Comprehensive Addiction and Recovery Act of 2016

Bill: 114-s-524
Sponsor: Sen. Whitehouse, Sheldon [D-RI]
Introduced: 2015-02-12 in the Senate
Policy area: Crime and Law Enforcement
Subjects: Advisory bodies
Alternative treatments
Child health
Child safety and welfare
Civil actions and liability
Congressional oversight
Correctional facilities and imprisonment
Crime prevention
Criminal investigation, prosecution, interrogation
Criminal procedure and sentencing
Department of Veterans Affairs
Drug safety, medical device, and laboratory regulation
Drug therapy
Drug trafficking and controlled substances
Drug, alcohol, tobacco use
Education programs funding
Elementary and secondary education
Emergency medical services and trauma care
Employee hiring
Employee performance
Family services
Government employee pay, benefits, personnel management
Government studies and investigations
Health care costs and insurance
Health care coverage and access
Health care quality
Health facilities and institutions
Health information and medical records
Health personnel
Health programs administration and funding
Health promotion and preventive care
Higher education
Home and outpatient care
Internet and video services
Internet, web applications, social media
Juvenile crime and gang violence
Law enforcement administration and funding
Law enforcement officers
Licensing and registrations
Medicaid
Medical ethics
Medical research
Medicare
Mental health
Military medicine
Prescription drugs
Teaching, teachers, curricula
Veterans' education, employment, rehabilitation
Veterans' medical care
Vocational and technical education
Women's health

Summary:
action_date: 2015-02-12
text: 

Comprehensive Addiction and Recovery Act of 2015

 
 Directs the Department of Health and Human Services (HHS) to convene a Pain Management Best Practices Inter-Agency Task Force to develop: (1) best practices for pain management and prescribing pain medication, and (2) a strategy for disseminating such best practices.
 
Amends the Omnibus Crime Control and Safe Streets Act of 1968 to authorize the Attorney General to make grants to: 
 
 
 states (with priority to states that provide civil liability protection for first responders, health professionals, and family members administering naloxone to counteract opioid overdoses), local governments, and nonprofit organizations to expand educational efforts to prevent abuse of opioids, heroin, and other substances of abuse, understand addiction as a chronic disease, and promote treatment and recovery; 
 
organizations that have received a grant under the Drug-Free Communities Act of 1997 to implement comprehensive community-wide strategies that address local drug crises;
 
 states (with priority to states that provide civil liability protection for administering naloxone), local governments, Indian tribes, and nonprofit organizations for treatment alternative to incarceration programs for individuals who have come into contact with the juvenile or criminal justice system or have been arrested or charged with an offense, who have a substance use disorder, mental illness, or both, and who have been approved for participation in such a program;
 
state, local, or tribal law enforcement agencies to create a demonstration law enforcement program to prevent opioid and heroin overdose death;
 
 state, local, or tribal law enforcement agencies, manufacturers, distributors, or reverse distributor of prescription medications, retail pharmacies, registered narcotic treatment programs, hospitals or clinics with an on-site pharmacy, eligible long-term care facilities, or any other entity authorized by the Drug Enforcement Administration to dispose of prescription medications to expand or make available disposal sites for unwanted prescription medications;
 
states (with priority to states that provide civil liability protection for administering naloxone), local governments, and Indian tribes to implement medication assisted treatment programs through their criminal justice agencies; 
 
states, local governments, nonprofit organizations, and Indian tribes for educational programs for incarcerated offenders; 
 
 state substance abuse and criminal justice agencies, jointly, to address the use of opioids and heroin among pregnant and parenting female offenders in a state to promote public safety, public health, family permanence, and well-being;
 
establish or expand veterans treatment court programs, peer to peer services or programs for qualified veterans, practices that identify and provide treatment, rehabilitation, legal, and transitional services to incarcerated veterans, and training programs to teach criminal justice, mental health, and substance abuse personnel how to identify and appropriately respond to incidents involving veterans; and
 
states to prepare a comprehensive plan for and implement an integrated opioid abuse response initiative. 
 
 
Amends the Public Health Service Act to authorize the Center for Substance Abuse Treatment to award grants to enable state substance abuse agencies, local governments, nonprofit organizations, and Indian tribes or tribal organizations that have a high rate of, or have had a rapid increase in, the use of heroin or other opioids to expand activities, including medication assisted treatment, for the treatment of addiction in the geographical areas affected.
 
Authorizes the Recovery Branch of the Office of National Drug Control Policy to award grants to: (1) enable high schools and colleges with substance abuse recovery programs and nonprofit organizations to provide substance abuse recovery support services to high school and college students, to help build communities of support for young people in recovery, and to encourage initiatives designed to help young people achieve and sustain recovery; and (2) enable recovery community organizations to develop, expand, and enhance recovery services.
 
Amends the Higher Education Act of 1965 to prohibit the Department of Education from including any question about the conviction of an applicant for the possession or sale of illegal drugs on the Free Application for Federal Student Aid form.
 
Directs HHS to establish a bipartisan Task Force on Recovery and Collateral Consequences to: (1) identify collateral consequences for individuals with drug convictions who are in recovery for a substance use disorder, and (2) determine whether such consequences unnecessarily delay such individuals from resuming their personal and professional activities.
 
Amends the Omnibus Crime Control and Safe Streets Act to direct the Attorney General to report annually on how grants awarded under such Act are used for family-based substance abuse treatment programs that serve as alternatives to incarceration for custodial parents to receive treatment and services as a family.
 
Expresses the sense of Congress that the amounts expended to carry out this Act should be offset by a corresponding reduction in federal non-defense discretionary spending.
 
Directs the Comptroller General to report on the impact that the Medicaid Institutions for Mental Disease exclusion (defined as the prohibition on federal matching payments under Medicaid for patients who have attained age 22, but have not attained age 65, in an institution for mental diseases) has on access to treatment for individuals with a substance use disorder.

action_date: 2016-02-22
text: 

Comprehensive Addiction and Recovery Act of 2016

 
TITLE I--PREVENTION AND EDUCATION
 
(Sec. 101) This bill requires the Department of Health and Human Services (HHS), in cooperation with the Department of Veterans Affairs, the Department of Defense, and the Drug Enforcement Administration (DEA), to convene a Pain Management Best Practices Inter-Agency Task Force to review, modify, and update best practices for pain management and prescription of pain medication. The task force does not have rulemaking authority. 
 
(Sec. 102) It directs HHS to promote education and awareness of prescription opioid abuse. (Opioids are drugs with effects similar to opium, such as certain prescription pain medication, fentanyl [a synthetic opioid], and heroin.)
 
The Office of National Drug Control Policy (ONDCP) must establish a national drug awareness campaign that addresses the similarities between opioids and heroin, the link between prescription opioid abuse and heroin use, and the dangerous effects of mixing fentanyl with heroin.
 
(Sec. 103) The bill amends the Omnibus Crime Control and Safe Streets Act of 1968 to authorize the Department of Justice (DOJ) to award grants to community-based coalitions to enhance community-wide prevention strategies to address a high rate or rapid increase of opioid or methamphetamine abuse. 
 
TITLE II--LAW ENFORCEMENT AND TREATMENT
 
(Sec. 201) HHS may award grants to state, local, or tribal governments or nonprofit organizations to develop, implement, or expand treatment alternative to incarceration programs and to enhance state criminal justice and substance abuse agency collaboration to address prescription opioid abuse and heroin use. HHS must give priority to joint applications from criminal justice and substance abuse agencies and applications from states that provide civil liability protection for trained first responders, health professionals, or family members who administer an opioid overdose reversal drug (e.g., naloxone) to counteract opioid overdose. 
 
(Sec. 202) HHS may award grants to state, local, or tribal governments to equip and train first responders to administer naloxone to treat an opioid overdose. HHS must provide technical assistance and training. At least 25% of grant funds must be awarded to entities in rural areas with limited access to emergency medical services. 
 
(Sec. 203) DOJ must expand disposal sites for unwanted prescription medications. 
 
(Sec. 204) DOJ may make grants to state law enforcement agencies to investigate illicit activities related to: (1) heroin or fentanyl distribution or unlawful prescription opioid distribution, and (2) methamphetamine manufacture or distribution. 
 
TITLE III--TREATMENT AND RECOVERY
 
(Sec. 301) The bill authorizes the Substance Abuse and Mental Health Services Administration (SAMHSA) to award grants to state, local, or tribal governments or community-based organizations to expand treatment programs, including medication-assisted treatment programs, in areas with a high rate or rapid increase in prescription opioid or heroin use. SAMHSA must ensure equitable geographic distribution of grants and provide technical assistance to grant recipients. 
 
(Sec. 302) HHS may award grants to state, local, or tribal governments to implement medication-assisted treatment programs through courts, prisons, jails, or other criminal justice agencies. HHS must prioritize entities in states that provide civil liability protection for trained first responders, health professionals, or family members who administer naloxone to counteract opioid overdose. Additionally, HHS must provide technical assistance and training to grant recipients. 
 
(Sec. 303) HHS may award grants to high schools, institutions of higher education, or nonprofit organizations to provide recovery support services, build supportive communities for young people in recovery, and promote sustained recovery for young people with substance use disorders. 
 
(Sec. 304) HHS may award matching grants to recovery community organizations to expand, develop, and enhance state and community recovery support services to facilitate long-term recovery from substance use disorders. A recovery community organization is an independent nonprofit organization led by individuals in long-term recovery from substance abuse disorders. 
 
TITLE IV--ADDRESSING COLLATERAL CONSEQUENCES
 
(Sec. 401) The bill authorizes DOJ to award grants to state, local, or tribal governments to design, implement, and expand educational programs for offenders in prisons, jails, and juvenile facilities. A grant recipient may restrict prisoners' Internet access to ensure public safety. 
 
(Sec. 402) DOJ must establish a bipartisan Task Force on Recovery and Collateral Consequences to identify collateral consequences imposed on convicted drug offenders who are in recovery for a substance use disorder and develop and submit legislative and regulatory recommendations to modify such collateral consequences. A collateral consequence is a penalty imposed as a result of a criminal conviction but not as part of the court judgment. 
 
TITLE V--ADDICTION AND TREATMENT SERVICES FOR WOMEN, FAMILIES, AND VETERANS
 
(Sec. 501) The bill authorizes SAMHSA to create a pilot program to award competitive grants to state substance abuse agencies to support family-based services for pregnant and postpartum women with a substance use disorder, address gaps in services provided to women in non-residential based settings, and encourage evidence-based services. The Center for Behavioral Health Statistics and Quality must evaluate the pilot program and report to Congress. 
 
(Sec. 502) DOJ must annually report the number of grant awards under the Family-Based Adult Offender Substance Abuse Treatment Program and how such grants are used for family-based substance abuse treatment programs that serve as an alternative to incarceration for custodial parent drug offenders. 
 
TITLE VI--INCENTIVIZING STATE COMPREHENSIVE INITIATIVES TO ADDRESS OPIOID AND HEROIN ABUSE
 
(Sec. 601) DOJ may award grants to states to establish and implement a comprehensive response to opioid abuse that includes prevention and education efforts, a prescription drug monitoring program, prescription drug and opioid addiction treatment programs, and overdose death prevention programs. DOJ must give priority to states that: (1) provide civil liability protection for trained first responders, health professionals, or family members who administer naloxone; (2) do not terminate Medicaid eligibility for individuals who are incarcerated for less than two years; (3) enroll incarcerated drug offenders in community-based treatment services prior to reentry; and (4) record, share, or analyze data from prescription drug monitoring database to identify potential abuse.
 
