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dress substance use addiction and narcotics traf-
ficking.’’. 
SEC. 3309. PROTECTING LAW ENFORCEMENT OFFICERS 
FROM ACCIDENTAL EXPOSURE. 
Section 707 of the Office of National Drug Control Pol-
icy Reauthorization Act of 1998 (21 U.S.C. 1706), as 
amended by section 3308, is amended by adding at the end 
the following: 
‘‘(s) SUPPLEMENTAL GRANTS.—The Director is au-
thorized to use not more than $10,000,000 of the amounts 
otherwise appropriated to carry out this section to provide 
supplemental competitive grants to high intensity drug 
trafficking areas that have experienced high seizures of 
fentanyl and new psychoactive substances for the purposes 
of— 
‘‘(1) purchasing portable equipment to test for 
fentanyl and other substances; 
‘‘(2) training law enforcement officers and other 
first responders on best practices for handling 
fentanyl and other substances; and 
‘‘(3) purchasing protective equipment, including 
overdose reversal drugs.’’.
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SEC. 3310. COPS ANTI-METH PROGRAM. 
Section 1701 of title I of the Omnibus Crime Control 
and Safe Streets Act of 1968 (34 U.S.C. 10381) is amend-
ed— 
(1) by redesignating subsection (k) as subsection 
(l); and 
(2) by inserting after subsection (j) the following: 
‘‘(k) COPS ANTI-METH PROGRAM.—The Attorney 
General shall use amounts otherwise appropriated to carry 
out this section to make competitive grants, in amounts of 
not less than $1,000,000 for a fiscal year, to State law en-
forcement agencies with high seizures of precursor chemi-
cals, finished methamphetamine, laboratories, and labora-
tory dump seizures for the purpose of locating or inves-
tigating illicit activities, such as precursor diversion, lab-
oratories, or methamphetamine traffickers.’’. 
SEC. 3311. COPS ANTI-HEROIN TASK FORCE PROGRAM. 
Section 1701 of title I of the Omnibus Crime Control 
and Safe Streets Act of 1968 (34 U.S.C. 10381) is amend-
ed— 
(1) by redesignating subsection (l), as so redesig-
nated by section 3310, as subsection (m); and 
(2) by inserting after subsection (k), as added by 
section 3310, the following: 
‘‘(l) COPS ANTI-HEROIN TASK FORCE PROGRAM.—The 
Attorney General shall use amounts otherwise appropriated
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to carry out this section, or other amounts as appropriated, 
to make competitive grants to State law enforcement agen-
cies in States with high per capita rates of primary treat-
ment admissions, for the purpose of locating or inves-
tigating illicit activities, through Statewide collaboration, 
relating to the distribution of heroin, fentanyl, or 
carfentanil or relating to the unlawful distribution of pre-
scription opioids.’’. 
SEC. 3312. COMPREHENSIVE ADDICTION AND RECOVERY 
ACT EDUCATION AND AWARENESS. 
Title VII of the Comprehensive Addiction and Recov-
ery Act of 2016 (Public Law 114–198; 130 Stat. 735) is 
amended by adding at the end the following: 
‘‘SEC. 709. SERVICES FOR FAMILIES AND PATIENTS IN CRI-
SIS. 
‘‘(a) IN GENERAL.—The Attorney General may make 
grants to entities that focus on addiction and substance use 
disorders and specialize in family and patient services, ad-
vocacy for patients and families, and educational informa-
tion. 
‘‘(b) ALLOWABLE USES.—A grant awarded under this 
section may be used for private, nonprofit national organi-
zations that engage in all of the following activities: 
‘‘(1) Expansion of phone line or call center serv-
ices with professional, clinical staff that provide, for
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families and individuals impacted by a substance use 
disorder, support, access to treatment resources, brief 
assessments, medication and overdose prevention edu-
cation, compassionate listening services, recovery sup-
port or peer specialists, bereavement and grief sup-
port, and case management. 
‘‘(2) Continued development of health informa-
tion technology systems that leverage new and upcom-
ing technology and techniques for prevention, inter-
vention, and filling resource gaps in communities 
that are underserved. 
‘‘(3) Enhancement and operation of treatment 
and recovery resources, easy-to-read scientific and evi-
dence-based education on addiction and substance use 
disorders, and other informational tools for families 
and individuals impacted by a substance use disorder 
and community stakeholders, such as law enforcement 
agencies. 
‘‘(4) Provision of training and technical assist-
ance to State and local governments, law enforcement 
agencies, health care systems, research institutions, 
and other stakeholders. 
‘‘(5) Expanding upon and implementing edu-
cational information using evidence-based informa-
tion on substance use disorders.
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‘‘(6) Expansion of training of community stake-
holders, law enforcement officers, and families across 
a broad-range of addiction, health, and related topics 
on substance use disorders, local issues and commu-
nity-specific issues related to the drug epidemic. 
