Enforcement Administration, the Secretary of 
Defense, the Secretary of Veterans Affairs, and 
the Director of the Indian Health Service, shall 
submit to Congress a plan of action, including 
warning letters and enforcement mechanisms, 
for addressing outliers in opioid prescribing 
practices and ensuring an adequate Federal re-
sponse to protect the public health. 
(B) UPDATED
PLAN.—The Secretary of 
Health and Human Services shall submit to 
Congress updates to the plan of action de-
scribed in subparagraph (A), as such Secretary, 
in consultation with the heads of agencies de-
scribed in such subparagraph, determines ap-
propriate. 
(c) DEFINITIONS.—In this section, the terms ‘‘dis-
penser’’ and ‘‘practitioner’’ have the meanings given such 
terms in section 102 of the Controlled Substances Act (21 
U.S.C. 802). 
(d) AUTHORIZATION OF APPROPRIATIONS.—In addi-
tion to any other amounts appropriated to carry out the 
Prescription Drug Overdose: Prevention for States pro-
gram of the Centers for Disease Control and Prevention, 
for purposes of enhancing the utilization, interoperability, 
and integration of State prescription drug monitoring pro-
VerDate Sep 11 2014 
02:43 Jul 09, 2016
Jkt 059200
PO 00000
Frm 00015
Fmt 6652
Sfmt 6201
E:\BILLS\H5655.IH
H5655
smartinez on DSK3GLQ082PROD with BILLS
grams, 
there 
are 
authorized 
to 
be 
appropriated 
$70,000,000 for each of fiscal years 2017 through 2021. 
SEC. 8. DEVELOPMENT OF NEW PAIN-RELATED MEASURES 
UNDER THE MEDICARE HOSPITAL VALUE- 
BASED PURCHASING PROGRAM TO ELIMI-
NATE FINANCIAL INCENTIVES TO OVER-PRE-
SCRIBE OPIOIDS. 
Section 1886(o)(2)(B) of the Social Security Act (42 
U.S.C. 1395ww(o)(2)(B)) is amended— 
(1) in clause (i)(II), by inserting ‘‘, subject to 
clause (iii),’’ after ‘‘shall’’; and 
(2) by adding at the end the following new 
clause: 
‘‘(iii) DEVELOPMENT OF NEW PAIN- 
RELATED MEASURES.— 
‘‘(I) MORATORIUM
UNTIL
NEW 
MEASURES
APPLICABLE.—For value- 
based incentive payments made with 
respect to discharges occurring during 
fiscal year 2018 and each subsequent 
fiscal year (before the first fiscal year 
in which new measures are applicable 
under subclause (II)(cc)), the Sec-
retary shall ensure that measures se-
lected under subparagraph (A) (such 
VerDate Sep 11 2014 
02:43 Jul 09, 2016
Jkt 059200
PO 00000
Frm 00016
Fmt 6652
Sfmt 6201
E:\BILLS\H5655.IH
H5655
smartinez on DSK3GLQ082PROD with BILLS
as measures related to the Hospital 
Consumer Assessment of Healthcare 
Providers and Systems survey) do not 
include measures based on any assess-
ments by patients, with respect to 
hospital stays of such patients, of— 
‘‘(aa) the need of such pa-
tients, during such stay, for med-
icine for pain; 
‘‘(bb) how often, during 
such stay, the pain of such pa-
tients was well controlled; or 
‘‘(cc) how often, during such 
stay, the staff of the hospital in 
which such stay occurred did ev-
erything they could to help the 
patient with the pain experienced 
by the patient. 
