#aad? ,,congress  #b;d ,session  ,h4 ,r4
 #djfc  ,,an ,,act  ,to improve ! use by
 ! ,secret>y ( ,vet]ans ,affairs (      
opioids 9 treat+ vet]ans1 & = o!r       
purposes4  #a4 ,%ort title ,?is ,act may
 be cit$ z ! ,promot+ ,responsible      
,opioid ,managem5t & ,incorporat+       
,sci5tific ,exp]tise ,act or ! ,jason   
,simcakoski ,,promise ,act4  #b4        
,improvem5t ( opioid safety measures by 
,dep>tm5t ( ,vet]ans ,affairs  7a7      
,expansion ( opioid safety initiative   
7#a7 ,inclusion ( all m$ical facilities 
,n lat] ?an #ahj days aft] ! date ( !   
enactm5t ( ?is ,act1 ! ,secret>y (      
,vet]ans ,affairs %all exp& ! ,opioid   
,safety ,initiative ( ! ,dep>tm5t (     
,vet]ans ,affairs to include all m$ical 
facilities ( ! ,dep>tm5t4  7#b7         
,guidance ,! ,secret>y %all e/abli%     
guidance t ea* heal? c>e provid] ( !    
,dep>tm5t ( ,vet]ans ,affairs1 be=e     
initiat+ opioid !rapy to treat a pati5t 
z "p ( ! compreh5sive assessm5t conduct$
 by ! heal? c>e provid]1 use ! ,opioid  

,!rapy ,risk ,report tool ( ! ,dep>tm5t 
( ,vet]ans ,affairs 7or any subsequ5t   
tool71 :i* %all include in=mation f !   
prescription drug monitor+ program ( ea*
 p>ticipat+ ,/ate z applicable1 t       
includes ! mo/ rec5t in=mation to date  
relat+ to ! pati5t t access$ su* program
 to assess ! risk = adv]se outcomes (   
opioid !rapy = ! pati5t1 includ+ !      
concurr5t use ( controll$ sub/ances su* 
z b5zodiazep9es1 z "p ( ! compreh5sive  
assessm5t conduct$ by ! heal? c>e       
provid]4  7#c7 ,enhanc$ /&>ds ,!        
,secret>y %all e/abli% enhanc$ /&>ds )  
respect to ! use ( r\t9e & r&om ur9e    
drug te/s = all pati5ts be=e & dur+     
opioid !rapy to help prev5t sub/ance    
abuse1 dep5d5ce1 & div]sion1 includ+--  
7,a7 t su* te/s occur n less frequ5tly  
?an once ea* ye>2 &  7,b7 t heal? c>e   
provid]s appropriately ord]1 int]pret & 
respond to ! results f su* te/s to      
tailor pa9 !rapy1 safegu>ds1 & risk     
managem5t /rategies to ea* pati5t4  7b7 
,pa9 managem5t education & tra9+  7#a7  

,9 g5]al ,9 c>ry+ out ! ,opioid ,safety 
,initiative ( ! ,dep>tm5t1 ! ,secret>y  
%all require all employees ( ! ,dep>tm5t
 responsible = prescrib+ opioids to     
receive education & tra9+ describ$ 9    
p>agraph 7#b74  7#b7 ,education & tra9+ 
,education & tra9+ describ$ 9 ?is       
p>agraph is education & tra9+ on pa9    
managem5t & safe opioid prescrib+       
practices = purposes ( safely &         
effectively manag+ pati5ts ) *ronic pa91
 includ+ education & tra9+ on ! foll[+3 
7,a7 ,! implem5tation ( & full          
compliance ) ! ,,va_/,,dod ,cl9ical     
,practice ,guidel9e = ,managem5t (      
,opioid ,!rapy = ,*ronic ,pa91 includ+  
any update to su* guidel9e4  7,b7 ,! use
 ( evid5ce-bas$ pa9 managem5t !rapies1  
includ+ cognitive-behavioral !rapy1     
non-opioid alt]natives1 & non-drug      
me?ods & proc$ures to manag+ pa9 &      
relat$ heal? conditions includ+ m$ical  
devices approv$ or cle>$ by ! ,food &   
,drug ,adm9i/ration = ! treatm5t (      
pati5ts ) *ronic pa9 & complem5t>y      

