,i #aadth ,,congress #b;d ,session ,h4 ,r4 #dcif ,,in ,,the ,,house ,,of ,,representatives ,january #bh1 #bjaf ,mr4 ,pallone introduced the following bill2 which was referred to the ,committee on ,energy and ,commerce1 and in addition to the ,committees on the ,judiciary1 ,ways and ,means1 and ,education and the ,workforce1 for a period to be subsequently determined by the ,speaker1 in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned ,a ,,bill ,to support a comprehensive public health response to the heroin and prescription drug abuse crisis4 #a4 ,short title2 table of contents 7a7 ,short title ,this ,act may be cited as the ,heroin and ,prescription ,drug ,abuse ,prevention and ,reduction ,act4 7b7 ,table of contents ,the table of contents for this ,act is as follows3 ,sec4 #a4 ,short title2 table of contents4 ,title ,i--,prevention ,sec4 #aja4 ,practitioner education4 ,sec4 #ajb4 ,co-prescribing opioid overdose reversal drugs grant program4 ,sec4 #ajc4 ,opioid overdose reversal co-prescribing guidelines4 ,sec4 #ajd4 ,surveillance capacity building4 ,title ,,ii--,crisis ,sec4 #bja4 ,grants to support syringe exchange programs4 ,sec4 #bjb4 ,grant program to reduce drug overdose deaths4 ,title ,,iii--,treatment ,sec4 #cja4 ,expansion of patient limits under waiver4 ,sec4 #cjb4 ,definitions4 ,sec4 #cjc4 ,evaluation by assistant ,secretary for planning and evaluation4 ,sec4 #cjd4 ,reauthorization of residential treatment programs for pregnant and postpartum women4 ,sec4 #cje4 ,pilot program grants for ,state substance abuse agencies4 ,sec4 #cjf4 ,evidence-based opioid and heroin treatment and interventions demonstration4 ,sec4 #cjg4 ,adolescent treatment and recovery services demonstration grant program4 ,sec4 #cjh4 ,strengthening parity in mental health and substance use disorder benefits4 ,sec4 #cji4 ,study on treatment infrastructure4 ,sec4 #caj4 ,substance use disorder professional loan repayment program4 ,title ,,iv--,recovery ,sec4 #dja4 ,national youth recovery initiative4 ,sec4 #djb4 ,grants to enhance and expand recovery support services4 ,i ,prevention #aja4 ,practitioner education 7a7 ,education requirements 7#a7 ,registration consideration ,section #cjc7;f7 of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hbc7;f77 is amended by inserting after paragraph 7#e7 the following3 7#f7 ,the applicant's compliance with the training requirements described in subsection 7g77#c7 during any previous period in which the applicant has been subject to such training requirements4 4 7#b7 ,training requirements ,section #cjc7;g7 of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hbc7;g77 is amended by adding at the end the following3 7#c7 7,a7 ,to be registered to prescribe or otherwise dispense opioids for the treatment of pain1 or pain management1 a practitioner described in paragraph 7#a7 shall comply with the #ab-;hour training requirement of subparagraph 7,b7 at least once during each #c-year period4 7,b7 ,the training requirement of this subparagraph is that the practitioner has completed not less than #ab hours of training 7through classroom situations1 seminars at professional society meetings1 electronic communications1 or otherwise7 with respect to-- 7i7 the treatment and management of opioid-dependent patients2 7ii7 pain management treatment guidelines2 and 7iii7 early detection of opioid addiction1 including through such methods as ,screening1 ,brief ,intervention1 and ,referral to ,treatment 7,,sbirt71 that is provided by the ,american ,society of ,addiction ,medicine1 the ,american ,academy of ,addiction ,psychiatry1 the ,american ,medical ,association1 the ,american ,osteopathic ,association1 the ,american ,psychiatric ,association1 the ,american ,academy of ,pain ,management1 the ,american ,pain ,society1 the ,american ,academy of ,pain ,medicine1 the ,american ,board of ,pain ,medicine1 the ,american ,society of ,interventional ,pain ,physicians1 or any other organization that the ,secretary determines is appropriate for purposes of this subparagraph4 4 7b7 ,funding ,the ,drug ,enforcement ,administration shall fund the enforcement of the requirements specified in section #cjc7;g77#c7 of the ,controlled ,substances ,act 7as added by subsection 7a77 through the use of a portion of the licensing fees paid by controlled substance prescribers under the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hja et seq474 7c7 ,authorization of ,appropriations ,there is authorized to be appropriated to carry out this section #a1jjj1jjj for each of fiscal years #bjag through #bjba4 #ajb4 ,co-prescribing opioid overdose reversal drugs grant program 7a7 ,establishment 7#a7 ,in general ,not later than six months after the date of the enactment of this ,act1 the ,secretary of ,health and ,human ,services shall establish1 in accordance with this section1 a four-year co-prescribing opioid overdose reversal drugs grant program 7in this title referred to as the grant program7 under which the ,secretary shall provide not more than a total of #ab grants to eligible entities to carry out the activities described in subsection 7c74 7#b7 ,eligible entity ,for purposes of this section1 the term eligible entity means a federally qualified health center 7as defined in section #ahfa7;aa7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7aa7771 an opioid treatment program under part #h of title #db1 ,code of ,federal ,regulations1 or section #cjc7;g7 of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hbc7;g771 a program approved by a ,state substance abuse agency1 or any other entity that the ,secretary deems appropriate4 7#c7 ,co-prescribing ,for purposes of this title1 the term co-prescribing means1 with respect to an opioid overdose reversal drug1 the practice of prescribing such drug in conjunction with an opioid prescription for patients at an elevated risk of overdose1 or in conjunction with an opioid agonist approved under section #eje of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cee7 for the treatment of opioid abuse disorders1 or in other circumstances in which a provider identifies a patient at an elevated risk for an