‘‘(7) Program evaluation. 
‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—For each 
of fiscal years 2018 through 2022, the Attorney General is 
authorized to award not more than $10,000,000 of amounts 
otherwise appropriated to the Attorney General for com-
prehensive opioid abuse reduction activities for purposes of 
carrying out this section.’’. 
SEC. 3313. PROTECTING CHILDREN WITH ADDICTED PAR-
ENTS. 
Part D of title V of the Public Health Service Act (42 
U.S.C. 290dd et seq.) is amended by adding at the end the 
following: 
‘‘SEC. 550. PROTECTING CHILDREN WITH ADDICTED PAR-
ENTS. 
‘‘(a) 
BEST
PRACTICES.—The 
Secretary, 
acting 
through the Assistant Secretary and in cooperation with the 
Commissioner of the Administration on Children, Youth 
and Families, shall collect and disseminate best practices 
for States regarding interventions and strategies to keep
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families affected by a substance use disorder together, when 
it can be done safely. Such best practices shall— 
‘‘(1) utilize comprehensive family-centered ap-
proaches; 
‘‘(2) ensure that families have access to drug 
screening, substance use disorder treatment, medica-
tion-assisted treatment approved by the Food and 
Drug Administration, and parental support; and 
‘‘(3) build upon lessons learned from— 
‘‘(A) programs such as the maternal, infant, 
and early childhood home visiting program 
under section 511 of the Social Security Act; and 
‘‘(B) identifying substance abuse prevention 
and treatment services that meet the require-
ments for promising, supported, or well-sup-
ported practices specified in section 471(e)(4)(C) 
of the Social Security Act (as such section shall 
be in effect beginning on October 1, 2018). 
‘‘(b) GRANT PROGRAM.—The Secretary shall award 
grants to States, units of local government, and tribal gov-
ernments to— 
‘‘(1) develop programs and models designed to 
keep pregnant and post-partum women who have a 
substance use disorder together with their newborns, 
including programs and models that provide for
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screenings of pregnant and post-partum women for 
substance use disorders, treatment interventions, sup-
portive housing, nonpharmacological interventions for 
children born with neonatal abstinence syndrome, 
medication assisted treatment, and other recovery 
supports; and 
‘‘(2) support the attendance of children who have 
a family member living with a substance use disorder 
at therapeutic camps or other therapeutic programs 
aimed at addiction prevention education and delay-
ing the onset of first use, providing trusted mentors 
and education on coping strategies that these children 
can use in their daily lives, and family support ini-
tiatives aimed at keeping these families together.’’. 
SEC. 3314. REIMBURSEMENT OF SUBSTANCE USE DISORDER 
TREATMENT PROFESSIONALS. 
Not later than January 1, 2020, the Comptroller Gen-
eral of the United States shall submit to Congress a report 
examining how substance use disorder services are reim-
bursed. 
SEC. 3315. SOBRIETY TREATMENT AND RECOVERY TEAMS 
(START). 
Title V of the Public Health Service Act (42 U.S.C. 
290dd et seq.), as amended by section 3313, is further 
amended by adding at the end the following:
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‘‘SEC. 551. SOBRIETY TREATMENT AND RECOVERY TEAMS. 
‘‘(a) IN GENERAL.—The Secretary may make grants 
to States, units of local government, or tribal governments 
to establish or expand Sobriety Treatment And Recovery 
Team (referred to in this section as ‘START’) or other simi-
lar programs to determine the effectiveness of pairing social 
workers or mentors with families that are struggling with 
a substance use disorder and child abuse or neglect in order 
to help provide peer support, intensive treatment, and child 
welfare services to such families. 
‘‘(b) ALLOWABLE USES.—A grant awarded under this 
section may be used for one or more of the following activi-
ties: 
‘‘(1) Training eligible staff, including social 
workers, social services coordinators, child welfare 
specialists, substance use disorder treatment profes-
sionals, and mentors. 
‘‘(2) Expanding access to substance use disorder 
treatment services and drug testing. 
‘‘(3) Enhancing data sharing with law enforce-
ment agencies, child welfare agencies, substance use 
disorder treatment providers, judges, and court per-
sonnel. 
‘‘(4) Program evaluation and technical assist-
ance.
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‘‘(c) PROGRAM REQUIREMENTS.—A State, unit of 
local government, or tribal government receiving a grant 
under this section shall— 
‘‘(1) serve only families for which— 
‘‘(A) there is an open record with the child 
welfare agency; and 
‘‘(B) substance use disorder was a reason 
for the record or finding described in paragraph 
(1); and 
‘‘(2) coordinate any grants awarded under this 
section with any grant awarded under section 437(f) 
of the Social Security Act focused on improving out-
comes for children affected by substance abuse. 
