I 

118TH CONGRESS 

1ST SESSION H. R. 4950 

To amend title XIX of the Social Security Act to encourage appropriate 

prescribing under Medicaid for victims of opioid overdose. 

IN THE HOUSE OF REPRESENTATIVES 

JULY 26, 2023 

Mr. TRONE (for himself, Mr. FITZPATRICK, and Ms. KUSTER) introduced the 

following bill; which was referred to the Committee on Energy and Commerce 

A BILL 

To amend title XIX of the Social Security Act to encourage 

appropriate prescribing under Medicaid for victims of 

opioid overdose. 

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 ‘‘Improving Medicaid 

5 Programs’ Response to Overdose Victims and Enhancing 

6 Addiction Care Act’’ or the ‘‘IMPROVE Addiction Care 

7 Act’’. 


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1 SEC. 2. ENCOURAGING APPROPRIATE PRESCRIBING 

2 UNDER MEDICAID FOR VICTIMS OF OPIOID 

3 OVERDOSE. 

4 (a) IN GENERAL.—Section 1927(g)(2) of the Social 

5 Security Act (42 U.S.C. 1396r–8(g)(2)) is amended by 

6 adding at the end the following new subparagraph: 

7 ‘‘(E) ADDITIONAL DRUG USE REVIEW RE8 QUIREMENTS.—As part of a State’s prospective 

9 and retrospective drug use review under sub10 paragraphs (A) and (B), as applicable, the 

11 State shall, not later than 24 months after the 

12 date of enactment of this subparagraph, develop 

13 and implement, or review and update, protocols 

14 to, subject to any applicable State or Federal 

15 privacy or confidentiality protections that could 

16 preclude such protocols— 

17 ‘‘(i) identify individuals receiving ben18 efits under this title who have experienced 

19 a nonfatal opioid-related overdose within a 

20 look-back period (to be determined by the 

21 Secretary except that such period shall not 

22 be less than 1 year and shall not exceed 5 

23 years), to the extent that such data is 

24 available, and make a good faith effort to 

25 connect these individuals to treatment op26 tions and recovery support services that 


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1 have been determined appropriate by the 

2 Secretary; 

3 ‘‘(ii) if an individual receiving benefits 

4 under this title experiences a fatal overdose 

5 that is opioid-related (without regard to 

6 whether such overdose was related to a 

7 covered outpatient drug), or, if specified by 

8 the Secretary, related to any other drug 

9 (including a drug that is not a covered out10 patient drug), not later than 6 months 

11 after the date of such overdose— 

12 ‘‘(I) provide notice of such over13 dose to each provider that, during the 

14 period (to be established by the Sec15 retary) preceding such overdose, pre16 scribed opioids (or such other speci17 fied drug, if applicable) to such indi18 vidual, to the extent that such data is 

19 available; and 

20 ‘‘(II) provide each such provider 

21 with educational materials on pre22 scribing opioids (or such other speci23 fied drugs, if applicable); 

24 ‘‘(iii) ensure that a provider who is 

25 treating an individual receiving benefits 


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1 under this title has notice of the individ2 ual’s diagnosis or history of opioid use dis3 order, opioid poisoning diagnosis, history 

4 of nonfatal opioid-related overdose, or a di5 agnosis or history of a substance use dis6 order or overdose for such other specified 

7 drug, if applicable, to the extent such data 

8 is available; and 

9 ‘‘(iv) perform ongoing retrospective 

10 drug utilization reviews and offer provider 

11 education that is informed by such reviews 

12 (which may include education provided 

13 under an educational outreach program es14 tablished under subparagraph (D) or 

15 through an intervention described in para16 graph (3)(C)(iii)) regarding appropriate 

17 prescribing practices for individuals receiv18 ing benefits under this title with a diag19 nosis or history of opioid use disorder, a 

20 history of nonfatal opioid-related overdose, 

21 an opioid poisoning diagnosis, or a diag22 nosis or history of a substance use disorder 

23 or overdose for such other specified drug, 

24 if applicable. 


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1 Nothing in this subparagraph shall be con2 strued as requiring a State to develop and im3 plement additional protocols if the State estab4 lishes to the satisfaction of the Secretary that 

5 the State has in place existing protocols meet6 ing or exceeding the standards set forth in this 

7 subparagraph.’’. 

8 (b) TECHNICAL AMENDMENTS.—Section 1932(i) of 

9 the Social Security Act (42 U.S.C. 1396u–2(i)) is amend10 ed— 

11 (1) by striking ‘‘section 483.3(s)(4)’’ and in12 serting ‘‘section 438.3(s)(4)’’; and 

13 (2) by striking ‘‘483.3(s)(5)’’ and inserting 

14 ‘‘438.3(s)(5)’’. 

Æ 


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