I 

115TH CONGRESS 

2D SESSION H. R. 5776 

To amend title XVIII to provide for Medicare coverage of certain services 

furnished by opioid treatment programs, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

MAY 11, 2018 

Mr. NEAL (for himself, Mr. HOLDING, Mr. CARTWRIGHT, and Mr. TAYLOR) 

introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and 

Means, for a period to be subsequently determined by the Speaker, in 

each case for consideration of such provisions as fall within the jurisdiction of the committee concerned 

A BILL 

To amend title XVIII to provide for Medicare coverage of 

certain services furnished by opioid treatment programs, 

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 ‘‘Medicare and Opioid 

5 Safe Treatment Act’’ or the ‘‘MOST Act’’. 


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1 SEC. 2. MEDICARE COVERAGE OF CERTAIN SERVICES FUR2 NISHED BY OPIOID TREATMENT PROGRAMS. 

3 (a) COVERAGE.—Section 1861(s)(2) of the Social Se4 curity Act (42 U.S.C. 1395x(s)(2)) is amended— 

5 (1) in subparagraph (FF), by striking at the 

6 end ‘‘and’’; 

7 (2) in subparagraph (GG), by inserting at the 

8 end ‘‘; and’’; and 

9 (3) by adding at the end the following new sub10 paragraph: 

11 ‘‘(HH) opioid use disorder treatment serv12 ices (as defined in subsection (jjj)).’’. 

13 (b) OPIOID USE DISORDER TREATMENT SERVICES

14 AND OPIOID TREATMENT PROGRAM DEFINED.—Section 

15 1861 of the Social Security Act is amended by adding at 

16 the end the following new subsection: 

17 ‘‘(jjj) OPIOID USE DISORDER TREATMENT SERV18 ICES; OPIOID TREATMENT PROGRAM.— 

19 ‘‘(1) OPIOID USE DISORDER TREATMENT SERV20 ICES.—The term ‘opioid use disorder treatment serv21 ices’ means items and services that are furnished by 

22 an opioid treatment program for the treatment of 

23 opioid abuse disorder, including— 

24 ‘‘(A) opioid agonist treatment medications 

25 (including oral versions) that are approved by 

26 the Food and Drug Administration under secVerDate Sep 11 2014 19:01 May 30, 2018 Jkt 079200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H5776.IH H5776

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1 tion 505 of the Federal Food, Drug and Cos2 metic Act for use in the treatment of opioid use 

3 disorder; 

4 ‘‘(B) dispensing and administration of 

5 such medications, if applicable; 

6 ‘‘(C) substance abuse counseling by a pro7 fessional to the extent authorized under State 

8 law to furnish such services; 

9 ‘‘(D) behavioral individual and group ther10 apy with physicians or psychologists (or other 

11 mental health professionals to the extent au12 thorized under State law); 

13 ‘‘(E) toxicology testing; and 

14 ‘‘(F) other items and services that the Sec15 retary determines are appropriate. 

16 ‘‘(2) OPIOID TREATMENT PROGRAM.—The term 

17 ‘opioid treatment program’ means an opioid treat18 ment program (as defined in section 8.2 of title 42 

19 of the Code of Federal Regulations, or any successor 

20 regulation) that— 

21 ‘‘(A) is enrolled under section 1866(j); 

22 ‘‘(B) has in effect a certification by the 

23 Substance Abuse and Mental Health Services 

24 Administration for such a program; 


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1 ‘‘(C) is accredited by an accrediting body 

2 approved by the Substance Abuse and Mental 

3 Health Services Administration; and 

4 ‘‘(D) meets such additional conditions as 

5 the Secretary may find necessary to ensure— 

6 ‘‘(i) the health and safety of individ7 uals being furnished services under such 

8 program; and 

9 ‘‘(ii) the effective and efficient fur10 nishing of such services.’’. 

11 (c) PAYMENT.— 

12 (1) IN GENERAL.—Section 1833(a)(1) of the 

13 Social Security Act (42 U.S.C. 1395l(a)(1)) is 

14 amended— 

15 (A) by striking ‘‘and (BB)’’ and inserting 

16 ‘‘(BB)’’; and 

17 (B) by inserting before the semicolon at 

18 the end the following ‘‘, and (CC) with respect 

19 to opioid use disorder treatment services fur20 nished during an episode of care, the amount 

21 paid shall be equal to the amount payable in ac22 cordance with section 1834(w) less any copay23 ment required as specified by the Secretary’’. 