alt]native m$ic9es4  7,c7 ,scre5+ &     
id5tification ( pati5ts ) sub/ance use  
disord]1 includ+ drug-seek+ behavior1   
be=e prescrib+ opioids1 assessm5t ( risk
 pot5tial = pati5ts develop+ an         
addiction1 & ref]ral ( pati5ts to       
appropriate addiction treatm5t          
pr(essionals if addiction is id5tifi$ or
 /rongly suspect$4  7,d7 ,communication 
) pati5ts on ! pot5tial h>m associat$ ) 
! use ( opioids & o!r controll$         
sub/ances1 includ+ ! ne$ to safely /ore 
& dispose ( supplies relat+ to ! use (  
opioids & o!r controll$ sub/ances4  7,e7
 ,su* o!r education & tra9+ z !         
,secret>y consid]s appropriate to ensure
 t vet]ans receive safe & high-quality  
pa9 managem5t c>e f ! ,dep>tm5t4  7#c7  
,use ( exi/+ program ,9 provid+         
education & tra9+ describ$ 9 p>agraph   
7#b71 ! ,secret>y %all use !            
,int]discipl9>y ,*ronic ,pa9 ,managem5t 
,tra9+ ,team ,program ( ! ,dep>tm5t 7or 
success program74  7c7 ,pa9 managem5t   
teams  7#a7 ,9 g5]al ,9 c>ry+ out !     

,opioid ,safety ,initiative ( !         
,dep>tm5t1 ! director ( ea* m$ical      
facility ( ! ,dep>tm5t %all id5tify &   
designate a pa9 managem5t team ( heal?  
c>e pr(essionals1 :i* may include bo>d  
c]tifi$ pa9 m$ic9e speciali/s1          
responsible = coord9at+ & ov]see+ pa9   
managem5t !rapy at su* facility =       
pati5ts exp]i5c+ acute & *ronic pa9 t is
 non-canc] relat$4  7#b7 ,e/abli%m5t (  
protocols  7,a7 ,9 g5]al ,9 consultation
 ) ! ,directors ( ea* ,vet]ans          
,integrat$ ,s]vice ,network1 ! ,secret>y
 %all e/abli% /&>d protocols = !        
designation ( pa9 managem5t teams at ea*
 m$ical facility )9 ! ,dep>tm5t4  7,b7  
,consultation on prescription ( opioids 
,ea* protocol e/abli%$ "u subp>agraph   
7,a7 %all ensure t any heal? c>e provid]
 )\t exp]tise 9 prescrib+ analgesics or 
:o has n complet$ ! education & tra9+ "u
 subsection 7b71 includ+ a m5tal heal?  
c>e provid]1 does n prescribe opioids to
 a pati5t unless t heal? c>e provid]--  
7i7 consults ) a heal? c>e provid] ) pa9

 managem5t exp]tise or :o is on ! pa9   
managem5t team ( ! m$ical facility2 &   
7ii7 ref]s ! pati5t to ! pa9 managem5t  
team = any subsequ5t prescriptions &    
relat$ !rapy4  7#c7 ,report  7,a7 ,9    
g5]al ,n lat] ?an #a ye> aft] ! date (  
enactm5t ( ?is ,act1 ! director ( ea*   
m$ical facility ( ! ,dep>tm5t %all      
submit to ! ,"u ,secret>y = ,heal? & !  
director ( ! ,vet]ans ,integrat$ ,s]vice
 ,network 9 :i* ! m$ical facility is    
locat$ a report id5tify+ ! heal? c>e    
pr(essionals t h be5 designat$ z memb]s 
( ! pa9 managem5t team at ! m$ical      
facility pursuant to p>agraph 7#a74     
7,b7 ,elem5ts ,ea* report submitt$ "u   
subp>agraph 7,a7 ) respect to a m$ical  
facility ( ! ,dep>tm5t %all include--   
7i7 a c]tification z to :e!r all memb]s 
( ! pa9 managem5t team at ! m$ical      
facility h complet$ ! education & tra9+ 
requir$ "u subsection 7b72  7ii7 a plan 
= ! managem5t & ref]ral ( pati5ts to su*
 pa9 managem5t team if heal? c>e        
provid]s )\t exp]tise 9 prescrib+       

