115TH CONGRESS 

2D SESSION H. R. 5590 

AN ACT 

To require the Secretary of Health and Human Services 

to provide for an action plan on recommendations for 

changes under Medicare and Medicaid to prevent opioids 

addictions and enhance access to medication-assisted 

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 ‘‘Opioid Addiction Ac3 tion Plan Act’’. 

4 SEC. 2. ACTION PLAN ON RECOMMENDATIONS FOR 

5 CHANGES UNDER MEDICARE AND MEDICAID 

6 TO PREVENT OPIOIDS ADDICTIONS AND EN7 HANCE ACCESS TO MEDICATION-ASSISTED 

8 TREATMENT. 

9 (a) IN GENERAL.—Not later than January 1, 2019, 

10 the Secretary of Health and Human Services (in this sec11 tion referred to as the ‘‘Secretary’’), in collaboration with 

12 the Pain Management Best Practices Inter-Agency Task 

13 Force convened under section 101(b) of the Comprehen14 sive Addiction and Recovery Act of 2016 (Public Law 

15 114–198), shall develop an action plan that provides rec16 ommendations described in subsection (b). 

17 (b) ACTION PLAN COMPONENTS.—Recommendations 

18 described in this subsection are, based on an examination 

19 by the Secretary of potential obstacles to an effective re20 sponse to the opioid crisis, recommendations, as deter21 mined appropriate by the Secretary, on the following: 

22 (1) Recommendations on changes to the Medi23 care program under title XVIII of the Social Secu24 rity Act and the Medicaid program under title XIX 

25 of such Act that would enhance coverage and pay26 ment under such programs of all medication-assisted 
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1 treatment approved by the Food and Drug Adminis2 tration for the treatment of opioid addiction and 

3 other therapies that manage chronic and acute pain 

4 and treat and minimize risk of opioid addiction, in5 cluding recommendations on changes to the Medi6 care prospective payment system for hospital inpa7 tient department services under section 1886(d) of 

8 such Act (42 U.S.C. 1395ww(d)) and the Medicare 

9 prospective payment system for hospital outpatient 

10 department services under section 1833(t) of such 

11 Act (42 U.S.C. 1395l(t)) that would allow for sepa12 rate payment for such therapies, if medically appro13 priate and if necessary to encourage development 

14 and adoption of such therapies. 

15 (2) Recommendations for payment and service 

16 delivery models to be tested by the Center for Medi17 care and Medicaid Innovation and other federally 

18 authorized demonstration projects, including value19 based models, that may encourage the use of appro20 priate medication-assisted treatment approved by the 

21 Food and Drug Administration for the treatment of 

22 opioid addiction and other therapies that manage 

23 chronic and acute pain and treat and minimize risk 

24 of opioid addiction. 
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1 (3) Recommendations for data collection that 

2 could facilitate research and policy making regarding 

3 prevention of opioid addiction and coverage and pay4 ment under the Medicare and Medicaid programs of 

5 appropriate opioid addiction treatments. 

6 (4) Recommendations for policies under the 

7 Medicare program and under the Medicaid program 

8 that can expand access for rural, or medically under9 served communities to the full range of medication10 assisted treatment approved by the Food and Drug 

11 Administration for the treatment of opioid addiction 

12 and other therapies that manage chronic and acute 

13 pain and treatment and minimize risk of opioid ad14 diction. 

15 (5) Recommendations on changes to the Medi16 care program and the Medicaid program to address 

17 coverage or payment barriers to patient access to 

18 medical devices that are non-opioid based treatments 

19 approved by the Food and Drug Administration for 

20 the management of acute pain and chronic pain, for 

21 monitoring substance use withdrawal and preventing 

22 overdoses of controlled substances, and for treating 

23 substance use disorder. 

24 (c) STAKEHOLDER MEETINGS.— 
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1 (1) IN GENERAL.—Beginning not later than 3 

2 months after the date of the enactment of this Act, 

3 the Secretary shall convene a public stakeholder 

4 meeting to solicit public comment on the components 

5 of the action plan recommendations described in 

6 subsection (b). 

7 (2) PARTICIPANTS.—Participants of meetings 

8 described in paragraph (1) shall include representa9 tives from the Food and Drug Administration and 

10 National Institutes of Health, biopharmaceutical in11 dustry members, medical researchers, health care 

12 providers, the medical device industry, the Medicare 

13 program, the Medicaid program, and patient advo14 cates. 

15 (d) REQUEST FOR INFORMATION.—Not later than 3 

16 months after the date of the enactment of this section, 

17 the Secretary shall issue a request for information seeking 

18 public feedback regarding ways in which the Centers for 

19 Medicare & Medicaid Services can help address the opioid 

20 crisis through the development of and application of the 

21 action plan. 

22 (e) REPORT TO CONGRESS.—Not later than June 1, 

23 2019, the Secretary shall submit to Congress, and make 

24 public, a report that includes— 
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1 (1) a summary of recommendations that have 

2 emerged under the action plan; 

3 (2) the Secretary’s planned next steps with re4 spect to the action plan; and 

5 (3) an evaluation of price trends for drugs used 

6 to reverse opioid overdoses (such as naloxone), in7 cluding recommendations on ways to lower such 

8 prices for consumers. 

9 (f) DEFINITION OF MEDICATION-ASSISTED TREAT10 MENT.—In this section, the term ‘‘medication-assisted 

11 treatment’’ includes opioid treatment programs, behav12 ioral therapy, and medications to treat substance abuse 

13 disorder. 

Passed the House of Representatives June 19, 2018. 

Attest: 

Clerk. 

115TH CONGRESS 

2D SESSION H. R. 5590 

AN ACT 

To require the Secretary of Health and Human 

and for other purposes. hance access to medication-assisted treatment, Medicaid to prevent opioids addictions and enommendations for changes under Medicare and Services to provide for an action plan on rec-