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[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[S. 1455 Reported in Senate (RS)]

<DOC>

                                                       Calendar No. 441
114th CONGRESS
  2d Session
                                S. 1455

    To provide access to medication-assisted therapy, and for other 
                               purposes.

_______________________________________________________________________

                   IN THE SENATE OF THE UNITED STATES

                              May 22, 2015

  Mr. Markey (for himself, Mr. Paul, Mrs. Feinstein, Mr. Durbin, Ms. 
 Hirono, Mr. Brown, Ms. Baldwin, Mr. Franken, Mr. Casey, Mrs. Shaheen, 
 Mr. King, Mr. Leahy, Mr. Sanders, Ms. Collins, Mr. Merkley, Mr. Reed, 
 Mr. Murphy, Mr. Menendez, Mr. Hatch, and Mrs. Gillibrand) introduced 
the following bill; which was read twice and referred to the Committee 
               on Health, Education, Labor, and Pensions

                             April 27, 2016

              Reported by Mr. Alexander, with an amendment
 [Strike out all after the enacting clause and insert the part printed 
                               in italic]

_______________________________________________________________________

                                 A BILL

 
    To provide access to medication-assisted therapy, and for other 
                               purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

<DELETED>SECTION 1. SHORT TITLE.</DELETED>

<DELETED>    This Act may be cited as the ``Recovery Enhancement for 
Addiction Treatment Act'' or the ``TREAT Act''.</DELETED>

<DELETED>SEC. 2. FINDINGS.</DELETED>

<DELETED>    Congress finds the following:</DELETED>
        <DELETED>    (1) Overdoses from opioids have increased 
        dramatically in the United States.</DELETED>
        <DELETED>    (2) Deaths from drug overdose, largely from 
        prescription pain relievers, have tripled among men and 
        increased five-fold among women over the past decade.</DELETED>
        <DELETED>    (3) Nationwide, drug overdoses now claim more 
        lives than car accidents.</DELETED>
        <DELETED>    (4) Opioid addiction is a chronic disease that, 
        untreated, places a large burden on the healthcare system. 
        Roughly 475,000 emergency room visits each year are 
        attributable to the misuse and abuse of opioid pain 
        medication.</DELETED>
        <DELETED>    (5) Effective medication-assisted treatment for 
        opioid addiction, in combination with counseling and behavioral 
        therapies, can decrease overdose deaths, be cost-effective, 
        reduce transmissions of HIV and viral hepatitis, and reduce 
        other social harms such as criminal activity.</DELETED>
        <DELETED>    (6) Effective medication-assisted treatment 
        programs for opioid addiction should include multiple 
        components, including medications, cognitive and behavioral 
        supports and interventions, and drug testing.</DELETED>
        <DELETED>    (7) Effective medication-assisted treatment 
        programs for opioid addiction may use a team of staff members, 
        in addition to a prescribing provider, to deliver comprehensive 
        care.</DELETED>
        <DELETED>    (8) Access to medication-assisted treatments, 
        including office-based buprenorphine opioid treatment, remains 
        limited in part due to current practice regulations and an 
        insufficient number of providers.</DELETED>
        <DELETED>    (9) More than 10 years of experience in the United 
        States with office-based buprenorphine opioid treatment has 
        informed best practices for delivering successful, high quality 
        care.</DELETED>

