I 
114TH CONGRESS 
2D SESSION 
H. R. 5189 
To address the opioid abuse crisis. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 11, 2016 
Ms. KUSTER introduced the following bill; which was referred to the Com-
mittee on Energy and Commerce, and in addition to the Committees on 
the Judiciary, Veterans’ Affairs, Education and the Workforce, Ways and 
Means, Armed Services, and Natural Resources, for a period to be subse-
quently 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 abuse crisis. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘Opioid Abuse Crisis Act of 2016’’. 
(b) TABLE OF CONTENTS.—The table of contents is 
as follows: 
Sec. 1. Short title; table of contents. 
TITLE I—PUBLIC HEALTH PROVISIONS 
Sec. 101. Funding for opioid and heroin abuse prevention and treatment. 
Sec. 102. Opioid overdose reversal drugs prescribing grant program. 
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Sec. 103. Partial fills of schedule II controlled substances. 
Sec. 104. Opioid use disorder treatment modernization. 
Sec. 105. Nurturing and supporting healthy babies. 
Sec. 106. Improving treatment for pregnant and postpartum women. 
Sec. 107. Assisting veterans with military emergency medical training to meet 
requirements for becoming civilian emergency medical techni-
cians. 
Sec. 108. Information materials and resources to prevent addiction related to 
youth sports injuries. 
Sec. 109. Lali’s Law. 
Sec. 110. Opioid review modernization. 
Sec. 111. Study on treatment infrastructure. 
Sec. 112. National youth recovery initiative. 
Sec. 113. Building communities of recovery. 
TITLE II—COMPREHENSIVE OPIOID ABUSE REDUCTION 
Sec. 201. Comprehensive opioid abuse grant program. 
Sec. 202. Audit and accountability of grantees. 
Sec. 203. Veterans treatment courts. 
Sec. 204. Emergency Federal law enforcement assistance. 
Sec. 205. Opioid Program Evaluation Act. 
Sec. 206. Good Samaritan Assessment Act. 
TITLE III—PROMOTING RESPONSIBLE OPIOID MANAGEMENT AND 
INCORPORATING SCIENTIFIC EXPERTISE 
Sec. 301. Short title. 
Subtitle A—Opioid Therapy and Pain Management 
Sec. 311. Guidelines on management of opioid therapy by Department of Vet-
erans Affairs and Department of Defense and implementation 
of such guidelines by Department of Veterans Affairs. 
Sec. 312. Improvement of opioid safety measures by Department of Veterans 
Affairs. 
Sec. 313. Strengthening of joint working group on pain management of the De-
partment of Veterans Affairs and the Department of Defense. 
Sec. 314. Review, investigation, and report on use of opioids in treatment by 
Department of Veterans Affairs. 
Subtitle B—Patient Advocacy 
Sec. 321. Community meetings on improving care furnished by Department of 
Veterans Affairs. 
Sec. 322. Improvement of awareness of patient advocacy program and patient 
bill of rights of Department of Veterans Affairs. 
Sec. 323. Comptroller general report on patient advocacy program of Depart-
ment of Veterans Affairs. 
Subtitle C—Complementary and Integrative Health 
Sec. 331. Expansion of research and education on and delivery of complemen-
tary and integrative health to veterans. 
Sec. 332. Pilot program on integration of complementary alternative medicines 
and related issues for veterans and family members of vet-
erans. 
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Subtitle D—Fitness of Health Care Providers 
Sec. 341. Additional requirements for hiring of health care providers by De-
partment of Veterans Affairs. 
Sec. 342. Provision of information on health care providers of Department of 
Veterans Affairs to State Medical Boards. 
Sec. 343. Report on compliance by Department of Veterans Affairs with re-
views of health care providers leaving the Department or trans-
ferring to other facilities. 
Subtitle E—Other Veterans Matters 
Sec. 351. Audit of Veterans Health Administration programs of Department of 
Veterans Affairs. 
TITLE IV—IMPROVING SAFE CARE FOR PREVENTING INFANT 
ABUSE AND NEGLECT 
Sec. 401. Short title. 
Sec. 402. Best practices for development of plans of safe care. 
Sec. 403. State plans. 
Sec. 404. Data reports. 
Sec. 405. Monitoring and oversight. 
Sec. 406. Rule of construction. 
TITLE V—OTHER PROVISIONS 
Sec. 501. Programs to prevent prescription drug abuse under Medicare parts 
C and D. 
Sec. 502. Exclusion of authorized generic drugs from calculation of average 
manufacturer price for brand name drugs. 
TITLE I—PUBLIC HEALTH 
PROVISIONS 
SEC. 101. FUNDING FOR OPIOID AND HEROIN ABUSE PRE-
VENTION AND TREATMENT. 
(a) FUNDING.—There are authorized to be appro-
priated, and are appropriated, out of monies in the Treas-
ury not otherwise obligated, $600,000,000 for fiscal year 
2017, to improve opioid prescribing practices and expand 
access to substance use treatments to reduce opioid use 
disorders and overdose, to be made available in accordance 
with this Act. 
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(b) STATE
TARGETED
RESPONSE
COOPERATIVE 
AGREEMENTS.—Subpart 1 of part B of title V of the Pub-
lic Health Service Act (42 U.S.C. 290bb et seq.) is amend-
ed by inserting after section 509 the following: 
‘‘SEC. 510. STATE TARGETED RESPONSE COOPERATIVE 
AGREEMENTS. 
‘‘(a) IN GENERAL.—The Secretary shall enter into 
additional targeted response cooperative agreements with 
States under this title to expand opioid treatment capacity 
and make services more affordable to those who cannot 
afford such services. 
‘‘(b) AWARDING OF FUNDING.—The Secretary shall 
allocate funding to States under this section based on— 
‘‘(1) the severity of the opioid epidemic in the 
State; and 
‘‘(2) the strength of the strategy of the State 
to respond to such epidemic. 
‘‘(c) USE OF FUNDS.—Amounts received by a State 
under this section shall be used to expand treatment ca-
pacity and make services more affordable to those who 
cannot afford such services and to help individuals seek 
treatment, successfully complete treatment, and sustain 
recovery. 
‘‘(d) FUNDING.—Of the amounts appropriated under 
section 101(a) of the Opioid Use Disorder Treatment Ex-
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pansion and Modernization Act for fiscal year 2017, 
$460,000,000 shall be made available to carry out this 
section, to remain available until expended.’’. 
(c) TREATMENT FOR PRESCRIPTION DRUG ABUSE 
AND HEROIN USE.—Section 331(b) of the Public Health 
Service Act (42 U.S.C. 254d(b)) is amended by adding 
at the end the following: 
‘‘(3)(A) The Secretary shall use amounts made 
available under subparagraph (B) to support en-
hanced loan repayment awards to increase the num-
ber of clinicians in the Corps with medication as-
sisted treatment training to treat individuals with 
opioid use disorders through loan repayments to cli-
nicians. 
‘‘(B) Of the amounts appropriated under sec-
tion 101(a) of the Opioid Use Disorder Treatment 
Expansion and Modernization Act for fiscal year 
2017, $25,000,000 shall be made available to carry 
out this section, to remain available until ex-
pended.’’. 
(d) EVALUATION OF MEDICATION-ASSISTED TREAT-
MENT.—Subpart 1 of part B of title V of the Public 
Health Service Act (42 U.S.C. 290bb et seq.) is amended 
by inserting after section 510, as added by subsection (b), 
the following: 
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‘‘SEC. 511. EVALUATION OF MEDICATION-ASSISTED TREAT-
MENT. 
‘‘(a) IN GENERAL.—In order to assess the treatment 
outcomes of patients with opioid addiction receiving medi-
cation-assisted treatment, the Secretary shall evaluate the 
short, medium, and long-term outcomes of such substance 
abuse treatment programs in order to increase effective-
ness in reducing opioid use disorders, overdose, and death. 
‘‘(b) FUNDING.—Of the amounts appropriated under 
section 101(a) of the Opioid Use Disorder Treatment Ex-
pansion and Modernization Act for fiscal year 2017, 
$15,000,000 shall be made available to carry out this sec-
tion, to remain available until expended.’’. 
SEC. 102. OPIOID OVERDOSE REVERSAL DRUGS PRE-
SCRIBING GRANT PROGRAM. 
(a) ESTABLISHMENT.— 
(1) IN GENERAL.—Not later than six months 
after the date of the enactment of this Act, the Sec-
retary of Health and Human Services may establish, 
in accordance with this section, a five-year opioid 
overdose reversal drugs prescribing grant program 
(in this section referred to as the ‘‘grant program’’). 
(2) MAXIMUM GRANT AMOUNT.—A grant made 
under this section may not be for more than 
$200,000 per grant year. 
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(3) ELIGIBLE ENTITY.—For purposes of this 
section, the term ‘‘eligible entity’’ means a federally 
qualified health center (as defined in section 
1861(aa) of the Social Security Act (42 U.S.C. 
1395x(aa))), an opioid treatment program under 
part 8 of title 42, Code of Federal Regulations, any 
practitioner dispensing narcotic drugs pursuant to 
section 303(g) of the Controlled Substances Act (21 
U.S.C. 823(g)), or any other entity that the Sec-
retary deems appropriate. 
(4) PRESCRIBING.—For purposes of this sec-
tion, the term ‘‘prescribing’’ means, with respect to 
an opioid overdose reversal drug, such as naloxone, 
the practice of prescribing such drug— 
(A) in conjunction with an opioid prescrip-
tion for patients at an elevated risk of overdose; 
(B) in conjunction with an opioid agonist 
approved under section 505 of the Federal 
Food, Drug, and Cosmetic Act (21 U.S.C. 355) 
for the treatment of opioid abuse disorder; 
(C) to the caregiver or a close relative of 
patients at an elevated risk of overdose from 
opioids; or 
(D) in other circumstances, as identified 
by the Secretary, in which a provider identifies 
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a patient is at an elevated risk for an inten-
tional or unintentional drug overdose from her-
oin or prescription opioid therapies. 
(b) APPLICATION.—To be eligible to receive a grant 
under this section, an eligible entity shall submit to the 
Secretary of Health and Human Services, in such form 
and manner as specified by the Secretary, an application 
that describes— 
(1) the extent to which the area to which the 
entity will furnish services through use of the grant 
is experiencing significant morbidity and mortality 
caused by opioid abuse; 
(2) the criteria that will be used to identify eli-
gible patients to participate in such program; and 
(3) how such program will work to try to iden-
tify State, local, or private funding to continue the 
program after expiration of the grant. 
(c) USE OF FUNDS.—An eligible entity receiving a 
grant under this section may use the grant for any of the 
following activities, but may use not more than 20 percent 
of the grant funds for activities described in paragraphs 
(4) and (5): 
(1) To establish a program for prescribing 
opioid overdose reversal drugs, such as naloxone. 
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(2) To train and provide resources for health 
care providers and pharmacists on the prescribing of 
opioid overdose reversal drugs, such as naloxone. 
(3) To establish mechanisms and processes for 
tracking patients participating in the program de-
scribed in paragraph (1) and the health outcomes of 
such patients. 
(4) To purchase opioid overdose reversal drugs, 
such as naloxone, for distribution under the program 
described in paragraph (1). 
(5) To offset the co-pays and other cost sharing 
associated with opioid overdose reversal drugs, such 
as naloxone, to ensure that cost is not a limiting fac-
tor for eligible patients. 
(6) To conduct community outreach, in con-
junction with community-based organizations, de-
signed to raise awareness of prescribing practices, 
and the availability of opioid overdose reversal 
drugs, such as naloxone. 
(7) To establish protocols to connect patients 
who have experienced a drug overdose with appro-
priate treatment, including medication assisted 
treatment and appropriate counseling and behavioral 
therapies. 
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(d) EVALUATIONS BY RECIPIENTS.—As a condition 
of receipt of a grant under this section, an eligible entity 
shall, for each year for which the grant is received, submit 
to the Secretary of Health and Human Services informa-
tion on appropriate outcome measures specified by the 
Secretary to assess the outcomes of the program funded 
by the grant, including— 
(1) the number of prescribers trained; 
(2) the number of prescribers who have co-pre-
scribed an opioid overdose reversal drug, such as 
naloxone, to at least one patient; 
(3) the total number of prescriptions written for 
opioid overdose reversal drugs, such as naloxone; 
(4) the percentage of patients at elevated risk 
who received a prescription for an opioid overdose 
reversal drug, such as naloxone; 
(5) the number of patients reporting use of an 
opioid overdose reversal drug, such as naloxone; and 
(6) any other outcome measures that the Sec-
retary deems appropriate. 
(e) REPORTS BY SECRETARY.—For each year of the 
grant program under this section, the Secretary of Health 
and Human Services shall submit to the appropriate com-
mittees of the House of Representatives and the Senate 
a report aggregating the information received from the 
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grant recipients for such year under subsection (d) and 
evaluating the outcomes achieved by the programs funded 
by grants made under this section. 
(f) PROVIDING INFORMATION TO PRESCRIBERS IN 
CERTAIN FEDERAL HEALTH CARE AND MEDICAL FACILI-
TIES
ON BEST PRACTICES
FOR PRESCRIBING OPIOID 
OVERDOSE REVERSAL DRUGS.— 
(1) IN
GENERAL.—Not later than 180 days 
after the date of enactment of this Act, the Sec-
retary of Health and Human Services (in this sub-
section referred to as the ‘‘Secretary’’) may, as ap-
propriate, provide information to prescribers within 
Federally qualified health centers (as defined in 
paragraph (4) of section 1861(aa) of the Social Se-
curity Act (42 U.S.C. 1395x(aa))), and the health 
care facilities of the Indian Health Service, on best 
practices for prescribing opioid overdose reversal 
drugs, such as naloxone, for patients receiving 
chronic opioid therapy, patients being treated for 
opioid use disorders, and other patients that a pro-
vider identifies as having an elevated risk of over-
dose from heroin or prescription opioid therapies. 
(2) NOT ESTABLISHING A MEDICAL STANDARD 
OF CARE.—The information on best practices pro-
vided under this section shall not be construed as 
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constituting or establishing a medical standard of 
care for prescribing opioid overdose reversal drugs, 
such as naloxone, for patients described in para-
graph (1). 
(3) NO AUTHORIZATION OF ANY ADDITIONAL 
APPROPRIATIONS.—The Secretary shall carry out 
this subsection through funds otherwise appro-
priated and nothing in this subsection shall be con-
strued as authorizing the appropriations of addi-
tional funds to carry out this subsection. 
(4) ELEVATED RISK OF OVERDOSE DEFINED.— 
In this subsection, the term ‘‘elevated risk of over-
dose’’ has the meaning given such term by the Sec-
retary, which— 
(A) may be based on the criteria provided 
in the Opioid Overdose Toolkit published by the 
Substance Abuse and Mental Health Services 
Administration (SAMHSA); and 
(B) may include patients on a first course 
opioid treatment, patients using extended-re-
lease and long-acting opioid analgesics, and pa-
tients with a respiratory disease or other co- 
morbidities. 
(g) FUNDING.—There is authorized to be appro-
priated $5,000,000 to carry out this section (other than 
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subsection (f)) for the period of fiscal years 2017 through 
2021, of which $5,000,000 shall be made available from 
amounts appropriated under section 101(a) of the Opioid 
Use Disorder Treatment Expansion and Modernization 
Act for fiscal year 2017, to remain available until ex-
pended. 
SEC. 103. PARTIAL FILLS OF SCHEDULE II CONTROLLED 
SUBSTANCES. 
(a) IN GENERAL.—Section 309 of the Controlled 
Substances Act (21 U.S.C. 829) is amended by adding at 
the end the following: 
‘‘(f) PARTIAL FILLS OF SCHEDULE II CONTROLLED 
SUBSTANCES.— 
‘‘(1) PARTIAL FILLS.— 
‘‘(A) IN GENERAL.—A prescription for a 
controlled substance in schedule II may be par-
tially filled if— 
‘‘(i) it is not prohibited by State law; 
‘‘(ii) the prescription is written and 
filled in accordance with this Act, regula-
tions prescribed by the Attorney General, 
and State law; 
‘‘(iii) the partial fill is requested by 
the patient or the practitioner that wrote 
the prescription; and 
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‘‘(iv) the total quantity dispensed in 
all partial fillings does not exceed the total 
quantity prescribed. 
‘‘(B) OTHER
CIRCUMSTANCES.—A pre-
scription for a controlled substance in schedule 
II may be partially filled in accordance with 
section 1306.13 of title 21, Code of Federal 
Regulations (as in effect on the date of enact-
ment of the Opioid Abuse Crisis Act of 2016). 
‘‘(2) REMAINING PORTIONS.— 
‘‘(A) IN GENERAL.—Except as provided in 
subparagraph (B), remaining portions of a par-
tially filled prescription for a controlled sub-
stance in schedule II— 
‘‘(i) may be filled; and 
‘‘(ii) shall be filled not later than 30 
days after the date on which the prescrip-
tion is written. 
‘‘(B) EMERGENCY SITUATIONS.—In emer-
gency situations, as described in subsection (a), 
the remaining portions of a partially filled pre-
scription for a controlled substance in schedule 
II— 
‘‘(i) may be filled; and 
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‘‘(ii) shall be filled not later than 72 
hours after the prescription is issued.’’. 
(b) RULE OF CONSTRUCTION.—Nothing in this sec-
tion shall be construed to affect the authority of the Attor-
ney General to allow a prescription for a controlled sub-
stance in schedule III, IV, or V of section 202(c) of the 
Controlled Substances Act (21 U.S.C. 812(c)) to be par-
tially filled. 
SEC. 104. OPIOID USE DISORDER TREATMENT MODERNIZA-
TION. 
(a) IN GENERAL.—Section 303(g)(2) of the Con-
trolled Substances Act (21 U.S.C. 823(g)(2)) is amend-
ed— 
(1) in subparagraph (B), by striking clauses (i), 
(ii), and (iii) and inserting the following: 
‘‘(i) The practitioner is a qualifying practitioner 
(as defined in subparagraph (G)). 
‘‘(ii) With respect to patients to whom the prac-
titioner will provide such drugs or combinations of 
drugs, the practitioner has the capacity to provide 
directly, by referral, or in such other manner as de-
termined by the Secretary— 
‘‘(I) all schedule III, IV, and V drugs, as 
well as unscheduled medications approved by 
the Food and Drug Administration, for the 
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treatment of opioid use disorder, including such 
drugs and medications for maintenance, detoxi-
fication, overdose reversal, and relapse preven-
tion, as available; and 
‘‘(II) appropriate counseling and other ap-
propriate ancillary services. 
‘‘(iii)(I) The total number of such patients of 
the practitioner at any one time will not exceed the 
applicable number. Except as provided in subclauses 
(II) and (III), the applicable number is 30. 
‘‘(II) The applicable number is 100 if, not soon-
er than 1 year after the date on which the practi-
tioner submitted the initial notification, the practi-
tioner submits a second notification to the Secretary 
of the need and intent of the practitioner to treat up 
to 100 patients. 
‘‘(III) The applicable number is 300 if the prac-
titioner is a qualifying physician meeting the re-
quirement of subclause (VI) and, not sooner than 1 
year after the date on which the physician submitted 
a second notification under subclause (II), the prac-
titioner submits a third notification to the Secretary 
of the need and intent of the physician to treat up 
to 300 patients. 
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‘‘(IV) The Secretary may by regulation change 
such total number. 
‘‘(V) The Secretary may exclude from the appli-
cable number patients to whom such drugs or com-
binations of drugs are directly administered by the 
qualifying practitioner in the office setting. 
‘‘(VI) For purposes of subclause (III), a quali-
fying physician meets the requirement of this sub-
clause if the physician— 
‘‘(aa) holds a special certification in addic-
tion psychiatry or addiction medicine as de-
scribed in clause (ii) from the American Board 
of Medical Specialties, the American Board of 
Addiction Medicine, the American Osteopathic 
Association, the American Society of Addiction 
Medicine, or such other organization as the Sec-
retary determines to be appropriate for pur-
poses of this subclause; or 
‘‘(bb) has completed not fewer than 24 
hours of training, with respect to the treatment 
and management of opiate-dependent patients, 
addressing the topics listed in subparagraph 
(G)(ii)(IV). 
