Following Ayotte Call to Remove Incentives to Overprescribe Opioids, CMS Excludes Pain Management Questions from Being Used to Determine Reimbursement

Press Release

U.S. Senator Kelly Ayotte welcomed the recent issuance of a final rule from the Centers for Medicare & Medicaid Services (CMS) to exclude questions related to pain management from being used to determine hospital reimbursement under the Hospital Value-Based Purchasing Program. The agency's action takes an important step to eliminate any actual or perceived financial incentive for health care providers to overprescribe pain medications, including opioid pain relievers.

"While we must ensure that pain is properly managed and that patients receive appropriate care, we must also recognize that many individuals who are struggling with an opioid use disorder first misused prescription opioids. During several roundtables I held in New Hampshire to discuss the opioid abuse crisis, I heard directly from health care providers that the patient satisfaction survey's pain management questions were leading to the overprescribing of opioids. I am encouraged that CMS has listened to the feedback I received from New Hampshire providers and has taken this important step to remove these questions from being used to determine reimbursement. I look forward to continuing to work with New Hampshire health care providers and CMS to ensure that this critical policy change is properly implemented," said Senator Ayotte.

In January, Ayotte, along with Senators Chuck Grassley (R-IA) and Diane Feinstein (D-CA), wrote to HHS Secretary Sylvia Burwell and CMS Acting Administrator Andy Slavitt, seeking a progress report on a federal review exploring whether patient satisfaction surveys linked to higher Medicare payments encourage opioid pain reliever abuse, a serious national epidemic.

Ayotte has also co-sponsored bipartisan legislation, the Promoting Responsible Opioid Prescribing Act (S. 2758), to remove pain-related questions from hospital quality surveys when determining incentive payments to hospitals in May. Under the Promoting Responsible Opioid Prescribing Act, the following would not be permitted to be taken into consideration when determining hospital incentive payments: the need of patients for pain medicine; how often during a hospital stay the patient believes their pain was well controlled; how often during a hospital stay the hospital staff did "everything they could to help the patient with the pain experienced by the patient." The legislation would still keep these questions on the patient satisfaction survey so that hospitals could get an understanding of the patient's perspective on how their pain was managed. However, the patients' responses would not be taken into consideration when determining the incentive payments, thereby eliminating the financial incentive for hospitals to pressure physicians to overprescribe pain management drugs like opioids. Key components of the legislation were finalized under the CMS rule recently issued.

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