117 
‘‘(B) require the designation of a single 
State agency to serve as the primary regulator 
in the State for substance use disorder treat-
ment services; 
‘‘(C) subject to paragraph (3), require that 
substance use disorder treatment services iden-
tified in accordance with subparagraph (A), be 
licensed by the respective States according to 
the standards for levels of care set forth by the 
American Society of Addiction Medicine in 
2013 or an equivalent set of standards; 
‘‘(D) require implementation of a process 
to ensure that substance use disorder treatment 
program qualifications are verified by means of 
an onsite inspection not less frequently than 
every 3 years by the State agency serving as 
the primary regulator in the State for substance 
use disorder treatment services or by an inde-
pendent third party that is approved by the 
State’s primary regulator; and 
‘‘(E) require that all patients leaving a res-
idential treatment program receive a written 
transition plan prior to discharge from that 
level of care. 
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‘‘(3) ANNUAL
ASSESSMENT.—Beginning with 
respect to fiscal year 2022, the Secretary shall make 
a determination with respect to each State on 
whether the State has adopted, for each of the sub-
stance use disorder treatment services identified in 
accordance with paragraph (2)(A), licensure stand-
ards that are in compliance in all material respects 
with the model standards promulgated in accordance 
with this subsection. In the event the American Soci-
ety of Addiction Medicine revises its criteria, the 
Secretary shall revise the national model level of 
care standards accordingly and disseminate any such 
update to the States, and the States may adopt any 
such updates to be in compliance with this sub-
section. 
‘‘(b) STANDARDS FOR OTHER SPECIFIED MATTERS 
RELATED TO SUBSTANCE USE DISORDER TREATMENT 
SERVICES AND RECOVERY RESIDENCES.— 
‘‘(1) IN GENERAL.—Not later than 2 year after 
the date of enactment of this title, the Secretary, in 
consultation with representatives of nonprofit service 
providers and State and tribal officials as the Sec-
retary determines necessary, shall promulgate model 
standards for the regulation of— 
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‘‘(A) other specified matters related to sub-
stance use disorder treatment services; and 
‘‘(B) recovery residences. 
‘‘(2) OTHER SPECIFIED MATTERS RELATED TO 
SUBSTANCE
USE
DISORDER
TREATMENT
SERV-
ICES.—The model standards promulgated under 
paragraph (1)(A) shall, at a minimum— 
‘‘(A) identify the professional credentials 
needed by each type of substance use disorder 
treatment professional; 
‘‘(B) include standards for data reporting 
and require compilation of statewide reports; 
‘‘(C) require the establishment and mainte-
nance within each State of a toll-free telephone 
number to receive complaints from the public 
regarding substance use disorder treatment 
service providers; and 
‘‘(D) require the establishment and main-
tenance on a publicly accessible internet website 
of a list of all substance use disorder treatment 
services in the State that have a certification in 
effect in accordance with this section. 
‘‘(3) RECOVERY RESIDENCES.— 
‘‘(A) 
ECONOMIC
RELATIONSHIP.—The 
model standards promulgated under paragraph 
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(1)(B) shall, at a minimum, be applied to recov-
ery residences that have an ongoing economic 
relationship with any commercial substance use 
disorder treatment service. 
‘‘(B) 
MINIMUM
REQUIREMENTS.—The 
model standards promulgated under paragraph 
(1)(B), which may include any model laws de-
veloped under section 550(a) shall, at a min-
imum, identify requirements for— 
‘‘(i) the designation of a single State 
agency to certify recovery residences; 
‘‘(ii) the implementation of a process 
to ensure that the qualifications of recov-
ery residences in which not fewer than 10 
individuals may lawfully reside are verified 
by means of an onsite inspection not less 
frequently than every 3 years by the State 
agency serving as the primary regulator in 
the State or by an independent third party 
that is approved by the State’s primary 
regulator; 
‘‘(iii) fire, safety, and health stand-
ards; 
‘‘(iv) equipping residences with opioid 
overdose reversal drug products, such as 
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naloxone and training residence owners, 
operators, and employees in the adminis-
tration of naloxone; 
‘‘(v) recovery residence owners and 
operators; 
‘‘(vi) a written policy that prohibits 
the exclusion of individuals on the basis 
that such individuals receive drugs ap-
proved by the Food and Drug Administra-
tion for the treatment of substance use dis-
order; 
‘‘(vii) the establishment and mainte-
nance within each State of a toll-free tele-
phone number to receive complaints from 
the public regarding recovery residences; 
and 
‘‘(viii) the establishment and mainte-
nance on a publicly accessible internet 
website of a list of all recovery residences 
in the State that have a certification in ef-
fect in accordance with this section. 
‘‘(4) ANNUAL
ASSESSMENT.—Beginning with 
respect to fiscal year 2023, the Secretary shall make 
a determination with respect to each State on 
whether the State has adopted, for each of the other 
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specified substance use disorder treatment services 
identified in this section and for recovery residences, 
standards that are in compliance in all material re-
spects with the model standards promulgated in ac-
cordance with this subsection. 
‘‘(c) ENSURING ACCESS TO MEDICATION-ASSISTED 
TREATMENT.— 
‘‘(1) MEDICATION-ASSISTED TREATMENT.—The 
Secretary may not make a grant under this section 
unless the applicant for the grant agrees to require 
all entities offering substance use disorder treatment 
services under the grant to offer all drugs approved 
by the Food and Drug Administration for the treat-
ment of substance use disorder for which the appli-
cant offers treatment. 
