SUPPORT for Patients and Communities Act

Bill: 115-hr-6
Sponsor: Rep. Walden, Greg [R-OR-2]
Introduced: 2018-06-13 in the House
Policy area: Health
Subjects: Administrative law and regulatory procedures
Administrative remedies
Adoption and foster care
Alaska Natives and Hawaiians
Child health
Congressional oversight
Correctional facilities and imprisonment
Criminal investigation, prosecution, interrogation
Department of Health and Human Services
Digestive and metabolic diseases
Drug safety, medical device, and laboratory regulation
Drug therapy
Drug trafficking and controlled substances
Drug, alcohol, tobacco use
Food and Drug Administration (FDA)
Fraud offenses and financial crimes
Government information and archives
Government studies and investigations
Hazardous wastes and toxic substances
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
Health technology, devices, supplies
Home and outpatient care
Indian social and development programs
Juvenile crime and gang violence
Licensing and registrations
Medicaid
Medical research
Medical tests and diagnostic methods
Medicare
Mental health
Minority health
Prescription drugs
Public participation and lobbying
Retail and wholesale trades
Right of privacy
Rural conditions and development
State and local government operations
Surgery and anesthesia
Women's health

Summary:
action_date: 2018-06-13
text: 

Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act or the SUPPORT for Patients and Communities Act

 
This bill makes several changes to state Medicaid programs to address opioid and substance use disorders. Specifically, the bill:
 
 
modifies provisions related to coverage for juvenile inmates and former foster care youth,
 
establishes a demonstration project to increase provider treatment capacity for substance use disorders,
 
requires the establishment of drug management programs for at-risk beneficiaries,
 
establishes drug review and utilization requirements, 
 
extends the enhanced federal matching rate for expenditures regarding substance use disorder health home services, and
 
temporarily requires coverage of medication-assisted treatment.
 
 
The bill also alters Medicare requirements to address opioid use. Specifically, the bill:
 
 
 exempts substance use disorder telehealth services from specified requirements,
 
requires the initial examination for new enrollees to include an opioid use disorder screening,
 
modifies provisions regarding electronic prescriptions and post-surgical pain management,
 
requires prescription drug plan sponsors to establish drug management programs for at-risk beneficiaries, and
 
requires coverage for services provided by certified opioid treatment programs.
 
 
 The bill also addresses other opioid-related issues. Specifically, the bill:
 
 
establishes and expands programs to support increased detection and monitoring of fentanyl and other synthetic opioids, and 
 
increases the maximum number of patients that health care practitioners may initially treat with medication-assisted treatment (i.e., under a buprenorphine waiver).
 
 
 Additionally, the bill temporarily eliminates the enhanced federal matching rate for Medicaid expenditures regarding specified medical services provided by certain managed care organizations.

action_date: 2018-06-22
text: 

Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act or the SUPPORT for Patients and Communities Act 

 
TITLE I--MEDICAID PROVISIONS TO ADDRESS THE OPIOID CRISIS
 
(Sec. 1001) The bill prohibits termination of Medicaid eligibility for juveniles who are inmates of public institutions. 
 
(Sec. 1003) The Centers for Medicare & Medicaid Services (CMS) must establish a demonstration project to increase provider treatment capacity for substance-use disorders. 
 
(Sec. 1004) State Medicaid programs must establish drug management programs and drug-review and utilization requirements for at-risk beneficiaries.
 
(Sec. 1007) The bill extends the enhanced federal matching rate for expenditures regarding substance-use disorder health-home services under Medicaid.
 
The bill also temporarily requires coverage of medication-assisted treatment under Medicaid.
 
TITLE II--MEDICARE PROVISIONS TO ADDRESS THE OPIOID CRISIS
 
(Sec. 2001) The bill exempts substance-use disorder telehealth services from specified requirements, such as geographic restrictions, under Medicare.
 
(Sec. 2003) The initial examination for new Medicare enrollees must include an opioid-use disorder screening and prescription history review.
 
(Sec. 2004) The bill temporarily freezes Medicare payment at 2016 levels for specified spinal surgery outpatient procedures that are conducted in ambulatory surgical centers. 
 
(Sec. 2005) In general, prescriptions for controlled substances that are covered drugs under Medicare must be transmitted through electronic prescription programs. 
 
(Sec. 2006) Medicare prescription drug plan sponsors must establish drug-management programs for at-risk beneficiaries.
 
(Sec. 2007) The bill also requires coverage for services provided by certified opioid-treatment programs under Medicare.
 
TITLE III--OTHER HEALTH PROVISIONS TO ADDRESS THE OPIOID CRISIS
 
(Sec. 3002) The bill establishes and expands programs to support increased detection and monitoring of fentanyl and other synthetic opioids, including a new grant program for public health laboratories and a pilot program for point-of-use drug testing. 
 
(Sec. 3003) The bill increases the maximum number of patients that health care practitioners may initially treat with medication-assisted treatment (i.e., under a buprenorphine waiver).
 
(Sec. 3007) The Department of Health and Human Services (HHS) must survey entities that receive federal funds for substance-use disorder treatment services; the scope of the survey must include the types of services provided, the populations served, and the adequacy of services. 
 
TITLE IV--OFFSETS 
 
(Sec. 4001) The bill temporarily eliminates the enhanced federal matching rate for Medicaid expenditures regarding specified medical services provided by certain managed care organizations.
 
TITLE V--OTHER MEDICAID PROVISIONS
 
Subtitle A--Mandatory Reporting with Respect to Adult Behavioral Health Measures 
 
(Sec. 5001) The bill requires certain Medicaid quality health measures to include behavioral health measures.
 
Subtitle B--Medicaid IMD Additional Info
 

Medicaid Institutes for Mental Disease Are Decisive in Delivering Inpatient Treatment for Individuals but Opportunities for Needed Access are Limited without Information Needed about Facility Obligations Act or the Medicaid IMD ADDITIONAL INFO Act

 
(Sec. 5012) The Medicaid and Children's Health Insurance Program (CHIP) Payment and Access Commission must report on information relating to services for Medicaid enrollees who are patients in institutions for mental diseases (IMDs), including the number and type of IMDs in each sampled state, services offered, and funding sources.
 
Subtitle C--CHIP Mental Health Parity
 

CHIP Mental Health Parity Act

 
(Sec. 5022) CHIP plans must cover mental health and substance-use disorder services. Financial requirements and treatment limitations applicable to such services shall not differ from those applicable to other medical services under CHIP.
 
Subtitle D--Medicaid Reentry
 

Medicaid Reentry Act

 
(Sec. 5032) The CMS must convene a stakeholder workgroup in order to develop best practices for states to help inmates released from public institutions transition to the community with health care (such as by ensuring continuity of health insurance or Medicaid coverage). The CMS must also issue a letter to states outlining opportunities for Medicaid demonstration waivers based on identified best practices.
 
Subtitle E--Medicaid Partnership
 

Medicaid Providers Are Required To Note Experiences in Record Systems to Help In-need Patients Act or the Medicaid PARTNERSHIP Act

 
(Sec. 5042) Each state must establish a qualifying prescription drug monitoring program (PDMP) and require health care providers to check the PDMP for a Medicaid enrollee's prescription drug history before prescribing controlled substances to the enrollee. 
 
TITLE VI--OTHER MEDICARE PROVISIONS 
 
Subtitle A--Testing of Incentive Payments for Behavioral Health Providers for Adoption and Use of Certified Electronic Health Record Technology
 
(Sec. 6001) The Center for Medicare and Medicaid Innovation may test models to provide incentive payments to behavioral health providers for adopting electronic health records technology and for using that technology to improve the quality and coordination of care.
 
Subtitle B--Abuse Deterrent Access
 

Abuse Deterrent Access Act of 2018

 
(Sec. 6012) The CMS must report on the adequacy of access to abuse-deterrent opioid formulations for individuals with chronic pain enrolled in a prescription drug plan under Medicare or Medicare Advantage (MA). 
 
