39–006

109TH CONGRESS REPT. 109–116 " HOUSE OF REPRESENTATIVES ! 1st Session Part 1

DRUG ADDICTION TREATMENT EXPANSION ACT 

JUNE 9, 2005.—Ordered to be printed 

Mr. BARTON of Texas, from the Committee on Energy and 

Commerce, submitted the following 

R E P O R T 

[To accompany H.R. 869] 

[Including cost estimate of the Congressional Budget Office]

The Committee on Energy and Commerce, to whom was referred 

the bill (H.R. 869) to amend the Controlled Substances Act to lift 

the patient limitation on prescribing drug addiction treatments by 

medical practitioners in group practices, and for other purposes, 

having considered the same, report favorably thereon without 

amendment and recommend that the bill do pass.

CONTENTS 

Page 

Purpose and Summary ............................................................................................ 1

Background and Need for Legislation .................................................................... 2

Hearings ................................................................................................................... 2

Committee Consideration ........................................................................................ 2

Committee Votes ...................................................................................................... 2

Committee Oversight Findings ............................................................................... 2

Statement of General Performance Goals and Objectives .................................... 3

New Budget Authority, Entitlement Authority, and Tax Expenditures ............. 3

Committee Cost Estimate ....................................................................................... 3

Congressional Budget Office Estimate ................................................................... 3

Federal Mandates Statement ................................................................................. 4

Advisory Committee Statement .............................................................................. 4

Constitutional Authority Statement ...................................................................... 4

Applicability to Legislative Branch ........................................................................ 4

Section-by-Section Analysis of the Legislation ...................................................... 4

Changes in Existing Law Made by the Bill, as Reported ..................................... 4

PURPOSE AND SUMMARY

The purpose of H.R. 869, the Drug Addiction Treatment Expansion Act, is to amend Section 303(g)(1)(B) of the Controlled Substances Act thereby increasing access to drug addiction therapy. 

2 

BACKGROUND AND NEED FOR LEGISLATION

In 2000, Congress passed the Drug Addiction Treatment Act, 

Public Law 106–310. Section 2(a)(2) of the Act established a new 

waiver mechanism for schedule IV or V treatment programs and 

placed it in paragraph 303(g)(2) of the Controlled Substances Act. 

The waiver is available to qualified physicians for maintenance 

treatment and detoxification treatment using approved schedule IV 

or V narcotic drugs, either alone or in combination. 

Physicians who wish to use the waiver must notify the Secretary 

of their intentions, certifying (1) that they meet one or more of the 

training and experience demands defined in section 303(g)(2)(G); 

(2) that they have the capacity to refer patients to counseling and 

other ancillary services as appropriate; and, (3) that they will 

honor the limitations placed on the number of patients they may 

treat at any one time. Subject to regulatory adjustment by the Secretary, neither sole practitioners nor any collection of physicians 

practicing as a group may treat more than 30 patients at any one 

time. 

The 30 patient limitation on group practices has proven to be an 

unnecessary barrier to addiction treatment medication. H.R. 869 

lifts the 30 patient limitation for group practices. The individual 

physician limitation of 30 patients remains in place. This small but 

substantive change in Section 303 of the Controlled Substances Act 

will improve access to drug addiction therapy. 

HEARINGS

The Committee on Energy and Commerce has not held hearings 

on the legislation. 

COMMITTEE CONSIDERATION

On Wednesday, April 27, 2005, the Subcommittee on Health met 

in open markup session and approved H.R. 869 for Full Committee 

consideration, without amendment, by a voice vote, a quorum being 

present. On Wednesday, May 4, 2005, the Full Committee met in 

open markup session and ordered H.R. 869 favorably reported to 

the House, without amendment, by a voice vote, a quorum being 

present. 

COMMITTEE VOTES

Clause 3(b) of rule XIII of the Rules of the House of Representatives requires the Committee to list the record votes on the motion 

to report legislation and amendments thereto. There were no 

record votes taken in connection with ordering H.R. 869 reported. 

A motion by Mr. Barton to order H.R. 869 reported to the House, 

without amendment, was agreed to by a voice vote. 

COMMITTEE OVERSIGHT FINDINGS

Pursuant to clause 3(c)(1) of rule XIII of the Rules of the House 

of Representatives, the Committee has not held oversight or legislative hearings on this legislation. 

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STATEMENT OF GENERAL PERFORMANCE GOALS AND OBJECTIVES

The objective of this legislation is to expand access to addiction 

treatment therapy. 

NEW BUDGET AUTHORITY, ENTITLEMENT AUTHORITY, AND TAX

EXPENDITURES

In compliance with clause 3(c)(2) of rule XIII of the Rules of the 

House of Representatives, the Committee finds that H.R. 869, the 

Drug Addiction Treatment Expansion Act, would result in no new 

or increased budget authority, entitlement authority, or tax expenditures or revenues. 

COMMITTEE COST ESTIMATE

The Committee adopts as its own the cost estimate prepared by 

the Director of the Congressional Budget Office pursuant to section 

402 of the Congressional Budget Act of 1974. 

CONGRESSIONAL BUDGET OFFICE ESTIMATE

Pursuant to clause 3(c)(3) of rule XIII of the Rules of the House 

of Representatives, the following is the cost estimate provided by 

the Congressional Budget Office pursuant to section 402 of the 

Congressional Budget Act of 1974:

U.S. CONGRESS, 

CONGRESSIONAL BUDGET OFFICE, 

Washington, DC, May 12, 2005. 