TITLE VII: MISCELLANEOUS
 
(Sec. 701) The Government Accountability Office must report to Congress on how the Medicaid institutions for mental disease (IMD) exclusion impacts access to inpatient treatment and quality of inpatient and outpatient treatment for Medicaid enrollees with substance use disorders. The Medicaid IMD exclusion bars Medicaid reimbursement for certain inpatient mental health care services (including substance use disorder treatment) for patients aged 21 to 64. 
 
(Sec. 702) The bill authorizes addiction and recovery programs under this Act through FY2020. 
 
(Sec. 704) It prohibits the use of DOJ and HHS grants under this Act for conferences that cost more than $20,000 without prior written approval. The Inspector General for DOJ and HHS must conduct annual audits of selected grant recipients. It bars DOJ and HHS grants to nonprofit organizations that hold money in an offshore account to avoid tax liability. Additionally, DOJ and HHS must identify and report on duplicative grant awards. 
 

action_date: 2016-03-10
text: 

Comprehensive Addiction and Recovery Act of 2016

 
TITLE I--PREVENTION AND EDUCATION
 
(Sec. 101) This bill requires the Department of Health and Human Services (HHS), in cooperation with the Department of Veterans Affairs, the Department of Defense, and the Drug Enforcement Administration , to convene a Pain Management Best Practices Interagency Task Force to review, modify, and update best practices for pain management and prescription of pain medication. The task force does not have rulemaking authority. 
 
(Sec. 102) It directs HHS to promote education and awareness of prescription opioid abuse. Such education and training must include information on the dangers, prevention, and early warning signs of opioid abuse. (Opioids are drugs with effects similar to opium, such as certain prescription pain medication, fentanyl [a synthetic opioid], and heroin.)
 
The Office of National Drug Control Policy must establish a national drug awareness campaign that addresses the similarities between opioids and heroin, the link between prescription opioid abuse and heroin use, and the dangerous effects of mixing fentanyl with heroin.
 
(Sec. 103) The bill amends the Omnibus Crime Control and Safe Streets Act of 1968 to authorize HHS to award grants to community-based coalitions to enhance community-wide prevention strategies to address a high rate or rapid increase of opioid or methamphetamine abuse. 
 
TITLE II--LAW ENFORCEMENT AND TREATMENT
 
(Sec. 201) HHS may award grants to state, local, or tribal governments or nonprofit organizations to develop, implement, or expand treatment alternative to incarceration programs and to enhance state criminal justice and substance abuse agency collaboration to address prescription opioid abuse and heroin use. HHS must give priority to joint applications from criminal justice and substance abuse agencies and applications from states that provide civil liability protection for trained first responders, health professionals, or family members who administer an opioid overdose reversal drug (e.g., naloxone) to counteract opioid overdose. 
 
(Sec. 202) HHS may award grants to state, local, or tribal governments to allow appropriately trained first responders to administer an opioid overdose reversal drug to treat an opioid overdose. Grant funds must be used to equip first responders with opioid overdose reversal drugs, train first responders to administer such drugs, and develop protocols to refer overdose victims to appropriate treatment. HHS must provide technical assistance and training grants. At least 25% of grant funds must be awarded to entities in rural areas with limited access to emergency medical services. 
 
(Sec. 203) The Department of Justice (DOJ) must expand or make available disposal sites for unwanted prescription medications. 
 
(Sec. 204) DOJ may make grants to state law enforcement agencies to investigate illicit activities related to: (1) heroin, fentanyl, or unlawful prescription opioid distribution, and (2) precursor diversion, laboratories, or methamphetamine manufacture or distribution.
 
TITLE III--TREATMENT AND RECOVERY
 
(Sec. 301) The bill authorizes the Substance Abuse and Mental Health Services Administration (SAMHSA) to award grants to state, local, or tribal governments or community-based organizations to expand treatment programs, including medication-assisted treatment programs, in areas with a high rate or rapid increase in prescription opioid or heroin use. SAMHSA must equitably distribute grants geographically, evaluate grant-supported activities, and provide technical assistance. 
 
(Sec. 302) HHS may award grants to state, local, or tribal governments to implement medication-assisted treatment programs through courts, prisons, jails, or other criminal justice agencies. HHS must prioritize entities in states that provide civil liability protection for trained first responders, health professionals, or family members who administer naloxone to counteract opioid overdose. Additionally, HHS must provide technical assistance and training to grant recipients. 
 
(Sec. 303) HHS may award grants to high schools, institutions of higher education, or nonprofit organizations to provide recovery support services, build supportive communities, and promote sustained recovery for young people with substance use disorders. 
 
(Sec. 304) HHS may award matching grants to recovery community organizations to expand, develop, and enhance state and community recovery support services to facilitate long-term recovery from substance use disorders. A recovery community organization is an independent nonprofit organization that is led by individuals who are in long-term recovery from substance abuse disorders. 
 
TITLE IV--ADDRESSING COLLATERAL CONSEQUENCES
 
(Sec. 401) The bill authorizes DOJ to award grants to state, local, or tribal governments to design, implement, and expand educational programs for offenders in prisons, jails, and juvenile facilities. A grant recipient may restrict prisoners' Internet access to ensure public safety. 
 
(Sec. 402) DOJ must establish a bipartisan Task Force on Recovery and Collateral Consequences to identify collateral consequences imposed on convicted drug offenders who are in recovery for a substance use disorder and develop and submit legislative and regulatory recommendations to modify such collateral consequences. A collateral consequence is a penalty imposed as a result of a criminal conviction but not as part of the court judgment. 
 
TITLE V--ADDICTION AND TREATMENT SERVICES FOR WOMEN, FAMILIES, AND VETERANS
 
(Sec. 501) The bill authorizes SAMHSA to create a pilot program to award competitive grants to state substance abuse agencies to support family-based services for pregnant and postpartum women with a substance use disorder, address gaps in services provided to women in non-residential based settings, and encourage evidence-based services. The Center for Behavioral Health Statistics and Quality must evaluate the pilot program and report to Congress. 
 
(Sec. 502) DOJ must annually report the number of grant awards under the Family-Based Adult Offender Substance Abuse Treatment Program and how such grants are used for family-based substance abuse treatment programs that serve as an alternative to incarceration for custodial parent drug offenders. 
 
TITLE VI--INCENTIVIZING STATE COMPREHENSIVE INITIATIVES TO ADDRESS OPIOID AND HEROIN ABUSE
 
(Sec. 601) DOJ may award grants to states to establish and implement a comprehensive response to opioid abuse that includes prevention and education efforts, a prescription drug monitoring program, prescription drug and opioid addiction treatment programs, and overdose death prevention programs. DOJ must give priority to states that: (1) provide civil liability protection for trained first responders, health professionals, or family members who administer naloxone; (2) do not terminate Medicaid eligibility for individuals who are incarcerated for less than two years; (3) enroll incarcerated drug offenders in community-based treatment services prior to reentry; and (4) record, share, or analyze data from prescription drug monitoring database to identify potential abuse.
 
TITLE VII--MISCELLANEOUS
 
(Sec. 701) The Government Accountability Office must report to Congress on how the Medicaid institutions for mental disease (IMD) exclusion impacts access to inpatient treatment and quality of inpatient and outpatient treatment for Medicaid enrollees with substance use disorders. The Medicaid IMD exclusion bars Medicaid reimbursement for certain inpatient mental health care services (including substance use disorder treatment) for patients aged 21 to 64. 
 
(Sec. 702) The bill authorizes addiction and recovery programs under this Act through FY2020. 
 
(Sec. 704) It prohibits the use of DOJ and HHS grants under this Act for conferences that cost more than $20,000 without prior written approval. The Inspector General for DOJ and HHS must conduct annual audits of selected grant recipients. It bars DOJ and HHS grants to nonprofit organizations that hold money in an offshore account to avoid tax liability. Additionally, DOJ and HHS must identify and report on duplicative grant awards.
 
(Sec. 705) This bill amends part D (Voluntary Prescription Drug Benefit Program) of title XVIII (Medicare) of the Social Security Act to authorize a Medicare prescription drug plan (PDP) sponsor to establish a drug management program to limit the prescribers and pharmacies who provide frequently abused drugs to an at-risk beneficiary. A PDP sponsor must have in place a utilization management tool to prevent drug abuse.
 
A PDP sponsor must: (1) notify a beneficiary who is identified as being at-risk for prescription drug abuse, (2) consider the beneficiary's preferences in selecting allowable prescribers and pharmacies, and (3) ensure the beneficiary has continued reasonable access to drugs. 
 
The bill exempts from identification as at-risk beneficiary an individual who is receiving hospice care or residing in a long-term care facility.
 
HHS must establish procedures for PDP plan sponsors to share information about at-risk beneficiaries. 
 
TITLE VIII--TRANSNATIONAL DRUG TRAFFICKING ACT
 

Transnational Drug Trafficking Act of 2015

 
(Sec. 802) This bill amends the Controlled Substances Import and Export Act to broaden the scope of persons subject to criminal prosecution for manufacturing or distributing a controlled substance in schedule I or II, a precursor chemical, or flunitrazepam for unlawful import into the United States. The Controlled Substances Act classifies drugs, substances, and chemicals used to make drugs into one of five schedules based on the drug's medical use, potential for abuse, and risk of dependence. 
Current law prohibits such manufacture or distribution by a person who knows or intends that the substance or chemical will be unlawfully imported. This bill broadens the scope to also prohibit such manufacture or distribution by a person who reasonably believes that the substance or chemical will be unlawfully imported. 
In addition, this bill prohibits the manufacture or distribution of a precursor chemical by a person who: (1) knows or intends that the chemical will be used to manufacture a controlled substance; and (2) knows, intends, or reasonably believes that the controlled substance will be unlawfully imported into the United States. 
(Sec. 803) The legislation amends the federal criminal code to replace statutory references to prohibited trafficking in a &quot;counterfeit drug&quot; with references to prohibited trafficking in a &quot;drug that uses a counterfeit mark on or in connection with the drug.&quot;
action_date: 2016-05-13
text: 
TITLE I--PAIN MANAGEMENT BEST PRACTICES INTER-AGENCY TASK FORCE
 
(Sec. 101) This bill requires the Department of Health and Human Services (HHS) to convene a Pain Management Best Practices Inter-Agency Task Force to: (1) review, modify, and update best practices for pain management and prescribing pain medication; and (2) examine and identify the need for, development of, and availability of medical alternatives to opioids (drugs with effects similar to opium, such as heroin and certain pain medications).
 
TITLE II--COMPREHENSIVE OPIOID ABUSE REDUCTION ACT
 

Comprehensive Opioid Abuse Reduction Act of 2016

 
(Sec. 202) This bill amends the Omnibus Crime Control and Safe Streets Act of 1968 to authorize the Department of Justice (DOJ) to award grants to state, local, and tribal governments to provide opioid abuse services, including: 
 
 
enhancing collaboration between criminal justice and substance abuse agencies;
 
developing, implementing, or expanding programs to prevent, treat, or respond to opioid abuse; 
 
 training first responders to administer opioid overdose reversal drugs; and
 
 investigating unlawful opioid distribution activities.
 
 
(Sec. 203) DOJ's Office of the Inspector General must audit a number of DOJ grant recipients each year. Grants may not be awarded to nonprofit organizations that hold money in offshore accounts to avoid tax liability. 
 
(Sec. 204) DOJ may award grants to state, local, and tribal governments to establish or expand programs for veterans, including veterans treatment courts, peer-to-peer services, and treatment, rehabilitation, legal, or transitional services for incarcerated veterans.
 