24 (2) PAYMENT DETERMINATION.—Section 1834 

25 of the Social Security Act (42 U.S.C. 1395m) is 


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1 amended by adding at the end the following new 

2 subsection: 

3 ‘‘(w) OPIOID USE DISORDER TREATMENT SERV4 ICES.— 

5 ‘‘(1) IN GENERAL.—The Secretary shall pay to 

6 an opioid treatment program (as defined in para7 graph (2) of section 1861(jjj)) an amount that is 

8 equal to 100 percent of a bundled payment under 

9 this part for opioid use disorder treatment services 

10 (as defined in paragraph (1) of such section) that 

11 are furnished by such program to an individual dur12 ing an episode of care (as defined by the Secretary) 

13 beginning on or after January 1, 2020. The Sec14 retary shall ensure that no duplicative payments are 

15 made under this part or part D to a physician, prac16 titioner, or pharmacy for items and services fur17 nished by an opioid treatment program. 

18 ‘‘(2) CONSIDERATIONS.—The Secretary may 

19 implement this subsection through one or more bun20 dles based on the type of medication provided (such 

21 as buprenorphine, methadone, naltrexone, or a new 

22 innovative drug), the frequency of services, the scope 

23 of services furnished, characteristics of the individ24 uals furnished such services, or other factors as the 

25 Secretary determine appropriate. In developing such 


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1 bundles, the Secretary may consider payment rates 

2 paid to opioid treatment programs for comparable 

3 services under State plans under title XIX, under 

4 the TRICARE program under chapter 55 of title 10 

5 of the United States Code, or by other health care 

6 payers. 

7 ‘‘(3) ANNUAL UPDATES.—The Secretary shall 

8 provide an update each year to the bundled payment 

9 amounts under this subsection.’’. 

10 (d) INCLUDING OPIOID TREATMENT PROGRAMS AS

11 MEDICARE PROVIDERS.—Section 1866(e) of the Social 

12 Security Act (42 U.S.C. 1395cc(e)) is amended— 

13 (1) in paragraph (2), by striking at the end 

14 ‘‘and’’; 

15 (2) in paragraph (3), by striking the period at 

16 the end and inserting ‘‘; and’’; and 

17 (3) by adding at the end the following new 

18 paragraph: 

19 ‘‘(3) opioid treatment programs (as defined in 

20 paragraph (2) of section 1861(jjj)), but only with re21 spect to the furnishing of opioid treatment program 

22 services (as defined in paragraph (1) of such sec23 tion).’’. 


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1 SEC. 3. REVIEW AND ADJUSTMENT OF PAYMENTS UNDER 

2 THE MEDICARE OUTPATIENT PROSPECTIVE 

3 PAYMENT SYSTEM TO AVOID FINANCIAL IN4 CENTIVES TO USE OPIOIDS INSTEAD OF NON5 OPIOID ALTERNATIVE TREATMENTS. 

6 (a) OUTPATIENT PROSPECTIVE PAYMENT SYS7 TEM.—Section 1833(t) of the Social Security Act (42 

8 U.S.C. 1395l(t)) is amended by adding at the end the fol9 lowing new paragraph: 

10 ‘‘(22) REVIEW AND REVISIONS OF PAYMENTS

11 FOR NON-OPIOID ALTERNATIVE TREATMENTS.— 

12 ‘‘(A) IN GENERAL.—With respect to pay13 ments made under this subsection for covered 

14 OPD services (or groups of services), including 

15 covered OPD services assigned to a comprehen16 sive ambulatory payment classification, the Sec17 retary— 

18 ‘‘(i) shall, as soon as practicable, con19 duct a review (part of which may include 

20 a request for information) of payments for 

21 opioids and evidence-based non-opioid al22 ternatives for pain management (including 

23 drugs and devices, nerve blocks, surgical 

24 injections, and neuromodulation) with a 

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1 cial incentives to use opioids instead of 

2 non-opioid alternatives; 

3 ‘‘(ii) may, as the Secretary determines 

4 appropriate, conduct subsequent reviews of 

5 such payments; and 

6 ‘‘(iii) shall consider the extent to 

7 which revisions under this subsection to 

8 such payments (such as the creation of ad9 ditional groups of covered OPD services to 

10 classify separately those procedures that 

11 utilize opioids and non-opioid alternatives 

12 for pain management) would reduce pay13 ment incentives to use opioids instead of 

14 non-opioid alternatives for pain manage15 ment. 

