I 

116TH CONGRESS 

1ST SESSION H. R. 4974 

To amend the Controlled Substances Act to require physicians and other 

prescribers of controlled substances to complete training on treating 

and managing patients with opioid and other substance use disorders 

(which shall also satisfy certain training required to receive a waiver 

for dispensing narcotic drugs for maintenance or detoxification treatment), and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

NOVEMBER 1, 2019 

Mrs. TRAHAN (for herself, Mr. BERGMAN, Mr. CARTER of Georgia, Mr. 

TRONE, Mr. ROGERS of Kentucky, Ms. KUSTER of New Hampshire, Mr. 

TONKO, Mr. CROW, Mr. ROSE of New York, and Mr. PAPPAS) introduced 

the following bill; which was referred to the Committee on Energy and 

Commerce, and in addition to the Committee on the Judiciary, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned 

A BILL 

To amend the Controlled Substances Act to require physicians and other prescribers of controlled substances to 

complete training on treating and managing patients 

with opioid and other substance use disorders (which 

shall also satisfy certain training required to receive a 

waiver for dispensing narcotic drugs for maintenance 

or detoxification treatment), and for other purposes. 


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1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Medication Access and 

5 Training Expansion Act of 2019’’ or the ‘‘MATE Act of 

6 2019’’. 

7 SEC. 2. REQUIRING PRESCRIBERS OF CONTROLLED SUB8 STANCES TO COMPLETE TRAINING ON 

9 TREATING AND MANAGING PATIENTS WITH 

10 OPIOID AND OTHER SUBSTANCE USE DIS11 ORDERS. 

12 (a) IN GENERAL.—Section 303 of the Controlled 

13 Substances Act (21 U.S.C. 823) is amended by adding at 

14 the end the following: 

15 ‘‘(l) REQUIRED TRAINING FOR PRESCRIBERS ON

16 TREATING AND MANAGING PATIENTS WITH OPIOID AND

17 OTHER SUBSTANCE USE DISORDERS.— 

18 ‘‘(1) APPLICABILITY.—This subsection ap19 plies— 

20 ‘‘(A) with respect to any practitioner who 

21 is licensed under State law to prescribe con22 trolled substances; and 

23 ‘‘(B) beginning with the first registration 

24 or renewal of registration by the practitioner 

25 under this section occurring 90 or more days 


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1 after the date of enactment of the Medication 

2 Access and Training Expansion Act of 2019. 

3 ‘‘(2) TRAINING REQUIRED.—As a condition on 

4 registration under this section to dispense controlled 

5 substances in schedule II, III, IV, or V, the Attorney 

6 General shall require any practitioner described in 

7 paragraph (1)(A) to meet the following: 

8 ‘‘(A) If the practitioner is a physician, the 

9 practitioner must meet one or more of the fol10 lowing conditions: 

11 ‘‘(i) The physician holds a board cer12 tification in addiction psychiatry or addic13 tion medicine from the American Board of 

14 Medical Specialties. 

15 ‘‘(ii) The physician holds an addiction 

16 certification or board certification from the 

17 American Society of Addiction Medicine or 

18 the American Board of Addiction Medicine. 

19 ‘‘(iii) The physician holds a board cer20 tification in addiction medicine from the 

21 American Osteopathic Association. 

22 ‘‘(iv) The physician has, with respect 

23 to the treatment and management of pa24 tients with opioid and other substance use 

25 disorders, completed not less than 8 hours 


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1 of training (through classroom situations, 

2 seminars at professional society meetings, 

3 electronic communications, or otherwise) 

4 that is provided by the American Society of 

5 Addiction Medicine, the American Acad6 emy of Addiction Psychiatry, the American 

7 Medical Association, the American Osteo8 pathic Association, the American Psy9 chiatric Association, or any other organiza10 tion that the Secretary determines is ap11 propriate for purposes of this clause. Such 

12 training shall include— 

13 ‘‘(I) opioid maintenance and de14 toxification; 

15 ‘‘(II) appropriate clinical use of 

16 all drugs approved by the Food and 

17 Drug Administration for the treat18 ment of a substance use disorder; 

19 ‘‘(III) initial and periodic patient 

20 assessments (including substance use 

21 monitoring); 

