H. R. 6—32 
(1) in paragraph (2)(B)— 
(A) in clause (i), in the matter preceding subclause 
(I), by striking ‘‘clause (ii)’’ and inserting ‘‘clause (ii) and 
paragraph (6)(C)’’; and 
(B) in clause (ii), in the heading, by striking ‘‘FOR 
HOME DIALYSIS THERAPY’’; 
(2) in paragraph (4)(C)— 
(A) in clause (i), by striking ‘‘paragraph (6)’’ and 
inserting ‘‘paragraphs (5), (6), and (7)’’; and 
(B) in clause (ii)(X), by inserting ‘‘or telehealth services 
described in paragraph (7)’’ before the period at the end; 
and 
(3) by adding at the end the following new paragraph: 
‘‘(7) TREATMENT OF SUBSTANCE USE DISORDER SERVICES FUR-
NISHED THROUGH TELEHEALTH.—The geographic requirements 
described in paragraph (4)(C)(i) shall not apply with respect 
to telehealth services furnished on or after July 1, 2019, to 
an eligible telehealth individual with a substance use disorder 
diagnosis for purposes of treatment of such disorder or co- 
occurring mental health disorder, as determined by the Sec-
retary, at an originating site described in paragraph (4)(C)(ii) 
(other than an originating site described in subclause (IX) of 
such paragraph).’’. 
(b) IMPLEMENTATION.—The Secretary of Health and Human 
Services (in this section referred to as the ‘‘Secretary’’) may imple-
ment the amendments made by this section by interim final rule. 
(c) REPORT.— 
(1) IN GENERAL.—Not later than 5 years after the date 
of the enactment of this Act, the Secretary shall submit to 
Congress a report on the impact of the implementation of 
the amendments made by this section with respect to telehealth 
services under section 1834(m) of the Social Security Act (42 
U.S.C. 1395m(m)) on— 
(A) the utilization of health care items and services 
under title XVIII of such Act (42 U.S.C. 1395 et seq.) 
related to substance use disorders, including emergency 
department visits; and 
(B) health outcomes related to substance use disorders, 
such as opioid overdose deaths. 
(2) FUNDING.—For purposes of carrying out paragraph (1), 
in addition to funds otherwise available, the Secretary shall 
provide for the transfer, from the Federal Supplementary Med-
ical Insurance Trust Fund under section 1841, of $3,000,000 
to the Centers for Medicare & Medicaid Services Program 
Management Account to remain available until expended. 
SEC. 2002. COMPREHENSIVE SCREENINGS FOR SENIORS. 
(a) INITIAL
PREVENTIVE
PHYSICAL
EXAMINATION.—Section 
1861(ww) of the Social Security Act (42 U.S.C. 1395x(ww)) is 
amended— 
(1) in paragraph (1)— 
(A) by striking ‘‘paragraph (2) and’’ and inserting ‘‘para-
graph (2),’’; and 
(B) by inserting ‘‘and the furnishing of a review of 
any current opioid prescriptions (as defined in paragraph 
(4)),’’ after ‘‘upon the agreement with the individual,’’; and 
(2) in paragraph (2)—
H. R. 6—33 
(A) by redesignating subparagraph (N) as subpara-
graph (O); and 
(B) by inserting after subparagraph (M) the following 
new subparagraph: 
‘‘(N) Screening for potential substance use disorders.’’; 
and 
(3) by adding at the end the following new paragraph: 
‘‘(4) For purposes of paragraph (1), the term ‘a review of any 
current opioid prescriptions’ means, with respect to an individual 
determined to have a current prescription for opioids— 
‘‘(A) a review of the potential risk factors to the individual 
for opioid use disorder; 
‘‘(B) an evaluation of the individual’s severity of pain and 
current treatment plan; 
‘‘(C) the provision of information on non-opioid treatment 
options; and 
‘‘(D) a referral to a specialist, as appropriate.’’. 
