IMPROVE Addiction Care Act
Bill: H.R.4203 | Sponsor: Rep. Mullin, Markwayne (R-OK)
Policy area: Health

Summary:
Improving Medicaid Programs' Response to Overdose Victims and Enhancing Addiction Care Act or the IMPROVE Addiction Care Act
This bill establishes additional requirements for state Medicaid drug-use review programs with respect to individuals who experience opioid-related overdoses.
Specifically, programs must include protocols that (1) connect individuals who have experienced an opioid-related overdose within the last five years to appropriate treatment; (2) notify providers who prescribe opioids about subsequent fatal overdoses; (3) ensure providers are notified about an individual's history of opioid-use disorder, overdoses, or poisonings; and (4) educate providers about proper prescribing practices for these individuals.

To amend title XIX of the Social Security Act to encourage appropriate 
       prescribing under Medicaid for victims of opioid overdose.

    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 ``Improving Medicaid Programs' 
Response to Overdose Victims and Enhancing Addiction Care Act'' or the 
``IMPROVE Addiction Care Act''.

SEC. 2. ENCOURAGING APPROPRIATE PRESCRIBING UNDER MEDICAID FOR VICTIMS 
              OF OPIOID OVERDOSE.

    (a) In General.--Section 1927(g)(2) of the Social Security Act (42 
U.S.C. 1396r-8(g)(2)) is amended by adding at the end the following new 
subparagraph:
                    ``(E) Additional drug use review requirements.--As 
                part of a State's prospective and retrospective drug 
                use review under subparagraphs (A) and (B), as 
                applicable, the State shall, not later than January 1, 
                2022, develop and implement, or review and update, 
                protocols to, subject to any applicable privacy or 
                confidentiality protections--
                            ``(i) identify individuals receiving 
                        benefits under this title who have experienced 
                        a nonfatal opioid-related overdose within the 
                        last 5 years, to the extent that such data is 
                        available, and make a good faith effort to 
                        connect these individuals to treatment options 
                        that have been determined appropriate by the 
                        Secretary;
                            ``(ii) if an individual receiving benefits 
                        under this title experiences a fatal overdose 
                        that is opioid-related (or, if specified by the 
                        Secretary, related to another covered 
                        outpatient drug), not later than 6 months after 
                        the date of such overdose--
                                    ``(I) notify each provider that, 
                                during the period (to be established by 
                                the Secretary) preceding such overdose, 
                                prescribed opioids (or such other 
                                specified covered outpatient drug, if 
                                applicable) to such individual of such 
                                overdose; and
                                    ``(II) provide each such provider 
                                with educational materials on 
                                prescribing opioids (or such other 
                                specified covered outpatient drugs, if 
                                applicable);
                            ``(iii) ensure that a provider who is 
                        treating an individual receiving benefits under 
                        this title has notice of the individual's 
                        diagnosis or history of opioid use disorder, 
                        opioid poisoning diagnosis, or history of 
                        nonfatal opioid-related overdose; and
                            ``(iv) perform ongoing retrospective drug 
                        utilization reviews and offer provider 
                        education that is informed by such reviews 
                        (which may include education provided under an 
                        educational outreach program established under 
                        subparagraph (D) or through an intervention 
                        described in paragraph (3)(C)(iii)) regarding 
                        appropriate prescribing practices for 
                        individuals receiving benefits under this title 
                        with a diagnosis or history of opioid use 
                        disorder, a history of nonfatal opioid-related 
                        overdose, or an opioid poisoning diagnosis.''.
    (b) Technical Amendments.--Section 1932(i) of the Social Security 
Act (42 U.S.C. 1396u-2(i)) is amended--
            (1) by striking ``section 483.3(s)(4)'' and inserting 
        ``section 438.3(s)(4)''; and
            (2) by striking ``483.3(s)(5)'' and inserting 
        ``438.3(s)(5)''.
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