II 

116TH CONGRESS 

2D SESSION S. 4640 

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 requirements to receive a waiver 

for dispensing narcotic drugs for maintenance or detoxification treatment, 

and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

SEPTEMBER 22, 2020 

Mr. BENNET (for himself and Ms. COLLINS) introduced the following bill; 

which was read twice and referred to the Committee on Health, Education, Labor, and Pensions 

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 requirements to receive 

a waiver for dispensing narcotic drugs for maintenance 

or detoxification treatment, 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, 


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1 SECTION 1. SHORT TITLE. 

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

3 Training Expansion Act of 2020’’ or the ‘‘MATE Act of 

4 2020’’. 

5 SEC. 2. REQUIRING PRESCRIBERS OF CONTROLLED SUB6 STANCES TO COMPLETE TRAINING ON 

7 TREATING AND MANAGING PATIENTS WITH 

8 OPIOID AND OTHER SUBSTANCE USE DIS9 ORDERS. 

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

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

12 the end the following: 

13 ‘‘(l) REQUIRED TRAINING FOR PRESCRIBERS ON

14 TREATING AND MANAGING PATIENTS WITH OPIOID AND

15 OTHER SUBSTANCE USE DISORDERS.— 

16 ‘‘(1) APPLICABILITY.—This subsection ap17 plies— 

18 ‘‘(A) to any practitioner who is licensed 

19 under State law to prescribe controlled sub20 stances; and 

21 ‘‘(B) beginning with the first registration 

22 or renewal of registration by the practitioner 

23 under this section that occurs on or after the 

24 date that is 90 days after the date of enactment 

25 of the Medication Access and Training Expan26 sion Act of 2020. 


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

2 registration under this section to dispense controlled 

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

4 General shall require any practitioner described in 

5 paragraph (1)(A) to meet the following conditions: 

6 ‘‘(A) In the case of a practitioner who is 

7 a physician, the physician shall meet not less 

8 than 1 of the following conditions: 

9 ‘‘(i) The physician holds a board cer10 tification in addiction psychiatry or addic11 tion medicine from the American Board of 

12 Medical Specialties. 

13 ‘‘(ii) The physician holds an addiction 

14 certification or board certification from the 

15 American Society of Addiction Medicine or 

16 the American Board of Addiction Medicine. 

17 ‘‘(iii) The physician holds a board cer18 tification in addiction medicine from the 

19 American Osteopathic Association. 

20 ‘‘(iv) The physician has completed not 

21 less than 8 hours of training on the treat22 ment and management of patients with 

23 opioid and other substance use disorders 

24 that— 


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1 ‘‘(I) is provided through class2 room situations, seminars at profes3 sional society meetings, electronic 

4 communication, or other means; 

5 ‘‘(II) is provided by the American 

6 Society of Addiction Medicine, the 

7 American Academy of Addiction Psy8 chiatry, the American Medical Asso9 ciation, the American Osteopathic As10 sociation, the American Psychiatric 

11 Association, or another organization 

12 that the Secretary determines appro13 priate; and 

14 ‘‘(III) includes content relating 

15 to— 

16 ‘‘(aa) opioid maintenance 

17 and detoxification; 

18 ‘‘(bb) the appropriate clin19 ical use of all drugs approved by 

20 the Food and Drug Administra21 tion for the treatment of a sub22 stance use disorder; 

23 ‘‘(cc) initial and periodic pa24 tient assessments, including sub25 stance use monitoring; 


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1 ‘‘(dd) individualized treat2 ment planning, overdose reversal, 

3 and relapse prevention; 

4 ‘‘(ee) counseling and recov5 ery support services; 

6 ‘‘(ff) staffing roles and con7 siderations, including bias and 

8 anti-racism training to reduce ra9 cial and ethnic disparities; 

10 ‘‘(gg) diversion control; and 

11 ‘‘(hh) other best practices, 

12 such as addiction prevention, as 

13 identified by the Secretary after 

14 consultation with practitioners 

15 from a variety of medical special16 ties and who practice in different 

17 settings in which controlled sub18 stances are prescribed. 