22 ‘‘(IV) individualized treatment 

23 planning, overdose reversal, and re24 lapse prevention; 


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1 ‘‘(V) counseling and recovery 

2 support services; 

3 ‘‘(VI) staffing roles and consider4 ations; 

5 ‘‘(VII) diversion control; and 

6 ‘‘(VIII) other best practices, such 

7 as prevention of addiction, as identi8 fied by the Secretary, after consulta9 tion with practitioners from a variety 

10 of medical specialties and who prac11 tice in different settings in which con12 trolled substances are prescribed. 

13 ‘‘(v) The physician has participated as 

14 an investigator in one or more clinical 

15 trials leading to the approval of a narcotic 

16 drug in schedule III, IV, or V for mainte17 nance or detoxification treatment, as dem18 onstrated by a statement submitted to the 

19 Secretary by the sponsor of such approved 

20 drug. 

21 ‘‘(vi) The physician has such other 

22 training or experience as the State medical 

23 licensing board of the State where the phy24 sician will provide maintenance or detoxi25 fication treatment considers to demVerDate Sep 11 2014 00:04 Nov 13, 2019 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H4974.IH H4974

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1 onstrate the ability of the physician to 

2 treat and manage patients with opioid and 

3 other substance use disorders. 

4 ‘‘(vii) The physician has such other 

5 training or experience as the Secretary 

6 considers to demonstrate the ability of the 

7 physician to treat and manage patients 

8 with opioid and other substance use dis9 orders. Any criteria of the Secretary under 

10 this clause shall be established by regula11 tion. Any such criteria are effective only 

12 for 3 years after the date on which the cri13 teria are promulgated, but may be ex14 tended for such additional discrete 3-year 

15 periods as the Secretary considers appro16 priate for purposes of this clause. Such an 

17 extension of criteria may only be effec18 tuated through a statement published in 

19 the Federal Register by the Secretary dur20 ing the 30-day period preceding the end of 

21 the 3-year period involved. 

22 ‘‘(viii) The physician graduated in 

23 good standing from an accredited school of 

24 allopathic medicine or osteopathic medicine 

25 in the United States during the 5-year peVerDate Sep 11 2014 00:04 Nov 13, 2019 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H4974.IH H4974

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1 riod immediately preceding the date on 

2 which the physician first registers or re3 news under this section and has success4 fully completed a comprehensive allopathic 

5 or osteopathic medicine curriculum or ac6 credited medical residency that— 

7 ‘‘(I) included not less than 8 

8 hours of training on treating and 

9 managing patients with opioid and 

10 other substance use disorders; and 

11 ‘‘(II) included, at a minimum— 

12 ‘‘(aa) the training described 

13 in subclauses (I) through (VIII) 

14 of clause (iv); and 

15 ‘‘(bb) training with respect 

16 to any other best practice the 

17 Secretary determines should be 

18 included in the curriculum, which 

19 may include training on pain 

20 management, including assess21 ment and appropriate use of 

22 opioid and non-opioid alter23 natives. 


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1 ‘‘(B) If the practitioner is not a physician, 

2 the practitioner must meet one or more of the 

3 following conditions: 

4 ‘‘(i) Completed not fewer than 24 

5 hours of initial training addressing each of 

6 the topics listed in subparagraph (A)(iv) 

7 (through classroom situations, seminars at 

8 professional society meetings, electronic 

9 communications, or otherwise) provided by 

10 the American Society of Addiction Medi11 cine, the American Academy of Addiction 

12 Psychiatry, the American Medical Associa13 tion, the American Osteopathic Associa14 tion, the American Nurses Credentialing 

15 Center, the American Psychiatric Associa16 tion, the American Association of Nurse 

17 Practitioners, the American Academy of 

18 Physician Assistants, or any other organi19 zation that the Secretary determines is ap20 propriate for purposes of this clause. 

21 ‘‘(ii) Has such other training or expe22 rience as the Secretary determines will 

23 demonstrate the ability of the practitioner 

24 to treat and manage patients with opioid 

25 and other substance use disorders. 