analgesics prescribe opioid m$ications  
to treat acute & *ronic pa9 t is        
non-canc] relat$2 &  7iii7 a            
c]tification z to :e!r ! m$ical         
facility--  7,i7 fully complies ) !     
/epp$-c>e model ( pa9 managem5t & o!r   
pa9 managem5t policies conta9$ 9        
,directive #bjji-jec ( ! ,vet]ans ,heal?
 ,adm9i/ration1 or successor directive2 
or  7,,ii7 does n fully comply ) su*    
/epp$-c>e model ( pa9 managem5t & o!r   
pa9 managem5t policies b is c>ry+ out a 
corrective plan ( action to ensure su*  
full compliance4  7d7 ,track+ & monitor+
 ( opioid use  7#a7 ,prescription drug  
monitor+ programs ( /ates ,9 c>ry+ out !
 ,opioid ,safety ,initiative & ! ,opioid
 ,!rapy ,risk ,report tool ( !          
,dep>tm5t1 ! ,secret>y %all-- 7,a7      
ensure access by heal? c>e provid]s ( ! 
,dep>tm5t to in=mation on controll$     
sub/ances1 includ+ opioids &            
b5zodiazep9es1 prescrib$ to vet]ans :o  
receive c>e outside ! ,dep>tm5t ?r\gh ! 
prescription drug monitor+ program ( ea*

 ,/ate ) su* a program1 includ+ by seek+
 to ent] into memor&a ( und]/&+ ) ,/ates
 to all[ %>$ access ( su* in=mation     
betwe5 ,/ates & ! ,dep>tm5t2  7,b7      
include su* in=mation 9 ! ,opioid ,!rapy
 ,risk ,report2 &  7,c7 require heal?   
c>e provid]s ( ! ,dep>tm5t to submit to 
! prescription drug monitor+ program (  
ea* ,/ate in=mation on prescriptions (  
controll$ sub/ances receiv$ by vet]ans 9
 t ,/ate "u ! laws adm9i/]$ by !        
,secret>y4  7#b7 ,report on track+ (    
data on opioid use ,n lat] ?an #ah mon?s
 aft] ! date ( ! enactm5t ( ?is ,act1 ! 
,secret>y %all submit to ! ,committee on
 ,vet]ans' ,affairs ( ! ,s5ate & !      
,committee on ,vet]ans' ,affairs ( !    
,h\se ( ,repres5tatives a report on !   
feasibility & advisability ( improv+ !  
,opioid ,!rapy ,risk ,report tool ( !   
,dep>tm5t to all[ = m advanc$ real-"t   
track+ ( & access to data on-- 7,a7 !   
key cl9ical indicators ) respect to !   
totality ( opioid use by vet]ans2  7,b7 
concurr5t prescrib+ by heal? c>e        

provid]s ( ! ,dep>tm5t ( opioids 9      
diff]5t heal? c>e sett+s1 includ+ data  
on concurr5t prescrib+ ( opioids to     
treat m5tal heal? disord]s o!r ?an      
opioid use disord]2 &  7,c7 mail-ord]   
prescriptions ( opioid prescrib$ to     
vet]ans "u ! laws adm9i/]$ by !         
,secret>y4  7e7 ,availability ( opioid  
receptor antagoni/s  7#a7 ,increas$     
availability & use  7,a7 ,9 g5]al ,!    
,secret>y %all maximize ! availability (
 opioid receptor antagoni/s approv$ by !
 ,food & ,drug ,adm9i/ration1 includ+   
naloxone1 to vet]ans4  7,b7             
,availability1 tra9+1 & di/ribut+ ,9    
c>ry+ out subp>agraph 7,a71 n lat] ?an  
#ij days aft] ! date ( ! enactm5t ( ?is 
,act1 ! ,secret>y %all--  7i7 equip ea* 
ph>macy ( ! ,dep>tm5t ) opioid receptor 
antagoni/s approv$ by ! ,food & ,drug   
,adm9i/ration to be disp5s$ to          
outpati5ts z ne$$2 &  7ii7 exp& !       
,ov]dose ,education & ,naloxone         
,di/ribution program ( ! ,dep>tm5t to   
ensure t all vet]ans 9 receipt ( heal?  

c>e "u laws adm9i/]$ by ! ,secret>y :o  
are at risk ( opioid ov]dose may access 
su* opioid receptor antagoni/s & tra9+  
on ! prop] adm9i/ration ( su* opioid    
receptor antagoni/s4  7,c7 ,vet]ans :o  
are at risk ,= purposes ( subp>agraph   
7,b71 vet]ans :o are at risk ( opioid   
ov]dose include-- 7i7 vet]ans receiv+   
long-t]m opioid !rapy2  7ii7 vet]ans    
receiv+ opioid !rapy :o h a hi/ory (    
sub/ance use disord] or prior in/ances (
 ov]dose2 &  7iii7 vet]ans :o are at    
risk z det]m9$ by a heal? c>e provid] :o
 is treat+ ! vet]an4  7#b7 ,report ,n   
lat] ?an #abj days aft] ! date ( !      
enactm5t ( ?is ,act1 ! ,secret>y %all   
submit to ! ,committee on ,vet]ans'     
,affairs ( ! ,s5ate & ! ,committee on   
,vet]ans' ,affairs ( ! ,h\se (          
,repres5tatives a report on c>ry+ out   
p>agraph 7#a71 includ+ an assessm5t (   
any rema9+ /eps to be c>ri$ out by !    
,secret>y to c>ry out su* p>agraph4  7f7
 ,inclusion ( c]ta9 in=mation &         
capabilities 9 opioid !rapy risk report 