Subtitle C--Medicare Opioid Safety Education
 

Medicare Opioid Safety Education Act of 2018

 
(Sec. 6022) The CMS must provide Medicare beneficiaries with educational resources regarding opioid use and pain management, as well as descriptions of covered alternative (non-opioid) pain-management treatments.
 
Subtitle D--Opioid Addiction Action Plan
 

Opioid Addiction Action Plan Act

 
(Sec. 6032) The CMS must develop an action plan to provide recommendations on changes to the Medicare and Medicaid programs to enhance the treatment and prevention of opioid addiction, as well as coverage and payment of medication-assisted treatment. 
 
The CMS must also publish a report that includes an evaluation of price trends for opioid overdose-reversal drugs (e.g., naloxone) and recommendations on ways to lower consumer prices for such drugs. 
 
Subtitle E--Advancing High Quality Treatment for Opioid Use Disorders in Medicare
 

Advancing High Quality Treatment for Opioid Use Disorders in Medicare Act

 
(Sec. 6042) The CMS must carry out a demonstration program to increase access to opioid-use disorder treatment services for Medicare beneficiaries, improve physical and mental health outcomes for such beneficiaries, and reduce Medicare expenditures. 
 
Subtitle F--Responsible Education Achieves Care and Healthy Outcomes for Users' Treatment 
 

Responsible Education Achieves Care and Healthy Outcomes for Users' Treatment Act of 2018 or the REACH OUT Act of 2018
 
 
(Sec. 6052) The CMS must also award grants, contracts, or cooperative agreements to qualifying organizations in order to support efforts to curb outlier prescribers of opioids under the Medicare prescription drug benefit and MA prescription drug plans. 
 
Subtitle G--Preventing Addiction for Susceptible Seniors 
 

Preventing Addiction for Susceptible Seniors Act of 2018 or the PASS Act of 2018
 
 
(Sec. 6062) The bill requires electronic prescription programs to be able to securely transmit prior authorization requests for covered drugs under Medicare. 
 
(Sec. 6063) The CMS must also establish a secure online portal to allow data sharing among the CMS, Medicare prescription drug benefit plans, and MA plans. The portal must also support referrals by such plans of substantiated fraud, waste, or abuse. 
 
(Sec. 6064) The bill also establishes individuals who are identified as at-risk beneficiaries for prescription drug abuse as qualifying participants in medication therapy management programs under the Medicare prescription drug benefit. 
 
(Sec. 6065) The CMS must also identify outlier prescribers of opioids under Medicare prescription drug benefit plans and MA plans, based on specialty and geographic area, and annually notify such prescribers of their status. 
 
Subtitle H--Expanding Oversight of Opioid Prescribing and Payment 
 

Expanding Oversight of Opioid Prescribing and Payment Act of 2018
 
 
(Sec. 6072) The Medicare Payment Advisory Commission must report on Medicare payment for opioid and non-opioid pain management treatments, current incentives for prescribing opioid and non-opioid treatments, and how opioid use is currently tracked and monitored. 
 
Subtitle I--Dr. Todd Graham Pain Management, Treatment, and Recovery 
 

Dr. Todd Graham Pain Management, Treatment, and Recovery Act of 2018
 
 
(Sec. 6082) The CMS must review payments under Medicare for opioid and non-opioid pain-management procedures, specifically with respect to ambulatory outpatient surgical procedures and hospital outpatient department services. The CMS must ensure that there are no payment incentives for using opioids instead of non-opioid alternatives and must make revisions accordingly. 
 
(Sec. 6083) The bill also requires payment under Medicare to federally qualified health centers and rural health clinics that have health care practitioners who are newly certified to provide medication-assisted treatment (e.g., buprenorphine). 
 
(Sec. 6085) The Center for Medicare and Medicaid Innovation may test models to help individuals learn about the availability of psychologist services under Medicare, as well as to explore the use of a behavioral health help-line that is available 24-7 to prevent unnecessary hospitalizations and emergency department visits. 
 
Subtitle J--Combating Opioid Abuse for Care in Hospitals 
 

Combating Opioid Abuse for Care in Hospitals Act of 2018 or the COACH Act of 2018
 
 
(Sec. 6092) The CMS must publish guidance for hospitals on pain management and opioid-use disorder prevention strategies for Medicare beneficiaries. 
 
Technical expert panels must also recommend opioid-use disorder quality measures for hospital reports, methods to reduce opioid use in surgical settings, and pain-management strategies.
 
Subtitle K--Stop Excessive Narcotics in Our Retirement Communities Protection 
 

Stop Excessive Narcotics in our Retirement Communities Protection Act of 2018 or the SENIOR Communities Protection Act of 2018
 
 
(Sec. 6102) The bill authorizes the suspension of payments to a pharmacy under the Medicare prescription drug benefit and MA prescription drug plans pending the investigation of a credible allegation of fraud by the pharmacy. 
 
Subtitle L--Providing Reliable Options for Patients and Educational Resources 
 

Providing Reliable Options for Patients and Educational Resources Act of 2018 or the PROPER Act of 2018
 
 
(Sec. 6112) Medicare and MA prescription drug plan sponsors must annually disclose information to enrollees about the risks of prolonged opioid use, as well as coverage of nonpharmacological therapies, devices, and non-opioid medications. 
 
(Sec. 6113) The bill also requires Medicare medication therapy management programs and MA in-home health-risk assessments to include information about the safe disposal of prescription drugs. 
 
(Sec. 6114) The bill prohibits inclusion of pain-management questions in certain health care system surveys, unless the questions address the risks of opioid use and the availability of non-opioid alternatives. 
 
TITLE VII--OTHER HEALTH PROVISIONS 
 
Subtitle A--Synthetic Drug Awareness 
 

Synthetic Drug Awareness Act of 2018
 
 
(Sec. 7002) The bill requires the Surgeon General to report on the health effects of new psychoactive substances (also known as synthetic drugs). The report specifically relates to substances used by individuals aged 12 to 18 since January 2010. Examples of synthetic drugs include synthetic marijuana (also known as "spice") and synthetic amphetamines (also known as "bath salts"). 
 
Subtitle B--Empowering Pharmacists in the Fight against Opioid Abuse 
 

Empowering Pharmacists in the Fight Against Opioid Abuse Act
 
 
(Sec. 7012) HHS must develop training programs and materials on the circumstances under which a pharmacist may refuse to fill a controlled substance prescription suspected to be fraudulent, forged, or indicative of abuse or diversion. 
 
Subtitle C-- Indexing Narcotics, Fentanyl, and Opioids 
 

Indexing Narcotics, Fentanyl, and Opioids Act of 2018 or the INFO Act 

 
(Sec. 7022) HHS must establish a public information dashboard that coordinates programs related to opioid-abuse reduction, allows data sharing between different programs and regions of the country, and recommends alternatives to controlled substances for pain management. 
 
Subtitle D--Ensuring Access to Quality Sober Living 
 

Ensuring Access to Quality Sober Living Act of 2018
 
 
(Sec. 7032) The bill amends the Public Health Service Act to require HHS to develop best practices for operating recovery housing (shared living environments free from alcohol and illegal drug use and centered on peer support and connection to services that promote recovery from substance-use disorders). 
 
Subtitle E--Advancing Cutting Edge Research 
 

Advancing Cutting Edge Research Act or the ACE Research Act
 
 
(Sec. 7042) The bill expands the National Institutes of Health's unique research initiatives to include cutting-edge research that is urgently required to respond to a public health threat. (Unique research initiatives may be supported through transactions other than contracts, grants, or cooperative agreements.)
 
Subtitle F--Jessie's Law
 

Jessie's Law

 
(Sec. 7052) HHS must develop best practices for health care providers and state agencies regarding the display of a patient's history of opioid addiction in the patient's medical records.
 
(Sec. 7053) The bill also requires the CMS and the Health Resources and Services Administration to notify annually health care providers about health information that may be disclosed under federal privacy laws to families, caregivers, and health care providers during emergencies, including overdoses. 
 