intentional or unintentional drug overdose from heroin or prescription opioid therapies4 ,for purposes of the previous sentence1 a patient may be at an elevated risk of overdose if the patient meets the criteria under the existing co-prescribing guidelines that the ,secretary deems appropriate1 such as the criteria provided in the ,opioid ,overdose ,toolkit published by the ,substance ,abuse and ,mental ,health ,services ,administration4 7b7 ,application ,to be eligible to receive a grant under this section1 an eligible entity shall submit to the ,secretary of ,health and ,human ,services1 in such form and manner as specified by the ,secretary1 an application that describes-- 7#a7 the extent to which the area to which the entity will furnish services through use of the grant is experiencing significant morbidity and mortality caused by opioid abuse2 7#b7 the criteria that will be used to identify eligible patients to participate in such program2 and 7#c7 how such program will work to try to identify ,state1 local1 or private funding to continue the program after expiration of the grant4 7c7 ,use of funds ,an eligible entity receiving a grant under this section may use the grant for any of the following activities3 7#a7 ,to establish a program for co-prescribing opioid overdose reversal drugs1 such as naloxone4 7#b7 ,to train and provide resources for health care providers and pharmacists on the co-prescribing of opioid overdose reversal drugs4 7#c7 ,to establish mechanisms and processes1 consistent with applicable ,federal and ,state privacy rules1 for tracking patients participating in the program described in paragraph 7#a7 and the health outcomes of such patients4 7#d7 ,to purchase opioid overdose reversal drugs for distribution under the program described in paragraph 7#a74 7#e7 ,to offset the co-pays and other cost sharing associated with opioid overdose reversal drugs to ensure that cost is not a limiting factor for eligible patients4 7#f7 ,to conduct community outreach1 in conjunction with community-based organizations1 designed to raise awareness of co-prescribing practices1 and the availability of opioid overdose reversal drugs4 7#g7 ,to establish protocols to connect patients who have experienced a drug overdose with appropriate treatment1 including medication assisted treatment and appropriate counseling and behavioral therapies4 7d7 ,evaluations by recipients ,as a condition of receipt of a grant under this section1 an eligible entity shall1 for each year for which the grant is received1 submit to the ,secretary of ,health and ,human ,services information on appropriate outcome measures specified by the ,secretary to assess the outcomes of the program funded by the grant1 including-- 7#a7 the number of prescribers trained2 7#b7 the number of prescribers who have co-prescribed an opioid overdose reversal drug to at least one patient2 7#c7 the total number of prescriptions written for opioid overdose reversal drugs2 7#d7 the percentage of patients at elevated risk who received a prescription for an opioid overdose reversal drug2 7#e7 the number of patients reporting use of an opioid overdose reversal drug2 and 7#f7 any other outcome measures that the ,secretary deems appropriate4 7e7 ,reports by ,secretary ,for each year of the grant program under this section1 the ,secretary of ,health and ,human ,services shall submit to the appropriate committees of the ,house of ,representatives and of the ,senate a report aggregating the information received from the grant recipients for such year under subsection 7d7 and evaluating the outcomes achieved by the programs funded by grants made under this section4 7f7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section and section #ajc #d1jjj1jjj for each of fiscal years #bjag through #bjba4 #ajc4 ,opioid overdose reversal co-prescribing guidelines 7a7 ,in general ,the ,secretary of ,health and ,human ,services shall establish a grant program under which the ,secretary shall award grants to eligible ,state entities to develop opioid overdose reversal co-prescribing guidelines4 7b7 ,eligible ,state entities ,for purposes of subsection 7a71 eligible ,state entities are ,state departments of health in conjunction with ,state medical boards2 city1 county1 and local health departments2 and community stakeholder groups involved in reducing opioid overdose deaths4 7c7 ,administrative provisions 7#a7 ,grant amounts ,a grant made under this section may not be for more than #bjj1jjj per grant4 7#b7 ,prioritization ,in awarding grants under this section1 the ,secretary shall give priority to eligible ,state entities which propose to base their guidelines on existing guidelines on co-prescribing to speed enactment1 including guidelines of-- 7,a7 the ,department of ,veterans ,affairs2 7,b7 nationwide medical societies1 such as the ,american ,society of ,addiction ,medicine or the ,american ,medical ,association2 and 7,c7 the ,centers for ,disease ,control and ,prevention4 #ajd4 ,surveillance capacity building 7a7 ,program authorized ,the ,secretary of ,health and ,human ,services1 acting through the ,director of the ,centers for ,disease ,control and ,prevention1 shall award cooperative agreements or grants to eligible entities to improve fatal and nonfatal drug overdose surveillance and reporting capabilities1 including-- 7#a7 providing training to improve identification of drug overdose as the cause of death by coroners and medical examiners2 7#b7 establishing1 in cooperation with the ,national ,poison ,data ,system1 coroners1 and medical examiners1 a comprehensive national program for surveillance of1 and reporting to an electronic database on1 drug overdose deaths in the ,united ,states2 and 7#c7 establishing1 in cooperation with the ,national ,poison ,data ,system1 a comprehensive national program for surveillance of1 and reporting to an electronic database on1 fatal and nonfatal drug overdose occurrences1 including epidemiological and toxicologic analysis and trends4 7b7 ,eligible entity ,to be eligible to receive a grant or cooperative agreement under this section1 an entity shall be-- 7#a7 a ,state1 local1 or tribal government2 or 7#b7 the ,national ,poison ,data ,system working in conjunction with a ,state1 local1 or tribal government4 7c7 ,application 7#a7 ,in general ,an eligible entity desiring a grant or cooperative agreement under this section shall submit to the ,secretary an application at such time1 in such manner1 and containing such information as the ,secretary may require4 7#b7 ,contents ,an application described in paragraph 7#a7 shall include-- 7,a7 a description of the activities to be funded through the grant or cooperative agreement2 and 7,b7 evidence that the eligible entity has the capacity to carry out such activities4 7d7 ,report ,as a condition of receipt of a grant or cooperative agreement under this section1 an eligible entity shall agree to prepare and submit1 not later than #ij days after the end of the grant or cooperative agreement period1 a report to the ,secretary describing the results of the activities supported through the grant or cooperative agreement4 7e7 ,national poison data system ,in this section1 the term ,national ,poison ,data ,system means the system operated by the ,american ,association of ,poison ,control ,centers1 in partnership with the ,centers for ,disease ,control and ,prevention1 for real-time local1 ,state1 and national electronic reporting1 and the corresponding database network4 7f7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section #e1jjj1jjj for each of the fiscal years #bjag through #bjba4 ,,ii ,crisis #bja4 ,grants to support syringe exchange programs 7a7 ,in general ,the ,secretary of ,health and ,human ,services may award grants to ,state1 local1 and tribal governments and community organizations to support syringe exchange programs4 7b7 ,use of funds ,grants under subsection 7a7 may be used to support carrying out syringe exchange programs1 including through-- 7#a7 providing outreach1 counseling1 health education1 case management1 syringe disposal1 and other services as determined appropriate by the ,secretary of ,health and ,human ,services2 and 7#b7 providing technical assistance1 including training and capacity building1 to assist the development and implementation of syringe exchange programs4 7c7 ,authorization of appropriations ,there is authorized to be appropriated #ae1jjj1jjj for each of fiscal years #bjag through #bjba to carry out this section1 of which-- 7#a7 at least #ae percent shall be for syringe exchange programs that have been in operation for less than #c years2 and 7#b7 #e percent shall be for technical assistance under subsection 7b77#b74 #bjb4 ,grant program to reduce drug overdose deaths 7a7 ,program authorized ,the ,secretary of ,health and ,human ,services1 acting through the ,administrator of the ,substance ,abuse and ,mental ,health ,services ,administration1 shall award grants or enter into cooperative agreements with eligible entities to enable the eligible entities to reduce deaths occurring from overdoses of drugs4 7b7 ,eligible entities ,to be eligible to receive a grant or cooperative agreement under this section1 an entity shall be a partnership between any of the following3 a ,state1 local1 or tribal government1 a correctional institution1 a law enforcement agency1 a community agency1 a professional organization in the field of poison control and surveillance1 or a private nonprofit organization4 7c7 ,application 7#a7 ,in general ,an eligible entity desiring a grant or cooperative agreement under this section shall submit to the ,secretary of ,health and ,human ,services an application at such time1 in such manner1 and containing such information as the ,secretary may require4 7#b7 ,contents ,an application under paragraph 7#a7 shall include-- 7,a7 a description of the activities to be funded through the grant or cooperative agreement2 and 7,b7 evidence that the eligible entity has the capacity to carry out such activities4 7d7 ,priority ,in entering into grants and cooperative agreements under subsection 7a71 the ,secretary of ,health and ,human ,services shall give priority to eligible entities that-- 7#a7 include a public health agency or community-based organization2 and 7#b7 have expertise in preventing deaths occurring from overdoses of drugs in populations at high risk of such deaths4 7e7 ,eligible activities ,as a condition of receipt of a grant or cooperative agreement under this section1 an eligible entity shall agree to use the grant or cooperative agreement to do each of the following3 7#a7 ,purchase and distribute the drug naloxone or a similarly effective medication4 7#b7 ,carry out one or more of the following activities3 7,a7 ,educating prescribers and pharmacists about overdose prevention and naloxone prescription1 or prescriptions of a similarly effective medication4 7,b7 ,training first responders1 other individuals in a position to respond to an overdose1 and law enforcement and corrections officials on the effective response to individuals who have overdosed on drugs4 ,training pursuant to this subparagraph may include any activity that is educational1 instructional1 or consultative in nature1 and may include volunteer training1 awareness building exercises1 outreach to individuals who are at-risk of a drug overdose1 and distribution of educational materials4 7,c7 ,implementing and enhancing programs to provide overdose prevention1 recognition1 treatment1 and response to individuals in need of such services4 7,d7 ,educating the public and providing outreach to the public about overdose prevention and naloxone prescriptions1 or prescriptions of other similarly effective medications4 7f7 ,coordinating center 7#a7 ,establishment ,the ,secretary of ,health and ,human ,services shall establish and provide for the operation of a coordinating center responsible for-- 7,a7 collecting1 compiling1 and disseminating data on the programs and activities under this section1 including tracking and evaluating the distribution and use of naloxone and other similarly effective medication2 7,b7 evaluating such data and1 based on such evaluation1 developing best practices for preventing deaths occurring from drug overdoses2 