tool ( ! ,dep>tm5t  7#a7 ,in=mation ,!  
,secret>y %all include 9 ! ,opioid      
,!rapy ,risk ,report tool ( !           
,dep>tm5t--  7,a7 in=mation on ! mo/    
rec5t "t ! tool 0 access$ by a heal? c>e
 provid] ( ! ,dep>tm5t ) respect to ea* 
vet]an2 &  7,b7 in=mation on ! results (
 ! mo/ rec5t ur9e drug te/ = ea* vet]an4
  7#b7 ,capabilities ,! ,secret>y %all  
include 9 ! ,opioid ,!rapy ,risk ,report
 tool ! ability ( ! heal? c>e provid]s (
 ! ,dep>tm5t to det]m9e :e!r a heal? c>e
 provid] ( ! ,dep>tm5t prescrib$ opioids
 to a vet]an )\t *eck+ ! in=mation 9 !  
tool ) respect to ! vet]an4  7g7        
,notifications ( risk 9 comput]iz$ heal?
 record ,! ,secret>y %all modify !      
comput]iz$ pati5t record sy/em ( !      
,dep>tm5t to ensure t any heal? c>e     
provid] t accesses ! record ( a vet]an1 
reg>dless ( ! reason ! vet]an seeks c>e 
f ! heal? c>e provid]1 w be imm$iately  
notifi$ :e!r ! vet]an--  7#a7 is receiv+
 opioid !rapy & has a hi/ory ( sub/ance 
use disord] or prior in/ances ( ov]dose2

  7#b7 has a hi/ory ( opioid abuse2 or  
7#c7 is at risk ( becom+ an opioid abus]
 z det]m9$ by a heal? c>e provid] :o is 
treat+ ! vet]an4  7h7 ,def9itions ,9 ?is
 section3  7#a7 ,! t]m controll$        
sub/ance has ! mean+ giv5 t t]m 9       
section #ajb ( ! ,controll$ ,sub/ances  
,act 7#ba ,u4,s4,c4 #hjb74  7#b7 ,! t]m 
,/ate means ea* ( ! sev]al ,/ates1      
t]ritories1 & possessions ( ! ,unit$    
,/ates1 ! ,di/rict ( ,columbia1 & !     
,commonweal? ( ,pu]to ,rico4  #c4       
,/r5g!n+ ( jo9t work+ gr\p on pa9       
managem5t ( ! ,dep>tm5t ( ,vet]ans      
,affairs & ! ,dep>tm5t ( ,def5se  7a7 ,9
 g5]al ,n lat] ?an #ij days aft] ! date 
( enactm5t ( ?is ,act1 ! ,secret>y (    
,vet]ans ,affairs & ! ,secret>y (       
,def5se %all ensure t ! ,pa9 ,managem5t 
,work+ ,gr\p ( ! ,heal? ,executive      
,committee ( ! ,dep>tm5t ( ,vet]ans     
,affairs-,dep>tm5t ( ,def5se ,jo9t      
,executive ,committee 7,pa9 ,managem5t  
,work+ ,gr\p7 e/abli%$ "u section #cbj (
 title #ch1 ,unit$ ,/ates ,code1        