Subtitle G--Safe Disposal of Unused Medication
 

Safe Disposal of Unused Medication Act

 
(Sec. 7062) The bill amends the Controlled Substances Act to allow a hospice employee to handle lawfully dispensed controlled substances of a deceased hospice patient to assist with disposal of the controlled substances, so long as such disposal occurs onsite in accordance with applicable law.
 
Subtitle H--Substance Use Disorder Workforce Loan Repayment
 

Substance Use Disorder Workforce Loan Repayment Act of 2018

 
(Sec. 7072) The bill creates a loan repayment program for individuals who complete a period of service in a substance-use disorder treatment job in a mental health professional shortage area or a county where the drug overdose death rate is higher than the national average.
 
Subtitle I--Preventing Overdoses While in Emergency Rooms
 

Preventing Overdoses While in Emergency Rooms Act of 2018

 
(Sec. 7082) HHS must establish a grant program to develop protocols for discharging patients who are treated for a drug overdose and to enhance the integration and coordination of postdischarge care for individuals with a substance-use disorder.
 
Subtitle J--Alternatives to Opioids in the Emergency Department
 

Alternatives to Opioids in the Emergency Department Act or the ALTO Act

 
(Sec. 7092) HHS must also establish a demonstration program through which hospitals and emergency departments receive grants to support alternative pain-management protocols and treatments that limit the use and prescription of opioids in emergency departments. 
 
Subtitle K--Stop Counterfeit Drugs by Regulating and Enhancing Enforcement Now
 

Stop Counterfeit Drugs by Regulating and Enhancing Enforcement Now Act or the SCREEN Act

 
(Sec. 7102) The bill amends the Federal Food, Drug, and Cosmetic Act to expand the authority of the Food and Drug Administration (FDA) to destroy illegally imported or hazardous drugs. 
 
(Sec. 7103) The bill requires the FDA to halt the distribution of a drug that is found to be a public hazard and, if appropriate, order the drug to be recalled. 
 
(Sec. 7104) The FDA may consider all drugs from a single manufacturer, distributor, or importer as adulterated or misbranded if a pattern emerges, unless otherwise shown. 
 
(Sec. 7105) The bill establishes a fund to support efforts by the FDA to address the opioid epidemic, including educational campaigns and inspections of imported drugs. 
 
(Sec. 7106) The FDA must deny an application for a new drug that contains a controlled substance and that is found to be unsafe due to a potential for misuse or abuse. 
 
Subtitle L--Treatment, Education, and Community Help to Combat Addiction
 

Treatment, Education, and Community Help to Combat Addiction Act of 2018 or the TEACH to Combat Addiction Act of 2018

 
(Sec. 7112) The bill requires the Substance Abuse and Mental Health Services Administration (SAMHSA) to designate Regional Centers of Excellence in Substance Use Disorder Education. Such centers must improve pain-management and substance-use disorder education through the distribution of evidence-based curricula for health care professional schools. 
 
Subtitle M--Guidance from National Mental Health and Substance Use Policy Laboratory 
 
(Sec. 7121) The National Mental Health and Substance Use Policy Laboratory within SAMHSA must issue guidance for SAMHSA grant applicants in order to encourage funding of evidence-based practices and to help applicants properly articulate funding rationales.
 
Subtitle N--Comprehensive Opioid Recovery Centers
 

Comprehensive Opioid Recovery Centers Act of 2018

 
(Sec. 7132) The bill also requires SAMHSA to award grants to establish or operate at least 10 comprehensive opioid recovery centers across the country. Such centers must conduct outreach and provide specified treatment and recovery services, including approved drug treatments (e.g., methadone), counseling, residential rehabilitation, and job-placement assistance. 
 
Subtitle O--Poison Center Network Enhancement 
 

Poison Center Network Enhancement Act of 2018
 
 
(Sec. 7142) The bill reauthorizes through FY2023 and revises the national toll-free phone number, public-awareness campaign, and grant program relating to poison-control centers, including provisions that specifically address the role of poison-control centers in combating opioid misuse.
 
Subtitle P--Eliminating Opioid Related Infectious Diseases
 

Eliminating Opioid Related Infectious Diseases Act of 2018

 
(Sec. 7152) HHS must expand its grant program for combating hepatitis C infections to include other infections associated with illicit drug use (e.g., HIV). The bill also includes Indian tribes in the program.
 
Subtitle Q--Better Pain Management through Better Data
 

Better Pain Management Through Better Data Act of 2018

 
(Sec. 7162) The FDA must develop guidance regarding alternative methods for collecting data on opioid sparing (i.e., the use of drugs that reduce pain while also allowing reduced use or avoidance of oral opioids) and using such information in product labels.
 
Subtitle R--Special Registration for Telemedicine Clarification
 

Special Registration for Telemedicine Clarification Act of 2018

 
(Sec. 7172) The bill establishes a deadline for the Drug Enforcement Administration (DEA) to promulgate regulations for the special registration of practitioners to practice telemedicine.
 
Subtitle S--Peer Support Communities of Recovery
 

Peer Support Communities of Recovery Act

 
(Sec. 7182) SAMHSA may award grants to nonprofits that focus on substance-use disorder in order to establish regional technical-assistance centers. Such centers must implement peer-delivered addiction-recovery support services and establish recovery community organizations and centers.
 
Subtitle T--Stop Illicit Drug Importation
 

Stop Illicit Drug Importation Act of 2018

 
(Sec. 7192) The bill prohibits the importation of drugs containing substances that have been requested, or are under review, to be scheduled as controlled substances.
 
(Sec. 7194) The FDA may prohibit a person from importing drugs or controlled substances under specified circumstances, including if the person has shown a pattern of importing adulterated or misbranded drugs that pose a serious health threat. 
 
Subtitle U--Creating Opportunities that Necessitate New and Enhanced Connections that Improve Opioid Navigation Strategies
 

Creating Opportunities that Necessitate New and Enhanced Connections That Improve Opioid Navigation Strategies Act of 2018 or the CONNECTIONS Act

 
(Sec. 7202) The Centers for Disease Control and Prevention may provide technical assistance and award grants in order to improve PDMPs, promote new approaches for responding to emerging public health crises, and improve overdose data reporting. 
 
(Sec. 7203) The bill also alters requirements relating to PDMPs. Among other changes, the bill authorizes federal support for specific PDMP improvements regarding use, data reporting, and intrastate and interstate interoperability. 
 
Subtitle V--Securing Opioids and Unused Narcotics with Deliberate Disposal and Packaging
 

Securing Opioids and Unused Narcotics with Deliberate Disposal and Packaging Act of 2018 or the SOUND Disposal and Packaging Act

 
(Sec. 7212) The FDA may require certain packaging and disposal technologies, controls, or measures to mitigate the risk of abuse or misuse of a drug or a class of drugs. 
 
Subtitle W--Postapproval study requirements
 
(Sec. 7221) The FDA may also require a post-approval study for certain drugs that contain controlled substances in order to assess potential reduced effectiveness. 
 
TITLE VIII--MISCELLANEOUS
 
Subtitle A--Synthetics Trafficking and Overdose Prevention
 

Synthetics Trafficking and Overdose Prevention Act of 2018 or STOP Act of 2018

 
(Sec. 8002) The bill increases shipment-tracking responsibilities and coordination between the U.S. Postal Service and the U.S. Customs and Border Protection regarding international shipments of controlled substances, such as through communication requirements and the development of technology to detect illicit fentanyl. 
 
Subtitle B--Recognizing Early Childhood Trauma Related to Substance Abuse
 

Recognizing Early Childhood Trauma Related to Substance Abuse Act of 2018
 
 
(Sec. 8012) HHS must provide resources to early childhood care and education providers and other professionals working with young children on ways to recognize and respond to children who may be affected by a family member's or other adult's substance abuse. 
 
Subtitle C--Assisting States' Implementation of Plans of Safe Care 
 

Assisting States' Implementation of Plans of Safe Care Act
 
 
(Sec. 8022) HHS must also provide states with guidance and technical assistance regarding their plans under the Child Abuse Prevention and Treatment Act for assuring the safe care of infants affected by prenatal substance use. 
 