Hon. JOE BARTON, 

Chairman, Committee on Energy and Commerce, 

House of Representatives, Washington, DC. 

DEAR MR. CHAIRMAN: The Congressional Budget Office has prepared the enclosed cost estimate for H.R. 869, a bill to amend the 

Controlled Substances Act to lift the patient limitation on prescribing drug addiction treatments by medical practitioners in 

group practices, and for other purposes. 

If you wish further details on this estimate, we will be pleased 

to provide them. The CBO staff contact is Eric Rollins. 

Sincerely, 

ELIZABETH M. ROBINSON, 

(For Douglas Holtz-Eakin, Director). 

Enclosure.

H.R. 869—A bill to amend the Controlled Substances Act to lift the 

patient limitation on prescribing drug addiction treatments by 

medical practitioners in group practices, and for other purposes 

H.R. 869 would allow medical group practices to prescribe and 

dispense narcotic drugs in schedules III, IV, or V (the drugs rated 

the lowest risk for abuse) for drug addiction treatment to more 

than 30 patients at a time without first registering with the Drug 

Enforcement Administration (DEA). The bill would prohibit individual practitioners within such groups from treating more than 30 

patients at a time. Individual practitioners and group practices 

that treat fewer than 30 patients are already exempt from the requirement to register with DEA. 

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CBO estimates that this bill would have no significant budgetary 

effect. Enacting the bill could affect direct spending, but any such 

effects would likely be negligible. H.R. 869 contains no intergovernmental or private-sector mandates as defined in the Unfunded 

Mandates Reform Act and would impose no costs on state, local, or 

tribal governments. 

The CBO staff contact for this estimate is Eric Rollins. This estimate was approved by Peter H. Fontaine, Deputy Assistant Director for Budget Analysis. 

FEDERAL MANDATES STATEMENT

The Committee adopts as its own the estimate of Federal mandates prepared by the Director of the Congressional Budget Office 

pursuant to section 423 of the Unfunded Mandates Reform Act. 

ADVISORY COMMITTEE STATEMENT

No advisory committees within the meaning of section 5(b) of the 

Federal Advisory Committee Act were created by this legislation. 

CONSTITUTIONAL AUTHORITY STATEMENT

Pursuant to clause 3(d)(1) of rule XIII of the Rules of the House 

of Representatives, the Committee finds that the Constitutional authority for this legislation is provided in Article I, section 8, clause 

3, which grants Congress the power to regulate commerce with foreign nations, among the several States, and with the Indian tribes. 

APPLICABILITY TO LEGISLATIVE BRANCH

The Committee finds that the legislation does not relate to the 

terms and conditions of employment or access to public services or 

accommodations within the meaning of section 102(b)(3) of the Congressional Accountability Act. 

SECTION-BY-SECTION ANALYSIS OF THE LEGISLATION

Section 1. Maintenance of detoxification treatment with certain narcotic drugs; elimination of 30-patient limit for group practices. 

Subsection (a) amends Section 303(g)(2)(B) of the Controlled Substance Act (21 U.S.C. 823(g)(2)(B) by striking clause (iv). Striking 

clause (iv) would lift the 30 patient limitation for group practices 

that dispense narcotic drugs for maintenance or detoxification 

treatment. 

Subsection (b) is a conforming amendment to ensure that the individual physician limit of 30 patients still applies to physicians in 

group practices. 

Subsection (c) states the section shall take affect on the date of 

enactment of the Act. 

CHANGES IN EXISTING LAW MADE BY THE BILL, AS REPORTED

In compliance with clause 3(e) of rule XIII of the Rules of the 

House of Representatives, changes in existing law made by the bill, 

as reported, are shown as follows (existing law proposed to be omitted is enclosed in black brackets, new matter is printed in italics, 

existing law in which no change is proposed is shown in roman): 

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SECTION 303 OF THE CONTROLLED SUBSTANCE ACT 

REGISTRATION REQUIREMENTS

SEC. 303. (a) * * * 

* * * * * * * 

(g)(1) * * * 

(2)(A) * * * 

(B) For purposes of subparagraph (A), the conditions specified in 

this subparagraph with respect to a practitioner are that, before 

the initial dispensing of narcotic drugs in schedule III, IV, or V or 

combinations of such drugs to patients for maintenance or detoxification treatment, the practitioner submit to the Secretary a notification of the intent of the practitioner to begin dispensing the 

drugs or combinations for such purpose, and that the notification 

contain the following certifications by the practitioner: 

(i) * * * 

* * * * * * * 

(iii) øIn any case in which the practitioner is not in a group 

practice, the total¿ The total number of such patients of the 

practitioner at any one time will not exceed the applicable 

number. For purposes of this clause, the applicable number is 

30, except that the Secretary may by regulation change such 

total number. 

ø(iv) In any case in which the practitioner is in a group practice, the total number of such patients of the group practice at 

any one time will not exceed the applicable number. For purposes of this clause, the applicable number is 30, except that 

the Secretary may by regulation change such total number, 

and the Secretary for such purposes may by regulation establish different categories on the basis of the number of practitioners in a group practice and establish for the various categories different numerical limitations on the number of such 

patients that the group practice may have.¿ 

* * * * * * * 

Æ