Mainstreaming Addiction Treatment Act of 2021
Bill: S.445 | Sponsor: Sen. Hassan, Margaret Wood (D-NH)
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 SCHEDULES III, IV, AND V FOR 
              MAINTENANCE OR DETOXIFICATION TREATMENT.

    (a) In General.--Section 303(g) of the Controlled Substances Act 
(21 U.S.C. 823(g)) is amended--
            (1) by striking paragraph (2);
            (2) 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'';
            (3) by redesignating subparagraphs (A), (B), and (C) as 
        paragraphs (1), (2), and (3), respectively; and
            (4) in paragraph (2), as so redesignated, by redesignating 
        clauses (i) and (ii) as subparagraphs (A) and (B), 
        respectively.
    (b) Technical and Conforming Edits.--
            (1) Section 304 of the Controlled Substances Act (21 U.S.C. 
        824) is amended--
                    (A) in subsection (a), by striking ``303(g)(1)'' 
                each place it appears and inserting ``303(g)''; and
                    (B) in subsection (d)(1), by striking ``303(g)(1)'' 
                and inserting ``303(g)''.
            (2) Section 309A(a) of the Controlled Substances Act (21 
        U.S.C. 829a(a)) is amended by striking paragraph (2) and 
        inserting the following:
            ``(2) the controlled substance--
                    ``(A) is a narcotic drug in schedule III, IV, or V 
                to be administered for the purpose of maintenance or 
                detoxification treatment; and
                    ``(B) 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, in the matter preceding 
        paragraph (1), 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(c) of the Controlled Substances Act (21 
        U.S.C. 812(c)) 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(a)(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 of the Social Security Act (42 U.S.C. 
        1395l) is amended by striking subsection (bb).
            (6) Section 1834(o) of the Social Security Act (42 U.S.C. 
        1395m(o)) is amended by striking paragraph (3).
            (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;
                    (B) by striking clause (ii); and
                    (C) by redesignating clause (iii) as 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) (relating to the definition of ``serious drug 
        felony'') 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 within the meaning 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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