West Virginia has the highest rate of opioid overdose deaths in the country — more than double the national average. This drug abuse epidemic is a tragedy that we cannot afford to ignore. It ravages our communities, rips families apart, stunts the development of our youth and harms our economy.   

    Overuse or addiction of prescription pain medication is one of leading causes of opioid addiction and often leads to heroin use. According to the National Institute on Drug Abuse, people who abuse opioid painkillers like Oxycontin are 19 times more likely to start using heroin than people who do not abuse those painkillers. Even more striking, eight out of 10 people who use heroin abused painkillers first.

    Last year, the number of fatal overdoses from prescription painkillers increased by 16 percent, and from heroin, 28 percent in the US.

We must work together to find innovative solutions to combat the opioid epidemic head on and save lives. One solution is my bipartisan bill, H.R. 4499 — the PROP Act.

    On June 8, I went before the Committee on Ways and Means to fight for this important piece of legislation.

    This bipartisan bill removes a harmful provision of Obamacare that places unnecessary pressure on doctors and hospitals to prescribe narcotic pain medicine- regardless of whether patients actually need it.

    This problem was first brought to my attention by a group of doctors in Charleston, who were attending a state medical society dinner. This bill was their idea. These doctors, most of whom treat Medicare patients, described the dilemma they face when deciding whether to prescribe narcotic pain medicine. Do they prescribe narcotic pain medicine to a patient who does not need it because they fear a low patient satisfaction score? Or do they use their education and expertise to prescribe the appropriate medication and risk their score, along with hospital reimbursement rates?

    Let me explain. In 2006, the Centers for Medicare and Medicaid Services and the Department of Health and Human Services developed a survey called “Hospital Consumer Survey of Healthcare Providers and Systems” as 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.

    Because of the tie to reimbursement, hospitals and physicians are pressured to perform well on the HCAHPS, including on the three pain management questions in the survey. However, doctors, not the federal government, know best how to treat patients, and that includes the question of how best to use narcotic pain medicine.

    The PROP Act would remove these pain management questions from consideration when CMS is conducting reimbursement analysis. However, the patient would still answer the pain management questions in their HCAHPS survey so that hospitals can monitor how they are doing.  

    By severing the relationship between the HCAHPS questions on pain management and reimbursement, doctors will no longer feel the undue pressure to prescribe unnecessary opioid medications.  

    This simple change will help reduce access to narcotic pain medication for patients who do not need it, thereby reducing the risk of addiction.

    This is an easy fix for the government agency involved. The agency has already provided my office with technical assistance on this bill. If this bill passes, CMS will simply remove the questions from reimbursement calculations during the next rule-making. The PROP Act is also broadly supported by groups active in this field. The American Medical Association, American Hospital Association, Physicians for Responsible Opioid Prescribing, Association of American Medical Colleges, and America’s Essential Hospitals all support the bill.

    It has also been introduced in the Senate by Sens. Johnson, Manchin, Capito, Barrasso, Blumenthal, Markey, Toomey, Ayotte and King.

    While there is no magical solution to this epidemic, I believe that my bill, the PROP Act, is a significant step in the right direction. If you have any suggestions about what we can do to fight drug abuse in West Virginia, please contact my Charleston office at 304-925-5964 or my Washington D.C. office at 202-225-2711.

    — Alex Mooney represents the Second Congressional District in the U.S.

House of Representatives

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