(E) by adding at the end the following new 
paragraph: 
‘‘(8) LIMITATIONS
ON
COST-SHARING
FOR 
OPIOID OVERDOSE REVERSAL DRUGS.— 
‘‘(A) IN GENERAL.—For plan year 2021 
and each subsequent plan year, each prescrip-
tion drug plan and MA–PD plan shall not im-
pose any cost-sharing requirement under the 
plan with respect to at least one brand or ge-
neric version of an opioid overdose reversal 
drug (as defined in section 2729B of the Public 
Health Service Act). The requirement under the 
preceding sentence shall also apply to cost-shar-
ing applicable to subsidy eligible individuals 
under section 1814D–14. 
‘‘(B) COST-SHARING.—For purposes of 
subparagraph (A), the elimination of cost-shar-
ing shall include the following: 
‘‘(i) NO
APPLICATION
OF
DEDUCT-
IBLE.—The waiver of the deductible under 
paragraph (1). 
‘‘(ii) NO
APPLICATION
OF
COINSUR-
ANCE.—The waiver of coinsurance under 
paragraph (2). 
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‘‘(iii) NO
APPLICATION
OF
INITIAL 
COVERAGE
LIMIT.—The initial coverage 
limit under paragraph (3) shall not apply. 
‘‘(iv) NO
COST-SHARING
ABOVE
AN-
NUAL OUT-OF-POCKET THRESHOLD.—The 
waiver of cost-sharing under paragraph 
(4).’’. 
(2) CONFORMING AMENDMENTS TO COST-SHAR-
ING
FOR
LOW-INCOME
INDIVIDUALS.—Section 
1860D–14(a) of the Social Security Act (42 U.S.C. 
1395w–114(a)) is amended— 
(A) in paragraph (1), in the matter pre-
ceding subparagraph (A), by striking ‘‘In the 
case’’ and inserting ‘‘Subject to section 1860D– 
2(b)(8), in the case’’; and 
(B) in paragraph (2), in the matter pre-
ceding subparagraph (A), by striking ‘‘In the 
case’’ and inserting ‘‘Subject to section 1860D– 
2(b)(8), in the case’’. 
SEC. 8. TARGETING HEALTH WORKFORCE LOAN REPAY-
MENT ASSISTANCE TO HARDEST-HIT STATES. 
(a) LOAN REPAYMENT PROGRAM FOR SUBSTANCE 
USE
DISORDER
TREATMENT
WORKFORCE.—Section 
781(j) of the Public Health Service Act (42 U.S.C. 
295h(j)) is amended to read as follows: 
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‘‘(j) APPROPRIATIONS.— 
‘‘(1) IN GENERAL.—To carry out this section 
(other than paragraph (2)), there is authorized to be 
appropriated, and there is appropriated, out of any 
monies in the Treasury not otherwise appropriated, 
$25,000,000 for each of fiscal years 2020 through 
2023. 
‘‘(2) STATES WITH HIGHEST DRUG OVERDOSE 
DEATH RATES.— 
‘‘(A) IN GENERAL.—To carry out the pro-
gram under this section with respect to individ-
uals who agree to provide obligated service in 
States described in subparagraph (B), there is 
authorized to be appropriated, and there is ap-
propriated, out of any monies in the Treasury 
not otherwise appropriated, $25,000,000 for 
each of fiscal years 2020 through 2024. 
‘‘(B) STATES
DESCRIBED.—A State de-
scribed in this subparagraph is a State that is 
in the top quintile of all States in terms of the 
highest mean drug overdose death rate per 
100,000 residents for the 3-year period imme-
diately preceding the year for which the deter-
mination is being made, as determined by the 
Secretary. 
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‘‘(C) APPLICATION OF SECTION.—Except 
as provided in this paragraph, the requirements 
of this section otherwise applicable to individ-
uals under this section shall apply to individuals 
receiving assistance under this paragraph.’’. 
(b) TRAINING DEMONSTRATION PROGRAM.—Section 
760(g) of the Public Health Service Act (42 U.S.C. 
294k(g)) is amended to read as follows: 
‘‘(g) APPROPRIATIONS.— 
‘‘(1) IN GENERAL.—To carry out this section 
(other than paragraph (2)), there is authorized to be 
appropriated, and there is appropriated, out of any 
monies in the Treasury not otherwise appropriated, 
$10,000,000 for each of fiscal years 2020 through 
2024. 