<DELETED>SEC. 3. EXPANSION OF PATIENT LIMITS UNDER WAIVER.</DELETED>

<DELETED>    Section 303(g)(2)(B) of the Controlled Substances Act (21 
U.S.C. 823(g)(2)(B)) is amended--</DELETED>
        <DELETED>    (1) in clause (i), by striking ``physician'' and 
        inserting ``practitioner'';</DELETED>
        <DELETED>    (2) in clause (iii)--</DELETED>
                <DELETED>    (A) by striking ``30'' and inserting 
                ``100''; and</DELETED>
                <DELETED>    (B) by striking ``, unless, not sooner'' 
                and all that follows through the end and inserting a 
                period; and</DELETED>
        <DELETED>    (3) by inserting at the end the following new 
        clause:</DELETED>
                <DELETED>    ``(iv) Not earlier than 1 year after the 
                date on which a qualifying practitioner obtained an 
                initial waiver pursuant to clause (iii), the qualifying 
                practitioner may submit a second notification to the 
                Secretary of the need and intent of the qualifying 
                practitioner to treat an unlimited number of patients, 
                if the qualifying practitioner--</DELETED>
                        <DELETED>    ``(I)(aa) satisfies the 
                        requirements of item (aa), (bb), (cc), or (dd) 
                        of subparagraph (G)(ii)(I); and</DELETED>
                        <DELETED>    ``(bb) agrees to fully participate 
                        in the Prescription Drug Monitoring Program of 
                        the State in which the qualifying practitioner 
                        is licensed, pursuant to applicable State 
                        guidelines; or</DELETED>
                        <DELETED>    ``(II)(aa) satisfies the 
                        requirements of item (ee), (ff), or (gg) of 
                        subparagraph (G)(ii)(I);</DELETED>
                        <DELETED>    ``(bb) agrees to fully participate 
                        in the Prescription Drug Monitoring Program of 
                        the State in which the qualifying practitioner 
                        is licensed, pursuant to applicable State 
                        guidelines;</DELETED>
                        <DELETED>    ``(cc) practices in a qualified 
                        practice setting; and</DELETED>
                        <DELETED>    ``(dd) has completed not less than 
                        24 hours of training (through classroom 
                        situations, seminars at professional society 
                        meetings, electronic communications, or 
                        otherwise) with respect to the treatment and 
                        management of opiate-dependent patients for 
                        substance use disorders provided by the 
                        American Society of Addiction Medicine, the 
                        American Academy of Addiction Psychiatry, the 
                        American Medical Association, the American 
                        Osteopathic Association, the American 
                        Psychiatric Association, or any other 
                        organization that the Secretary determines is 
                        appropriate for purposes of this 
                        subclause.''.</DELETED>