‘‘(d) TECHNICAL ASSISTANCE.—The Secretary may re-
serve not more than 5 percent of funds provided under this 
section to provide technical assistance on the establishment 
or expansion of programs funded under this section from 
the National Center on Substance Abuse and Child Welfare. 
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—For each 
of fiscal years 2018 through 2022, the Secretary is author-
ized to award not more than $10,000,000 of amounts other-
wise appropriated to the Secretary for comprehensive opioid 
abuse reduction activities for purposes of carrying out this 
section.’’.
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SEC. 3316. PROVIDER EDUCATION. 
Not later than 60 days after the date of enactment of 
this Act, the Attorney General, in consultation with the Sec-
retary of Health and Human Services, shall complete the 
plan related to medical registration coordination required 
by Senate Report 114–239, which accompanied the Veterans 
Care Financial Protection Act of 2017 (Public Law 115– 
131; 132 Stat. 334). 
SEC. 3317. DEMAND REDUCTION. 
Section 702(1) of the Office of National Drug Control 
Policy Reauthorization Act of 1998 (21 U.S.C. 1701(1)) is 
amended— 
(1) by redesignating subparagraphs (F) through 
(J) as subparagraphs (G) through (K), respectively; 
and 
(2) by inserting after subparagraph (E) the fol-
lowing: 
‘‘(F) support for long-term recovery from 
substance use disorders;’’. 
SEC. 3318. ANTI-DRUG MEDIA CAMPAIGN. 
Section 709 of the Office of National Drug Control Pol-
icy Reauthorization Act of 1998 (21 U.S.C. 1708) is amend-
ed— 
(1) 
in 
the 
section 
heading, 
by 
striking 
‘‘YOUTH’’; 
(2) in subsection (a)—
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(A) in the matter preceding paragraph (1), 
by striking ‘‘youth’’; 
(B) in paragraph (1), by striking ‘‘young’’; 
(C) in paragraph (2), by striking ‘‘of adults 
of the impact of drug abuse on young people’’ 
and inserting ‘‘among the population about the 
impact of drug abuse’’; and 
(D) in paragraph (3), by striking ‘‘parents 
and other interested adults to discuss with young 
people’’ and inserting ‘‘interested persons to dis-
cuss’’; and 
(3) in subsection (b)(2)(C)(ii), by striking 
‘‘among youth’’. 
SEC. 3319. TECHNICAL CORRECTIONS TO THE OFFICE OF 
NATIONAL DRUG CONTROL POLICY REAU-
THORIZATION ACT OF 1998. 
The Office of National Drug Control Policy Reauthor-
ization Act of 1998 (21 U.S.C. 1701 et seq.) is amended— 
(1) 
in 
section 
703(b)(3)(E) 
(21 
U.S.C. 
1702(b)(3)(E))— 
(A) in clause (i), by adding ‘‘and’’ at the 
end; 
(B) in clause (ii), by striking ‘‘; and’’ and 
inserting a period; and 
(C) by striking clause (iii);
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(2) in section 704 (21 U.S.C. 1703)— 
(A) in subsection (c)(3)(C)— 
(i) in clause (v), by adding ‘‘and’’ at 
the end; 
(ii) in clause (vi), by striking ‘‘; and’’ 
and inserting a period; and 
(iii) by striking clause (vii); and 
(B) in subsection (f)— 
(i) by striking the first paragraph (5); 
and 
(ii) by striking the second paragraph 
(4); 
(3) 
in 
section 
706(a)(2)(A) 
(21 
U.S.C. 
1705(a)(2)(A))— 
(A) by striking clause (ix); and 
(B) by redesignating clauses (x) through 
(xiv) as clauses (ix) through (xiii), respectively; 
and 
(4) by striking section 708 (21 U.S.C. 1707). 
Subtitle D—Synthetic Abuse and 
Labeling of Toxic Substances 
SEC. 3401. SHORT TITLE. 
This subtitle may be cited as the ‘‘Synthetic Abuse and 
Labeling of Toxic Substances Act of 2017’’ or the ‘‘SALTS 
Act’’.
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† HR 6 EAS 
SEC. 3402. CONTROLLED SUBSTANCE ANALOGUES. 
Section 203 of the Controlled Substances Act (21 
U.S.C. 813) is amended— 
(1) by striking ‘‘A controlled’’ and inserting ‘‘(a) 
IN GENERAL.—A controlled’’; and 
(2) by adding at the end the following: 
‘‘(b) DETERMINATION.—In determining whether a con-
trolled substance analogue was intended for human con-
sumption under subsection (a), evidence related to the fol-
lowing factors may be considered, along with all other rel-
evant evidence: 
‘‘(1) The marketing, advertising, and labeling of 
the substance. 
