I 
115TH CONGRESS 
2D SESSION 
H. R. 5590 
To require the Secretary of Health and Human Services to provide for 
an action plan on recommendations for changes under Medicare and 
Medicaid to prevent opioids addictions and enhance access to medication- 
assisted treatment, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
APRIL 24, 2018 
Mr. KINZINGER (for himself, Ms. CLARKE of New York, Mr. LAHOOD, and 
Mr. DANNY K. DAVIS of Illinois) introduced the following bill; which was 
referred to the Committee on Energy and Commerce, and in addition to 
the Committee on Ways and Means, for a period to be subsequently de-
termined by the Speaker, in each case for consideration of such provisions 
as fall within the jurisdiction of the committee concerned 
A BILL 
To require the Secretary of Health and Human Services 
to provide for an action plan on recommendations for 
changes under Medicare and Medicaid to prevent opioids 
addictions and enhance access to medication-assisted 
treatment, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Opioid Addiction Ac-
tion Plan Act’’. 
VerDate Sep 11 2014 
04:01 Apr 26, 2018
Jkt 079200
PO 00000
Frm 00001
Fmt 6652
Sfmt 6201
E:\BILLS\H5590.IH
H5590
lotter on DSKBCFDHB2PROD with BILLS
SEC. 
2. 
ACTION 
PLAN 
ON 
RECOMMENDATIONS 
FOR 
CHANGES UNDER MEDICARE AND MEDICAID 
TO PREVENT OPIOIDS ADDICTIONS AND EN-
HANCE ACCESS TO MEDICATION-ASSISTED 
TREATMENT. 
(a) IN GENERAL.—Not later than January 1, 2019, 
the Secretary of Health and Human Services (in this sec-
tion referred to as the ‘‘Secretary’’), in collaboration with 
the Pain Management Best Practices Inter-Agency Task 
Force convened under section 101(b) of the Comprehen-
sive Addiction and Recovery Act of 2016 (Public Law 
114–198), shall develop an action plan that provides rec-
ommendations described in subsection (b). 
(b) ACTION PLAN COMPONENTS.—Recommendations 
provided under the action plan under subsection (a) shall 
include recommendations on the following: 
(1) Recommendations on changes to the Medi-
care program under title XVIII of the Social Secu-
rity Act and the Medicaid program under title XIX 
of such Act that would enhance coverage and reim-
bursement under such programs of all medication- 
assisted treatment approved by the Food and Drug 
Administration for the treatment of opioid addiction 
and other therapies that manage chronic and acute 
pain and treat and minimize risk of opioid addiction, 
including recommendations on changes to the Medi-
VerDate Sep 11 2014 
04:01 Apr 26, 2018
Jkt 079200
PO 00000
Frm 00002
Fmt 6652
Sfmt 6201
E:\BILLS\H5590.IH
H5590
lotter on DSKBCFDHB2PROD with BILLS
care prospective payment system for hospital inpa-
tient department services under section 1886(d) of 
such Act (42 U.S.C. 1395ww(d)) and the Medicare 
prospective payment system for hospital outpatient 
department services under section 1833(t) of such 
Act (42 U.S.C. 1395l(t)) that would allow for sepa-
rate reimbursement for such therapies to encourage 
development and adoption of such therapies, if medi-
cally appropriate. 
(2) Recommendations for payment and service 
delivery models to be tested by the Center for Medi-
care and Medicaid Innovation and other federally 
authorized demonstration projects, including value- 
based models, that may encourage the use of appro-
priate medication-assisted treatment approved by the 
Food and Drug Administration for the treatment of 
opioid addiction and other therapies that manage 
chronic and acute pain and treat and minimize risk 
of opioid addiction. 
(3) Recommendations for data collection that 
can facilitate research and policy making regarding 
prevention of opioid addiction and coverage and re-
imbursement under the Medicare program and the 
Medicaid program of appropriate opioid addiction 
treatments. 
VerDate Sep 11 2014 
04:01 Apr 26, 2018
Jkt 079200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6201
E:\BILLS\H5590.IH
H5590
lotter on DSKBCFDHB2PROD with BILLS
(4) Recommendations for provider education 
that can expand patient access to the full range of 
medication-assisted treatment approved by the Food 
and Drug Administration for the treatment of opioid 
addiction and other therapies that manage chronic 
and acute pain and treat and minimize risk of opioid 
addiction. 
(5) Recommendations for policies under the 
Medicare program and under the Medicaid program 
that can expand access for rural, or medically under-
served communities to the full range of medication- 
assisted treatment approved by the Food and Drug 
Administration for the treatment of opioid addiction 
and other therapies that manage chronic and acute 
pain and treatment and minimize risk of opioid ad-
diction. 
(c) STAKEHOLDER MEETINGS.— 
(1) IN GENERAL.—Beginning not later than 3 
months after the date of the enactment of this Act, 
the Secretary shall convene a public stakeholder 
meeting to solicit public comment on the components 
of the action plan recommendations described in 
subsection (b). 