(b) ANNUAL WELLNESS VISIT.—Section 1861(hhh)(2) of the 
Social Security Act (42 U.S.C. 1395x(hhh)(2)) is amended— 
(1) by redesignating subparagraph (G) as subparagraph 
(I); and 
(2) by inserting after subparagraph (F) the following new 
subparagraphs: 
‘‘(G) Screening for potential substance use disorders 
and referral for treatment as appropriate. 
‘‘(H) The furnishing of a review of any current opioid 
prescriptions (as defined in subsection (ww)(4)).’’. 
(c) RULE OF CONSTRUCTION.—Nothing in the amendments made 
by subsection (a) or (b) shall be construed to prohibit separate 
payment for structured assessment and intervention services for 
substance abuse furnished to an individual on the same day as 
an initial preventive physical examination or an annual wellness 
visit. 
(d) EFFECTIVE DATE.—The amendments made by this section 
shall apply to examinations and visits furnished on or after January 
1, 2020. 
SEC. 2003. EVERY PRESCRIPTION CONVEYED SECURELY. 
(a) IN GENERAL.—Section 1860D–4(e) of the Social Security 
Act (42 U.S.C. 1395w–104(e)) is amended by adding at the end 
the following: 
‘‘(7) REQUIREMENT OF E-PRESCRIBING FOR CONTROLLED SUB-
STANCES.— 
‘‘(A) IN
GENERAL.—Subject to subparagraph (B), a 
prescription for a covered part D drug under a prescription 
drug plan (or under an MA–PD plan) for a schedule II, 
III, IV, or V controlled substance shall be transmitted 
by a health care practitioner electronically in accordance 
with an electronic prescription drug program that meets 
the requirements of paragraph (2). 
‘‘(B) EXCEPTION
FOR
CERTAIN
CIRCUMSTANCES.—The 
Secretary shall, through rulemaking, specify circumstances 
and processes by which the Secretary may waive the 
requirement under subparagraph (A), with respect to a 
covered part D drug, including in the case of— 
‘‘(i) a prescription issued when the practitioner 
and dispensing pharmacy are the same entity;
H. R. 6—34 
‘‘(ii) a prescription issued that cannot be trans-
mitted electronically under the most recently imple-
mented version of the National Council for Prescription 
Drug Programs SCRIPT Standard; 
‘‘(iii) a prescription issued by a practitioner who 
received a waiver or a renewal thereof for a period 
of time as determined by the Secretary, not to exceed 
one year, from the requirement to use electronic pre-
scribing due to demonstrated economic hardship, 
technological limitations that are not reasonably within 
the control of the practitioner, or other exceptional 
circumstance demonstrated by the practitioner; 
‘‘(iv) a prescription issued by a practitioner under 
circumstances in which, notwithstanding the practi-
tioner’s ability to submit a prescription electronically 
as required by this subsection, such practitioner 
reasonably determines that it would be impractical 
for the individual involved to obtain substances pre-
scribed by electronic prescription in a timely manner, 
and such delay would adversely impact the individual’s 
medical condition involved; 
‘‘(v) a prescription issued by a practitioner pre-
scribing a drug under a research protocol; 
‘‘(vi) a prescription issued by a practitioner for 
a drug for which the Food and Drug Administration 
requires a prescription to contain elements that are 
not able to be included in electronic prescribing, such 
as a drug with risk evaluation and mitigation strate-
gies that include elements to assure safe use; 
‘‘(vii) a prescription issued by a practitioner— 
‘‘(I) for an individual who receives hospice care 
under this title; and 
‘‘(II) that is not covered under the hospice 
benefit under this title; and 
‘‘(viii) a prescription issued by a practitioner for 
an individual who is— 
‘‘(I) a resident of a nursing facility (as defined 
in section 1919(a)); and 
‘‘(II) dually eligible for benefits under this title 
and title XIX. 
‘‘(C) DISPENSING.—(i) Nothing in this paragraph shall 
be construed as requiring a sponsor of a prescription drug 
plan under this part, MA organization offering an MA– 
PD plan under part C, or a pharmacist to verify that 
a practitioner, with respect to a prescription for a covered 
part D drug, has a waiver (or is otherwise exempt) under 
subparagraph (B) from the requirement under subpara-
graph (A). 