includes a focus on ! foll[+3 7#a7 ,!   
opioid prescrib+ practices ( heal? c>e  
provid]s ( ea* ,dep>tm5t4  7#b7 ,!      
ability ( ea* ,dep>tm5t to manage acute 
& *ronic pa9 among individuals receiv+  
heal? c>e f ! ,dep>tm5t1 includ+ tra9+  
heal? c>e provid]s ) respect to pa9     
managem5t4  7#c7 ,! use by ea* ,dep>tm5t
 ( complem5t>y & integrative heal? &    
complem5t>y alt]native m$ic9es 9 treat+ 
su* individuals4  7#d7 ,! concurr5t use 
by heal? c>e provid]s ( ea* ,dep>tm5t ( 
opioids & prescription drugs to treat   
m5tal heal? disord]s1 includ+           
b5zodiazep9es4  7#e7 ,! practice by     
heal? c>e provid]s ( ea* ,dep>tm5t (    
prescrib+ opioids to treat m5tal heal?  
disord]s4  7#f7 ,! coord9ation 9 cov]age
 ( & consi/5t access to m$ications      
prescrib$ = pati5ts transition+ f       
receiv+ heal? c>e f ! ,dep>tm5t (       
,def5se to receiv+ heal? c>e f !        
,dep>tm5t ( ,vet]ans ,affairs4  7#g7 ,! 
ability ( ea* ,dep>tm5t to id5tify &    
treat sub/ance use disord]s among       

individuals receiv+ heal? c>e f t       
,dep>tm5t4  7b7 ,coord9ation &          
consultation ,! ,secret>y ( ,vet]ans    
,affairs & ! ,secret>y ( ,def5se %all   
ensure t ! work+ gr\p describ$ 9        
subsection 7a7-- 7#a7 coord9ates !      
activities ( ! work+ gr\p ) o!r relevant
 work+ gr\ps e/abli%$ "u section #cbj ( 
title #ch1 ,unit$ ,/ates ,code2  7#b7   
consults ) o!r relevant ,f$]al ag5cies )
 respect to ! activities ( ! work+ gr\p2
 &  7#c7 consults ) ! ,dep>tm5t (       
,vet]ans ,affairs & ! ,dep>tm5t (       
,def5se ) respect to1 reviews1 & comm5ts
 on ! ,,va_/,,dod ,cl9ical ,practice    
,guidel9e = ,managem5t ( ,opioid ,!rapy 
= ,*ronic ,pa91 or any successor        
guidel9e1 be=e any update to ! guidel9e 
is releas$4  7c7 ,cl9ical practice      
guidel9es  7#a7 ,9 g5]al ,n lat] ?an    
#ahj days aft] ! date ( ! enactm5t ( ?is
 ,act1 ! ,secret>y ( ,vet]ans ,affairs &
 ! ,secret>y ( ,def5se %all issue an    
update to ! ,,va_/,,dod ,cl9ical        
,practice ,guidel9e = ,managem5t (      

,opioid ,!rapy = ,*ronic ,pa94  7#b7    
,matt]s includ$ ,9 conduct+ ! update "u 
subsection 7a71 ! ,pa9 ,managem5t ,work+
 ,gr\p1 9 coord9ation ) ! ,cl9ical      
,practice ,guidel9e ,,va_/,,dod         
,managem5t ( ,opioid ,!rapy = ,*ronic   
,pa9 ,work+ ,gr\p1 %all exam9e :e!r !   
,cl9ical ,practical ,guidel9e %\ld      
include ! foll[+3  7,a7 ,enhanc$        
guidance ) respect to-- 7i7 !           
coadm9i/ration ( an opioid & o!r drugs1 
includ+ b5zodiazep9es1 t may result 9   
life-limit+ drug int]actions2  7ii7 !   
treatm5t ( pati5ts ) curr5t acute       
psy*iatric in/ability or sub/ance use   
disord] or pati5ts at risk ( suicide2 & 
7iii7 ! use ( opioid !rapy to treat     
m5tal heal? disord]s o!r ?an opioid use 
disord]4  7,b7 ,enhanc$ guidance )      
respect to ! treatm5t ( pati5ts )       
behaviors or comorbidities1 su* z       
po/-traumatic /ress disord] or o!r      
psy*iatric disord]s1 or a hi/ory (      
sub/ance abuse or addiction1 t requires 
a consultation or comanagem5t ( opioid  

