I 
116TH CONGRESS 
1ST SESSION H. R. 2922 
To address the opioid epidemic, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 22, 2019 
Ms. KUSTER of New Hampshire (for herself, Mr. FITZPATRICK, Ms. SCAN-
LON, Ms. PINGREE, Ms. STEVENS, Ms. JACKSON LEE, Ms. FRANKEL, 
Mr. TRONE, Mr. TONKO, Mr. RASKIN, Ms. BROWNLEY of California, Mr. 
DOGGETT, Mr. PAPPAS, Ms. CLARK of Massachusetts, Mrs. TRAHAN, Mr. 
WELCH, Mr. CASTRO of Texas, Mrs. DINGELL, Ms. SHALALA, Ms. 
MOORE, Mr. MCNERNEY, Mr. MOULTON, Ms. BLUNT ROCHESTER, Mr. 
MCGOVERN, Mr. LARSON of Connecticut, Mr. CROW, Ms. MATSUI, Ms. 
KELLY of Illinois, Ms. BARRAGA´N, Ms. SCHAKOWSKY, Mr. VEASEY, and 
Ms. BASS) introduced the following bill; which was referred to the Com-
mittee on Energy and Commerce, and in addition to the Committees on 
the Judiciary, Ways and Means, the Budget, and Education and Labor, 
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 address the opioid epidemic, 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 ‘‘Respond to the Needs 
in the Opioid War Act’’ or the ‘‘Respond NOW Act’’. 
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SEC. 2. TABLE OF CONTENTS. 
The table of contents of this Act is as follows: 
Sec. 1. Short title. 
Sec. 2. Table of contents. 
TITLE I—OPIOID EPIDEMIC RESPONSE FUND 
Sec. 101. Opioid Epidemic Response Fund. 
Sec. 102. Substance Abuse and Mental Health Services Administration. 
Sec. 103. Centers for Disease Control and Prevention. 
Sec. 104. Food and Drug Administration. 
Sec. 105. National Institutes of Health. 
Sec. 106. Health Resources and Services Administration. 
Sec. 107. Administration for Children and Families. 
TITLE II—ADDITIONAL INVESTMENTS IN EXISTING PROGRAMS 
TO RESPOND TO THE OPIOID EPIDEMIC 
Sec. 201. Increase in funding for regional partnership grants. 
Sec. 202. Account for the State and Tribal Response to the Opioid Abuse Cri-
sis. 
TITLE III—EXPANDING ACCESS TO TREATMENT SERVICES 
Sec. 301. Eliminating time limitation for nurse practitioners, clinical nurse spe-
cialists, certified registered nurse anesthetists, certified nurse 
midwives, and physician assistants To be qualifying practi-
tioners. 
Sec. 302. Coverage of methadone under Medicare part B. 
TITLE I—OPIOID EPIDEMIC 
RESPONSE FUND 
SEC. 101. OPIOID EPIDEMIC RESPONSE FUND. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services (referred to in this section as the ‘‘Sec-
retary’’) shall use any funds appropriated pursuant to the 
authorization of appropriations under subsection (c) to 
carry out the programs and activities described in sub-
section (d) to address the opioid and substance use epi-
demic. Such funds shall be in addition to any funds which 
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are otherwise available to carry out such programs and 
activities. 
(b) OPIOID EPIDEMIC RESPONSE FUND.— 
(1) ESTABLISHMENT OF ACCOUNT.—There is 
established in the Treasury an account, to be known 
as the Opioid Epidemic Response Fund (referred to 
in this section as the ‘‘Fund’’), for purposes of fund-
ing the programs and activities described in sub-
section (d). 
(2) TRANSFER.—For each of fiscal years 2020 
through 2024, $5,000,000,000 shall be transferred 
to the Fund from the general fund of the Treasury. 
(3) 
AMOUNTS
DEPOSITED.—Any 
amounts 
transferred under paragraph (2) shall remain un-
available in the Fund until such amounts are appro-
priated pursuant to subsection (c). 
(c) APPROPRIATIONS.— 
(1) AUTHORIZATION OF APPROPRIATIONS.—For 
the period of fiscal years 2020 through 2024, there 
is authorized to be appropriated from the Fund to 
the Department of Health and Human Services, for 
the purpose of carrying out the programs and activi-
ties described in subsection (d), an amount not to 
exceed the total amount transferred to the Fund 
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under subsection (b)(2), to remain available until ex-
pended. 