‘‘(II) DEVELOPMENT
OF
NEW 
MEASURES.— 
‘‘(aa) DEVELOPMENT.—Not 
later than 3 years after the date 
of enactment of this clause, the 
Secretary shall develop measures 
of patient experience of care with 
VerDate Sep 11 2014 
02:43 Jul 09, 2016
Jkt 059200
PO 00000
Frm 00017
Fmt 6652
Sfmt 6201
E:\BILLS\H5655.IH
H5655
smartinez on DSK3GLQ082PROD with BILLS
respect to pain management that 
balance the breadth of effective 
pain 
management 
tools 
with 
awareness for the role of over- 
prescribing (including, if appro-
priate, opioid-seeking behaviors) 
in the prescription opioid epi-
demic. 
‘‘(bb) CONSULTATION.—The 
Secretary shall consult with rel-
evant stakeholders in developing 
measures under item (aa). 
‘‘(cc) 
APPLICATION
FOR 
VALUE-BASED
INCENTIVE
PAY-
MENTS.—For value-based incen-
tive payments made with respect 
to discharges occurring during a 
fiscal year beginning on or after 
the date on which the Secretary 
develops new measures under 
item (aa), the Secretary shall en-
sure 
that 
measures 
selected 
under subparagraph (A) (such as 
measures related to the Hospital 
Consumer Assessment of Health-
VerDate Sep 11 2014 
02:43 Jul 09, 2016
Jkt 059200
PO 00000
Frm 00018
Fmt 6652
Sfmt 6201
E:\BILLS\H5655.IH
H5655
smartinez on DSK3GLQ082PROD with BILLS
care Providers and Systems sur-
vey) include such new meas-
ures.’’. 
SEC. 9. NATIONAL ACADEMY OF MEDICINE STUDY. 
(a) STUDY.—The Secretary of Health and Human 
Services shall enter into a contract with the National 
Academy of Medicine to carry out a study on the addition 
of coverage under the Medicare program under title XVIII 
of the Social Security Act of alternative treatment modali-
ties (such as integrative medicine, including acupuncture 
and exercise therapy, neural stimulation, biofeedback, ra-
diofrequency ablation, and trigger point injections) fur-
nished to Medicare beneficiaries who suffer from acute or 
chronic lower back pain. Such study shall, pursuant to the 
contract under this paragraph, include an analysis of— 
(1) scientific research on the short-term and 
long-term impact of the addition of such coverage on 
clinical efficacy for pain management of such bene-
ficiaries; 
(2) whether the lack of Medicare coverage for 
alternative treatment modalities impacts the volume 
of opioids prescribed for beneficiaries; and 
(3) the cost to the Medicare program of the ad-
dition of such coverage to treat pain and mitigate 
the progression of chronic pain, as weighed against 
VerDate Sep 11 2014 
02:43 Jul 09, 2016
Jkt 059200
PO 00000
Frm 00019
Fmt 6652
Sfmt 6201
E:\BILLS\H5655.IH
H5655
smartinez on DSK3GLQ082PROD with BILLS
the cost of opioid use disorder, overdose, readmis-
sion, subsequent surgeries, and utilization and ex-
penditures under parts B and D of such title. 
(b) REPORT.—Not later than 1 year after the date 
of enactment of this Act, pursuant to the contract under 
subsection (a), the National Academy of Medicine shall 
submit to Congress a report on the study under subsection 
(a). 
(c) AUTHORIZATION OF APPROPRIATIONS.—To carry 
out this section, there are authorized to be appropriated 
such sums as may be necessary. 
SEC. 10. EXCISE TAX ON OPIOID PAIN RELIEVERS. 
(a) IN GENERAL.—Subchapter E of chapter 32 of the 
Internal Revenue Code of 1986 is amended by adding at 
the end the following new section: 
‘‘SEC. 4192. OPIOID PAIN RELIEVERS. 
‘‘(a) IN GENERAL.—There is hereby imposed on the 
manufacturer or producer of any taxable active opioid a 
tax equal to the amount determined under subsection (b). 