7,c7 making such best practices specific to the type of community involved2 7,d7 coordinating and harmonizing data collection measures2 7,e7 evaluating the effects of the program on overdose rates2 and 7,f7 education and outreach to the public about overdose prevention and prescription of naloxone and other similarly effective medication4 7#b7 ,reports to center ,as a condition on receipt of a grant or cooperative agreement under this section1 an eligible entity shall agree to prepare and submit1 not later than #ij days after the end of the award period1 a report to such coordinating center and the ,secretary of ,health and ,human ,services describing the results of the activities supported through the grant or cooperative agreement4 7g7 ,duration ,the period of a grant or cooperative agreement under this section shall be #d years4 7h7 ,definition ,in this part1 the term drug-- 7#a7 means a drug1 as defined in section #bja of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cba72 and 7#b7 includes controlled substances1 as defined in section #ajb of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hjb74 7i7 ,authorization of appropriations ,there is authorized to be appropriated #bj1jjj1jjj to carry out this section for each of the fiscal years #bjag through #bjba4 ,,iii ,treatment #cja4 ,expansion of patient limits under waiver ,section #cjc7;g77#b77;,b7 of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hbc7;g77#b77;,b77 is amended-- 7#a7 in clause 7i71 by striking physician and inserting practitioner2 7#b7 in clause 7iii7-- 7,a7 by striking #cj and inserting #ajj2 and 7,b7 by striking 1 unless1 not sooner and all that follows through the end and inserting a period2 and 7#c7 by inserting at the end the following new clause3 7iv7 ,not earlier than #a year after the date on which a qualifying practitioner obtained an initial waiver pursuant to clause 7iii71 the qualifying practitioner may submit a second notification to the ,secretary of the need and intent of the qualifying practitioner to treat an unlimited number of patients1 if the qualifying practitioner-- 7,i7 7aa7 satisfies the requirements of item 7aa71 7bb71 7cc71 or 7dd7 of subparagraph 7,g77ii77,i72 and 7bb7 agrees to fully participate in the ,prescription ,drug ,monitoring ,program of the ,state in which the qualifying practitioner is licensed1 pursuant to applicable ,state guidelines2 or 7,,ii7 7aa7 satisfies the requirements of item 7ee71 7ff71 or 7gg7 of subparagraph 7,g77ii77,i72 7bb7 agrees to fully participate in the ,prescription ,drug ,monitoring ,program of the ,state in which the qualifying practitioner is licensed1 pursuant to applicable ,state guidelines2 7cc7 practices in a qualified practice setting2 and 7dd7 has completed not less than #bd hours of training 7through classroom situations1 seminars at professional society meetings1 electronic communications1 or otherwise7 with respect to the treatment and management of opiate-dependent patients for substance use disorders provided by the ,american ,society of ,addiction ,medicine1 the ,american ,academy of ,addiction ,psychiatry1 the ,american ,medical ,association1 the ,american ,osteopathic ,association1 the ,american ,psychiatric ,association1 or any other organization that the ,secretary determines is appropriate for purposes of this subclause4 4 #cjb4 ,definitions ,section #cjc7;g77#b77;,g7 of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hbc7;g77#b77;,g77 is amended-- 7#a7 by striking clause 7ii7 and inserting the following3 7ii7 ,the term qualifying practitioner means the following3 7,i7 ,a physician who is licensed under ,state law and who meets #a or more of the following conditions3 7aa7 ,the physician holds a board certification in addiction psychiatry from the ,american ,board of ,medical ,specialties4 7bb7 ,the physician holds an addiction certification from the ,american ,society of ,addiction ,medicine4 7cc7 ,the physician holds a board certification in addiction medicine from the ,american ,osteopathic ,association4 7dd7 ,the physician holds a board certification from the ,american ,board of ,addiction ,medicine4 7ee7 ,the physician has completed not less than #h hours of training 7through classroom situations1 seminar at professional society meetings1 electronic communications1 or otherwise7 with respect to the treatment and management of opiate-dependent patients for substance use disorders provided by the ,american ,society of ,addiction ,medicine1 the ,american ,academy of ,addiction ,psychiatry1 the ,american ,medical ,association1 the ,american ,osteopathic ,association1 the ,american ,psychiatric ,association1 or any other organization that the ,secretary determines is appropriate for purposes of this subclause4 7ff7 ,the physician has participated as an investigator in #a or more clinical trials leading to the approval of a narcotic drug in schedule ,,iii1 ,,iv1 or ,v for maintenance or detoxification treatment1 as demonstrated by a statement submitted to the ,secretary by this sponsor of such approved drug4 7gg7 ,the physician has such other training or experience as the ,secretary determines will demonstrate the ability of the physician to treat and manage opiate-dependent patients4 7,,ii7 ,a nurse practitioner or physician assistant who is licensed under ,state law and meets all of the following conditions3 7aa7 ,the nurse practitioner or physician assistant is licensed under ,state law to prescribe schedule ,,iii1 ,,iv1 or ,v medications for pain4 7bb7 ,the nurse practitioner or physician assistant satisfies #a or more of the following3 7,,aa7 ,has completed not fewer than #bd hours of training 7through classroom situations1 seminar at professional society meetings1 electronic communications1 or otherwise7 with respect to the treatment and management of opiate-dependent patients for substance use disorders provided by the ,american ,society of ,addiction ,medicine1 the ,american ,academy of ,addiction ,psychiatry1 the ,american ,medical ,association1 the ,american ,osteopathic ,association1 the ,american ,psychiatric ,association1 or any other organization that the ,secretary