(2) OFFSETTING FUTURE APPROPRIATIONS.— 
For any of fiscal years 2020 through 2024, for any 
discretionary appropriation to the Department of 
Health and Human Services (or any agency therein) 
pursuant to the authorization of appropriations 
under paragraph (1) for the purpose of carrying out 
the programs and activities described in subsection 
(d), the total amount of such appropriations for the 
applicable fiscal year (not to exceed the total amount 
remaining in the Account) shall be subtracted from 
the estimate of discretionary budget authority and 
the resulting outlays for any estimate under the 
Congressional Budget and Impoundment Control 
Act of 1974 or the Balanced Budget and Emergency 
Deficit Control Act of 1985, and the amount trans-
ferred to the Fund shall be reduced by the same 
amount. 
(d) PROGRAMS
AND
ACTIVITIES.—Of the total 
amount authorized to be appropriated from the Fund to 
the Department of Health and Human Services by sub-
section (c)(1), such amount shall be allocated as follows: 
(1) SAMHSA.—For the Substance Abuse and 
Mental Health Services Administration to carry out 
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programs and activities pursuant to section 102, 
$3,650,000,000 for each of fiscal years 2020 
through 2024. 
(2) CDC.—For the Centers for Disease Control 
and Prevention to carry out programs and activities 
pursuant to section 103, $500,000,000 for each of 
fiscal years 2020 through 2024. 
(3) FDA.—For the Food and Drug Adminis-
tration to carry out programs and activities pursu-
ant to section 104, $65,000,000 for each of fiscal 
years 2020 through 2024. 
(4) NIH.—For the National Institutes of 
Health to carry out programs and activities pursu-
ant to section 105, $500,000,000 for each of fiscal 
years 2020 through 2024. 
(5) HRSA.—For the Health Resources and 
Services Administration to carry out programs and 
activities pursuant to section 106, $235,000,000 for 
each of fiscal years 2020 through 2024. 
(6) ACF.—For the Administration for Children 
and Families to carry out programs and activities 
pursuant to section 107, $50,000,000 for each of 
fiscal years 2020 through 2024. 
(e) ACCOUNTABILITY AND OVERSIGHT.— 
(1) WORK PLAN.— 
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(A) IN
GENERAL.—Not later than 180 
days after the date of enactment of this Act, 
the Secretary of Health and Human Services 
shall submit to the Committee on Health, Edu-
cation, Labor, and Pensions and the Committee 
on Appropriations of the Senate and the Com-
mittee on Energy and Commerce and the Com-
mittee on Appropriations of the House of Rep-
resentatives, a work plan including the proposed 
allocation of funds appropriated pursuant to the 
authorization of appropriations under subsec-
tion (c) for each of fiscal years 2020 through 
2024 and the contents described in subpara-
graph (B). 
(B) CONTENTS.—The work plan submitted 
under subparagraph (A) shall include— 
(i) the amount of money to be obli-
gated or expended out of the Fund in each 
fiscal year for each program and activity 
described in subsection (d); and 
(ii) a description and justification of 
each such program and activity. 
(2) REPORTS.— 
(A) ANNUAL
REPORTS.—Not later than 
October 1 of each of fiscal years 2020 through 
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2024, the Secretary of Health and Human 
Services shall submit to the Committee on 
Health, Education, Labor, and Pensions and 
the Committee on Appropriations of the Senate 
and the Committee on Energy and Commerce 
and the Committee on Appropriations of the 
House of Representatives, a report including— 
(i) the amount of money obligated or 
expended out of the Fund in the prior fis-
cal year for each program and activity de-
scribed in subsection (d); 
(ii) a description of all programs and 
activities using funds provided pursuant to 
the authorization of appropriations under 
subsection (c); and 
(iii) how the programs and activities 
are responding to the opioid epidemic. 
(B) ADDITIONAL
REPORTS.—At the re-
quest of the Committee on Health, Education, 
Labor, and Pensions or the Committee on Ap-
propriations of the Senate, or the Committee on 
Energy and Commerce or the Committee on 
Appropriations of the House of Representatives, 
the Secretary of Health and Human Services 
shall provide an update in the form of testi-
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mony and any additional reports to the respec-
tive congressional committee regarding the allo-
cation of funding under this section or the de-
scription of the programs and activities under-
taken with such funding. 
(f) LIMITATIONS.—Notwithstanding any transfer au-
thority authorized by this Act or any appropriations Act, 
any funds made available pursuant to the authorization 
of appropriations under subsection (c) may not be used 
for any purpose other than the programs and activities 
described in subsection (d) to address the opioid and sub-
stance use epidemic. 
(g) SUNSET.—This section shall expire at the end of 
fiscal year 2029. 
SEC. 102. SUBSTANCE ABUSE AND MENTAL HEALTH SERV-
ICES ADMINISTRATION. 
The entirety of the funds made available pursuant to 
section 101(d)(1) shall be for carrying out subsections (b) 
and (c) of section 1003 of the 21st Century Cures Act 
(42 U.S.C. 290ee–3 note). 