‘‘(b) AMOUNT DETERMINED.—The amount deter-
mined under this subsection with respect to a manufac-
turer or producer for a calendar year is 1 cent per milli-
gram of taxable active opioid in the production or manu-
facturing quota determined for such manufacturer or pro-
VerDate Sep 11 2014 
02:43 Jul 09, 2016
Jkt 059200
PO 00000
Frm 00020
Fmt 6652
Sfmt 6201
E:\BILLS\H5655.IH
H5655
smartinez on DSK3GLQ082PROD with BILLS
ducer for the calendar year under section 306 of the Con-
trolled Substances Act (21 U.S.C. 826). 
‘‘(c) TAXABLE ACTIVE OPIOID.—For purposes of this 
section— 
‘‘(1) IN GENERAL.—The term ‘taxable active 
opioid’ means any controlled substance (as defined 
in section 102 of the Controlled Substances Act (21 
U.S.C. 802), as in effect on the date of the enact-
ment of this section) manufactured in the United 
States which is opium, an opiate, or any derivative 
thereof. 
‘‘(2) EXCLUSIONS.— 
‘‘(A) OTHER INGREDIENTS.—In the case 
of a product that includes a taxable active 
opioid and another ingredient, subsection (a) 
shall apply only to the portion of such product 
that is a taxable active opioid. 
‘‘(B) DRUGS USED IN ADDICTION TREAT-
MENT.—The term ‘taxable active opioid’ shall 
not include any controlled substance (as so de-
fined) which is used exclusively for the treat-
ment of opioid addiction as part of a medica-
tion-assisted treatment.’’. 
(b) CLERICAL AMENDMENTS.— 
VerDate Sep 11 2014 
02:43 Jul 09, 2016
Jkt 059200
PO 00000
Frm 00021
Fmt 6652
Sfmt 6201
E:\BILLS\H5655.IH
H5655
smartinez on DSK3GLQ082PROD with BILLS
(1) The heading of subchapter E of chapter 32 
of the Internal Revenue Code of 1986 is amended by 
striking 
‘‘Medical 
Devices’’ 
and 
inserting 
‘‘Other Medical Products’’. 
(2) The table of subchapters for chapter 32 of 
such Code is amended by striking the item relating 
to subchapter E and inserting the following new 
item: 
‘‘SUBCHAPTER E. OTHER MEDICAL PRODUCTS’’. 
(3) The table of sections for subchapter E of 
chapter 32 of such Code is amended by adding at 
the end the following new item: 
‘‘Sec. 4192. Opioid pain relievers.’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply to calendar years beginning after 
the date of the enactment of this Act. 
SEC. 11. OPIOID CONSUMER ABUSE REDUCTION PROGRAM. 
(a) OPIOID TAKE-BACK PROGRAM.—Section 302 of 
the Controlled Substances Act (21 U.S.C. 822) is amend-
ed by adding at the end the following: 
‘‘(h)(1) The Attorney General shall establish a na-
tional take-back program for the safe and environmentally 
responsible disposal of controlled substances. 
‘‘(2) In establishing the take-back program required 
under paragraph (1), the Attorney General— 
VerDate Sep 11 2014 
02:43 Jul 09, 2016
Jkt 059200
PO 00000
Frm 00022
Fmt 6652
Sfmt 6201
E:\BILLS\H5655.IH
H5655
smartinez on DSK3GLQ082PROD with BILLS
‘‘(A) shall consult with the Secretary and the 
Administrator of the Environmental Protection 
Agency; and 
‘‘(B) may coordinate with States, law enforce-
ment agencies, water resource management agencies, 
manufacturers, practitioners, pharmacists, public 
health entities, transportation and incineration serv-
ice contractors, and other entities and individuals, as 
appropriate. 
