Title: A bill to require the Secretary of Health and Human Services to provide for an action plan on recommendations for changes under Medicare and Medicaid to prevent opioids addictions and enhance access to medication-assisted treatment, and for other purposes.
Policy area: Health

Summary:
This bill requires the Centers for Medicare & Medicaid Services (CMS) to develop an action plan to provide recommendations on changes to the Medicare and Medicaid programs to enhance: (1) the treatment and prevention of opioid addiction, and (2) the coverage and reimbursement of medication-assisted treatment for opioid addiction.
The CMS must convene a stakeholder meeting to solicit public comment on the action plan.

[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[S. 2769 Introduced in Senate (IS)]

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115th CONGRESS
  2d Session
                                S. 2769

To require the Secretary of Health and Human Services to provide for an 
action plan on recommendations for changes under Medicare and Medicaid 
to prevent opioids addictions and enhance access to medication-assisted 
                   treatment, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             April 26, 2018

Mr. Heller (for himself, Mr. Menendez, and Mr. Isakson) introduced the 
 following bill; which was read twice and referred to the Committee on 
                                Finance

_______________________________________________________________________

                                 A BILL


 
To require the Secretary of Health and Human Services to provide for an 
action plan on recommendations for changes under Medicare and Medicaid 
to prevent opioids addictions and enhance access to medication-assisted 
                   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. ACTION PLAN ON RECOMMENDATIONS FOR CHANGES UNDER MEDICARE 
              AND MEDICAID TO PREVENT OPIOIDS ADDICTIONS AND ENHANCE 
              ACCESS TO MEDICATION-ASSISTED TREATMENT.

    (a) In General.--Not later than January 1, 2019, the Secretary of 
Health and Human Services (in this section referred to as the 
``Secretary''), in collaboration with the Pain Management Best 
Practices Inter-Agency Task Force convened under section 101(b) of the 
Comprehensive Addiction and Recovery Act of 2016 (Public Law 114-198), 
shall develop an action plan that provides recommendations described in 
subsection (b).
    (b) Action Plan Components.--Recommendations provided under the 
action plan under subsection (a) shall include recommendations on the 
following:
            (1) Recommendations on changes to the Medicare program 
        under title XVIII of the Social Security Act and the Medicaid 
        program under title XIX of such Act that would enhance coverage 
        and reimbursement under such programs of all medication-
        assisted treatment approved by the Food and Drug Administration 
        for the treatment of opioid addiction and other therapies that 
        manage chronic and acute pain and treat and minimize risk of 
        opioid addiction, including recommendations on changes to the 
        Medicare prospective payment system for hospital inpatient 
        department services under section 1886(d) of such Act (42 
        U.S.C. 1395ww(d)) and the Medicare prospective payment system 
        for hospital outpatient department services under section 
        1833(t) of such Act (42 U.S.C. 1395l(t)) that would allow for 
        separate reimbursement for such therapies to encourage 
        development and adoption of such therapies, if medically 
        appropriate.
            (2) Recommendations for payment and service delivery models 
        to be tested by the Center for Medicare and Medicaid Innovation 
        and other federally authorized demonstration projects, 
        including value-based models, that may encourage the use of 
        appropriate medication-assisted treatment approved by the Food 
        and Drug Administration for the treatment of opioid addiction 
        and other therapies that manage chronic and acute pain and 
        treat and minimize risk of opioid addiction.
            (3) Recommendations for data collection that can facilitate 
        research and policy making regarding prevention of opioid 
        addiction and coverage and reimbursement under the Medicare 
        program and the Medicaid program of appropriate opioid 
        addiction treatments.
            (4) Recommendations for provider education that can expand 
        patient access to the full range of medication-assisted 
        treatment approved by the Food and Drug Administration for the 
        treatment of opioid addiction and other therapies that manage 
        chronic and acute pain and treat and minimize risk of opioid 
        addiction.
            (5) Recommendations for policies under the Medicare program 
        and under the Medicaid program that can expand access for 
        rural, or medically underserved communities to the full range 
        of medication-assisted treatment approved by the Food and Drug 
        Administration for the treatment of opioid addiction and other 
        therapies that manage chronic and acute pain and treatment and 
        minimize risk of opioid addiction.
    (c) Stakeholder Meetings.--
            (1) In general.--Beginning not later than 3 months after 
        the date of the enactment of this Act, the Secretary shall 
        convene a public stakeholder meeting to solicit public comment 
        on the components of the action plan recommendations described 
        in subsection (b).
            (2) Participants.--Participants of meetings described in 
        paragraph (1) shall include representatives from the Food and 
        Drug Administration and National Institutes of Health, 
        biopharmaceutical industry members, medical researchers, health 
        care providers, the medical device industry, the Medicare 
        program, the Medicaid program, and patient advocates.
    (d) Request for Information.--Not later than 3 months after the 
date of the enactment of this section, the Secretary shall issue a 
request for information seeking public feedback regarding ways in which 
the Centers for Medicare & Medicaid Services can help address the 
opioid crisis through the development of and application of the action 
plan.
    (e) Report to Congress.--Not later than March 1, 2019, the 
Secretary shall submit to Congress, and make public, a report that 
includes a summary of steps taken under the action plan, 
recommendations that have emerged under the action plan, and the 
Secretary's planned next steps with respect to the action plan.
    (f) Definition of Medication-Assisted Treatment.--In this section, 
the term ``medication-assisted treatment'' includes opioid treatment 
programs, behavioral therapy, and medications to treat substance abuse 
disorder.

