I 
117TH CONGRESS 
1ST SESSION H. R. 3259 
To amend title XVIII of the Social Security Act to combat the opioid crisis 
by promoting access to non-opioid treatments in the hospital outpatient 
setting. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 14, 2021 
Ms. SEWELL
(for herself, Mr. MCKINLEY, Ms. KUSTER, and Mr. 
FITZPATRICK) 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 of the Social Security Act to combat 
the opioid crisis by promoting access to non-opioid treat-
ments in the hospital outpatient setting. 
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 ‘‘Non-Opioids Prevent 
Addiction In the Nation Act’’ or the ‘‘NOPAIN Act’’. 
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SEC. 2. ACCESS TO NON-OPIOID TREATMENTS FOR PAIN. 
(a) IN GENERAL.—Section 1833(t) of the Social Se-
curity Act (42 U.S.C. 1395l(t)) is amended— 
(1) in paragraph (2)(E), by inserting ‘‘and sep-
arate payments for non-opioid treatments under 
paragraph (16)(G),’’ after ‘‘payments under para-
graph (6)’’; and 
(2) in paragraph (16), by adding at the end the 
following new subparagraph: 
‘‘(G) ACCESS TO NON-OPIOID TREATMENTS 
FOR PAIN.— 
‘‘(i) IN
GENERAL.—Notwithstanding 
any other provision of this subsection, with 
respect to a covered OPD service (or group 
of services) furnished on or after January 
1, 2022, and before January 1, 2027, the 
Secretary shall not package, and shall 
make a separate payment as specified in 
clause (ii) for, a non-opioid treatment (as 
defined in clause (iii)) furnished as part of 
such service (or group of services). 
‘‘(ii) AMOUNT
OF
PAYMENT.—The 
amount of the payment specified in this 
clause is, with respect to a non-opioid 
treatment that is— 
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‘‘(I) a drug or biological product, 
the amount of payment for such drug 
or biological determined under section 
1847A; or 
‘‘(II) 
a 
medical 
device, 
the 
amount of the hospital’s charges for 
the device, adjusted to cost. 
‘‘(iii) DEFINITION
OF
NON-OPIOID 
TREATMENT.—A 
‘non-opioid 
treatment’ 
means— 
‘‘(I) a drug or biological product 
that is indicated to produce analgesia 
without acting upon the body’s opioid 
receptors; or 
‘‘(II) an implantable, reusable, or 
disposable medical device cleared or 
approved by the Administrator for 
Food and Drugs for the intended use 
of managing or treating pain, 
that has demonstrated the ability to re-
place, reduce, or avoid opioid use or the 
quantity of opioids prescribed in a clinical 
trial or through data published in a peer- 
reviewed journal.’’. 
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(b) AMBULATORY SURGICAL CENTER PAYMENT SYS-
TEM.—Section 1833(i)(2)(D) of the Social Security Act 
(42 U.S.C. 1395l(i)(2)(D)) is amended— 
(1) by aligning the margins of clause (v) with 
the margins of clause (iv); 
(2) by redesignating clause (vi) as clause (vii); 
and 
(3) by inserting after clause (v) the following 
new clause: 
‘‘(vi) In the case of surgical services 
furnished on or after January 1, 2022, and 
before January 1, 2027, the payment sys-
tem described in clause (i) shall provide, in 
a budget-neutral manner, for a separate 
payment for a non-opioid treatment (as de-
fined 
in 
clause 
(iii) 
of 
subsection 
(t)(16)(G)) furnished as part of such serv-
ices in the amount specified in clause (ii) 
of such subsection.’’. 
(c) EVALUATION OF THERAPEUTIC SERVICES FOR 
PAIN MANAGEMENT.— 
(1) REPORT TO CONGRESS.—Not later than 1 
year after the date of the enactment of this Act, the 
Secretary of Health and Human Services (in this 
subsection referred to as the ‘‘Secretary’’), acting 
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through the Administrator of the Centers for Medi-
care & Medicaid Services, shall submit to Congress 
a report identifying— 
(A) limitations, gaps, barriers to access, or 
deficits in Medicare coverage or reimbursement 
for restorative therapies, behavioral approaches, 
and complementary and integrative health serv-
ices that are identified in the Pain Management 
Best Practices Inter-Agency Task Force Report 
and that have demonstrated the ability to re-
place or reduce opioid consumption; and 
(B) recommendations to address the limi-
tations, gaps, barriers to access, or deficits 
identified under subparagraph (A) to improve 
Medicare coverage and reimbursement for such 
therapies, approaches, and services. 
(2) PUBLIC CONSULTATION.—In developing the 
report described in paragraph (1), the Secretary 
shall consult with relevant stakeholders as deter-
mined appropriate by the Secretary. 
(3) EXCLUSIVE TREATMENT.—Any drug, bio-
logical product, or medical device that is a non- 
opioid 
treatment 
(as 
defined 
in 
section 
1833(t)(16)(G)(iii) of the Social Security Act, as 
added by subsection (a)) shall not be considered a 
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therapeutic service for the purpose of the report de-
scribed in paragraph (1). 
Æ 
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