‘‘(2) STATES WITH HIGHEST DRUG OVERDOSE 
DEATH RATES.— 
‘‘(A) IN GENERAL.—To carry out the pro-
gram under this section with respect to grant-
ees located in States described in subparagraph 
(B), there is authorized to be appropriated, and 
there is appropriated, out of any monies in the 
Treasury 
not 
otherwise 
appropriated, 
$20,000,000 for each of fiscal years 2020 
through 2024. 
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‘‘(B) STATES
DESCRIBED.—A State de-
scribed in this subparagraph is a State that is 
in the top quintile of all States in terms of the 
highest mean drug overdose death rate per 
100,000 residents for the 3-year period imme-
diately preceding the year for which the deter-
mination is being made, as determined by the 
Secretary. 
‘‘(C) APPLICATION OF SECTION.—Except 
as provided in this paragraph, the requirements 
of this section otherwise applicable to grantees 
under this section shall apply to grantees re-
ceiving assistance under this paragraph.’’. 
SEC. 9. MEDICAID PAYMENTS FOR BEHAVIORAL HEALTH 
AND MENTAL HEALTH PROVIDERS. 
(a) IN GENERAL.— 
(1) FEE-FOR-SERVICE.—Section 1902 of the 
Social Security Act (42 U.S.C. 1396a) is amended— 
(A) in subsection (a)(13)— 
(i) by striking ‘‘and’’ at the end of 
subparagraph (B); 
(ii) by adding ‘‘and’’ at the end of 
subparagraph (C); and 
(iii) by adding at the end the fol-
lowing new subparagraph: 
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‘‘(D) payment for mental health and be-
havioral health services (as defined in sub-
section (qq)(1)) furnished on or after October 
1, 2019, and before October 1, 2024, by a phy-
sician or applicable professional (as defined in 
subsection (qq)(2)) at a rate not less than 100 
percent of the payment rate that applies to 
such services and physician or applicable profes-
sional under part B of title XVIII (or, if great-
er, the payment rate that would be applicable 
under such part if the conversion factor under 
section 1848(d) for the year involved were the 
conversion factor under such section for 2019, 
and, if such services are not covered under such 
part, the reasonable and customary rate the 
Secretary determines would apply to such serv-
ices and physician or applicable professional);’’; 
and 
(B) by adding at the end the following new 
subsection: 
‘‘(qq) MENTAL HEALTH AND BEHAVIORAL HEALTH 
SERVICES.—For purposes of subsection (a)(13)(D): 
‘‘(1) 
MENTAL
HEALTH
AND
BEHAVIORAL 
HEALTH SERVICES.— 
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‘‘(A) IN
GENERAL.—The term ‘mental 
health and behavioral health services’ means the 
following services, when provided to a patient 
with a diagnosis of substance use disorder (as 
defined in subparagraph (B)) as a part of the 
management or treatment of the patient’s sub-
stance use disorder (as determined in accord-
ance with regulations promulgated by the Sec-
retary under subparagraph (C)): 
‘‘(i) Evaluation and management serv-
ices that are procedure codes (for services 
covered under title XVIII) for services in 
the category designated Evaluation and 
Management in the Healthcare Common 
Procedure Coding System (established by 
the Secretary under section 1848(c)(5) as 
of December 31, 2018, and as subse-
quently modified). 
‘‘(ii) Counseling services, as defined 
by the Secretary. 
‘‘(iii) Payment codes established by 
the Secretary for opioid use disorder treat-
ment services under section 1866F. 
‘‘(iv) Any other services the Secretary 
determines are necessary for the manage-
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ment or treatment of a patient with a di-
agnosis of substance use disorder. 
‘‘(B) PATIENT WITH A DIAGNOSIS OF SUB-
STANCE USE DISORDER.—For purposes of sub-
paragraph (A), the term ‘patient with a diag-
nosis of substance use disorder’ means an indi-
vidual who has been diagnosed with 1 or more 
diagnosis codes within the code set entitled the 
‘Mental health and behavioral disorders due to 
psychoactive substance use’ under the 10th re-
vision of the International Statistical Classifica-
tion of Diseases and Related Health Problems. 
‘‘(C) REGULATIONS.—Not later than 90 
days after the enactment of this subsection, the 
Secretary shall promulgate regulations regard-
ing when services are sufficiently related to part 
of the management or treatment of a patient’s 
substance use disorder. 
‘‘(2) APPLICABLE
PROFESSIONAL.—The term 
‘applicable professional’ means— 
‘‘(A) a clinical psychologist (as defined for 
purposes of section 1861(ii)); 
‘‘(B) a clinical social worker (as defined in 
section 1861(hh)(1)); 
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‘‘(C) a medical professional approved to 
furnish medication-assisted treatment under 
section 303(g)(2) of the Controlled Substances 
Act; or 
‘‘(D) a medical professional that is author-
ized under the State plan to furnish mental and 
behavioral health services (as defined in para-
graph (1)).’’. 