The Secretary may review and update the require-
ments of this subclause. 
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‘‘(iv) In the case of a third notification under 
clause (iii)(III), the qualifying physician maintains 
and implements a diversion control plan that con-
tains specific measures to reduce the likelihood of 
the diversion of controlled substances prescribed by 
the physician for the treatment of opioid use dis-
order. 
‘‘(v) In the case of a third notification under 
clause (iii)(III), the qualifying physician obtains a 
written agreement from each patient, including the 
patient’s signature, that the patient— 
‘‘(I) will receive an initial assessment and 
treatment plan and periodic assessments and 
treatment plans thereafter; 
‘‘(II) will be subject to medication adher-
ence and substance use monitoring; 
‘‘(III) understands available treatment op-
tions, including all drugs approved by the Food 
and Drug Administration for the treatment of 
opioid use disorder, including their potential 
risks and benefits; and 
‘‘(IV) understands that receiving regular 
counseling services is critical to recovery. 
‘‘(vi) The practitioner will comply with the re-
porting requirements of subparagraph (D)(i)(IV).’’; 
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(2) in subparagraph (D)— 
(A) in clause (i), by adding at the end the 
following: 
‘‘(IV) The practitioner reports to the Secretary, 
at such times and in such manner as specified by 
the Secretary, such information and assurances as 
the Secretary determines necessary to assess wheth-
er the practitioner continues to meet the require-
ments for a waiver under this paragraph.’’; 
(B) in clause (ii), by striking ‘‘Upon re-
ceiving a notification under subparagraph (B)’’ 
and inserting ‘‘Upon receiving a determination 
from the Secretary under clause (iii) finding 
that a practitioner meets all requirements for a 
waiver under subparagraph (B)’’; and 
(C) in clause (iii)— 
(i) by inserting ‘‘and shall forward 
such determination to the Attorney Gen-
eral’’ before the period at the end of the 
first sentence; and 
(ii) by striking ‘‘physician’’ and in-
serting ‘‘practitioner’’; 
(3) in subparagraph (G)— 
(A) by amending clause (ii)(IV) to read as 
follows: 
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‘‘(IV) The physician has, with respect to 
the treatment and management of opiate-de-
pendent patients, completed not less than eight 
hours of training (through classroom situations, 
seminars at professional society meetings, elec-
tronic communications, or otherwise) that is 
provided by the American Society of Addiction 
Medicine, the American Academy of Addiction 
Psychiatry, the American Medical Association, 
the American Osteopathic Association, the 
American Psychiatric Association, or any other 
organization that the Secretary determines is 
appropriate for purposes of this subclause. Such 
training shall address— 
‘‘(aa) opioid maintenance and detoxi-
fication; 
‘‘(bb) appropriate clinical use of all 
drugs approved by the Food and Drug Ad-
ministration for the treatment of opioid 
use disorder; 
‘‘(cc) initial and periodic patient as-
sessments (including substance use moni-
toring); 
‘‘(dd) individualized treatment plan-
ning; overdose reversal; relapse prevention; 
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(through classroom situations, seminars at 
professional society meetings, electronic 
communications, or otherwise) provided by 
the American Society of Addiction Medi-
cine, the American Academy of Addiction 
Psychiatry, the American Medical Associa-
tion, the American Osteopathic Associa-
tion, the American Nurses Credentialing 
Center, the American Psychiatric Associa-
tion, the American Association of Nurse 
Practitioners, the American Academy of 
Physician Assistants, or any other organi-
zation that the Secretary determines is ap-
propriate for purposes of this subclause. 
‘‘(bb) Has such other training or ex-
perience as the Secretary determines will 
demonstrate the ability of the nurse practi-
tioner or physician assistant to treat and 
manage opiate-dependent patients. 
‘‘(III) The nurse practitioner or physician 
assistant is supervised by or works in collabora-
tion with a qualifying physician, if the nurse 
practitioner or physician assistant is required 
by State law to prescribe medications for the 
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treatment of opioid use disorder in collaboration 
with or under the supervision of a physician. 
The Secretary may review and update the require-
ments for being a qualifying other practitioner under 
this clause.’’; and 
(4) in subparagraph (H)— 
(A) in clause (i), by inserting after sub-
clause (II) the following: 
‘‘(III) Such other elements of the requirements 
under this paragraph as the Secretary determines 
necessary for purposes of implementing such re-
quirements.’’; and 
(B) by amending clause (ii) to read as fol-
lows: 
‘‘(ii) Not later than one year after the date of enact-
ment of the Opioid Use Disorder Treatment Expansion 
and Modernization Act, the Secretary shall update the 
treatment improvement protocol containing best practice 
guidelines for the treatment of opioid-dependent patients 
in office-based settings. The Secretary shall update such 
protocol in consultation with experts in opioid use disorder 
research and treatment.’’. 
(b) RECOMMENDATION OF REVOCATION OR SUSPEN-
SION OF REGISTRATION IN CASE OF SUBSTANTIAL NON-
COMPLIANCE.—The Secretary of Health and Human 
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Services may recommend to the Attorney General that the 
registration of a practitioner be revoked or suspended if 
the Secretary determines, according to such criteria as the 
Secretary establishes by regulation, that a practitioner 
who is registered under section 303(g)(2) of the Controlled 
Substances Act (21 U.S.C. 823(g)(2)) is not in substantial 
compliance with the requirements of such section, as 
amended by this Act. 
(c) OPIOID DEFINED.—Section 102(18) of the Con-
trolled Substances Act (21 U.S.C. 802(18)) is amended 
by inserting ‘‘or ‘opioid’ ’’ after ‘‘The term ‘opiate’ ’’. 
(d) REPORTS TO CONGRESS.— 
(1) IN GENERAL.—Not later than 2 years after 
the date of enactment of this Act and not less than 
over every 5 years thereafter, the Secretary of 
Health and Human Services, in consultation with 
the Drug Enforcement Administration and experts 
in opioid use disorder research and treatment, 
shall— 
(A) perform a thorough review of the pro-
vision of opioid use disorder treatment services 
in the United States, including services pro-
vided in opioid treatment programs and other 
specialty and nonspecialty settings; and 
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(B) submit a report to the Congress on the 
findings and conclusions of such review. 
(2) CONTENTS.—Each report under paragraph 
(1) shall include an assessment of— 
(A) compliance with the requirements of 
section 303(g)(2) of the Controlled Substances 
Act (21 U.S.C. 823(g)(2)), as amended by this 
Act; 
(B) the measures taken by the Secretary of 
Health and Human Services to ensure such 
compliance; 
(C) whether there is further need to in-
crease or decrease the number of patients a 
waivered practitioner is permitted to treat, as 
provided for by the amendment made by sub-
section (a)(1); 
(D) the extent to which, and proportions 
with which, the full range of Food and Drug 
Administration-approved treatments for opioid 
use disorder are used in routine health care set-
tings and specialty substance use disorder treat-
ment settings; 
(E) access to, and use of, counseling and 
recovery support services, including the percent-
age of patients receiving such services; 
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(F) changes in State or local policies and 
legislation relating to opioid use disorder treat-
ment; 
(G) the use of prescription drug moni-
toring programs by practitioners who are per-
mitted to dispense narcotic drugs to individuals 
pursuant to a waiver under section 303(g)(2) of 
the Controlled Substances Act (21 U.S.C. 
823(g)(2)); 
(H) the findings resulting from inspections 
by the Drug Enforcement Administration of 
practitioners described in subparagraph (G); 
and 
(I) the effectiveness of cross-agency col-
laboration between the Department of Health 
and Human Services and the Drug Enforce-
ment Administration for expanding effective 
opioid use disorder treatment. 
SEC. 105. NURTURING AND SUPPORTING HEALTHY BABIES. 
(a) GAO REPORT ON NEONATAL ABSTINENCE SYN-
DROME (NAS).— 
(1) IN
GENERAL.—Not later than one year 
after the date of the enactment of this Act, the 
Comptroller General of the United States shall sub-
mit to the Committee on Energy and Commerce of 
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the House of Representatives and the Committee on 
Finance and the Committee on Health, Education, 
Labor, and Pensions of the Senate a report on neo-
natal abstinence syndrome (in this section referred 
to as ‘‘NAS’’) in the United States. 
(2) INFORMATION
TO
BE
INCLUDED
IN
RE-
PORT.—Such report shall include information on the 
following: 
(A) The prevalence of NAS in the United 
States, including the proportion of children 
born in the United States with NAS who are el-
igible for medical assistance under State Med-
icaid programs under title XIX of the Social 
Security Act at birth and the costs associated 
with NAS through such programs. 
(B) The services for which coverage is 
available under State Medicaid programs for 
treatment of infants with NAS. 
(C) The settings (including inpatient, out-
patient, hospital-based, and other settings) for 
the treatment of infants with NAS and the re-
imbursement methodologies and costs associ-
ated with such treatment in such settings. 
(D) The prevalence of utilization of various 
care settings under State Medicaid programs 
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for treatment of infants with NAS and any 
Federal barriers to treating such infants under 
such programs, particularly in non-hospital- 
based settings. 
(3) RECOMMENDATIONS.—Such report also 
shall include such recommendations as the Comp-
troller General determines appropriate for improve-
ments that will ensure access to treatment for in-
fants with NAS under State Medicaid programs. 
(b) EXCLUDING ABUSE-DETERRENT FORMULATIONS 
OF PRESCRIPTION DRUGS FROM THE MEDICAID ADDI-
TIONAL REBATE REQUIREMENT
FOR NEW FORMULA-
TIONS OF PRESCRIPTION DRUGS.— 
(1) IN GENERAL.—The last sentence of section 
1927(c)(2)(C) of the Social Security Act (42 U.S.C. 
1396r–8(c)(2)(C)) is amended by inserting before 
the period at the end the following: ‘‘, but does not 
include an abuse-deterrent formulation of the drug 
(as determined by the Secretary), regardless of 
whether such abuse-deterrent formulation is an ex-
tended release formulation’’. 
(2) EFFECTIVE DATE.—The amendment made 
by paragraph (1) shall apply to drugs that are paid 
for by a State in calendar quarters beginning on or 
after the date of the enactment of this Act. 
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(c) LIMITING DISCLOSURE
OF PREDICTIVE MOD-
ELING AND OTHER ANALYTICS TECHNOLOGIES TO IDEN-
TIFY AND PREVENT WASTE, FRAUD, AND ABUSE.— 
(1) IN GENERAL.—Title XI of the Social Secu-
rity Act is amended by inserting after section 1128J 
(42 U.S.C. 1320a–7k) the following new section: 
‘‘SEC. 1128K. DISCLOSURE OF PREDICTIVE MODELING AND 
OTHER ANALYTICS TECHNOLOGIES TO IDEN-
TIFY AND PREVENT WASTE, FRAUD, AND 
ABUSE. 
‘‘(a) REFERENCE TO PREDICTIVE MODELING TECH-
NOLOGIES REQUIREMENTS.—For provisions relating to 
the use of predictive modeling and other analytics tech-
nologies to identify and prevent waste, fraud, and abuse 
with respect to the Medicare program under title XVIII, 
the Medicaid program under title XIX, and the Children’s 
Health Insurance Program under title XXI, see section 
4241 of the Small Business Jobs Act of 2010 (42 U.S.C. 
1320a–7m). 
‘‘(b) LIMITING DISCLOSURE OF PREDICTIVE MOD-
ELING TECHNOLOGIES.—In implementing such provisions 
under such section 4241 with respect to covered algo-
rithms (as defined in subsection (c)), the following shall 
apply: 
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‘‘(1) NONAPPLICATION OF FOIA.—The covered 
algorithms used or developed for purposes of such 
section (including by the Secretary or a State (or an 
entity operating under a contract with a State)) 
shall be exempt from disclosure under section 
552(b)(3) of title 5, United States Code. 
‘‘(2) LIMITATION WITH RESPECT TO USE AND 
DISCLOSURE
OF
INFORMATION
BY
STATE
AGEN-
CIES.— 
‘‘(A) IN GENERAL.—A State agency may 
not use or disclose covered algorithms used or 
developed for purposes of such section except 
for purposes of administering the State plan (or 
a waiver of the plan) under the Medicaid pro-
gram under title XIX or the State child health 
plan (or a waiver of the plan) under the Chil-
dren’s Health Insurance Program under title 
XXI, including by enabling an entity operating 
under a contract with a State to assist the 
State to identify or prevent waste, fraud and 
abuse with respect to such programs. 
‘‘(B) INFORMATION
SECURITY.—A State 
agency shall have in effect data security and 
control policies that the Secretary finds ade-
quate to ensure the security of covered algo-
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rithms used or developed for purposes of such 
section 4241 and to ensure that access to such 
information is restricted to authorized persons 
for purposes of authorized uses and disclosures 
described in subparagraph (A). 
‘‘(C) 
PROCEDURAL
REQUIREMENTS.— 
State agencies to which information is disclosed 
pursuant to such section 4241 shall adhere to 
uniform procedures established by the Sec-
retary. 
‘‘(c) COVERED ALGORITHM DEFINED.—In this sec-
tion, the term ‘covered algorithm’— 
‘‘(1) means a predictive modeling or other ana-
lytics technology, as used for purposes of section 
4241(a) of the Small Business Jobs Act of 2010 (42 
U.S.C. 1320a–7m(a)) to identify and prevent waste, 
fraud, and abuse with respect to the Medicare pro-
gram under title XVIII, the Medicaid program 
under title XIX, and the Children’s Health Insur-
ance Program under title XXI; and 
‘‘(2) includes the mathematical expressions uti-
lized in the application of such technology and the 
means by which such technology is developed.’’. 
(2) CONFORMING AMENDMENTS.— 
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(A) MEDICAID
STATE
PLAN
REQUIRE-
MENT.—Section 1902(a) of the Social Security 
Act (42 U.S.C. 1396a(a)) is amended— 
(i) in paragraph (80), by striking 
‘‘and’’ at the end; 
(ii) in paragraph (81), by striking the 
period at the end and inserting ‘‘; and’’; 
and 
(iii) by inserting after paragraph (81) 
the following new paragraph: 
‘‘(82) provide that the State agency responsible 
for administering the State plan under this title pro-
vides assurances to the Secretary that the State 
agency is in compliance with subparagraphs (A), 
(B), and (C) of section 1128K(b)(2).’’. 
(B) STATE CHILD HEALTH PLAN REQUIRE-
MENT.—Section 2102(a)(7) of the Social Secu-
rity Act (42 U.S.C. 1397bb(a)(7)) is amend-
ed— 
(i) in subparagraph (A), by striking ‘‘, 
and’’ at the end and inserting a semicolon; 
(ii) in subparagraph (B), by striking 
the period at the end and inserting ‘‘; 
and’’; and 
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(iii) by adding at the end the fol-
lowing new subparagraph: 
‘‘(C) to ensure that the State agency in-
volved is in compliance with subparagraphs (A), 
(B), and (C) of section 1128K(b)(2).’’. 
(d) 
MEDICAID
IMPROVEMENT
FUND.—Section 
1941(b)(1) of the Social Security Act (42 U.S.C. 1396w– 
1(b)(1)) is amended to read as follows: 
‘‘(1) IN GENERAL.—There shall be available to 
the Fund, for expenditures from the Fund for fiscal 
year 2021 and thereafter, $5,000,000.’’. 
SEC. 106. IMPROVING TREATMENT FOR PREGNANT AND 
POSTPARTUM WOMEN. 
(a) REAUTHORIZATION
OF RESIDENTIAL TREAT-
MENT PROGRAMS
FOR PREGNANT
AND POSTPARTUM 
WOMEN.—Section 508 of the Public Health Service Act 
(42 U.S.C. 290bb–1) is amended— 
(1) in subsection (p), in the first sentence, by 
inserting ‘‘(other than subsection (r))’’ after ‘‘sec-
tion’’; and 
(2) in subsection (r), by striking ‘‘such sums’’ 
and all that follows through ‘‘2003’’ and inserting 
‘‘$16,900,000 for each of fiscal years 2017 through 
2021’’. 
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(b) PILOT PROGRAM GRANTS
FOR STATE SUB-
STANCE ABUSE AGENCIES.— 
(1) IN GENERAL.—Section 508 of the Public 
Health Service Act (42 U.S.C. 290bb–1) is amend-
ed— 
(A) by redesignating subsection (r), as 
amended by subsection (a), as subsection (s); 
and 
(B) by inserting after subsection (q) the 
following new subsection: 
‘‘(r) PILOT
PROGRAM
FOR
STATE
SUBSTANCE 
ABUSE AGENCIES.— 
‘‘(1) IN GENERAL.—From amounts made avail-
able under subsection (s), the Director of the Center 
for Substance Abuse Treatment shall carry out a 
pilot program under which competitive grants are 
made by the Director to State substance abuse agen-
cies to— 
‘‘(A) enhance flexibility in the use of funds 
designed to support family-based services for 
pregnant and postpartum women with a pri-
mary diagnosis of a substance use disorder, in-
cluding opioid use disorders; 
‘‘(B) help State substance abuse agencies 
address identified gaps in services furnished to 
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such women along the continuum of care, in-
cluding services provided to women in nonresi-
dential based settings; and 
‘‘(C) promote a coordinated, effective, and 
efficient State system managed by State sub-
stance abuse agencies by encouraging new ap-
proaches and models of service delivery. 
‘‘(2) REQUIREMENTS.—In carrying out the 
pilot program under this subsection, the Director 
shall— 
‘‘(A) require State substance abuse agen-
cies to submit to the Director applications, in 
such form and manner and containing such in-
formation as specified by the Director, to be eli-
gible to receive a grant under the program; 
‘‘(B) identify, based on such submitted ap-
plications, State substance abuse agencies that 
are eligible for such grants; 
‘‘(C) require services proposed to be fur-
nished through such a grant to support family- 
based treatment and other services for pregnant 
and postpartum women with a primary diag-
nosis of a substance use disorder, including 
opioid use disorders; 
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‘‘(D) not require that services furnished 
through such a grant be provided solely to 
women that reside in facilities; 
‘‘(E) not require that grant recipients 
under the program make available through use 
of the grant all services described in subsection 
(d); and 
‘‘(F) consider not applying requirements 
described in paragraphs (1) and (2) of sub-
section (f) to applicants, depending on the cir-
cumstances of the applicant. 
‘‘(3) REQUIRED SERVICES.— 
‘‘(A) IN
GENERAL.—The Director shall 
specify a minimum set of services required to be 
made available to eligible women through a 
grant awarded under the pilot program under 
this subsection. Such minimum set— 
‘‘(i) shall include requirements de-
scribed in subsection (c) and be based on 
the recommendations submitted under sub-
paragraph (B); and 
‘‘(ii) may be selected from among the 
services described in subsection (d) and in-
clude other services as appropriate. 
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‘‘(B) STAKEHOLDER INPUT.—The Director 
shall convene and solicit recommendations from 
stakeholders, including State substance abuse 
agencies, health care providers, persons in re-
covery from substance abuse, and other appro-
priate individuals, for the minimum set of serv-
ices described in subparagraph (A). 
‘‘(4) DURATION.—The pilot program under this 
subsection shall not exceed 5 years. 
‘‘(5) EVALUATION
AND
REPORT
TO
CON-
GRESS.—The Director of the Center for Behavioral 
Health Statistics and Quality shall fund an evalua-
tion of the pilot program at the conclusion of the 
first grant cycle funded by the pilot program. The 
Director of the Center for Behavioral Health Statis-
tics and Quality, in coordination with the Director of 
the Center for Substance Abuse Treatment shall 
submit to the relevant committees of jurisdiction of 
the House of Representatives and the Senate a re-
port on such evaluation. The report shall include at 
a minimum outcomes information from the pilot pro-
gram, including any resulting reductions in the use 
of alcohol and other drugs; engagement in treatment 
services; retention in the appropriate level and dura-
tion of services; increased access to the use of medi-
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cations approved by the Food and Drug Administra-
tion for the treatment of substance use disorders in 
combination with counseling; and other appropriate 
measures. 
