II 

116TH CONGRESS 

2D SESSION S. 4242 

To establish programs related to prevention of prescription opioid misuse, 

and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

JULY 21, 2020 

Mr. DURBIN introduced the following bill; which was read twice and referred 

to the Committee on Finance 

A BILL 

To establish programs related to prevention of prescription 

opioid misuse, and for other purposes. 

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 ‘‘Addiction Prevention 

5 and Responsible Opioid Practices Act’’. 

6 SEC. 2. EXCISE TAX ON OPIOID PAIN RELIEVERS. 

7 (a) IN GENERAL.—Subchapter E of chapter 32 of the 

8 Internal Revenue Code of 1986 is amended by adding at 

9 the end the following new section: 


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1 ‘‘SEC. 4192. OPIOID PAIN RELIEVERS. 

2 ‘‘(a) IN GENERAL.—There is hereby imposed on the 

3 manufacturer or producer of any taxable active opioid a 

4 tax equal to the amount determined under subsection (b). 

5 ‘‘(b) AMOUNT DETERMINED.—The amount deter6 mined under this subsection with respect to a manufac7 turer or producer for a calendar year is 1 cent per milli8 gram of taxable active opioid in the production or manu9 facturing quota determined for such manufacturer or pro10 ducer for the calendar year under section 306 of the Con11 trolled Substances Act (21 U.S.C. 826). 

12 ‘‘(c) TAXABLE ACTIVE OPIOID.—For purposes of this 

13 section— 

14 ‘‘(1) IN GENERAL.—The term ‘taxable active 

15 opioid’ means any controlled substance (as defined 

16 in section 102 of the Controlled Substances Act (21 

17 U.S.C. 802), as in effect on the date of the enact18 ment of this section) manufactured in the United 

19 States which is opium, an opiate, or any derivative 

20 thereof. 

21 ‘‘(2) EXCLUSIONS.— 

22 ‘‘(A) OTHER INGREDIENTS.—In the case 

23 of a product that includes a taxable active 

24 opioid and another ingredient, subsection (a) 

25 shall apply only to the portion of such product 

26 that is a taxable active opioid. 


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1 ‘‘(B) DRUGS USED IN ADDICTION TREAT2 MENT.—The term ‘taxable active opioid’ shall 

3 not include any controlled substance (as so de4 fined) which is used exclusively for the treat5 ment of opioid addiction as part of a medica6 tion-assisted treatment.’’. 

7 (b) CLERICAL AMENDMENTS.— 

8 (1) The heading of subchapter E of chapter 32 

9 of the Internal Revenue Code of 1986 is amended by 

10 striking ‘‘Medical Devices’’ and inserting 

11 ‘‘Other Medical Products’’. 

12 (2) The table of subchapters for chapter 32 of 

13 such Code is amended by striking the item relating 

14 to subchapter E and inserting the following new 

15 item: 

‘‘SUBCHAPTER E. OTHER MEDICAL PRODUCTS’’. 

16 (3) The table of sections for subchapter E of 

17 chapter 32 of such Code is amended by adding at 

18 the end the following new item: 

‘‘Sec. 4192. Opioid pain relievers.’’. 

19 (c) EFFECTIVE DATE.—The amendments made by 

20 this section shall apply to calendar years beginning after 

21 the date of the enactment of this Act. 


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1 SEC. 3. OPIOID CONSUMER ABUSE REDUCTION PROGRAM. 

2 (a) OPIOID TAKE-BACK PROGRAM.—Section 302 of 

3 the Controlled Substances Act (21 U.S.C. 822) is amend4 ed by adding at the end the following: 

5 ‘‘(h)(1) The Attorney General shall establish a na6 tional take-back program for the safe and environmentally 

7 responsible disposal of controlled substances. 

8 ‘‘(2) In establishing the take-back program required 

9 under paragraph (1), the Attorney General— 

10 ‘‘(A) shall consult with the Secretary and the 

11 Administrator of the Environmental Protection 

12 Agency; and 

13 ‘‘(B) may coordinate with States, law enforce14 ment agencies, water resource management agencies, 

15 manufacturers, practitioners, pharmacists, public 

16 health entities, transportation and incineration serv17 ice contractors, and other entities and individuals, as 

18 appropriate. 