‘‘(2) The known efficacy or usefulness of the sub-
stance for the marketed, advertised, or labeled pur-
pose. 
‘‘(3) The difference between the price at which 
the substance is sold and the price at which the sub-
stance it is purported to be or advertised as is nor-
mally sold. 
‘‘(4) The diversion of the substance from legiti-
mate channels and the clandestine importation, man-
ufacture, or distribution of the substance. 
‘‘(5) Whether the defendant knew or should have 
known the substance was intended to be consumed by
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injection, inhalation, ingestion, or any other imme-
diate means. 
‘‘(c) LIMITATION.—For purposes of this section, the ex-
istence of evidence that a substance was not marketed, ad-
vertised, or labeled for human consumption shall not pre-
clude the Government from establishing, based on all the 
evidence, that the substance was intended for human con-
sumption.’’. 
Subtitle E—Opioid Quota Reform 
SEC. 3501. SHORT TITLE. 
This subtitle may be cited as the ‘‘Opioid Quota Re-
form Act’’. 
SEC. 3502. STRENGTHENING CONSIDERATIONS FOR DEA 
OPIOID QUOTAS. 
(a) IN GENERAL.—Section 306 of the Controlled Sub-
stances Act (21 U.S.C. 826) is amended— 
(1) in subsection (a)— 
(A) by inserting ‘‘(1)’’ after ‘‘(a)’’; 
(B) in the second sentence, by striking 
‘‘Production’’ and inserting ‘‘Except as provided 
in paragraph (2), production’’; and 
(C) by adding at the end the following: 
‘‘(2) The Attorney General may, if the Attorney Gen-
eral determines it will assist in avoiding the overproduc-
tion, shortages, or diversion of a controlled substance, estab-
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† HR 6 EAS 
lish an aggregate or individual production quota under this 
subsection, or a procurement quota established by the Attor-
ney General by regulation, in terms of pharmaceutical dos-
age forms prepared from or containing the controlled sub-
stance.’’; 
(2) in subsection (b), in the first sentence, by 
striking ‘‘production’’ and inserting ‘‘manufac-
turing’’; 
(3) in subsection (c), by striking ‘‘October’’ and 
inserting ‘‘December’’; and 
(4) by adding at the end the following: 
‘‘(i)(1)(A) In establishing any quota under this sec-
tion, or any procurement quota established by the Attorney 
General 
by 
regulation, 
for 
fentanyl, 
oxycodone, 
hydrocodone, oxymorphone, or hydromorphone (in this sub-
section referred to as a ‘covered controlled substance’), the 
Attorney General shall estimate the amount of diversion of 
the covered controlled substance that occurs in the United 
States. 
‘‘(B) In estimating diversion under this paragraph, 
the Attorney General— 
‘‘(i) shall consider information the Attorney Gen-
eral, in consultation with the Secretary of Health and 
Human Services, determines reliable on rates of over-
dose deaths and abuse and overall public health im-
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pact related to the covered controlled substance in the 
United States; and 
‘‘(ii) may take into consideration whatever other 
sources of information the Attorney General deter-
mines reliable. 
‘‘(C) After estimating the amount of diversion of a cov-
ered controlled substance, the Attorney General shall make 
appropriate quota reductions, as determined by the Attor-
ney General, from the quota the Attorney General would 
have otherwise established had such diversion not been con-
sidered. 
‘‘(2)(A) For any year for which the approved aggregate 
production quota for a covered controlled substance is high-
er than the approved aggregate production quota for the 
covered controlled substance for the previous year, the Attor-
ney General shall include in the final order an explanation 
of why the public health benefits of increasing the quota 
clearly outweigh the consequences of having an increased 
volume of the covered controlled substance available for sale, 
and potential diversion, in the United States. 
‘‘(B) Not later than 1 year after the date of enactment 
of this subsection, and every year thereafter, the Attorney 
General shall submit to the Caucus on International Nar-
cotics Control, the Committee on the Judiciary, the Com-
mittee on Health, Education, Labor, and Pensions, and the
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Committee on Appropriations of the Senate and the Com-
mittee on the Judiciary, the Committee on Energy and 
Commerce, and the Committee on Appropriations of the 
House of Representatives the following information with re-
gard to each covered controlled substance: 
‘‘(i) An anonymized count of the total number of 
manufacturers 
issued 
individual 
manufacturing 
quotas that year for the covered controlled substance. 
‘‘(ii) An anonymized count of how many such 
manufacturers were issued an approved manufac-
turing quota that was higher than the quota issued to 
that manufacturer for the covered controlled substance 
in the previous year. 