16 ‘‘(B) PRIORITY.—In conducting the review 

17 under clause (i) of subparagraph (A) and con18 sidering revisions under clause (iii) of such sub19 paragraph, the Secretary shall focus on covered 

20 OPD services (or groups of services) assigned 

21 to a comprehensive ambulatory payment classi22 fication, ambulatory payment classifications 

23 that primarily include surgical services, and 

24 other services determined by the Secretary 


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1 which generally involve treatment for pain man2 agement. 

3 ‘‘(C) REVISIONS.—If the Secretary identi4 fies revisions to payments pursuant to subpara5 graph (A)(iii), the Secretary shall, as deter6 mined appropriate, begin making such revisions 

7 for services furnished on or after January 1, 

8 2020. Revisions under the previous sentence 

9 shall be treated as adjustments for purposes of 

10 application of paragraph (9)(B). 

11 ‘‘(D) RULES OF CONSTRUCTION.—Nothing 

12 in this paragraph shall be construed to preclude 

13 the Secretary— 

14 ‘‘(i) from conducting a demonstration 

15 before making the revisions described in 

16 subparagraph (C); or 

17 ‘‘(ii) prior to implementation of this 

18 paragraph, from changing payments under 

19 this subsection for covered OPD services 

20 (or groups of services) which include 

21 opioids or non-opioid alternatives for pain 

22 management.’’. 

23 (b) AMBULATORY SURGICAL CENTERS.—Section 

24 1833(i) of the Social Security Act (42 U.S.C. 1395l(i)) 


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1 is amended by adding at the end the following new para2 graph: 

3 ‘‘(8) The Secretary shall apply the provisions of 

4 paragraph (22) of section 1833(t), including the sec5 ond sentence of subparagraph (C) of such para6 graph, to payment for services under this subsection 

7 in an appropriate manner (as determined by the 

8 Secretary).’’. 

9 SEC. 4. EXPANDING ACCESS UNDER THE MEDICARE PRO10 GRAM TO ADDICTION TREATMENT IN FEDER11 ALLY QUALIFIED HEALTH CENTERS AND 

12 RURAL HEALTH CLINICS. 

13 (a) FEDERALLY QUALIFIED HEALTH CENTERS.— 

14 Section 1834(o) of the Social Security Act (42 U.S.C. 

15 1395m(o)) is amended by adding at the end the following 

16 new paragraph: 

17 ‘‘(3) ADDITIONAL PAYMENTS FOR CERTAIN

18 FQHCS WITH PRACTITIONERS RECEIVING DATA 2000

19 CERTIFICATION.— 

20 ‘‘(A) IN GENERAL.—In the case of a Fed21 erally qualified health center with respect to 

22 which, beginning January 1, 2019, Federally23 qualified health center services (as defined in 

24 section 1861(aa)(3)) are furnished by a health 

25 care practitioner who first receives on or after 


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1 such date a registration or waiver under section 

2 303(g) of the Controlled Substances Act to pre3 scribe or dispense methadone, buprenorphine, 

4 or suboxone for the purpose of maintenance or 

5 detoxification treatment, the Secretary shall, 

6 subject to availability of funds under subpara7 graph (B), make a payment (in accordance with 

8 such timing, method, and procedures as speci9 fied by the Secretary) to such Federally quali10 fied health center in an amount determined by 

11 the Secretary, based on an approximation of the 

12 cost to receive training for purposes of such 

13 registration or waiver, as applicable. For pur14 poses of the previous sentence, a Federally15 qualified health center shall apply for a pay16 ment described in such sentence at such time 

17 and in such manner as specified by the Sec18 retary and may apply for such a payment for 

19 each practitioner furnishing such services at 

20 such center who is described in such sentence. 

21 ‘‘(B) FUNDING.—For purposes of making 

22 payments under this paragraph, there are ap23 propriated, out of amounts in the Treasury not 

24 otherwise appropriated, $6,000,000, which shall 

25 remain available until expended.’’. 