‘‘(6) STATE SUBSTANCE ABUSE AGENCIES DE-
FINED.—For purposes of this subsection, the term 
‘State substance abuse agency’ means, with respect 
to a State, the agency in such State that manages 
the Substance Abuse Prevention and Treatment 
Block Grant under part B of title XIX.’’. 
(2) FUNDING.—Subsection (s) of section 508 of 
the Public Health Service Act (42 U.S.C. 290bb–1), 
as amended by subsection (a) and redesignated by 
paragraph (1), is further amended by adding at the 
end the following new sentence: ‘‘Of the amounts 
made available for a year pursuant to the previous 
sentence to carry out this section, not more than 25 
percent of such amounts shall be made available for 
such year to carry out subsection (r), other than 
paragraph (5) of such subsection. Notwithstanding 
the preceding sentence, no funds shall be made 
available to carry out subsection (r) for a fiscal year 
unless the amount made available to carry out this 
section for such fiscal year is more than the amount 
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made available to carry out this section for fiscal 
year 2016.’’. 
(c) CUT-GO COMPLIANCE.—Subsection (f) of section 
319D of the Public Health Service Act (42 U.S.C. 247d– 
4) is amended by striking ‘‘through 2018’’ and inserting 
‘‘through 2016, $133,300,000 for fiscal year 2017, and 
$138,300,000 for fiscal year 2018’’. 
SEC. 107. ASSISTING VETERANS WITH MILITARY EMER-
GENCY MEDICAL TRAINING TO MEET RE-
QUIREMENTS 
FOR 
BECOMING 
CIVILIAN 
EMERGENCY MEDICAL TECHNICIANS. 
Part B of title III of the Public Health Service Act 
(42 U.S.C. 243 et seq.) is amended by inserting after sec-
tion 314 the following: 
‘‘SEC. 315. ASSISTING VETERANS WITH MILITARY EMER-
GENCY MEDICAL TRAINING TO MEET RE-
QUIREMENTS 
FOR 
BECOMING 
CIVILIAN 
EMERGENCY MEDICAL TECHNICIANS. 
‘‘(a) PROGRAM.—The Secretary shall establish a pro-
gram consisting of awarding demonstration grants to 
States to streamline State requirements and procedures 
in order to assist veterans who completed military emer-
gency medical technician training while serving in the 
Armed Forces of the United States to meet certification, 
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licensure, and other requirements applicable to becoming 
an emergency medical technician in the State. 
‘‘(b) USE OF FUNDS.—Amounts received as a dem-
onstration grant under this section shall be used to pre-
pare and implement a plan to streamline State require-
ments and procedures as described in subsection (a), in-
cluding by— 
‘‘(1) determining the extent to which the re-
quirements for the education, training, and skill level 
of emergency medical technicians in the State are 
equivalent to requirements for the education, train-
ing, and skill level of military emergency medical 
technicians; and 
‘‘(2) identifying methods, such as waivers, for 
military emergency medical technicians to forgo or 
meet any such equivalent State requirements. 
‘‘(c) ELIGIBILITY.—To be eligible for a grant under 
this section, a State shall demonstrate that the State has 
a shortage of emergency medical technicians. 
‘‘(d) REPORT.—The Secretary shall submit to the 
Congress an annual report on the program under this sec-
tion. 
‘‘(e) FUNDING.—No additional funds are authorized 
to be appropriated for the purpose of carrying out this 
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section. This section shall be carried out using amounts 
otherwise available for such purpose.’’. 
SEC. 108. INFORMATION MATERIALS AND RESOURCES TO 
PREVENT ADDICTION RELATED TO YOUTH 
SPORTS INJURIES. 
(a) TECHNICAL CLARIFICATION.—Effective as if in-
cluded in the enactment of the Children’s Health Act of 
2000 (Public Law 106–310), section 3405(a) of such Act 
(114 Stat. 1221) is amended by striking ‘‘Part E of title 
III’’ and inserting ‘‘Part E of title III of the Public Health 
Service Act’’. 
(b) AMENDMENT.—Title III of the Public Health 
Service Act is amended by inserting after part D of such 
title (42 U.S.C. 254b et seq.) the following new part E: 
‘‘PART E—OPIOID USE DISORDER 
‘‘SEC. 341. INFORMATION MATERIALS AND RESOURCES TO 
PREVENT ADDICTION RELATED TO YOUTH 
SPORTS INJURIES. 
‘‘(a) REPORT.—The Secretary shall— 
‘‘(1) not later than 24 months after the date of 
the enactment of this section, make publicly avail-
able a report determining the extent to which infor-
mational materials and resources described in sub-
section (b) are available to teenagers and adolescents 
who play youth sports, families of such teenagers 
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and adolescents, nurses, youth sports groups, and 
relevant health care provider groups; and 
‘‘(2) for purposes of educating and preventing 
addiction in teenagers and adolescents who are in-
jured playing youth sports and are subsequently pre-
scribed an opioid, not later than 12 months after 
such report is made publicly available and taking 
into consideration the findings of such report, de-
velop and, in coordination with youth sports groups, 
disseminate informational materials and resources 
described in subsection (b) for teenagers and adoles-
cents who play youth sports, families of such teen-
agers and adolescents, nurses, youth sports groups, 
and relevant health care provider groups. 
‘‘(b) MATERIALS AND RESOURCES DESCRIBED.—For 
purposes of this section, the informational materials and 
resources described in this subsection are informational 
materials and resources with respect to youth sports inju-
ries for which opioids are potentially prescribed and subse-
quently potentially lead to addiction, including materials 
and resources focused on the dangers of opioid use and 
misuse, treatment options for such injuries that do not 
involve the use of opioids, and how to seek treatment for 
addiction. 
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‘‘(c) NO ADDITIONAL FUNDS.—No additional funds 
are authorized to be appropriated for the purpose of car-
rying out this section. This section shall be carried out 
using amounts otherwise available for such purpose.’’. 
SEC. 109. LALI’S LAW. 
(a) OPIOID OVERDOSE REVERSAL MEDICATION AC-
CESS AND EDUCATION GRANT PROGRAM.—Part E of title 
III of the Public Health Service Act, as added by section 
109, is amended by adding at the end the following 
‘‘SEC. 342. OPIOID OVERDOSE REVERSAL MEDICATION AC-
CESS AND EDUCATION GRANT PROGRAMS. 
‘‘(a) GRANTS TO STATES.—The Secretary may make 
grants to States for— 
‘‘(1) developing standing orders for pharmacies 
regarding opioid overdose reversal medication; 
‘‘(2) encouraging pharmacies to dispense opioid 
overdose reversal medication pursuant to a standing 
order; 
‘‘(3) implementing best practices for persons 
authorized to prescribe medication regarding— 
‘‘(A) prescribing opioids for the treatment 
of chronic pain; 
‘‘(B) co-prescribing opioid overdose rever-
sal medication with opioids; and 
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‘‘(C) discussing the purpose and adminis-
tration of opioid overdose reversal medication 
with patients; 
‘‘(4) developing or adapting training materials 
and methods for persons authorized to prescribe or 
dispense medication to use in educating the public 
regarding— 
‘‘(A) when and how to administer opioid 
overdose reversal medication; and 
‘‘(B) steps to be taken after administering 
opioid overdose reversal medication; and 
‘‘(5) educating the public regarding— 
‘‘(A) the public health benefits of opioid 
overdose reversal medication; and 
‘‘(B) the availability of opioid overdose re-
versal medication without a person-specific pre-
scription. 
‘‘(b) CERTAIN REQUIREMENT.—A grant may be 
made under this section only if the State involved has au-
thorized standing orders regarding opioid overdose rever-
sal medication. 
‘‘(c) PREFERENCE IN MAKING GRANTS.—In making 
grants under this section, the Secretary shall give pref-
erence to States that— 
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‘‘(1) have not issued standing orders regarding 
opioid overdose reversal medication; 
‘‘(2) authorize standing orders that permit com-
munity-based organizations, substance abuse pro-
grams, or other nonprofit entities to acquire, dis-
pense, or administer opioid overdose reversal medica-
tion; 
‘‘(3) authorize standing orders that permit po-
lice, fire, or emergency medical services agencies to 
acquire and administer opioid overdose reversal 
medication; 
‘‘(4) have a higher per capita rate of opioid 
overdoses than other applicant States; or 
‘‘(5) meet any other criteria deemed appro-
priate by the Secretary. 
‘‘(d) GRANT TERMS.— 
‘‘(1) NUMBER.—A State may not receive more 
than 1 grant under this section. 
‘‘(2) PERIOD.—A grant under this section shall 
be for a period of 3 years. 
‘‘(3) AMOUNT.—A grant under this section may 
not exceed $500,000. 
‘‘(4) LIMITATION.—A State may use not more 
than 20 percent of a grant under this section for 
educating the public pursuant to subsection (a)(5). 
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‘‘(e) APPLICATIONS.—To be eligible to receive a grant 
under this section, a State shall submit an application to 
the Secretary in such form and manner and containing 
such information as the Secretary may require, including 
detailed proposed expenditures of grant funds. 
‘‘(f) REPORTING.—Not later than 3 months after the 
Secretary disburses the first grant payment to any State 
under this section and every 6 months thereafter for 3 
years, such State shall submit a report to the Secretary 
that includes the following: 
‘‘(1) The name and ZIP Code of each pharmacy 
in the State that dispenses opioid overdose reversal 
medication under a standing order. 
‘‘(2) The total number of opioid overdose rever-
sal medication doses dispensed by each such phar-
macy, specifying how many were dispensed with or 
without a person-specific prescription. 
‘‘(3) The number of pharmacists in the State 
who have participated in training pursuant to sub-
section (a)(4). 
‘‘(g) DEFINITIONS.—In this section: 
‘‘(1) OPIOID
OVERDOSE
REVERSAL
MEDICA-
TION.—The term ‘opioid overdose reversal medica-
tion’ means any drug, including naloxone, that— 
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‘‘(A) blocks opioids from attaching to, but 
does not itself activate, opioid receptors; or 
‘‘(B) inhibits the effects of opioids on 
opioid receptors. 
‘‘(2) STANDING
ORDER.—The term ‘standing 
order’ means a document prepared by a person au-
thorized to prescribe medication that permits an-
other person to acquire, dispense, or administer 
medication without a person-specific prescription. 
‘‘(h) AUTHORIZATION OF APPROPRIATIONS.— 
‘‘(1) IN GENERAL.—To carry out this section, 
there is authorized to be appropriated $5,000,000 
for the period of fiscal years 2017 through 2019. 
‘‘(2) ADMINISTRATIVE COSTS.—Not more than 
3 percent of the amounts made available to carry 
out this section may be used by the Secretary for 
administrative expenses of carrying out this sec-
tion.’’. 
(b) CUT-GO COMPLIANCE.—Subsection (f) of section 
319D of the Public Health Service Act (42 U.S.C. 247d– 
4) is amended by inserting before the period at the end 
the following: ‘‘(except such dollar amount shall be re-
duced by $5,000,000 for fiscal year 2017)’’. 
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SEC. 110. OPIOID REVIEW MODERNIZATION. 
(a) FDA OPIOID ACTION PLAN.—Chapter V of the 
Federal Food, Drug, and Cosmetic Act is amended by in-
serting after section 569 of such Act (21 U.S.C. 350bbb– 
8) the following: 
‘‘SEC. 569–1. OPIOID ACTION PLAN. 
‘‘(a) NEW DRUG APPLICATION.— 
‘‘(1) IN GENERAL.—Subject to paragraph (2), 
prior to the approval pursuant to an application 
under section 505(b) of a new drug that is an opioid 
and does not have abuse-deterrent properties, the 
Secretary shall refer the application to an advisory 
committee of the Food and Drug Administration to 
seek recommendations from such advisory com-
mittee. 
‘‘(2) PUBLIC HEALTH EXEMPTION.—A referral 
to an advisory committee under paragraph (1) is not 
required with respect to a new drug if the Sec-
retary— 
‘‘(A) finds that such a referral is not in 
the interest of protecting and promoting public 
health; 
‘‘(B) finds that such a referral is not nec-
essary based on a review of the relevant sci-
entific information; and 
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‘‘(C) submits a notice containing the ra-
tionale for such findings to the Committee on 
Health, Education, Labor, and Pensions of the 
Senate and the Committee on Energy and Com-
merce of the House of Representatives. 
‘‘(b) PEDIATRIC OPIOID LABELING.—The Secretary 
shall convene the Pediatric Advisory Committee of the 
Food and Drug Administration to seek recommendations 
from such Committee regarding a framework for the inclu-
sion of information in the labeling of drugs that are 
opioids relating to the use of such drugs in pediatric popu-
lations before the Secretary approves any labeling or 
change to labeling for any drug that is an opioid intended 
for use in a pediatric population. 
‘‘(c) SUNSET.—The requirements of subsections (a) 
and (b) shall cease to be effective on October 1, 2022.’’. 
(b) PRESCRIBER EDUCATION.—Not later than 1 year 
after the date of the enactment of this Act, the Secretary 
of Health and Human Services, acting through the Com-
missioner of Food and Drugs, as part of the Food and 
Drug Administration’s evaluation of the Extended-Re-
lease/Long-Acting Opioid Analgesics Risk Evaluation and 
Mitigation Strategy, and in consultation with relevant 
stakeholders, shall develop recommendations regarding 
education programs for prescribers of opioids pursuant to 
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section 505–1 of the Federal Food, Drug, and Cosmetic 
Act (21 U.S.C. 355–1), including recommendations on— 
(1) which prescribers should participate in such 
programs; and 
(2) how often participation in such programs is 
necessary. 
(c) GUIDANCE ON EVALUATING THE ABUSE DETER-
RENCE OF GENERIC SOLID ORAL OPIOID DRUG PROD-
UCTS.—Not later than 2 years after the end of the period 
for public comment on the draft guidance entitled ‘‘Gen-
eral Principals for Evaluating the Abuse Deterrence of Ge-
neric Solid Oral Opioid Drug Products’’ issued by the 
Center for Drug Evaluation and Research of the Food and 
Drug Administration in March 2016, the Commissioner 
of Food and Drugs shall publish in the Federal Register 
a final version of such guidance. 
SEC. 111. STUDY ON TREATMENT INFRASTRUCTURE. 
Not later than 24 months after the date of enactment 
of this Act, the Comptroller General of the United States 
shall initiate an evaluation, and submit to Congress a re-
port, of the inpatient and outpatient treatment capacity, 
availability, and needs of the United States, which shall 
include, to the extent data are available— 
(1) the capacity of acute residential or inpatient 
detoxification programs; 
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(2) the capacity of inpatient clinical stabiliza-
tion programs, transitional residential support serv-
ices, and residential rehabilitation programs; 
(3) the capacity of demographic specific resi-
dential or inpatient treatment programs, such as 
those designed for pregnant women or adolescents; 
(4) geographical differences of the availability 
of residential and outpatient treatment and recovery 
options for substance use disorders across the con-
tinuum of care; 
(5) the availability of residential and outpatient 
treatment programs that offer treatment options 
based on reliable scientific evidence of efficacy for 
the treatment of substance use disorders, including 
the use of Food and Drug Administration-approved 
medicines and evidence-based nonpharmacological 
therapies; 
(6) the number of patients in residential and 
specialty outpatient treatment services for substance 
use disorders; 
(7) an assessment of the need for residential 
and outpatient treatment for substance use disorders 
across the continuum of care; 
(8) the availability of residential and outpatient 
treatment programs to American Indians and Alaska 
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Natives through an Indian health program (as de-
fined by section 4 of the Indian Health Care Im-
provement Act (25 U.S.C. 1603)); and 
(9) the barriers (including technological bar-
riers) at the Federal, State, and local levels to real- 
time reporting of de-identified information on drug 
overdoses and ways to overcome such barriers. 
SEC. 112. NATIONAL YOUTH RECOVERY INITIATIVE. 
Part II of title I of the Omnibus Crime Control and 
Safe Streets Act of 1968 (42 U.S.C. 3797cc et seq.) is 
amended by adding at the end the following: 
‘‘SEC. 2999A. NATIONAL YOUTH RECOVERY INITIATIVE. 
‘‘(a) DEFINITIONS.—In this section: 
‘‘(1) ELIGIBLE ENTITY.—The term ‘eligible en-
tity’ means— 
‘‘(A) a high school that has been accred-
ited as a recovery high school by the Associa-
tion of Recovery Schools; 
‘‘(B) an accredited high school that is 
seeking to establish or expand recovery support 
services; 
‘‘(C) an institution of higher education; 
‘‘(D) a recovery program at a nonprofit 
collegiate institution; or 
‘‘(E) a nonprofit organization. 
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‘‘(2) INSTITUTION OF HIGHER EDUCATION.— 
The term ‘institution of higher education’ has the 
meaning given the term in section 101 of the Higher 
Education Act of 1965 (20 U.S.C. 1001). 
‘‘(3) RECOVERY PROGRAM.—The term ‘recovery 
program’— 
‘‘(A) means a program to help individuals 
who are recovering from substance use dis-
orders to initiate, stabilize, and maintain 
healthy and productive lives in the community; 
and 
‘‘(B) includes peer-to-peer support and 
communal activities to build recovery skills and 
supportive social networks. 
‘‘(b) GRANTS
AUTHORIZED.—The Secretary of 
Health and Human Services, in coordination with the Sec-
retary of Education, may award grants to eligible entities 
to enable the entities to— 
‘‘(1) provide substance use disorder recovery 
support services to young people in high school and 
enrolled in institutions of higher education; 
‘‘(2) help build communities of support for 
young people in recovery through a spectrum of ac-
tivities such as counseling and health- and wellness- 
oriented social activities; and 
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‘‘(3) encourage initiatives designed to help 
young people achieve and sustain recovery from sub-
stance use disorders. 
‘‘(c) USE OF FUNDS.—Grants awarded under sub-
section (b) may be used for activities to develop, support, 
and maintain youth recovery support services, including— 
‘‘(1) the development and maintenance of a 
dedicated physical space for recovery programs; 
‘‘(2) dedicated staff for the provision of recov-
ery programs; 
‘‘(3) health- and wellness-oriented social activi-
ties and community engagement; 
‘‘(4) establishment of recovery high schools; 
‘‘(5) coordination of recovery programs with— 
‘‘(A) substance use disorder treatment pro-
grams and systems; 
‘‘(B) providers of mental health services; 
‘‘(C) primary care providers and physi-
cians; 
‘‘(D) the criminal justice system, including 
the juvenile justice system; 
‘‘(E) employers; 
‘‘(F) housing services; 
‘‘(G) child welfare services; 
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‘‘(H) high schools and institutions of high-
er education; and 
‘‘(I) other programs or services related to 
the welfare of an individual in recovery from a 
substance use disorder; 
‘‘(6) the development of peer-to-peer support 
programs or services; and 
‘‘(7) additional activities that help youths and 
young adults to achieve recovery from substance use 
disorders. 
‘‘(d) FUNDING.—There is authorized to be appro-
priated $5,000,000 to carry out this section for each of 
fiscal years 2017 through 2021, of which $5,000,000 shall 
be made available from amounts appropriated under sec-
tion 101(a) of the Opioid Use Disorder Treatment Expan-
sion and Modernization Act for fiscal year 2017, to remain 
available until expended.’’. 
SEC. 113. BUILDING COMMUNITIES OF RECOVERY. 
Part II of title I of the Omnibus Crime Control and 
Safe Streets Act of 1968 (42 U.S.C. 3797cc et seq.), as 
amended by section 113, is amended by adding at the end 
the following: 
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‘‘SEC. 2999B. BUILDING COMMUNITIES OF RECOVERY. 
‘‘(a) DEFINITION.—In this section, the term ‘recov-
ery community organization’ means an independent non-
profit organization that— 
‘‘(1) mobilizes resources within and outside of 
the recovery community to increase the prevalence 
and quality of long-term recovery from substance 
use disorders; and 
‘‘(2) is wholly or principally governed by people 
in recovery for substance use disorders who reflect 
the community served. 