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1 ‘‘(iii) Graduated in good standing 

2 from an accredited physician assistant 

3 school or school of advanced practice nurs4 ing in the United States during the 5-year 

5 period immediately preceding the date on 

6 which the practitioner first registers or re7 news under this section and has success8 fully completed a comprehensive physician 

9 assistant or advanced practice nursing cur10 riculum that includes not less than 24 

11 hours of training on treating and man12 aging patients with opioid and other sub13 stance use disorders and, at a minimum— 

14 ‘‘(I) the training described in 

15 subclauses (I) through (VIII) of sub16 paragraph (A)(iv); and 

17 ‘‘(II) training with respect to any 

18 other best practice the Secretary de19 termines should be included in the 

20 curriculum, which may include train21 ing on pain management, including 

22 assessment and appropriate use of 

23 opioid and non-opioid alternatives. 

24 ‘‘(3) RECIPROCAL TREATMENT.— 


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1 ‘‘(A) PHYSICIANS.—A physician who meets 

2 one or more of the conditions listed in para3 graph (2)(A) is deemed to meet one or more of 

4 the conditions listed in subsection (g)(2)(G)(ii), 

5 and a physician who meets one or more of the 

6 conditions listed in subsection (g)(2)(G)(ii) is 

7 deemed to meet one or more of the conditions 

8 listed in paragraph (2)(A). 

9 ‘‘(B) OTHER PRACTITIONERS.—A practi10 tioner who is not a physician, and who meets 

11 one or more of the conditions listed in para12 graph (2)(B), is deemed to meet one or more 

13 of the conditions listed in subsection 

14 (g)(2)(G)(iv)(II), and a practitioner who is not 

15 a physician, and who meets one or more of the 

16 conditions listed in subsection (g)(2)(G)(iv)(II), 

17 is deemed to meet one or more of the conditions 

18 listed in paragraph (2)(B).’’. 

19 (b) TRAINING REQUIRED.— 

20 (1) PHYSICIANS.—Section 

21 303(g)(2)(G)(ii)(IV)(hh) of the Controlled Sub22 stances Act (21 U.S.C. 823(g)(2)(G)(ii)(IV)) is 

23 amended by inserting ‘‘such as prevention of addic24 tion,’’ after ‘‘other best practices,’’. 


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1 (2) OTHER PRACTITIONERS.—Section 

2 303(g)(2)(G)(iv)(II) of the Controlled Substances 

3 Act (21 U.S.C. 823(g)(2)(G)(iv)(II)) is amended— 

4 (A) in item (aa), by striking ‘‘or’’ at the 

5 end; 

6 (B) in item (bb), by striking the period at 

7 the end and inserting ‘‘; or’’; and 

8 (C) by adding at the end the following new 

9 item: 

10 ‘‘(cc) graduated in good standing from an 

11 accredited physician assistant school or school 

12 of advanced practice nursing in the United 

13 States during the 5-year period immediately 

14 preceding the date on which the practitioner 

15 submits to the Secretary a written notification 

16 under subparagraph (B) and has successfully 

17 completed a comprehensive physician assistant 

18 or advanced practice nursing curriculum that 

19 includes not less than 24 hours of training on 

20 treating and managing opioid-dependent pa21 tients and, at a minimum— 

22 ‘‘(AA) the training described in items 

23 (aa) through (hh) of clause (ii)(IV); and 

24 ‘‘(BB) training with respect to any 

25 other best practice the Secretary deterVerDate Sep 11 2014 00:04 Nov 13, 2019 Jkt 099200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H4974.IH H4974

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1 mines should be included in the cur2 riculum, which may include training on 

3 pain management, including assessment 

4 and appropriate use of opioid and non5 opioid alternatives.’’. 

6 (3) TECHNICAL CORRECTION.—Section 

7 303(g)(2)(G)(iv)(II)(bb) of the Controlled Sub8 stances Act (21 U.S.C. 823(g)(2)(G)(iv)(II)(bb)) is 

9 amended by striking ‘‘has’’ before ‘‘such other train10 ing’’. 

Æ 


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