‘‘(3) Not later than 1 year after the date of enactment 
of this subsection, the Attorney General shall submit to Con-
gress a report on how the Attorney General, when fixing 
and adjusting production and manufacturing quotas under 
this section for covered controlled substances, will— 
‘‘(A) take into consideration changes in the ac-
cepted medical use of the covered controlled sub-
stances; and 
‘‘(B) work with the Secretary of Health and 
Human Services on methods to appropriately and 
anonymously estimate the type and amount of cov-
ered controlled substances that are submitted for col-
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lection from approved drug collection receptacles, 
mail-back programs, and take-back events.’’. 
(b) CONFORMING CHANGE.—The Law Revision Coun-
sel is directed to amend the heading for subsection (b) of 
section 826 of title 21, United States Code, by striking 
‘‘PRODUCTION’’ and inserting ‘‘MANUFACTURING’’. 
Subtitle F—Preventing Drug 
Diversion 
SEC. 3601. SHORT TITLE. 
This subtitle may be cited as the ‘‘Preventing Drug 
Diversion Act of 2018’’. 
SEC. 3602. IMPROVEMENTS TO PREVENT DRUG DIVERSION. 
(a) DEFINITION.—Section 102 of the Controlled Sub-
stances Act (21 U.S.C. 802) is amended by adding at the 
end the following: 
‘‘(57) The term ‘suspicious order’ includes— 
‘‘(A) an order of a controlled substance of 
unusual size; 
‘‘(B) an order of a controlled substance de-
viating substantially from a normal pattern; 
‘‘(C) orders of controlled substances of un-
usual frequency; and 
‘‘(D) an order having any characteristic 
that would indicate to a reasonable registrant 
that it is suspicious or not legitimate.’’.
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† HR 6 EAS 
(b) SUSPICIOUS ORDERS.—Part C of the Controlled 
Substances Act (21 U.S.C. 821 et seq.) is amended by add-
ing at the end the following: 
‘‘SEC. 312. SUSPICIOUS ORDERS. 
‘‘(a) REPORTING.—Each registrant shall— 
‘‘(1) design and operate a system to identify sus-
picious orders for the registrant; 
‘‘(2) ensure that the system designed and oper-
ated under paragraph (1) by the registrant complies 
with applicable Federal and State privacy laws; and 
‘‘(3) upon discovering a suspicious order or se-
ries of orders, notify the Administrator of the Drug 
Enforcement Administration and the Special Agent 
in Charge of the Division Office of the Drug Enforce-
ment Administration for the area in which the reg-
istrant is located or conducts business. 
‘‘(b) SUSPICIOUS ORDER DATABASE.— 
‘‘(1) IN GENERAL.—Not later than 1 year after 
the date of enactment of this section, the Attorney 
General shall establish a centralized database for col-
lecting reports of suspicious orders. 
‘‘(2) SATISFACTION
OF
REPORTING
REQUIRE-
MENTS.—If a registrant reports a suspicious order to 
the centralized database established under paragraph 
(1), the registrant shall be considered to have com-
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† HR 6 EAS 
plied with the requirement under subsection (a)(3) to 
notify the Administrator of the Drug Enforcement 
Administration and the Special Agent in Charge of 
the Division Office of the Drug Enforcement Adminis-
tration for the area in which the registrant is located 
or conducts business. 
‘‘(c) SHARING INFORMATION WITH THE STATES.— 
‘‘(1) IN GENERAL.—The Attorney General shall 
prepare and make available information regarding 
suspicious orders in a State, including information 
in the database established under subsection (b)(1), to 
the point of contact for purposes of administrative, 
civil, and criminal oversight relating to the diversion 
of controlled substances for the State, as designated by 
the Governor or chief executive officer of the State. 
‘‘(2) TIMING.—The Attorney General shall pro-
vide information in accordance with paragraph (1) 
within a reasonable period of time after obtaining the 
information. 
‘‘(3) COORDINATION.—In establishing the process 
for the provision of information under this subsection, 
the Attorney General shall coordinate with States to 
ensure that the Attorney General has access to infor-
mation, as permitted under State law, possessed by
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† HR 6 EAS 
the States relating to prescriptions for controlled sub-
stances that will assist in enforcing Federal law.’’. 
(c) REPORTS TO CONGRESS.— 
(1) DEFINITION.—In this subsection, the term 
‘‘suspicious order’’ has the meaning given that term 
in section 102 of the Controlled Substances Act, as 
amended by this subtitle. 
(2) ONE TIME REPORT.—Not later than 1 year 
after the date of enactment of this Act, the Attorney 
General shall submit to Congress a report on the re-
porting of suspicious orders, which shall include— 
(A) a description of the centralized database 
established under section 312 of the Controlled 
Substances Act, as added by this section, to col-
lect reports of suspicious orders; 
(B) a description of the system and reports 
established under section 312 of the Controlled 
Substances Act, as added by this section, to share 
information with States; 
(C) information regarding how the Attorney 
General used reports of suspicious orders before 
the date of enactment of this Act and after the 
date of enactment of this Act, including how the 
Attorney General received the reports and what
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† HR 6 EAS 
actions were taken in response to the reports; 
and 
(D) descriptions of the data analyses con-
ducted on reports of suspicious orders to identify, 
analyze, and stop suspicious activity. 