(2) MANAGED CARE.—Section 1932(f) of such 
Act (42 U.S.C. 1396u–2(f)) is amended— 
(A) in the subsection heading, by inserting 
‘‘AND
MENTAL
HEALTH
AND
BEHAVIORAL 
HEALTH SERVICES’’ after ‘‘CARE SERVICES’’; 
and 
(B) by inserting before the period at the 
end the following: ‘‘, and, in the case of mental 
health and behavioral health services described 
in section 1902(a)(13)(D), consistent with the 
minimum payment rates specified in such sec-
tion (regardless of the manner in which such 
payments are made, including in the form of 
capitation or partial capitation)’’. 
(b) INCREASED FMAP FOR ADDITIONAL COSTS.— 
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(1) IN GENERAL.—Section 1905 of the Social 
Security Act (42 U.S.C. 1396d) is amended by add-
ing at the end the following new subsection: 
‘‘(ff) INCREASED FMAP FOR ADDITIONAL EXPENDI-
TURES FOR MENTAL HEALTH AND BEHAVIORAL HEALTH 
SERVICES.—Notwithstanding subsection (b), with respect 
to the portion of the amounts expended for medical assist-
ance for services described in section 1902(a)(13)(D) fur-
nished on or after October 1, 2019, and before October 
1, 2024, that is attributable to the amount by which the 
minimum payment rate required under such section (or, 
by application, section 1932(f)) exceeds the payment rate 
applicable to such services under the State plan or a waiv-
er of such plan as of July 1, 2019, the Federal medical 
assistance percentage for a State shall be equal to 100 
percent. The preceding sentence shall not be construed as 
prohibiting the payment of Federal financial participation 
based on the Federal medical assistance percentage for the 
portion of the amounts expended for medical assistance 
for such services that is attributable to the amount (if 
any) by which the payment rate applicable to such services 
under the State plan or waiver exceeds such minimum 
payment rate.’’. 
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(2) DISREGARD OF LIMITS ON PAYMENTS TO 
TERRITORIES.—Section 1108(g)(4) of the Social Se-
curity Act (42 U.S.C. 1308(g)(4)) is amended— 
(A) by striking ‘‘With respect to fiscal 
years beginning with fiscal year 2009,’’ and in-
serting the following: 
‘‘(A) IN GENERAL.—With respect to fiscal 
years beginning with fiscal year 2009,’’; and 
(B) by adding at the end the following: 
‘‘(B) 
OTHER
EXPENDITURES.—The 
amounts received by a commonwealth or terri-
tory for a calendar quarter of a fiscal year that 
are attributable to the application of section 
1905(ff), shall not be taken into account in ap-
plying subsection (f) (as increased in accord-
ance with paragraphs (1), (2), (3), and (5) of 
this subsection) to such commonwealth or terri-
tory for such fiscal year.’’. 
SEC. 10. EXTENSION OF MEDICAID DELIVERY SYSTEM RE-
FORM AND INCENTIVE PAYMENT WAIVERS. 
(a) EXTENSION OF WAIVERS.—In the case of a Med-
icaid section 1115 waiver described in subsection (b), not 
later than 60 days after the date of enactment of this Act, 
the Secretary of Health and Human Services shall— 
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(1) extend the termination date for the waiver 
to December 31, 2025 (or such earlier date as the 
State conducting the waiver may elect); 
(2) apply the same annual dollar allotment for 
the period for which the waiver is extended under 
paragraph (1) as the annual dollar allotment that 
applied to the waiver period in effect on the date of 
enactment of this Act; and 
(3) allow any State with such a waiver to use 
funds provided during the period for which the waiv-
er is extended under paragraph (1) to support the 
training of direct service workers that provide home 
and community-based services. 
(b) MEDICAID SECTION 1115 WAIVER DESCRIBED.— 
The Medicaid section 1115 waiver described in this sub-
section is a waiver approved under section 1115 of the 
Social Security Act (42 U.S.C. 1315) relating to delivery 
system reform incentive payments that— 
(1) as of the date of enactment of this Act, is 
to terminate on or before December 31, 2020; 
(2) is in effect on the date of enactment of this 
Act; and 
(3) was approved for any State that ranks in 
the top quintile of all States in terms of the highest 
mean drug overdose death rate per 100,000 resi-
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dents for the most recent 3-year period preceding 
the date of enactment of this Act for which data is 
available. 