(Sec. 205) As an offset, this title amends the Justice Assistance Act of 1984 to eliminate existing authority for DOJ to award grants under the Emergency Federal Law Enforcement Assistance Program through FY2021.
 
(Sec. 206) The Family-Based Substance Abuse Treatment Program is expanded to include prison-based family treatment programs for pregnant women.
 
(Sec. 207) The Government Accountability Office (GAO) must report on how DOJ grant programs address substance use and substance use disorders among adolescents and young adults. 
 
TITLE III--JASON SIMCAKOSKI PROMISE ACT
 

Promoting Responsible Opioid Management and Incorporating Scientific Expertise Act or the Jason Simcakoski PROMISE Act

 
(Sec. 302) This bill directs the Department of Veterans Affairs (VA) to expand its Opioid Safety Initiative to include all VA medical facilities. 
 
The VA must direct VA health care providers, before initiating opioid therapy, to use the VA's Opioid Therapy Risk Report tool, which must include: (1) information from state prescription drug monitoring programs, (2) a patient's most recent information, (3) information on controlled substances prescribed to a patient outside the VA, (4) the most recent time the tool was accessed by a VA health care provider regarding a patient, (5) the results of a patient's most recent drug test, and (6) the ability to determine whether a health care provider prescribed an opioid to a patient without checking information in the tool.
 
The VA must establish enhanced standards for urine drug tests before and during opioid therapy to help prevent substance abuse, dependence, and diversion. 
 
The VA must use the Interdisciplinary Chronic Pain Management Training Team Program to provide education and training on pain management and safe opioid prescribing practices.
 
 Each VA medical facility must designate a pain management team of health care professionals to coordinate pain management therapy for patients experiencing pain that is not related to cancer. The VA must establish standard protocols for the designation of pain management teams. The protocols must ensure that a health care provider without expertise or training in prescribing pain medications does not prescribe opioids unless the health care provider: (1) consults with a provider who has pain management expertise or who is on the pain management team; and (2) refers the patient to the pain management team for subsequent prescriptions and therapy. 
 
VA health care providers to must provide information on prescriptions of controlled substances received by veterans to state prescription drug monitoring programs. 
 
The VA must report on improving the Opioid Therapy Risk Report tool to allow for improved real-time tracking and access to data on certain clinical indicators, concurrent prescribing of opioids by VA health care providers, and mail-order opioid prescriptions.
 
The VA must: (1) maximize the availability to veterans of opioid overdose reversal drugs, such as naloxone; (2) equip each VA pharmacy with such medications for outpatient use; and (3) expand the Overdose Education and Naloxone Distribution program to ensure that veterans receiving VA health care who are at risk of opioid overdose may access such drugs and training on the proper administration of such drugs. 
 
The VA must modify its patient record system to ensure that health care providers who access a veteran's record will be immediately notified about whether the veteran is receiving opioid therapy, has a history of substance use disorder or overdose, or is at risk of opioid abuse.
 
(Sec. 303) The VA and the Department of Defense (DOD) must ensure that the VA/DOD Pain Management Working Group: (1) includes a focus on specified practices, (2) coordinates with other working groups, (3) consults with other federal agencies, and (4) and consults with the VA and DOD regarding proposed updates to the VA/DOD Clinical Practice Guideline for Management of Opioid Therapy for Chronic Pain. 
 
The VA and DOD must update the VA/DOD Clinical Practice Guideline for Management of Opioid Therapy for Chronic Pain.
 
(Sec. 304) The GAO must report on the VA's Opioid Safety Initiative and the opioid prescribing practices of VA health care providers.
 
The VA must report on the prescription of opioids to certain patients at each VA facility and notify Congress and investigate if a provider's or facility's prescription rate is inconsistent with safe care standards. 
 
(Sec. 305) VA disclosure of certain information to a state prescription drug monitoring program in order to prevent misuse of prescription medicines by a veteran or dependent is made mandatory.
 
(Sec. 306) This bill amends the Veterans Access, Choice, and Accountability Act of 2014 to reduce the aggregate amount of awards and bonuses that may be paid by the VA in each of FY2017-FY2021.
 
TITLE IV--KINGPIN DESIGNATION IMPROVEMENT ACT
 

Kingpin Designation Improvement Act of 2016

 
(Sec. 402) This bill amends the Foreign Narcotics Kingpin Designation Act to allow classified information to be submitted to a reviewing court ex parte (without all parties present) or in camera (in private) in a judicial review of a determination by the President that a foreign person is subject to sanctions as a significant foreign narcotics trafficker.
 
TITLE V--GOOD SAMARITAN ASSESSMENT ACT
 

Good Samaritan Assessment Act of 2016

 
(Sec. 503) The GAO must report on the Office of National Drug Control Policy's review of state and local Good Samaritan laws that exempt from criminal or civil liability any individual who administers an opioid overdose reversal drug or device (e.g., naloxone) or who contacts emergency services providers in response to an overdose.
 
TITLE VI--OPEN ACT
 

Opioid Program Evaluation Act or the OPEN Act

 
(Sec. 602) DOJ and HHS must each enter into an arrangement with the National Academy of Sciences to identify outcomes and develop metrics to evaluate: (1) the incidence of opioid abuse and illegal opioid distribution, and (2) the effectiveness of department grant programs regarding opioid abuse. DOJ and HHS must each publish outcomes and metrics and require grant recipients to collect and report data. The National Academy of Sciences must publish the evaluations.
 
(Sec. 606) As an offset, this title reduces the authorization of appropriations for financial assistance under the Emergency Federal Law Enforcement Assistance program for FY2022.
 
TITLE VII--INFANT PLAN OF SAFE CARE IMPROVEMENT ACT
 

Infant Plan of Safe Care Improvement Act 

 
(Sec. 702) This bill amends the Child Abuse Prevention and Treatment Act to require the national clearinghouse for information relating to child abuse to maintain and disseminate information about requirements and best practices relating to the development of plans of safe care for infants born affected by illegal substance abuse symptoms, withdrawal symptoms, or a Fetal Alcohol Spectrum Disorder.
 
(Sec. 703) The plan of safe care for such infants that is required for a state to receive a grant to improve its child protective services system must: (1) address the health and substance use disorder treatment needs of the infant and affected family or caregiver, and (2) specify a system for monitoring whether and in what manner local entities are providing services in accordance with state requirements.
 
(Sec. 704) Annual state data reports must include the number of such infants, the number for whom a plan of safe care was developed, and the number for whom referrals are made for services, including services for the affected family or caregiver.
 
(Sec. 705) HHS must monitor state compliance with child protective services system grant requirements.
 
TITLE VIII--NAS HEALTHY BABIES ACT
 

Nurturing and Supporting Healthy Babies Act or the NAS Healthy Babies Act

 
(Sec. 802) The GAO must report on:
 
 
the prevalence of neonatal abstinence syndrome (NAS), which is the symptoms of withdrawal in a newborn; 
 
NAS treatment services for which coverage is available under state Medicaid programs; 
 
the care settings and reimbursement for NAS treatment; 
 
the prevalence of use of various care settings for NAS treatment under state Medicaid programs; 

any federal barriers to treating infants with NAS under state Medicaid programs; and
 
its recommendations for improvements that will ensure access to NAS treatment under state Medicaid programs.
 
 
(Sec. 803) This bill amends title XIX (Medicaid) of the Social Security Act to exclude abuse-deterrent prescription drugs from the requirement that manufacturers of single-source or innovator drugs pay additional rebates to state Medicaid programs.
 
(Sec. 804) Under current law, the Centers for Medicare & Medicaid Services must use analytic technologies to identify improper Medicaid claims. The bill prohibits a state agency from using or disclosing such technologies except for purposes of administering a state Medicaid program or Children's Health Insurance Program (CHIP). State agencies must have adequate data security and control policies to ensure that access to such information is restricted to authorized persons for authorized uses.
 
(Sec. 805) The bill places $5 million in the Medicaid Improvement Fund to be available beginning in FY2021.
 
TITLE IX--CO-PRESCRIBING TO REDUCE OVERDOSES ACT
 

Co-Prescribing to Reduce Overdoses Act of 2016

 
(Sec. 902) HHS may establish a grant program to support prescribing opioid overdose reversal drugs (e.g., naloxone) for patients at an elevated risk of overdose, including patients prescribed an opioid.
 
Grant recipients may use the funds to purchase opioid overdose reversal drugs, establish a program for prescribing such drugs, train health care providers and pharmacists, track patients and outcomes, offset patient cost sharing, conduct community outreach, and connect patients to treatment.
 
(Sec. 903) HHS may provide information to prescribers in federally qualified health centers and Indian Health Service facilities on best practices for prescribing opioid overdose reversal drugs for patients at an elevated risk of overdose.
 
(Sec. 904) This title amends the Public Health Service Act to reduce, as an offset, the authorization of appropriations for Centers for Disease Control and Prevention facilities for FY2018.
 
TITLE X--IMPROVING TREATMENT FOR PREGNANT AND POSTPARTUM WOMEN ACT
 

Improving Treatment for Pregnant and Postpartum Women Act of 2016

 
(Sec. 1002) Support for residential substance abuse treatment programs for pregnant and postpartum women is extended through FY2021.
 
(Sec. 1003) The Center for Substance Abuse Treatment must carry out a pilot program to make grants to state substance abuse agencies to support services for pregnant and postpartum women who have a primary diagnosis of a substance use disorder, including opioid use disorders. The Center for Behavioral Health Statistics and Quality must fund an evaluation of the pilot program.
 
(Sec. 1004) As an offset, this title reduces the authorization of appropriations for Centers for Disease Control and Prevention facilities for FY2017.
 
TITLE XI--VETERAN EMERGENCY MEDICAL TECHNICIAN SUPPORT ACT
 

Veteran Emergency Medical Technician Support Act of 2016

 
(Sec. 1102) HHS must establish a demonstration program for states with a shortage of emergency medical technicians (EMTs) to streamline state requirements and procedures to assist veterans who completed military EMT training to meet state EMT certification, licensure, and other requirements.
 
TITLE XII--JOHN THOMAS DECKER ACT
 

John Thomas Decker Act of 2016

 
(Sec. 1202) HHS must report on the availability of information regarding prescription of opioids after youth sports injury, including information on opioid use and misuse, injury treatments that do not involve opioids, and treatment for opioid addiction. The report must determine the extent this information is available to teenagers and adolescents who play youth sports, their families, youth sports groups, and health care providers.
 
Taking into consideration the findings of the report, HHS must develop and disseminate such information. 
 
TITLE XIII--LALI'S LAW
 

Lali's Law

 
(Sec. 1302) HHS may make grants to states that allow standing orders (documents that allow a person to acquire, dispense, or administer a prescription medication without a person-specific prescription) for opioid overdose reversal drugs (e.g., naloxone). Grants may be used for:
 
 
 developing standing orders for opioid overdose reversal drugs for pharmacies,
 
encouraging pharmacies to dispense drugs pursuant to such a standing order,
 
implementing best practices for prescribing opioids and prescribing and discussing with patients opioid overdose reversal drugs,
 
developing training for prescribers to use in educating the public on administration of opioid overdose reversal drugs, and
 
educating the public on the availability and public health benefits of opioid overdose reversal drugs.
 
 
States must report on pharmacies that dispense opioid overdose reversal drugs under a standing order and the number of pharmacists trained in educating the public on administration of opioid overdose reversal drugs. 
 
(Sec. 1303) As an offset, this title reduces the authorization of appropriations for Centers for Disease Control and Prevention facilities for FY2017.
 