(3) ADDITIONAL
REPORTS.—Not later than 1 
year after the date of enactment of this Act, and an-
nually thereafter until the date that is 5 years after 
the date of enactment of this Act, the Attorney Gen-
eral shall submit to Congress a report providing, for 
the previous year— 
(A) the number of reports of suspicious or-
ders; 
(B) a summary of actions taken in response 
to reports, in the aggregate, of suspicious orders; 
and 
(C) a description of the information shared 
with States based on reports of suspicious orders. 
(4) ONE TIME GAO REPORT.—Not later than 1 
year after the date of enactment of this Act, the 
Comptroller General of the United States, in consulta-
tion with the Administrator of the Drug Enforcement 
Administration, shall submit to Congress a report on 
the reporting of suspicious orders, which shall include 
an evaluation of the utility of real-time reporting of
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potential suspicious orders of opioids on a national 
level using computerized algorithms, including the ex-
tent to which such algorithms— 
(A) would help ensure that potentially sus-
picious orders are more accurately captured, 
identified, and reported in real-time to suppliers 
before orders are filled; 
(B) may produce false positives of sus-
picious order reports that could result in market 
disruptions for legitimate orders of opioids; and 
(C) would reduce the overall length of an 
investigation that prevents the diversion of sus-
picious orders of opioids. 
Subtitle G—Sense of Congress 
SEC. 3701. SENSE OF CONGRESS. 
It is the sense of Congress that: 
(1) Americans with substance use disorders often 
seek treatment through recovery homes and clinical 
treatment facilities that offer detoxification, risk re-
duction, outpatient treatment, residential treatment, 
or rehabilitation for substance use. Most of those fa-
cilities provide a critical function in addressing sub-
stance misuse and abuse, particularly as the inci-
dence and prevalence of substance use disorders, and 
drug overdose numbers continue to rise.
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(2) Despite the necessity of such treatment facili-
ties and the important services most provide, there 
are some bad actors in the industry who, through tele-
marketing and other schemes, actively recruit patients 
with private insurance so that programs can bill the 
insurers without providing the necessary treatment 
services. Often these ‘‘patient brokers’’ are paid for 
each patient successfully recruited. Payments are also 
made as a percentage of billings, which incentivizes 
brokers to recommend patients even at low risk levels 
to the most aggressive and most expensive treatment 
programs. 
(3) Unless the patient is enrolled in a Federal 
health care program, a gap in Federal law exists with 
respect to patient brokers who are improperly recruit-
ing unsuspecting patients to defraud insurance com-
panies. 
(4) It is important that Congress provide a 
mechanism to penalize these bad actors, while mind-
ing legitimate entities who continue to help patients 
find reputable treatment programs.
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TITLE IV—COMMERCE 
Subtitle A—Fighting Opioid Abuse 
in Transportation 
SEC. 4101. SHORT TITLE. 
This subtitle may be cited as the ‘‘Fighting Opioid 
Abuse in Transportation Act’’. 
SEC. 4102. RAIL MECHANICAL EMPLOYEE CONTROLLED 
SUBSTANCES AND ALCOHOL TESTING. 
(a) RAIL MECHANICAL EMPLOYEES.—Not later than 
2 years after the date of enactment of this Act, the Secretary 
of Transportation shall publish a final rule in the Federal 
Register revising the regulations promulgated under section 
20140 of title 49, United States Code, to designate a rail 
mechanical employee as a railroad employee responsible for 
safety-sensitive functions for purposes of that section. 
(b) DEFINITION OF RAIL MECHANICAL EMPLOYEE.— 
The Secretary shall define the term ‘‘rail mechanical em-
ployee’’ by regulation under subsection (a). 
(c) SAVINGS CLAUSE.—Nothing in this section may be 
construed as limiting or otherwise affecting the discretion 
of the Secretary of Transportation to set different require-
ments by railroad size or other factors, consistent with ap-
plicable law.
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† HR 6 EAS 
SEC. 4103. RAIL YARDMASTER CONTROLLED SUBSTANCES 
AND ALCOHOL TESTING. 
(a) YARDMASTERS.—Not later than 2 years after the 
date of enactment of this Act, the Secretary of Transpor-
tation shall publish a final rule in the Federal Register re-
vising the regulations promulgated under section 20140 of 
title 49, United States Code, to designate a yardmaster as 
a railroad employee responsible for safety-sensitive func-
tions for purposes of that section. 
(b) DEFINITION
OF YARDMASTER.—The Secretary 
shall define the term ‘‘yardmaster’’ by regulation under sub-
section (a). 