determines is appropriate for purposes of this subclause4 7,,bb7 ,has such other training or experience as the ,secretary determines will demonstrate the ability of the nurse practitioner or physician assistant to treat and manage opiate-dependent patients4 7cc7 ,the nurse practitioner or physician assistant practices within the scope of their ,state license1 including compliance with any supervision or collaboration requirements under ,state law4 7dd7 ,the nurse practitioner or physician assistant practice in a qualified practice setting4 2 and 7#b7 by adding at the end the following3 7iii7 ,the term qualified practice setting means #a or more of the following treatment settings3 7,i7 ,a ,national ,committee for ,quality ,assurance-recognized ,patient-,centered ,medical ,home or ,patient-,centered ,specialty ,practice4 7,,ii7 ,a ,centers for ,medicaid ,medicare ,services-recognized ,accountable ,care ,organization4 7,,iii7 ,a clinical facility administered by the ,department of ,veterans ,affairs1 ,department of ,defense1 or ,indian ,health ,service4 7,,iv7 ,a ,behavioral ,health ,home accredited by the ,joint ,commission4 7,v7 ,a ,federally-qualified health center 7as defined in section #aije7l77#b77;,b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7l77#b77;,b777 or a ,federally-qualified health center look-alike4 7,,vi7 ,a ,substance ,abuse and ,mental ,health ,services-certified ,opioid ,treatment ,program4 7,,vii7 ,a clinical program of a ,state or ,federal jail1 prison1 or other facility where individuals are incarcerated4 7,,viii7 ,a clinic that demonstrates compliance with the ,model ,policy on ,,data #bjjj and ,treatment of ,opioid ,addiction in the ,medical ,office issued by the ,federation of ,state ,medical ,boards4 7,,ix7 ,a treatment setting that is part of an ,accreditation ,council for ,graduate ,medical ,education1 ,american ,association of ,colleges of ,osteopathic ,medicine1 or ,american ,osteopathic ,association-accredited residency or fellowship training program4 7,x7 ,any other practice setting approved by a ,state regulatory board1 ,state substance abuse agency1 or ,state ,medicaid ,plan to provide addiction treatment services4 7,,xi7 ,any other practice setting approved by the ,secretary4 4 #cjc4 ,evaluation by assistant ,secretary for planning and evaluation ,two years after the date on which the first notification under clause 7iv7 of section #cjc7;g77#b77;,b7 of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hbc7;g77#b77;,b771 as added by section #cja1 is received by the ,secretary of ,health and ,human ,services1 the ,assistant ,secretary for ,planning and ,evaluation shall initiate an evaluation of the effectiveness of the amendments made by sections #cja and #cjb1 which shall include an evaluation of-- 7#a7 any changes in the availability and use of medication-assisted treatment for opioid addiction2 7#b7 the quality of medication-assisted treatment programs2 7#c7 the integration of medication-assisted treatment with routine healthcare services2 7#d7 diversion of opioid addiction treatment medication2 7#e7 changes in ,state or local policies and legislation relating to opioid addiction treatment2 7#f7 the use of nurse practitioners and physician assistants who prescribe opioid addiction medication2 7#g7 the use of ,prescription ,drug ,monitoring ,programs by waived practitioners to maximize safety of patient care and prevent diversion of opioid addiction medication2 7#h7 the findings of the ,drug ,enforcement ,administration inspections of waived practitioners1 including the frequency with which the ,drug ,enforcement ,administration finds no documentation of access to behavioral health services2 and 7#i7 the effectiveness of cross-agency collaboration between ,department of ,health and ,human ,services and the ,drug ,enforcement ,administration for expanding effective opioid addiction treatment4 #cjd4 ,reauthorization of residential treatment programs for pregnant and postpartum women ,section #ejh of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;bb-#a7 is amended-- 7#a7 in subsection 7p71 by inserting 7other than subsection 7r77 after section2 and 7#b7 in subsection 7r71 by striking such sums and all that follows through #bjjc and inserting #dj1jjj1jjj for each of fiscal years #bjag through #bjba4 #cje4 ,pilot program grants for ,state substance abuse agencies 7a7 ,in general ,section #ejh of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;bb-#a7 is amended-- 7#a7 by redesignating subsection 7r71 as amended by section #cjd1 as subsection 7s72 and 7#b7 by inserting after subsection 7q7 the following new subsection3 7r7 ,pilot program for ,state substance abuse agencies 7#a7 ,in general ,from amounts made available under subsection 7s71 the ,director of the ,center for ,substance ,abuse ,treatment shall carry out a pilot program under which competitive grants are made by the ,director to ,state substance abuse agencies to-- 7,a7 enhance flexibility in the use of funds designed to support family-based services for pregnant and postpartum women with a primary diagnosis of a substance use disorder1 including opioid use disorders2 7,b7 help ,state substance abuse agencies address identified gaps in services furnished to such women along the continuum of care1 including services provided to women in non-residential based settings2 and 7,c7 promote a coordinated1 effective1 and efficient ,state system managed by ,state substance abuse agencies by encouraging new approaches and models of service delivery4 7#b7 ,requirements ,in carrying out the pilot program under this subsection1 the ,director shall-- 7,a7 require ,state substance abuse agencies to submit to the ,director applications1 in such form and manner and containing such information as specified by the ,director1 to be eligible to receive a grant under the program2 7,b7 identify1 based on such submitted applications1 ,state substance abuse agencies that are eligible for such grants2 7,c7 require services proposed to be furnished through such a grant to support family-based treatment and other services for pregnant and postpartum women