TITLE XIV--REDUCING UNUSED MEDICATIONS ACT
 

Reducing Unused Medications Act of 2016

 
(Sec. 1402) This bill amends the Controlled Substances Act to allow a pharmacist to partially fill a prescription for a schedule II controlled substance (such as an opioid) if: (1) such partial fills are not prohibited by state law, (2) a partial fill is requested by the patient or prescribing practitioner, and (3) the total quantity dispensed in partial fillings does not exceed the quantity prescribed. Such prescriptions may also be partially filled in accordance with existing Drug Enforcement Administration (DEA) regulations that permit partial fills when a pharmacist cannot supply a full quantity, a patient resides in a long-term care facility, or a patient is terminally ill.
 
The bill specifies time limits for filling the remaining portion of a partially filled prescription.
 
TITLE XV--OPIOID REVIEW MODERNIZATION ACT
 

Opioid Review Modernization Act of 2016

 
(Sec. 1502) This bill amends the Federal Food, Drug, and Cosmetic Act to require the Food and Drug Administration (FDA) to refer new drug applications for opioids to an advisory committee before approval, unless the FDA finds that such a referral is scientifically unnecessary and not in the interest of protecting and promoting public health and the FDA notifies Congress of its rationale.
 
The FDA must convene an advisory committee on labeling opioids for pediatric use before approving any such labeling.
 
(Sec. 1503) As part of its evaluation of the Extended-Release/Long-Acting Opioid Analgesics Risk Evaluation and Mitigation Strategy, the FDA must develop recommendations regarding education programs for prescribers of opioids.
 
(Sec. 1504) The FDA must finalize the draft guidance entitled "General Principles for Evaluating the Abuse Deterrence of Generic Solid Oral Opioid Drug Products." 
 
TITLE XVI--EXAMINING OPIOID TREATMENT INFRASTRUCTURE ACT
 

Examining Opioid Treatment Infrastructure Act of 2016

 
(Sec. 1602) The GAO must report on inpatient and outpatient treatment capacity, availability, and needs, including detoxification programs, clinical stabilization programs, transitional residential support services, rehabilitation programs, treatment programs for pregnant women or adolescents, and treatment through Indian health programs. The report must include the barriers to real-time reporting of drug overdoses at the federal, state, and local level and ways to overcome those barriers.
 
TITLE XVII--OPIOID USE DISORDER TREATMENT EXPANSION AND MODERNIZATION ACT
 

Opioid Use Disorder Treatment Expansion and Modernization Act

 
 (Sec. 1703) This bill revises the qualifications required for a practitioner to administer, dispense, or prescribe narcotic drugs for maintenance or detoxification treatment in an office-based opioid treatment program. 
 
The bill expands qualifying practitioners to include licensed nurse practitioners and physician assistants who have expertise and prescribe medications for opioid use disorder in collaboration with or under the supervision of a qualifying physician if state law requires physician oversight of prescribing authority. Qualifying practitioners must comply with reporting requirements and have the capacity to provide all FDA-approved drugs for opioid use disorder. 
 
 HHS may change the maximum patient limit for qualifying practitioners. If HHS increases the limit, then a qualifying practitioner must obtain written consent from each patient regarding assessment and treatment.
 
HHS must update the treatment improvement protocol containing best practice guidelines for the treatment of opioid-dependent patients in office-based settings. 
 
HHS may recommend revoking or suspending the registration of a practitioner who fails to comply with the requirements of the Controlled Substances Act.
 
(Sec. 1705) This section repeats section 1402.
 
TITLE XVIII--NATIONAL ALL SCHEDULES PRESCRIPTION ELECTRONIC REPORTING REAUTHORIZATION ACT
 

National All Schedules Prescription Electronic Reporting Reauthorization Act of 2015

 
(Sec. 1802) This bill amends the National All Schedules Prescription Electronic Reporting Act of 2005 to include as a purpose of state prescription drug monitoring systems ensuring access to prescription history information for the investigative purposes of law enforcement, regulatory, and state professional licensing authorities.
 
 (Sec. 1803) The grant program for state prescription drug monitoring programs is extended through FY2020 and revised, including to:
 
 
allow grants to be used to maintain and operate existing state prescription drug monitoring programs, 
 
require HHS to redistribute any returned funds among the remaining grantees,
 
require a state to provide HHS with aggregate data and other information to enable HHS to evaluate the success of the state's program, and
 
expand the program to include any commonwealth or territory of the United States.
 
 
The DEA, HHS, a state Medicaid program, a state health department, or a state substance abuse agency receiving nonidentifiable information from a prescription drug monitoring database for research purposes may make that information available to other entities for research purposes.
 
A state receiving a grant must: (1) facilitate prescriber and dispenser use of the state's prescription drug monitoring system, and (2) educate prescribers and dispensers on the benefits of the system both to them and society.

action_date: 2016-07-06
text: 

Comprehensive Addiction and Recovery Act of 2016

 
TITLE I--PREVENTION AND EDUCATION
 
(Sec. 101) This bill requires the Department of Health and Human Services (HHS) to convene a Pain Management Best Practices Inter-Agency Task Force to review best practices for pain management developed or adopted by federal agencies. The task force must propose updates to best practices and recommendations for addressing gaps or inconsistencies.
 
(Sec. 102) HHS must advance education and awareness regarding the risk of abuse of prescription opioids if they are not taken as prescribed. (Opioids are drugs with effects similar to opium, such as certain pain medications and heroin.)
 
(Sec. 103) The Office of National Drug Control Policy, in coordination with the Substance Abuse and Mental Health Services Administration, may award grants to implement community-wide strategies to address a high rate of, or sudden increase in, opioid or methamphetamine abuse or a sudden increase in opioid-related deaths.
 
(Sec. 104) HHS must report on the availability of information regarding the prescription of opioids after youth sports injury, including information on opioid use and misuse, injury treatments that do not involve opioids, and treatment for opioid addiction. The report must determine the extent this information is available to teenagers and adolescents who play youth sports, their families, youth sports groups, and health care providers. Taking into consideration the findings of the report, HHS may facilitate the development of such information.
 
(Sec. 105) This bill amends the Public Health Service Act to require HHS to award grants to states to: (1) streamline state requirements and procedures to assist certain veterans to meet state certification, licensure, and other requirements applicable to civilian health care professions; and (2) develop or expand career pathways at institutions of higher education to support veterans in meeting such requirements.
 
(Sec. 106) This bill amends the Federal Food, Drug, and Cosmetic Act to require the Food and Drug Administration (FDA) to refer new drug applications for opioids to an advisory committee before approval, unless the FDA finds that such a referral is scientifically unnecessary and not in the interest of protecting and promoting public health and the FDA notifies Congress of its rationale.
 
The FDA must convene an advisory committee on labeling opioids for pediatric use before approving any such labeling.
 
As part of its evaluation of the Extended-Release/Long-Acting Opioid Analgesics Risk Evaluation and Mitigation Strategy, the FDA must develop recommendations regarding education programs for prescribers of opioids.
 
The FDA must finalize the draft guidance entitled "General Principles for Evaluating the Abuse Deterrence of Generic Solid Oral Opioid Drug Products."
 
(Sec. 107) HHS must award grants to expand access to drugs or devices approved by the FDA for emergency treatment of opioid overdose (e.g., naloxone). Grant recipients may use the funds to purchase such treatments, establish a program for prescribing such treatments, train health care providers and pharmacists, offset patient cost sharing, and connect patients to treatment.
 
HHS may provide information to prescribers in federally qualified health centers and Indian Health Service facilities on best practices for prescribing such treatments. The Department of Defense and the Department of Veterans Affairs may provide such information to prescribers in their medical facilities.
 
(Sec. 108) The National Institutes of Health (NIH) may intensify and coordinate NIH research into the understanding of pain, therapies for chronic pain, and alternatives to opioids for pain treatments. The prioritization and direction of federally funded pain research must consider recommendations made by the Interagency Pain Research Coordinating Committee.
 
 (Sec. 109) The grant program for state prescription drug monitoring programs is extended through FY2021 and revised, including to:
 
 
allow grants to be used to maintain and operate existing state prescription drug monitoring programs, 
 
require HHS to redistribute any returned funds among the remaining grantees,
 
require a state to provide HHS with aggregate data to enable HHS to evaluate the success of the state's program, and
 
expand the program to include any commonwealth or territory of the United States.
 
 
The Drug Enforcement Administration (DEA), HHS, a state Medicaid program, a state health department, or a state substance abuse agency receiving nonidentifiable information from a prescription drug monitoring database for research purposes may make that information available to other entities for research purposes.
 
A state receiving a grant must: (1) facilitate prescriber and dispenser use of the state's prescription drug monitoring system, and (2) educate prescribers and dispensers on the benefits of the system both to them and society.
 
(Sec. 110) HHS must make grants to states that allow standing orders (documents that allow a person to acquire, dispense, or administer a prescription medication without a person-specific prescription) for drugs or devices for emergency treatment of opioid overdose (e.g., naloxone). Grants may be used for:
 
 
 implementing strategies for pharmacists to dispense such treatments pursuant to a standing order,
 
encouraging pharmacies to dispense such treatments pursuant to a standing order,
 
developing or providing training materials for prescribers to use in educating the public on administration of such treatments, and
 
educating the public on the availability of such treatments.
 
 
States must report on pharmacies that dispense such treatments under a standing order. 
 
TITLE II--LAW ENFORCEMENT AND TREATMENT
 
(Sec. 201) This bill amends the Omnibus Crime Control and Safe Streets Act of 1968 to authorize the Department of Justice (DOJ) to award grants to state, local, and tribal governments to provide opioid abuse services, including: 
 
 
developing, implementing, or expanding a treatment alternative to incarceration program;
 
enhancing collaboration between criminal justice and substance abuse agencies;
 
developing, implementing, or expanding programs to prevent, treat, or respond to opioid abuse; 
 
 training first responders to administer opioid overdose treatments; and
 
 investigating unlawful opioid distribution activities.
 
 
This bill amends the Justice Assistance Act of 1984 to eliminate existing authority for DOJ to award grants under the Emergency Federal Law Enforcement Assistance Program through FY2021.
 
The Family-Based Substance Abuse Treatment Program is expanded to include prison-based family treatment programs for pregnant women.
 
The Government Accountability Office (GAO) must report on how federal grant programs address substance use and substance use disorders among adolescents and young adults.
 
(Sec. 202) HHS must make grants to states, local governmental entities, Indian tribes, and tribal organizations to enable first responders and others to administer drugs or devices for emergency treatment of opioid overdose. Grants may be used to make such treatments available, train first responders and others on the use of such treatments, and establish processes to refer individuals receiving treatment to follow-up care.
 
(Sec. 203) DOJ must coordinate with law enforcement agencies, pharmacies, distributors of prescription medications, and others to expand or make available disposal sites for unwanted prescription medications.
 
TITLE III--TREATMENT AND RECOVERY
 
(Sec. 301) HHS must provide support to state substance abuse agencies, units of local government, nonprofit organizations, and Indian tribes and tribal organizations that have a high rate of, or a rapid increase in, use of opioids to expand treatment of addiction in the areas affected.
 (Sec. 302) HHS must award grants to enable recovery community organizations to develop, expand, and enhance substance use disorder recovery services. A recovery community organization is a nonprofit organization governed by people in recovery for substance use disorders that mobilizes resources to increase the prevalence and quality of long-term recovery. 
(Sec. 303) This bill amends the Controlled Substances Act to revise the qualifications required for a practitioner to administer, dispense, or prescribe narcotic drugs for maintenance or detoxification treatment in an office-based opioid treatment program. 
 
