II 

116TH CONGRESS 

2D SESSION S. 4702 

To amend title XIX of the Social Security Act to encourage appropriate 

prescribing under Medicaid for victims of opioid overdose. 

IN THE SENATE OF THE UNITED STATES 

SEPTEMBER 24, 2020 

Mr. TOOMEY (for himself and Mr. MANCHIN) introduced the following bill; 

which was read twice and referred to the Committee on Finance 

A BILL 

To amend title XIX of the Social Security Act to encourage 

appropriate prescribing under Medicaid for victims of 

opioid overdose. 

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 ‘‘Improving Medicaid 

5 Programs’ Response to Overdose Victims and Enhancing 

6 Addiction Care Act’’ or the ‘‘IMPROVE Addiction Care 

7 Act’’. 


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1 SEC. 2. ENCOURAGING APPROPRIATE PRESCRIBING 

2 UNDER MEDICAID FOR VICTIMS OF OPIOID 

3 OVERDOSE. 

4 (a) IN GENERAL.—Section 1927(g)(2) of the Social 

5 Security Act (42 U.S.C. 1396r–8(g)(2)) is amended by 

6 adding at the end the following new subparagraph: 

7 ‘‘(E) ADDITIONAL DRUG USE REVIEW RE8 QUIREMENTS.—As part of a State’s prospective 

9 and retrospective drug use review under sub10 paragraphs (A) and (B), as applicable, the 

11 State shall, not later than January 1, 2022, de12 velop and implement, or review and update, 

13 protocols to, subject to any applicable privacy 

14 or confidentiality protections— 

15 ‘‘(i) identify individuals receiving ben16 efits under this title who have experienced 

17 a nonfatal opioid-related overdose within 

18 the last 5 years, to the extent that such 

19 data is available, and make a good faith ef20 fort to connect these individuals to treat21 ment options that have been determined 

22 appropriate by the Secretary; 

23 ‘‘(ii) if an individual receiving benefits 

24 under this title experiences a fatal overdose 

25 that is opioid-related (or, if specified by 

26 the Secretary, related to another covered 


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1 outpatient drug), not later than 6 months 

2 after the date of such overdose— 

3 ‘‘(I) notify each provider that, 

4 during the period (to be established 

5 by the Secretary) preceding such over6 dose, prescribed opioids (or such other 

7 specified covered outpatient drug, if 

8 applicable) to such individual of such 

9 overdose; and 

10 ‘‘(II) provide each such provider 

11 with educational materials on pre12 scribing opioids (or such other speci13 fied covered outpatients drugs, if ap14 plicable); 

15 ‘‘(iii) ensure that a provider who is 

16 treating an individual receiving benefits 

17 under this title has notice of the individ18 ual’s diagnosis or history of opioid use dis19 order, opioid poisoning diagnosis, or his20 tory of nonfatal opioid-related overdose; 

21 and 

22 ‘‘(iv) perform ongoing retrospective 

23 drug utilization reviews and offer provider 

24 education that is informed by such reviews 

25 (which may include education provided 


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1 under an educational outreach program es2 tablished under subparagraph (D) or 

3 through an intervention described in para4 graph (3)(C)(iii)) regarding appropriate 

5 prescribing practices for individuals receiv6 ing benefits under this title with a diag7 nosis or history of opioid use disorder, a 

8 history of nonfatal opioid-related overdose, 

9 or an opioid poisoning diagnosis.’’. 

10 (b) TECHNICAL AMENDMENTS.—Section 1932(i) of 

11 the Social Security Act (42 U.S.C. 1396u–2(i)) is amend12 ed— 

13 (1) by striking ‘‘section 483.3(s)(4)’’ and in14 serting ‘‘section 438.3(s)(4)’’; and 

15 (2) by striking ‘‘483.3(s)(5)’’ and inserting 

16 ‘‘438.3(s)(5)’’. 

Æ 


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