I 
114TH CONGRESS 
1ST SESSION H. R. 2536 
To provide access to medication-assisted therapy, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 21, 2015 
Mr. HIGGINS (for himself, Mr. HANNA, Mr. TONKO, and Mr. KATKO) intro-
duced the following bill; which was referred to the Committee on Energy 
and Commerce, and in addition to the Committee on the Judiciary, 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 com-
mittee concerned 
A BILL 
To provide access to medication-assisted therapy, and for 
other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Recovery Enhancement 
for Addiction Treatment Act’’ or the ‘‘TREAT Act’’. 
SEC. 2. FINDINGS. 
Congress finds the following: 
(1) Overdoses from opioids have increased dra-
matically in the United States. 
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(2) Deaths from drug overdose, largely from 
prescription pain relievers, have tripled among men 
and increased five-fold among women over the past 
decade. 
(3) Nationwide, drug overdoses now claim more 
lives than car accidents. 
(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. 
(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. 
(6) Effective medication-assisted treatment pro-
grams for opioid addiction should include multiple 
components, including medications, cognitive and be-
havioral supports and interventions, and drug test-
ing. 
(7) Effective medication-assisted treatment pro-
grams for opioid addiction may use a team of staff 
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members, in addition to a prescribing provider, to 
deliver comprehensive care. 
(8) Access to medication-assisted treatments, 
including office-based buprenorphine opioid treat-
ment, remains limited in part due to current prac-
tice regulations and an insufficient number of pro-
viders. 
(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. 
SEC. 3. 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 in-
serting ‘‘practitioner’’; 
(2) in clause (iii)— 
(A) by striking ‘‘30’’ and inserting ‘‘100’’; 
and 
(B) by striking ‘‘, unless, not sooner’’ and 
all that follows through the end and inserting a 
period; and 
(3) by inserting at the end the following new 
clause: 
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‘‘(iv) Not earlier than 1 year after the date 
on which a qualifying practitioner obtained an 
initial waiver pursuant to clause (iii), the quali-
fying practitioner may submit a second notifica-
tion to the Secretary of the need and intent of 
the qualifying practitioner to treat an unlimited 
number of patients, if the qualifying practi-
tioner— 
‘‘(I)(aa) satisfies the requirements of 
item (aa), (bb), (cc), or (dd) of subpara-
graph (G)(ii)(I); and 
‘‘(bb) agrees to fully participate in the 
Prescription Drug Monitoring Program of 
the State in which the qualifying practi-
tioner 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 practi-
tioner is licensed, pursuant to applicable 
State guidelines; 
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‘‘(cc) practices in a qualified practice 
setting; and 
‘‘(dd) has completed not less than 24 
hours of training (through classroom situa-
tions, seminars at professional society 
meetings, electronic communications, or 
otherwise) with respect to the treatment 
and management of opiate-dependent pa-
tients for substance use disorders provided 
by the American Society of Addiction Med-
icine, the American Academy of Addiction 
Psychiatry, the American Medical Associa-
tion, the American Osteopathic Associa-
tion, the American Psychiatric Association, 
or any other organization that the Sec-
retary determines is appropriate for pur-
poses of this subclause.’’. 
SEC. 4. DEFINITIONS. 
Section 303(g)(2)(G) of the Controlled Substances 
Act (21 U.S.C. 823(g)(2)(G)) is amended— 
(1) by striking clause (ii) and inserting the fol-
lowing: 
‘‘(ii) The term ‘qualifying practitioner’ 
means the following: 
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‘‘(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 psychi-
atry from the American Board of 
Medical Specialties. 
‘‘(bb) The physician holds an ad-
diction certification from the Amer-
ican Society of Addiction Medicine. 
‘‘(cc) The physician holds a 
board certification in addiction medi-
cine from the American Osteopathic 
Association. 
‘‘(dd) The physician holds a 
board certification from the American 
Board of Addiction Medicine. 