Subtitle D--Improving the Federal Response to Families Impacted by Substance Use Disorder
 

Improving the Federal Response to Families Impacted by Substance Use Disorder Act

 
(Sec. 8032) The bill establishes the Interagency Task Force to Improve the Federal Response to Families Impacted by Substance Use Disorders to recommend ways to better coordinate the responses of federal agencies to substance-use disorders and the opioid crisis. 
 
Subtitle E--Establishment of an Advisory Committee on Opioids and the Workplace
 
(Sec. 8041) The Department of Labor must establish an Advisory Committee on Opioids and the Workplace to recommend ways to address the impact of opioid abuse on the workplace and to support workers who abuse opioids.
 
Subtitle F--Veterans Treatment Court Improvement
 

Veterans Treatment Court Improvement Act of 2018

 
(Sec. 8052) The Department of Veterans Affairs (VA) must hire at least 50 Veterans Justice Outreach Specialists under the Veterans Justice Outreach Program. Each of these specialists must serve as part of a justice team in a veterans treatment court or other veteran-focused court. 
 
Subtitle G--Peer Support Counseling Program for Women Veterans
 
(Sec. 8061) The VA must also emphasize appointing peer-support counselors for women veterans. The VA shall recruit women peer-support counselors with expertise in gender-specific issues and services, VA services and benefits, and employment mentoring. 
 
Subtitle H--Treating Barriers to Prosperity
 

Treating Barriers to Prosperity Act of 2018

 
(Sec. 8072) The bill allows the Appalachian Regional Commission to support projects and activities addressing drug abuse, such as infrastructure development for telemedicine. 
 
Subtitle I--Supporting Grandparents Raising Grandchildren
 

Supporting Grandparents Raising Grandchildren Act

 
(Sec. 8083) The bill establishes an Advisory Council to Support Grandparents Raising Grandchildren. The council must develop resources to help older relatives meet the needs of the children in their care and maintain their own health and emotional well-being. 
 
Subtitle J--Reauthorizing and Extending Grants for Recovery from Opioid Use Programs
 

Reauthorizing and Extending Grants for Recovery from Opioid Use Programs Act of 2018 or the REGROUP Act of 2018

 
(Sec. 8092) The bill reauthorizes through FY2023 the comprehensive opioid abuse grant program administered by the Department of Justice.
 
TITLE IX--SITSA ACT
 

Stop the Importation and Trafficking of Synthetic Analogues Act of 2017 or the SITSA Act

 
(Sec. 9002) The bill establishes a new, sixth schedule of controlled substances--schedule A. A drug or substance in schedule A has a chemical structure that is similar to a controlled substance in schedule I, II, III, IV, or V, and has a similar or greater depressive, stimulant, or hallucinogenic effect than a controlled substance in one of those schedules. 
 
The bill also authorizes, and establishes procedures for, the DEA to place a drug or substance in schedule A. 
 
The bill also establishes registration and labeling requirements, as well as criminal penalties, relating to schedule A substances.
 
(Sec. 9012) The bill also sets forth factors that may be considered to determine whether a controlled substance analogue is intended for human consumption. Under current law, a controlled substance analogue that is intended for human consumption is treated as a schedule I controlled substance and is subject to certain regulatory controls.
 
TITLE X--THRIVE ACT
 

Transitional Housing for Recovery in Viable Environments Demonstration Program Act or the THRIVE Act 

 
(Sec. 10002) The bill amends the United States Housing Act of 1937 to require the Department of Housing and Urban Development to establish a five-year demonstration program for nonprofit organizations and tribally designated housing entities to provide low-income rental-assistance vouchers to individuals recovering from an opioid- or other substance-use disorder. 
 
TITLE XI--IMD CARE ACT
 

Individuals in Medicaid Deserve Care that is Appropriate and Responsible in its Execution Act or the IMD CARE Act

 
(Sec. 11002) The bill temporarily allows states to apply to receive federal Medicaid payment for services provided in IMDs and for other medically necessary services for enrollees (aged 21 to 64) with opioid-use or cocaine-use disorders. Services may be covered for a total of up to 30 days in a 12-month period for an eligible enrollee. States must include specified information in their applications, including plans to improve access to outpatient care. 
 
Current law generally prohibits federal payment under Medicaid for services provided in IMDs for individuals under the age of 65 (although states may receive payment through certain mechanisms, such as through a Medicaid demonstration waiver). 

action_date: 2018-10-24
text: 

Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act or the SUPPORT for Patients and Communities Act 

 
TITLE I--MEDICAID PROVISIONS TO ADDRESS THE OPIOID CRISIS 
 
(Sec. 1001) The bill prohibits termination of Medicaid eligibility for juveniles who are inmates of public institutions. 
 
(Sec. 1003) The Centers for Medicare & Medicaid Services (CMS) must establish a demonstration project to increase provider treatment capacity for substance-use disorders. 
 
(Sec. 1004) State Medicaid programs must establish drug-review and utilization requirements, including safety measures for subsequent prescriptions of opioids. 
 
(Sec. 1006) The bill extends the enhanced federal matching rate for expenditures regarding substance-use disorder health-home services under Medicaid.
 
The bill also temporarily requires coverage of medication-assisted treatment under Medicaid.
 
(Sec. 1007) The bill allows state Medicaid programs to cover residential pediatric recovery center services for infants with neonatal abstinence syndrome.
 
(Sec. 1012) States may also receive federal payment under Medicaid for outside services that are provided to pregnant and postpartum women who are substance-use disorder patients at institutions for mental diseases (IMDs).
 
(Sec. 1016) State Medicaid agencies, to the extent permitted under state law, may also access prescription drug monitoring programs (PDMPs), facilitate access to PDMPs for Medicaid providers and managed care entities, and share accessed information with such providers and entities. 
 
TITLE II--MEDICARE PROVISIONS TO ADDRESS THE OPIOID CRISIS
 
(Sec. 2001) The bill exempts substance-use disorder telehealth services from specified requirements, such as geographic restrictions, under Medicare.
 
(Sec. 2002) The initial examination for new enrollees and annual wellness visits under Medicare must include a substance-use disorder screening and a review of any current opioid prescriptions.
 
(Sec. 2003) In general, prescriptions for controlled substances that are covered drugs under Medicare must be transmitted through electronic prescription programs. 
 
(Sec. 2004) Medicare prescription drug plan sponsors must establish drug-management programs for at-risk beneficiaries.
 
(Sec. 2005) The bill also requires coverage for services provided by certified opioid-treatment programs under Medicare.
 
(Sec. 2006) The CMS must notify Medicare prescription drug plan sponsors about individuals who have a history of opioid-related overdoses, so that such individuals are included in drug-management programs for at-risk beneficiaries. 
 
(Sec. 2008) The bill authorizes the suspension of payments to a pharmacy under the Medicare prescription drug benefit and Medicare Advantage (MA) prescription drug plans pending the investigation of a credible allegation of fraud by the pharmacy.
 
TITLE III--FDA AND CONTROLLED SUBSTANCE PROVISIONS
 
Subtitle A--FDA Provisions 
 
Chapter 1--In General 
 
(Sec. 3001) The Food and Drug Administration (FDA) must issue guidance that addresses the challenges of developing nonaddictive products to treat pain and addiction. 
 
(Sec. 3002) The FDA must also issue guidance regarding the prescription of opioid analgesics for pain management. 
 
Chapter 2--Stop Counterfeit Drugs by Regulating and Enhancing Enforcement Now
 

Stop Counterfeit Drugs by Regulating and Enhancing Enforcement Now Act or the SCREEN Act

 
(Sec. 3012) The bill requires the FDA to halt the distribution of a controlled substance that is found to be a public hazard and, if appropriate, order the controlled substance to be recalled. 
 
(Sec. 3013) The FDA may consider all drugs from a single manufacturer, distributor, or importer as adulterated or misbranded if a pattern emerges, unless otherwise shown.
 