(c) SAVINGS CLAUSE.—Nothing in this section may be 
construed as limiting or otherwise affecting the discretion 
of the Secretary of Transportation to set different require-
ments by railroad size or other factors, consistent with ap-
plicable law. 
SEC. 4104. DEPARTMENT OF TRANSPORTATION PUBLIC 
DRUG AND ALCOHOL TESTING DATABASE. 
(a) IN GENERAL.—Subject to subsection (c), the Sec-
retary of Transportation shall— 
(1) not later than March 31, 2019, establish and 
make publicly available on its website a database of 
the drug and alcohol testing data reported by employ-
ers for each mode of transportation; and 
(2) update the database annually.
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(b) CONTENTS.—The database under subsection (a) 
shall include, for each mode of transportation— 
(1) the total number of drug and alcohol tests by 
type of substance tested; 
(2) the drug and alcohol test results by type of 
substance tested; 
(3) the reason for the drug or alcohol test, such 
as pre-employment, random, post-accident, reasonable 
suspicion or cause, return-to-duty, or follow-up, by 
type of substance tested; and 
(4) the number of individuals who refused test-
ing. 
(c) COMMERCIALLY SENSITIVE DATA.—The Depart-
ment of Transportation shall not release any commercially 
sensitive data furnished by an employer under this section 
unless the data is aggregated or otherwise in a form that 
does not identify the employer providing the data. 
(d) SAVINGS CLAUSE.—Nothing in this section may 
be construed as limiting or otherwise affecting the require-
ments of the Secretary of Transportation to adhere to re-
quirements applicable to confidential business information 
and sensitive security information, consistent with applica-
ble law.
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SEC. 4105. GAO REPORT ON DEPARTMENT OF TRANSPOR-
TATION’S COLLECTION AND USE OF DRUG 
AND ALCOHOL TESTING DATA. 
(a) IN GENERAL.—Not later than 2 years after the 
date the Department of Transportation public drug and al-
cohol testing database is established under section 4104, the 
Comptroller General of the United States shall— 
(1) review the Department of Transportation 
Drug and Alcohol Testing Management Information 
System; and 
(2) submit to the Committee on Commerce, 
Science, and Transportation of the Senate and the 
Committee on Transportation and Infrastructure of 
the House of Representatives a report on the review, 
including recommendations under subsection (c). 
(b) CONTENTS.—The report under subsection (a) shall 
include— 
(1) a description of the process the Department 
of Transportation uses to collect and record drug and 
alcohol testing data submitted by employers for each 
mode of transportation; 
(2) an assessment of whether and, if so, how the 
Department of Transportation uses the data described 
in paragraph (1) in carrying out its responsibilities; 
and
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(3) an assessment of the Department of Trans-
portation public drug and alcohol testing database 
under section 4104. 
(c) RECOMMENDATIONS.—The report under subsection 
(a) may include recommendations regarding— 
(1) how the Department of Transportation can 
best use the data described in subsection (b)(1); 
(2) any improvements that could be made to the 
process described in subsection (b)(1); 
(3) whether and, if so, how the Department of 
Transportation public drug and alcohol testing data-
base under section 4104 could be made more effective; 
and 
(4) such other recommendations as the Comp-
troller General considers appropriate. 
SEC. 4106. TRANSPORTATION WORKPLACE DRUG AND AL-
COHOL TESTING PROGRAM; ADDITION OF 
FENTANYL. 
(a) MANDATORY GUIDELINES FOR FEDERAL WORK-
PLACE DRUG TESTING PROGRAMS.— 
(1) IN GENERAL.—Not later than 180 days after 
the date of enactment of this Act, the Secretary of 
Health and Human Services shall determine whether 
a revision of the Mandatory Guidelines for Federal 
Workplace Drug Testing Programs to expand the
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opioid category on the list of authorized drug testing 
to include fentanyl is justified, based on the reli-
ability and cost-effectiveness of available testing. 
(2) REVISION OF GUIDELINES.—If the expansion 
of the opioid category is determined to be justified 
under paragraph (1), the Secretary of Health and 
Human Services shall— 
(A) notify the Committee on Commerce, 
Science, and Transportation of the Senate and 
the Committee on Transportation and Infra-
structure of the House of Representatives of the 
determination; and 
(B) publish in the Federal Register, not 
later than 18 months after the date of the deter-
mination under that paragraph, a final notice of 
the revision of the Mandatory Guidelines for 
Federal Workplace Drug Testing Programs to ex-
pand the opioid category on the list of authorized 
drug testing to include fentanyl. 