19 ‘‘(3) The take-back program established under para20 graph (1)— 

21 ‘‘(A) shall— 

22 ‘‘(i) ensure appropriate geographic dis23 tribution so as to provide— 

24 ‘‘(I) reasonably convenient and equi25 table access to permanent take-back loca26 tions, including not less than 1 disposal 


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1 site for every 25,000 residents and not less 

2 than 1 physical disposal site per town, city, 

3 county, or other unit of local government, 

4 where possible; and 

5 ‘‘(II) periodic collection events and 

6 mail-back programs, including public no7 tice of such events and programs, as a sup8 plement to the permanent take-back loca9 tions described in subclause (I), particu10 larly in areas in which the provision of ac11 cess to such locations at the level described 

12 in that subclause is not possible; 

13 ‘‘(ii) establish a process for the accurate 

14 cataloguing and reporting of the quantities of 

15 controlled substances collected; and 

16 ‘‘(iii) include a public awareness campaign 

17 and education of practitioners and pharmacists; 

18 and 

19 ‘‘(B) may work in coordination with State and 

20 locally implemented public and private take-back 

21 programs. 

22 ‘‘(4) From time to time, beginning in the second cal23 endar year that begins after the date of enactment of this 

24 subsection, the Secretary of the Treasury shall transfer 

25 from the general fund of the Treasury an amount equal 


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1 to one-half of the total amount of taxes collected under 

2 section 4192 of the Internal Revenue Code of 1986 to the 

3 Attorney General to carry out this subsection. Amounts 

4 transferred under this subparagraph shall remain avail5 able until expended.’’. 

6 (b) FUNDING OF SUBSTANCE ABUSE PROGRAMS.— 

7 From time to time, beginning in the second calendar year 

8 that begins after the date of enactment of this Act, the 

9 Secretary of the Treasury shall transfer from the general 

10 fund of the Treasury an amount equal to one-half of the 

11 total amount of taxes collected under section 4192 of the 

12 Internal Revenue Code of 1986, as added by this Act, to 

13 the Director of the Center for Substance Abuse Treatment 

14 of the Substance Abuse and Mental Health Services Ad15 ministration for programs of the Center, including the 

16 Block Grants for Prevention and Treatment of Substance 

17 Abuse program under subpart II of part B of title XIX 

18 of the Public Health Service Act (42 U.S.C. 300x–21 et 

19 seq.) and Programs of Regional and National Significance. 

20 Amounts transferred under this subsection shall remain 

21 available until expended. 

22 SEC. 4. GAO STUDY. 

23 Not later than 1 year after the date of enactment 

24 of this Act, the Comptroller General of the United States 

25 shall— 


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1 (1) conduct a study examining the coverage of2 fered under commercial health insurance plans and 

3 reimbursement rates under the Medicare program 

4 and State Medicaid plans with respect to— 

5 (A) substance use disorder treatment serv6 ices, as compared to other health services, and 

7 how any disparity identified under this para8 graph may contribute to differences in salary 

9 and turnover among substance abuse disorder 

10 providers; and 

11 (B) rates of coverage or reimbursement, as 

12 applicable, for substance abuse disorder services 

13 provided via telehealth, as compared to such 

14 services provided in-person; and 

15 (2) provide recommendations with respect to 

16 addressing any disparities identified under subpara17 graph (A) or (B) of paragraph (1) in order to bol18 ster retention of substance abuse disorder providers 

19 and the provision of substance abuse disorder serv20 ices. 