‘‘(ee) The physician has com-
pleted not less than 8 hours of train-
ing (through classroom situations, 
seminar at professional society meet-
ings, electronic communications, or 
otherwise) with respect to the treat-
ment and management of opiate-de-
pendent patients for substance use 
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disorders provided by the American 
Society of Addiction Medicine, the 
American Academy of Addiction Psy-
chiatry, the American Medical Asso-
ciation, the American Osteopathic As-
sociation, the American Psychiatric 
Association, or any other organization 
that the Secretary determines is ap-
propriate for purposes of this sub-
clause. 
‘‘(ff) The physician has partici-
pated 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 pa-
tients. 
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‘‘(II) A nurse practitioner or physi-
cian assistant who is licensed under State 
law and meets all of the following condi-
tions: 
‘‘(aa) The nurse practitioner or 
physician assistant is licensed under 
State law to prescribe schedule III, 
IV, or V medications for pain. 
‘‘(bb) The nurse practitioner or 
physician assistant satisfies 1 or more 
of the following: 
‘‘(AA) Has completed not 
fewer than 24 hours of training 
(through 
classroom 
situations, 
seminar at professional society 
meetings, electronic communica-
tions, or otherwise) with respect 
to the treatment and manage-
ment of opiate-dependent pa-
tients for substance use disorders 
provided by the American Society 
of Addiction Medicine, the Amer-
ican Academy of Addiction Psy-
chiatry, the American Medical 
Association, the American Osteo-
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pathic Association, the American 
Psychiatric Association, or any 
other organization that the Sec-
retary determines is appropriate 
for purposes of this subclause. 
‘‘(BB) Has such other train-
ing or experience as the Sec-
retary 
determines 
will 
dem-
onstrate the ability of the nurse 
practitioner or physician assist-
ant to treat and manage opiate- 
dependent patients. 
‘‘(cc) The nurse practitioner or 
physician assistant practices under 
the supervision of a licensed physician 
who holds an active waiver to pre-
scribe schedule III, IV, or V narcotic 
medications for opioid addiction ther-
apy, and— 
‘‘(AA) the supervising physi-
cian satisfies the conditions of 
item (aa), (bb), (cc), or (dd) of 
subclause (I); or 
‘‘(BB) both the supervising 
physician and the nurse practi-
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tioner 
or 
physician 
assistant 
practice in a qualified practice 
setting. 
‘‘(III) A nurse practitioner who is li-
censed under State law and meets all of 
the following conditions: 
‘‘(aa) The nurse practitioner is li-
censed under State law to prescribe 
schedule III, IV, or V medications for 
pain. 
‘‘(bb) The nurse practitioner has 
training or experience that the Sec-
retary determines demonstrates spe-
cialization in the ability to treat opi-
ate-dependent patients, such as a cer-
tification in addiction specialty accred-
ited by the American Board of Nurs-
ing Specialties or the National Com-
mission for Certifying Agencies, or a 
certification in addiction nursing as a 
Certified 
Addiction 
Registered 
Nurse—Advanced Practice. 
‘‘(cc) In accordance with State 
law, the nurse practitioner prescribes 
opioid addiction therapy in collabora-
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tion with a physician who holds an ac-
tive waiver to prescribe schedule III, 
IV, or V narcotic medications for 
opioid addiction therapy. 
‘‘(dd) The nurse practitioner 
practices in a qualified practice set-
ting.’’; and 
(2) by adding at the end the following: 
‘‘(iii) The term ‘qualified practice setting’ 
means 1 or more of the following treatment set-
tings: 
‘‘(I) A National Committee for Qual-
ity Assurance-recognized Patient-Centered 
Medical Home or Patient-Centered Spe-
cialty Practice. 
‘‘(II) A Centers for Medicaid & Medi-
care Services-recognized Accountable Care 
Organization. 
‘‘(III) A clinical facility administered 
by the Department of Veterans Affairs, 
Department of Defense, or Indian Health 
Service. 
‘‘(IV) A Behavioral Health Home ac-
credited by the Joint Commission. 
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