SEC. 2. REPORT ON COVERAGE, CODING, AND REIMBURSEMENT POLICIES UNDER 
              MEDICARE.

    (a) In General.--Not later than 1 year after the date of the 
enactment of this Act, the Secretary of Health and Human Services (in 
this section referred to as the ``Secretary'') shall--
            (1) identify--
                    (A) medical devices that are non-opioid based 
                treatments approved by the Food and Drug Administration 
                for the management of acute pain and chronic pain;
                    (B) medical devices that are non-opioid based 
                treatments approved by the Food and Drug Administration 
                that monitor substance use withdrawal and prevent 
                overdoses of controlled substances; and
                    (C) medical devices that are non-opioid based 
                treatments approved by the Food and Drug Administration 
                that treat substance use disorder; and
            (2) submit to the Committee on Finance of the Senate and 
        the Committees on Ways and Means and Energy and Commerce of the 
        House of Representatives, and publish on a public Internet 
        website of the Department of Health and Human Services, a 
        report containing recommendations on ways to encourage the use 
        of such medical devices by individuals entitled to benefits 
        under part A of title XVIII of the Social Security Act and 
        enrolled under part B of such title (including individuals 
        enrolled in a Medicare Advantage plan under part C of such 
        title or in a prescription drug plan under part D of such 
        title) and individuals enrolled under a State plan under title 
        XIX of such Act.
    (b) Contents.--The report under subsection (a) shall include an 
analysis of the following, with respect to the Medicare program under 
title XVIII of the Social Security Act and the Medicaid program under 
title XIX of such Act:
            (1) Various opioid alternatives for pain treatment that are 
        covered under such programs, that are not covered under such 
        programs, that have limited coverage under such program, or 
        with respect to which there are payment barriers under such 
        programs.
            (2) Various medical devices that monitor substance use 
        withdrawal and prevent overdose of controlled substances that 
        are covered so covered, that are not so covered, that have such 
        limited coverage, or with respect to which there are such 
        payment barriers.
            (3) Various medical devices that treat substance use 
        disorder and opioid use disorder that are so covered, that are 
        not so covered, that have such limited coverage, or with 
        respect to which there are such payment barriers.
            (4) Access to payment codes used by health care providers 
        that promote alternative options for pain management therapies 
        without the use of opioids, including minimally invasive pain 
        therapies.
            (5) Ways to improve communications between Medicare 
        prescription drug plans and Medicare Advantage plans, Medicare 
        and Medicaid health care providers, and Medicare beneficiaries 
        and Medicaid beneficiaries on the potential harm associated 
        with the use of opioids and other controlled substances, 
        including the need to safely store and dispose of supplies 
        relating to the use of opioids and other controlled substances.
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