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1 SEC. 5. EXPANDING ACCESS TO SUBSTANCE USE DISORDER 

2 AND MENTAL HEALTH SERVICES FURNISHED 

3 THROUGH TELEHEALTH UNDER THE MEDI4 CARE PROGRAM. 

5 Section 1834(m)(7) of the Social Security Act (42 

6 U.S.C. 1395m(m)(7)) is amended— 

7 (1) in the paragraph heading, by inserting 

8 ‘‘AND MENTAL HEALTH SERVICES’’ after ‘‘SUB9 STANCE USE DISORDER SERVICES’’; 

10 (2) by inserting ‘‘or, on or after the first day 

11 after the end of the public health emergency de12 scribed in section 1135(g)(1)(B), to an eligible tele13 health individual for purposes of diagnosis of a sub14 stance use disorder or diagnosis or treatment of a 

15 mental health disorder, as determined by the Sec16 retary,’’ after ‘‘as determined by the Secretary,’’. 

17 SEC. 6. ENSURING PARITY FOR MENTAL HEALTH AND AD18 DICTION TREATMENT SERVICES. 

19 Title V of the Public Health Service Act (42 U.S.C. 

20 290ll et seq.) is amended— 

21 (1) in part K, by redesignating section 550 (42 

22 U.S.C. 290ee–10), relating to sobriety treatment 

23 and recovery teams, as section 553 and transferring 

24 such section to appear after section 552 in part D; 

25 and 


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1 (2) by adding at the end of such part D the fol2 lowing: 

3 ‘‘SEC. 554. COMPLIANCE WITH MENTAL HEALTH AND AD4 DICTION TREATMENT PARITY. 

5 ‘‘(a) IN GENERAL.—The Secretary, in coordination 

6 with the Secretary of Labor, shall award grants to, or 

7 enter into cooperative agreements with, States to ensure 

8 that health insurance issuers in the State comply with sec9 tion 2726. 

10 ‘‘(b) USE OF GRANT.—A State shall use amounts re11 ceived under a grant or cooperative agreement under this 

12 section to— 

13 ‘‘(1) establish clear guidelines for parity compli14 ance for mental health and substance use disorder 

15 benefits; 

16 ‘‘(2) ensure parity compliance during public 

17 health emergencies with best practices for delivering 

18 evidence-based mental health and substance use dis19 order treatment, including to ensure virtual, video, 

20 internet, telephonic, and other remote services are 

21 appropriately covered, including alignment with au22 thorities, flexibilities, and coverage promulgated by 

23 the Centers for Medicare & Medicaid Services; 

24 ‘‘(3) engage with health insurance issuers to en25 sure that they comply with the guidelines promulVerDate Sep 11 2014 03:51 Aug 04, 2020 Jkt 099200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S4242.IS S4242

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1 gated and other provisions of section 2726, including 

2 through audits, market conduct examinations, secret 

3 shopper programs, or other means; 

4 ‘‘(4) share information with other States who 

5 receive grants under this section; 

6 ‘‘(5) submit a report to the Secretary and the 

7 Secretary of Labor on information, actions, rec8 ommendations, and such other information as such 

9 secretaries may require; and 

10 ‘‘(6) publicly post a summary of the report sub11 mitted under paragraph (6) on the websites of the 

12 Department of Health and Human Services and the 

13 Department of Labor. 

14 ‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—There 

15 are authorized to be appropriated to carry out this section 

16 $10,000,000 for each of fiscal years 2021 through 2025.’’. 

17 SEC. 7. FEDERAL LICENSURE OF PHARMACEUTICAL REP18 RESENTATIVES WHO PROMOTE CERTAIN 

19 OPIOIDS. 

20 Subchapter E of chapter V of the Federal Food, 

21 Drug, and Cosmetic Act (21 U.S.C. 360bbb et seq.) is 

22 amended by adding at the end the following: 


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1 ‘‘SEC. 569E. FEDERAL LICENSURE OF PHARMACEUTICAL 

2 REPRESENTATIVES WHO PROMOTE CERTAIN 

3 OPIOIDS. 

4 ‘‘(a) IN GENERAL.—The Secretary, in consultation 

5 with the Attorney General, shall establish a licensure pro6 gram for pharmaceutical representatives described in sub7 section (b). 

8 ‘‘(b) LICENSURE PROGRAM.— 

9 ‘‘(1) REQUIREMENT.—Beginning on July 1, 

10 2021, no individual described in paragraph (2) may 

11 engage in the marketing or promoting of opioid 

12 drugs unless such individual is licensed under this 

13 section. 