<DELETED>SEC. 4. DEFINITIONS.</DELETED>

<DELETED>    Section 303(g)(2)(G) of the Controlled Substances Act (21 
U.S.C. 823(g)(2)(G)) is amended--</DELETED>
        <DELETED>    (1) by striking clause (ii) and inserting the 
        following:</DELETED>
                <DELETED>    ``(ii) The term `qualifying practitioner' 
                means the following:</DELETED>
                        <DELETED>    ``(I) A physician who is licensed 
                        under State law and who meets 1 or more of the 
                        following conditions:</DELETED>
                                <DELETED>    ``(aa) The physician holds 
                                a board certification in addiction 
                                psychiatry from the American Board of 
                                Medical Specialties.</DELETED>
                                <DELETED>    ``(bb) The physician holds 
                                an addiction certification from the 
                                American Society of Addiction 
                                Medicine.</DELETED>
                                <DELETED>    ``(cc) The physician holds 
                                a board certification in addiction 
                                medicine from the American Osteopathic 
                                Association.</DELETED>
                                <DELETED>    ``(dd) The physician holds 
                                a board certification from the American 
                                Board of Addiction Medicine.</DELETED>
                                <DELETED>    ``(ee) The physician has 
                                completed not less than 8 hours of 
                                training (through classroom situations, 
                                seminars at professional society 
                                meetings, electronic communications, or 
                                otherwise) with respect to the 
                                treatment and management of opiate-
                                dependent patients for substance use 
                                disorders provided by the American 
                                Society of Addiction Medicine, the 
                                American Academy of Addiction 
                                Psychiatry, the American Medical 
                                Association, the American Osteopathic 
                                Association, the American Psychiatric 
                                Association, or any other organization 
                                that the Secretary determines is 
                                appropriate for purposes of this 
                                subclause.</DELETED>
                                <DELETED>    ``(ff) The physician has 
                                participated as an investigator in 1 or 
                                more clinical trials leading to the 
                                approval of a narcotic drug in schedule 
                                III, IV, or V for maintenance or 
                                detoxification treatment, as 
                                demonstrated by a statement submitted 
                                to the Secretary by this sponsor of 
                                such approved drug.</DELETED>
                                <DELETED>    ``(gg) The physician has 
                                such other training or experience as 
                                the Secretary determines will 
                                demonstrate the ability of the 
                                physician to treat and manage opiate-
                                dependent patients.</DELETED>
                        <DELETED>    ``(II) A nurse practitioner or 
                        physician assistant who is licensed under State 
                        law and meets all of the following 
                        conditions:</DELETED>
                                <DELETED>    ``(aa) The nurse 
                                practitioner or physician assistant is 
                                licensed under State law to prescribe 
                                schedule III, IV, or V medications for 
                                pain.</DELETED>
                                <DELETED>    ``(bb) The nurse 
                                practitioner or physician assistant 
                                satisfies 1 or more of the 
                                following:</DELETED>
                                        <DELETED>    ``(AA) Has 
                                        completed not fewer than 24 
                                        hours of training (through 
                                        classroom situations, seminars 
                                        at professional society 
                                        meetings, electronic 
                                        communications, or otherwise) 
                                        with respect to the treatment 
                                        and management of opiate-
                                        dependent patients for 
                                        substance use disorders 
                                        provided by the American 
                                        Society of Addiction Medicine, 
                                        the American Academy of 
                                        Addiction Psychiatry, the 
                                        American Medical Association, 
                                        the American Osteopathic 
                                        Association, the American 
                                        Psychiatric Association, or any 
                                        other organization that the 
                                        Secretary determines is 
                                        appropriate for purposes of 
                                        this subclause.</DELETED>
                                        <DELETED>    ``(BB) Has such 
                                        other training or experience as 
                                        the Secretary determines will 
                                        demonstrate the ability of the 
                                        nurse practitioner or physician 
                                        assistant to treat and manage 
                                        opiate-dependent 
                                        patients.</DELETED>
                                <DELETED>    ``(cc) The nurse 
                                practitioner or physician assistant 
                                practices under the supervision of a 
                                licensed physician who holds an active 
                                waiver to prescribe schedule III, IV, 
                                or V narcotic medications for opioid 
                                addiction therapy, and--</DELETED>
                                        <DELETED>    ``(AA) the 
                                        supervising physician satisfies 
                                        the conditions of item (aa), 
                                        (bb), (cc), or (dd) of 
                                        subclause (I); or</DELETED>
                                        <DELETED>    ``(BB) both the 
                                        supervising physician and the 
                                        nurse practitioner or physician 
                                        assistant practice in a 
                                        qualified practice 
                                        setting.</DELETED>
                        <DELETED>    ``(III) A nurse practitioner who 
                        is licensed under State law and meets all of 
                        the following conditions:</DELETED>
                                <DELETED>    ``(aa) The nurse 
                                practitioner is licensed under State 
                                law to prescribe schedule III, IV, or V 
                                medications for pain.</DELETED>
                                <DELETED>    ``(bb) The nurse 
                                practitioner has training or experience 
                                that the Secretary determines 
                                demonstrates specialization in the 
                                ability to treat opiate-dependent 
                                patients, such as a certification in 
                                addiction specialty accredited by the 
                                American Board of Nursing Specialties 
                                or the National Commission for 
                                Certifying Agencies, or a certification 
                                in addiction nursing as a Certified 
                                Addiction Registered Nurse--Advanced 
                                Practice.</DELETED>
                                <DELETED>    ``(cc) In accordance with 
                                State law, the nurse practitioner 
                                prescribes opioid addiction therapy in 
                                collaboration with a physician who 
                                holds an active waiver to prescribe 
                                schedule III, IV, or V narcotic 
                                medications for opioid addiction 
                                therapy.</DELETED>
                                <DELETED>    ``(dd) The nurse 
                                practitioner practices in a qualified 
                                practice setting.''; and</DELETED>
        <DELETED>    (2) by adding at the end the following:</DELETED>
                <DELETED>    ``(iii) The term `qualified practice 
                setting' means 1 or more of the following treatment 
                settings:</DELETED>
                        <DELETED>    ``(I) A National Committee for 
                        Quality Assurance-recognized Patient-Centered 
                        Medical Home or Patient-Centered Specialty 
                        Practice.</DELETED>
                        <DELETED>    ``(II) A Centers for Medicaid & 
                        Medicare Services-recognized Accountable Care 
                        Organization.</DELETED>
                        <DELETED>    ``(III) A clinical facility 
                        administered by the Department of Veterans 
                        Affairs, Department of Defense, or Indian 
                        Health Service.</DELETED>
                        <DELETED>    ``(IV) A Behavioral Health Home 
                        accredited by the Joint Commission.</DELETED>
                        <DELETED>    ``(V) A Federally-qualified health 
                        center (as defined in section 1905(l)(2)(B) of 
                        the Social Security Act (42 U.S.C. 
                        1396d(l)(2)(B))) or a Federally-qualified 
                        health center look-alike.</DELETED>
                        <DELETED>    ``(VI) A Substance Abuse and 
                        Mental Health Services-certified Opioid 
                        Treatment Program.</DELETED>
                        <DELETED>    ``(VII) A clinical program of a 
                        State or Federal jail, prison, or other 
                        facility where individuals are 
                        incarcerated.</DELETED>
                        <DELETED>    ``(VIII) A clinic that 
                        demonstrates compliance with the Model Policy 
                        on DATA 2000 and Treatment of Opioid Addiction 
                        in the Medical Office issued by the Federation 
                        of State Medical Boards.</DELETED>
                        <DELETED>    ``(IX) A treatment setting that is 
                        part of an Accreditation Council for Graduate 
                        Medical Education, American Association of 
                        Colleges of Osteopathic Medicine, or American 
                        Osteopathic Association-accredited residency or 
                        fellowship training program.</DELETED>
                        <DELETED>    ``(X) Any other practice setting 
                        approved by a State regulatory board or State 
                        Medicaid Plan to provide addiction treatment 
                        services.</DELETED>
                        <DELETED>    ``(XI) Any other practice setting 
                        approved by the Secretary.''.</DELETED>