!rapy ) "o or m speciali/s 9 pa9        
managem5t1 m5tal heal?1 or addictions4  
7,c7 ,enhanc$ guidance ) respect to     
heal? c>e provid]s--  7i7 conduct+ an   
effective assessm5t = pati5ts beg9n+ or 
cont9u+ opioid !rapy1 includ+ und]/&+ & 
sett+ reali/ic goals ) respect to a*iev+
 & ma9ta9+ an expect$ level ( pa9       
relief1 improv$ function1 or a cl9ically
 appropriate comb9ation ( bo?2 &  7ii7  
effectively assess+ :e!r opioid !rapy is
 a*iev+ or ma9ta9+ ! e/abli%$ treatm5t  
goals ( ! pati5t or :e!r ! pati5t &     
heal? c>e provid] %\ld discuss adju/+1  
augm5t+1 or discont9u+ ! opioid !rapy4  
7,d7 ,guidel9es to gov]n ! me?odologies 
us$ by heal? c>e provid]s ( ! ,dep>tm5t 
( ,vet]ans ,affairs & ! ,dep>tm5t (     
,def5se to tap] opioid !rapy :5 adju/+  
or discont9u+ ! use ( opioid !rapy4     
7,e7 ,guidel9es ) respect to appropriate
 case managem5t = pati5ts receiv+ opioid
 !rapy :o transition betwe5 inpati5t &  
outpati5t heal? c>e sett+s1 :i* may     
include ! use ( c>e transition plans4   

7,f7 ,guidel9es ) respect to appropriate
 case managem5t = pati5ts receiv+ opioid
 !rapy :o transition f receiv+ c>e dur+ 
active duty to po/-milit>y heal? c>e    
networks4  7,g7 ,guidel9es ) respect to 
provid+ options1 be=e initiat+ opioid   
!rapy1 = pa9 managem5t !rapies )\t ! use
 ( opioids & options to augm5t opioid   
!rapy ) o!r cl9ical & complem5t>y &     
integrative heal? s]vices to m9imize    
opioid dep5d5ce4  7,h7 ,guidel9es )     
respect to ! provision ( evid5ce-bas$   
non-opioid treatm5ts )9 ! ,dep>tm5t (   
,vet]ans ,affairs & ! ,dep>tm5t (       
,def5se1 includ+ m$ical devices & o!r   
!rapies approv$ or cle>$ by ! ,food &   
,drug ,adm9i/ration = ! treatm5t (      
*ronic pa9 z an alt]native to or to     
augm5t opioid !rapy4  #d4 ,review1      
inve/igation1 & report on use ( opioids 
9 treatm5t by ,dep>tm5t ( ,vet]ans      
,affairs  7a7 ,comptroll] g5]al report  
7#a7 ,9 g5]al ,n lat] ?an #b ye>s aft] !
 date ( ! enactm5t ( ?is ,act1 !        
,comptroll] ,g5]al ( ! ,unit$ ,/ates    

%all submit to ! ,committee on ,vet]ans'
 ,affairs ( ! ,s5ate & ! ,committee on  
,vet]ans' ,affairs ( ! ,h\se (          
,repres5tatives a report on ! ,opioid   
,safety ,initiative ( ! ,dep>tm5t (     
,vet]ans ,affairs & ! opioid prescrib+  
practices ( heal? c>e provid]s ( !      
,dep>tm5t4  7#b7 ,elem5ts ,! report     
submitt$ "u p>agraph 7#a7 %all include !
 foll[+3 7,a7 ,recomm5dations on su*    
improvem5ts to ! ,opioid ,safety        
,initiative ( ! ,dep>tm5t z !           
,comptroll] ,g5]al consid]s appropriate4
  7,b7 ,in=mation ) respect to-- 7i7    
dea?s result+ f s5t9el ev5ts involv+    
vet]ans prescrib$ opioids by a heal? c>e
 provid] ( ! ,dep>tm5t2  7ii7 ov]all    
prescription rates & prescriptions      
indications ( opioids to treat          
non-canc]1 non-palliative1 & non-hospice
 c>e pati5ts2  7iii7 ! prescription     
rates & prescriptions indications (     
b5zodiazep9es & opioids concomitantly by
 heal? c>e provid]s ( ! ,dep>tm5t2  7iv7
 ! practice by heal? c>e provid]s ( !   

,dep>tm5t ( prescrib+ opioids to treat  
pati5ts )\t any pa91 includ+ to treat   
pati5ts ) m5tal heal? disord]s o!r ?an  
opioid use disord]2 &  7v7 !            
effectiv5ess ( opioid !rapy = pati5ts   
receiv+ su* !rapy1 includ+ !            
effectiv5ess ( long-t]m opioid !rapy4   
7,c7 ,an evaluation ( processes ( !     
,dep>tm5t 9 place to ov]see opioid use  
among vet]ans1 includ+ proc$ures to     
id5tify & rem$y pot5tial ov]-prescrib+ (
 opioids by heal? c>e provid]s ( !      
,dep>tm5t4  7,d7 ,an assessm5t ( !      
implem5tation by ! ,secret>y ( !        
,,va_/,,dod ,cl9ical ,practice ,guidel9e
 = ,managem5t ( ,opioid ,!rapy = ,*ronic
 ,pa94  7b7 ,qu>t]ly progress report on 
implem5tation ( comptroll] g5]al        
recomm5dations ,n lat] ?an #b ye>s aft] 
! date ( ! enactm5t ( ?is ,act1 & n lat]
 ?an #cj days aft] ! end ( ea* qu>t]    
!reaft]1 ! ,secret>y ( ,vet]ans ,affairs
 %all submit to ! ,committee on         
,vet]ans' ,affairs ( ! ,s5ate & !       
,committee on ,vet]ans' ,affairs ( !    

