An act to amend the Controlled Substances Act with regard to the provision of emergency medical services
PL 115-83 (H.R.304), enacted 11/17/2017

131 STAT. 1267 
PUBLIC LAW 115–83—NOV. 17, 2017 
Public Law 115–83 
115th Congress 
An Act 
To amend the Controlled Substances Act with regard to the provision of emergency 
medical services. 
Be it enacted by the Senate and House of Representatives of 
the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Protecting Patient Access to 
Emergency Medications Act of 2017’’. 
SEC. 2. EMERGENCY MEDICAL SERVICES. 
Section 303 of the Controlled Substances Act (21 U.S.C. 823) 
is amended— 
(1) by redesignating subsection (j) as subsection (k); and 
(2) by inserting after subsection (i) the following: 
‘‘(j) EMERGENCY MEDICAL SERVICES THAT ADMINISTER CON-
TROLLED SUBSTANCES.— 
‘‘(1) REGISTRATION.—For the purpose of enabling emergency 
medical services professionals to administer controlled sub-
stances in schedule II, III, IV, or V to ultimate users receiving 
emergency medical services in accordance with the require-
ments of this subsection, the Attorney General— 
‘‘(A) shall register an emergency medical services 
agency if the agency submits an application demonstrating 
it is authorized to conduct such activity under the laws 
of each State in which the agency practices; and 
‘‘(B) may deny an application for such registration 
if the Attorney General determines that the issuance of 
such registration would be inconsistent with the require-
ments of this subsection or the public interest based on 
the factors listed in subsection (f). 
‘‘(2) OPTION FOR SINGLE REGISTRATION.—In registering an 
emergency medical services agency pursuant to paragraph (1), 
the Attorney General shall allow such agency the option of 
a single registration in each State where the agency administers 
controlled substances in lieu of requiring a separate registration 
for each location of the emergency medical services agency. 
‘‘(3) HOSPITAL-BASED AGENCY.—If a hospital-based emer-
gency medical services agency is registered under subsection 
(f), the agency may use the registration of the hospital to 
administer controlled substances in accordance with this sub-
section without being registered under this subsection. 
‘‘(4) ADMINISTRATION OUTSIDE PHYSICAL PRESENCE OF MED-
ICAL DIRECTOR OR AUTHORIZING MEDICAL PROFESSIONAL.—Emer-
gency medical services professionals of a registered emergency 
Protecting 
Patient Access to 
Emergency 
Medications Act 
of 2017. 
21 USC 801 note. 
Nov. 17, 2017 
[H.R. 304] 
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131 STAT. 1268 
PUBLIC LAW 115–83—NOV. 17, 2017 
medical services agency may administer controlled substances 
in schedule II, III, IV, or V outside the physical presence 
of a medical director or authorizing medical professional in 
the course of providing emergency medical services if the 
administration is— 
‘‘(A) authorized by the law of the State in which it 
occurs; and 
‘‘(B) pursuant to— 
‘‘(i) a standing order that is issued and adopted 
by one or more medical directors of the agency, 
including any such order that may be developed by 
a specific State authority; or 
‘‘(ii) a verbal order that is— 
‘‘(I) issued in accordance with a policy of the 
agency; and 
‘‘(II) provided by a medical director or author-
izing medical professional in response to a request 
by the emergency medical services professional 
with respect to a specific patient— 
‘‘(aa) in the case of a mass casualty 
incident; or 
‘‘(bb) to ensure the proper care and treat-
ment of a specific patient. 
‘‘(5) DELIVERY.—A registered emergency medical services 
agency may deliver controlled substances from a registered 
location of the agency to an unregistered location of the agency 
only if the agency— 
‘‘(A) designates the unregistered location for such 
delivery; and 
‘‘(B) notifies the Attorney General at least 30 days 
prior to first delivering controlled substances to the unregis-
tered location. 
