WASHINGTON — Sen. Ron Johnson (R-Wis.), chairman of the Senate Homeland Security and Governmental Affairs Committee, urged the Obama administration last week to finalize a proposed rule that implements measures against opioid abuse that Johnson and others sought to enact into law.

Johnson sent a letter to Andrew Slavitt, Acting Administrator for the Centers for Medicare and Medicaid Services (CMS), on Friday urging the agency to finalize its rule to remove pain management questions from hospital payment calculations. Today, pain management questions on patient surveys are factored into Medicare reimbursement calculations, which can serves as an incentive for the overprescription of opioids.

In April 2016, Johnson, joined by Sens. Joe Manchin (D-W. Va.), John Barrasso (R-Wyo.), and Richard Blumenthal (D-Conn.),  introduced S. 2758, the Promoting Responsible Opioid Prescribing (PROP) Act, which prohibits pain management questions on patient surveys from being factored into Medicare reimbursement calculations, to help address the issue of opioid overprescription.  In July, CMS proposed a rule that would effectively implement the PROP Act. 

“I write regarding a proposed rule by CMS to remove the pain management dimension from the HCAHPS survey for the hospital Value-Based Purchasing Program beginning in Fiscal Year (FY) 2018. I support this proposal, and I write to highlight the numerous other comments that were filed in this proceeding also supporting such an approach,” Johnson wrote in the letter. “Given the importance of this rule in stemming the tide of opioid abuse in Wisconsin and across the country and the overwhelming support for the change among doctors, administrators, and patients, I respectfully urge you to implement the rule as soon as possible and provide the Committee with regular briefings on your progress.”

In the letter, Johnson highlighted numerous comments filed in support of implementing the PROP Act.  “As one pain management physician pointed out, these questions ‘absolutely result[] in increased narcotic prescribing in the inpatient and outpatient setting, and also contributes to higher rates of adverse patient events due to narcotics.’ A nurse of 21 years elaborated: ‘Physicians will give pain meds to patients so they don’t receive negative patient satisfaction scores.  Their pay is often directly related to that scoring system.  Our nation has raised a whole new generation of people who expect a pill to fix them.’  Similarly, a neurosurgeon wrote ‘we need to treat our patients’ pain, but within reason.’  Finally, a hospitalist explained that these questions, ‘led to increased opiate prescribing at our facility and inappropriate prescribing at that.’  This commenter went on to explain: ‘The number of times I have heard from physicians at not just our facility but other facilities throughout the city, that they feel forced into prescribing opiates in spite of their better judgment due to patient satisfaction surveys is astounding.’ 

The letter can be found here.