II 

116TH CONGRESS 

1ST SESSION S. 2074 

To amend section 303(g) of the Controlled Substances Act (21 U.S.C. 823(g)) 

to eliminate the separate registration requirement for dispensing narcotic 

drugs in schedule III, IV, or V, such as buprenorphine, for maintenance 

or detoxification treatment, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

JULY 10, 2019 

Ms. HASSAN (for herself and Ms. MURKOWSKI) introduced the following bill; 

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

A BILL 

To amend section 303(g) of the Controlled Substances Act 

(21 U.S.C. 823(g)) to eliminate the separate registration 

requirement for dispensing narcotic drugs in schedule 

III, IV, or V, such as buprenorphine, 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, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Mainstreaming Addic5 tion Treatment Act of 2019’’. 


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1 SEC. 2. ELIMINATING SEPARATE REGISTRATION REQUIRE2 MENT FOR DISPENSING NARCOTIC DRUGS IN 

3 SCHEDULES III, IV, AND V FOR MAINTENANCE 

4 OR DETOXIFICATION TREATMENT. 

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

6 Substances Act (21 U.S.C. 823(g)) is amended— 

7 (1) by striking paragraph (2); 

8 (2) by striking ‘‘(g)(1) Except as provided in 

9 paragraph (2), practitioners who dispense narcotic 

10 drugs to individuals for maintenance treatment or 

11 detoxification treatment’’ and inserting ‘‘(g) Practi12 tioners who dispense narcotic drugs (other than nar13 cotic drugs in schedule III, IV, or V) to individuals 

14 for maintenance treatment or detoxification treat15 ment’’; 

16 (3) by redesignating subparagraphs (A), (B), 

17 and (C) as paragraphs (1), (2), and (3), respectively; 

18 and 

19 (4) in paragraph (2), as redesignated, by redes20 ignating clauses (i) and (ii) as subparagraphs (A) 

21 and (B), respectively. 

22 (b) TECHNICAL AND CONFORMING EDITS.— 

23 (1) Section 304 of the Controlled Substances 

24 Act (21 U.S.C. 824) is amended— 


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1 (A) in subsection (a), by striking 

2 ‘‘303(g)(1)’’ each place it appears and inserting 

3 ‘‘303(g)’’; and 

4 (B) in subsection (d)(1), by striking 

5 ‘‘303(g)(1)’’ and inserting ‘‘303(g)’’. 

6 (2) Section 309A(a) of the Controlled Sub7 stances Act (21 U.S.C. 829a(a)) is amended by 

8 striking paragraph (2) and inserting the following: 

9 ‘‘(2) the controlled substance— 

10 ‘‘(A) is a narcotic drug in schedule III, IV, 

11 or V to be administered for the purpose of 

12 maintenance or detoxification treatment; and 

13 ‘‘(B) is to be administered by injection or 

14 implantation;’’. 

15 (3) Section 520E–4(c) of the Public Health 

16 Service Act (42 U.S.C. 290bb–36d(c)) is amended, 

17 in the matter preceding paragraph (1), by striking 

18 ‘‘information on any qualified practitioner that is 

19 certified to prescribe medication for opioid depend20 ency under section 303(g)(2)(B) of the Controlled 

21 Substances Act’’ and inserting ‘‘information on any 

22 practitioner who prescribes narcotic drugs in sched23 ule III, IV, or V of section 202 of the Controlled 

24 Substances Act for the purpose of maintenance or 

25 detoxification treatment’’. 


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1 (4) Section 544(a)(3) of the Public Health 

2 Service Act (42 U.S.C. 290dd–3) is amended by 

3 striking ‘‘any practitioner dispensing narcotic drugs 

4 pursuant to section 303(g) of the Controlled Sub5 stances Act’’ and inserting ‘‘any practitioner dis6 pensing narcotic drugs for the purpose of mainte7 nance or detoxification treatment’’. 

8 (5) Section 1833(bb)(3)(B) of the Social Secu9 rity Act (42 U.S.C. 1395l(bb)(3)(B)) is amended by 

10 striking ‘‘first receives a waiver under section 303(g) 

11 of the Controlled Substances Act on or after Janu12 ary 1, 2019’’ and inserting ‘‘first begins prescribing 

13 narcotic drugs in schedule III, IV, or V of section 

14 202 of the Controlled Substances Act for the pur15 pose of maintenance or detoxification treatment on 

16 or after January 1, 2019’’. 