14 ‘‘(2) INDIVIDUALS REQUIRED TO OBTAIN LI15 CENSURE.—An individual required to obtain a li16 cense under this section is any individual who, on 

17 behalf of a drug manufacturer, engaged, on more 

18 than 15 days in a calendar year, in the marketing 

19 or promotion to health care professionals, including 

20 educational or sales communications, meetings or 

21 paid events, and the provision of goods, gifts, and 

22 samples, of any opioid drug (other than methadone) 

23 that is listed in schedule II of section 202(c) of the 

24 Controlled Substances Act. 


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1 ‘‘(3) LICENSURE PERIOD.—Each license issued 

2 under this section shall be valid for 3 years, and 

3 may be renewed for additional 3-year periods. 

4 ‘‘(c) REQUIREMENTS.—An individual required to ob5 tain a license under this section shall— 

6 ‘‘(1) submit to the Secretary, at such time and 

7 in such manner as the Secretary may require— 

8 ‘‘(A) such information as the Secretary 

9 may require; and 

10 ‘‘(B) a registration fee in the amount of 

11 $3,000; 

12 ‘‘(2) certify that such individual has completed 

13 training on ethics, pharmaceutical marketing regula14 tions, the ‘CDC Guidelines for Prescribing Opioids 

15 for Chronic Pain’, published by the Centers for Dis16 ease Control and Prevention in 2016 (or any suc17 cessor document) or the ‘FDA Blueprint for Pre18 scriber Education for Extended-Release and Long19 Acting Opioid Analgesics’, and applicable Federal 

20 laws pertaining to drug marketing, labeling, and 

21 clinical trials, as the Secretary may require; 

22 ‘‘(3) certify that such individual will not engage 

23 in any illegal, fraudulent, misleading, or other decep24 tive marketing of schedule II opioid drugs; and 


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1 ‘‘(4) file with the Secretary annual reports dis2 closing the names of providers visited and any drug 

3 samples or gifts such individual gives any such pro4 vider. 

5 ‘‘(d) MANUFACTURER REPORTING REQUIRE6 MENTS.—The manufacturer who employs or contracts 

7 with any individual required to obtain a license under this 

8 section shall include in reports required under section 

9 1128G of the Social Security Act the name of each such 

10 licensed individual that provides payments or other trans11 fers of value required to be reported under such section 

12 1128G that relates to an opioid drug that is listed in 

13 schedule II of the Controlled Substances Act.’’. 

14 SEC. 8. WITHDRAWAL OF APPROVAL OF CERTAIN OPIOIDS. 

15 (a) IN GENERAL.—Notwithstanding any other provi16 sion of law, any ultra-high-dose opioid shall be considered 

17 a drug that presents an imminent hazard to the public 

18 health within the meaning of section 505(e) of the Federal 

19 Food, Drug, and Cosmetic Act (21 U.S.C. 355(e)), and 

20 the Secretary of Health and Human Services shall sus21 pend the approval of such drug, in accordance with such 

22 section 505(e). 

23 (b) DEFINITION.—In this section, the term ‘‘ultra24 high-dose opioid’’ means an opioid drug for which the 

25 daily dosage provided for in the approved label exceeds 


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1 the morphine milligram equivalents per day outlined in the 

2 report entitled ‘‘CDC Guidelines for Prescribing Opioids 

3 for Chronic Pain’’, published by the Centers for Disease 

4 Control and Prevention in 2016 (or any successor docu5 ment). 

6 SEC. 9. CONTINUING MEDICAL EDUCATION AND PRESCRIP7 TION DRUG MONITORING PROGRAM REG8 ISTRATION FOR PRESCRIBERS. 

9 Section 303 of the Controlled Substances Act (21 

10 U.S.C. 823) is amended— 

11 (1) by redesignating subsection (k) as sub12 section (l); and 

13 (2) by inserting after subsection (j) the fol14 lowing: 