19 ‘‘(v) The physician has participated as 

20 an investigator in one or more clinical 

21 trials leading to the approval of a narcotic 

22 drug in schedule III, IV, or V for mainte23 nance or detoxification treatment, as dem24 onstrated by a statement submitted to the 


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1 Secretary by the sponsor of the approved 

2 drug. 

3 ‘‘(vi) The physician has other training 

4 or experience that the medical licensing 

5 board of the State where the physician will 

6 provide maintenance or detoxification 

7 treatment considers demonstrative of the 

8 ability of the physician to treat and man9 age patients with opioid and other sub10 stance use disorders. 

11 ‘‘(vii)(I) The physician has other 

12 training or experience that the Secretary 

13 identifies, in a regulation promulgated in 

14 accordance with subclause (II), as demon15 strative of the ability of the physician to 

16 treat and manage patients with opioid and 

17 other substance use disorders. 

18 ‘‘(II)(aa) The Secretary may by regu19 lation establish criteria for purposes of 

20 subclause (I). 

21 ‘‘(bb) Subject to item (cc), any cri22 teria established by the Secretary under 

23 item (aa) shall be effective for a 3-year pe24 riod. 


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1 ‘‘(cc) During the 30-day period pre2 ceding the expiration of a 3-year period of 

3 effectiveness of criteria established under 

4 this subclause, the Secretary may extend 

5 the effectiveness of the criteria for an addi6 tional 3-year period by publishing a notice 

7 of the extension in the Federal Register. 

8 ‘‘(viii) The physician— 

9 ‘‘(I) graduated in good standing 

10 from an accredited school of allopathic 

11 medicine or osteopathic medicine in 

12 the United States during the 5-year 

13 period preceding the date of the first 

14 registration or renewal of registration 

15 by the physician described in para16 graph (1)(B); and 

17 ‘‘(II) has successfully completed 

18 a comprehensive allopathic or osteo19 pathic medicine curriculum or accred20 ited medical residency that included— 

21 ‘‘(aa) not less than 8 hours 

22 of training on treating and man23 aging patients with opioid and 

24 other substance use disorders; 

25 and 


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1 ‘‘(bb) at a minimum— 

2 ‘‘(AA) the training de3 scribed in items (aa) 

4 through (hh) of clause 

5 (iv)(III); and 

6 ‘‘(BB) training with re7 spect to any other best prac8 tice the Secretary deter9 mines necessary, which may 

10 include training on pain 

11 management, including as12 sessment and appropriate 

13 use of opioid and non-opioid 

14 alternatives. 

15 ‘‘(B) In the case of a practitioner who is 

16 not a physician, the practitioner shall meet not 

17 less than 1 of the following conditions: 

18 ‘‘(i) The practitioner has completed 

19 not less than 8 hours of initial training on 

20 the topics listed in subparagraph 

21 (A)(iv)(III) that— 

22 ‘‘(I) is provided through class23 room situations, seminars at profes24 sional society meetings, electronic 

25 communication, or other means; and 


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1 ‘‘(II) is provided by the American 

2 Society of Addiction Medicine, the 

3 American Academy of Addiction Psy4 chiatry, the American Medical Asso5 ciation, the American Osteopathic As6 sociation, the American Nurses 

7 Credentialing Center, the American 

8 Psychiatric Association, the American 

9 Association of Nurse Practitioners, 

10 the American Academy of Physician 

11 Assistants, or any other organization 

12 that the Secretary determines appro13 priate. 

14 ‘‘(ii) The practitioner has other train15 ing or experience that the Secretary identi16 fies as demonstrative of the ability of the 

17 practitioner to treat and manage patients 

18 with opioid and other substance use dis19 orders. 

20 ‘‘(iii) The practitioner— 

21 ‘‘(I) graduated in good standing 

22 from an accredited physician assistant 

23 school or school of advanced practice 

24 nursing in the United States during 

25 the 5-year period immediately preVerDate Sep 11 2014 19:34 Oct 05, 2020 Jkt 019200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S4640.IS S4640

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1 ceding the date of the first registra2 tion or renewal of registration by the 

3 practitioner described in paragraph 

4 (1)(B); and 

5 ‘‘(II) has successfully completed 

6 a comprehensive physician assistant 

7 or advanced practice nursing cur8 riculum that includes— 

9 ‘‘(aa) not less than 8 hours 

10 of training on treating and man11 aging patients with opioid and 

12 other substance use disorders; 

13 and 

14 ‘‘(bb) at a minimum— 

15 ‘‘(AA) the training de16 scribed in items (aa) 

17 through (hh) of subpara18 graph (A)(iv)(III); and 

19 ‘‘(BB) training with re20 spect to any other best prac21 tice the Secretary deter22 mines necessary, which may 

23 include training on pain 

24 management, including as25 sessment and appropriate 


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1 use of opioid and non-opioid 

2 alternatives. 