(Sec. 3014) The FDA must coordinate with the Department of Homeland Security and the U.S. Postal Service to improve screening and identification of unlawful controlled substances at international drug import facilities.
 
Chapter 3--Stop Illicit Drug Importation
 

Stop Illicit Drug Importation Act of 2018

 
(Sec. 3022) The FDA may prohibit a person from importing drugs or controlled substances under specified circumstances, including if the person has shown a pattern of importing adulterated or misbranded drugs that pose a serious health threat. 
 
The bill also prohibits the importation, in accordance with specified criteria, of counterfeit drugs and drugs that pose a significant public health concern. 
 
Chapter 4--Securing Opioids and Unused Narcotics with Deliberate Disposal and Packaging
 

Securing Opioids and Unused Narcotics with Deliberate Disposal and Packaging Act of 2018 or the SOUND Disposal and Packaging Act

 
(Sec. 3032) The FDA may require certain packaging and disposal measures to mitigate the risk of abuse or misuse of a drug. 
 
Chapter 5--Postapproval Study Requirements
 
(Sec. 3041) The FDA may also require a post-approval study for certain drugs in order to assess potential reduced effectiveness. 
 
Subtitle B--Controlled Substance Provisions
 
Chapter 1--More Flexibility with Respect to Medication-Assisted Treatment for Opioid Use Disorders
 
(Sec. 3201) The bill increases the maximum number of patients that health care practitioners may initially treat with medication-assisted treatment (i.e., under a buprenorphine waiver).
 
(Sec. 3204) The bill amends the Controlled Substances Act to allow a pharmacy to deliver a controlled substance to a practitioner, in accordance with a prescription, to be administered to a specific patient for maintenance or detoxification treatment. 
 
Chapter 2--Empowering Pharmacists in the Fight Against Opioid Abuse
 

Empowering Pharmacists in the Fight Against Opioid Abuse Act

 
(Sec. 3212) The Department of Health and Human Services (HHS) must develop training programs and materials on the circumstances under which a pharmacist may refuse to fill a controlled substance prescription suspected to be fraudulent, forged, or of suspicious origin. 
 
Chapter 3--Safe Disposal of Unused Medication
 

Safe Disposal of Unused Medication Act

 
(Sec. 3222) The bill allows a hospice employee, under specified circumstances, to handle lawfully dispensed controlled substances of a hospice patient in order to assist with disposal of the controlled substances, so long as such disposal occurs onsite in accordance with applicable law.
 
Chapter 4--Special Registration for Telemedicine Clarification
 

Special Registration for Telemedicine Clarification Act of 2018

 
(Sec. 3232) The bill establishes a deadline for the Drug Enforcement Administration (DEA) to promulgate regulations for the special registration of practitioners to practice telemedicine.
 
Chapter 5--Synthetic Abuse and Labeling of Toxic Substances
 
(Sec. 3241) The bill also sets forth factors that may be considered to determine whether a controlled substance analogue is intended for human consumption. Under current law, a controlled substance analogue that is intended for human consumption is treated as a schedule I controlled substance and is subject to certain regulatory controls.
 
Chapter 6--Access to Increased Drug Disposal
 

Access to Increased Drug Disposal Act of 2018

 
(Sec. 3252) The bill directs the Office of Justice Programs in the Department of Justice (DOJ) to award grants to states to increase the number of pharmacies and other eligible entities (e.g., narcotic treatment programs) that collect unused prescription drugs for disposal. Grants must be used for costs associated with the collection and disposal of such drugs.
 
Chapter 7--Using Data to Prevent Opioid Diversion
 

Using Data to Prevent Opioid Diversion Act of 2018

 
(Sec. 3272) In order to identify and prevent drug diversion, the DEA must use an automated data system to inform drug manufacturers and distributors about the quantity and type of opioids that are distributed to pharmacies and practitioners. 
 
Chapter 8--Opioid Quota Reform
 

Opioid Quota Reform Act

 
(Sec. 3282) The DEA must also estimate the extent of any diversion of specified controlled substances (e.g., fentanyl) when determining manufacturing quotas for such substances. In estimating diversion rates, the DEA must consider information relating to overdose deaths and abuse of such substances. 
 
Chapter 9--Preventing Drug Diversion
 

Preventing Drug Diversion Act of 2018

 
(Sec. 3292) The bill also establishes reporting requirements regarding suspicious orders of controlled substances; information must be collected in a centralized DEA database and shared with states.
 
TITLE IV--OFFSETS 
 
(Sec. 4001) The bill temporarily eliminates the enhanced federal matching rate for Medicaid expenditures regarding specified medical services provided by certain managed care organizations.
 
(Sec. 4003) The bill amends the Internal Revenue Code to expand the religious conscience exemption under the Patient Protection and Affordable Care Act to exempt individuals who rely solely on a religious method of healing and for whom the acceptance of medical health services would be inconsistent with their religious beliefs from the requirement to purchase and maintain minimum essential health care coverage.
 
TITLE V--OTHER MEDICAID PROVISIONS
 
Subtitle A--Mandatory Reporting with Respect to Adult Behavioral Health Measures 
 
(Sec. 5001) The bill requires certain Medicaid quality health measures to include behavioral health measures.
 
Subtitle B--Medicaid IMD Additional Info
 

Medicaid Institutes for Mental Disease Are Decisive in Delivering Inpatient Treatment for Individuals but Opportunities for Needed Access are Limited without Information Needed about Facility Obligations Act or the Medicaid IMD ADDITIONAL INFO Act

 
(Sec. 5012) The Medicaid and Children's Health Insurance Program (CHIP) Payment and Access Commission must report on information relating to services for Medicaid enrollees who are patients in IMDs, including the number and type of IMDs in each sampled state, services offered, and funding sources.
 
Subtitle C--CHIP Mental Health and Substance Use Disorder Parity
 

CHIP Mental Health and Substance Use Disorder Parity Act

 
(Sec. 5022) CHIP plans must cover mental health and substance-use disorder services. Financial requirements and treatment limitations applicable to such services shall not differ from those applicable to other medical services under CHIP.
 
Subtitle D--Medicaid Reentry
 

Medicaid Reentry Act

 
(Sec. 5032) The CMS must convene a stakeholder workgroup in order to develop best practices for states to help inmates released from public institutions transition to the community with health care (such as by ensuring continuity of health insurance or Medicaid coverage). The CMS must also issue a letter to states outlining opportunities for Medicaid demonstration waivers based on identified best practices.
 
Subtitle E--Medicaid Partnership
 

Medicaid Providers Are Required To Note Experiences in Record Systems to Help In-need Patients Act or the Medicaid PARTNERSHIP Act

 
(Sec. 5042) Each state must establish a qualifying PDMP and require health care providers to check the PDMP for a Medicaid enrollee's prescription drug history before prescribing controlled substances to the enrollee. 
 
Subtitle F--IMD CARE Act
 

Individuals in Medicaid Deserve Care that is Appropriate and Responsible in its Execution Act or the IMD CARE Act

 
(Sec. 5052) The bill temporarily allows states to apply to receive federal Medicaid payment for specified services provided in IMDs for enrollees (aged 21 to 64) with substance-use disorders. Services may be covered for a total of up to 30 days in a 12-month period for an eligible enrollee. 
 
Current law generally prohibits federal payment under Medicaid for services provided in IMDs for individuals under the age of 65 (although states may receive payment through certain mechanisms, such as through a Medicaid demonstration waiver). 
 
Subtitle G--Medicaid Improvement Fund
 
(Sec. 5061) The bill reauthorizes annual funding for the Medicaid Improvement Fund beginning in FY2021. (The fund is used to improve management of the Medicaid program by the CMS, such as through demonstration project evaluations.)
 
TITLE VI--OTHER MEDICARE PROVISIONS 
 
Subtitle A--Testing of Incentive Payments for Behavioral Health Providers for Adoption and Use of Certified Electronic Health Record Technology
 
(Sec. 6001) The Center for Medicare and Medicaid Innovation may test models to provide incentive payments to behavioral health providers for adopting electronic health records technology and for using that technology to improve the quality and coordination of care.
 