SEC. 11. SEPARATE AMBULATORY PAYMENT CLASSIFICA-
TIONS (APC) CODES UNDER THE MEDICARE 
HOSPITAL OUTPATIENT DEPARTMENT PRO-
SPECTIVE PAYMENT SYSTEM AND THE MEDI-
CARE AMBULATORY SURGICAL CENTER PAY-
MENT SYSTEM FOR SURGERIES UTILIZING 
NON-OPIOID PAIN MANAGEMENT DRUGS. 
(a) HOSPITAL OUTPATIENT DEPARTMENT PROSPEC-
TIVE PAYMENT SYSTEM.—Section 1833(t) of the Social 
Security Act (42 U.S.C. 1395l(t)) is amended— 
(1) in paragraph (2)(A), by striking ‘‘the Sec-
retary’’ and inserting ‘‘subject to paragraph (23), 
the Secretary’’; and 
(2) by adding at the end the following new 
paragraph: 
‘‘(23) SEPARATE APCS FOR SURGERIES USING 
NON-OPIOID PAIN MANAGEMENT DRUGS.— 
‘‘(A) IN GENERAL.—In the case of covered 
OPD services furnished on or after January 1, 
2021, the classification system developed under 
paragraph (2)(A) shall provide for separate am-
bulatory payment classification codes for— 
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(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, 2021, the payment system described in 
clause (i) shall provide for separate ambulatory payment 
classification codes for— 
‘‘(I) consistent with subsection (t)(23), sur-
geries that utilize non-opioid drugs, including such 
drugs delivered using an external infusion pump and 
the delivery mechanisms necessary for the delivery of 
such drugs, to treat pain after the surgery; and 
‘‘(II) surgeries that utilize opioid drugs to treat 
pain after the surgery.’’. 
SEC. 12. ADVERSE CHILDHOOD EXPERIENCES RESPONSE 
TEAM GRANT PROGRAM. 
Title I of the Omnibus Crime Control and Safe 
Streets Act of 1968 (34 U.S.C. 10101 et seq.) is amended 
by adding at the end the following: 
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‘‘PART OO—ADVERSE CHILDHOOD EXPERIENCES 
RESPONSE TEAM GRANT PROGRAM 
‘‘SEC. 3051. GRANTS FOR ADVERSE CHILDHOOD EXPERI-
ENCES RESPONSE TEAMS. 
‘‘(a) GRANTS AUTHORIZED.—From amounts made 
available to carry out this section, the Attorney General, 
in coordination with the Secretary of Health and Human 
Services, shall make grants to States, units of local gov-
ernment, Indian Tribes, and neighborhood or community- 
based organizations to address adverse childhood experi-
ences associated with exposure to trauma. 
‘‘(b) USE OF FUNDS.—Amounts received under a 
grant under this section may be used to establish an ad-
verse childhood experiences response team, including by— 
‘‘(1) establishing protocols to follow when en-
countering a child or youth exposed to trauma to fa-
cilitate access to services; 
‘‘(2) developing referral partnership agreements 
with behavioral health providers, substance treat-
ment facilities, and recovery services for family 
members of children exposed to trauma; 
‘‘(3) 
integrating 
law 
enforcement, 
mental 
health, and crisis services to respond to situations 
where children have been exposed to trauma; 
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‘‘(4) implementing comprehensive, evidence- 
based programs and practices to support children 
exposed to trauma; 
‘‘(5) identifying barriers for children to access 
trauma-informed care in their communities; 
‘‘(6) providing training in trauma-informed care 
to emergency response providers, victim service pro-
viders, child protective service professionals, edu-
cational institutions, and other community partners; 
and 
‘‘(7) supporting cross-system planning and col-
laboration among officers and employees who work 
in law enforcement, court systems, child welfare 
services, correctional reentry programs, emergency 
medical services, health care services, public health, 
and substance abuse treatment and recovery sup-
port. 
‘‘(c) APPLICATION.—A State, unit of local govern-
ment, Indian Tribe, or neighborhood or community-based 
organization desiring a grant under this section shall sub-
mit to the Attorney General an application in such form, 
and containing such information, as the Attorney General 
may reasonably require. 
‘‘(d) FUNDING.—To carry out this section, there is 
authorized to be appropriated, and there is appropriated, 
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out of any monies in the Treasury not otherwise appro-
priated, $20,000,000 for each of fiscal years 2020 through 
2023.’’. 
SEC. 13. EXPANDING DRUG FREE COMMUNITIES SUPPORT 
GRANTS. 