(2) PARTICIPANTS.—Participants of meetings 
described in paragraph (1) shall include representa-
VerDate Sep 11 2014 
04:01 Apr 26, 2018
Jkt 079200
PO 00000
Frm 00004
Fmt 6652
Sfmt 6201
E:\BILLS\H5590.IH
H5590
lotter on DSKBCFDHB2PROD with BILLS
tives from the Food and Drug Administration and 
National Institutes of Health, biopharmaceutical in-
dustry members, medical researchers, health care 
providers, the medical device industry, the Medicare 
program, the Medicaid program, and patient advo-
cates. 
(d) REQUEST FOR INFORMATION.—Not later than 3 
months after the date of the enactment of this section, 
the Secretary shall issue a request for information seeking 
public feedback regarding ways in which the Centers for 
Medicare & Medicaid Services can help address the opioid 
crisis through the development of and application of the 
action plan. 
(e) REPORT TO CONGRESS.—Not later than March 
1, 2019, the Secretary shall submit to Congress, and make 
public, a report that includes a summary of steps taken 
under the action plan, recommendations that have 
emerged under the action plan, and the Secretary’s 
planned next steps with respect to the action plan. 
(f) DEFINITION OF MEDICATION-ASSISTED TREAT-
MENT.—In this section, the term ‘‘medication-assisted 
treatment’’ includes opioid treatment programs, behav-
ioral therapy, and medications to treat substance abuse 
disorder. 
VerDate Sep 11 2014 
04:01 Apr 26, 2018
Jkt 079200
PO 00000
Frm 00005
Fmt 6652
Sfmt 6201
E:\BILLS\H5590.IH
H5590
lotter on DSKBCFDHB2PROD with BILLS
SEC. 3. REPORT ON COVERAGE, CODING, AND REIMBURSE-
MENT POLICIES UNDER MEDICARE. 
(a) IN GENERAL.—Not later than 1 year after the 
date of the enactment of this Act, the Secretary of Health 
and Human Services (in this section referred to as the 
‘‘Secretary’’) shall— 
(1) identify— 
(A) medical devices that are non-opioid 
based treatments approved by the Food and 
Drug Administration for the management of 
acute pain and chronic pain; 
(B) medical devices that are non-opioid 
based treatments approved by the Food and 
Drug Administration that monitor substance 
use withdrawal and prevent overdoses of con-
trolled substances; and 
(C) medical devices that are non-opioid 
based treatments approved by the Food and 
Drug Administration that treat substance use 
disorder; and 
(2) submit to the Committee on Finance of the 
Senate and the Committees on Ways and Means and 
Energy and Commerce of the House of Representa-
tives, and publish on a public Internet website of the 
Department of Health and Human Services, a re-
port containing recommendations on ways to encour-
VerDate Sep 11 2014 
04:01 Apr 26, 2018
Jkt 079200
PO 00000
Frm 00006
Fmt 6652
Sfmt 6201
E:\BILLS\H5590.IH
H5590
lotter on DSKBCFDHB2PROD with BILLS
age the use of such medical devices by individuals 
entitled to benefits under part A of title XVIII of 
the Social Security Act and enrolled under part B 
of such title (including individuals enrolled in a 
Medicare Advantage plan under part C of such title 
or in a prescription drug plan under part D of such 
title) and individuals enrolled under a State plan 
under title XIX of such Act. 
(b) CONTENTS.—The report under subsection (a) 
shall include an analysis of the following, with respect to 
the Medicare program under title XVIII of the Social Se-
curity Act and the Medicaid program under title XIX of 
such Act: 
(1) Various opioid alternatives for pain treat-
ment that are covered under such programs, that 
are not covered under such programs, that have lim-
ited coverage under such program, or with respect to 
which there are payment barriers under such pro-
grams. 
(2) Various medical devices that monitor sub-
stance use withdrawal and prevent overdose of con-
trolled substances that are covered under such pro-
grams, that are not so covered, that have such lim-
ited coverage, or with respect to which there are 
such payment barriers. 
VerDate Sep 11 2014 
04:01 Apr 26, 2018
Jkt 079200
PO 00000
Frm 00007
Fmt 6652
Sfmt 6201
E:\BILLS\H5590.IH
H5590
lotter on DSKBCFDHB2PROD with BILLS
(3) Various medical devices that treat substance 
use disorder and opioid use disorder that are covered 
under such programs, that are not so covered, that 
have such limited coverage, or with respect to which 
there are such payment barriers. 
(4) Access to payment codes used by health 
care providers that promote alternative options for 
pain management therapies without the use of 
opioids, including minimally invasive pain therapies. 
(5) Ways to improve communications between 
Medicare prescription drug plans and Medicare Ad-
vantage plans, Medicare and Medicaid health care 
providers, and Medicare beneficiaries and Medicaid 
beneficiaries on the potential harm associated with 
the use of opioids and other controlled substances, 
including the need to safely store and dispose of sup-
plies relating to the use of opioids and other con-
trolled substances. 
Æ 
VerDate Sep 11 2014 
04:01 Apr 26, 2018
Jkt 079200
PO 00000
Frm 00008
Fmt 6652
Sfmt 6301
E:\BILLS\H5590.IH
H5590
lotter on DSKBCFDHB2PROD with BILLS