Subtitle B--Abuse Deterrent Access
 

Abuse Deterrent Access Act of 2018

 
(Sec. 6012) The CMS must report on the adequacy of access to abuse-deterrent opioid formulations for individuals with chronic pain enrolled in a prescription drug plan under Medicare or MA, as well as the effectiveness and impact of such formulations. 
 
Subtitle C--Medicare Opioid Safety Education
 
(Sec. 6021) The CMS must provide Medicare beneficiaries with educational resources regarding opioid use and pain management, as well as descriptions of covered alternative (non-opioid) pain-management treatments.
 
Subtitle D--Opioid Addiction Action Plan
 

Opioid Addiction Action Plan Act

 
(Sec. 6032) The CMS must develop an action plan to provide recommendations on changes to the Medicare and Medicaid programs to enhance the treatment and prevention of opioid addiction, as well as coverage and payment of medication-assisted treatment. 
 
The CMS must also publish a report that includes an evaluation of price trends for opioid overdose-reversal drugs (e.g., naloxone) and recommendations on ways to lower consumer prices for such drugs. 
 
Subtitle E--Advancing High Quality Treatment for Opioid Use Disorders in Medicare
 

Advancing High Quality Treatment for Opioid Use Disorders in Medicare Act

 
(Sec. 6042) The CMS must carry out a demonstration program to increase access to opioid-use disorder treatment services for Medicare beneficiaries, improve physical and mental health outcomes for such beneficiaries, and reduce Medicare expenditures. 
 
Subtitle F--Responsible Education Achieves Care and Healthy Outcomes for Users' Treatment 
 

Responsible Education Achieves Care and Healthy Outcomes for Users' Treatment Act of 2018 or the REACH OUT Act of 2018
 
 
(Sec. 6052) The CMS must also award grants, contracts, or cooperative agreements to qualifying organizations in order to support efforts to curb outlier prescribers of opioids under the Medicare prescription drug benefit and MA prescription drug plans. 
 
Subtitle G--Preventing Addiction for Susceptible Seniors 
 

Preventing Addiction for Susceptible Seniors Act of 2018 or the PASS Act of 2018
 
 
(Sec. 6062) The bill requires electronic prescription programs to be able to securely transmit prior authorization requests for covered drugs under Medicare. 
 
(Sec. 6063) The CMS must also establish a secure online portal to allow data sharing among the CMS, Medicare prescription drug benefit plans, and MA plans. The portal must also support referrals by such plans of substantiated fraud, waste, or abuse. 
 
(Sec. 6064) The bill also establishes individuals who are identified as at-risk beneficiaries for prescription drug abuse as qualifying participants in medication therapy management programs under the Medicare prescription drug benefit. 
 
(Sec. 6065) The CMS must also identify outlier prescribers of opioids under Medicare prescription drug benefit plans and MA plans, based on specialty and geographic area, and annually notify such prescribers of their status. 
 
Subtitle H--Expanding Oversight of Opioid Prescribing and Payment 
 

Expanding Oversight of Opioid Prescribing and Payment Act of 2018
 
 
(Sec. 6072) The Medicare Payment Advisory Commission must report on Medicare payment for opioid and non-opioid pain management treatments, current incentives for prescribing opioid and non-opioid treatments, and how opioid use is currently tracked and monitored. 
 
Subtitle I--Dr. Todd Graham Pain Management, Treatment, and Recovery 
 

Dr. Todd Graham Pain Management, Treatment, and Recovery Act of 2018
 
 
(Sec. 6082) The CMS must review payments under Medicare for opioid and non-opioid pain-management procedures, specifically with respect to ambulatory outpatient surgical procedures and hospital outpatient department services. The CMS must ensure that there are no payment incentives for using opioids instead of non-opioid alternatives and must make revisions accordingly. 
 
(Sec. 6083) The bill also requires payment under Medicare to federally qualified health centers and rural health clinics that have health care practitioners who are newly certified to provide medication-assisted treatment (e.g., buprenorphine). 
 
(Sec. 6085) The Center for Medicare and Medicaid Innovation may test models to help individuals learn about the availability of psychologist services under Medicare, as well as to explore the use of a behavioral health help-line that is available 24-7 to prevent unnecessary hospitalizations and emergency department visits. 
 
Subtitle J--Combating Opioid Abuse for Care in Hospitals 
 

Combating Opioid Abuse for Care in Hospitals Act of 2018 or the COACH Act of 2018
 
 
(Sec. 6092) The CMS must publish guidance for hospitals on pain management and opioid-use disorder prevention strategies for Medicare beneficiaries. 
 
Technical expert panels must also recommend opioid-use disorder quality measures for hospital reports, methods to reduce opioid use in surgical settings, and pain-management strategies.
 

 
Subtitle K--Providing Reliable Options for Patients and Educational Resources 
 

Providing Reliable Options for Patients and Educational Resources Act of 2018 or the PROPER Act of 2018
 
 
(Sec. 6102) Medicare and MA prescription drug plan sponsors must annually disclose information to enrollees about the risks of prolonged opioid use, as well as coverage of nonpharmacological therapies, devices, and non-opioid medications. 
 
(Sec. 6103) The bill also requires Medicare medication therapy management programs and MA in-home health-risk assessments to include information about the safe disposal of prescription drugs. 
 
(Sec. 6104) The bill prohibits inclusion of pain-management questions in certain health care system surveys, unless the questions address the risks of opioid use and the availability of non-opioid alternatives. 
 
Subtitle L--Fighting the Opioid Epidemic With Sunshine
 
(Sec. 6111) The bill expands Medicaid and Medicare reporting requirements related to the transparency of physician ownership or investment interests by including additional health care practitioners (e.g., physician assistants and nurses) in such requirements.
 
TITLE VII--PUBLIC HEALTH PROVISIONS 
 
Subtitle A--Awareness and Training
 

 
(Sec. 7001) The bill requires HHS and the Surgeon General to report on the health effects of new psychoactive substances (also known as "synthetic drugs") that are used by adolescents and young adults. Examples of synthetic drugs include synthetic marijuana (also known as "spice") and synthetic amphetamines (also known as "bath salts"). 
 
(Sec. 7002) The bill also reauthorizes through FY2023 and revises the grant program for first responders regarding opioid overdose treatment, which is administered by the Substance Abuse and Mental Health Services Administration (SAMHSA). The bill includes safety training for handling specified drugs (e.g., fentanyl) as a component of the grant program.
 

 
Subtitle B--Pilot Program for Public Health Laboratories to Detect Fentanyl and Other Synthetic Opioids
 
(Sec. 7011) HHS must establish a grant program to improve coordination between public health laboratories and law enforcement regarding synthetic opioid detection.
 
Subtitle C-- Indexing Narcotics, Fentanyl, and Opioids 
 
(Sec. 7021) HHS must establish a public information dashboard that coordinates programs related to opioid-abuse reduction, allows data sharing between different programs and regions of the country, and provides information on alternatives to controlled substances for pain management. 
 
(Sec. 7023) HHS must also develop national milestones to measure progress in reducing the opioid crisis over a five-year period based on certain metrics. 
 
Subtitle D--Ensuring Access to Quality Sober Living 
 

 
(Sec. 7031) The bill amends the Public Health Service Act to require SAMHSA to develop best practices for operating recovery housing (shared living environments free from alcohol and illegal drug use and centered on peer support and connection to services that promote recovery from substance-use disorders). 
 
Subtitle E--Advancing Cutting Edge Research 
 

 
(Sec. 7041) The bill expands the National Institutes of Health's unique research initiatives to include cutting-edge research that is urgently required to respond to a public health threat. (Unique research initiatives may be supported through transactions other than contracts, grants, or cooperative agreements.)
 
Subtitle F--Jessie's Law
 
(Sec. 7051) HHS must develop best practices for health care providers and state agencies regarding the display of a patient's history of opioid addiction in the patient's medical records.
 