SEC. 103. CENTERS FOR DISEASE CONTROL AND PREVEN-
TION. 
(a) ADDRESSING OPIOID USE DISORDER.—The en-
tirety of the funds made available pursuant to section 
101(d)(2) shall be for the Director of the Centers for Dis-
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ease Control and Prevention, pursuant to applicable au-
thorities in the Public Health Service Act (42 U.S.C. 201 
et seq.), to continue and expand programs of the Centers 
for Disease Control and Prevention to address opioid use 
disorder, including by— 
(1) improving the timeliness and quality of data 
on the opioid epidemic, including improvement of— 
(A) data on fatal and nonfatal overdoses; 
(B) syndromic surveillance; 
(C) data on long-term sequelae (including 
neonatal abstinence syndrome); and 
(D) cause of death reporting related to 
substance abuse or opioid overdose; 
(2) expanding and strengthening evidence-based 
prevention and education strategies; 
(3) supporting responsible prescribing practices, 
including through development and dissemination of 
prescriber guidelines; 
(4) improving access to and use of effective pre-
vention, treatment, and recovery support, including 
through grants and the provision of technical assist-
ance to States and localities; 
(5) strengthening partnerships with first re-
sponders, including to protect their safety; 
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(6) considering the needs of vulnerable popu-
lations; 
(7) addressing infectious diseases linked to the 
opioid crisis; 
(8) strengthening prescription drug monitoring 
programs; and 
(9) providing financial and technical assistance 
to State and local health department efforts to treat 
and prevent substance use disorder. 
(b) LIMITATION.—Of the funds made available pur-
suant to section 101(d)(2) for carrying out this section, 
not more than 20 percent may be used for intramural pur-
poses. 
SEC. 104. FOOD AND DRUG ADMINISTRATION. 
The entirety of the funds made available pursuant to 
section 101(d)(3) shall be for the Commissioner of Food 
and Drugs, pursuant to applicable authorities in the Pub-
lic Health Service Act (42 U.S.C. 201 et seq.) or the Fed-
eral Food, Drug, and Cosmetic Act (21 U.S.C. 301 et 
seq.) and other applicable law, to support widespread inno-
vation in non-opioid and non-addictive medical products 
for pain treatment, access to opioid addiction treatments, 
appropriate use of approved opioids, and efforts to reduce 
illicit importation of opioids. Such support may include the 
following: 
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(1) Facilitating the development of non-opioid 
and non-addictive pain treatments. 
(2) Advancing guidance documents for sponsors 
of non-opioid pain products. 
(3) Developing evidence to inform the potential 
for nonprescription overdose therapies. 
(4) Examining expanded labeling indications for 
medication-assisted treatment. 
(5) Conducting public education and outreach, 
including public workshops or public meetings, re-
garding the benefits of medication-assisted treat-
ment, and approved non-opioid drug and device 
treatment options. 
(6) Exploring the expansion and possible man-
datory nature of prescriber education regarding pain 
management and appropriate opioid prescribing 
through authorities under section 505–1 of the Fed-
eral Food, Drug, and Cosmetic Act (21 U.S.C. 355– 
1). 
(7) Examining options to limit the duration of 
opioid prescriptions for acute pain, including 
through packaging options. 
(8) Increasing staff and infrastructure capacity 
to inspect and analyze packages at international 
mail facilities and pursue criminal investigations. 
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SEC. 105. NATIONAL INSTITUTES OF HEALTH. 
The entirety of the funds made available pursuant to 
section 101(d)(4) shall be for the Director of the National 
Institutes of Health, pursuant to applicable authorities in 
the Public Health Service Act (42 U.S.C. 201 et seq.), 
to carry out activities related to— 
(1) accelerating research for addressing the 
opioid epidemic, including developing non-opioid 
medications and interventions, including non-addict-
ive medications, to manage pain, as well as to treat 
and to prevent substance use disorders; 
(2) conducting and supporting research on 
which treatments (in terms of pain management as 
well as treating and preventing substance use dis-
orders) are optimal for which patients; and 
(3) conducting and supporting research on cre-
ating longer-lasting or faster-acting antidotes for 
opioid overdose, particularly in response to the prev-
alence of fentanyl and carfentanyl overdoses. 
SEC. 106. HEALTH RESOURCES AND SERVICES ADMINIS-
TRATION. 
The entirety of the funds made available pursuant to 
section 101(d)(5) shall be for the Administrator of the 
Health Resources and Services Administration, pursuant 
to applicable authorities in titles III, VII, and VIII of the 
Public Health Service Act (42 U.S.C. 241 et seq.), to 
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