15 ‘‘(k)(1) The Attorney General shall not register, or 

16 renew the registration of, a practitioner under subsection 

17 (f) who is licensed under State law to prescribe controlled 

18 substances in schedule II, III, or IV, unless the practi19 tioner submits to the Attorney General, for each such reg20 istration or renewal request, a written certification that— 

21 ‘‘(A)(i) the practitioner has, during the 1-year 

22 period preceding the registration or renewal request, 

23 completed a training program described in para24 graph (2); or 


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1 ‘‘(ii) the practitioner, during the applicable reg2 istration period, will not prescribe such controlled 

3 substances in amounts in excess of a 72-hour supply 

4 (for which no refill is available); and 

5 ‘‘(B) the practitioner has registered with the 

6 prescription drug monitoring program of the State 

7 in which the practitioner practices, if the State has 

8 such program. 

9 ‘‘(2) A training program described in this paragraph 

10 is a training program that— 

11 ‘‘(A) follows the best practices for pain manage12 ment, as described in the ‘Guideline for Prescribing 

13 Opioids for Chronic Pain’ as published by the Cen14 ters for Disease Control and Prevention in 2016, or 

15 any successor thereto, or the ‘FDA Blueprint for 

16 Prescriber Education for Extended-Release and 

17 Long-Acting Opioid Analgesics’ as published by the 

18 Food and Drug Administration in 2017, or any suc19 cessor thereto; 

20 ‘‘(B) includes information on— 

21 ‘‘(i) recommending non-opioid and non22 pharmacological therapy; 

23 ‘‘(ii) establishing treatment goals and eval24 uating patient risks; 


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1 ‘‘(iii) prescribing the lowest dose and few2 est number of pills considered effective; 

3 ‘‘(iv) addictive and overdose risks of 

4 opioids; 

5 ‘‘(v) diagnosing and managing substance 

6 use disorders, including linking patients to evi7 dence-based treatment; 

8 ‘‘(vi) identifying narcotics-seeking behav9 iors; and 

10 ‘‘(vii) using prescription drug monitoring 

11 programs; and 

12 ‘‘(C) is approved by the Secretary.’’. 

13 SEC. 10. REPORT ON PRESCRIBER EDUCATION COURSES 

14 FOR MEDICAL AND DENTAL STUDENTS. 

15 Each school of medicine, school of osteopathic medi16 cine, and school of dentistry participating in a program 

17 under title IV of the Higher Education Act of 1965 (20 

18 U.S.C. 1070a et seq.), as a condition for such participa19 tion, shall submit an annual report to the Secretary of 

20 Education and the Secretary of Health and Human Serv21 ices on any prescriber education courses focused specifi22 cally on pain management and responsible opioid pre23 scribing practices that such school requires students to 

24 take, and whether such courses are consistent with the 

25 most recently published version of the ‘‘Guideline for PreVerDate Sep 11 2014 03:51 Aug 04, 2020 Jkt 099200 PO 00000 Frm 00016 Fmt 6652 Sfmt 6201 E:\BILLS\S4242.IS S4242

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1 scribing Opioids for Chronic Pain’’ of the Centers for Dis2 ease Control and Prevention or the ‘‘FDA Blueprint for 

3 Prescriber Education for Extended-Release and Long-Act4 ing Opioid Analgesics’’, as published by the Food and 

5 Drug Administration in 2017. The Secretary of Education 

6 and the Secretary of Health and Human Services shall 

7 compile the reports submitted by such schools and submit 

8 an annual summary of such reports to Congress. 

9 SEC. 11. REQUIREMENTS UNDER PRESCRIPTION DRUG 

10 MONITORING PROGRAMS. 

11 (a) IN GENERAL.—Beginning 1 year after the date 

12 of enactment of this Act, each State that receives funding 

13 under any of the programs described in subsection (c) 

14 shall— 

15 (1) require practitioners, or their designees, in 

16 the State to consult the database of the prescription 

17 drug monitoring program before writing prescrip18 tions for controlled substances (as such term is de19 fined in section 102 of the Controlled Substances 

20 Act (21 U.S.C. 802)) in schedule II, III, or IV 

21 under section 202 of such Act (21 U.S.C. 812); 