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1 (b) RURAL HEALTH CLINIC.—Section 1833 of the 

2 Social Security Act (42 U.S.C. 1395l) is amended— 

3 (1) by redesignating the subsection (z) relating 

4 to medical review of spinal subluxation services as 

5 subsection (aa); and 

6 (2) by adding at the end the following new sub7 section: 

8 ‘‘(bb) ADDITIONAL PAYMENTS FOR CERTAIN RURAL

9 HEALTH CLINICS WITH PRACTITIONERS RECEIVING

10 DATA 2000 CERTIFICATION.— 

11 ‘‘(1) IN GENERAL.—In the case of a rural 

12 health clinic with respect to which, beginning Janu13 ary 1, 2019, rural health clinic services (as defined 

14 in section 1861(aa)(1)) are furnished by a health 

15 care practitioner who first receives on or after such 

16 date a registration or waiver under section 303(g) of 

17 the Controlled Substances Act to prescribe or dis18 pense methadone, buprenorphine, or suboxone for 

19 the purpose of maintenance or detoxification treat20 ment, the Secretary shall, subject to availability of 

21 funds under subparagraph (B), make a payment (in 

22 accordance with such timing, method, and proce23 dures as specified by the Secretary) to such rural 

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1 ceive training for purposes of such registration or 

2 waiver, as applicable. For purposes of the previous 

3 sentence, a rural health clinic shall apply for a pay4 ment described in such sentence at such time and in 

5 such manner as specified by the Secretary and may 

6 apply for such a payment for each practitioner fur7 nishing such services at such clinic who is described 

8 in such sentence. 

9 ‘‘(2) FUNDING.—For purposes of making pay10 ments under this subsection, there are appropriated, 

11 out of amounts in the Treasury not otherwise appro12 priated, $2,000,000, which shall remain available 

13 until expended.’’. 

14 SEC. 5. STUDYING THE AVAILABILITY OF SUPPLEMENTAL 

15 BENEFITS DESIGNED TO TREAT OR PREVENT 

16 SUBSTANCE USE DISORDERS UNDER MEDI17 CARE ADVANTAGE PLANS. 

18 (a) IN GENERAL.—Not later than 2 years after the 

19 date of the enactment of this Act, the Secretary of Health 

20 and Human Services (in this section referred to as the 

21 ‘‘Secretary’’) shall submit to Congress a report on the 

22 availability of supplemental health care benefits (as de23 scribed in section 1852(a)(3)(A) of the Social Security Act 

24 (42 U.S.C. 1395w–22(a)(3)(A))) designed to treat or pre25 vent substance use disorders under Medicare Advantage 


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1 plans offered under part C of title XVIII of such Act. Such 

2 report shall include the analysis described in subsection 

3 (c) and any differences in the availability of such benefits 

4 under specialized MA plans for special needs individuals 

5 (as defined in section 1859(b)(6) of such Act (42 U.S.C. 

6 1395w–28(b)(6))) offered to individuals entitled to med7 ical assistance under title XIX of such Act and other such 

8 Medicare Advantage plans. 

9 (b) CONSULTATION.—The Secretary shall develop the 

10 report described in subsection (a) in consultation with rel11 evant stakeholders, including— 

12 (1) individuals entitled to benefits under part A 

13 or enrolled under part B of title XVIII of the Social 

14 Security Act; 

15 (2) entities who advocate on behalf of such indi16 viduals; 

17 (3) Medicare Advantage organizations; 

18 (4) pharmacy benefit managers; and 

19 (5) providers of services and suppliers (as such 

20 terms are defined in section 1861 of such Act (42 

21 U.S.C. 1395x)). 

22 (c) CONTENTS.—The report described in subsection 

23 (a) shall include an analysis on the following: 


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1 (1) The extent to which plans described in such 

2 subsection offer supplemental health care benefits 

3 relating to coverage of— 

4 (A) medication-assisted treatments for 

5 opioid use, substance use disorder counseling, 

6 peer recovery support services, or other forms 

7 of substance use disorder treatments (whether 

8 furnished in an inpatient or outpatient setting); 

9 and 

10 (B) non-opioid alternatives for the treat11 ment of pain. 

12 (2) Challenges associated with such plans offer13 ing supplemental health care benefits relating to cov14 erage of items and services described in subpara15 graph (A) or (B) of paragraph (1). 

16 (3) The impact, if any, of increasing the appli17 cable rebate percentage determined under section 

18 1854(b)(1)(C) of the Social Security Act (42 U.S.C. 

19 1395w–24(b)(1)(C)) for plans offering such benefits 

20 relating to such coverage would have on the avail21 ability of such benefits relating to such coverage of22 fered under Medicare Advantage plans. 

23 (4) Potential ways to improve upon such cov24 erage or to incentivize such plans to offer additional 


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1 supplemental health care benefits relating to such 

2 coverage. 