17 (6) Section 1834(o)(3)(C)(ii) of the Social Se18 curity Act (42 U.S.C. 1395m(o)(3)(C)(ii)) is amend19 ed by striking ‘‘first receives a waiver under section 

20 303(g) of the Controlled Substances Act on or after 

21 January 1, 2019’’ and inserting ‘‘first begins pre22 scribing narcotic drugs in schedule III, IV, or V of 

23 section 202 of the Controlled Substances Act for the 

24 purpose of maintenance or detoxification treatment 

25 on or after January 1, 2019’’. 


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1 (7) Section 1866F(c)(3) of the Social Security 

2 Act (42 U.S.C. 1395cc–6(c)(3)) is amended— 

3 (A) in subparagraph (A), by inserting 

4 ‘‘and’’ at the end; 

5 (B) in subparagraph (B), by striking ‘‘; 

6 and’’ and inserting a period; and 

7 (C) by striking subparagraph (C). 

8 (8) Section 1903(aa)(2)(C) of the Social Secu9 rity Act (42 U.S.C. 1396b(aa)(2)(C)) is amended— 

10 (A) in clause (i), by inserting ‘‘and’’ at the 

11 end; 

12 (B) by striking clause (ii); and 

13 (C) by redesignating clause (iii) as clause 

14 (ii). 

15 SEC. 3. NATIONAL EDUCATION CAMPAIGN. 

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

17 Human Services, acting through the Assistant Secretary 

18 for Mental Health and Substance Use, shall conduct a na19 tional campaign to educate practitioners with respect to 

20 the elimination of the separate registration requirement 

21 under section 303(g) of the Controlled Substances Act (21 

22 U.S.C. 823(g)), as in effect on the day before the date 

23 of enactment of this Act, for dispensing narcotic drugs in 

24 schedule III, IV, and V for maintenance or detoxification 

25 treatment. 


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1 (b) REQUIRED COMPONENTS.—The national edu2 cation campaign under subsection (a) shall— 

3 (1) encourage practitioners to integrate sub4 stance use treatment into their practices; and 

5 (2) include education on publicly available edu6 cational resources and training modules that can as7 sist practitioners in treating patients with a sub8 stance use disorder. 

9 SEC. 4. COMMUNITY HEALTH AIDES AND COMMUNITY 

10 HEALTH PRACTITIONERS. 

11 (a) PRACTICE OF TELEMEDICINE.—Section 102 of 

12 the Controlled Substances Act (21 U.S.C. 802) is amend13 ed— 

14 (1) in paragraph (54)(A), by striking clause (i) 

15 and inserting the following: 

16 ‘‘(i) while the patient is— 

17 ‘‘(I) being treated by, and physically 

18 located in, a hospital or clinic registered 

19 under section 303(f); or 

20 ‘‘(II) for purposes of section 302(h), 

21 being treated by a community health aide 

22 or community health practitioner; and’’; 

23 (2) by redesignating paragraph (58) as para24 graph (59); 


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1 (3) by redesignating the second paragraph des2 ignated as paragraph (57) as paragraph (58); 

3 (4) by moving paragraphs (57), (58) (as so re4 designated), and (59) (as so redesignated) 2 ems to 

5 the left; and 

6 (5) by adding at the end the following: 

7 ‘‘(60) The terms ‘community health aide’ and ‘com8 munity health practitioner’ have the meanings within the 

9 meaning of section 119 of the Indian Health Care Im10 provement Act (25 U.S.C. 1616l).’’. 

11 (b) DISPENSATION OF NARCOTIC DRUGS IN SCHED12 ULE III, IV, OR V.—Section 302 of the Controlled Sub13 stances Act (21 U.S.C. 822) is amended by adding at the 

14 end the following: 

15 ‘‘(h) DISPENSATION OF NARCOTIC DRUGS IN SCHED16 ULE III, IV, OR V BY CERTAIN PRACTITIONERS.— 

17 ‘‘(1) IN GENERAL.—Notwithstanding subsection 

18 (a)(2), a community health aide or community 

19 health practitioner may dispense a narcotic drug in 

20 schedule III, IV, or V, such as buprenorphine, or a 

21 combination of such drugs, to an individual for 

22 maintenance treatment or detoxification treatment 

23 (or both) without being registered under this title if 

24 the drug is prescribed by a practitioner through the 

25 practice of telemedicine. 


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1 ‘‘(2) PREEMPTION.—Notwithstanding section 

2 708, a State may not require a community health 

3 aide or community health practitioner to be licensed 

4 by the State in order to dispense narcotic drugs in 

5 accordance with paragraph (1) of this subsection.’’. 

Æ 


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