22 (2) require dispensers of controlled substances 

23 in schedule II, III, or IV, or their designees, to input 

24 data into the database of the prescription drug mon25 itoring program within 24 hours of filling a qualiVerDate Sep 11 2014 03:51 Aug 04, 2020 Jkt 099200 PO 00000 Frm 00017 Fmt 6652 Sfmt 6201 E:\BILLS\S4242.IS S4242

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1 fying prescription, as required by the Attorney Gen2 eral and the Secretary of Health and Human Serv3 ices, including patient identifier information, the na4 tional drug code of the dispensed drug, date of dis5 pensing the drug, quantity and dosage of the drug 

6 dispensed, form of payment, Drug Enforcement Ad7 ministration registration number of the practitioner, 

8 Drug Enforcement Administration registration num9 ber of the dispenser; 

10 (3) allow practitioners and dispensers to des11 ignate other appropriate individuals to act as agents 

12 of such practitioners and dispensers for purposes of 

13 obtaining and inputting data from the database for 

14 purposes of complying with paragraphs (1) and (2), 

15 as applicable; 

16 (4) provide informational materials for practi17 tioners and dispensers to identify and refer patients 

18 with possible substance use disorders to professional 

19 treatment specialists; 

20 (5) establish formal data sharing agreements to 

21 foster electronic connectivity with the prescription 

22 drug monitoring programs of each State (if such 

23 State has such a program) with which the State 

24 shares a border, to facilitate the exchange of infor25 mation through an established technology architecVerDate Sep 11 2014 03:51 Aug 04, 2020 Jkt 099200 PO 00000 Frm 00018 Fmt 6652 Sfmt 6201 E:\BILLS\S4242.IS S4242

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1 ture that ensures common data standards, privacy 

2 protection, and secure and streamlined information 

3 sharing; 

4 (6) authorize direct access to the State’s data5 base of the prescription drug monitoring program to 

6 all State law enforcement agencies, State boards re7 sponsible for the licensure, regulation, or discipline 

8 of practitioners, pharmacists, or other persons au9 thorized to prescribe, administer, or dispense con10 trolled substances; and 

11 (7) in order to enhance accountability in pre12 scribing and dispensing patterns, not fewer than 4 

13 times per year, proactively provide informational re14 ports on aggregate trends and individual outliers, 

15 based on information available through the State 

16 prescription drug monitoring program to— 

17 (A) the State entities and persons de18 scribed in paragraph (6); and 

19 (B) the Medicaid agency and the depart20 ment of public health of the State. 

21 (b) TRANSPARENCY IN PRESCRIBING PRACTICES AND

22 INTERVENTION FOR HIGH PRESCRIBERS.— 

23 (1) STATE REPORTING REQUIREMENT.—Each 

24 State that receives funding under any of the pro25 grams described in subsection (c) shall, twice per 


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1 year, submit to the Secretary of Health and Human 

2 Services and the Administrator of the Drug Enforce3 ment Administration— 

4 (A) a list of all practitioners and dis5 pensers who, in the applicable reporting period, 

6 have prescribed or dispensed schedule II, III, or 

7 IV opioids in the State; 

8 (B) the amount of schedule II, III, or IV 

9 opioids that were prescribed and dispensed by 

10 each individual practitioner and dispenser de11 scribed in subparagraph (A); and 

12 (C) any additional information that the 

13 Secretary and Administrator may require to 

14 support surveillance and evaluation of trends in 

15 prescribing or dispensing of schedule II, III, or 

16 IV opioids, or to identify possible non-medical 

17 use and diversion of such substances. 

18 (2) ANNUAL REPORT.—Not later than 1 year 

19 after the date of enactment of this Act, and annually 

20 thereafter, the Secretary of Health and Human 

21 Services, in consultation with the Administrator of 

22 the Drug Enforcement Administration, the Secretary 

23 of Defense, the Secretary of Veterans Affairs, and 

24 the Director of the Indian Health Service, shall sub25 mit to Congress, and make public, a report identiVerDate Sep 11 2014 03:51 Aug 04, 2020 Jkt 099200 PO 00000 Frm 00020 Fmt 6652 Sfmt 6201 E:\BILLS\S4242.IS S4242

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1 fying outliers among the medical specialties and geo2 graphic areas with the highest rates of opioid pre3 scribing in the Nation, by ZIP code. 