‘‘(b) GRANTS
AUTHORIZED.—The Secretary of 
Health and Human Services may award grants to recovery 
community organizations to enable such organizations to 
develop, expand, and enhance recovery services. 
‘‘(c) FEDERAL SHARE.—The Federal share of the 
costs of a program funded by a grant under this section 
may not exceed 50 percent. 
‘‘(d) USE OF FUNDS.—Grants awarded under sub-
section (b)— 
‘‘(1) shall be used to develop, expand, and en-
hance community and statewide recovery support 
services; and 
‘‘(2) may be used to— 
‘‘(A) advocate for individuals in recovery 
from substance use disorders; 
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‘‘(B) build connections between recovery 
networks, between recovery community organi-
zations, and with other recovery support serv-
ices, including— 
‘‘(i) substance use disorder treatment 
programs and systems; 
‘‘(ii) providers of mental health serv-
ices; 
‘‘(iii) primary care providers and phy-
sicians; 
‘‘(iv) the criminal justice system; 
‘‘(v) employers; 
‘‘(vi) housing services; 
‘‘(vii) child welfare agencies; and 
‘‘(viii) other recovery support services 
that facilitate recovery from substance use 
disorders; 
‘‘(C) reduce the stigma associated with 
substance use disorders; 
‘‘(D) conduct public education and out-
reach on issues relating to substance use dis-
orders and recovery, including— 
‘‘(i) how to identify the signs of addic-
tion; 
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‘‘(ii) the resources that are available 
to individuals struggling with addiction 
and families who have a family member 
struggling with or being treated for addic-
tion, including programs that mentor and 
provide support services to children; 
‘‘(iii) the resources that are available 
to help support individuals in recovery; and 
‘‘(iv) information on the medical con-
sequences of substance use disorders, in-
cluding neonatal abstinence syndrome and 
potential infection with human immuno-
deficiency virus and viral hepatitis; and 
‘‘(E) carry out other activities that 
strengthen the network of community support 
for individuals in recovery. 
‘‘(e) FUNDING.—Of the amounts appropriated under 
section 101(a) of the Opioid Use Disorder Treatment Ex-
pansion and Modernization Act for fiscal year 2017, 
$25,000,000 shall be made available to carry out this sec-
tion, to remain available until expended’’. 
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TITLE II—COMPREHENSIVE 
OPIOID ABUSE REDUCTION 
SEC. 201. COMPREHENSIVE OPIOID ABUSE GRANT PRO-
GRAM. 
(a) IN GENERAL.—Title I of the Omnibus Crime 
Control and Safe Streets Act of 1968 (42 U.S.C. 3711 
et seq.) is amended by adding at the end the following: 
‘‘PART LL—COMPREHENSIVE OPIOID ABUSE 
GRANT PROGRAM 
‘‘SEC. 3021. DESCRIPTION. 
‘‘(a) GRANTS AUTHORIZED.—From amounts made 
available to carry out this part, the Attorney General may 
make grants to States, units of local government, and In-
dian tribes, for use by the State, unit of local government, 
or Indian tribe to provide services primarily relating to 
opioid abuse, including for any one or more of the fol-
lowing: 
‘‘(1) Developing, implementing, or expanding a 
treatment alternative to incarceration program, 
which may include— 
‘‘(A) pre-booking or post-booking compo-
nents, which may include the activities de-
scribed in part HH of this title; 
‘‘(B) training for criminal justice agency 
personnel on substance use disorders and co-oc-
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curring mental illness and substance use dis-
orders; 
‘‘(C) a mental health court, including the 
activities described in part V of this title; 
‘‘(D) a drug court, including the activities 
described in part EE of this title; and 
‘‘(E) a veterans treatment court program, 
including the activities described in subsection 
(i) of section 2991 of this title. 
‘‘(2) In the case of a State, facilitating or en-
hancing planning and collaboration between State 
criminal justice agencies and State substance abuse 
systems in order to more efficiently and effectively 
carry out programs described in paragraph (1) that 
address problems related to opioid abuse. 
‘‘(3) Providing training and resources for first 
responders on carrying and administering an opioid 
overdose reversal drug or device approved by the 
Food and Drug Administration, and purchasing 
such a drug or device for first responders who have 
received such training to carry and administer. 
‘‘(4) Investigative purposes to locate or inves-
tigate illicit activities related to the unlawful dis-
tribution of opioids. 
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‘‘(5) Developing, implementing, or expanding a 
medication-assisted treatment program used or oper-
ated by a criminal justice agency, which may include 
training criminal justice agency personnel on medi-
cation-assisted treatment, and carrying out the ac-
tivities described in part S of this title. 
‘‘(6) In the case of a State, developing, imple-
menting, or expanding a prescription drug moni-
toring program to collect and analyze data related to 
the prescribing of schedule II, III, and IV controlled 
substances through a centralized database adminis-
tered by an authorized State agency, which includes 
tracking the dispensation of such substances, and 
providing for data sharing with other States. 
‘‘(7) Developing, implementing, or expanding a 
program to prevent and address opioid abuse by ju-
veniles. 
‘‘(8) Developing, implementing, or expanding an 
integrated and comprehensive opioid abuse response 
program. 
‘‘(b) CONTRACTS AND SUBAWARDS.—A State, unit of 
local government, or Indian tribe may, in using a grant 
under this subpart for purposes authorized by subsection 
(a), use all or a portion of that grant to contract with 
or make one or more subawards to one or more— 
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‘‘(1) local or regional organizations that are pri-
vate and nonprofit, including faith-based organiza-
tions; 
‘‘(2) units of local government; or 
‘‘(3) tribal organizations. 
‘‘(c) PROGRAM ASSESSMENT COMPONENT; WAIV-
ER.— 
‘‘(1) PROGRAM
ASSESSMENT
COMPONENT.— 
Each program funded under this subpart shall con-
tain a program assessment component, developed 
pursuant to guidelines established by the Attorney 
General, in coordination with the National Institute 
of Justice. 
‘‘(2) WAIVER.—The Attorney General may 
waive the requirement of paragraph (1) with respect 
to a program if, in the opinion of the Attorney Gen-
eral, the program is not of sufficient size to justify 
a full program assessment. 
‘‘(d) ADMINISTRATIVE COSTS.—Not more than 10 
percent of a grant made under this subpart may be used 
for costs incurred to administer such grant. 
‘‘(e) PERIOD.—The period of a grant made under 
this part may not be longer than 4 years, except that re-
newals and extensions beyond that period may be granted 
at the discretion of the Attorney General. 
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‘‘SEC. 3022. APPLICATIONS. 
‘‘To request a grant under this part, the chief execu-
tive officer of a State, unit of local government, or Indian 
tribe shall submit an application to the Attorney General 
at such time and in such form as the Attorney General 
may require. Such application shall include the following: 
‘‘(1) A certification that Federal funds made 
available under this subpart will not be used to sup-
plant State, local, or tribal funds, but will be used 
to increase the amounts of such funds that would, 
in the absence of Federal funds, be made available 
for the activities described in section 3021(a). 
‘‘(2) An assurance that, for each fiscal year 
covered by an application, the applicant shall main-
tain and report such data, records, and information 
(programmatic and financial) as the Attorney Gen-
eral may reasonably require. 
‘‘(3) A certification, made in a form acceptable 
to the Attorney General and executed by the chief 
executive officer of the applicant (or by another offi-
cer of the applicant, if qualified under regulations 
promulgated by the Attorney General), that— 
‘‘(A) the programs to be funded by the 
grant meet all the requirements of this part; 
‘‘(B) all the information contained in the 
application is correct; 
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‘‘(C) there has been appropriate coordina-
tion with affected agencies; and 
‘‘(D) the applicant will comply with all 
provisions of this part and all other applicable 
Federal laws. 
‘‘(4) An assurance that the applicant will work 
with the Drug Enforcement Administration to de-
velop an integrated and comprehensive strategy to 
address opioid abuse. 
‘‘SEC. 3023. REVIEW OF APPLICATIONS. 
‘‘The Attorney General shall not finally disapprove 
any application (or any amendment to that application) 
submitted under this part without first affording the ap-
plicant reasonable notice of any deficiencies in the applica-
tion and opportunity for correction and reconsideration. 
‘‘SEC. 3024. GEOGRAPHIC DIVERSITY. 
‘‘The Attorney General shall ensure equitable geo-
graphic distribution of grants under this part and take 
into consideration the needs of underserved populations, 
including rural and tribal communities. 
‘‘SEC. 3025. DEFINITIONS. 
‘‘In this part: 
‘‘(1) The term ‘first responder’ includes a fire-
fighter, law enforcement officer, paramedic, emer-
gency medical technician, or other individual (includ-
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ing an employee of a legally organized and recog-
nized volunteer organization, whether compensated 
or not), who, in the course of professional duties, re-
sponds to fire, medical, hazardous material, or other 
similar emergencies. 
‘‘(2) The term ‘medication-assisted treatment’ 
means the use of medications approved by the Food 
and Drug Administration for the treatment of opioid 
abuse. 
‘‘(3) The term ‘opioid’ means any drug, includ-
ing heroin, having an addiction-forming or addiction- 
sustaining liability similar to morphine or being ca-
pable of conversion into a drug having such addic-
tion-forming or addiction-sustaining liability. 
‘‘(4) The term ‘schedule II, III, or IV controlled 
substance’ means a controlled substance that is list-
ed on schedule II, schedule III, or schedule IV of 
section 202(c) of the Controlled Substances Act (21 
U.S.C. 812(c)). 
‘‘(5) The terms ‘drug’ and ‘device’ have the 
meanings given those terms in section 201 of the 
Federal Food, Drug, and Cosmetic Act (21 U.S.C. 
321). 
‘‘(6) The term ‘criminal justice agency’ means 
a State, local, or tribal— 
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‘‘(A) court; 
‘‘(B) prison; 
‘‘(C) jail; 
‘‘(D) law enforcement agency; or 
‘‘(E) other agency that performs the ad-
ministration of criminal justice, including pros-
ecution, pretrial services, and community super-
vision. 
‘‘(7) The term ‘tribal organization’ has the 
meaning given that term in section 4 of the Indian 
Self-Determination and Education Assistance Act 
(25 U.S.C. 450b).’’. 
(b) FUNDING.—There is authorized to be appro-
priated $65,000,000 to carry out this section, section 203, 
and section 204 (including the amendments made by such 
sections) for the period of fiscal years 2017 through 2021, 
of which $65,000,000 shall be made available from 
amounts appropriated under section 101(a) of the Opioid 
Use Disorder Treatment Expansion and Modernization 
Act for fiscal year 2017, to remain available until ex-
pended. 
SEC. 202. AUDIT AND ACCOUNTABILITY OF GRANTEES. 
(a) DEFINITIONS.—In this section— 
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(1) the term ‘‘covered grant program’’ means a 
grant program operated by the Department of Jus-
tice; 
(2) the term ‘‘covered grantee’’ means a recipi-
ent of a grant from a covered grant program; 
(3) the term ‘‘nonprofit’’, when used with re-
spect to an organization, means an organization that 
is described in section 501(c)(3) of the Internal Rev-
enue Code of 1986, and is exempt from taxation 
under section 501(a) of such Code; and 
(4) the term ‘‘unresolved audit finding’’ means 
an audit report finding in a final audit report of the 
Inspector General of the Department of Justice that 
a covered grantee has used grant funds awarded to 
that grantee under a covered grant program for an 
unauthorized expenditure or otherwise unallowable 
cost that is not closed or resolved during a 12-month 
period prior to the date on which the final audit re-
port is issued. 
(b) AUDIT REQUIREMENT.—Beginning in fiscal year 
2016, and annually thereafter, the Inspector General of 
the Department of Justice shall conduct audits of covered 
grantees to prevent waste, fraud, and abuse of funds 
awarded under covered grant programs. The Inspector 
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General shall determine the appropriate number of cov-
ered grantees to be audited each year. 
(c) MANDATORY EXCLUSION.—A grantee that is 
found to have an unresolved audit finding under an audit 
conducted under subsection (b) may not receive grant 
funds under a covered grant program in the fiscal year 
following the fiscal year to which the finding relates. 
(d) REIMBURSEMENT.—If a covered grantee is 
awarded funds under the covered grant program from 
which it received a grant award during the 1-fiscal-year 
period during which the covered grantee is ineligible for 
an allocation of grant funds under subsection (c), the At-
torney General shall— 
(1) deposit into the General Fund of the Treas-
ury an amount that is equal to the amount of the 
grant funds that were improperly awarded to the 
covered grantee; and 
(2) seek to recoup the costs of the repayment 
to the Fund from the covered grantee that was im-
properly awarded the grant funds. 
(e) PRIORITY OF GRANT AWARDS.—The Attorney 
General, in awarding grants under a covered grant pro-
gram shall give priority to eligible entities that during the 
2-year period preceding the application for a grant have 
not been found to have an unresolved audit finding. 
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(f) NONPROFIT REQUIREMENTS.— 
(1) PROHIBITION.—A nonprofit organization 
that holds money in offshore accounts for the pur-
pose of avoiding the tax described in section 511(a) 
of the Internal Revenue Code of 1986, shall not be 
eligible to receive, directly or indirectly, any funds 
from a covered grant program. 
(2) DISCLOSURE.—Each nonprofit organization 
that is a covered grantee shall disclose in its applica-
tion for such a grant, as a condition of receipt of 
such a grant, the compensation of its officers, direc-
tors, and trustees. Such disclosure shall include a 
description of the criteria relied on to determine 
such compensation. 
SEC. 203. VETERANS TREATMENT COURTS. 
Section 2991 of the Omnibus Crime Control and Safe 
Streets Act of 1968 (42 U.S.C. 3797aa) is amended— 
(1) by redesignating subsection (i) as subsection 
(j); and 
(2) by inserting after subsection (h) the fol-
lowing: 
‘‘(i) ASSISTING VETERANS.— 
‘‘(1) DEFINITIONS.—In this subsection: 
‘‘(A) PEER TO PEER SERVICES OR PRO-
GRAMS.—The term ‘peer to peer services or 
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programs’ means services or programs that con-
nect qualified veterans with other veterans for 
the 
purpose 
of 
providing 
support 
and 
mentorship to assist qualified veterans in ob-
taining treatment, recovery, stabilization, or re-
habilitation. 
‘‘(B) QUALIFIED
VETERAN.—The term 
‘qualified veteran’ means a preliminarily quali-
fied offender who— 
‘‘(i) served on active duty in any 
branch of the Armed Forces, including the 
National Guard or Reserves; and 
‘‘(ii) was discharged or released from 
such service under conditions other than 
dishonorable. 
‘‘(C) VETERANS TREATMENT COURT PRO-
GRAM.—The term ‘veterans treatment court 
program’ means a court program involving col-
laboration among criminal justice, veterans, and 
mental health and substance abuse agencies 
that provides qualified veterans with— 
‘‘(i) intensive judicial supervision and 
case management, which may include ran-
dom and frequent drug testing where ap-
propriate; 
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‘‘(ii) a full continuum of treatment 
services, including mental health services, 
substance abuse services, medical services, 
and services to address trauma; 
‘‘(iii) alternatives to incarceration; or 
‘‘(iv) other appropriate services, in-
cluding housing, transportation, mentoring, 
employment, job training, education, or as-
sistance in applying for and obtaining 
available benefits. 
‘‘(2) VETERANS ASSISTANCE PROGRAM.— 
‘‘(A) IN GENERAL.—The Attorney General, 
in consultation with the Secretary of Veterans 
Affairs, may award grants under this sub-
section to applicants to establish or expand— 
‘‘(i) veterans treatment court pro-
grams; 
‘‘(ii) peer to peer services or programs 
for qualified veterans; 
‘‘(iii) practices that identify and pro-
vide treatment, rehabilitation, legal, transi-
tional, and other appropriate services to 
qualified veterans who have been incarcer-
ated; or 
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‘‘(iv) training programs to teach 
criminal justice, law enforcement, correc-
tions, mental health, and substance abuse 
personnel how to identify and appro-
priately respond to incidents involving 
qualified veterans. 
‘‘(B) 
PRIORITY.—In 
awarding 
grants 
under this subsection, the Attorney General 
shall give priority to applications that— 
‘‘(i) demonstrate collaboration be-
tween and joint investments by criminal 
justice, mental health, substance abuse, 
and veterans service agencies; 
‘‘(ii) promote effective strategies to 
identify and reduce the risk of harm to 
qualified veterans and public safety; and 
‘‘(iii) propose interventions with em-
pirical support to improve outcomes for 
qualified veterans.’’. 
SEC. 204. EMERGENCY FEDERAL LAW ENFORCEMENT AS-
SISTANCE. 
Section 609Y(a) of the Justice Assistance Act of 
1984 (42 U.S.C. 10513(a)) is amended by striking ‘‘Sep-
tember 30, 1984’’ and inserting ‘‘September 30, 2021’’. 
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SEC. 205. OPIOID PROGRAM EVALUATION ACT. 
(a) SHORT TITLE.—This section may be cited as the 
‘‘Opioid Program Evaluation Act’’ or the ‘‘OPEN Act’’. 
(b) EVALUATION
OF PERFORMANCE
OF DEPART-
MENT OF JUSTICE PROGRAM.— 
(1) EVALUATION
OF
JUSTICE
DEPARTMENT 
COMPREHENSIVE OPIOID ABUSE GRANT PROGRAM.— 
Not later than 5 years after the date of enactment 
of this Act, the Attorney General shall complete an 
evaluation of the effectiveness of the Comprehensive 
Opioid Abuse Grant Program under part LL of the 
Omnibus Crime Control and Safe Streets Act of 
1968 administered by the Department of Justice 
based upon the information reported under para-
graph (4) of this subsection. 
(2) INTERIM EVALUATION.—Not later than 3 
years after the date of enactment of this Act, the 
Attorney General shall complete an interim evalua-
tion assessing the nature and extent of the incidence 
of opioid abuse and illegal opioid distribution in the 
United States. 
(3) METRICS
AND
OUTCOMES
FOR
EVALUA-
TION.—Not later than 180 days after the date of en-
actment of this Act, the Attorney General shall iden-
tify outcomes that are to be achieved by activities 
funded by the Comprehensive Opioid Grant Abuse 
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Program and the metrics by which the achievement 
of such outcomes shall be determined. 
(4) METRICS DATA COLLECTION.—The Attor-
ney General shall require grantees under the Com-
prehensive Opioid Abuse Grant Program (and those 
receiving subawards under section 3021(b) of part 
LL of the Omnibus Crime Control and Safe Streets 
Act of 1968) to collect and annually report to the 
Department of Justice data based upon the metrics 
identified under paragraph (3). 
(5) PUBLICATION OF DATA AND FINDINGS.— 
(A) PUBLICATION
OF
OUTCOMES
AND 
METRICS.—The Attorney General shall, not 
later than 30 days after completion of the re-
quirement under paragraph (3), publish the 
outcomes and metrics identified under that 
paragraph. 
(B) PUBLICATION
OF
EVALUATION.—In 
the case of the interim evaluation under para-
graph (2), and the final evaluation under para-
graph (1), the Secretary shall arrange for an 
independent, external evaluator to, not later 
than 90 days after such an evaluation is com-
pleted, publish the results of such evaluation 
and issue a report on such evaluation to the 
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Committee on the Judiciary of the House of 
Representatives and the Committee on the Ju-
diciary of the Senate. Such report shall also be 
published along with the data used to make 
such evaluation. 
(6) ARRANGEMENT WITH THE NATIONAL ACAD-
EMY
OF
SCIENCES.—For purposes of paragraphs 
(1), (2), and (3), the Attorney General shall enter 
into an arrangement with the National Academy of 
Sciences. 