Section 1032 of the Anti-Drug Abuse Act of 1988 
(21 U.S.C. 1532) is amended— 
(1) in subsection (b)— 
(A) in paragraph (3)— 
(i) in subparagraph (A), by striking 
‘‘subparagraph (F)’’ and inserting ‘‘sub-
paragraph (H)’’; 
(ii) by redesignating subparagraphs 
(D), (E), and (F) as subparagraphs (F), 
(G), and (H), respectively; 
(iii) by inserting after subparagraph 
(C) the following: 
‘‘(D) 
SUBSEQUENT
ADDITIONAL 
GRANTS.—Subject to subparagraph (H), the 
Administrator may award a subsequent addi-
tional grant to a grant recipient under subpara-
graph (A), for each fiscal year during the 4-fis-
cal-year period following the fiscal year for 
which the initial additional grant under sub-
paragraph (A) is awarded, in an amount not to 
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exceed the amount of non-Federal funds, in-
cluding in-kind contributions, raised by the 
grant recipient for the fiscal year for which the 
subsequent additional grant is awarded. 
‘‘(E) RENEWAL GRANTS.—Subject to sub-
paragraph (H), the Administrator may award a 
renewal grant to a grant recipient under sub-
paragraph (D), for the first fiscal year following 
the 4-fiscal-year period for which the subse-
quent additional grant under subparagraph (D) 
is awarded, in an amount not to exceed the 
amount of non-Federal funds, including in-kind 
contributions, raised by the grant recipient for 
the fiscal year for which the renewal grant is 
awarded.’’; and 
(iv) in subparagraph (F), as so redes-
ignated— 
(I) in the subparagraph heading, 
by striking ‘‘RENEWAL’’ and inserting 
‘‘SUBSEQUENT RENEWAL’’; and 
(II) in the matter preceding 
clause (i)— 
(aa) by striking ‘‘subpara-
graph (F)’’ and inserting ‘‘sub-
paragraph (H)’’; 
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(bb) by striking ‘‘renewal 
grant to a grant recipient under 
this paragraph’’ and inserting 
‘‘subsequent renewal grant to a 
grant recipient under subpara-
graph (E)’’; and 
(cc) by striking ‘‘initial addi-
tional grant under subparagraph 
(A)’’ 
and 
inserting 
‘‘renewal 
grant under subparagraph (E)’’; 
and 
(B) in paragraph (4), by striking ‘‘(3)(E)’’ 
and inserting ‘‘(3)(G)’’; 
(2) in subsection (d)— 
(A) by striking ‘‘In awarding’’ and insert-
ing the following: 
‘‘(1) PRIORITY FOR ECONOMICALLY DISADVAN-
TAGED AREAS.—In awarding’’; and 
(B) by adding at the end the following: 
‘‘(2) PRIORITY
FOR
STATES
DEMONSTRATING 
HIGH MORTALITY RATES RELATING TO OPIOID USE 
DISORDER.— 
‘‘(A) GRANTS TO MORE THAN 1 ELIGIBLE 
COALITION REPRESENTING A COMMUNITY.—In 
awarding grants under subsection (b)(1)(B)(ii), 
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the Administrator shall give priority to eligible 
coalitions that serve 1 or more communities in 
a State that has a high mortality rate relating 
to opioid use disorder. 
‘‘(B) 
SUBSEQUENT
ADDITIONAL 
GRANTS.—In awarding subsequent additional 
grants under subsection (b)(3)(D), the Admin-
istrator shall give priority to an eligible coali-
tion that serves 1 or more communities in a 
State that has a high mortality rate relating to 
opioid use disorder.’’; and 
(3) by adding at the end the following: 
‘‘(e) 
LIMITATION
ON
SUBSEQUENT
RENEWAL 
GRANTS.—A recipient of a subsequent renewal grant 
awarded under subsection (b)(3)(F) may not be awarded 
any further grant under this section.’’. 
SEC. 14. SUPPORT FOR LAW ENFORCEMENT MENTAL 
HEALTH AND WELLNESS. 
There is authorized to be appropriated, and there is 
appropriated, out of any monies in the Treasury not other-
wise appropriated, $10,000,000 for each of fiscal years 
2020 through 2023 for grants under section 1701(b)(23) 
of title I of the Omnibus Crime Control and Safe Streets 
Act of 1968 (34 U.S.C. 10381(b)(23)) to establish peer 
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mentoring mental health and wellness pilot programs 
within State, tribal, and local law enforcement agencies. 
Æ 
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