4 (3) DEVELOPMENT OF ACTION PLAN.— 

5 (A) INITIAL PLAN.—Not later than 1 year 

6 after the date of enactment of this Act, the Sec7 retary of Health and Human Services, in con8 sultation with the Administrator of the Drug 

9 Enforcement Administration, the Secretary of 

10 Defense, the Secretary of Veterans Affairs, and 

11 the Director of the Indian Health Service, shall 

12 submit to Congress a plan of action, including 

13 warning letters and enforcement mechanisms, 

14 for addressing outliers in opioid prescribing 

15 practices and ensuring an adequate Federal re16 sponse to protect the public health. 

17 (B) UPDATED PLAN.—The Secretary of 

18 Health and Human Services shall submit to 

19 Congress updates to the plan of action de20 scribed in subparagraph (A), as such Secretary, 

21 in consultation with the heads of agencies de22 scribed in such subparagraph, determines ap23 propriate. 

24 (c) PROGRAMS DESCRIBED.—The programs de25 scribed in this subsection are— 


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1 (1) the Harold Rogers Prescription Drug Moni2 toring Program established under the Departments 

3 of Commerce, Justice, and State, the Judiciary, and 

4 Related Agencies Appropriations Act, 2002 (Public 

5 Law 107–77; 115 Stat. 748); 

6 (2) the controlled substance monitoring pro7 gram under section 399O of the Public Health Serv8 ice Act (42 U.S.C. 280g–3); 

9 (3) the Prescription Drug Overdose: Prevention 

10 for States program of the Centers for Disease Con11 trol and Prevention; 

12 (4) the Prescription Drug Overdose: Data-Driv13 en Prevention Initiative of Centers for Disease Con14 trol and Prevention; 

15 (5) the Enhanced State Opioid Overdose Sur16 veillance program of the Centers for Disease Control 

17 and Prevention; 

18 (6) the opioid grant program under section 

19 1003 of the 21st Century Cures Act (Public Law 

20 114–255); and 

21 (7) the State Opioid Response Grant program 

22 described under the heading ‘‘SUBSTANCE ABUSE

23 TREATMENT’’ under the heading ‘‘SUBSTANCE

24 ABUSE AND MENTAL HEALTH SERVICES ADMINIS25 TRATION’’ of title II of division A of the Further 


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1 Consolidated Appropriations Act, 2020 (Public Law 

2 116–94). 

3 (d) DEFINITIONS.—In this section, the terms ‘‘dis4 penser’’ and ‘‘practitioner’’ have the meanings given such 

5 terms in section 102 of the Controlled Substances Act (21 

6 U.S.C. 802). 

7 SEC. 12. INTEROPERABILITY OF CERTIFIED HEALTH IN8 FORMATION TECHNOLOGY. 

9 Section 3001(c)(5) of the Public Health Service Act 

10 (42 U.S.C. 300jj–11(c)(5)) is amended by adding at the 

11 end the following: 

12 ‘‘(F) INTEROPERABILITY.—Beginning on 

13 January 1, 2021, the National Coordinator 

14 shall not certify electronic health records as 

15 health information technology that is in compli16 ance with applicable certification criteria under 

17 this paragraph unless such technology is inter18 operable with the prescription drug monitoring 

19 programs of each State that, at the time of the 

20 request for such certification, has such a pro21 gram.’’. 

22 SEC. 13. STUDIES RELATED TO OVERDOSE DISCHARGE AND 

23 FOLLOW-UP POLICIES. 

24 (a) STUDY.—Not later than January 1, 2021, the 

25 Secretary of Health and Human Services shall— 


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1 (1) conduct a study on the scope and cir2 cumstances of non-fatal opioid overdoses, the policies 

3 and procedures that States, health care systems, and 

4 first responders have implemented; and 

5 (2) in partnership with stakeholder organiza6 tions with subject matter expertise, establish guide7 lines for hospital procedures following non-fatal 

8 opioid overdose and the administration of overdose 

9 reversal medication. 