(c) EVALUATION
OF PERFORMANCE
OF DEPART-
MENT OF HEALTH AND HUMAN SERVICES PROGRAM.— 
(1) EVALUATION
OF
JUSTICE
DEPARTMENT 
COMPREHENSIVE OPIOID ABUSE GRANT PROGRAM.— 
Not later than 5 years after the date of enactment 
of this Act, the Secretary of Health and Human 
Services shall complete an evaluation of any pro-
gram administered by the Secretary that provides 
grants for the primary purpose of providing assist-
ance in addressing problems pertaining to opioid 
abuse based upon the information reported under 
paragraph (4) of this subsection. 
(2) INTERIM EVALUATION.—Not later than 3 
years after the date of enactment of this Act, the 
Secretary shall complete an interim evaluation as-
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sessing the nature and extent of the incidence of 
opioid abuse and illegal opioid distribution in the 
United States. 
(3) METRICS
AND
OUTCOMES
FOR
EVALUA-
TION.—Not later than 180 days after the date of en-
actment of this Act, the Secretary shall identify out-
comes that are to be achieved by activities funded by 
the programs described in paragraph (1) and the 
metrics by which the achievement of such outcomes 
shall be determined. 
(4) METRICS
DATA
COLLECTION.—The Sec-
retary shall require grantees under the programs de-
scribed in paragraph (1) to collect and annually re-
port to the Department of Health and Human Serv-
ices data based upon the metrics identified under 
paragraph (3). 
(5) PUBLICATION OF DATA AND FINDINGS.— 
(A) PUBLICATION
OF
OUTCOMES
AND 
METRICS.—The Secretary shall, not later than 
30 days after completion of the requirement 
under paragraph (3), publish the outcomes and 
metrics identified under that paragraph. 
(B) PUBLICATION
OF
EVALUATION.—In 
the case of the interim evaluation under sub-
paragraph (B), and each final evaluation under 
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paragraph (1), the Secretary shall arrange for 
an independent, external evaluator to, not later 
than 90 days after such an evaluation is com-
pleted, publish the results of such evaluation 
and issue a report on such evaluation to the 
Committee on Energy and Commerce of the 
House of Representatives and the Committee 
on Health, Education, Labor, and Pensions of 
the Senate. Such report shall also be published 
along with the data used to make such evalua-
tion. 
(6) ARRANGEMENT
WITH
AN
INDEPENDENT, 
EXTERNAL
EVALUATOR.—For purposes of para-
graphs (1), (2), (3), and (5), the Secretary shall 
enter into an arrangement with an independent, ex-
ternal evaluator. 
(d) DEFINITION.—In this section, the term ‘‘opioid’’ 
has the meaning given the term ‘‘opiate’’ in section 102 
of the Controlled Substances Act (21 U.S.C. 802). 
(e) NO ADDITIONAL FUNDS AUTHORIZED.—No addi-
tional funds are authorized to be appropriated to carry 
out this Act. 
SEC. 206. GOOD SAMARITAN ASSESSMENT ACT. 
(a) GAO STUDY ON GOOD SAMARITAN LAWS PER-
TAINING TO TREATMENT OF OPIOID OVERDOSES.—The 
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Comptroller General of the United States shall submit to 
the Committee on the Judiciary of the House of Rep-
resentatives, the Committee on Oversight and Government 
Reform of the House of Representatives, the Committee 
on the Judiciary of the Senate, and the Committee on 
Homeland Security and Governmental Affairs of the Sen-
ate a report on— 
(1) the extent to which the Director of National 
Drug Control Policy has reviewed Good Samaritan 
laws, and any findings from such a review, including 
findings related to the potential effects of such laws, 
if available; 
(2) efforts by the Director to encourage the en-
actment of Good Samaritan laws; and 
(3) a compilation of Good Samaritan laws in ef-
fect in the States, the territories, and the District of 
Columbia. 
(b) DEFINITIONS.—In this section— 
(1) the term ‘‘Good Samaritan law’’ means a 
law of a State or unit of local government that ex-
empts from criminal or civil liability any individual 
who administers an opioid overdose reversal drug or 
device, or who contacts emergency services providers 
in response to an overdose; and 
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(2) the term ‘‘opioid’’ means any drug, includ-
ing heroin, having an addiction-forming or addiction- 
sustaining liability similar to morphine or being ca-
pable of conversion into a drug having such addic-
tion-forming or addiction-sustaining liability. 
TITLE III—PROMOTING RESPON-
SIBLE OPIOID MANAGEMENT 
AND 
INCORPORATING 
SCI-
ENTIFIC EXPERTISE 
SEC. 301. SHORT TITLE. 
This title may be cited as the ‘‘Promoting Respon-
sible Opioid Management and Incorporating Scientific Ex-
pertise Act’’ or the ‘‘Jason Simcakoski PROMISE Act’’. 
Subtitle A—Opioid Therapy and 
Pain Management 
SEC. 311. GUIDELINES ON MANAGEMENT OF OPIOID THER-
APY BY DEPARTMENT OF VETERANS AFFAIRS 
AND DEPARTMENT OF DEFENSE AND IMPLE-
MENTATION OF SUCH GUIDELINES BY DE-
PARTMENT OF VETERANS AFFAIRS. 
(a) IN GENERAL.—Not later than one year after the 
date of the enactment of this Act, the Secretary of Vet-
erans Affairs and the Secretary of Defense shall jointly 
update the VA/DOD Clinical Practice Guideline for Man-
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agement of Opioid Therapy for Chronic Pain to include 
the following: 
(1) In accordance with subsection (b), common 
recommended 
guidelines 
for 
safely 
prescribing 
opioids for the treatment of chronic, non-cancer pain 
in outpatient settings as compiled by the Director of 
the Centers for Disease Control and Prevention. 
(2) Enhanced guidance with respect to— 
(A) the administration of two or more 
drugs that may result in a life-limiting drug-to- 
drug interaction, including benzodiazepines; 
(B) the treatment of patients with current 
acute psychiatric instability or substance use 
disorder or patients at risk of suicide; and 
(C) the use of opioid therapy to treat men-
tal health disorders other than opioid use dis-
order. 
(3) Enhanced guidance with respect to the 
treatment 
of 
patients 
with 
behaviors 
or 
comorbidities, such as post-traumatic stress dis-
order, psychiatric disorders, or a history of sub-
stance abuse or addiction, that requires a consulta-
tion or comanagement of opioid therapy with one or 
more specialists in pain management, mental health, 
or addictions. 
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(4) Enhanced guidance with respect to the con-
duct by health care providers of an effective assess-
ment for patients receiving opioid therapy, including 
patients on long-term opioid therapy, to determine— 
(A) whether opioid therapy is meeting the 
expected goals of the patient and health care 
provider of relieving pain, improving function, 
and providing patient satisfaction; and 
(B) whether opioid therapy should be con-
tinued. 
(5) Guidance that each health care provider of 
the Department of Veterans Affairs and the Depart-
ment of Defense, before initiating opioid therapy to 
treat a patient as part of the comprehensive assess-
ment conducted by the health care provider, use the 
Opioid Therapy Risk Report tool of the Department 
of Veterans Affairs (or successor tool), which shall 
include the ability to access the most recent patient 
information from the prescription drug monitoring 
program of each State that has such a program to 
assess the risk for adverse outcomes of opioid ther-
apy for the patient, including with respect to the 
concurrent use of controlled substances, including 
benzodiazepines. 
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(6) Guidelines to govern the methodologies used 
by health care providers of the Department of Vet-
erans Affairs and the Department of Defense to 
safely titrate and taper opioid therapy when adjust-
ing or discriminating the use of opioid therapy, in-
cluding with respect to— 
(A) prescription of the lowest effective dose 
based on patient need; 
(B) use of opioid only for a limited period 
of time; and 
(C) augmentation of opioid therapy with 
other pain management therapies and modali-
ties. 
(7) Guidelines with respect to appropriate case 
management for patients receiving opioid therapy 
who transition between inpatient and outpatient 
health care settings, which may include the use of 
care transition plans. 
(8) Guidelines with respect to appropriate 
transfer of case management responsibility for pa-
tients receiving opioid therapy who transition from 
receiving care furnished by the Secretary of Defense 
to receiving care furnished by other health care pro-
viders after the patient has been discharged or sepa-
rated from the Armed Forces. 
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(9) Enhanced standards with respect to the use 
of routine and random urine drug tests for all pa-
tients before and during opioid therapy to help pre-
vent substance abuse, dependence, and diversion, in-
cluding— 
(A) that such tests occur not less fre-
quently than once each year; and 
(B) that health care providers appro-
priately interpret and respond to the results 
from such tests to tailor pain therapy, safe-
guards, and risk management strategies to each 
patient. 
(10) Guidance that health care providers dis-
cuss with patients, before initiating opioid therapy, 
options for pain management therapies without the 
use of opioids and options to augment opioid therapy 
with other clinical and complementary and integra-
tive health services to minimize opioid dependence. 
(b) TREATMENT OF CERTAIN GUIDELINES DEVEL-
OPED AFTER DEADLINE.—If the Director of the Centers 
for Disease Control and Prevention issues the guidelines 
described in paragraph (1) of subsection (a) after the date 
on which the Secretary of Veterans Affairs and the Sec-
retary of Defense jointly update the VA/DOD Clinical 
Practice Guideline for Management of Opioid Therapy for 
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Chronic Pain pursuant to such subsection, the Secretaries 
shall jointly modify the VA/DOD Clinical Practice Guide-
line for Management of Opioid Therapy for Chronic Pain 
to incorporate such guidelines of the Director. 
(c) CONSULTATION BEFORE UPDATE.—Before up-
dating the guideline under subsection (a), the Secretary 
of Veterans Affairs and the Secretary of Defense shall 
jointly consult with the Pain Management Working Group 
of the Department of Veterans Affairs–Department of De-
fense Joint Executive Committee established by section 
320 of title 38, United States Code. 
(d) DEFINITIONS.—In this section: 
(1) The term ‘‘controlled substance’’ has the 
meaning given that term in section 102 of the Con-
trolled Substances Act (21 U.S.C. 802). 
(2) The term ‘‘State’’ means each of the several 
States, territories, and possessions of the United 
States, the District of Columbia, and the Common-
wealth of Puerto Rico. 
SEC. 312. IMPROVEMENT OF OPIOID SAFETY MEASURES BY 
DEPARTMENT OF VETERANS AFFAIRS. 
(a) EXPANSION OF OPIOID SAFETY INITIATIVE.— 
Not later than 180 days after the date of the enactment 
of this Act, the Secretary of Veterans Affairs shall expand 
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the Opioid Safety Initiative of the Department of Veterans 
Affairs to include all medical facilities of the Department. 
(b) PAIN MANAGEMENT EDUCATION
AND TRAIN-
ING.— 
(1) IN GENERAL.—In carrying out the Opioid 
Safety Initiative of the Department, the Secretary 
shall require all employees of the Department re-
sponsible for prescribing opioids to receive education 
and training described in paragraph (2). 
(2) EDUCATION
AND
TRAINING.—Education 
and training described in this paragraph is edu-
cation and training on pain management and safe 
opioid prescribing practices for purposes of safely 
and effectively managing patients with chronic pain, 
including education and training on the following: 
(A) The implementation of and full compli-
ance with the VA/DOD Clinical Practice Guide-
line for Management of Opioid Therapy for 
Chronic Pain, including any update to such 
guideline. 
(B) The use of evidence-based pain man-
agement therapies, including cognitive-behav-
ioral therapy, non-opioid alternatives, and non- 
drug methods and procedures to managing pain 
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and related health conditions including com-
plementary alternative medicines. 
(C) Screening and identification of patients 
with substance use disorder, including drug- 
seeking behavior, before prescribing opioids, as-
sessment of risk potential for patients devel-
oping an addiction, and referral of patients to 
appropriate addiction treatment professionals if 
addiction is identified or strongly suspected. 
(D) Communication with patients on the 
potential harm associated with the use of 
opioids and other controlled substances, includ-
ing the need to safely store and dispose of sup-
plies relating to the use of opioids and other 
controlled substances. 
(E) Such other education and training as 
the Secretary considers appropriate to ensure 
that veterans receive safe and high-quality pain 
management care from the Department. 
(3) USE OF EXISTING PROGRAM.—In providing 
education and training described in paragraph (2), 
the Secretary shall use the Interdisciplinary Chronic 
Pain Management Training Team Program of the 
Department (or success program). 
(c) PAIN MANAGEMENT TEAMS.— 
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(1) IN GENERAL.—In carrying out the Opioid 
Safety Initiative of the Department, the director of 
each medical facility of the Department shall iden-
tify and designate a pain management team of 
health care professionals, which may include board 
certified pain medicine specialists, responsible for co-
ordinating and overseeing pain management therapy 
at such facility for patients experiencing acute and 
chronic pain that is non-cancer related. 
(2) ESTABLISHMENT OF PROTOCOLS.— 
(A) IN
GENERAL.—In consultation with 
the Directors of each Veterans Integrated Serv-
ice Network, the Secretary shall establish 
standard protocols for the designation of pain 
management teams at each medical facility 
within the Department. 
(B) CONSULTATION ON PRESCRIPTION OF 
OPIOIDS.—Each protocol established under sub-
paragraph (A) shall ensure that any health care 
provider without expertise in prescribing anal-
gesics or who has not completed the education 
and training under subsection (b), including a 
mental health care provider, does not prescribe 
opioids to a patient unless that health care pro-
vider— 
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(i) consults with a health care pro-
vider with pain management expertise or 
who is on the pain management team of 
the medical facility; and 
(ii) refers the patient to the pain man-
agement team for any subsequent prescrip-
tions and related therapy. 
(3) REPORT.— 
(A) IN GENERAL.—Not later than one year 
after the date of enactment of this Act, the di-
rector of each medical facility of the Depart-
ment shall submit to the Under Secretary for 
Health and the director of the Veterans Inte-
grated Service Network in which the medical fa-
cility is located a report identifying the health 
care professionals that have been designated as 
members of the pain management team at the 
medical facility pursuant to paragraph (1). 
(B) ELEMENTS.—Each report submitted 
under subparagraph (A) with respect to a med-
ical facility of the Department shall include— 
(i) a certification as to whether all 
members of the pain management team at 
the medical facility have completed the 
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education and training required under sub-
section (b); and 
(ii) a plan for the management and 
referral of patients to such pain manage-
ment team if health care providers without 
expertise in prescribing analgesics pre-
scribe opioid medications to treat acute 
and chronic pain that is non-cancer re-
lated. 
(d) TRACKING AND MONITORING OF OPIOID USE.— 
(1) PRESCRIPTION
DRUG
MONITORING
PRO-
GRAMS
OF
STATES.—In carrying out the Opioid 
Safety Initiative and the Opioid Therapy Risk Re-
port tool of the Department, the Secretary shall— 
(A) ensure access by health care providers 
of the Department to information on controlled 
substances, 
including 
opioids 
and 
benzodiazepines, prescribed to veterans who re-
ceive care outside the Department through the 
prescription drug monitoring program of each 
State with such a program, including by seek-
ing to enter into memoranda of understanding 
with States to allow shared access of such infor-
mation between States and the Department; 
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(B) include such information in the Opioid 
Therapy Risk Report; and 
(C) require health care providers of the 
Department to submit to the prescription drug 
monitoring program of each State information 
on prescriptions of controlled substances re-
ceived by veterans in that State under the laws 
administered by the Secretary. 
(2) REPORT ON TRACKING OF DATA ON OPIOID 
USE.—Not later than 18 months after the date of 
the enactment of this Act, the Secretary shall submit 
to the Committee on Veterans’ Affairs of the Senate 
and the Committee on Veterans’ Affairs of the 
House of Representatives a report on the feasibility 
and advisability of improving the Opioid Therapy 
Risk Report tool of the Department to allow for 
more advanced real-time tracking of and access to 
data on— 
(A) the key clinical indicators with respect 
to the totality of opioid use by veterans; 
(B) concurrent prescribing by health care 
providers of the Department of opioids in dif-
ferent health care settings, including data on 
concurrent prescribing of opioids to treat men-
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tal health disorders other than opioid use dis-
order; and 
(C) mail-order prescriptions of opioid pre-
scribed to veterans under the laws administered 
by the Secretary. 
(e) AVAILABILITY OF OPIOID RECEPTOR ANTAGO-
NISTS.— 
(1) INCREASED AVAILABILITY AND USE.— 
(A) IN
GENERAL.—The Secretary shall 
maximize the availability of opioid receptor an-
tagonists approved by the Food and Drug Ad-
ministration, including naloxone, to veterans. 
(B) AVAILABILITY, TRAINING, AND
DIS-
TRIBUTING.—In carrying out subparagraph 
(A), not later than 90 days after the date of the 
enactment of this Act, the Secretary shall— 
(i) equip each pharmacy of the De-
partment with opioid receptor antagonists 
approved by the Food and Drug Adminis-
tration to be dispensed to outpatients as 
needed; and 
(ii) expand the Overdose Education 
and Naloxone Distribution program of the 
Department to ensure that all veterans in 
receipt of health care under laws adminis-
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tered by the Secretary who are at risk of 
opioid overdose may access such opioid re-
ceptor antagonists and training on the 
proper administration of such opioid recep-
tor antagonists. 
(C) VETERANS WHO ARE AT RISK.—For 
purposes of subparagraph (B), veterans who are 
at risk of opioid overdose include— 
(i) veterans receiving long-term opioid 
therapy; 
(ii) veterans receiving opioid therapy 
who have a history of substance use dis-
order or prior instances of overdose; and 
(iii) veterans who are at risk as deter-
mined by a health care provider who is 
treating the veteran. 
(2) REPORT.—Not later than 120 days after 
the date of the enactment of this Act, the Secretary 
shall submit to the Committee on Veterans’ Affairs 
of the Senate and the Committee on Veterans’ Af-
fairs of the House of Representatives a report on 
carrying out paragraph (1), including an assessment 
of any remaining steps to be carried out by the Sec-
retary to carry out such paragraph. 
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(f) INCLUSION OF CERTAIN INFORMATION AND CA-
PABILITIES IN OPIOID THERAPY RISK REPORT TOOL OF 
THE DEPARTMENT.— 
(1) INFORMATION.—The Secretary shall include 
in the Opioid Therapy Risk Report tool of the De-
partment— 
(A) information on the most recent time 
the tool was accessed by a health care provider 
of the Department with respect to each veteran; 
and 
(B) information on the results of the most 
recent urine drug test for each veteran. 
(2) CAPABILITIES.—The Secretary shall include 
in the Opioid Therapy Risk Report tool the ability 
of the health care providers of the Department to 
determine whether a health care provider of the De-
partment prescribed opioids to a veteran without 
checking the information in the tool with respect to 
the veteran. 
(g) NOTIFICATIONS
OF RISK
IN COMPUTERIZED 
HEALTH RECORD.—The Secretary shall modify the com-
puterized patient record system of the Department to en-
sure that any health care provider that accesses the record 
of a veteran, regardless of the reason the veteran seeks 
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care from the health care provider, will be immediately no-
tified whether the veteran— 
(1) is receiving opioid therapy and has a history 
of substance use disorder or prior instances of over-
dose; 
(2) has a history of opioid abuse; or 
(3) is at risk of becoming an opioid abuser as 
determined by a health care provider who is treating 
the veteran. 
(h) DEFINITIONS.—In this section: 
(1) The term ‘‘controlled substance’’ has the 
meaning given that term in section 102 of the Con-
trolled Substances Act (21 U.S.C. 802). 
(2) The term ‘‘State’’ means each of the several 
States, territories, and possessions of the United 
States, the District of Columbia, and the Common-
wealth of Puerto Rico. 
SEC. 313. STRENGTHENING OF JOINT WORKING GROUP ON 
PAIN MANAGEMENT OF THE DEPARTMENT 
OF VETERANS AFFAIRS AND THE DEPART-
MENT OF DEFENSE. 
(a) IN GENERAL.—Not later than 90 days after the 
date of enactment of this Act, the Secretary of Veterans 
Affairs and the Secretary of Defense shall ensure that the 
Pain Management Working Group of the Health Execu-
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tive Committee of the Department of Veterans Affairs– 
Department of Defense Joint Executive Committee estab-
lished under section 320 of title 38, United States Code, 
includes a focus on the following: 
(1) The opioid prescribing practices of health 
care providers of each Department. 