‘‘(3) The take-back program established under para-
graph (1)— 
‘‘(A) shall— 
‘‘(i) ensure appropriate geographic dis-
tribution so as to provide— 
‘‘(I) reasonably convenient and equi-
table access to permanent take-back loca-
tions, including not less than 1 disposal 
site for every 25,000 residents and not less 
than 1 physical disposal site per town, city, 
county, or other unit of local government, 
where possible; and 
‘‘(II) periodic collection events and 
mail-back programs, including public no-
tice of such events and programs, as a sup-
plement to the permanent take-back loca-
VerDate Sep 11 2014 
02:43 Jul 09, 2016
Jkt 059200
PO 00000
Frm 00023
Fmt 6652
Sfmt 6201
E:\BILLS\H5655.IH
H5655
smartinez on DSK3GLQ082PROD with BILLS
tions described in subclause (I), particu-
larly in areas in which the provision of ac-
cess to such locations at the level described 
in that subclause is not possible; 
‘‘(ii) establish a process for the accurate 
cataloguing and reporting of the quantities of 
controlled substances collected; and 
‘‘(iii) include a public awareness campaign 
and education of practitioners and pharmacists; 
and 
‘‘(B) may work in coordination with State and 
locally implemented public and private take-back 
programs. 
‘‘(4) From time to time, beginning in the second cal-
endar year that begins after the date of enactment of this 
subsection, the Secretary of the Treasury shall transfer 
from the general fund of the Treasury an amount equal 
to one-half of the total amount of taxes collected under 
section 4192 of the Internal Revenue Code of 1986 to the 
Attorney General to carry out this subsection. Amounts 
transferred under this subparagraph shall remain avail-
able until expended.’’. 
(b) FUNDING OF SUBSTANCE ABUSE PROGRAMS.— 
From time to time, beginning in the second calendar year 
that begins after the date of enactment of this Act, the 
VerDate Sep 11 2014 
02:43 Jul 09, 2016
Jkt 059200
PO 00000
Frm 00024
Fmt 6652
Sfmt 6201
E:\BILLS\H5655.IH
H5655
smartinez on DSK3GLQ082PROD with BILLS
Secretary of the Treasury shall transfer from the general 
fund of the Treasury an amount equal to one-half of the 
total amount of taxes collected under section 4192 of the 
Internal Revenue Code of 1986, as added by this Act, to 
the Director of the Center for Substance Abuse Treatment 
of the Substance Abuse and Mental Health Services Ad-
ministration for programs of the Center, including the 
Block Grants for Prevention and Treatment of Substance 
Abuse program under subpart II of part B of title XIX 
of the Public Health Service Act (42 U.S.C. 300x–21 et 
seq.) and Programs of Regional and National Significance. 
Amounts transferred under this subsection shall remain 
available until expended. 
SEC. 12. GAO STUDY. 
Not later than 1 year after the date of enactment 
of this Act, the Comptroller General of the United States 
shall conduct a study evaluating the various State laws, 
commercial insurance methods, and existing research on 
requirements that place limitations on opioid prescribing 
practices and provide analysis on best practices to address 
over-prescribing of opioids, while ensuring that individuals 
who need such opioids can access them safely. Such study 
shall provide recommendations, including with respect 
to— 
VerDate Sep 11 2014 
02:43 Jul 09, 2016
Jkt 059200
PO 00000
Frm 00025
Fmt 6652
Sfmt 6201
E:\BILLS\H5655.IH
H5655
smartinez on DSK3GLQ082PROD with BILLS
(1) limiting first-time opioid prescriptions to a 
patient for acute pain to a 72-hour supply; 
(2) allowing patients or practitioners to request 
that a prescription for a schedule II opioid be par-
tially filled by a pharmacist; and 
(3) pain management treatment contracts be-
tween practitioners and patients that establish in-
formed consent regarding the expectations, risks, 
long-term effects, and benefits of the course of 
opioid treatment, treatment goals, the potential for 
opioid misuse, abuse, or diversion, and requirements 
and responsibilities of patients, such as submitting 
to a urine drug screening. 
Æ 
VerDate Sep 11 2014 
02:43 Jul 09, 2016
Jkt 059200
PO 00000
Frm 00026
Fmt 6652
Sfmt 6301
E:\BILLS\H5655.IH
H5655
smartinez on DSK3GLQ082PROD with BILLS