Mainstreaming Addiction Treatment Act of 2021
Bill: H.R.1384 | Sponsor: Rep. Tonko, Paul (D-NY)
Policy area: Crime and Law Enforcement

Summary:
Mainstreaming Addiction Treatment Act of 2021
This bill removes the requirement that a health care practitioner apply for a separate waiver through the Drug Enforcement Administration (DEA) to dispense certain narcotic drugs (e.g., buprenorphine) for maintenance or detoxification treatment (i.e., substance use disorder treatment).
Further, a community health aide or community health practitioner may dispense certain narcotic drugs for maintenance or detoxification treatment without registering with the DEA if the drug is prescribed by a health care practitioner through telemedicine. It preempts state laws related to licensure for this activity.
The bill also directs the Substance Abuse and Mental Health Services Administration to conduct a national campaign to educate health care practitioners and encourage them to integrate substance use disorder treatment into their practices.

To amend section 303(g) of the Controlled Substances Act (21 U.S.C. 
    823(g)) to eliminate the separate registration requirement for 
     dispensing narcotic drugs in schedule III, IV, or V (such as 
  buprenorphine) for maintenance or detoxification treatment, and for 
                            other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Mainstreaming Addiction Treatment 
Act of 2021''.

SEC. 2. ELIMINATING SEPARATE REGISTRATION REQUIREMENT FOR DISPENSING 
              NARCOTIC DRUGS IN SCHEDULE III, IV, AND V FOR MAINTENANCE 
              OR DETOXIFICATION TREATMENT.

    (a) In General.--Section 303 of the Controlled Substances Act (21 
U.S.C. 823) is amended--
            (1) by striking paragraph (2) of subsection (g); and
            (2) in subsection (g), as amended--
                    (A) by striking ``(g)(1) Except as provided in 
                paragraph (2), practitioners who dispense narcotic 
                drugs to individuals for maintenance treatment or 
                detoxification treatment'' and inserting ``(g) 
                Practitioners who dispense narcotic drugs (other than 
                narcotic drugs in schedule III, IV, or V) to 
                individuals for maintenance treatment or detoxification 
                treatment'';
                    (B) by redesignating subparagraphs (A), (B), and 
                (C) as paragraphs (1), (2), and (3), respectively; and
                    (C) in paragraph (2), as redesignated, by 
                redesignating clauses (i) and (ii) as subparagraphs (A) 
                and (B), respectively.
    (b) Conforming Changes.--
            (1) Subsections (a) and (d)(1) of section 304 of the 
        Controlled Substances Act (21 U.S.C. 824) are amended by 
        striking ``303(g)(1)'' each place it appears and inserting 
        ``303(g)''.
            (2) Section 309A(a)(2) of the Controlled Substances Act (21 
        U.S.C. 829a) is amended--
                    (A) in the matter preceding subparagraph (A), by 
                striking ``the controlled substance is to be 
                administered for the purpose of maintenance or 
                detoxification treatment under section 303(g)(2)'' and 
                inserting ``the controlled substance is a narcotic drug 
                in schedule III, IV, or V to be administered for the 
                purpose of maintenance or detoxification treatment''; 
                and
                    (B) by striking ``and--'' and all that follows 
                through ``is to be administered by injection or 
                implantation;'' and inserting ``and is to be 
                administered by injection or implantation;''.
            (3) Section 520E-4(c) of the Public Health Service Act (42 
        U.S.C. 290bb-36d(c)) is amended by striking ``information on 
        any qualified practitioner that is certified to prescribe 
        medication for opioid dependency under section 303(g)(2)(B) of 
        the Controlled Substances Act'' and inserting ``information on 
        any practitioner who prescribes narcotic drugs in schedule III, 
        IV, or V of section 202 of the Controlled Substances Act for 
        the purpose of maintenance or detoxification treatment''.
            (4) Section 544(a)(3) of the Public Health Service Act (42 
        U.S.C. 290dd-3) is amended by striking ``any practitioner 
        dispensing narcotic drugs pursuant to section 303(g) of the 
        Controlled Substances Act'' and inserting ``any practitioner 
        dispensing narcotic drugs for the purpose of maintenance or 
        detoxification treatment''.
            (5) Section 1833(bb)(3)(B) of the Social Security Act (42 
        U.S.C. 1395l(bb)(3)(B)) is amended by striking ``first receives 
        a waiver under section 303(g) of the Controlled Substances Act 
        on or after January 1, 2019'' and inserting ``first begins 
        prescribing narcotic drugs in schedule III, IV, or V of section 
        202 of the Controlled Substances Act for the purpose of 
        maintenance or detoxification treatment on or after January 1, 
        2021''.
            (6) Section 1834(o)(3)(C)(ii) of the Social Security Act 
        (42 U.S.C. 1395m(o)(3)(C)(ii)) is amended by striking ``first 
        receives a waiver under section 303(g) of the Controlled 
        Substances Act on or after January 1, 2019'' and inserting 
        ``first begins prescribing narcotic drugs in schedule III, IV, 
        or V of section 202 of the Controlled Substances Act for the 
        purpose of maintenance or detoxification treatment on or after 
        January 1, 2021''.
            (7) Section 1866F(c)(3) of the Social Security Act (42 
        U.S.C. 1395cc-6(c)(3)) is amended--
                    (A) in subparagraph (A), by inserting ``and'' at 
                the end;
                    (B) in subparagraph (B), by striking ``; and'' and 
                inserting a period; and
                    (C) by striking subparagraph (C).
            (8) Section 1903(aa)(2)(C) of the Social Security Act (42 
        U.S.C. 1396b(aa)(2)(C)) is amended--
                    (A) in clause (i), by inserting ``and'' at the end; 
                and
                    (B) by striking clause (ii).