3 SEC. 6. CLINICAL PSYCHOLOGIST SERVICES MODELS 

4 UNDER THE CENTER FOR MEDICARE AND 

5 MEDICAID INNOVATION; GAO STUDY AND RE6 PORT. 

7 (a) CMI MODELS.—Section 1115A(b)(2)(B) of the 

8 Social Security Act (42 U.S.C. 1315a(b)(2)(B)) is amend9 ed by adding at the end the following new clauses: 

10 ‘‘(xxv) Supporting ways to familiarize 

11 individuals with the availability of coverage 

12 under part B of title XVIII for qualified 

13 psychologist services (as defined in section 

14 1861(ii)). 

15 ‘‘(xxvi) Exploring ways to avoid un16 necessary hospitalizations or emergency de17 partment visits for mental and behavioral 

18 health services (such as for treating de19 pression) through use of a 24-hour, 7-day 

20 a week help line that may inform individ21 uals about the availability of treatment op22 tions, including the availability of qualified 

23 psychologist services (as defined in section 

24 1861(ii)).’’. 


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1 (b) GAO STUDY AND REPORT.—Not later than 18 

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

3 Comptroller General of the United States shall conduct 

4 a study, and submit to Congress a report, on mental and 

5 behavioral health services under the Medicare program 

6 under title XVIII of the Social Security Act, including an 

7 examination of the following: 

8 (1) Information about services furnished by 

9 psychiatrists, clinical psychologists, and other profes10 sionals. 

11 (2) Information about ways that Medicare bene12 ficiaries familiarize themselves about the availability 

13 of Medicare payment for qualified psychologist serv14 ices (as defined in section 1861(ii) of the Social Se15 curity Act (42 U.S.C. 1395x(ii))) and ways that the 

16 provision of such information could be improved. 

17 SEC. 7. PAIN MANAGEMENT STUDY. 

18 (a) IN GENERAL.—Not later than 1 year after the 

19 date of enactment of this Act, the Secretary of Health and 

20 Human Services (referred to in this section as the ‘‘Sec21 retary’’) shall conduct a study and submit to the Com22 mittee on Ways and Means and the Committee on Energy 

23 and Commerce of the House of Representatives and the 

24 Committee on Finance of the Senate a report containing 

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1 viders and suppliers of services and coverage related to 

2 the use of multi-disciplinary, evidence-based, non-opioid 

3 treatments for acute and chronic pain management for in4 dividuals entitled to benefits under part A or enrolled 

5 under part B of title XVIII of the Social Security Act 

6 should be revised. The Secretary shall make such report 

7 available on the public website of the Centers for Medicare 

8 & Medicaid Services. 

9 (b) CONSULTATION.—In developing the report de10 scribed in subsection (a), the Secretary shall consult 

11 with— 

12 (1) relevant agencies within the Department of 

13 Health and Human Services; 

14 (2) licensed and practicing osteopathic and 

15 allopathic physicians, behavioral health practitioners, 

16 physician assistants, nurse practitioners, dentists, 

17 pharmacists, and other providers of health services; 

18 (3) providers and suppliers of services (as such 

19 terms are defined in section 1861 of the Social Secu20 rity Act (42 U.S.C. 1395x)); 

21 (4) substance abuse and mental health profes22 sional organizations; 

23 (5) pain management professional organizations 

24 and advocacy entities, including individuals who per25 sonally suffer chronic pain; 


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1 (6) medical professional organizations and med2 ical specialty organizations; 

3 (7) licensed health care providers who furnish 

4 alternative pain management services; 

5 (8) organizations with expertise in the develop6 ment of innovative medical technologies for pain 

7 management; 

8 (9) beneficiary advocacy organizations; and 

9 (10) other organizations with expertise in the 

10 assessment, diagnosis, treatment, and management 

11 of pain, as determined appropriate by the Secretary. 

12 (c) CONTENTS.—The report described in subsection 

13 (a) shall include the following: 

14 (1) The recommendations described in sub15 section (d). 

16 (2) The impact analysis described in subsection 

17 (e). 

18 (3) An assessment of pain management guid19 ance published by the Federal Government that may 

20 be relevant to coverage determinations or other cov21 erage requirements under title XVIII of the Social 

22 Security Act. Such assessment shall consider incor23 porating into such guidance relevant elements of the 

24 ‘‘Va/DoD Clinical Practice Guideline for Opioid 

25 Therapy for Chronic Pain’’ published in February 


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1 2017 by the Department of Veterans Affairs and 

2 Department of Defense, including adoption of ele3 ments of the Department of Defense and Veterans 

4 Administration pain rating scale. 

5 (4) An evaluation of the following: 

6 (A) Barriers inhibiting individuals entitled 

7 to benefits under part A or enrolled under part 

8 B of such title from accessing treatments and 

9 technologies described in subparagraphs (A) 

10 through (F) of paragraph (6). 