‘‘(6) STORAGE.—A registered emergency medical services 
agency may store controlled substances— 
‘‘(A) at a registered location of the agency; 
‘‘(B) at any designated location of the agency or in 
an emergency services vehicle situated at a registered or 
designated location of the agency; or 
‘‘(C) in an emergency medical services vehicle used 
by the agency that is— 
‘‘(i) traveling from, or returning to, a registered 
or designated location of the agency in the course of 
responding to an emergency; or 
‘‘(ii) otherwise actively in use by the agency under 
circumstances that provide for security of the controlled 
substances consistent with the requirements estab-
lished by regulations of the Attorney General. 
‘‘(7) NO TREATMENT AS DISTRIBUTION.—The delivery of con-
trolled substances by a registered emergency medical services 
agency pursuant to this subsection shall not be treated as 
distribution for purposes of section 308. 
‘‘(8) 
RESTOCKING
OF
EMERGENCY
MEDICAL
SERVICES 
VEHICLES AT A HOSPITAL.—Notwithstanding paragraph (13)(J), 
a registered emergency medical services agency may receive 
controlled substances from a hospital for purposes of restocking 
an emergency medical services vehicle following an emergency 
Records. 
Notification. 
Time period. 
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131 STAT. 1269 
PUBLIC LAW 115–83—NOV. 17, 2017 
response, and without being subject to the requirements of 
section 308, provided all of the following conditions are satisfied: 
‘‘(A) The registered or designated location of the agency 
where the vehicle is primarily situated maintains a record 
of such receipt in accordance with paragraph (9). 
‘‘(B) The hospital maintains a record of such delivery 
to the agency in accordance with section 307. 
‘‘(C) If the vehicle is primarily situated at a designated 
location, such location notifies the registered location of 
the agency within 72 hours of the vehicle receiving the 
controlled substances. 
‘‘(9) MAINTENANCE OF RECORDS.— 
‘‘(A) IN
GENERAL.—A registered emergency medical 
services agency shall maintain records in accordance with 
subsections (a) and (b) of section 307 of all controlled sub-
stances that are received, administered, or otherwise dis-
posed of pursuant to the agency’s registration, without 
regard to subsection 307(c)(1)(B). 
‘‘(B) REQUIREMENTS.—Such records— 
‘‘(i) shall include records of deliveries of controlled 
substances between all locations of the agency; and 
‘‘(ii) shall be maintained, whether electronically 
or otherwise, at each registered and designated location 
of the agency where the controlled substances involved 
are received, administered, or otherwise disposed of. 
‘‘(10) OTHER REQUIREMENTS.—A registered emergency med-
ical services agency, under the supervision of a medical director, 
shall be responsible for ensuring that— 
‘‘(A) all emergency medical services professionals who 
administer controlled substances using the agency’s reg-
istration act in accordance with the requirements of this 
subsection; 
‘‘(B) the recordkeeping requirements of paragraph (9) 
are met with respect to a registered location and each 
designated location of the agency; 
‘‘(C) the applicable physical security requirements 
established by regulation of the Attorney General are com-
plied with wherever controlled substances are stored by 
the agency in accordance with paragraph (6); and 
‘‘(D) the agency maintains, at a registered location 
of the agency, a record of the standing orders issued or 
adopted in accordance with paragraph (9). 
‘‘(11) REGULATIONS.—The Attorney General may issue regu-
lations— 
‘‘(A) specifying, with regard to delivery of controlled 
substances under paragraph (5)— 
‘‘(i) the types of locations that may be designated 
under such paragraph; and 
‘‘(ii) the manner in which a notification under para-
graph (5)(B) must be made; 
‘‘(B) specifying, with regard to the storage of controlled 
substances under paragraph (6), the manner in which such 
substances must be stored at registered and designated 
locations, including in emergency medical service vehicles; 
and 
‘‘(C) addressing the ability of hospitals, emergency med-
ical services agencies, registered locations, and designated 
Notification. 
Deadline. 
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131 STAT. 1270 
PUBLIC LAW 115–83—NOV. 17, 2017 
locations to deliver controlled substances to each other 
in the event of— 
‘‘(i) shortages of such substances; 
‘‘(ii) a public health emergency; or 
‘‘(iii) a mass casualty event. 
‘‘(12) RULE OF CONSTRUCTION.—Nothing in this subsection 
shall be construed— 
‘‘(A) to limit the authority vested in the Attorney Gen-
eral by other provisions of this title to take measures 
to prevent diversion of controlled substances; or 
‘‘(B) to override the authority of any State to regulate 
the provision of emergency medical services consistent with 
this subsection. 
