Budgeting for Opioid Addiction Treatment Act

Summary: Budgeting for Opioid Addiction Treatment Act  This bill amends the Internal Revenue Code to impose a one cent per milligram excise tax on the sale of active opioids by the manufacturer, producer, or importer. The tax excludes prescription drugs used exclusively for the treatment of opioid addiction as part of a medically assisted treatment effort.  The Department of Health and Human Services (HHS) must establish a program to provide rebates or discounts to cancer and hospice patients to ensure that they do not pay the tax.  The bill amends the Public Health Service Act to require any increase in federal revenues from the tax after rebates and discounts are subtracted to be distributed to states under the Substance Abuse Prevention and Treatment Block Grant program to be used exclusively for substance abuse (including opioid abuse) efforts in the states, including specified treatment programs.  HHS must report to Congress on the impact of this bill on the retail cost of opioids and patient access to opioid medication, the effectiveness of the discount or rebate for cancer and hospice patients, how the funds are being used to improve substance abuse treatment efforts, and suggestions for improving access to opioids for cancer and hospice patients and substance abuse treatment efforts. 

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Budgeting for Opioid Addiction 
Treatment Act''.

SEC. 2. EXCISE TAX ON OPIOID PAIN RELIEVERS.

    (a) In General.--Subchapter E of chapter 32 of the Internal Revenue 
Code of 1986 is amended by adding at the end the following new section:

``SEC. 4192. OPIOID PAIN RELIEVERS.

    ``(a) In General.--There is hereby imposed on the sale of any 
taxable active opioid by the manufacturer, producer, or importer a tax 
equal to 1 cent per milligram so sold.
    ``(b) Taxable Active Opioid.--For purposes of this section--
            ``(1) In general.--The term `taxable active opioid' means 
        any controlled substance (as defined in section 102 of the 
        Controlled Substances Act, as in effect on the date of the 
        enactment of this section) which is opium, an opiate, or any 
        derivative thereof.
            ``(2) Exclusion for certain prescription medications.--Such 
        term shall not include any prescribed drug which is used 
        exclusively for the treatment of opioid addiction as part of a 
        medically assisted treatment effort.
            ``(3) Exclusion of other ingredients.--In the case of a 
        product that includes a taxable active opioid and another 
        ingredient, subsection (a) shall apply only to the portion of 
        such product that is a taxable active opioid.''.
    (b) Clerical Amendments.--
            (1) The heading of subchapter E of chapter 32 of the 
        Internal Revenue Code of 1986 is amended by striking ``Medical 
        Devices'' and inserting ``Other Medical Products''.
            (2) The table of subchapters for chapter 32 of such Code is 
        amended by striking the item relating to subchapter E and 
        inserting the following new item:

               ``subchapter e. other medical products''.

            (3) The table of sections for subchapter E of chapter 32 of 
        such Code is amended by adding at the end the following new 
        item:

``Sec. 4192. Opioid pain relievers.''.
    (c) Effective Date.--The amendments made by this section shall 
apply to sales on or after the date that is 1 year after the date of 
the enactment of this Act.
    (d) Rebate or Discount Program for Certain Cancer and Hospice 
Patients.--
            (1) In general.--The Secretary of Health and Human 
        Services, in consultation with patient advocacy groups and 
        other relevant stakeholders as determined by such Secretary, 
        shall establish a mechanism by which--
                    (A) any amount paid by an eligible patient in 
                connection with the tax under section 4192 of the 
                Internal Revenue Code of 1986 (as added by this 
                section) shall be rebated to such patient in as timely 
                a manner as possible, or
                    (B) amounts paid by an eligible patient for taxable 
                active opioids (as defined in section 4192(b) of such 
                Code) are discounted at time of payment or purchase to 
                ensure that such patient does not pay any amount 
                attributable to such tax,
        with as little burden on the patient as possible. The Secretary 
        shall choose whichever of the options described in subparagraph 
        (A) or (B) is, in the Secretary's determination, most effective 
        and efficient in ensuring eligible patients face no economic 
        burden from such tax.
            (2) Eligible patient.--For purposes of this section, the 
        term ``eligible patient'' means--
                    (A) a patient for whom any taxable active opioid 
                (as so defined) is prescribed to treat pain relating to 
                cancer or cancer treatment;
                    (B) a patient participating in hospice care; and
                    (C) in the case of the death or incapacity of a 
                patient described in subparagraph (A) or (B) or any 
                similar situation as determined by the Secretary of 
                Health and Human Services, the appropriate family 
                member, medical proxy, or similar representative or the 
                estate of such patient.