<DELETED>SEC. 5. GAO EVALUATION.</DELETED>

<DELETED>    Two years after the date on which the first notification 
under clause (iv) of section 303(g)(2)(B) of the Controlled Substances 
Act (21 U.S.C. 823(g)(2)(B)), as added by this Act, is received by the 
Secretary of Health and Human Services, the Comptroller General of the 
United States shall initiate an evaluation of the effectiveness of the 
amendments made by this Act, which shall include an evaluation of--
</DELETED>
        <DELETED>    (1) any changes in the availability and use of 
        medication-assisted treatment for opioid addiction;</DELETED>
        <DELETED>    (2) the quality of medication-assisted treatment 
        programs;</DELETED>
        <DELETED>    (3) the integration of medication-assisted 
        treatment with routine healthcare services;</DELETED>
        <DELETED>    (4) diversion of opioid addiction treatment 
        medication;</DELETED>
        <DELETED>    (5) changes in State or local policies and 
        legislation relating to opioid addiction treatment;</DELETED>
        <DELETED>    (6) the use of nurse practitioners and physician 
        assistants who prescribe opioid addiction medication;</DELETED>
        <DELETED>    (7) the use of Prescription Drug Monitoring 
        Programs by waived practitioners to maximize safety of patient 
        care and prevent diversion of opioid addiction 
        medication;</DELETED>
        <DELETED>    (8) the findings of Drug Enforcement 
        Administration inspections of waived practitioners, including 
        the frequency with which the Drug Enforcement Administration 
        finds no documentation of access to behavioral health services; 
        and</DELETED>
        <DELETED>    (9) the effectiveness of cross-agency 
        collaboration between Department of Health and Human Services 
        and the Drug Enforcement Administration for expanding effective 
        opioid addiction treatment.</DELETED>

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Recovery Enhancement for Addiction 
Treatment Act'' or the ``TREAT Act''.

SEC. 2. EXPANSION OF PATIENT LIMITS UNDER WAIVER.

    Section 303(g)(2)(B) of the Controlled Substances Act (21 U.S.C. 
823(g)(2)(B)) is amended--
            (1) in clause (i), by striking ``physician'' and inserting 
        ``practitioner'';
            (2) in clause (iii)--
                    (A) by striking ``The total number'' and inserting 
                ``(I) The total number'';
                    (B) by striking ``30'' and inserting ``100'';
                    (C) by striking ``, unless, not sooner'' and all 
                that follows through ``of this subparagraph''; and
                    (D) by adding at the end the following:
                    ``(II) If a patient is referred by a qualifying 
                practitioner that is a physician to another qualifying 
                practitioner that is a physician that provides short-
                term services (such as induction or titration), the 
                patient shall only be included in the total number of 
                such patients of the qualifying physician that makes 
                the referral.
                    ``(III) In this clause, the term `the total number 
                of such patients' shall not include a patient to whom a 
                qualifying practitioner that is a physician meeting the 
                requirements described in clause (iv)(I), or an 
                authorized agent of such qualifying practitioner that 
                is a physician, directly administers such drugs or 
                combination drugs.''; and
            (4) by adding at the end the following:
            ``(iv) Not earlier than 1 year after the date on which a 
        qualifying practitioner that is a physician obtained an initial 
        waiver pursuant to clause (iii), such qualifying practitioner 
        may submit a second notification to the Secretary of the need 
        and intent of such qualifying practitioner to treat up to 500 
        patients, if such qualifying practitioner--
            ``(I)(aa) satisfies the requirements of item (aa), (bb), 
        (cc), or (dd) of subparagraph (G)(ii)(I); and
            ``(bb) agrees to fully participate in the Prescription Drug 
        Monitoring Program of the State in which the qualifying 
        practitioner is licensed, pursuant to applicable State 
        guidelines; or
            ``(II)(aa) satisfies the requirements of item (ee), (ff), 
        or (gg) of subparagraph (G)(ii)(I);
            ``(bb) agrees to fully participate in the Prescription Drug 
        Monitoring Program of the State in which the qualifying 
        practitioner is licensed, pursuant to applicable State 
        guidelines; and
            ``(cc) has completed not less than 24 hours of training 
        (through classroom situations, seminars at professional society 
        meetings, electronic communications, or otherwise) with respect 
        to the treatment and management of opiate-dependent patients 
        for substance use disorders provided by the American Society of 
        Addiction Medicine, the American Academy of Addiction 
        Psychiatry, the American Medical Association, the American 
        Osteopathic Association, the American Psychiatric Association, 
        or any other organization that the Secretary determines is 
        appropriate for purposes of this subclause.
            ``(v) The qualifying practitioner shall maintain records 
        relating to the dispensing of drugs or combinations of drugs to 
        treat patients under this paragraph, including--
                    ``(I) whether the qualifying practitioner provides 
                counseling services on-site, and how frequently 
                patients are using such services;
                    ``(II) whether the qualifying practitioner referred 
                patients for counseling services off-site, the 
                percentage of the patients of the qualifying 
                practitioner using such services, and how frequently 
                the patients are using such services; and
                    ``(III) the frequency with which patients being 
                treated under this paragraph terminate the treatment 
                against medical advice.''.