10 (b) STUDY AND DEVELOPMENT OF QUALITY MEAS11 URES UNDER MEDICARE RELATED TO OPIOID ABUSE

12 AND SUBSTANCE USE DISORDER.—Section 1890A(e) of 

13 the Social Security Act (42 U.S.C. 1395aaa–1(e)) is 

14 amended— 

15 (1) by striking ‘‘MEASURES.—The Adminis16 trator’’ and inserting ‘‘MEASURES.— 

17 ‘‘(1) IN GENERAL.—The Administrator’’; and 

18 (2) by adding at the end the following new 

19 paragraph: 

20 ‘‘(2) STUDY AND DEVELOPMENT OF QUALITY

21 MEASURES RELATED TO OPIOID ABUSE AND SUB22 STANCE USE DISORDER.—Beginning not later than 

23 1 year after the date of enactment of this para24 graph, the Administrator of the Center for Medicare 

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1 tracts develop, in coordination with appropriate sub2 ject matter organizations (such as the entity with a 

3 contract under section 1890), for use under this Act, 

4 quality measures related to standards of care for 

5 treating individuals with non-fatal opioid overdose, 

6 discharge procedures, and linkages to appropriate 

7 substance use disorder treatment and community 

8 support services.’’. 

9 SEC. 14. MEDICAID OPIOID DRUG MAPPING TOOL. 

10 (a) IN GENERAL.—The Secretary of Health and 

11 Human Services shall create an interactive opioid drug 

12 mapping tool, which shall be made publicly available on 

13 the internet website of the Centers for Medicare & Med14 icaid Services, showing prescribing practices of providers 

15 that participate in State Medicaid programs and geo16 graphic comparisons, at the State, county, and ZIP code 

17 levels, of de-identified opioid prescription claims made 

18 under State Medicaid programs under title XIX of the So19 cial Security Act (42 U.S.C. 1396 et seq.). 

20 (b) COLLECTION OF DATA FROM STATES.—The Sec21 retary of Health and Human Services may request from 

22 States such data as the Secretary determines necessary 

23 to create the opioid mapping tool described in subsection 

24 (a). 


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1 SEC. 15. NATIONAL ACADEMIES STUDY. 

2 (a) STUDY.—The Secretary of Health and Human 

3 Services shall enter into a contract with the National 

4 Academies of Science, Engineering, and Medicine (re5 ferred to in this section as the ‘‘National Academies’’) to 

6 carry out a study on the addition of coverage under the 

7 Medicare program under title XVIII of the Social Security 

8 Act of alternative treatment modalities (such as integra9 tive medicine, including acupuncture and exercise therapy, 

10 neural stimulation, biofeedback, radiofrequency ablation, 

11 and trigger point injections) furnished to Medicare bene12 ficiaries who suffer from acute or chronic lower back pain. 

13 Such study shall, pursuant to the contract under this 

14 paragraph, include an analysis of— 

15 (1) scientific research on the short-term and 

16 long-term impact of the addition of such coverage on 

17 clinical efficacy for pain management of such bene18 ficiaries; 

19 (2) whether the lack of Medicare coverage for 

20 alternative treatment modalities impacts the volume 

21 of opioids prescribed for beneficiaries; and 

22 (3) the cost to the Medicare program of the ad23 dition of such coverage to treat pain and mitigate 

24 the progression of chronic pain, as weighed against 

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1 sion, subsequent surgeries, and utilization and ex2 penditures under parts B and D of such title. 

3 (b) REPORT.—Not later than 1 year after the date 

4 of enactment of this Act, pursuant to the contract under 

5 subsection (a), the National Academies shall submit to 

6 Congress a report on the study under subsection (a). 

7 (c) AUTHORIZATION OF APPROPRIATIONS.—To carry 

8 out this section, there are authorized to be appropriated 

9 such sums as may be necessary. 

Æ 


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