with a primary diagnosis of a substance use disorder1 including opioid use disorders2 7,d7 not require that services furnished through such a grant be provided solely to women that reside in facilities2 7,e7 not require that grant recipients under the program make available through use of the grant all services described in subsection 7d72 and 7,f7 consider not applying requirements described in paragraphs 7#a7 and 7#b7 of subsection 7f7 to applicants1 depending on the circumstances of the applicant4 7#c7 ,required services 7,a7 ,in general ,the ,director shall specify a minimum set of services required to be made available to eligible women through a grant awarded under the pilot program under this subsection4 ,such minimum set-- 7i7 shall include requirements described in subsection 7c7 and be based on the recommendations submitted under subparagraph 7,b72 and 7ii7 may be selected from among the services described in subsection 7d7 and include other services as appropriate4 7,b7 ,stakeholder input ,the ,director shall convene and solicit recommendations from stakeholders1 including ,state substance abuse agencies1 health care providers1 persons in recovery from substance abuse1 and other appropriate individuals1 for the minimum set of services described in subparagraph 7,a74 7#d7 ,duration ,the pilot program under this subsection shall not exceed #e years4 7#e7 ,evaluation and ,report to ,congress ,the ,director of the ,center for ,behavioral ,health ,statistics and ,quality shall fund an evaluation of the pilot program at the conclusion of the first grant cycle funded by the pilot program4 ,the ,director of the ,center for ,behavioral ,health ,statistics and ,quality1 in coordination with the ,director of the ,center for ,substance ,abuse ,treatment shall submit to the relevant committees of jurisdiction of the ,house of ,representatives and the ,senate a report on such evaluation4 ,the report shall include at a minimum outcomes information from the pilot program1 including any resulting reductions in the use of alcohol and other drugs2 engagement in treatment services2 retention in the appropriate level and duration of services2 increased access to the use of medications approved by the ,food and ,drug ,administration for the treatment of substance use disorders in combination with counseling2 and other appropriate measures4 7#f7 ,state substance abuse agencies defined ,for purposes of this subsection1 the term ,state substance abuse agency means1 with respect to a ,state1 the agency in such ,state that manages the ,substance ,abuse ,prevention and ,treatment ,block ,grant under part ,b of title ,,xix4 4 7b7 ,funding ,subsection 7s7 of section #ejh of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;bb-#a71 as amended by section #cjd and redesignated by subsection 7a71 is further amended by adding at the end the following new sentence3 ,of the amounts made available for a year pursuant to the previous sentence to carry out this section1 not more than #be percent of such amounts shall be made available for such year to carry out subsection 7r71 other than paragraph 7#e7 of such subsection44 #cjf4 ,evidence-based opioid and heroin treatment and interventions demonstration ,subpart #a of part ,b of title ,v of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;bb et seq47 is amended-- 7#a7 by redesignating section #ead 7#db ,u4,s4,c4 #bij;bb-#i71 as added by section #cfcb of the ,methamphetamine ,anti-,proliferation ,act of #bjjj 7,public ,law #ajf-caj2 #aad ,stat4 #abcf71 as section #ead;,b2 and 7#b7 by adding at the end the following3 #ead;,c4 ,evidence-based opioid and heroin treatment and interventions demonstration 7a7 ,grants 7#a7 ,authority to make grants ,the ,director of the ,center for ,substance ,abuse ,treatment 7referred to in this section as the ,director7 shall award grants to ,state substance abuse agencies1 units of local government1 nonprofit organizations1 and ,indian tribes or tribal organizations 7as defined in section #d of the ,indian ,health ,care ,improvement ,act 7#be ,u4,s4,c4 #afjc77 that have a high rate1 or have had a rapid increase1 in the use of heroin or other opioids1 in order to permit such entities to expand activities1 including an expansion in the availability of medication assisted treatment1 evidence-based counseling1 or behavioral therapies with respect to the treatment of addiction in the specific geographical areas of such entities where there is a rate or rapid increase in the use of heroin or other opioids4 7#b7 ,recipients ,the entities receiving grants under paragraph 7#a7 shall be selected by the ,director4 7#c7 ,nature of activities ,the grant funds awarded under paragraph 7#a7 shall be used for activities that are based on reliable scientific evidence of efficacy in the treatment of problems related to heroin or other opioids4 7b7 ,geographic distribution ,the ,director shall ensure that grants awarded under subsection 7a7 are distributed equitably among the various regions of the ,nation and among rural1 urban1 and suburban areas that are affected by the use of heroin or other opioids4 7c7 ,additional activities ,the ,director shall-- 7#a7 evaluate the activities supported by grants awarded under subsection 7a72 7#b7 disseminate widely such significant information derived from the evaluation as the ,director considers appropriate2 7#c7 provide ,states1 ,indian tribes and tribal organizations1 and providers with technical assistance in connection with the provision of treatment of problems related to heroin and other opioids2 and 7#d7 fund only those applications that specifically support recovery services as a critical component of the grant program4 7d7 ,definition ,the term medication assisted treatment means the use1 for problems relating to heroin and other opioids1 of medications approved by the ,food and ,drug ,administration in combination with counseling and behavioral therapies4 7e7 ,authorization of appropriations 7#a7 ,in general ,there is authorized to be appropriated to carry out this section #cjj1jjj1jjj for each of fiscal years #bjag through #bjba4 7#b7 ,use of certain