SEC. 3. DEFINITIONS.

    Section 303(g)(2)(G) of the Controlled Substances Act (21 U.S.C. 
823(g)(2)(G)) is amended by striking clause (ii) and inserting the 
following:
                    ``(ii) The term `qualifying practitioner' means the 
                following:
                            ``(I) A physician who is licensed under 
                        State law and who meets 1 or more of the 
                        following conditions:
                                    ``(aa) The physician holds a board 
                                certification in addiction psychiatry 
                                or addiction medicine from the American 
                                Board of Medical Specialties.
                                    ``(bb) The physician holds an 
                                addiction certification from the 
                                American Society of Addiction Medicine 
                                or the American Board of Addiction 
                                Medicine.
                                    ``(cc) The physician holds a board 
                                certification in addiction medicine 
                                from the American Osteopathic 
                                Association.
                                    ``(dd) The physician holds a board 
                                certification from the American Board 
                                of Addiction Medicine.
                                    ``(ee) The physician has completed 
                                not less than 8 hours of training 
                                (through classroom situations, seminars 
                                at professional society meetings, 
                                electronic communications, or 
                                otherwise) with respect to the 
                                treatment and management of opiate-
                                dependent patients for substance use 
                                disorders provided by the American 
                                Society of Addiction Medicine, the 
                                American Academy of Addiction 
                                Psychiatry, the American Medical 
                                Association, the American Osteopathic 
                                Association, the American Psychiatric 
                                Association, or any other organization 
                                that the Secretary determines is 
                                appropriate for purposes of this 
                                subclause, after notice and the 
                                opportunity for comment.
                                    ``(ff) The physician has 
                                participated as an investigator in 1 or 
                                more clinical trials leading to the 
                                approval of a narcotic drug in schedule 
                                III, IV, or V for maintenance or 
                                detoxification treatment, as 
                                demonstrated by a statement submitted 
                                to the Secretary by this sponsor of 
                                such approved drug.
                                    ``(gg) The physician has such other 
                                training or experience as the Secretary 
                                determines will demonstrate the ability 
                                of the physician to treat and manage 
                                opiate dependent patients.
                            ``(II) A nurse practitioner or physician 
                        assistant who is licensed under State law and 
                        meets all of the following conditions:
                                    ``(aa) The nurse practitioner or 
                                physician assistant is licensed under 
                                State law to prescribe schedule III, 
                                IV, or V medications.
                                    ``(bb) The nurse practitioner or 
                                physician assistant has completed not 
                                fewer than 24 hours of training 
                                (through classroom situations, seminars 
                                at professional society meetings, 
                                electronic communications, or 
                                otherwise) with respect to the 
                                treatment and management of opiate-
                                dependent patients for substance use 
                                disorders provided by the American 
                                Society of Addiction Medicine, the 
                                American Academy of Addiction 
                                Psychiatry, the American Medical 
                                Association, the American Osteopathic 
                                Association, the American Psychiatric 
                                Association, the American Association 
                                of Nurse Practitioners, the American 
                                Academy of Physician Assistants, or any 
                                other organization that the Secretary 
                                determines is appropriate for purposes 
                                of this subclause, after notice and 
                                opportunity for comment.
                                    ``(cc) If required by State law, 
                                the nurse practitioner or physician 
                                assistant prescribes opioid addiction 
                                therapy in collaboration with or under 
                                the supervision of, as applicable, a 
                                physician.''.