(3) REPORT.—If the expansion of the opioid cat-
egory is determined not to be justified under para-
graph (1), the Secretary of Health and Human Serv-
ices shall submit to the Committee on Commerce, 
Science, and Transportation of the Senate and the 
Committee on Transportation and Infrastructure of
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the House of Representatives a report explaining, in 
detail, the reasons the expansion of the opioid cat-
egory on the list of authorized drugs to include 
fentanyl is not justified. 
(b) DEPARTMENT OF TRANSPORTATION DRUG-TESTING 
PANEL.—If the expansion of the opioid category is deter-
mined to be justified under subsection (a)(1), the Secretary 
of Transportation shall publish in the Federal Register, not 
later than 18 months after the date the final notice is pub-
lished under subsection (a)(2), a final rule revising part 
40 of title 49, Code of Federal Regulations, to include 
fentanyl in the Department of Transportation’s drug-test-
ing panel, consistent with the Mandatory Guidelines for 
Federal Workplace Drug Testing Programs as revised by 
the Secretary of Health and Human Services under sub-
section (a). 
(c) SAVINGS PROVISION.—Nothing in this section may 
be construed as— 
(1) delaying the publication of the notices de-
scribed in sections 4107 and 4108 until the Secretary 
of Health and Human Services makes a determina-
tion or publishes a notice under this section; or 
(2) limiting or otherwise affecting any authority 
of the Secretary of Health and Human Services or the 
Secretary of Transportation to expand the list of au-
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thorized drug testing to include an additional sub-
stance. 
SEC. 4107. STATUS REPORTS ON HAIR TESTING GUIDE-
LINES. 
(a) IN GENERAL.—Not later than 30 days after the 
date of enactment of this Act, and every 180 days thereafter 
until the date that the Secretary of Health and Human 
Services publishes in the Federal Register a final notice of 
scientific and technical guidelines for hair testing in ac-
cordance with section 5402(b) of the Fixing America’s Sur-
face Transportation Act (Public Law 114–94; 129 Stat. 
1312), the Secretary of Health and Human Services shall 
submit to the Committee on Commerce, Science, and Trans-
portation of the Senate and the Committee on Transpor-
tation and Infrastructure of the House of Representatives 
a report on— 
(1) the status of the hair testing guidelines; 
(2) an explanation for why the hair testing 
guidelines have not been issued; 
(3) a schedule, including benchmarks, for the 
completion of the hair testing guidelines; and 
(4) an estimated date of completion of the hair 
testing guidelines. 
(b) REQUIREMENT.—To the extent practicable and 
consistent with the objective of the hair testing described in
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subsection (a) to detect illegal or unauthorized use of sub-
stances by the individual being tested, the final notice of 
scientific and technical guidelines under that subsection, as 
determined by the Secretary of Health and Human Serv-
ices, shall eliminate the risk of positive test results of the 
individual being tested caused solely by the drug use of oth-
ers and not caused by the drug use of the individual being 
tested. 
SEC. 4108. MANDATORY GUIDELINES FOR FEDERAL WORK-
PLACE DRUG TESTING PROGRAMS USING 
ORAL FLUID. 
(a) DEADLINE.—Not later than December 31, 2018, the 
Secretary of Health and Human Services shall publish in 
the Federal Register a final notice of the Mandatory Guide-
lines for Federal Workplace Drug Testing Programs using 
Oral Fluid, based on the notice of proposed mandatory 
guidelines published in the Federal Register on May 15, 
2015 (80 Fed. Reg. 28054). 
(b) REQUIREMENT.—To the extent practicable and 
consistent with the objective of the testing described in sub-
section (a) to detect illegal or unauthorized use of substances 
by the individual being tested, the final notice of scientific 
and technical guidelines under that subsection, as deter-
mined by the Secretary of Health and Human Services, 
shall eliminate the risk of positive test results of the indi-
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vidual being tested caused solely by the drug use of others 
and not caused by the drug use of the individual being test-
ed. 
(c) RULE OF CONSTRUCTION.—Nothing in this section 
may be construed as requiring the Secretary of Health and 
Human Services to reissue a notice of proposed mandatory 
guidelines to carry out subsection (a). 
SEC. 4109. ELECTRONIC RECORDKEEPING. 
(a) DEADLINE.—Not later than 1 year after the date 
of enactment of this Act, the Secretary of Health and 
Human Services shall— 
(1) ensure that each certified laboratory that re-
quests approval for the use of completely paperless 
electronic Federal Drug Testing Custody and Control 
Forms from the National Laboratory Certification 
Program’s Electronic Custody and Control Form sys-
tems receives approval for those completely paperless 
electronic forms instead of forms that include any 
combination of electronic traditional handwritten sig-
natures executed on paper forms; and 
(2) establish a deadline for a certified laboratory 
to request approval under paragraph (1). 
(b) SAVINGS CLAUSE.—Nothing in this section may be 
construed as limiting or otherwise affecting any authority 
of the Secretary of Health and Human Services to grant