‘‘(13) DEFINITIONS.—In this section: 
‘‘(A) The term ‘authorizing medical professional’ means 
an emergency or other physician, or another medical profes-
sional (including an advanced practice registered nurse 
or physician assistant)— 
‘‘(i) who is registered under this Act; 
‘‘(ii) who is acting within the scope of the registra-
tion; and 
‘‘(iii) whose scope of practice under a State license 
or certification includes the ability to provide verbal 
orders. 
‘‘(B) The term ‘designated location’ means a location 
designated by an emergency medical services agency under 
paragraph (5). 
‘‘(C) The term ‘emergency medical services’ means 
emergency medical response and emergency mobile medical 
services provided outside of a fixed medical facility. 
‘‘(D) The term ‘emergency medical services agency’ 
means an organization providing emergency medical serv-
ices, including such an organization that— 
‘‘(i) is governmental (including fire-based and hos-
pital-based agencies), nongovernmental (including hos-
pital-based agencies), private, or volunteer-based; 
‘‘(ii) provides emergency medical services by 
ground, air, or otherwise; and 
‘‘(iii) is authorized by the State in which the 
organization is providing such services to provide emer-
gency medical care, including the administering of con-
trolled substances, to members of the general public 
on an emergency basis. 
‘‘(E) The term ‘emergency medical services professional’ 
means a health care professional (including a nurse, para-
medic, or emergency medical technician) licensed or cer-
tified by the State in which the professional practices and 
credentialed by a medical director of the respective emer-
gency medical services agency to provide emergency med-
ical services within the scope of the professional’s State 
license or certification. 
‘‘(F) The term ‘emergency medical services vehicle’ 
means an ambulance, fire apparatus, supervisor truck, or 
other vehicle used by an emergency medical services agency 
for the purpose of providing or facilitating emergency med-
ical care and transport or transporting controlled sub-
stances to and from the registered and designated locations. 
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131 STAT. 1271 
PUBLIC LAW 115–83—NOV. 17, 2017 
LEGISLATIVE HISTORY—H.R. 304: 
CONGRESSIONAL RECORD, Vol. 163 (2017): 
Jan. 9, considered and passed House. 
Oct. 24, considered and passed Senate, amended. 
Nov. 2, House concurred in Senate amendment. 
‘‘(G) The term ‘hospital-based’ means, with respect to 
an agency, owned or operated by a hospital. 
‘‘(H) The term ‘medical director’ means a physician 
who is registered under subsection (f) and provides medical 
oversight for an emergency medical services agency. 
‘‘(I) The term ‘medical oversight’ means supervision 
of the provision of medical care by an emergency medical 
services agency. 
‘‘(J) The term ‘registered emergency medical services 
agency’ means— 
‘‘(i) an emergency medical services agency that 
is registered pursuant to this subsection; or 
‘‘(ii) a hospital-based emergency medical services 
agency that is covered by the registration of the hos-
pital under subsection (f). 
‘‘(K) The term ‘registered location’ means a location 
that appears on the certificate of registration issued to 
an emergency medical services agency under this sub-
section or subsection (f), which shall be where the agency 
receives controlled substances from distributors. 
‘‘(L) The term ‘specific State authority’ means a govern-
mental agency or other such authority, including a regional 
oversight and coordinating body, that, pursuant to State 
law or regulation, develops clinical protocols regarding the 
delivery of emergency medical services in the geographic 
jurisdiction of such agency or authority within the State 
that may be adopted by medical directors. 
‘‘(M) The term ‘standing order’ means a written medical 
protocol in which a medical director determines in advance 
the medical criteria that must be met before administering 
controlled substances to individuals in need of emergency 
medical services. 
‘‘(N) The term ‘verbal order’ means an oral directive 
that is given through any method of communication 
including by radio or telephone, directly to an emergency 
medical services professional, to contemporaneously admin-
ister a controlled substance to individuals in need of emer-
gency medical services outside the physical presence of 
the medical director or authorizing medical professional.’’. 
Approved November 17, 2017. 
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