I 
114TH CONGRESS 
2D SESSION 
H. R. 5845 
To amend the Internal Revenue Code of 1986 to establish an excise tax 
on the production and importation of opioid pain relievers, and for 
other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JULY 14, 2016 
Mr. LARSON of Connecticut introduced the following bill; which was referred 
to the Committee on Ways and Means, and in addition to the Committee 
on Energy and Commerce, for a period to be subsequently determined by 
the Speaker, in each case for consideration of such provisions as fall with-
in the jurisdiction of the committee concerned 
A BILL 
To amend the Internal Revenue Code of 1986 to establish 
an excise tax on the production and importation of opioid 
pain relievers, 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 ‘‘Budgeting for Opioid 
Addiction Treatment Act’’. 
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SEC. 2. 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 
sale of any taxable active opioid by the manufacturer, pro-
ducer, or importer a tax equal to 1 cent per milligram 
so sold. 
‘‘(b) 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, as 
in effect on the date of the enactment of this sec-
tion) which is opium, an opiate, or any derivative 
thereof. 
‘‘(2) EXCLUSION FOR CERTAIN PRESCRIPTION 
MEDICATIONS.—Such term shall not include any 
prescribed drug which is used exclusively for the 
treatment of opioid addiction as part of a medically 
assisted treatment effort. 
‘‘(3) EXCLUSION OF OTHER INGREDIENTS.—In 
the case of a product that includes a taxable active 
opioid and another ingredient, subsection (a) shall 
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apply only to the portion of such product that is a 
taxable active opioid.’’. 
(b) CLERICAL AMENDMENTS.— 
(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 sales on or after the date that 
is 1 year after the date of the enactment of this Act. 
(d) REBATE OR DISCOUNT PROGRAM FOR CERTAIN 
CANCER AND HOSPICE PATIENTS.— 
(1) IN GENERAL.—The Secretary of Health and 
Human Services, in consultation with patient advo-
cacy groups and other relevant stakeholders as de-
termined by such Secretary, shall establish a mecha-
nism by which— 
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(A) any amount paid by an eligible patient 
in connection with the tax under section 4192 
of the Internal Revenue Code of 1986 (as added 
by this section) shall be rebated to such patient 
in as timely a manner as possible, or 
(B) amounts paid by an eligible patient for 
taxable active opioids (as defined in section 
4192(b) of such Code) are discounted at time 
of payment or purchase to ensure that such pa-
tient does not pay any amount attributable to 
such tax, 
with as little burden on the patient as possible. The 
Secretary shall choose whichever of the options de-
scribed in subparagraph (A) or (B) is, in the Sec-
retary’s determination, most effective and efficient 
in ensuring eligible patients face no economic burden 
from such tax. 
(2) ELIGIBLE PATIENT.—For purposes of this 
section, the term ‘‘eligible patient’’ means— 
(A) a patient for whom any taxable active 
opioid (as so defined) is prescribed to treat pain 
relating to cancer or cancer treatment; 
(B) a patient participating in hospice care; 
and 
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(C) in the case of the death or incapacity 
of a patient described in subparagraph (A) or 
(B) or any similar situation as determined by 
the Secretary of Health and Human Services, 
the appropriate family member, medical proxy, 
or similar representative or the estate of such 
patient. 
SEC. 3. BLOCK GRANTS FOR PREVENTION AND TREATMENT 
OF SUBSTANCE ABUSE. 
(a) GRANTS TO STATES.—Section 1921(b) of the 
Public Health Service Act (42 U.S.C. 300x–21(b)) is 
amended by inserting ‘‘, and, as applicable, for carrying 
out section 1923A’’ before the period. 
(b) NONAPPLICABILITY OF PREVENTION PROGRAM 
PROVISION.—Section 1922(a)(1) of the Public Health 
Service Act (42 U.S.C. 300x–22(a)(1)) is amended by in-
serting ‘‘except with respect to amounts made available 
as described in section 1923A,’’ before ‘‘will expend’’. 
(c) OPIOID TREATMENT PROGRAMS.—Subpart II of 
part B of title XIX of the Public Health Service Act (42 
U.S.C. 300x–21 et seq.) is amended by inserting after sec-
tion 1923 the following: 
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‘‘SEC. 1923A. ADDITIONAL SUBSTANCE ABUSE TREATMENT 
PROGRAMS. 
‘‘A funding agreement for a grant under section 1921 
is that the State involved shall provide that any amounts 
made available by any increase in revenues to the Treas-
ury in the previous fiscal year resulting from the enact-
ment of section 4192 of the Internal Revenue Code of 
1986, reduced by any amounts rebated or discounted 
under section 2(d) of the Budgeting for Opioid Addiction 
Treatment Act (as described in section 1933(a)(1)(B)(i)) 
be used exclusively for substance abuse (including opioid 
abuse) treatment efforts in the State, including treatment 
programs— 
‘‘(1) establishing new addiction treatment facili-
ties, residential and outpatient, including covering 
capital costs; 
‘‘(2) establishing sober living facilities; 
‘‘(3) recruiting and increasing reimbursement 
for certified mental health providers providing sub-
stance abuse treatment in medically underserved 
communities or communities with high rates of pre-
scription drug abuse; 
‘‘(4) expanding access to long-term, residential 
treatment programs for opioid addicts (including 
30-, 60-, and 90-day programs); 
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‘‘(5) establishing or operating support programs 
that offer employment services, housing, and other 
support services to help recovering addicts transition 
back into society; 
‘‘(6) establishing or operating housing for chil-
dren whose parents are participating in substance 
abuse treatment programs, including capital costs; 
‘‘(7) establishing or operating facilities to pro-
vide care for babies born with neonatal abstinence 
syndrome, including capital costs; and 
‘‘(8) other treatment programs, as the Sec-
retary determines appropriate.’’. 
(d) 
ADDITIONAL
FUNDING.—Section 
1933(a)(1)(B)(i) of the Public Health Service Act (42 
U.S.C. 300x–33(a)(1)(B)(i)) is amended by inserting ‘‘, 
plus any increase in revenues to the Treasury in the pre-
vious fiscal year resulting from the enactment of section 
4192 of the Internal Revenue Code of 1986, reduced by 
any amounts rebated or discounted under section 2(d) of 
the Budgeting for Opioid Addiction Treatment Act’’ be-
fore the period. 
SEC. 4. REPORT. 
Not later than 2 years after the date described in sec-
tion 2(c), the Secretary of Health and Human Services 
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shall submit to Congress a report on the impact of the 
amendments made by sections 2 and 3 on— 
(1) the retail cost of taxable active opioids (as 
defined in section 4192 of the Internal Revenue 
Code of 1986, as added by section 2); 
(2) patient access to such opioids, particularly 
cancer and hospice patients, including the effect of 
the discount or rebate on such opioids for cancer 
and hospice patients under section 2(d); 
(3) how the increase in revenue to the Treasury 
resulting from the enactment of section 4192 of the 
Internal Revenue Code of 1986 is used to improve 
substance abuse treatment efforts in accordance 
with section 1923A of the Public Health Service Act 
(as added by section 3); and 
(4) suggestions for improving— 
(A) access to opioids for cancer and hos-
pice patients; and 
(B) substance abuse treatment efforts 
under such section 1923A. 
Æ 
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