II 

115TH CONGRESS 

1ST SESSION S. 2134 

To require the Secretary of Veterans Affairs to establish processes to ensure 

that non-Department of Veterans Affairs health care providers are using 

safe practices in prescribing opioids to veterans under the laws administered by the Secretary, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

NOVEMBER 15, 2017 

Ms. BALDWIN (for herself, Mrs. CAPITO, Mr. MORAN, Mr. BLUMENTHAL, Mr. 

MANCHIN, Mr. TESTER, and Mr. BROWN) introduced the following bill; 

which was read twice and referred to the Committee on Veterans’ Affairs 

A BILL 

To require the Secretary of Veterans Affairs to establish 

processes to ensure that non-Department of Veterans 

Affairs health care providers are using safe practices 

in prescribing opioids to veterans under the laws administered by the Secretary, 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 ‘‘Andrew White Vet5 erans Community Care Opioid Safety Act’’. 


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1 SEC. 2. ESTABLISHMENT OF PROCESSES TO ENSURE SAFE 

2 OPIOID PRESCRIBING PRACTICES BY NON3 DEPARTMENT OF VETERANS AFFAIRS 

4 HEALTH CARE PROVIDERS. 

5 (a) RECEIPT AND REVIEW OF GUIDELINES.—The 

6 Secretary of Veterans Affairs shall ensure that all covered 

7 health care providers are provided a copy of and certify 

8 that they have reviewed the evidence-based guidelines for 

9 prescribing opioids set forth by the Opioid Safety Initia10 tive of the Department of Veterans Affairs under sections 

11 911(a)(2) and 912(c) of the Jason Simcakoski Memorial 

12 and Promise Act (Public Law 114–198; 38 U.S.C. 1701 

13 note) before first providing care under the laws adminis14 tered by the Secretary and at any time when those guide15 lines are modified thereafter. 

16 (b) INCLUSION OF MEDICAL HISTORY AND CURRENT

17 MEDICATIONS.—The Secretary shall implement a process 

18 to ensure that, if care of a veteran by a covered health 

19 care provider is authorized under the laws administered 

20 by the Secretary, the document authorizing such care in21 cludes the relevant medical history of the veteran and a 

22 list of all medications prescribed to the veteran. 

23 (c) SUBMITTAL OF PRESCRIPTIONS.— 

24 (1) IN GENERAL.—Except as provided in para25 graph (2), the Secretary shall require all covered 

26 health care providers who prescribe opioids to vetVerDate Sep 11 2014 22:28 Nov 20, 2017 Jkt 079200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S2134.IS S2134

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1 erans under the laws administered by the Secretary 

2 to submit any such prescription directly to a phar3 macy of the Department— 

4 (A) for the dispensing of such prescription; 

5 (B) for the recording of such prescription 

6 in the electronic health record of the veteran; 

7 and 

8 (C) to enable other monitoring of such pre9 scription as outlined in the Opioid Safety Initia10 tive of the Department. 

11 (2) EXCEPTION.— 

12 (A) IN GENERAL.—A covered health care 

13 provider is not required under paragraph (1) to 

14 submit an opioid prescription directly to a phar15 macy of the Department if— 

16 (i) the health care provider determines 

17 that there is an immediate medical need 

18 for the prescription, including an urgent or 

19 emergent prescription or a prescription dis20 pensed as part of an opioid treatment pro21 gram that provides office-based medica22 tions; and 

23 (ii)(I) following an inquiry into the 

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1 not fill the prescription in a timely man2 ner; or 

3 (II) the health care provider deter4 mines that the requirement under para5 graph (1) would impose an undue hardship 

6 on the veteran, including with respect to 

7 travel distances, as determined by the Sec8 retary. 

9 (B) NOTIFICATION TO DEPARTMENT.—If a 

10 covered health care provider uses an exception 

11 under subparagraph (A) with respect to an 

12 opioid prescription for a veteran, the health 

13 care provider shall, on the same day the pre14 scription is written, submit to the Secretary for 

15 inclusion in the electronic health record of the 

16 veteran a notice, in such form as the Secretary 

17 may establish, providing information about the 

18 prescription and describing the reason for the 

19 exception. 

20 (C) REPORT.— 

21 (i) IN GENERAL.—Not less frequently 

22 than quarterly, the Secretary shall submit 

23 to the Committee on Veterans’ Affairs of 

24 the Senate and the Committee on Vet25 erans’ Affairs of the House of RepresentaVerDate Sep 11 2014 22:28 Nov 20, 2017 Jkt 079200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S2134.IS S2134

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1 tives a report evaluating the compliance of 

2 covered health care providers with the re3 quirements under this paragraph and set4 ting forth data on the use by health care 

5 providers of exceptions under subpara6 graph (A) and notices under subparagraph 

7 (B). 

8 (ii) ELEMENTS.—Each report re9 quired by clause (i) shall include the fol10 lowing with respect to the quarter covered 

11 by the report: 

12 (I) The number of exceptions 

13 used under subparagraph (A) and no14 tices received under subparagraph 

15 (B). 

16 (II) The rate of compliance by 

17 the Department with the requirement 

18 under subparagraph (B) to include 

19 such notices in the health records of 

20 veterans. 

21 (III) The identification of any 

22 covered health care providers that, 

23 based on criteria prescribed the Sec24 retary, are determined by the Sec25 retary to be statistical outliers regardVerDate Sep 11 2014 22:28 Nov 20, 2017 Jkt 079200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S2134.IS S2134

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1 ing the use of exceptions under sub2 paragraph (A). 

3 (d) USE OF OPIOID SAFETY INITIATIVE GUIDE4 LINES.— 

5 (1) IN GENERAL.—If a director of a medical 

6 center of the Department or a Veterans Integrated 

7 Service Network determines that the opioid pre8 scribing practices of a covered health care provider 

9 conflicts with or is otherwise inconsistent with the 

10 standards of appropriate and safe care, as that term 

11 is used in section 913(d) of the Jason Simcakoski 

12 Memorial and Promise Act (Public Law 114–198; 

13 38 U.S.C. 1701 note), the director shall take such 

14 action as the director considers appropriate to en15 sure the safety of all veterans receiving care from 

16 that health care provider, including removing or di17 recting the removal of any such health care provider 

18 from provider networks or otherwise refusing to au19 thorize care of veterans by such health care provider 

20 in any program authorized under the laws adminis21 tered by the Secretary. 

22 (2) INCLUSION IN CONTRACTS.—The Secretary 

23 shall ensure that any contracts entered into by the 

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1 nity to veterans under the laws administered by the 

2 Secretary specifically grant the authority set forth in 

3 paragraph (1) to such third parties and to the direc4 tors described in that paragraph, as the case may 

5 be. 

6 (e) DENIAL OR REVOCATION OF ELIGIBILITY OF

7 NON-DEPARTMENT PROVIDERS.—The Secretary shall 

8 deny or revoke the eligibility of a non-Department health 

9 care provider to provide health care to veterans under the 

10 laws administered by the Secretary if the Secretary deter11 mines that the opioid prescribing practices of the pro12 vider— 

13 (1) violate the requirements of a medical license 

14 of the health care provider; or 

15 (2) detract from the ability of the health care 

16 provider to deliver safe and appropriate health care. 

17 (f) COVERED HEALTH CARE PROVIDER DEFINED.— 

18 In this section, the term ‘‘covered health care provider’’ 

19 means a non-Department of Veterans Affairs health care 

20 provider who provides health care to veterans under the 

21 laws administered by the Secretary of Veterans Affairs. 

Æ 


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