‘‘(2) WAIVER.—The Secretary may grant a 
waiver with respect to any requirement of this sec-
tion if the grant applicant involved— 
‘‘(A) submits to the Secretary a justifica-
tion for such waiver containing such informa-
tion as the Secretary shall require; and 
‘‘(B) agrees to require all entities offering 
substance use disorder treatment services under 
the grant to— 
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‘‘(i) offer, on site, at least 2 drugs ap-
proved by the Food and Drug Administra-
tion for the treatment of substance use dis-
order; 
‘‘(ii) provide counseling to patients on 
the benefits and risks of all drugs ap-
proved by the Food and Drug Administra-
tion for the treatment of substance use dis-
order; and 
‘‘(iii) maintain an affiliation agree-
ment with a provider that can prescribe or 
otherwise dispense all other forms of drugs 
approved by the Food and Drug Adminis-
tration for the treatment of substance use 
disorder. 
‘‘(3) GAO STUDY.—Not later than 1 year after 
the date of enactment of this title, the Comptroller 
General of the United States shall submit to Con-
gress a comprehensive report describing any rela-
tionship between substance use rates, pain manage-
ment practices of the Indian Health Service, and pa-
tient request denials through the purchased/referred 
care program of the Indian Health Service. 
‘‘(d) ENSURING
A FULL CONTINUUM
OF SERV-
ICES.— 
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‘‘(1) IN GENERAL.—Not later than 6 months 
after the date of the enactment of this title, the Ad-
ministrator of the Centers for Medicare & Medicaid 
Services shall issue a State Medicaid Director letter 
and tribal leader letter explaining how States and 
tribes can ensure access to a continuum of services 
for adults with substance use disorders who are re-
ceiving medical assistance under title XIX of the So-
cial Security Act. Such letter shall describe how 
States can cover the continuum of community-based, 
residential, and inpatient substance use disorder 
services and care coordination between different lev-
els of care as medical assistance, as defined in sec-
tion 1905(a) of such Act, including through section 
1915 of such Act and through demonstration 
projects under section 1115 of such Act. 
‘‘(2) MACPAC ANALYSIS.—Not later than 1 
year after the date of the enactment of this title, the 
Medicaid and CHIP Payment and Access Commis-
sion shall conduct an analysis, and make publicly 
available a report containing the results of such 
analysis, of States’ coverage of substance use serv-
ices for Medicaid beneficiaries. Such report shall in-
clude examples of promising strategies States use to 
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cover a continuum of community-based substance 
use services. 
‘‘(3) ANNUAL
ASSESSMENT.—Beginning with 
respect to fiscal year 2022, the Secretary shall make 
a determination with respect to each State on 
whether the State has carried out the requirements 
to ensure a continuum of services as described in 
section 1915(l)(4)(C) of the Social Security Act. 
‘‘SEC. 3436. NALOXONE DISTRIBUTION PROGRAM. 
‘‘(a) ESTABLISHMENT OF PROGRAM.— 
‘‘(1) IN GENERAL.—The Secretary shall provide 
for the purchase and delivery of federally approved 
opioid overdose reversal drug products on behalf of 
each State (or Indian tribe as defined in section 4 
of the Indian Health Care Improvement Act) that 
receives a grant under subtitle B. This paragraph 
constitutes budget authority in advance of appro-
priations Acts, and represents the obligation of the 
Federal Government to provide for the purchase and 
delivery to States and Indian tribes of the opioid 
overdose reversal drug products in accordance with 
this paragraph. 
‘‘(2) SPECIAL RULES WHERE OPIOID OVERDOSE 
REVERSAL DRUG PRODUCTS ARE UNAVAILABLE.—To 
the extent that a sufficient quantity of opioid over-
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dose reversal drug products are not available for 
purchase or delivery under paragraph (1), the Sec-
retary shall provide for the purchase and delivery of 
the available opioid overdose reversal drug products 
in accordance with priorities established by the Sec-
retary, with priority given to States with at least one 
local area eligible for funding under section 3401(a). 
‘‘(b) NEGOTIATION OF CONTRACTS WITH MANUFAC-
TURERS.— 
‘‘(1) IN
GENERAL.—For the purpose of car-
rying out this section, the Secretary shall negotiate 
and enter into contracts with manufacturers of 
opioid overdose reversal drug products consistent 
with the requirements of this subsection and, to the 
maximum extent practicable, consolidate such con-
tracting with any other contracting activities con-
ducted by the Secretary to purchase opioid overdose 
reversal drug products. The Secretary may enter 
into such contracts under which the Federal Govern-
ment is obligated to make outlays, the budget au-
thority for which is not provided for in advance in 
appropriations Acts, for the purchase and delivery of 
opioid overdose reversal drug products under sub-
section (a). 
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‘‘(2) AUTHORITY
TO
DECLINE
CONTRACTS.— 
The Secretary may decline to enter into contracts 
under this subsection and may modify or extend 
such contracts. 
‘‘(3) CONTRACT PRICE.— 
‘‘(A) IN GENERAL.—The Secretary, in ne-
gotiating the prices at which opioid overdose re-
versal drug products will be purchased and de-
livered from a manufacturer under this sub-
section, shall take into account quantities of 
opioid overdose reversal drug products to be 
purchased by States under the option under 
paragraph (4)(B). 
‘‘(B) NEGOTIATION OF DISCOUNTED PRICE 
FOR OPIOID OVERDOSE REVERSAL DRUG PROD-
UCTS.—With respect to contracts entered into 
for the purchase of opioid overdose reversal 
drug products on behalf of States under this 
subsection, the price for the purchase of such 
drug product shall be a discounted price nego-
tiated by the Secretary. 
‘‘(4) PRODUCT
DOSAGE.—All opioid overdose 
reversal products purchased under this section shall 
contain— 
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