The bill expands qualifying practitioners to include licensed nurse practitioners and physician assistants who have expertise and prescribe medications for opioid use disorder in collaboration with or under the supervision of a qualifying physician if state law requires physician oversight of prescribing authority. Qualifying practitioners must comply with reporting requirements and have the capacity to provide all FDA-approved drugs for opioid use disorder and other ancillary services. 
 
 HHS may change the maximum patient limit for qualifying practitioners.
 
HHS must update the treatment improvement protocol containing best practice guidelines for the treatment of opioid-dependent patients in office-based settings. 
 
TITLE IV--ADDRESSING COLLATERAL CONSEQUENCES
 
(Sec. 401) The GAO must report on the collateral consequences for individuals with convictions for nonviolent drug-related offenses, including the effect of those consequences on individuals resuming their personal and professional activities and the justifications for imposing those consequences. Collateral consequences are penalties or disadvantages imposed on such individuals by law, an administrative agency, or a court, not including consequences imposed at sentencing.
 
TITLE V--ADDICTION AND TREATMENT SERVICES FOR WOMEN, FAMILIES, AND VETERANS
 
(Sec. 501) Support for residential substance abuse treatment programs for pregnant and postpartum women is expanded to include outpatient treatment and extended through FY2021. Such programs must provide services to the children of participants, including therapeutic, comprehensive child care. Priority for support must be given to programs serving rural areas, health professional shortage areas, or areas with a shortage of family-based substance use disorder treatment options.
 
The Center for Substance Abuse Treatment must carry out a pilot program to make grants to state substance abuse agencies to support services for pregnant and postpartum women who have a primary diagnosis of a substance use disorder, including opioid use disorders. The Center for Behavioral Health Statistics and Quality must evaluate the pilot program.
 
(Sec. 502) DOJ may award grants to state, local, and tribal governments to establish or expand programs for veterans, including veterans treatment courts, peer-to-peer services, and treatment, rehabilitation, legal, or transitional services for incarcerated veterans.
 
(Sec. 503) This bill amends the Child Abuse Prevention and Treatment Act to require the national clearinghouse for information relating to child abuse to maintain and disseminate information about requirements and best practices relating to the development of plans of safe care for infants born affected by substance abuse symptoms, withdrawal symptoms, or a Fetal Alcohol Spectrum Disorder.
 
The plan of safe care for such infants that is required for a state to receive a grant to improve its child protective services system must: (1) address the health and substance use disorder treatment needs of the infant and affected family or caregiver, and (2) specify a system for monitoring whether and in what manner local entities are providing services in accordance with state requirements.
 
Annual state data reports must include the number of such infants, the number for whom a plan of safe care was developed, and the number for whom referrals are made for services, including services for the affected family or caregiver.
 
HHS must monitor state compliance with child protective services system grant requirements.
 
(Sec. 504) The GAO must report on:
 
 
the prevalence of neonatal abstinence syndrome (NAS), which is the symptoms of withdrawal in a newborn; 
 
NAS treatment services for which coverage is available under state Medicaid programs; 
 
the care settings and reimbursement for NAS treatment; 
 
the prevalence of use of various care settings for NAS treatment under state Medicaid programs; 
 
any federal barriers to treating infants with NAS under state Medicaid programs; 
 
what is known about best practices for treating infants with NAS; and
 
its recommendations for improvements that will ensure access to NAS treatment under state Medicaid programs.
 
 
TITLE VI--INCENTIVIZING STATE COMPREHENSIVE INITIATIVES TO ADDRESS PRESCRIPTION OPIOID ABUSE
 
(Sec. 601) HHS must award grants to establish and implement a comprehensive state and local response to opioid abuse that includes education efforts, a prescription drug monitoring program, prescription drug and opioid addiction treatment programs, and overdose death prevention efforts. HHS must give priority to entities that: (1) provide civil liability protection for first responders, health professionals, or family members who are trained in administering an opioid overdose treatment; (2) enroll incarcerated drug offenders in community-based treatment services prior to reentry; (3) ensure that data from their prescription drug monitoring program can be shared with other states and is regularly updated; and (4) maximize use of prescription drug monitoring programs and ensure programs notify prescribers and dispensers of suspected abuse of controlled substances by patients.
 
TITLE VII--MISCELLANEOUS
 
(Sec. 701) Each fiscal year, DOJ's Office of the Inspector General must audit a number of opioid abuse services grant recipients. Grant recipients with unresolved audit findings are not eligible to receive grant funds for two years. Nonprofit organizations that hold money in offshore accounts to avoid tax liability may not receive grant funds.
 
DOJ and HHS must each enter into an arrangement with the National Academy of Sciences or a nonfederal entity to evaluate the effectiveness of grants pertaining to opioid abuse established by this bill. The bill limits expenditures for conferences under these grants.
 
(Sec. 702) This bill amends the Controlled Substances Act to allow a pharmacist to partially fill a prescription for a schedule II controlled substance (such as an opioid) if: (1) such partial fills are not prohibited by state law, (2) a partial fill is requested by the patient or prescribing practitioner, and (3) the total quantity dispensed in partial fillings does not exceed the quantity prescribed. 
 
(Sec. 703) The GAO must report on the Office of National Drug Control Policy's review of state and local Good Samaritan laws that exempt from criminal or civil liability any individual who administers an opioid overdose reversal drug or device (e.g., naloxone) or who contacts emergency services providers in response to an overdose.
 
(Sec. 704) This bill amends part D (Voluntary Prescription Drug Benefit Program) of title XVIII (Medicare) of the Social Security Act (SSAct) to authorize prescription drug plan (PDP) sponsors to establish a drug management program for beneficiaries at-risk for prescription drug abuse. PDP sponsors with drug management programs must provide to the Centers for Medicare and Medicaid Services (CMS) data on limitations imposed on beneficiaries and data to identify patterns of drug use that may indicate fraudulent, medically unnecessary, or unsafe use.
 
PDP sponsors must have in place a utilization management tool designed to prevent the abuse and diversion of frequently abused drugs.
 
Medicare drug integrity contractors (MEDICs) may accept an individual's prescription and necessary medical records from pharmacies, PDPs, and physicians in order to provide information relevant to determining whether the individual is an at-risk beneficiary.
 
The Inspector General of HHS must study the effectiveness of MEDICs in identifying, combating, and preventing Medicare fraud.
 
Funds are made available to the Medicare Improvement Fund for services provided during and after FY2021.
 
(Sec. 705) This bill amends title XIX (Medicaid) of the SSAct to exclude abuse-deterrent prescription drugs from the requirement that manufacturers of single-source or innovator drugs pay additional rebates to state Medicaid programs.
 
(Sec. 706) Under current law, the CMS must use analytic technologies to identify improper Medicaid claims. The bill prohibits a state agency from using or disclosing such technologies except for purposes of administering a state Medicaid program or Children's Health Insurance Program (CHIP). State agencies must have adequate data security and control policies to ensure that access to such information is restricted to authorized persons for authorized uses.
 
(Sec. 707) The bill places $5 million in the Medicaid Improvement Fund to be available beginning in FY2021.
 
TITLE VIII--KINGPIN DESIGNATION IMPROVEMENT
 
(Sec. 801) This bill amends the Foreign Narcotics Kingpin Designation Act to allow classified information to be submitted to a reviewing court ex parte (without all parties present) or in camera (in private) in a judicial review of a determination by the President that a foreign person is subject to sanctions as a significant foreign narcotics trafficker.
 
TITLE IX--DEPARTMENT OF VETERANS AFFAIRS
 

Jason Simcakoski Memorial and Promise Act

 
Subtitle A--Opioid Therapy and Pain Management
 
(Sec. 911) This bill directs the Department of Veterans Affairs (VA) to expand its Opioid Safety Initiative to include all VA medical facilities. 
 
The VA must direct its health care providers, before initiating opioid therapy, to use the VA's Opioid Therapy Risk Report tool, which must include: (1) information from state prescription drug monitoring programs, (2) a patient's most recent information, and (3) information on controlled substances prescribed to a patient outside the VA.
 
The VA must establish enhanced standards for urine drug tests before and during opioid therapy to help prevent substance abuse, dependence, and diversion. 
 
The VA must use the Interdisciplinary Chronic Pain Management Training Team Program to provide education and training on pain management and safe opioid prescribing practices.
 
 Each VA medical facility must designate a pain management team of health care professionals to coordinate pain management therapy for patients experiencing pain that is not related to cancer. 
 
VA health care providers to must provide information on prescriptions of controlled substances received by veterans to state prescription drug monitoring programs. 
 
The VA must: (1) maximize the availability to veterans of opioid overdose reversal drugs, such as naloxone; (2) equip each VA pharmacy with such medications for outpatient use; and (3) expand the Overdose Education and Naloxone Distribution program to ensure that veterans receiving VA health care who are at risk of opioid overdose may access such drugs and training on the proper administration of such drugs. 
 
The VA must modify its patient record system to ensure that health care providers who access a veteran's record will be immediately notified about whether the veteran is receiving opioid therapy, has a history of substance use disorder or overdose, or is at risk of developing an opioid use disorder.
 
(Sec. 912) The VA and the Department of Defense (DOD) must ensure that the VA/DOD Pain Management Working Group: (1) includes a focus on specified practices, (2) coordinates with other working groups, (3) consults with other federal agencies, and (4) and consults with the VA and DOD regarding proposed updates to the VA/DOD Clinical Practice Guideline for Management of Opioid Therapy for Chronic Pain. 
 
The VA and DOD must update the VA/DOD Clinical Practice Guideline for Management of Opioid Therapy for Chronic Pain.
 
(Sec. 913) The GAO must report on the VA's Opioid Safety Initiative and the opioid prescribing practices of VA health care providers.
 
The VA must report on opioid therapy and prescription rates for VA patients and notify Congress and investigate if a provider's or facility's prescription rate is inconsistent with safe care standards. 
 
(Sec. 914) The bill makes mandatory the disclosure by the VA of certain information to a state prescription drug monitoring program in order to prevent misuse of prescription medicines by a veteran or dependent.
 
(Sec. 915) Veterans at high risk of an opioid overdose are exempt from paying a copayment to the VA for opioid overdose treatments. Veterans are exempt from paying a copayment to the VA for education on the use of such treatments.
 
Subtitle B--Patient Advocacy
 
(Sec. 921) At least once every 90 days, each VA medical facility must host a public meeting on improving health care furnished by the VA. Community-based VA outpatient clinics must host such meetings at least once every year.
 
(Sec. 922) Not more than 90 days after enactment of this bill, the VA must display: (1) the purposes of the Patient Advocacy Program and patient advocate contact information at VA medical facilities, and (2) the rights and responsibilities of patients and family members at medical and residential facilities.
 (Sec. 923) The GAO must report on the Patient Advocacy Program and include an assessment of staffing, staff training, and awareness and use of the program. 
(Sec. 924) The Office of Patient Advocacy is established in the VA's Office of the Under Secretary for Health. The office must carry out the Patient Advocacy Program and ensure that patient advocates are trained and advocate on behalf of veterans receiving or seeking health care through the VA.
 
Subtitle C--Complementary and Integrative Health
 
(Sec. 931) The bill establishes the Creating Options for Veterans' Expedited Recovery Commission or the COVER Commission to examine the evidence-based therapy treatment model used by the VA for treating mental health conditions of veterans and the potential benefits of incorporating complementary and integrative treatments including music, acupuncture, yoga, meditation, and sports.
 
Not more than 90 days after receiving a report from the commission with recommendations, the VA must submit a report that includes: (1) an action plan for implementing recommendations and a time frame for implementing complementary and integrative treatments, and (2) a justification for any determination that a recommendation is not appropriate or feasible and an alternative solution to improve the therapy model.
 