SEC. 3. NATIONAL EDUCATION CAMPAIGN.

    (a) In General.--The Secretary of Health and Human Services, acting 
through the Assistant Secretary for Mental Health and Substance Use, 
shall conduct a national campaign to educate practitioners with respect 
to the elimination of the separate registration requirement under 
section 303(g) of the Controlled Substances Act (21 U.S.C. 823(g)), as 
in effect on the day before the date of enactment of this Act, for 
dispensing narcotic drugs in schedule III, IV, and V for maintenance or 
detoxification treatment.
    (b) Required Components.--The national education campaign under 
subsection (a) shall--
            (1) encourage practitioners to integrate substance use 
        treatment into their practices; and
            (2) include education on publicly available educational 
        resources and training modules that can assist practitioners in 
        treating patients with a substance use disorder.

SEC. 4. COMMUNITY HEALTH AIDES AND COMMUNITY HEALTH PRACTITIONERS.

    (a) Practice of Telemedicine.--Section 102 of the Controlled 
Substances Act (21 U.S.C. 802) is amended--
            (1) in paragraph (54)(A), by striking clause (i) and 
        inserting the following:
                    ``(i) while the patient is--
                            ``(I) being treated by, and physically 
                        located in, a hospital or clinic registered 
                        under section 303(f); or
                            ``(II) for purposes of section 302(h), 
                        being treated by a community health aide or 
                        community health practitioner; and'';
            (2) by redesignating paragraph (58) as paragraph (59);
            (3) by redesignating the second paragraph designated as 
        paragraph (57) as paragraph (58);
            (4) by moving paragraphs (57), (58) (as so redesignated), 
        and (59) (as so redesignated) 2 ems to the left; and
            (5) by adding at the end the following:
    ``(60) The terms `community health aide' and `community health 
practitioner' have the meanings given to such terms for purposes of 
section 119 of the Indian Health Care Improvement Act (25 U.S.C. 
1616l).''.
    (b) Dispensation of Narcotic Drugs in Schedule III, IV, or V.--
Section 302 of the Controlled Substances Act (21 U.S.C. 822) is amended 
by adding at the end the following:
    ``(h) Dispensation of Narcotic Drugs in Schedule III, IV, or V by 
Certain Practitioners.--
            ``(1) In general.--Notwithstanding subsection (a)(2), a 
        community health aide or community health practitioner may 
        dispense a narcotic drug in schedule III, IV, or V, such as 
        buprenorphine, or a combination of such drugs, to an individual 
        for maintenance treatment or detoxification treatment (or both) 
        without being registered under this title if the drug is 
        prescribed by a practitioner through the practice of 
        telemedicine.
            ``(2) Preemption.--Notwithstanding section 708, a State may 
        not require a community health aide or community health 
        practitioner to be licensed by the State in order to dispense 
        narcotic drugs in accordance with paragraph (1) of this 
        subsection.''.
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