SEC. 3. BLOCK GRANTS FOR PREVENTION AND TREATMENT OF SUBSTANCE ABUSE.

    (a) Grants to States.--Section 1921(b) of the Public Health Service 
Act (42 U.S.C. 300x-21(b)) is amended by inserting ``, and, as 
applicable, for carrying out section 1923A'' before the period.
    (b) Nonapplicability of Prevention Program Provision.--Section 
1922(a)(1) of the Public Health Service Act (42 U.S.C. 300x-22(a)(1)) 
is amended by inserting ``except with respect to amounts made available 
as described in section 1923A,'' before ``will expend''.
    (c) Opioid Treatment Programs.--Subpart II of part B of title XIX 
of the Public Health Service Act (42 U.S.C. 300x-21 et seq.) is amended 
by inserting after section 1923 the following:

``SEC. 1923A. ADDITIONAL SUBSTANCE ABUSE TREATMENT PROGRAMS.

    ``A funding agreement for a grant under section 1921 is that the 
State involved shall provide that any amounts made available by any 
increase in revenues to the Treasury in the previous fiscal year 
resulting from the enactment of section 4192 of the Internal Revenue 
Code of 1986, reduced by any amounts rebated or discounted under 
section 2(d) of the Budgeting for Opioid Addiction Treatment Act (as 
described in section 1933(a)(1)(B)(i)) be used exclusively for 
substance abuse (including opioid abuse) treatment efforts in the 
State, including treatment programs--
            ``(1) establishing new addiction treatment facilities, 
        residential and outpatient, including covering capital costs;
            ``(2) establishing sober living facilities;
            ``(3) recruiting and increasing reimbursement for certified 
        mental health providers providing substance abuse treatment in 
        medically underserved communities or communities with high 
        rates of prescription drug abuse;
            ``(4) expanding access to long-term, residential treatment 
        programs for opioid addicts (including 
        30-, 60-, and 90-day programs);
            ``(5) establishing or operating support programs that offer 
        employment services, housing, and other support services to 
        help recovering addicts transition back into society;
            ``(6) establishing or operating housing for children whose 
        parents are participating in substance abuse treatment 
        programs, including capital costs;
            ``(7) establishing or operating facilities to provide care 
        for babies born with neonatal abstinence syndrome, including 
        capital costs; and
            ``(8) other treatment programs, as the Secretary determines 
        appropriate.''.
    (d) Additional Funding.--Section 1933(a)(1)(B)(i) of the Public 
Health Service Act (42 U.S.C. 300x-33(a)(1)(B)(i)) is amended by 
inserting ``, plus any increase in revenues to the Treasury in the 
previous fiscal year resulting from the enactment of section 4192 of 
the Internal Revenue Code of 1986, reduced by any amounts rebated or 
discounted under section 2(d) of the Budgeting for Opioid Addiction 
Treatment Act'' before the period.

SEC. 4. REPORT.

    Not later than 2 years after the date described in section 2(c), 
the Secretary of Health and Human Services shall submit to Congress a 
report on the impact of the amendments made by sections 2 and 3 on--
            (1) the retail cost of taxable active opioids (as defined 
        in section 4192 of the Internal Revenue Code of 1986, as added 
        by section 2);
            (2) patient access to such opioids, particularly cancer and 
        hospice patients, including the effect of the discount or 
        rebate on such opioids for cancer and hospice patients under 
        section 2(d);
            (3) how the increase in revenue to the Treasury resulting 
        from the enactment of section 4192 of the Internal Revenue Code 
        of 1986 is used to improve substance abuse treatment efforts in 
        accordance with section 1923A of the Public Health Service Act 
        (as added by section 3); and
            (4) suggestions for improving--
                    (A) access to opioids for cancer and hospice 
                patients; and
                    (B) substance abuse treatment efforts under such 
                section 1923A.