(Sec. 932) The VA must develop a plan to expand the scope of its research and education on, and delivery and integration of, complementary and integrative health services.
 
(Sec. 933) The VA must carry out a pilot program to assess the feasibility and advisability of using complementary and integrative health and wellness-based services by complementing the provision of pain management and related health care services with such services. In selecting the medical centers for this pilot program, the VA must give priority to centers where the prescription rate of opioids conflicts or is inconsistent with the standards of appropriate and safe care.
 
Subtitle D--Fitness of Health Care Providers
 
(Sec. 941) As part of the VA's hiring process for health care providers, the VA must require from each medical board that licensed the provider information on any violation of the license and any settlement agreement for a disciplinary charge relating to the provider's practice of medicine.
 
(Sec. 942) The VA must provide information on any violation of a medical license by a VA health care provider to each medical board licensing that provider.
 
(Sec. 943) Not later than 180 days after enactment of this bill, the VA must report on its compliance with its policy to review each health care provider who transfers, resigns, retires, or is terminated to determine whether there are any concerns, complaints, or allegations of violations relating to the medical practice of the provider and take appropriate action.
 
Subtitle E--Other Matters
 
(Sec. 951) This bill amends the Veterans Access, Choice, and Accountability Act of 2014 to reduce the aggregate amount of awards and bonuses that may be paid by the VA in each of FY2017-FY2021.

action_date: 2016-07-22
text: 
(This measure has not been amended since the Conference Report was filed in the House on July 6, 2016. The summary of that version is repeated here.)
 

Comprehensive Addiction and Recovery Act of 2016

 
TITLE I--PREVENTION AND EDUCATION
 
(Sec. 101) This bill requires the Department of Health and Human Services (HHS) to convene a Pain Management Best Practices Inter-Agency Task Force to review best practices for pain management developed or adopted by federal agencies. The task force must propose updates to best practices and recommendations for addressing gaps or inconsistencies.
 
(Sec. 102) HHS must advance education and awareness regarding the risk of abuse of prescription opioids if they are not taken as prescribed. (Opioids are drugs with effects similar to opium, such as certain pain medications and heroin.)
 
(Sec. 103) The Office of National Drug Control Policy, in coordination with the Substance Abuse and Mental Health Services Administration, may award grants to implement community-wide strategies to address a high rate of, or sudden increase in, opioid or methamphetamine abuse or a sudden increase in opioid-related deaths.
 
(Sec. 104) HHS must report on the availability of information regarding the prescription of opioids after youth sports injury, including information on opioid use and misuse, injury treatments that do not involve opioids, and treatment for opioid addiction. The report must determine the extent this information is available to teenagers and adolescents who play youth sports, their families, youth sports groups, and health care providers. Taking into consideration the findings of the report, HHS may facilitate the development of such information.
 
(Sec. 105) This bill amends the Public Health Service Act to require HHS to award grants to states to: (1) streamline state requirements and procedures to assist certain veterans to meet state certification, licensure, and other requirements applicable to civilian health care professions; and (2) develop or expand career pathways at institutions of higher education to support veterans in meeting such requirements.
 
(Sec. 106) This bill amends the Federal Food, Drug, and Cosmetic Act to require the Food and Drug Administration (FDA) to refer new drug applications for opioids to an advisory committee before approval, unless the FDA finds that such a referral is scientifically unnecessary and not in the interest of protecting and promoting public health and the FDA notifies Congress of its rationale.
 
The FDA must convene an advisory committee on labeling opioids for pediatric use before approving any such labeling.
 
As part of its evaluation of the Extended-Release/Long-Acting Opioid Analgesics Risk Evaluation and Mitigation Strategy, the FDA must develop recommendations regarding education programs for prescribers of opioids.
 
The FDA must finalize the draft guidance entitled "General Principles for Evaluating the Abuse Deterrence of Generic Solid Oral Opioid Drug Products."
 
(Sec. 107) HHS must award grants to expand access to drugs or devices approved by the FDA for emergency treatment of opioid overdose (e.g., naloxone). Grant recipients may use the funds to purchase such treatments, establish a program for prescribing such treatments, train health care providers and pharmacists, offset patient cost sharing, and connect patients to treatment.
 
HHS may provide information to prescribers in federally qualified health centers and Indian Health Service facilities on best practices for prescribing such treatments. The Department of Defense and the Department of Veterans Affairs may provide such information to prescribers in their medical facilities.
 
(Sec. 108) The National Institutes of Health (NIH) may intensify and coordinate NIH research into the understanding of pain, therapies for chronic pain, and alternatives to opioids for pain treatments. The prioritization and direction of federally funded pain research must consider recommendations made by the Interagency Pain Research Coordinating Committee.
 
 (Sec. 109) The grant program for state prescription drug monitoring programs is extended through FY2021 and revised, including to:
 
 
allow grants to be used to maintain and operate existing state prescription drug monitoring programs, 
 
require HHS to redistribute any returned funds among the remaining grantees,
 
require a state to provide HHS with aggregate data to enable HHS to evaluate the success of the state's program, and
 
expand the program to include any commonwealth or territory of the United States.
 
 
The Drug Enforcement Administration (DEA), HHS, a state Medicaid program, a state health department, or a state substance abuse agency receiving nonidentifiable information from a prescription drug monitoring database for research purposes may make that information available to other entities for research purposes.
 
A state receiving a grant must: (1) facilitate prescriber and dispenser use of the state's prescription drug monitoring system, and (2) educate prescribers and dispensers on the benefits of the system both to them and society.
 
(Sec. 110) HHS must make grants to states that allow standing orders (documents that allow a person to acquire, dispense, or administer a prescription medication without a person-specific prescription) for drugs or devices for emergency treatment of opioid overdose (e.g., naloxone). Grants may be used for:
 
 
 implementing strategies for pharmacists to dispense such treatments pursuant to a standing order,
 
encouraging pharmacies to dispense such treatments pursuant to a standing order,
 
developing or providing training materials for prescribers to use in educating the public on administration of such treatments, and
 
educating the public on the availability of such treatments.
 
 
States must report on pharmacies that dispense such treatments under a standing order. 
 
TITLE II--LAW ENFORCEMENT AND TREATMENT
 
(Sec. 201) This bill amends the Omnibus Crime Control and Safe Streets Act of 1968 to authorize the Department of Justice (DOJ) to award grants to state, local, and tribal governments to provide opioid abuse services, including: 
 
 
developing, implementing, or expanding a treatment alternative to incarceration program;
 
enhancing collaboration between criminal justice and substance abuse agencies;
 
developing, implementing, or expanding programs to prevent, treat, or respond to opioid abuse; 
 
 training first responders to administer opioid overdose treatments; and
 
 investigating unlawful opioid distribution activities.
 
 
This bill amends the Justice Assistance Act of 1984 to eliminate existing authority for DOJ to award grants under the Emergency Federal Law Enforcement Assistance Program through FY2021.
 
The Family-Based Substance Abuse Treatment Program is expanded to include prison-based family treatment programs for pregnant women.
 
The Government Accountability Office (GAO) must report on how federal grant programs address substance use and substance use disorders among adolescents and young adults.
 
(Sec. 202) HHS must make grants to states, local governmental entities, Indian tribes, and tribal organizations to enable first responders and others to administer drugs or devices for emergency treatment of opioid overdose. Grants may be used to make such treatments available, train first responders and others on the use of such treatments, and establish processes to refer individuals receiving treatment to follow-up care.
 
(Sec. 203) DOJ must coordinate with law enforcement agencies, pharmacies, distributors of prescription medications, and others to expand or make available disposal sites for unwanted prescription medications.
 
TITLE III--TREATMENT AND RECOVERY
 
(Sec. 301) HHS must provide support to state substance abuse agencies, units of local government, nonprofit organizations, and Indian tribes and tribal organizations that have a high rate of, or a rapid increase in, use of opioids to expand treatment of addiction in the areas affected.
 (Sec. 302) HHS must award grants to enable recovery community organizations to develop, expand, and enhance substance use disorder recovery services. A recovery community organization is a nonprofit organization governed by people in recovery for substance use disorders that mobilizes resources to increase the prevalence and quality of long-term recovery. 
(Sec. 303) This bill amends the Controlled Substances Act to revise the qualifications required for a practitioner to administer, dispense, or prescribe narcotic drugs for maintenance or detoxification treatment in an office-based opioid treatment program. 
 
The bill expands qualifying practitioners to include licensed nurse practitioners and physician assistants who have expertise and prescribe medications for opioid use disorder in collaboration with or under the supervision of a qualifying physician if state law requires physician oversight of prescribing authority. Qualifying practitioners must comply with reporting requirements and have the capacity to provide all FDA-approved drugs for opioid use disorder and other ancillary services. 
 
 HHS may change the maximum patient limit for qualifying practitioners.
 
HHS must update the treatment improvement protocol containing best practice guidelines for the treatment of opioid-dependent patients in office-based settings. 
 
TITLE IV--ADDRESSING COLLATERAL CONSEQUENCES
 
(Sec. 401) The GAO must report on the collateral consequences for individuals with convictions for nonviolent drug-related offenses, including the effect of those consequences on individuals resuming their personal and professional activities and the justifications for imposing those consequences. Collateral consequences are penalties or disadvantages imposed on such individuals by law, an administrative agency, or a court, not including consequences imposed at sentencing.
 
TITLE V--ADDICTION AND TREATMENT SERVICES FOR WOMEN, FAMILIES, AND VETERANS
 
(Sec. 501) Support for residential substance abuse treatment programs for pregnant and postpartum women is expanded to include outpatient treatment and extended through FY2021. Such programs must provide services to the children of participants, including therapeutic, comprehensive child care. Priority for support must be given to programs serving rural areas, health professional shortage areas, or areas with a shortage of family-based substance use disorder treatment options.
 
The Center for Substance Abuse Treatment must carry out a pilot program to make grants to state substance abuse agencies to support services for pregnant and postpartum women who have a primary diagnosis of a substance use disorder, including opioid use disorders. The Center for Behavioral Health Statistics and Quality must evaluate the pilot program.
 
(Sec. 502) DOJ may award grants to state, local, and tribal governments to establish or expand programs for veterans, including veterans treatment courts, peer-to-peer services, and treatment, rehabilitation, legal, or transitional services for incarcerated veterans.
 
(Sec. 503) This bill amends the Child Abuse Prevention and Treatment Act to require the national clearinghouse for information relating to child abuse to maintain and disseminate information about requirements and best practices relating to the development of plans of safe care for infants born affected by substance abuse symptoms, withdrawal symptoms, or a Fetal Alcohol Spectrum Disorder.
 
The plan of safe care for such infants that is required for a state to receive a grant to improve its child protective services system must: (1) address the health and substance use disorder treatment needs of the infant and affected family or caregiver, and (2) specify a system for monitoring whether and in what manner local entities are providing services in accordance with state requirements.
 
Annual state data reports must include the number of such infants, the number for whom a plan of safe care was developed, and the number for whom referrals are made for services, including services for the affected family or caregiver.
 
HHS must monitor state compliance with child protective services system grant requirements.
 
(Sec. 504) The GAO must report on:
 
 
the prevalence of neonatal abstinence syndrome (NAS), which is the symptoms of withdrawal in a newborn; 
 
NAS treatment services for which coverage is available under state Medicaid programs; 
 
the care settings and reimbursement for NAS treatment; 
 
the prevalence of use of various care settings for NAS treatment under state Medicaid programs; 
 
any federal barriers to treating infants with NAS under state Medicaid programs; 
 
what is known about best practices for treating infants with NAS; and
 
its recommendations for improvements that will ensure access to NAS treatment under state Medicaid programs.
 