SEC. 4. STATE FLEXIBILITY.

    Section 303(g)(2) of the Controlled Substances Act (21 U.S.C. 
823(g)(2)) is amended by striking subparagraphs (I) and (J), and 
inserting the following:
            ``(I) Notwithstanding section 708, nothing in this 
        paragraph shall be construed to preempt any State law that--
                    ``(i) permits a qualifying practitioner to dispense 
                narcotic drugs in schedule III, IV, or V, or 
                combinations of such drugs, for maintenance or 
                detoxification treatment in accordance with this 
                paragraph to a total number of patients that is more 
                than 30 or less than the total number applicable to the 
                qualifying practitioner under clause (iv) of 
                subparagraph (B) if a State enacts a law modifying such 
                total number and the Attorney General is notified by 
                the State of such modification; or
                    ``(ii) requires a qualifying practitioner to comply 
                with additional requirements relating to the dispensing 
                of narcotic drugs in schedule III, IV, or V, or 
                combinations of such drugs, including requirements 
                relating to the practice setting in which the 
                qualifying practitioner practices and education, 
                training, and reporting requirements.''.

SEC. 5. UPDATE REGULATIONS.

    Not later than 1 year after the date of enactment of this Act, the 
Attorney General shall update regulations regarding waived 
practitioners (as amended by this Act) to include nurse practitioners 
and physician assistants to ensure the quality of patient care and 
prevent diversion.

SEC. 6. EVALUATIONS.

    (a) Definition.--In this section, the term ``appropriate committees 
of Congress'' means--
            (1) the Committee on Health, Education, Labor, and Pensions 
        and the Committee on the Judiciary of the Senate; and
            (2) the Committee on Energy and Commerce and the Committee 
        on the Judiciary of the House of Representatives.
    (b) HHS.--Not later than 2 years after the date of enactment of 
this Act, the Secretary of Health and Human Services, in coordination 
with the Attorney General, shall submit to the appropriate committees 
of Congress a report on the effect on the amendments made by this title 
on the availability of evidence-based treatment and any increased risk 
in diversion, including the impact of nurse practitioners and physician 
assistants as qualifying practitioners.
    (c) GAO.--
            (1) In general.--Four years after the date on which the 
        first notification under clause (iv) of section 303(g)(2)(B) of 
        the Controlled Substances Act (21 U.S.C. 823(g)(2)(B)), as 
        added by this Act, is received by the Secretary of Health and 
        Human Services, the Comptroller General of the United States 
        shall initiate an evaluation of the effectiveness of the 
        amendments made by this Act, which shall include an evaluation 
        of--
                    (A) any changes in the availability and use of 
                medication-assisted treatment for opioid addiction;
                    (B) the quality of medication-assisted treatment 
                programs;
                    (C) the integration of medication-assisted 
                treatment with routine healthcare services;
                    (D) diversion of opioid addiction treatment 
                medication;
                    (E) changes in State or local policies and 
                legislation relating to opioid addiction treatment;
                    (F) the use of nurse practitioners and physician 
                assistants who prescribe opioid addiction medication;
                    (G) the use of Prescription Drug Monitoring 
                Programs by waived practitioners to maximize safety of 
                patient care and prevent diversion of opioid addiction 
                medication;
                    (H) the findings of Drug Enforcement Agency 
                inspections of waived practitioners, including the 
                frequency with which the Drug Enforcement Agency finds 
                no documentation of access to behavioral health 
                services; and
                    (I) the effectiveness of cross-agency collaboration 
                between Department of Health and Human Services and the 
                Drug Enforcement Agency for expanding effective opioid 
                addiction treatment.
            (2) Report.--The Comptroller General shall submit to the 
        appropriate committees of Congress a report regarding the 
        evaluation conducted under paragraph (1).
                                                       Calendar No. 441

114th CONGRESS

  2d Session

                                S. 1455

_______________________________________________________________________

                                 A BILL

    To provide access to medication-assisted therapy, and for other 
                               purposes.

_______________________________________________________________________

                             April 27, 2016

                       Reported with an amendment
```