,h\se ( ,repres5tatives a progress      
report detail+ ! actions by ! ,secret>y 
dur+ ! p]iod cov]$ by ! report to       
address any out/&+ f9d+s &              
recomm5dations by ! ,comptroll] ,g5]al (
 ! ,unit$ ,/ates "u subsection 7a7 )    
respect to ! ,vet]ans ,heal?            
,adm9i/ration4  7c7 ,annual review (    
prescription rates ,n lat] ?an #a ye>   
aft] ! date ( ! enactm5t ( ?is ,act1 & n
 less frequ5tly ?an annually = ! foll[+ 
#e ye>s1 ! ,secret>y %all submit to !   
,committee on ,vet]ans' ,affairs ( !    
,s5ate & ! ,committee on ,vet]ans'      
,affairs ( ! ,h\se ( ,repres5tatives a  
report1 ) respect to ea* m$ical facility
 ( ! ,dep>tm5t ( ,vet]ans ,affairs1 to  
collect & review in=mation on opioids   
prescrib$ by heal? c>e provid]s at !    
facility to treat non-canc]1            
non-palliative1 & non-hospice c>e       
pati5ts t conta9s1 = ! #a-ye> p]iod     
prec$+ ! submission ( ! report1 !       
foll[+3  7#a7 ,! numb] ( pati5ts & !    
p]c5tage ( ! pati5t population ( !      

,dep>tm5t :o 7 prescrib$ b5zodiazep9es &
 opioids concurr5tly by a heal? c>e     
provid] ( ! ,dep>tm5t4  7#b7 ,! numb] ( 
pati5ts & ! p]c5tage ( ! pati5t         
population ( ! ,dep>tm5t )\t any pa9 :o 
7 prescrib$ opioids by a heal? c>e      
provid] ( ! ,dep>tm5t1 includ+ ^? :o 7  
prescrib$ b5zodiazep9es & opioids       
concurr5tly4  7#c7 ,! numb] ( non-canc]1
 non-palliative1 & non-hospice c>e      
pati5ts & ! p]c5tage ( su* pati5ts :o 7 
treat$ ) opioids by a heal? c>e provid] 
( ! ,dep>tm5t on an inpati5t-basis & :o 
also receiv$ prescription opioids by    
mail f ! ,dep>tm5t :ile be+ treat$ on an
 inpati5t-basis4  7#d7 ,! numb] (       
non-canc]1 non-palliative1 & non-hospice
 c>e pati5ts & ! p]c5tage ( su* pati5ts 
:o 7 prescrib$ opioids concurr5tly by a 
heal? c>e provid] ( ! ,dep>tm5t & a     
heal? c>e provid] t is n heal? c>e      
provid] ( ! ,dep>tm5t4  7#e7 ,) respect 
to ea* m$ical facility ( ! ,dep>tm5t1   
in=mation on opioids prescrib$ by heal? 
c>e provid]s at ! facility to treat     

non-canc]1 non-palliative1 & non-hospice
 c>e pati5ts1 includ+ in=mation on--    
7,a7 ! prescription rate at :i* ea*     
heal? c>e provid] at ! facility         
prescrib$ b5zodiazep9es & opioids       
concurr5tly to su* pati5ts & ! aggregate
 su* prescription rate = all heal? c>e  
provid]s at ! facility2  7,b7 !         
prescription rate at :i* ea* heal? c>e  
provid] at ! facility prescrib$         
b5zodiazep9es or opioids to su* pati5ts 
to treat conditions = :i* b5zodiazep9es 
or opioids are n approv$ treatm5t & !   
aggregate su* prescription rate = all   
heal? c>e provid]s at ! facility2  7,c7 
! prescription rate at :i* ea* heal? c>e
 provid] at ! facility prescrib$ or     
disp5s$ mail-ord] prescriptions (       
opioids to su* pati5ts :ile su* pati5ts 
7 be+ treat$ ) opioids on an            
inpati5t-basis & ! aggregate ( su*      
prescription rate = all heal? c>e       
provid]s at ! facility2 &  7,d7 !       
prescription rate at :i* ea* heal? c>e  
provid] at ! facility prescrib$ opioids 