 
TITLE VI--INCENTIVIZING STATE COMPREHENSIVE INITIATIVES TO ADDRESS PRESCRIPTION OPIOID ABUSE
 
(Sec. 601) HHS must award grants to establish and implement a comprehensive state and local response to opioid abuse that includes education efforts, a prescription drug monitoring program, prescription drug and opioid addiction treatment programs, and overdose death prevention efforts. HHS must give priority to entities that: (1) provide civil liability protection for first responders, health professionals, or family members who are trained in administering an opioid overdose treatment; (2) enroll incarcerated drug offenders in community-based treatment services prior to reentry; (3) ensure that data from their prescription drug monitoring program can be shared with other states and is regularly updated; and (4) maximize use of prescription drug monitoring programs and ensure programs notify prescribers and dispensers of suspected abuse of controlled substances by patients.
 
TITLE VII--MISCELLANEOUS
 
(Sec. 701) Each fiscal year, DOJ's Office of the Inspector General must audit a number of opioid abuse services grant recipients. Grant recipients with unresolved audit findings are not eligible to receive grant funds for two years. Nonprofit organizations that hold money in offshore accounts to avoid tax liability may not receive grant funds.
 
DOJ and HHS must each enter into an arrangement with the National Academy of Sciences or a nonfederal entity to evaluate the effectiveness of grants pertaining to opioid abuse established by this bill. The bill limits expenditures for conferences under these grants.
 
(Sec. 702) This bill amends the Controlled Substances Act to allow a pharmacist to partially fill a prescription for a schedule II controlled substance (such as an opioid) if: (1) such partial fills are not prohibited by state law, (2) a partial fill is requested by the patient or prescribing practitioner, and (3) the total quantity dispensed in partial fillings does not exceed the quantity prescribed. 
 
(Sec. 703) The GAO must report on the Office of National Drug Control Policy's review of state and local Good Samaritan laws that exempt from criminal or civil liability any individual who administers an opioid overdose reversal drug or device (e.g., naloxone) or who contacts emergency services providers in response to an overdose.
 
(Sec. 704) This bill amends part D (Voluntary Prescription Drug Benefit Program) of title XVIII (Medicare) of the Social Security Act (SSAct) to authorize prescription drug plan (PDP) sponsors to establish a drug management program for beneficiaries at-risk for prescription drug abuse. PDP sponsors with drug management programs must provide to the Centers for Medicare and Medicaid Services (CMS) data on limitations imposed on beneficiaries and data to identify patterns of drug use that may indicate fraudulent, medically unnecessary, or unsafe use.
 
PDP sponsors must have in place a utilization management tool designed to prevent the abuse and diversion of frequently abused drugs.
 
Medicare drug integrity contractors (MEDICs) may accept an individual's prescription and necessary medical records from pharmacies, PDPs, and physicians in order to provide information relevant to determining whether the individual is an at-risk beneficiary.
 
The Inspector General of HHS must study the effectiveness of MEDICs in identifying, combating, and preventing Medicare fraud.
 
Funds are made available to the Medicare Improvement Fund for services provided during and after FY2021.
 
(Sec. 705) This bill amends title XIX (Medicaid) of the SSAct to exclude abuse-deterrent prescription drugs from the requirement that manufacturers of single-source or innovator drugs pay additional rebates to state Medicaid programs.
 
(Sec. 706) Under current law, the CMS must use analytic technologies to identify improper Medicaid claims. The bill prohibits a state agency from using or disclosing such technologies except for purposes of administering a state Medicaid program or Children's Health Insurance Program (CHIP). State agencies must have adequate data security and control policies to ensure that access to such information is restricted to authorized persons for authorized uses.
 
(Sec. 707) The bill places $5 million in the Medicaid Improvement Fund to be available beginning in FY2021.
 
TITLE VIII--KINGPIN DESIGNATION IMPROVEMENT
 
(Sec. 801) This bill amends the Foreign Narcotics Kingpin Designation Act to allow classified information to be submitted to a reviewing court ex parte (without all parties present) or in camera (in private) in a judicial review of a determination by the President that a foreign person is subject to sanctions as a significant foreign narcotics trafficker.
 
TITLE IX--DEPARTMENT OF VETERANS AFFAIRS
 

Jason Simcakoski Memorial and Promise Act

 
Subtitle A--Opioid Therapy and Pain Management
 
(Sec. 911) This bill directs the Department of Veterans Affairs (VA) to expand its Opioid Safety Initiative to include all VA medical facilities. 
 
The VA must direct its health care providers, before initiating opioid therapy, to use the VA's Opioid Therapy Risk Report tool, which must include: (1) information from state prescription drug monitoring programs, (2) a patient's most recent information, and (3) information on controlled substances prescribed to a patient outside the VA.
 
The VA must establish enhanced standards for urine drug tests before and during opioid therapy to help prevent substance abuse, dependence, and diversion. 
 
The VA must use the Interdisciplinary Chronic Pain Management Training Team Program to provide education and training on pain management and safe opioid prescribing practices.
 
 Each VA medical facility must designate a pain management team of health care professionals to coordinate pain management therapy for patients experiencing pain that is not related to cancer. 
 
VA health care providers to must provide information on prescriptions of controlled substances received by veterans to state prescription drug monitoring programs. 
 
The VA must: (1) maximize the availability to veterans of opioid overdose reversal drugs, such as naloxone; (2) equip each VA pharmacy with such medications for outpatient use; and (3) expand the Overdose Education and Naloxone Distribution program to ensure that veterans receiving VA health care who are at risk of opioid overdose may access such drugs and training on the proper administration of such drugs. 
 
The VA must modify its patient record system to ensure that health care providers who access a veteran's record will be immediately notified about whether the veteran is receiving opioid therapy, has a history of substance use disorder or overdose, or is at risk of developing an opioid use disorder.
 
(Sec. 912) The VA and the Department of Defense (DOD) must ensure that the VA/DOD Pain Management Working Group: (1) includes a focus on specified practices, (2) coordinates with other working groups, (3) consults with other federal agencies, and (4) and consults with the VA and DOD regarding proposed updates to the VA/DOD Clinical Practice Guideline for Management of Opioid Therapy for Chronic Pain. 
 
The VA and DOD must update the VA/DOD Clinical Practice Guideline for Management of Opioid Therapy for Chronic Pain.
 
(Sec. 913) The GAO must report on the VA's Opioid Safety Initiative and the opioid prescribing practices of VA health care providers.
 
The VA must report on opioid therapy and prescription rates for VA patients and notify Congress and investigate if a provider's or facility's prescription rate is inconsistent with safe care standards. 
 
(Sec. 914) The bill makes mandatory the disclosure by the VA of certain information to a state prescription drug monitoring program in order to prevent misuse of prescription medicines by a veteran or dependent.
 
(Sec. 915) Veterans at high risk of an opioid overdose are exempt from paying a copayment to the VA for opioid overdose treatments. Veterans are exempt from paying a copayment to the VA for education on the use of such treatments.
 
Subtitle B--Patient Advocacy
 
(Sec. 921) At least once every 90 days, each VA medical facility must host a public meeting on improving health care furnished by the VA. Community-based VA outpatient clinics must host such meetings at least once every year.
 
(Sec. 922) Not more than 90 days after enactment of this bill, the VA must display: (1) the purposes of the Patient Advocacy Program and patient advocate contact information at VA medical facilities, and (2) the rights and responsibilities of patients and family members at medical and residential facilities.
 (Sec. 923) The GAO must report on the Patient Advocacy Program and include an assessment of staffing, staff training, and awareness and use of the program. 
(Sec. 924) The Office of Patient Advocacy is established in the VA's Office of the Under Secretary for Health. The office must carry out the Patient Advocacy Program and ensure that patient advocates are trained and advocate on behalf of veterans receiving or seeking health care through the VA.
 
Subtitle C--Complementary and Integrative Health
 
(Sec. 931) The bill establishes the Creating Options for Veterans' Expedited Recovery Commission or the COVER Commission to examine the evidence-based therapy treatment model used by the VA for treating mental health conditions of veterans and the potential benefits of incorporating complementary and integrative treatments including music, acupuncture, yoga, meditation, and sports.
 
Not more than 90 days after receiving a report from the commission with recommendations, the VA must submit a report that includes: (1) an action plan for implementing recommendations and a time frame for implementing complementary and integrative treatments, and (2) a justification for any determination that a recommendation is not appropriate or feasible and an alternative solution to improve the therapy model.
 
(Sec. 932) The VA must develop a plan to expand the scope of its research and education on, and delivery and integration of, complementary and integrative health services.
 
(Sec. 933) The VA must carry out a pilot program to assess the feasibility and advisability of using complementary and integrative health and wellness-based services by complementing the provision of pain management and related health care services with such services. In selecting the medical centers for this pilot program, the VA must give priority to centers where the prescription rate of opioids conflicts or is inconsistent with the standards of appropriate and safe care.
 
Subtitle D--Fitness of Health Care Providers
 
(Sec. 941) As part of the VA's hiring process for health care providers, the VA must require from each medical board that licensed the provider information on any violation of the license and any settlement agreement for a disciplinary charge relating to the provider's practice of medicine.
 
(Sec. 942) The VA must provide information on any violation of a medical license by a VA health care provider to each medical board licensing that provider.
 
(Sec. 943) Not later than 180 days after enactment of this bill, the VA must report on its compliance with its policy to review each health care provider who transfers, resigns, retires, or is terminated to determine whether there are any concerns, complaints, or allegations of violations relating to the medical practice of the provider and take appropriate action.
 
Subtitle E--Other Matters
 
(Sec. 951) This bill amends the Veterans Access, Choice, and Accountability Act of 2014 to reduce the aggregate amount of awards and bonuses that may be paid by the VA in each of FY2017-FY2021.