(Sec. 7052) The bill also requires the CMS and the Health Resources and Services Administration to notify annually health care providers about health information that may be disclosed under federal privacy laws to families, caregivers, and health care providers during emergencies, including overdoses. 
 
Subtitle G--Protecting Pregnant Women and Infants
 
(Sec. 7061) The bill requires HHS to issue several reports relating to pregnant and postpartum women with substance-use disorders, including non-opioid pain management practices.
 
(Sec. 7065) The bill also authorizes a grant program that supports the care of infants who are affected by substance-use disorders (e.g., infants with neonatal abstinence syndrome).
 
Subtitle H--Substance Use Disorder Treatment Workforce 
 
(Sec. 7071) The bill creates a loan repayment program for individuals who complete a period of service in a substance-use disorder treatment job in a mental health professional shortage area or a county where the drug overdose death rate is higher than the national average.
 
(Sec. 7073) The bill also reauthorizes through FY2023 and revises a grant program regarding pain care training for health care professionals. The bill specifically requires information about opioid misuse and nonaddictive treatments to be incorporated into the grant program.
 
Subtitle I--Preventing Overdoses While in Emergency Rooms
 
(Sec. 7081) HHS must establish a grant program to implement best practices (as developed by HHS) regarding treatment for individuals who experience a drug overdose, including emergency treatment and the use of recovery coaches. 
 
Subtitle J--Alternatives to Opioids in the Emergency Department
 
(Sec. 7091) HHS must also establish a demonstration program through which hospitals and emergency departments receive grants to support alternatives to opioids for pain management. 
 

 
Subtitle K--Treatment, Education, and Community Help to Combat Addiction
 
(Sec. 7101) The bill requires SAMHSA to designate Regional Centers of Excellence in Substance Use Disorder Education. Such centers must improve substance-use disorder training through the distribution of evidence-based resources for health care professional schools. 
 
(Sec. 7102) HHS must also award grants to support substance-use disorder prevention and treatment programs for children, adolescents, and young adults.
 
Subtitle L--Information from National Mental Health and Substance Use Policy Laboratory 
 
(Sec. 7111) The National Mental Health and Substance Use Policy Laboratory within SAMHSA must issue guidance for SAMHSA grant applicants in order to encourage funding of evidence-based practices and to help applicants properly articulate funding rationales.
 
Subtitle M--Comprehensive Opioid Recovery Centers
 
(Sec. 7121) The bill also requires SAMHSA to award grants to establish or operate at least 10 comprehensive opioid recovery centers across the country. Such centers must conduct outreach and provide specified treatment and recovery services, including approved drug treatments (e.g., methadone), counseling, residential rehabilitation, and job-placement assistance. 
 
Subtitle N--Trauma-Informed Care 
 
(Sec. 7131) The Centers for Disease Control and Prevention (CDC) may collect and report data using specified surveys regarding adverse childhood experiences, particularly with respect to rural and tribal areas. 
 
(Sec. 7135) HHS must provide resources to early childhood care and education providers and other professionals working with young children on ways to recognize and respond to children who may be affected by a family member's or other adult's substance abuse. 
 
Subtitle O--Eliminating Opioid Related Infectious Diseases
 
(Sec. 7141) The bill expands the CDC grant program for combating hepatitis C infections to include other infections associated with illicit drug use (e.g., HIV). The bill also includes Indian tribes in the program.
 
Subtitle P--Peer Support Communities of Recovery
 
(Sec. 7151) SAMHSA must award grants to support recovery community organizations (nonprofit organizations that are wholly or principally governed by individuals in recovery for substance-use disorders). 
 
Subtitle Q--Creating Opportunities that Necessitate New and Enhanced Connections that Improve Opioid Navigation Strategies
 
(Sec. 7161) The CDC may provide technical assistance and award grants in order to improve PDMPs, promote new approaches for responding to emerging public health crises, and improve overdose data reporting. 
 
(Sec. 7162) The bill also alters requirements relating to PDMPs. Among other changes, the bill authorizes federal support for specific PDMP improvements regarding use, data reporting, and intrastate and interstate interoperability. 
 
Subtitle R--Review of Substance Use Disorder Treatment Providers Receiving Federal Funding
 
(Sec. 7171) HHS must review entities that receive federal funds for substance-use disorder treatment services; the scope of the review must include the types of services provided, the populations served, and the adequacy of services.
 
Subtitle S--Other Health Provisions
 
(Sec. 7183) HHS must establish a grant program to help individuals who are in substance-use disorder treatment or recovery to live independently and to participate in the workforce. 
 

 
TITLE VIII--MISCELLANEOUS
 
Subtitle A--Synthetics Trafficking and Overdose Prevention
 

Synthetics Trafficking and Overdose Prevention Act of 2018 or STOP Act of 2018

 
(Sec. 8002) The bill increases shipment-tracking responsibilities and coordination between the U.S. Postal Service and the U.S. Customs and Border Protection regarding international shipments of controlled substances, such as through communication requirements and the development of technology to detect illicit fentanyl. 
 

 
Subtitle B--Opioid Addiction Recovery Fraud Prevention
 

Opioid Addiction Recovery Fraud Prevention Act of 2018

 
(Sec. 8022) The bill prohibits unfair or deceptive trade practices regarding substance-use disorder treatment services or products.
 
Subtitle C--Addressing Economic and Workforce Impacts of the Opioid Crisis
 
(Sec. 8041) The Department of Labor must establish a pilot program that awards grants in order to address the economic and workforce impacts of substance-use disorders, such as through treatment services for employees.
 
Subtitle D--Peer Support Counseling Program for Women Veterans
 
(Sec. 8051) The Department of Veterans Affairs (VA) must also emphasize appointing peer-support counselors for women veterans. The VA shall recruit women peer-support counselors with expertise in gender-specific issues and services, VA services and benefits, and employment mentoring. 
 
Subtitle E--Treating Barriers to Prosperity
 

Treating Barriers to Prosperity Act of 2018

 
(Sec. 8062) The bill allows the Appalachian Regional Commission to support projects and activities addressing drug abuse, such as infrastructure development for telemedicine. 
 
Subtitle F--Pilot Program to Help Individuals in Recovery from a Substance Use Disorder Become Stably Housed
 
(Sec. 8071) The bill authorizes a grant program, based on funding formulas determined by the Department of Housing and Urban Development, to help states provide temporary housing for individuals who are in recovery from a substance-use disorder.
 
Subtitle G--Human Services
 
(Sec. 8081) HHS must develop guidance for states on ways to support family-focused residential treatment programs (substance-use disorder treatment programs for pregnant and postpartum women, as well as parents and guardians, which allow their children to remain with them during treatment). The guidance must include descriptions of funding opportunities under Medicaid and federal foster care and adoption assistance programs.
 
Subtitle H--Reauthorizing and Extending Grants for Recovery from Opioid Use Programs
 

Reauthorizing and Extending Grants for Recovery from Opioid Use Programs Act of 2018 or the REGROUP Act of 2018

 
(Sec. 8092) The bill reauthorizes through FY2023 the comprehensive opioid abuse grant program administered by DOJ.
 
Subtitle I--Fighting Opioid Abuse in Transportation
 

Fighting Opioid Abuse in Transportation Act

 
(Sec. 8102) The bill institutes a series of requirements relating to transportation workplace drug- and alcohol-testing. Among other things, the bill requires the Department of Transportation (DOT) to establish a public database with testing results for each mode of transportation; DOT must also include fentanyl in drug-testing policies, if HHS determines that inclusion is justified based on the reliability and cost-effectiveness of available testing.
 
Subtitle J--Eliminating Kickbacks in Recovery
 

Eliminating Kickbacks in Recovery Act of 2018

 
(Sec.8122) The bill amends the federal criminal code make it a crime to knowingly and willfully solicit, receive, pay, or offer payment for referrals to a recovery home, clinical treatment facility, or laboratory, subject to limitations.
 