funds ,of the funds appropriated to carry out this section in any fiscal year1 not more than #e percent of such funds shall be available to the ,director for purposes of carrying out subsection 7c74 4 #cjg4 ,adolescent treatment and recovery services demonstration grant program ,subpart #a of part ,b of title ,v of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;bb et seq471 as amended by section #cjf1 is further amended by adding at the end the following3 #ead;,d4 ,grants to improve access to treatment and recovery for adolescents 7a7 ,in general ,the ,secretary1 acting through the ,director of the ,center for ,substance ,abuse ,treatment1 shall award grants1 contracts1 or cooperative agreements to eligible ,state substance abuse agencies and other entities determined appropriate by the ,director for the purpose of increasing the capacity of substance use disorder treatment and recovery services for adolescents4 7b7 ,eligibility ,to be eligible to receive a grant1 contract1 or cooperative agreement under subsection 7a7 an entity shall-- 7#a7 prepare and submit to the ,director an application at such time1 in such manner1 and contain such information as the ,director may require1 including a plan for the evaluation of any activities carried out with the funds provided under this section2 7#b7 ensure that all entities receiving support under the grant1 contract1 or cooperative agreement comply with all applicable ,state licensure or certification requirements regarding the provision of the services involved2 and 7#c7 provide the ,director with periodic evaluations of the progress of the activities funded under this section and an evaluation at the completion of such activities1 as the ,director determines to be appropriate4 7c7 ,priority ,in awarding grants1 contracts1 and cooperative agreements under subsection 7a71 the ,director shall give priority to applicants who propose to fill a demonstrated geographic need for adolescent specific residential treatment services4 7d7 ,use of funds ,amounts awarded under grants1 contracts1 or cooperative agreements under this section may be used to enable health care providers or facilities that provide treatment and recovery assistance for adolescents with a substance use disorder to provide the following services3 7#a7 ,individualized patient centered care that is specific to circumstances of the individual patient4 7#b7 ,clinically appropriate1 trauma-informed1 gender-specific and age appropriate treatment services that are based on reliable scientific evidence of efficacy in the treatment of problems related to substance use disorders4 7#c7 ,clinically appropriate care to address treatment for substance use and any co-occurring physical and mental health disorders at the same location1 and through access to primary care services4 7#d7 ,coordination of treatment services with recovery and other social support1 including educational1 vocational training1 assistance with the juvenile justice system1 child welfare1 and mental health agencies4 7#e7 ,aftercare and long-term recovery support1 including peer support services4 7e7 ,duration of assistance ,grants1 contracts1 and cooperative agreements awarded under subsection 7a7 shall be for a period not to exceed #e years4 7f7 ,additional activities ,the ,director shall-- 7#a7 collect and evaluate the activities carried out with amounts received under subsection 7a72 7#b7 disseminate widely such significant information derived from the evaluation as the ,secretary considers appropriate2 and 7#c7 provide ,states1 ,indian tribes and tribal organizations1 and providers with technical assistance in connection with the provision of treatment and recovery services funded through this section to adolescents related to the abuse of heroin and other opioids4 7g7 ,authorization of appropriations 7#a7 ,in general ,there is authorized to be appropriated to carry out this section1 #be1jjj1jjj for each of fiscal years #bjag through #bjba4 7#b7 ,use of certain funds ,of the funds appropriated to carry out this section in any fiscal year1 not more than #e percent of such funds shall be available to the ,director for purposes of carrying out subsection 7f74 4 #cjh4 ,strengthening parity in mental health and substance use disorder benefits 7a7 ,public ,health ,service ,act ,section #bgbf7;a7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjj;gg-#bf7;a77 is amended by adding at the end the following new paragraphs3 7#f7 ,disclosure and enforcement requirements 7,a7 ,disclosure requirements 7i7 ,regulations ,not later than ,december #ca1 #bjaf1 the ,secretary1 in cooperation with the ,secretaries of ,labor and the ,treasury1 as appropriate1 shall issue additional regulations for carrying out this section1 including an explanation of documents that must be disclosed by plans and issuers1 the process governing such disclosures by plans and issuers1 and analyses that must be conducted by plans and issuers by a group health plan or health insurance issuer offering health insurance coverage in the group or individual market in order for such plan or issuer to demonstrate compliance with the provisions of this section4 7ii7 ,disclosure requirements ,documents required to be disclosed by a group health plan or health insurance issuer offering health insurance coverage in the group or individual market under clause 7i7 shall include an annual report that details the specific analyses performed to ensure compliance of such plan or coverage with the law and regulations4 ,at a minimum1 with respect to the application of non-quantitative treatment limitations 7in this paragraph referred to as ,n,q,t,ls7 to benefits under the plan or coverage1 such report shall-- 7,i7 identify the specific factors the plan or coverage used in performing its ,,nqtl analysis2 7,,ii7 identify and define the specific evidentiary standards relied on to evaluate the factors2 7,,iii7 describe how the evidentiary standards are applied to each service category for mental health1 substance use disorders1 medical benefits1 and surgical benefits2 7,,iv7 disclose the results of the analyses of the specific