(2) The ability of each Department to manage 
acute and chronic pain among individuals receiving 
health care from the Department, including training 
health care providers with respect to pain manage-
ment. 
(3) The use by each Department of complemen-
tary and integrative health and complementary alter-
native medicines in treating such individuals. 
(4) The concurrent use by health care providers 
of each Department of opioids and prescription 
drugs to treat mental health disorders, including 
benzodiazepines. 
(5) The practice by health care providers of 
each Department of prescribing opioids to treat 
mental health disorders. 
(6) The coordination in coverage of and con-
sistent access to medications prescribed for patients 
transitioning from receiving health care from the 
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Department of Defense to receiving health care from 
the Department of Veterans Affairs. 
(7) The ability of each Department to identify 
and treat substance use disorders among individuals 
receiving health care from that Department. 
(b) COORDINATION AND CONSULTATION.—The Sec-
retary of Veterans Affairs and the Secretary of Defense 
shall ensure that the working group described in sub-
section (a)— 
(1) coordinates the activities of the working 
group with other relevant working groups estab-
lished under section 320 of title 38, United States 
Code, including the working groups on evidence- 
based practice, patient safety, pharmacy, psycho-
logical health, and psychological health; 
(2) consults with other relevant Federal agen-
cies, including the Centers for Disease Control and 
Prevention, with respect to the activities of the 
working group; and 
(3) consults with the Department of Veterans 
Affairs and the Department of Defense with respect 
to, reviews, and comments on the VA/DOD Clinical 
Practice Guideline for Management of Opioid Ther-
apy for Chronic Pain, or any successor guideline, be-
fore any update to the guideline is released. 
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(c) CONSULTATIONS.—The Secretary of Veterans Af-
fairs and the Secretary of Defense shall ensure that the 
working group described in subsection (a) is able to mean-
ingfully consult with respect to the updated guideline re-
quired under subsection (a) of section 311, as required 
by subsection (b) of such section, not later than 1 year 
after the date of enactment of this Act. 
SEC. 314. REVIEW, INVESTIGATION, AND REPORT ON USE 
OF OPIOIDS IN TREATMENT BY DEPARTMENT 
OF VETERANS AFFAIRS. 
(a) COMPTROLLER GENERAL REPORT.— 
(1) IN
GENERAL.—Not later than two years 
after the date of the enactment of this Act, the 
Comptroller General of the United States shall sub-
mit to the Committee on Veterans’ Affairs of the 
Senate and the Committee on Veterans’ Affairs of 
the House of Representatives a report on the Opioid 
Safety Initiative of the Department of Veterans Af-
fairs and the opioid prescribing practices of health 
care providers of the Department. 
(2) ELEMENTS.—The report submitted under 
paragraph (1) shall include the following: 
(A) Recommendations on such improve-
ments to the Opioid Safety Initiative of the De-
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partment as the Comptroller General considers 
appropriate. 
(B) Information with respect to— 
(i) deaths resulting from sentinel 
events involving veterans prescribed opioids 
by a health care provider of the Depart-
ment; 
(ii) overall prescription rates and pre-
scriptions indications of opioids to treat 
non-cancer, non-palliative, and non-hospice 
care patients; 
(iii) the prescription rates and pre-
scriptions indications of benzodiazepines 
and opioids concomitantly by health care 
providers of the Department; 
(iv) the practice by health care pro-
viders of the Department of prescribing 
opioids to treat patients without any pain, 
including to treat patients with mental 
health disorders other than opioid use dis-
order; and 
(v) the effectiveness of opioid therapy 
for patients receiving such therapy, includ-
ing the effectiveness of long-term opioid 
therapy. 
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(C) An evaluation of processes of the De-
partment in place to oversee opioid use among 
veterans, including procedures to identify and 
remedy potential over-prescribing of opioids by 
health care providers of the Department. 
(D) An assessment of the implementation 
by the Secretary of the VA/DOD Clinical Prac-
tice Guideline for Management of Opioid Ther-
apy for Chronic Pain. 
(b) QUARTERLY PROGRESS REPORT ON IMPLEMEN-
TATION
OF
COMPTROLLER
GENERAL
RECOMMENDA-
TIONS.—Not later than two years after the date of the 
enactment of this Act, and not later than 30 days after 
the end of each quarter thereafter, the Secretary of Vet-
erans Affairs shall submit to the Committee on Veterans’ 
Affairs of the Senate and the Committee on Veterans’ Af-
fairs of the House of Representatives a progress report 
detailing the actions by the Secretary during the period 
covered by the report to address any outstanding findings 
and recommendations by the Comptroller General of the 
United States under subsection (a) with respect to the 
Veterans Health Administration. 
(c) ANNUAL REVIEW OF PRESCRIPTION RATES.— 
Not later than one year after the date of the enactment 
of this Act, and not less frequently than annually for the 
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100 
following five years, the Secretary shall submit to the 
Committee on Veterans’ Affairs of the Senate and the 
Committee on Veterans’ Affairs of the House of Rep-
resentatives a report, with respect to each medical facility 
of the Department of Veterans Affairs, to collect and re-
view information on opioids prescribed by health care pro-
viders at the facility to treat non-cancer, non-palliative, 
and non-hospice care patients that contains, for the one- 
year period preceding the submission of the report, the 
following: 
(1) The number of patients and the percentage 
of the patient population of the Department who 
were prescribed benzodiazepines and opioids concur-
rently by a health care provider of the Department. 
(2) The number of patients and the percentage 
of the patient population of the Department without 
any pain who were prescribed opioids by a health 
care provider of the Department, including those 
who were prescribed benzodiazepines and opioids 
concurrently. 
(3) The number of non-cancer, non-palliative, 
and non-hospice care patients and the percentage of 
such patients who were treated with opioids by a 
health care provider of the Department on an inpa-
tient-basis and who also received prescription opioids 
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101 
by mail from the Department while being treated on 
an inpatient-basis. 
(4) The number of non-cancer, non-palliative, 
and non-hospice care patients and the percentage of 
such patients who were prescribed opioids concur-
rently by a health care provider of the Department 
and a health care provider that is not health care 
provider of the Department. 
(5) With respect to each medical facility of the 
Department, information on opioids prescribed by 
health care providers at the facility to treat non-can-
cer, non-palliative, and non-hospice care patients, in-
cluding information on— 
(A) the prescription rate at which each 
health care provider at the facility prescribed 
benzodiazepines and opioids concurrently to 
such patients and the aggregate such prescrip-
tion rate for all health care providers at the fa-
cility; 
(B) the prescription rate at which each 
health care provider at the facility prescribed 
benzodiazepines or opioids to such patients to 
treat conditions for which benzodiazepines or 
opioids are not approved treatment and the ag-
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102 
gregate such prescription rate for all health 
care providers at the facility; 
(C) the prescription rate at which each 
health care provider at the facility prescribed or 
dispensed mail-order prescriptions of opioids to 
such patients while such patients were being 
treated with opioids on an inpatient-basis and 
the aggregate of such prescription rate for all 
health care providers at the facility; and 
(D) the prescription rate at which each 
health care provider at the facility prescribed 
opioids to such patients who were also concur-
rently prescribed opioids by a health care pro-
vider that is not a health care provider of the 
Department and the aggregate of such prescrip-
tion rates for all health care providers at the fa-
cility. 
(6) With respect to each medical facility of the 
Department, the number of times a pharmacist at 
the facility overrode a critical drug interaction warn-
ing with respect to an interaction between opioids 
and another medication before dispensing such medi-
cation to a veteran. 
(d) INVESTIGATION OF PRESCRIPTION RATES.—If 
the Secretary determines that a prescription rate with re-
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103 
spect to a health care provider or medical facility of the 
Department conflicts with or is otherwise inconsistent 
with the standards of appropriate and safe care, the Sec-
retary shall— 
(1) immediately notify the Committee on Vet-
erans’ Affairs of the Senate and the Committee on 
Veterans’ Affairs of the House of Representatives of 
such determination, including information relating to 
such determination, prescription rate, and health 
care provider or medical facility, as the case may be; 
and 
(2) through the Office of the Medical Inspector 
of the Veterans Health Administration, conduct a 
full investigation of the health care provider or med-
ical facility, as the case may be. 
(e) PRESCRIPTION RATE DEFINED.—In this section, 
the term ‘‘prescription rate’’ means, with respect to a 
health care provider or medical facility of the Department, 
each of the following: 
(1) The number of patients treated with opioids 
by the health care provider or at the medical facility, 
as the case may be, divided by the total number of 
pharmacy users of that health care provider or med-
ical facility. 
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104 
(2) The average number of morphine equiva-
lents per day prescribed by the health care provider 
or at the medical facility, as the case may be, to pa-
tients being treated with opioids. 
(3) Of the patients being treated with opioids 
by the health care provider or at the medical facility, 
as the case may be, the average number of prescrip-
tions of opioids per patient. 
Subtitle B—Patient Advocacy 
SEC. 321. COMMUNITY MEETINGS ON IMPROVING CARE 
FURNISHED BY DEPARTMENT OF VETERANS 
AFFAIRS. 
(a) COMMUNITY MEETINGS.— 
(1) MEDICAL
CENTERS.—Not later than 90 
days after the date of the enactment of this Act, and 
not less frequently than once every 90 days there-
after, the Secretary shall ensure that each medical 
facility of the Department of Veterans Affairs hosts 
a community meeting open to the public on improv-
ing health care furnished by the Secretary. 
(2) COMMUNITY
BASED
OUTPATIENT
CLIN-
ICS.—Not later than one year after the date of the 
enactment of this Act, and not less frequently than 
annually thereafter, the Secretary shall ensure that 
each community based outpatient clinic of the De-
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105 
partment hosts a community meeting open to the 
public on improving health care furnished by the 
Secretary. 
(b) ATTENDANCE BY DIRECTOR OF VETERANS INTE-
GRATED SERVICE NETWORK OR DESIGNEE.— 
(1) IN
GENERAL.—Each community meeting 
hosted by a medical facility or community based out-
patient clinic under subsection (a) shall be attended 
by the Director of the Veterans Integrated Service 
Network in which the medical facility or community 
based outpatient clinic, as the case may be, is lo-
cated. Subject to paragraph (2), the Director may 
delegate such attendance only to an employee who 
works in the Office of the Director. 
(2) ATTENDANCE BY DIRECTOR.—Each Direc-
tor of a Veterans Integrated Service Network shall 
personally attend not less than one community meet-
ing under subsection (a) hosted by each medical fa-
cility located in the Veterans Integrated Service Net-
work each year. 
(c) NOTICE.—The Secretary shall notify the Com-
mittee on Veterans’ Affairs of the Senate, the Committee 
on Veterans’ Affairs of the House of Representatives, and 
each Member of Congress (as defined in section 314) who 
represents the area in which the medical facility is located 
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106 
of a community meeting under subsection (a) by not later 
than 10 days before such community meeting occurs. 
SEC. 322. IMPROVEMENT OF AWARENESS OF PATIENT AD-
VOCACY PROGRAM AND PATIENT BILL OF 
RIGHTS OF DEPARTMENT OF VETERANS AF-
FAIRS. 
Not later than 90 days after the date of the enact-
ment of this Act, the Secretary of Veterans Affairs shall, 
in as many prominent locations as the Secretary deter-
mines appropriate to be seen by the largest percentage of 
patients and family members of patients at each medical 
facility of the Department of Veterans Affairs— 
(1) display the purposes of the Patient Advo-
cacy Program of the Department and the contact in-
formation for the patient advocate at such medical 
facility; and 
(2) display the rights and responsibilities of— 
(A) patients and family members and pa-
tients at such medical facility; and 
(B) with respect to community living cen-
ters and other residential facilities of the De-
partment, residents and family members of resi-
dents at such medical facility. 
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107 
SEC. 323. COMPTROLLER GENERAL REPORT ON PATIENT 
ADVOCACY PROGRAM OF DEPARTMENT OF 
VETERANS AFFAIRS. 
(a) IN GENERAL.—Not later than two years after the 
date of the enactment of this Act, the Comptroller General 
of the United States shall submit to the Committee on 
Veterans’ Affairs of the Senate and the Committee on Vet-
erans’ Affairs of the House of Representatives a report 
on the Patient Advocacy Program of the Department of 
Veterans Affairs (in this section referred to as the ‘‘Pro-
gram’’). 
(b) ELEMENTS.—The report required by subsection 
(a) shall include the following: 
(1) A description of the Program, including— 
(A) the purpose of the Program; 
(B) the activities carried out under the 
Program; and 
(C) the sufficiency of the Program in 
achieving the purpose of the Program. 
(2) An assessment of the sufficiency of staffing 
of employees of the Department responsible for car-
rying out the Program. 
(3) An assessment of the sufficiency of the 
training of such employees. 
(4) An assessment of— 
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(A) the awareness of the Program among 
veterans and family members of veterans; and 
(B) the use of the Program by veterans 
and family members of veterans. 
(5) Such recommendations and proposals for 
improving or modifying the Program as the Comp-
troller General considers appropriate. 
(6) Such other information with respect to the 
Program as the Comptroller General considers ap-
propriate. 
Subtitle C—Complementary and 
Integrative Health 
SEC. 331. EXPANSION OF RESEARCH AND EDUCATION ON 
AND DELIVERY OF COMPLEMENTARY AND IN-
TEGRATIVE HEALTH TO VETERANS. 
(a) ESTABLISHMENT.—There is established a com-
mission to be known as the ‘‘Creating Options for Vet-
erans’ Expedited Recovery’’ or the ‘‘COVER Commission’’ 
(in this Act referred to as the ‘‘Commission’’). The Com-
mission shall examine the evidence-based therapy treat-
ment model used by the Secretary of Veterans Affairs for 
treating mental health conditions of veterans and the po-
tential benefits of incorporating complementary alter-
native treatments available in non-Department facilities 
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(as defined in section 1701 of title 38, United States 
Code). 
(b) DUTIES.—The Commission shall perform the fol-
lowing duties: 
(1) Examine the efficacy of the evidence-based 
therapy model used by the Secretary for treating 
mental health illnesses of veterans and identify areas 
to improve wellness-based outcomes. 
(2) Conduct a patient-centered survey within 
each of the Veterans Integrated Service Networks to 
examine— 
(A) the experience of veterans with the De-
partment of Veterans Affairs when seeking 
medical assistance for mental health issues 
through the health care system of the Depart-
ment; 
(B) the experience of veterans with non- 
Department facilities and health professionals 
for treating mental health issues; 
(C) the preference of veterans regarding 
available treatment for mental health issues and 
which methods the veterans believe to be most 
effective; 
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(D) the experience, if any, of veterans with 
respect to the complementary alternative treat-
ment therapies described in paragraph (3); 
(E) the prevalence of prescribing prescrip-
tion medication among veterans seeking treat-
ment through the health care system of the De-
partment as remedies for addressing mental 
health issues; and 
(F) the outreach efforts of the Secretary 
regarding the availability of benefits and treat-
ments for veterans for addressing mental health 
issues, including by identifying ways to reduce 
barriers to gaps in such benefits and treat-
ments. 
(3) Examine available research on complemen-
tary alternative treatment therapies for mental 
health issues and identify what benefits could be 
made with the inclusion of such treatments for vet-
erans, including with respect to— 
(A) music therapy; 
(B) equine therapy; 
(C) training and caring for service dogs; 
(D) yoga therapy; 
(E) acupuncture therapy; 
(F) meditation therapy; 
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(G) outdoor sports therapy; 
(H) hyperbaric oxygen therapy; 
(I) accelerated resolution therapy; 
(J) art therapy; 
(K) magnetic resonance therapy; and 
(L) other therapies the Commission deter-
mines appropriate. 
(4) Study the sufficiency of the resources of the 
Department to ensure the delivery of quality health 
care for mental health issues among veterans seek-
ing treatment within the Department. 
(5) Study the current treatments and resources 
available within the Department and assess— 
(A) the effectiveness of such treatments 
and resources in decreasing the number of sui-
cides per day by veterans; 
(B) the number of veterans who have been 
diagnosed with mental health issues; 
(C) the percentage of veterans using the 
resources of the Department who have been di-
agnosed with mental health issues; 
(D) the percentage of veterans who have 
completed counseling sessions offered by the 
Department; and 
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(E) the efforts of the Department to ex-
pand complementary alternative treatments via-
ble to the recovery of veterans with mental 
health issues as determined by the Secretary to 
improve the effectiveness of treatments offered 
with the Department. 
(c) MEMBERSHIP.— 
(1) IN
GENERAL.—The Commission shall be 
composed of 10 members, appointed as follows: 
(A) Two members appointed by the Speak-
er of the House of Representatives, at least one 
of whom shall be a veteran. 
(B) Two members appointed by the Minor-
ity Leader of the House of Representatives, at 
least one of whom shall be a veteran. 
(C) Two members appointed by the Major-
ity Leader of the Senate, at least one of whom 
shall be a veteran. 
(D) Two members appointed by the Minor-
ity Leader of the Senate, at least one of whom 
shall be a veteran. 
(E) Two members appointed by the Presi-
dent, at least one of whom shall be a veteran. 
(2) QUALIFICATIONS.—Members of the Com-
mission shall be— 
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(A) individuals who are of recognized 
standing and distinction within the medical 
community with a background in treating men-
tal health; 
(B) individuals with experience working 
with the military and veteran population; and 
(C) individuals who do not have a financial 
interest in any of the complementary alternative 
treatments reviewed by the Commission. 
(3) CHAIRMAN.—The President shall designate 
a member of the Commission to be the Chairman. 
(4) PERIOD
OF
APPOINTMENT.—Members of 
the Commission shall be appointed for the life of the 
Commission. 
(5) VACANCY.—A vacancy in the Commission 
shall be filled in the manner in which the original 
appointment was made. 
(6) APPOINTMENT
DEADLINE.—The appoint-
ment of members of the Commission in this section 
shall be made not later than 90 days after the date 
of the enactment of this Act. 
(d) POWERS OF COMMISSION.— 
(1) MEETINGS.— 
(A) INITIAL
MEETING.—The Commission 
shall hold its first meeting not later than 30 
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days after a majority of members are appointed 
to the Commission. 
(B) MEETING.—The Commission shall reg-
ularly meet at the call of the Chairman. Such 
meetings may be carried out through the use of 
telephonic or other appropriate telecommuni-
cation technology if the Commission determines 
that such technology will allow the members to 
communicate simultaneously. 
(2) HEARINGS.—The Commission may hold 
such hearings, sit and act at such times and places, 
take such testimony, and receive evidence as the 
Commission considers advisable to carry out the re-
sponsibilities of the Commission. 
(3) INFORMATION FROM FEDERAL AGENCIES.— 
The Commission may secure directly from any de-
partment or agency of the Federal Government such 
information as the Commission considers necessary 
to carry out the duties of the Commission. 
(4) INFORMATION
FROM
NONGOVERNMENTAL 
ORGANIZATIONS.—In carrying out its duties, the 
Commission may seek guidance through consultation 
with foundations, veteran service organizations, non-
profit groups, faith-based organizations, private and 
public institutions of higher education, and other or-
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ganizations as the Commission determines appro-
priate. 
(5) COMMISSION
RECORDS.—The Commission 
shall keep an accurate and complete record of the 
actions and meeting of the Commission. Such record 
shall be made available for public inspection and the 
Comptroller General of the United States may audit 
and examine such record. 
(6) PERSONNEL
RECORDS.—The Commission 
shall keep an accurate and complete record of the 
actions and meetings of the Commission. Such 
record shall be made available for public inspection 
and the Comptroller General of the United States 
may audit and examine such records. 
(7) COMPENSATION OF MEMBERS; TRAVEL EX-
PENSES.—Each member shall serve without pay but 
shall receive travel expenses to perform the duties of 
the Commission, including per diem in lieu of sub-
stances, at rates authorized under subchapter I of 
chapter 57 of title 5, United States Code. 