3 ‘‘(3) RECIPROCAL TREATMENT.— 

4 ‘‘(A) PHYSICIANS.— 

5 ‘‘(i) MEETING CONDITIONS FOR PRE6 SCRIBING.—A physician who meets one or 

7 more of the conditions listed in paragraph 

8 (2)(A) shall be deemed to meet one or 

9 more of the conditions listed in subsection 

10 (g)(2)(G)(ii). 

11 ‘‘(ii) MEETING CONDITIONS FOR

12 WAIVER FOR DISPENSING.—A physician 

13 who meets one or more of the conditions 

14 listed in subsection (g)(2)(G)(ii) shall be 

15 deemed to meet one or more of the condi16 tions listed in paragraph (2)(A). 

17 ‘‘(B) OTHER PRACTITIONERS.— 

18 ‘‘(i) MEETING CONDITIONS FOR PRE19 SCRIBING.—A practitioner who is not a 

20 physician, and who meets one or more of 

21 the conditions listed in paragraph (2)(B), 

22 shall be deemed to meet one or more of the 

23 conditions listed in subsection 

24 (g)(2)(G)(iv)(II). 


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1 ‘‘(ii) MEETING CONDITIONS FOR

2 WAIVER FOR DISPENSING.—A practitioner 

3 who is not a physician, and who meets one 

4 or more of the conditions listed in sub5 section (g)(2)(G)(iv)(II), shall be deemed 

6 to meet one or more of the conditions list7 ed in paragraph (2)(B).’’. 

8 (b) TRAINING REQUIRED.— 

9 (1) PHYSICIANS.—Section 

10 303(g)(2)(G)(ii)(IV)(hh) of the Controlled Sub11 stances Act (21 U.S.C. 823(g)(2)(G)(ii)(IV)(hh)) is 

12 amended by inserting after ‘‘, as identified by the 

13 Secretary’’ the following: ‘‘, which may include best 

14 practices for addiction prevention’’. 

15 (2) OTHER PRACTITIONERS.—Section 

16 303(g)(2)(G)(iv)(II) of the Controlled Substances 

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

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

19 end; 

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

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

22 (C) by adding at the end the following: 

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

24 accredited physician assistant school or school 

25 of advanced practice nursing in the United 


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1 States during the 5-year period immediately 

2 preceding the date on which the practitioner 

3 submits to the Secretary a notification under 

4 subparagraph (B) and has successfully com5 pleted a comprehensive physician assistant or 

6 advanced practice nursing curriculum that in7 cludes— 

8 ‘‘(AA) not less than 8 hours of train9 ing on treating and managing opioid-de10 pendent patients; 

11 ‘‘(BB) the training described in items 

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

13 ‘‘(CC) training with respect to any 

14 other best practice the Secretary deter15 mines necessary, which may include train16 ing on pain management, including assess17 ment and appropriate use of opioid and 

18 non-opioid alternatives.’’. 

19 (3) TECHNICAL CORRECTIONS.—Section 

20 303(g)(2)(G) of the Controlled Substances Act (21 

21 U.S.C. 823(g)(2)(G)) is amended— 

22 (A) in clause (ii)— 

23 (i) by moving subclauses (I) and (II) 

24 4 ems to the left; 

25 (ii) in subclause (VIII)— 


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1 (I) in item (bb), by moving 

2 subitems (AA) and (BB) 2 ems to the 

3 right; and 

4 (II) by moving items (aa) and 

5 (bb) 2 ems to the right; and 

6 (iii) by moving subclause (VIII) 2 ems 

7 to the right; and 

8 (B) in clause (iv)(II)(bb), by striking 

9 ‘‘has’’ before ‘‘such other training’’. 

Æ 


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