
  Because of the tie to reimbursement, hospitals and physicians are 
pressured to perform well under HCAHPS, including the pain management 
questions. However, doctors, not the Federal Government, know how best 
to treat patients, and that includes the question of how best to use 
narcotic pain medication.

[[Page 1668]]

  The PROP Act would remove these pain management questions from 
consideration when CMS is conducting reimbursement analysis. However, 
the patient would still answer the survey questions so that hospitals 
can monitor patient satisfaction.
  By severing the relationship between HCAHPS questions on pain 
management and reimbursement, doctors would no longer feel the undue 
pressure to overprescribe opioid narcotics to people they believe may 
be abusing it. This simple change will help reduce access to narcotic 
pain medication for patients who do not need it, thereby reducing the 
risk of addiction.
  I would like to take the time to thank the bipartisan cosponsors of 
this bill: Annie Kuster, Chairman Hal Rogers, Stephen Lynch, Frank 
Guinta, Tim Ryan, and Barbara Comstock.
  Our bill has been endorsed by the American Medical Association and 
the American Society of Addiction Medicine.
  I encourage my colleagues in the House to consider cosponsoring my 
bill, H.R. 4499, the PROP Act.

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