Subtitle K--Substance Abuse Prevention
 

Substance Abuse Prevention Act of 2018

 
(Sec. 8202) The bill reauthorizes several programs relating to drug control through FY2023, including the Office of National Drug Control Policy, the Drug-Free Communities Program, and the High-Intensity Drug Trafficking Area Program.
 
The bill also reauthorizes and establishes several other judicial, treatment, and administrative programs relating to controlled substances. Among other things, the bill reauthorizes funding for drug courts, authorizes grants to support the safe handling of fentanyl by first responders, and authorizes grants for family substance-use disorder treatment services. 
 



Legislative actions:
action_date: 2018-10-24
text: Became Public Law No: 115-271.
action_date: 2018-10-24
text: Became Public Law No: 115-271.
action_date: 2018-10-24
text: Signed by President.
action_date: 2018-10-24
text: Signed by President.
action_date: 2018-10-16
text: Presented to President.
action_date: 2018-10-16
text: Presented to President.
action_date: 2018-10-04
text: Message on Senate action sent to the House.
action_date: 2018-10-03
text: Senate agreed to the House amendment to the Senate amendment to H.R. 6. by Yea-Nay Vote. 98 - 1. Record Vote Number: 221.
action_date: 2018-10-03
text: Resolving differences -- Senate actions: Senate agreed to the House amendment to the Senate amendment to H.R. 6. by Yea-Nay Vote. 98 - 1. Record Vote Number: 221.
action_date: 2018-10-03
text: Motion by Senator Thune to concur in the House amendment to the Senate amendment to H.R. 6 made in Senate.
action_date: 2018-10-03
text: Measure laid before Senate by unanimous consent. (consideration: CR S6467-6483)
action_date: 2018-10-01
text: Message on House action received in Senate and at desk: House amendment to Senate amendment.
action_date: 2018-09-28
text: House agreed to Senate amendment with an amendment pursuant to H. Res. 1099.
action_date: 2018-09-28
text: Resolving differences -- House actions: House agreed to Senate amendment with an amendment pursuant to H. Res. 1099.
action_date: 2018-09-18
text: Message on Senate action sent to the House.
action_date: 2018-09-17
text: Passed Senate with an amendment by Yea-Nay Vote. 99 - 1. Record Vote Number: 210.
action_date: 2018-09-17
text: Passed/agreed to in Senate: Passed Senate with an amendment by Yea-Nay Vote. 99 - 1. Record Vote Number: 210.
action_date: 2018-09-17
text: Measure laid before Senate by unanimous consent. (consideration: CR S6159-6180)
action_date: 2018-06-26
text: Read the second time. Placed on Senate Legislative Calendar under General Orders. Calendar No. 485.
action_date: 2018-06-25
text: Received in the Senate. Read the first time. Placed on Senate Legislative Calendar under Read the First Time.
action_date: 2018-06-22
text: Motion to reconsider laid on the table Agreed to without objection.
action_date: 2018-06-22
text: On passage Passed by the Yeas and Nays: 396 - 14 (Roll no. 288). (text: CR H5522-5560)
action_date: 2018-06-22
text: Passed/agreed to in House: On passage Passed by the Yeas and Nays: 396 - 14 (Roll no. 288).(text: CR H5522-5560)
action_date: 2018-06-22
text: On motion to recommit with instructions Failed by the Yeas and Nays: 185 - 226 (Roll no. 287).
action_date: 2018-06-22
text: The previous question on the motion to recommit with instructions was ordered without objection.
action_date: 2018-06-22
text: DEBATE - The House proceeded with 10 minutes of debate on the motion to recommit with instructions. The instructions contained in the motion seek to require the bill to be reported back to the House with an amendment to add 2 sections to the bill titled "Distribution of Additional Residency Positions to Help Combat Opioid Crisis" and "Funding for Opioid Grant Program for State Response to Opioid Abuse Crisis".
action_date: 2018-06-22
text: Mr. Tonko moved to recommit with instructions to the Committees on Energy and Commerce and Ways and Means. (consideration: CR H5567-5572; text: CR H5567-5570)
action_date: 2018-06-22
text: The House adopted the amendments en gross as agreed to by the Committee of the Whole House on the state of the Union.
action_date: 2018-06-22
text: The previous question was ordered pursuant to the rule.
action_date: 2018-06-22
text: The House rose from the Committee of the Whole House on the state of the Union to report H.R. 6.
action_date: 2018-06-22
text: DEBATE - Pursuant to the provisions of H. Res. 949, the Committee of the Whole proceeded with 10 minutes of debate on the Maxine Waters amendment No. 7.
action_date: 2018-06-22
text: DEBATE - Pursuant to the provisions of H. Res. 949, the Committee of the Whole proceeded with 10 minutes of debate on the Keating amendment No. 5.
action_date: 2018-06-22
text: DEBATE - Pursuant to the provisions of H. Res. 949, the Committee of the Whole proceeded with 10 minutes of debate on the Curtis amendment No. 4.
action_date: 2018-06-22
text: DEBATE - Pursuant to the provisions of H. Res. 949, the Committee of the Whole proceeded with 10 minutes of debate on the Barton amendment No. 3.
action_date: 2018-06-22
text: DEBATE - Pursuant to the provisions of H. Res. 949, the Committee of the Whole proceeded with 10 minutes of debate on the Dunn amendment No. 2.
action_date: 2018-06-22
text: The Committee resumed its sitting.
action_date: 2018-06-22
text: DEBATE - Pursuant to the provisions of H.Res. 949, the Committee of the Whole proceeded with 10 minutes of debate on the Walden amendment No. 1.
action_date: 2018-06-22
text: GENERAL DEBATE - The Committee of the Whole proceeded with one hour of general debate on H.R. 6.
action_date: 2018-06-22
text: The Speaker designated the Honorable Don Bacon to act as Chairman of the Committee.
action_date: 2018-06-22
text: House resolved itself into the Committee of the Whole House on the state of the Union pursuant to H. Res. 949 and Rule XVIII.
action_date: 2018-06-22
text: Rule provides for consideration of H.R. 6, H.R. 5797 and H.R. 6082. Rule provides for consideration of H.R. 6 and H.R.5797 under structured rules; and provides for consideration of H.R. 6082 under a closed rule. Additionally, the rule directs the Clerk to, in the engrossment of H.R. 6, add the text of H.R. 2851, H.R. 5735, and H.R. 5797 as passed by the House as a new matter at the end of H.R. 6.
action_date: 2018-06-22
text: Considered under the provisions of rule H. Res. 949. (consideration: CR H5511-5572)
action_date: 2018-06-21
text: ORDER OF PROCEDURE - Mr. Burgess asked unanimous consent that, notwithstanding H.Res. 949, during consideration of H.R. 6 pursuant to such resolution, general debate shall not exceed one hour, with 40 minutes equally divided and controlled by the chair and ranking minority member of the Committee on Energy and Commerce and 20 minutes equally divided and controlled by the chair and ranking minority member of the Committee on Ways and Means.
action_date: 2018-06-19
text: Rules Committee Resolution H. Res. 949 Reported to House. Rule provides for consideration of H.R. 6, H.R. 5797 and H.R. 6082. Rule provides for consideration of H.R. 6 and H.R.5797 under structured rules; and provides for consideration of H.R. 6082 under a closed rule. Additionally, the rule directs the Clerk to, in the engrossment of H.R. 6, add the text of H.R. 2851, H.R. 5735, and H.R. 5797 as passed by the House as a new matter at the end of H.R. 6.
action_date: 2018-06-14
text: Referred to the Subcommittee on Health.
action_date: 2018-06-13
text: Referred to the Subcommittee on Crime, Terrorism, Homeland Security, and Investigations.
action_date: 2018-06-13
text: Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, and the Judiciary, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
action_date: 2018-06-13
text: Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, and the Judiciary, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
action_date: 2018-06-13
text: Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, and the Judiciary, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
action_date: 2018-06-13
text: Introduced in House
action_date: 2018-06-13
text: Introduced in House

Enacted as: number: 115-271