(8) STAFF.—The Chairman, in accordance with 
rules agreed upon the Commission, may appoint fix 
the compensation of a staff director and such other 
personnel as may be necessary to enable the Com-
mission to carry out its functions, without regard to 
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the provisions of title 5, United States Code, gov-
erning appointments in the competitive service, with-
out regard to the provision of chapter 51 and sub-
chapter III of chapter 53 of such title relating to 
classification and General Schedule pay rates, except 
that no rate of pay fixed under this paragraph may 
exceed the equivalent of that payable for a position 
at a level IV of the Executive Schedule under section 
5316 of title 5, United States Code. 
(9) PERSONNEL AS FEDERAL EMPLOYEES.— 
(A) IN GENERAL.—The executive director 
and any personnel of the Commission are em-
ployees under section 2105 of title 5, United 
States Code, for purpose of chapters 63, 81, 83, 
84, 85, 87, 89, and 90 of such title. 
(B) MEMBERS
OF
THE
COMMISSION.— 
Subparagraph (A) shall not be construed to 
apply to members of the Commission. 
(10) CONTRACTING.—The Commission may, to 
such extent and in such amounts as are provided in 
appropriations Acts, enter into contracts to enable 
the Commission to discharge the duties of the Com-
mission under this Act. 
(11) EXPERT AND CONSULTANT SERVICE.—The 
Commission may procure the services of experts and 
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consultants in accordance with section 3109 or title 
5, United States Code, at rates not to exceed the 
daily rate paid to a person occupying a position at 
level IV of the Executive Schedule under section 
3109 of title 5, United States Code. 
(12) POSTAL SERVICE.—The Commission may 
use the United States mails in the same manner and 
under the same conditions as departments and agen-
cies of the United States. 
(13) PHYSICAL FACILITIES AND EQUIPMENT.— 
Upon the request of the Commission, the Adminis-
trator of General Services shall provide to the Com-
mission, on a reimbursable basis, the administrative 
support services necessary for the Commission to 
carry out its responsibilities under this Act. These 
administrative services may include human resource 
management, budget, leasing accounting, and payroll 
services. 
(e) REPORT.— 
(1) INTERIM REPORTS.— 
(A) IN GENERAL.—Not later than 60 days 
after the date on which the Commission first 
meets, and each 30-day period thereafter end-
ing on the date on which the Commission sub-
mits the final report under paragraph (2), the 
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Commission shall submit to the Committees on 
Veterans’ Affairs of the House of Representa-
tives and the Senate and the President a report 
detailing the level of cooperation the Secretary 
of Veterans Affairs (and the heads of other de-
partments or agencies of the Federal Govern-
ment) has provided to the Commission. 
(B) OTHER REPORTS.—In carrying out its 
duties, at times that the Commission deter-
mines appropriate, the Commission shall submit 
to the Committee on Veterans’ Affairs of the 
House of Representatives and the Senate and 
any other appropriate entities an interim report 
with respect to the findings identified by the 
Commission. 
(2) FINAL REPORT.—Not later than 18 months 
after the first meeting of the Commission, the Com-
mission shall submit to the Committee on Veterans’ 
Affairs of the House of Representatives and the Sen-
ate, the President, and the Secretary of Veterans Af-
fairs a final report on the findings of the Commis-
sion. Such report shall include the following: 
(A) Recommendations to implement in a 
feasible, timely, and cost efficient manner the 
solutions and remedies identified within the 
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findings of the Commission pursuant to sub-
section (b). 
(B) An analysis of the evidence-based ther-
apy model used by the Secretary of Veterans 
Affairs for treating veterans with mental health 
care issues, and an examination of the preva-
lence and efficacy of prescription drugs as a 
means for treatment. 
(C) The findings of the patient-centered 
survey conducted within each of the Veterans 
Integrated Service Networks pursuant to sub-
section (b)(2). 
(D) An examination of complementary al-
ternative treatments described in subsection 
(b)(3) and the potential benefits of incor-
porating such treatments in the therapy models 
used by the Secretary for treating veterans with 
mental health issues. 
(3) PLAN.—Not later than 90 days after the 
date on which the Commission submits the final re-
port under paragraph (2), the Secretary of Veterans 
Affairs shall submit to the Committee on Veterans’ 
Affairs of the House of Representatives and the Sen-
ate a report on the following: 
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(A) An action plan for implementing the 
recommendations established by the Commis-
sion on such solutions and remedies for improv-
ing wellness-based outcomes for veterans with 
mental health care issues. 
(B) A feasible timeframe on when the com-
plementary alternative treatments described in 
subsection (b)(3) can be implemented Depart-
ment-wide. 
(C) With respect to each recommendation 
established by the Commission, including any 
complementary alternative treatment, that the 
Secretary determines is not appropriate or fea-
sible to implement, a justification for such de-
termination and an alternative solution to im-
prove the efficacy of the therapy models used by 
the Secretary for treating veterans with mental 
health issues. 
(f) TERMINATION OF COMMISSION.—The Commis-
sion shall terminate 30 days after the Commission submits 
the final report under subsection (e)(2). 
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SEC. 332. PILOT PROGRAM ON INTEGRATION OF COM-
PLEMENTARY ALTERNATIVE MEDICINES AND 
RELATED ISSUES FOR VETERANS AND FAM-
ILY MEMBERS OF VETERANS. 
(a) PILOT PROGRAM.— 
(1) IN
GENERAL.—Not later than 180 days 
after the date on which the Secretary of Veterans 
Affairs receives the final report under section 
331(e), the Secretary shall commence a pilot pro-
gram to assess the feasibility and advisability of 
using wellness-based programs (as defined by the 
Secretary) to complement the provision of pain man-
agement and related health care services, including 
mental health care services, to veterans. 
(2) MATTERS ADDRESSED.—In carrying out the 
pilot program, the Secretary shall assess the fol-
lowing: 
(A) Means of improving coordination be-
tween Federal, State, local, and community pro-
viders of health care in the provision of pain 
management and related health care services to 
veterans. 
(B) Means of enhancing outreach, and co-
ordination of outreach, by and among providers 
of health care referred to in subparagraph (A) 
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on the pain management and related health 
care services available to veterans. 
(C) Means of using wellness-based pro-
grams of providers of health care referred to in 
subparagraph (A) as complements to the provi-
sion by the Department of pain management 
and related health care services to veterans. 
(D) Whether wellness-based programs de-
scribed in subparagraph (C)— 
(i) are effective in enhancing the qual-
ity of life and well-being of veterans; 
(ii) are effective in increasing the ad-
herence of veterans to the primary pain 
management and related health care serv-
ices provided such veterans by the Depart-
ment; 
(iii) have an effect on the sense of 
well-being of veterans who receive primary 
pain management and related health care 
services from the Department; and 
(iv) are effective in encouraging vet-
erans receiving health care from the De-
partment to adopt a more healthy lifestyle. 
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(b) DURATION.—The Secretary shall carry out the 
pilot program under subsection (a)(1) for a period of three 
years. 
(c) LOCATIONS.— 
(1) FACILITIES.—The Secretary shall carry out 
the pilot program under subsection (a)(1) at facili-
ties of the Department providing pain management 
and related health care services, including mental 
health care services, to veterans. In selecting such 
facilities to carry out the pilot program, the Sec-
retary shall select not fewer than 15 medical centers 
of the Department, of which not fewer than two 
shall be polytrauma rehabilitation centers of the De-
partment. 
(2) MEDICAL
CENTERS
WITH
PRESCRIPTION 
RATES
OF
OPIOIDS
THAT
CONFLICT
WITH
CARE 
STANDARDS.—In selecting the medical centers under 
paragraph (1), the Secretary shall give priority to 
medical centers of the Department at which there is 
a prescription rate of opioids that conflicts with or 
is otherwise inconsistent with the standards of ap-
propriate and safe care. 
(d) PROVISION OF SERVICES.—Under the pilot pro-
gram under subsection (a)(1), the Secretary shall provide 
covered services to covered veterans by integrating com-
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plementary and alternative medicines and integrative 
health services with other services provided by the Depart-
ment at the medical centers selected under subsection (c). 
(e) COVERED VETERANS.—For purposes of the pilot 
program under subsection (a)(1), a covered veteran is any 
veteran who— 
(1) has a mental health condition diagnosed by 
a clinician of the Department; 
(2) experiences chronic pain; 
(3) has a chronic condition being treated by a 
clinician of the Department; or 
(4) is not described in paragraph (1), (2), or 
(3) and requests to participate in the pilot program 
or is referred by a clinician of the Department who 
is treating the veteran. 
(f) COVERED SERVICES.— 
(1) IN GENERAL.—For purposes of the pilot 
program, covered services are services consisting of 
complementary and integrative health services as se-
lected by the Secretary. 
(2) ADMINISTRATION
OF
SERVICES.—Covered 
services shall be administered under the pilot pro-
gram as follows: 
(A) Covered services shall be administered 
by professionals or other instructors with ap-
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propriate training and expertise in complemen-
tary and integrative health services who are em-
ployees of the Department or with whom the 
Department enters into an agreement to pro-
vide such services. 
(B) Covered services shall be included as 
part of the Patient Aligned Care Teams initia-
tive of the Office of Patient Care Services, Pri-
mary Care Program Office, in coordination with 
the Office of Patient Centered Care and Cul-
tural Transformation. 
(C) Covered services shall be made avail-
able to— 
(i) covered veterans who have received 
conventional treatments from the Depart-
ment for the conditions for which the cov-
ered veteran seeks complementary and in-
tegrative health services under the pilot 
program; and 
(ii) covered veterans who have not re-
ceived conventional treatments from the 
Department for such conditions. 
(g) REPORTS.— 
(1) IN GENERAL.—Not later than 30 months 
after the date on which the Secretary commences the 
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pilot program under subsection (a)(1), the Secretary 
shall submit to the Committee on Veterans’ Affairs 
of the Senate and the Committee on Veterans’ Af-
fairs of the House of Representatives a report on the 
pilot program. 
(2) ELEMENTS.—The report under paragraph 
(1) shall include the following: 
(A) The findings and conclusions of the 
Secretary with respect to the pilot program 
under subsection (a)(1), including with respect 
to— 
(i) the use and efficacy of the com-
plementary and integrative health services 
established under the pilot program; 
(ii) the outreach conducted by the 
Secretary to inform veterans and commu-
nity organizations about the pilot program; 
and 
(iii) an assessment of the benefit of 
the pilot program to covered veterans in 
mental health diagnoses, pain manage-
ment, and treatment of chronic illness. 
(B) Identification of any unresolved bar-
riers that impede the ability of the Secretary to 
incorporate 
complementary 
and 
integrative 
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health services with other health care services 
provided by the Department. 
(C) Such recommendations for the continu-
ation or expansion of the pilot program as the 
Secretary considers appropriate. 
(h) COMPLEMENTARY AND INTEGRATIVE HEALTH 
DEFINED.—In this section, the term ‘‘complementary and 
integrative health’’ shall have the meaning given that term 
by the National Institutes of Health. 
Subtitle D—Fitness of Health Care 
Providers 
SEC. 341. ADDITIONAL REQUIREMENTS FOR HIRING OF 
HEALTH CARE PROVIDERS BY DEPARTMENT 
OF VETERANS AFFAIRS. 
As part of the hiring process for each health care pro-
vider considered for a position at the Department of Vet-
erans Affairs after the date of the enactment of the Act, 
the Secretary of Veterans Affairs shall require from the 
medical board of each State in which the health care pro-
vider has a medical license— 
(1) information on any violation of the require-
ments of the medical license of the health care pro-
vider during the 20-year period preceding the con-
sideration of the health care provider by the Depart-
ment; and 
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128 
(2) information on whether the health care pro-
vider has entered into any settlement agreement for 
the disciplinary charge relating to the practice of 
medicine by the health care provider. 
SEC. 342. PROVISION OF INFORMATION ON HEALTH CARE 
PROVIDERS OF DEPARTMENT OF VETERANS 
AFFAIRS TO STATE MEDICAL BOARDS. 
Notwithstanding section 552a of title 5, United 
States Code, with respect to each health care provider of 
the Department of Veterans Affairs who has violated a 
requirement of the medical license of the health care pro-
vider, the Secretary of Veterans Affairs shall provide to 
the medical board of each State in which the health care 
provider is licensed detailed information with respect to 
such violation, regardless of whether such board has for-
mally requested such information. 
SEC. 343. REPORT ON COMPLIANCE BY DEPARTMENT OF 
VETERANS 
AFFAIRS 
WITH 
REVIEWS 
OF 
HEALTH CARE PROVIDERS LEAVING THE DE-
PARTMENT OR TRANSFERRING TO OTHER 
FACILITIES. 
Not later than two years after the date of the enact-
ment of this Act, the Secretary of Veterans Affairs shall 
submit to the Committee on Veterans’ Affairs of the Sen-
ate and the Committee on Veterans’ Affairs of the House 
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129 
of Representatives a report on the compliance by the De-
partment of Veterans Affairs with the policy of the De-
partment— 
(1) to conduct a review of each health care pro-
vider of the Department who transfers to another 
medical facility of the Department, retires, or is ter-
minated to determine whether there are any con-
cerns, complaints, or allegations of violations relat-
ing to the medical practice of the health care pro-
vider; and 
(2) to take appropriate action with respect to 
any such concern, complaint, or allegation. 
Subtitle E—Other Veterans Matters 
SEC. 351. AUDIT OF VETERANS HEALTH ADMINISTRATION 
PROGRAMS OF DEPARTMENT OF VETERANS 
AFFAIRS. 
(a) AUDIT.—The Secretary of Veterans Affairs shall 
seek to enter into a contract with a nongovernmental enti-
ty under which the entity shall conduct a audits of the 
programs of the Veterans Health Administration of the 
Department of Veterans Affairs to identify ways to im-
prove the furnishing of benefits and health care adminis-
tered by the Veterans Health Administration to veterans 
and families of veterans. 
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(b) AUDIT REQUIREMENTS.—In carrying out each 
audit under subsection (a), the entity shall perform the 
following: 
(1) Five-year risk assessments to identify the 
functions, staff organizations, and staff offices of the 
Veterans Health Administration that would lead to-
wards the greatest improvement in furnishing of 
benefits and health care to veterans and families of 
veterans. 
(2) Development of plans that are informed by 
the risk assessment under paragraph (1) to conduct 
audits of the functions, staff organizations, and staff 
offices identified under paragraph (1). 
(3) Conduct audits in accordance with the plans 
developed pursuant to paragraph (2). 
(c) REPORTS.—Not later than 90 days after the date 
on which each audit is completed under subsection (a), 
the Secretary shall submit to the Committees on Veterans’ 
Affairs of the House of Representatives and the Senate 
a report that includes— 
(1) a summary of the audit; 
(2) the findings of the entity that conducted the 
audit with respect to the audit; and 
(3) such recommendations as the Secretary de-
termines appropriate for legislative or administrative 
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131 
action to improve the furnishing of benefits and 
health care to veterans and families of veterans. 
TITLE 
IV—IMPROVING 
SAFE 
CARE FOR PREVENTING IN-
FANT ABUSE AND NEGLECT 
SEC. 401. SHORT TITLE. 
This title may be cited as the ‘‘Improving Safe Care 
for the Prevention of Infant Abuse and Neglect Act’’. 
SEC. 402. BEST PRACTICES FOR DEVELOPMENT OF PLANS 
OF SAFE CARE. 
Section 103(b) of the Child Abuse Prevention and 
Treatment Act (42 U.S.C. 5104(b)) is amended— 
(1) by redesignating paragraphs (5) through 
(8) as paragraphs (6) through (9), respectively; and 
(2) by inserting after paragraph (4), the fol-
lowing: 
‘‘(5) maintain and disseminate information 
about the best practices relating to the development 
of plans of safe care as described in section 
106(b)(2)(B)(iii) for infants born and identified as 
being affected by illegal substance abuse or with-
drawal symptoms, or a Fetal Alcohol Spectrum Dis-
order;’’. 
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SEC. 403. STATE PLANS. 
Section 106(b)(2)(B)(iii) of the Child Abuse Preven-
tion and Treatment Act (42 U.S.C. 5106a(b)(2)(B)(iii)) 
is amended by inserting before the period at the end the 
following: ‘‘to ensure the safety and well-being of such in-
fant following release from the care of healthcare pro-
viders, including through addressing the health of the af-
fected family or caregiver’’. 
SEC. 404. DATA REPORTS. 
(a) IN GENERAL.—Section 106(d) of the Child Abuse 
Prevention and Treatment Act (42 U.S.C. 5106a(d)) is 
amended by adding at the end of the following: 
‘‘(17) The total number of infants— 
‘‘(A) 
identified 
under 
subsection 
(b)(2)(B)(ii); 
‘‘(B) for whom a plan of safe care was de-
veloped under subsection (b)(2)(B)(iii); and 
‘‘(C) for whom referrals are made for ap-
propriate services, including services for the af-
fected family or caregiver, as may be necessary 
under subsection (b)(2)(B)(iii).’’. 
(b) REDESIGNATION.—Effective on May 29, 2017, 
section 106(d) of the Child Abuse Prevention and Treat-
ment Act (42 U.S.C. 5106a(d)) is amended by redesig-
nating paragraph (17) (as added by subsection (a)) as 
paragraph (18). 
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SEC. 405. MONITORING AND OVERSIGHT. 
(a) AMENDMENT.—Title I of the Child Abuse Preven-
tion and Treatment Act (42 U.S.C. 5101 et seq.) is fur-
ther amended by adding at the end the following: 
‘‘SEC. 114. MONITORING AND OVERSIGHT. 
‘‘The Secretary shall conduct monitoring to ensure 
that each State that receives a grant under section 106 
is in compliance with the requirements of section 106(b), 
which— 
‘‘(1) shall— 
‘‘(A) be in addition to the review of the 
State plan upon its submission under section 
106(b)(1)(A); and 
‘‘(B) include monitoring of State policies 
and procedures required under clauses (ii) and 
(iii) of section 106(b)(2)(B); and 
‘‘(2) may include— 
‘‘(A) a comparison of activities carried out 
by the State to comply with the requirements of 
section 106(b) with the State plan most re-
cently approved under section 432 of the Social 
Security Act; 
‘‘(B) information available on the Website 
of the State relating to its compliance with the 
requirements of section 106(b); 
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‘‘(C) site visits, as may be necessary to 
carry out such monitoring; and 
‘‘(D) information available in the State’s 
Annual Progress and Services Report most re-
cently submitted under section 1357.16 of title 
45, Code of Federal Regulations (or successor 
regulations).’’. 
(b) TABLE OF CONTENTS.—The table of contents in 
section 1(b) of the Child Abuse Prevention and Treatment 
Act (42 U.S.C. 5101 note) is amended by inserting after 
the item relating to section 113, the following: 
‘‘Sec. 114. Monitoring and oversight.’’. 
SEC. 406. RULE OF CONSTRUCTION. 
Nothing in this Act shall be construed to authorize 
the Secretary of Health and Human Services or any other 
officer of the Federal Government to add new require-
ments to section 106(b) of the Child Abuse Prevention and 
Treatment Act (42 U.S.C. 5106a(b)), as amended by this 
Act. 
TITLE V—OTHER PROVISIONS 
SEC. 501. PROGRAMS TO PREVENT PRESCRIPTION DRUG 
ABUSE UNDER MEDICARE PARTS C AND D. 
(a) DRUG MANAGEMENT PROGRAM
FOR AT-RISK 
BENEFICIARIES.— 
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(1) IN GENERAL.—Section 1860D–4(c) of the 
Social Security Act (42 U.S.C. 1395w–10(c)) is 
amended by adding at the end the following: 
‘‘(5) DRUG MANAGEMENT PROGRAM FOR AT- 
RISK BENEFICIARIES.— 
‘‘(A) AUTHORITY TO ESTABLISH.—A PDP 
sponsor may establish a drug management pro-
gram for at-risk beneficiaries under which, sub-
ject to subparagraph (B), the PDP sponsor 
may, in the case of an at-risk beneficiary for 
prescription drug abuse who is an enrollee in a 
prescription drug plan of such PDP sponsor, 
limit such beneficiary’s access to coverage for 
frequently abused drugs under such plan to fre-
quently abused drugs that are prescribed for 
such beneficiary by one or more prescribers se-
lected under subparagraph (D), and dispensed 
for such beneficiary by one or more pharmacies 
selected under such subparagraph. 