11 (B) Potential legislative and administrative 

12 changes under such title to improve individuals’ 

13 access to items and services currently covered 

14 under such title and used for the treatment of 

15 pain, such as cognitive behavioral interventions, 

16 physical therapy, occupational therapy, physical 

17 medicine, biofeedback therapy, and chiropractic 

18 therapy, and other pain treatments services fur19 nished in a hospital or post-acute care setting. 

20 (C) Costs and benefits associated with po21 tential expansion of coverage under such title to 

22 include items and services not covered under 

23 such title that may be used for the treatment 

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1 sage, and items and services furnished by inte2 grated pain management programs. 

3 (5) An analysis on payment and coverage under 

4 title XVIII of the Social Security Act with respect 

5 to the following: 

6 (A) Evidence-based treatments and tech7 nologies for chronic or acute pain, including 

8 such treatments that are covered, not covered, 

9 or have limited coverage under such title. 

10 (B) Evidence-based treatments and tech11 nologies that monitor substance use withdrawal 

12 and prevent overdoses of opioids. 

13 (C) Evidence-based treatments and tech14 nologies that treat substance use disorders. 

15 (D) Items and services furnished by practi16 tioners through a multi-disciplinary treatment 

17 model for pain management, including the pa18 tient-centered medical home. 

19 (E) Medical devices, non-opioid based 

20 drugs, and other therapies (including inter21 ventional and integrative pain therapies) ap22 proved or cleared by the Food and Drug Ad23 ministration for the treatment of pain. 

24 (F) Items and services furnished to bene25 ficiaries with psychiatric disorders, substance 


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1 use disorders, or who are at risk of suicide, or 

2 have comorbidities and require consultation or 

3 management of pain with one or more special4 ists in pain management, mental health, or ad5 diction treatment. 

6 (d) RECOMMENDATIONS.—The recommendations de7 scribed in this subsection are, with respect to individuals 

8 entitled to benefits under part A or enrolled under part 

9 B of title XVIII of the Social Security Act, legislative and 

10 administrative recommendations on the following: 

11 (1) Options for additional coverage of pain 

12 management therapies without the use of opioids, in13 cluding interventional pain therapies, and options to 

14 augment opioid therapy with other clinical and com15 plementary, integrative health services to minimize 

16 the risk of substance use disorder, including in a 

17 hospital setting. 

18 (2) Options for coverage and payment modifica19 tions of medical devices and non-opioid based phar20 macological and non-pharmacological therapies (in21 cluding interventional and integrative pain thera22 pies) approved or cleared by the Food and Drug Ad23 ministration for the treatment of pain as an alter24 native or augment to opioid therapy. 


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1 (3) Treatment strategies for beneficiaries with 

2 psychiatric disorders, substance use disorders, or 

3 who are at risk of suicide, and treatment strategies 

4 to address health disparities related to opioid use 

5 and opioid abuse treatment. 

6 (4) Treatment strategies for beneficiaries with 

7 comorbidities who require a consultation or co8 management of pain with one or more specialists in 

9 pain management, mental health, or addiction treat10 ment, including in a hospital setting. 

11 (5) Coadministration of opioids and other 

12 drugs, particularly benzodiazepines. 

13 (6) Appropriate case management for bene14 ficiaries who transition between inpatient and out15 patient hospital settings, or between opioid therapy 

16 to non-opioid therapy, which may include the use of 

17 care transition plans. 

18 (7) Outreach activities designed to educate pro19 viders of services and suppliers under the Medicare 

20 program and individuals entitled to benefits under 

21 part A or under part B of such title on alternative, 

22 non-opioid therapies to manage and treat acute and 

23 chronic pain. 

24 (8) Creation of a beneficiary education tool on 

25 alternatives to opioids for chronic pain management. 


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1 (e) IMPACT ANALYSIS.—The impact analysis de2 scribed in this subsection consists of an analysis of any 

3 potential effects implementing the recommendations de4 scribed in subsection (d) would have— 

5 (1) on expenditures under the Medicare pro6 gram; and 

7 (2) on preventing or reducing opioid addiction 

8 for individuals receiving benefits under the Medicare 

9 program. 

Æ 


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