Legislative actions:
action_date: 2016-07-22
text: Became Public Law No: 114-198.
action_date: 2016-07-22
text: Became Public Law No: 114-198.
action_date: 2016-07-22
text: Signed by President.
action_date: 2016-07-22
text: Signed by President.
action_date: 2016-07-14
text: Presented to President.
action_date: 2016-07-14
text: Presented to President.
action_date: 2016-07-13
text: Message on Senate action sent to the House.
action_date: 2016-07-13
text: Senate agreed to conference report to accompany S. 524 by Yea-Nay Vote. 92 - 2. Record Vote Number: 129.
action_date: 2016-07-13
text: Conference report agreed to in Senate: Senate agreed to conference report to accompany S. 524 by Yea-Nay Vote. 92 - 2. Record Vote Number: 129.
action_date: 2016-07-13
text: Cloture on the conference report to accompany S. 524 invoked in Senate by Yea-Nay Vote. 90 - 2. Record Vote Number: 126. (consideration: CR S5027-5028; text: CR S5027)
action_date: 2016-07-13
text: Conference report considered in Senate. (consideration: CR S5022-5028, S5045-5058, S5058-5066)
action_date: 2016-07-12
text: Conference report considered in Senate. (consideration: CR S4955-4962, S4975-4993)
action_date: 2016-07-11
text: Cloture motion on the conference report to accompany S. 524 presented in Senate. (consideration: CR S4926; text: CR S4926)
action_date: 2016-07-11
text: Conference report considered in Senate. (consideration: CR S4926-4929)
action_date: 2016-07-11
text: Conference papers: Senate report and manager's statement and message on House action held at the desk in Senate.
action_date: 2016-07-08
text: Motions to reconsider laid on the table Agreed to without objection.
action_date: 2016-07-08
text: On agreeing to the conference report Agreed to by the Yeas and Nays: 407 - 5 (Roll No. 399). (consideration: CR H4561)
action_date: 2016-07-08
text: Conference report agreed to in House: On agreeing to the conference report Agreed to by the Yeas and Nays: 407 - 5 (Roll No. 399).(consideration: CR H4561)
action_date: 2016-07-08
text: The previous question was ordered pursuant to the rule. (consideration: CR H4561)
action_date: 2016-07-08
text: DEBATE - The House proceeded with one hour of debate on the conference report to accompany S. 524.
action_date: 2016-07-08
text: Mr. Upton brought up conference report H. Rept. 114-669 for consideration as a privileged matter. (consideration: CR H4554-4561)
action_date: 2016-07-08
text: CALLING UP CONFERENCE REPORT - Pursuant to the provisions of H. Res. 809, the Chair recognized Mr. Upton for the purpose of calling up the conference report to accompany S. 524.
action_date: 2016-07-07
text: Rule H. Res. 809 passed House.
action_date: 2016-07-07
text: Rules Committee Resolution H. Res. 809 Reported to House. Rule provides for consideration of the conference report to S. 524 with 1 hour of general debate. Previous question shall be considered as ordered without intervening motions except motion to recommit. Sec. 2 provides that upon adoption of the resolution, the House shall be considered to have taken S. 2943 from the Speaker's table, stricken all after the enacting clause and inserted the provisions of H.R. 4909 as passed by the House. S. 2943 shall be considered as passed as amended. It shall also be in order for the Chair of the Committee on Armed services to move that the House insist on its amendment to S. 2943 and request a conference with the Senate thereon.
action_date: 2016-07-06
text: Conference report H. Rept. 114-669 filed. (text of conference report: CR H4392-4419)
action_date: 2016-07-06
text: Conference report filed: Conference report H. Rept. 114-669 filed.(text of conference report: CR H4392-4419)
action_date: 2016-07-06
text: Conferees agreed to file conference report.
action_date: 2016-07-06
text: Conference committee actions: Conferees agreed to file conference report.
action_date: 2016-06-16
text: Message on Senate action sent to the House.
action_date: 2016-06-16
text: Motion by Senator Whitehouse to instruct Senate conferees agreed to in Senate by Yea-Nay Vote. 70 - 24. Record Vote Number: 102. (consideration: CR S4284; text: CR S4284)
action_date: 2016-06-16
text: Motion by Senator Shaheen to instruct Senate conferees agreed to in Senate by Yea-Nay Vote. 66 - 29. Record Vote Number: 101. (consideration: CR S4284; text: CR S4284)
action_date: 2016-06-16
text: Senate disagrees to the House amendments to the Senate bill, agrees to the request for conference, and the Presiding Officer appoints the following conferees: Grassley, Alexander, Hatch, Sessions, Leahy, Murray, and Wyden.
action_date: 2016-06-16
text: Motion to disagree to the House amendments to the Senate bill, agree to the request for conference, and the Presiding Officer appoint the following conferees: Grassley, Alexander, Hatch, Sessions, Leahy, Murray, and Wyden agreed to in Senate by Voice Vote.
action_date: 2016-06-16
text: Cloture on the motion to disagree to the House amendments to the Senate bill, agree to the request for conference, and the Presiding Officer appoint the following conferees: Grassley, Alexander, Hatch, Sessions, Leahy, Murray, and Wyden invoked in Senate by Yea-Nay Vote. 95 - 1. Record Vote Number: 100. (consideration: CR S4283; text: CR S4283)
action_date: 2016-06-16
text: Cloture motion on the motion to disagree to the House amendments to the Senate bill, agree to the request for conference, and the Presiding Officer appoint the following conferees: Grassley, Alexander, Hatch, Sessions, Leahy, Murray, and Wyden presented in Senate. (consideration: CR S4277; text: CR S4277)
action_date: 2016-06-16
text: Motion to disagree to the House amendments to the Senate bill, agree to the request for conference, and the Presiding Officer appoint the following conferees: Grassley, Alexander, Hatch, Sessions, Leahy, Murray, and Wyden made in Senate. (consideration: CR S4277)
action_date: 2016-06-16
text: Measure laid before Senate by unanimous consent. (consideration: CR S4277-4285)
action_date: 2016-05-17
text: Message on House action received in Senate and at desk: House amendments to Senate bill and House requests a conference.
action_date: 2016-05-17
text: The Speaker appointed conferees - from the Committee on Ways and Means for consideration of sec. 705 of the Senate bill, and sec. 804 of the House amendment, and modifications committed to conference: Meehan, Dold, and McDermott.
action_date: 2016-05-17
text: The Speaker appointed conferees - from the Committee on Veterans' Affairs for consideration of title III of the House amendment, and modifications committed to conference: Bilirakis, Walorski, and Ruiz.
action_date: 2016-05-17
text: The Speaker appointed conferees - from the Committee on Education and the Workforce for consideration of title VII of the House amendment, and modifications committed to conference: Barletta, Carter of Georgia, and Scott of Virginia.
action_date: 2016-05-17
text: The Speaker appointed conferees for consideration of the Senate bill and the House amendments, and modifications committed to conference: Upton, Pitts, Lance, Guthrie, Kinzinger of Illinois, Bucshon, Brooks of Indiana, Goodlatte, Sensenbrenner, Smith of Texas, Marino, Collins of Georgia, Trott, Bishop of Michigan, McCarthy, Pallone, Ben Ray Luján of New Mexico, Sarbanes, Gene Green of Texas, Conyers, Jackson Lee, Judy Chu of California, Cohen, Esty, Kuster, and Courtney.
action_date: 2016-05-17
text: Motion to reconsider laid on the table Agreed to without objection.
action_date: 2016-05-17
text: On motion that the House instruct conferees Failed by the Yeas and Nays: 182 - 236 (Roll no. 198).
action_date: 2016-05-17
text: Considered as unfinished business. (consideration: CR H2456-2457)
action_date: 2016-05-13
text: POSTPONED PROCEEDINGS - The Chair put the question on adoption of the motion to instruct conferees and by voice vote, announced that the noes had prevailed. Ms. Esty demanded the yeas and nays and the Chair postponed further proceedings on the question of adoption of the motion until a time to be announced.
action_date: 2016-05-13
text: The previous question was ordered without objection. (consideration: CR H2376)
action_date: 2016-05-13
text: DEBATE - The House proceeded with one hour of debate on the Esty motion to instruct conferees. The instructions contained in the motion seek to require the managers on the part of the House to recede to title III of the bill (relating to treatment and recovery programs).
action_date: 2016-05-13
text: Ms. Esty moved that the House instruct conferees. (consideration: CR H2374-2375; text: CR H2374)
action_date: 2016-05-13
text: On motion that the House insist upon its amendments, and request a conference Agreed to without objection.
action_date: 2016-05-13
text: Mrs. Brooks (IN) asked unanimous consent that the House insist upon its amendments, and request a conference. (consideration: CR H2374)
action_date: 2016-05-13
text: The title of the measure was amended pursuant to H. Res. 725.
action_date: 2016-05-13
text: Motion to reconsider laid on the table Agreed to without objection.
action_date: 2016-05-13
text: On passage Passed by the Yeas and Nays: 400 - 5 (Roll no. 193). (text: CR H2355-2368)
action_date: 2016-05-13
text: Passed/agreed to in House: On passage Passed by the Yeas and Nays: 400 - 5 (Roll no. 193).(text: CR H2355-2368)
action_date: 2016-05-13
text: The previous question was ordered pursuant to the rule. (consideration: CR H2373)
action_date: 2016-05-13
text: DEBATE - The House continued with debate on S. 524.
action_date: 2016-05-13
text: DEBATE - The House proceeded with one hour of debate on S. 524.
action_date: 2016-05-13
text: Rule provides for consideration of S. 524. Motion to recommit with or without instructions allowed. Bill is closed to amendments.
action_date: 2016-05-13
text: Considered under the provisions of rule H. Res. 725. (consideration: CR H2355-2374)
action_date: 2016-05-13
text: Rule H. Res. 725 passed House.
action_date: 2016-05-12
text: Rules Committee Resolution H. Res. 725 Reported to House. Rule provides for consideration of S. 524. Motion to recommit with or without instructions allowed. Bill is closed to amendments.
action_date: 2016-03-14
text: Held at the desk.
action_date: 2016-03-14
text: Received in the House.
action_date: 2016-03-10
text: Message on Senate action sent to the House.
action_date: 2016-03-10
text: Passed Senate with an amendment by Yea-Nay Vote. 94 - 1. Record Vote Number: 34. (text as passed Senate: CR S1404-1416)
action_date: 2016-03-10
text: Passed/agreed to in Senate: Passed Senate with an amendment by Yea-Nay Vote. 94 - 1. Record Vote Number: 34.(text as passed Senate: CR S1404-1416)
action_date: 2016-03-10
text: Considered by Senate. (consideration: CR S1403-1416)
action_date: 2016-03-09
text: Cloture on the measure invoked in Senate by Yea-Nay Vote. 93 - 3. Record Vote Number: 33. (consideration: CR S1361; text: CR S1361)
action_date: 2016-03-09
text: Considered by Senate. (consideration: CR S1357-1384)
action_date: 2016-03-08
text: Considered by Senate. (consideration: CR S1328-1332, S1332-1341)
action_date: 2016-03-07
text: Considered by Senate. (consideration: CR S1303-1313)
action_date: 2016-03-03
text: Cloture motion on the measure presented in Senate. (consideration: CR S1273; text: CR S1273)
action_date: 2016-03-03
text: Considered by Senate. (consideration: CR S1245-1273)
action_date: 2016-03-02
text: The committee substitute withdrawn by Unanimous Consent. (consideration: CR S1180)
action_date: 2016-03-02
text: Measure laid before Senate by unanimous consent. (consideration: CR S1171-1218; text of measure as reported in Senate: CR S1171-1180)
action_date: 2016-03-02
text: Motion to proceed to consideration of measure agreed to in Senate by Unanimous Consent. (consideration: CR S1171)
action_date: 2016-03-01
text: Motion to proceed to measure considered in Senate. (consideration: CR S1106-1115, S1115-1132)
action_date: 2016-02-29
text: Cloture on the motion to proceed to the measure invoked in Senate by Yea-Nay Vote. 89 - 0. Record Vote Number: 27. (consideration: CR S1076; text: CR S1076)
action_date: 2016-02-29
text: Motion to proceed to measure considered in Senate. (consideration: CR S1074-1080)
action_date: 2016-02-25
text: Cloture motion on the motion to proceed to the measure presented in Senate. (consideration: CR S1037-1038; text: CR S1037)
action_date: 2016-02-25
text: Motion to proceed to consideration of measure made in Senate. (consideration: CR S1037-1038)
action_date: 2016-02-22
text: Placed on Senate Legislative Calendar under General Orders. Calendar No. 369.
action_date: 2016-02-22
text: Committee on the Judiciary. Reported by Senator Grassley with an amendment in the nature of a substitute. Without written report.
action_date: 2016-02-22
text: Committee on the Judiciary. Reported by Senator Grassley with an amendment in the nature of a substitute. Without written report.
action_date: 2016-02-11
text: Committee on the Judiciary. Ordered to be reported with an amendment in the nature of a substitute favorably.
action_date: 2016-01-27
text: Committee on the Judiciary. Hearings held.
action_date: 2015-02-12
text: Read twice and referred to the Committee on the Judiciary.
action_date: 2015-02-12
text: Introduced in Senate

Enacted as: number: 114-198