‘‘(B) REQUIREMENT FOR NOTICES.— 
‘‘(i) IN
GENERAL.—A PDP sponsor 
may not limit the access of an at-risk ben-
eficiary for prescription drug abuse to cov-
erage for frequently abused drugs under a 
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prescription drug plan until such spon-
sor— 
‘‘(I) provides to the beneficiary 
an initial notice described in clause 
(ii) and a second notice described in 
clause (iii); and 
‘‘(II) verifies with the providers 
of the beneficiary that the beneficiary 
is an at-risk beneficiary for prescrip-
tion drug abuse. 
‘‘(ii) INITIAL NOTICE.—An initial no-
tice described in this clause is a notice that 
provides to the beneficiary— 
‘‘(I) notice that the PDP sponsor 
has identified the beneficiary as po-
tentially being an at-risk beneficiary 
for prescription drug abuse; 
‘‘(II) information describing all 
State and Federal public health re-
sources that are designed to address 
prescription drug abuse to which the 
beneficiary has access, including men-
tal health services and other coun-
seling services; 
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‘‘(III) notice of, and information 
about, the right of the beneficiary to 
appeal such identification under sub-
section (h) and the option of an auto-
matic escalation to external review; 
‘‘(IV) a request for the bene-
ficiary to submit to the PDP sponsor 
preferences for which prescribers and 
pharmacies the beneficiary would pre-
fer the PDP sponsor to select under 
subparagraph (D) in the case that the 
beneficiary is identified as an at-risk 
beneficiary 
for 
prescription 
drug 
abuse as described in clause (iii)(I); 
‘‘(V) an explanation of the mean-
ing and consequences of the identi-
fication of the beneficiary as poten-
tially being an at-risk beneficiary for 
prescription drug abuse, including an 
explanation of the drug management 
program established by the PDP 
sponsor pursuant to subparagraph 
(A); 
‘‘(VI) clear instructions that ex-
plain how the beneficiary can contact 
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the PDP sponsor in order to submit 
to the PDP sponsor the preferences 
described in subclause (IV) and any 
other communications relating to the 
drug management program for at-risk 
beneficiaries established by the PDP 
sponsor; and 
‘‘(VII) contact information for 
other organizations that can provide 
the beneficiary with assistance regard-
ing such drug management program 
(similar to the information provided 
by the Secretary in other standardized 
notices provided to part D eligible in-
dividuals enrolled in prescription drug 
plans under this part). 
‘‘(iii) SECOND NOTICE.—A second no-
tice described in this clause is a notice that 
provides to the beneficiary notice— 
‘‘(I) that the PDP sponsor has 
identified the beneficiary as an at-risk 
beneficiary 
for 
prescription 
drug 
abuse; 
‘‘(II) that such beneficiary is 
subject to the requirements of the 
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drug management program for at-risk 
beneficiaries established by such PDP 
sponsor for such plan; 
‘‘(III) of the prescriber (or pre-
scribers) and pharmacy (or phar-
macies) selected for such individual 
under subparagraph (D); 
‘‘(IV) of, and information about, 
the beneficiary’s right to appeal such 
identification under subsection (h) 
and the option of an automatic esca-
lation to external review; 
‘‘(V) that the beneficiary can, in 
the case that the beneficiary has not 
previously submitted to the PDP 
sponsor preferences for which pre-
scribers and pharmacies the bene-
ficiary would prefer the PDP sponsor 
select under subparagraph (D), sub-
mit such preferences to the PDP 
sponsor; and 
‘‘(VI) that includes clear instruc-
tions that explain how the beneficiary 
can contact the PDP sponsor. 
‘‘(iv) TIMING OF NOTICES.— 
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‘‘(I) IN
GENERAL.—Subject to 
subclause (II), a second notice de-
scribed in clause (iii) shall be provided 
to the beneficiary on a date that is 
not less than 60 days after an initial 
notice described in clause (ii) is pro-
vided to the beneficiary. 
‘‘(II) EXCEPTION.—In the case 
that the PDP sponsor, in conjunction 
with the Secretary, determines that 
concerns 
identified 
through 
rule-
making by the Secretary regarding 
the health or safety of the beneficiary 
or regarding significant drug diversion 
activities require the PDP sponsor to 
provide a second notice described in 
clause (iii) to the beneficiary on a 
date that is earlier than the date de-
scribed in subclause (I), the PDP 
sponsor may provide such second no-
tice on such earlier date. 
‘‘(C) AT-RISK
BENEFICIARY
FOR
PRE-
SCRIPTION DRUG ABUSE.— 
‘‘(i) IN
GENERAL.—For purposes of 
this paragraph, the term ‘at-risk bene-
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141 
ficiary for prescription drug abuse’ means 
a part D eligible individual who is not an 
exempted individual described in clause (ii) 
and— 
‘‘(I) who is identified as such an 
at-risk beneficiary through the use of 
clinical guidelines developed by the 
Secretary in consultation with PDP 
sponsors and other stakeholders de-
scribed in section 3141(f)(2)(A) of the 
21st Century Cures Act; or 
‘‘(II) with respect to whom the 
PDP sponsor of a prescription drug 
plan, upon enrolling such individual in 
such plan, received notice from the 
Secretary that such individual was 
identified under this paragraph to be 
an at-risk beneficiary for prescription 
drug abuse under the prescription 
drug plan in which such individual 
was most recently previously enrolled 
and such identification has not been 
terminated under subparagraph (F). 
‘‘(ii) 
EXEMPTED
INDIVIDUAL
DE-
SCRIBED.—An exempted individual de-
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scribed in this clause is an individual 
who— 
‘‘(I) receives hospice care under 
this title; 
‘‘(II) is a resident of a long-term 
care facility, of an intermediate care 
facility for the mentally retarded, or 
of another facility for which fre-
quently abused drugs are dispensed 
for residents through a contract with 
a single pharmacy; or 
‘‘(III) the Secretary elects to 
treat as an exempted individual for 
purposes of clause (i). 
‘‘(D) SELECTION
OF
PRESCRIBERS
AND 
PHARMACIES.— 
‘‘(i) IN
GENERAL.—With respect to 
each at-risk beneficiary for prescription 
drug abuse enrolled in a prescription drug 
plan offered by such sponsor, a PDP spon-
sor shall, based on the preferences sub-
mitted to the PDP sponsor by the bene-
ficiary pursuant to clauses (ii)(IV) and 
(iii)(V) of subparagraph (B) (except as 
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otherwise provided in this subparagraph), 
select— 
‘‘(I) one or more individuals who 
are authorized to prescribe frequently 
abused drugs (referred to in this 
paragraph as ‘prescribers’) who may 
write prescriptions for such drugs for 
such beneficiary; and 
‘‘(II) one or more pharmacies 
that may dispense such drugs to such 
beneficiary. 
‘‘(ii) REASONABLE ACCESS.—In mak-
ing the selections under this subpara-
graph— 
‘‘(I) a PDP sponsor shall ensure 
that the beneficiary continues to have 
reasonable access to frequently abused 
drugs (as defined in subparagraph 
(G)), taking into account geographic 
location, beneficiary preference, im-
pact on cost-sharing, and reasonable 
travel time; and 
‘‘(II) a PDP sponsor shall ensure 
such access (including access to pre-
scribers and pharmacies with respect 
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to frequently abused drugs) in the 
case of individuals with multiple resi-
dences and in the case of natural dis-
asters and similar emergency situa-
tions. 
‘‘(iii) BENEFICIARY PREFERENCES.— 
If an at-risk beneficiary for prescription 
drug abuse submits preferences for which 
in-network prescribers and pharmacies the 
beneficiary would prefer the PDP sponsor 
select in response to a notice under sub-
paragraph (B), the PDP sponsor shall— 
‘‘(I) review such preferences; 
‘‘(II) select or change the selec-
tion of prescribers and pharmacies for 
the beneficiary based on such pref-
erences; and 
‘‘(III) inform the beneficiary of 
such selection or change of selection. 
‘‘(iv) EXCEPTION REGARDING BENE-
FICIARY PREFERENCES.—In the case that 
the PDP sponsor determines that a change 
to the selection of prescriber or pharmacy 
under clause (iii)(II) by the PDP sponsor 
is contributing or would contribute to pre-
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scription drug abuse or drug diversion by 
the beneficiary, the PDP sponsor may 
change the selection of prescriber or phar-
macy for the beneficiary without regard to 
the preferences of the beneficiary described 
in clause (iii). 
‘‘(v) CONFIRMATION.—Before select-
ing a prescriber (or prescribers) or phar-
macy (or pharmacies) under this subpara-
graph, a PDP sponsor must request and 
receive confirmation from such a prescriber 
or pharmacy acknowledging and accepting 
that the beneficiary involved is in the drug 
management program for at-risk bene-
ficiaries. 
‘‘(E) TERMINATIONS AND APPEALS.—The 
identification of an individual as an at-risk ben-
eficiary for prescription drug abuse under this 
paragraph, a coverage determination made 
under a drug management program for at-risk 
beneficiaries, and the selection of prescriber or 
pharmacy under subparagraph (D) with respect 
to such individual shall be subject to reconsider-
ation and appeal under subsection (h) and the 
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option of an automatic escalation to external re-
view to the extent provided by the Secretary. 
‘‘(F) TERMINATION OF IDENTIFICATION.— 
‘‘(i) IN
GENERAL.—The Secretary 
shall develop standards for the termination 
of identification of an individual as an at- 
risk beneficiary for prescription drug abuse 
under this paragraph. Under such stand-
ards such identification shall terminate as 
of the earlier of— 
‘‘(I) the date the individual dem-
onstrates that the individual is no 
longer likely, in the absence of the re-
strictions under this paragraph, to be 
an at-risk beneficiary for prescription 
drug abuse described in subparagraph 
(C)(i); and 
‘‘(II) the end of such maximum 
period of identification as the Sec-
retary may specify. 
‘‘(ii) 
RULE
OF
CONSTRUCTION.— 
Nothing in clause (i) shall be construed as 
preventing a plan from identifying an indi-
vidual as an at-risk beneficiary for pre-
scription drug abuse under subparagraph 
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147 
(C)(i) after such termination on the basis 
of additional information on drug use oc-
curring after the date of notice of such ter-
mination. 
‘‘(G) FREQUENTLY
ABUSED
DRUG.—For 
purposes of this subsection, the term ‘frequently 
abused drug’ means a drug that is a controlled 
substance that the Secretary determines to be 
frequently abused or diverted. 
‘‘(H) DATA DISCLOSURE.—In the case of 
an at-risk beneficiary for prescription drug 
abuse whose access to coverage for frequently 
abused drugs under a prescription drug plan 
has been limited by a PDP sponsor under this 
paragraph, such PDP sponsor shall disclose 
data, including any necessary individually iden-
tifiable health information, in a form and man-
ner specified by the Secretary, about the deci-
sion to impose such limitations and the limita-
tions imposed by the sponsor under this part to 
other PDP sponsors that request such data. 
‘‘(I) EDUCATION.—The Secretary shall 
provide education to enrollees in prescription 
drug plans of PDP sponsors and providers re-
garding the drug management program for at- 
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risk beneficiaries described in this paragraph, 
including education— 
‘‘(i) provided by Medicare administra-
tive contractors through the improper pay-
ment outreach and education program de-
scribed in section 1874A(h); and 
‘‘(ii) through current education efforts 
(such as State health insurance assistance 
programs described in subsection (a)(1)(A) 
of section 119 of the Medicare Improve-
ments for Patients and Providers Act of 
2008 (42 U.S.C. 1395b–3 note)) and ma-
terials directed toward such enrollees. 
‘‘(J) 
APPLICATION
UNDER
MA–PD 
PLANS.—Pursuant to section 1860D–21(c)(1), 
the provisions of this paragraph apply under 
part D to MA organizations offering MA–PD 
plans to MA eligible individuals in the same 
manner as such provisions apply under this 
part to a PDP sponsor offering a prescription 
drug plan to a part D eligible individual.’’. 
(2) INFORMATION
FOR
CONSUMERS.—Section 
1860D–4(a)(1)(B) of the Social Security Act (42 
U.S.C. 1395w–104(a)(1)(B)) is amended by adding 
at the end the following: 
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‘‘(v) The drug management program 
for at-risk beneficiaries under subsection 
(c)(5).’’. 
(b) UTILIZATION MANAGEMENT PROGRAMS.—Sec-
tion 1860D–4(c) of the Social Security Act (42 U.S.C. 
1395w–104(c)), as amended by subsection (a)(1), is fur-
ther amended— 
(1) in paragraph (1), by inserting after sub-
paragraph (D) the following new subparagraph: 
‘‘(E) A utilization management tool to pre-
vent drug abuse (as described in paragraph 
(6)(A)).’’; and 
(2) by adding at the end the following new 
paragraph: 
‘‘(6) UTILIZATION MANAGEMENT TOOL TO PRE-
VENT DRUG ABUSE.— 
‘‘(A) IN
GENERAL.—A tool described in 
this paragraph is any of the following: 
‘‘(i) A utilization tool designed to pre-
vent the abuse of frequently abused drugs 
by individuals and to prevent the diversion 
of such drugs at pharmacies. 
‘‘(ii) Retrospective utilization review 
to identify— 
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‘‘(I) individuals that receive fre-
quently abused drugs at a frequency 
or in amounts that are not clinically 
appropriate; and 
‘‘(II) providers of services or sup-
pliers that may facilitate the abuse or 
diversion of frequently abused drugs 
by beneficiaries. 
‘‘(iii) Consultation with the contractor 
described in subparagraph (B) to verify if 
an individual enrolling in a prescription 
drug plan offered by a PDP sponsor has 
been previously identified by another PDP 
sponsor as an individual described in 
clause (ii)(I). 
‘‘(B) REPORTING.—A PDP sponsor offer-
ing a prescription drug plan (and an MA orga-
nization offering an MA–PD plan) in a State 
shall submit to the Secretary and the Medicare 
drug integrity contractor with which the Sec-
retary has entered into a contract under section 
1893 with respect to such State a report, on a 
monthly basis, containing information on— 
‘‘(i) any provider of services or sup-
plier described in subparagraph (A)(ii)(II) 
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151 
that is identified by such plan sponsor (or 
organization) during the 30-day period be-
fore such report is submitted; and 
‘‘(ii) 
the 
name 
and 
prescription 
records of individuals described in para-
graph (5)(C).’’. 
(c) EXPANDING ACTIVITIES OF MEDICARE DRUG IN-
TEGRITY CONTRACTORS (MEDICS).— 
(1) IN GENERAL.—Section 1893 of the Social 
Security Act (42 U.S.C. 1395ddd) is amended by 
adding at the end the following new subsection: 
‘‘(j) EXPANDING ACTIVITIES OF MEDICARE DRUG 
INTEGRITY CONTRACTORS (MEDICS).— 
‘‘(1) ACCESS
TO
INFORMATION.—Under con-
tracts entered into under this section with Medicare 
drug integrity contractors (including any successor 
entity to a Medicare drug integrity contractor), the 
Secretary shall authorize such contractors to directly 
accept prescription and necessary medical records 
from entities such as pharmacies, prescription drug 
plans, MA–PD plans, and physicians with respect to 
an individual in order for such contractors to pro-
vide information relevant to the determination of 
whether such individual is an at-risk beneficiary for 
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prescription drug abuse, as defined in section 
1860D–4(c)(5)(C). 
‘‘(2) REQUIREMENT
FOR
ACKNOWLEDGMENT 
OF REFERRALS.—If a PDP sponsor or MA organiza-
tion refers information to a contractor described in 
paragraph (1) in order for such contractor to assist 
in the determination described in such paragraph, 
the contractor shall— 
‘‘(A) acknowledge to the sponsor or organi-
zation receipt of the referral; and 
‘‘(B) in the case that any PDP sponsor or 
MA organization contacts the contractor re-
questing to know the determination by the con-
tractor of whether or not an individual has been 
determined to be an individual described such 
paragraph, shall inform such sponsor or organi-
zation of such determination on a date that is 
not later than 15 days after the date on which 
the sponsor or organization contacts the con-
tractor. 
‘‘(3) MAKING DATA AVAILABLE TO OTHER EN-
TITIES.— 
‘‘(A) IN GENERAL.—For purposes of car-
rying out this subsection, subject to subpara-
graph (B), the Secretary shall authorize MED-
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ICs to respond to requests for information from 
PDP sponsors and MA organizations, State 
prescription drug monitoring programs, and 
other entities delegated by such sponsors or or-
ganizations using available programs and sys-
tems in the effort to prevent fraud, waste, and 
abuse. 
‘‘(B) HIPAA COMPLIANT
INFORMATION 
ONLY.—Information may only be disclosed by a 
MEDIC under subparagraph (A) if the disclo-
sure of such information is permitted under the 
Federal regulations (concerning the privacy of 
individually identifiable health information) pro-
mulgated under section 264(c) of the Health 
Insurance Portability and Accountability Act of 
1996 (42 U.S.C. 1320d–2 note).’’. 
(2) OIG STUDY AND REPORT ON EFFECTIVE-
NESS OF MEDICS.— 
(A) STUDY.—The Inspector General of the 
Department of Health and Human Services 
shall conduct a study on the effectiveness of 
Medicare drug integrity contractors with which 
the Secretary of Health and Human Services 
has entered into a contract under section 1893 
of the Social Security Act (42 U.S.C. 1395ddd) 
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in identifying, combating, and preventing fraud 
under the Medicare Program, including under 
the authority provided under section 1893(j) of 
the Social Security Act, added by paragraph 
(1). 
(B) REPORT.—Not later than 1 year after 
the date of the enactment of this Act, the In-
spector General shall submit to Congress a re-
port on the study conducted under subpara-
graph (A). Such report shall include such rec-
ommendations for improvements in the effec-
tiveness of such contractors as the Inspector 
General determines appropriate. 
(d) TREATMENT OF CERTAIN COMPLAINTS FOR PUR-
POSES OF QUALITY OR PERFORMANCE ASSESSMENT.— 
Section 1860D–42 of the Social Security Act (42 U.S.C. 
1395w–152) is amended by adding at the end the fol-
lowing new subsection: 
‘‘(d) TREATMENT
OF CERTAIN COMPLAINTS
FOR 
PURPOSES
OF
QUALITY
OR
PERFORMANCE
ASSESS-
MENT.—In conducting a quality or performance assess-
ment of a PDP sponsor, the Secretary shall develop or 
utilize existing screening methods for reviewing and con-
sidering complaints that are received from enrollees in a 
prescription drug plan offered by such PDP sponsor and 
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that are complaints regarding the lack of access by the 
individual to prescription drugs due to a drug manage-
ment program for at-risk beneficiaries.’’. 
(e) SENSE OF CONGRESS REGARDING USE OF TECH-
NOLOGY TOOLS TO COMBAT FRAUD.—It is the sense of 
Congress that MA organizations and PDP sponsors 
should consider using e-prescribing and other health infor-
mation technology tools to support combating fraud under 
MA–PD plans and prescription drug plans under parts C 
and D of the Medicare Program. 
(f) EFFECTIVE DATE.— 
(1) IN GENERAL.—The amendments made by 
this section shall apply to prescription drug plans 
(and MA–PD plans) for plan years beginning more 
than 1 year after the date of the enactment of this 
Act. 
(2) STAKEHOLDER MEETINGS PRIOR TO EFFEC-
TIVE DATE.— 
(A) IN GENERAL.—Not later than January 
1, 2016, the Secretary of Health and Human 
Services shall convene stakeholders, including 
individuals entitled to benefits under part A of 
title XVIII of the Social Security Act or en-
rolled under part B of such title of such Act, 
advocacy groups representing such individuals, 
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