to su* pati5ts :o 7 also concurr5tly    
prescrib$ opioids by a heal? c>e provid]
 t is n a heal? c>e provid] ( !         
,dep>tm5t & ! aggregate ( su*           
prescription rates = all heal? c>e      
provid]s at ! facility4  7#f7 ,) respect
 to ea* m$ical facility ( ! ,dep>tm5t1 !
 numb] ( times a ph>maci/ at ! facility 
ov]rode a critical drug int]action w>n+ 
) respect to an int]action betwe5       
opioids & ano!r m$ication be=e disp5s+  
su* m$ication to a vet]an4  7d7         
,inve/igation ( prescription rates ,if !
 ,secret>y det]m9es t a prescription    
rate ) respect to a heal? c>e provid] or
 m$ical facility ( ! ,dep>tm5t conflicts
 ) or is o!rwise inconsi/5t ) ! /&>ds ( 
appropriate & safe c>e1 ! ,secret>y     
%all-- 7#a7 imm$iately notify !         
,committee on ,vet]ans' ,affairs ( !    
,s5ate & ! ,committee on ,vet]ans'      
,affairs ( ! ,h\se ( ,repres5tatives (  
su* det]m9ation1 includ+ in=mation      
relat+ to su* det]m9ation1 prescription 
rate1 & heal? c>e provid] or m$ical     

facility1 z ! case may be2 &  7#b7 ?r\gh
 ! ,(fice ( ! ,m$ical ,inspector ( !    
,vet]ans ,heal? ,adm9i/ration1 conduct a
 full inve/igation ( ! heal? c>e provid]
 or m$ical facility1 z ! case may be4   
7e7 ,prescription rate def9$ ,9 ?is     
section1 ! t]m prescription rate means1 
) respect to a heal? c>e provid] or     
m$ical facility ( ! ,dep>tm5t1 ea* ( !  
foll[+3  7#a7 ,! numb] ( pati5ts treat$ 
) opioids by ! heal? c>e provid] or at !
 m$ical facility1 z ! case may be1      
divid$ by ! total numb] ( ph>macy us]s (
 t heal? c>e provid] or m$ical facility4
  7#b7 ,! av]age numb] ( morph9e        
equival5ts p] day prescrib$ by ! heal?  
c>e provid] or at ! m$ical facility1 z !
 case may be1 to pati5ts be+ treat$ )   
opioids4  7#c7 ,( ! pati5ts be+ treat$ )
 opioids by ! heal? c>e provid] or at ! 
m$ical facility1 z ! case may be1 !     
av]age numb] ( prescriptions ( opioids  
p] pati5t4  #e4 ,m&atory disclosure (   
c]ta9 vet]an in=mation to ,/ate         
controll$ sub/ance monitor+ programs    

,section #egja7l7 ( title #ch1 ,unit$   
,/ates ,code1 is am5d$ by /rik+ may &   
ins]t+ %all4  #f4 ,modification to      
limitation on aw>ds & bonuses ,section  
#gje ( ! ,vet]ans ,access1 ,*oice1 &    
,acc\ntability ,act ( #bjad 7,public    
,law #aac-adf2 #ch ,u4,s4,c4 #gjc note7 
is am5d$ to read z foll[s3  #gje4       
,limitation on aw>ds & bonuses paid to  
employees ( ,dep>tm5t ( ,vet]ans        
,affairs ,! ,secret>y ( ,vet]ans        
,affairs %all ensure t ! aggregate am\nt
 ( aw>ds & bonuses paid by ! ,secret>y 9
 a fiscal ye> "u *apt] #de or #ec (     
title #e1 ,unit$ ,/ates ,code1 or any   
o!r aw>ds or bonuses au?oriz$ "u su*    
title or title #ch1 ,unit$ ,/ates ,code1
 does n exce$ ! foll[+ am\nts3  7#a7 ,) 
respect to ea* ( fiscal ye>s #bjag ?r\gh
 #bjba1 #bcj1jjj1jjj4  7#b7 ,) respect  
to ea* ( fiscal ye>s #bjbb ?r\gh #bjbd1 
#cfj1jjj1jjj4  4  ,pass$ ! ,h\se (      
,repres5tatives ,may #aj1 #bjaf4;,cl]k4