‘‘(ii) Nothing in this paragraph shall be construed as 
affecting the ability of the plan to cover or the pharmacists’ 
ability to continue to dispense covered part D drugs from 
otherwise valid written, oral, or fax prescriptions that are 
consistent with laws and regulations. 
‘‘(iii) Nothing in this paragraph shall be construed 
as affecting the ability of an individual who is being pre-
scribed a covered part D drug to designate a particular 
pharmacy to dispense the covered part D drug to the extent
H. R. 6—35 
consistent with the requirements under subsection (b)(1) 
and under this paragraph. 
‘‘(D) ENFORCEMENT.—The Secretary shall, through 
rulemaking, have authority to enforce and specify appro-
priate penalties for non-compliance with the requirement 
under subparagraph (A).’’. 
(b) EFFECTIVE DATE.—The amendment made by subsection (a) 
shall apply to coverage of drugs prescribed on or after January 
1, 2021. 
(c) UPDATE
OF
BIOMETRIC
COMPONENT
OF
MULTIFACTOR 
AUTHENTICATION.—Not later than 1 year after the date of enact-
ment of this Act, the Attorney General shall update the require-
ments for the biometric component of multifactor authentication 
with respect to electronic prescriptions of controlled substances. 
SEC. 2004. REQUIRING PRESCRIPTION DRUG PLAN SPONSORS UNDER 
MEDICARE TO ESTABLISH DRUG MANAGEMENT PRO-
GRAMS FOR AT-RISK BENEFICIARIES. 
Section 1860D–4(c) of the Social Security Act (42 U.S.C. 1395w– 
104(c)) is amended— 
(1) in paragraph (1), by inserting after subparagraph (E) 
the following new subparagraph: 
‘‘(F) With respect to plan years beginning on or after 
January 1, 2022, a drug management program for at-risk 
beneficiaries described in paragraph (5).’’; and 
(2) in paragraph (5)(A), by inserting ‘‘(and for plan years 
beginning on or after January 1, 2022, a PDP sponsor shall)’’ 
after ‘‘A PDP sponsor may’’. 
SEC. 2005. MEDICARE COVERAGE OF CERTAIN SERVICES FURNISHED 
BY OPIOID TREATMENT PROGRAMS. 
(a) COVERAGE.—Section 1861(s)(2) of the Social Security Act 
(42 U.S.C. 1395x(s)(2)) is amended— 
(1) in subparagraph (FF), by striking at the end ‘‘and’’; 
(2) in subparagraph (GG), by inserting at the end ‘‘and’’; 
and 
(3) by adding at the end the following new subparagraph: 
‘‘(HH) opioid use disorder treatment services (as defined 
in subsection (jjj)).’’. 
(b) OPIOID USE DISORDER TREATMENT SERVICES AND OPIOID 
TREATMENT PROGRAM DEFINED.—Section 1861 of the Social Security 
Act (42 U.S.C. 1395x) is amended by adding at the end the following 
new subsection: 
‘‘(jjj) OPIOID
USE
DISORDER
TREATMENT
SERVICES; OPIOID 
TREATMENT PROGRAM.— 
‘‘(1) OPIOID USE DISORDER TREATMENT SERVICES.—The term 
‘opioid use disorder treatment services’ means items and serv-
ices that are furnished by an opioid treatment program for 
the treatment of opioid use disorder, including— 
‘‘(A) opioid agonist and antagonist treatment medica-
tions (including oral, injected, or implanted versions) that 
are approved by the Food and Drug Administration under 
section 505 of the Federal Food, Drug, and Cosmetic Act 
for use in the treatment of opioid use disorder; 
‘‘(B) dispensing and administration of such medica-
tions, if applicable; 
‘‘(C) substance use counseling by a professional to the 
extent authorized under State law to furnish such services;