evidentiary standards in each service category2 and 7,v7 disclose the specific findings of the plan or coverage in each service category and the conclusions reached with respect to whether the processes1 strategies1 evidentiary standards1 or other factors used in applying the ,,nqtl to mental health or substance use disorder benefits are comparable to1 and applied no more stringently than1 the processes1 strategies1 evidentiary standards1 or other factors used in applying the limitation with respect to medical and surgical benefits in the same classification4 7iii7 ,guidance ,the ,secretary1 in cooperation with the ,secretaries of ,labor and the ,treasury1 as appropriate1 shall issue guidance to group health plans and health insurance issuers offering health insurance coverage in the group or individual markets on how to satisfy the requirements of this section with respect to making information available to current and potential participants and beneficiaries4 ,such information shall include certificate of coverage documents and instruments under which the plan or coverage involved is administered and operated that specify1 include1 or refer to procedures1 formulas1 and methodologies applied to determine a participant or beneficiary's benefit under the plan or coverage1 regardless of whether such information is contained in a document designated as the plan document4 ,such guidance shall include a disclosure of how the plan or coverage involved has provided that processes1 strategies1 evidentiary standards1 and other factors used in applying the ,,nqtl to mental health or substance use disorder benefits are comparable to1 and applied no more stringently than1 the processes1 strategies1 evidentiary standards1 or other factors used in applying the limitation with respect to medical and surgical benefits in the same classification4 7iv7 ,definitions ,in this paragraph and paragraph 7#g71 the terms non-quantitative treatment limitations1 comparable to1 and applied no more stringently than have the meanings given such terms in sections #adf and #adg of title #de1 ,code of ,federal ,regulations 7or any successor regulation74 7,b7 ,enforcement 7i7 ,process for complaints ,the ,secretary1 in cooperation with the ,secretaries of ,labor and the ,treasury1 as appropriate1 shall1 with respect to group health plans and health insurance issuers offering health insurance coverage in the group or individual market1 issue guidance to clarify the process and timeline for current and potential participants and beneficiaries 7and authorized representatives and health care providers of such participants and beneficiaries7 with respect to such plans and coverage to file formal complaints of such plans or issuers being in violation of this section1 including guidance1 by plan type1 on the relevant ,state1 regional1 and national offices with which such complaints should be filed4 7ii7 ,authority for public enforcement ,the ,secretary1 in consultation with the ,secretaries of ,labor and the ,treasury1 shall make available to the public on the ,consumer ,parity ,portal website established under paragraph 7#g7 de-identified information on audits and investigations of group health plans and health insurance issuers conducted under this section4 7iii7 ,audits 7,i7 ,randomized audits ,the ,secretary in cooperation with the ,secretaries of ,labor and the ,treasury1 is authorized to conduct randomized audits of group health plans and health insurance issuers offering health insurance coverage in the group or individual market to determine compliance with this section4 ,such audits shall be conducted on no fewer than twelve plans and issuers per plan year4 ,information from such audits shall be made plainly available on the ,consumer ,parity ,portal website established under paragraph 7#g74 7,,ii7 ,additional audits ,in the case of a group health plan or health insurance issuer offering health insurance coverage in the group or individual market with respect to which any claim has been filed during a plan year1 the ,secretary may audit the books and records of such plan or issuer to determine compliance with this section4 ,information detailing the results of the audit shall be made available on the ,consumer ,parity ,portal website established under paragraph 7#g74 7iv7 ,denial rates ,the ,secretary shall collect information on the rates of and reasons for denial by group health plans and health insurance issuers offering health insurance coverage in the group or individual market of claims for outpatient and inpatient mental health and substance use disorder services compared to the rates of and reasons for denial of claims for medical and surgical services4 ,for the first plan year beginning at least two years after the date of the enactment of this paragraph and each subsequent plan year1 the ,secretary shall submit to the ,committee on ,energy and ,commerce of the ,house of ,representatives and the ,committee on ,health1 ,education1 ,labor1 and ,pensions of the ,senate1 and make plainly available on the ,consumer ,parity ,portal website under paragraph 7#g71 the information collected under the previous sentence with respect to the previous plan year4 7#g7 ,consumer ,parity ,portal website ,the ,secretary1 in consultation with the ,secretaries of ,labor and the ,treasury1 shall establish a one-stop ,internet website portal for-- 7,a7 submitting complaints and violations relating to this section1 section #gab of the ,employee ,retirement ,income ,security ,act of #aigd1 and section #ihab of the ,internal ,revenue ,code of #aihf2 and 7,b7 for each of such ,secretaries to submit information in order to provide such information to health care consumers pursuant to paragraph 7#f71 section #gab7;a77#f7 of the ,employee ,retirement ,income ,security ,act of #aigd1 and section #ihab7;a77#f7 of the ,internal ,revenue ,code of #aihf4 ,such portal shall have the ability to take basic information related to the complaint1 including name1 contact information1 and brief narrative1 and transmit such information in a timely fashion to the appropriate ,state or ,federal enforcement agency4 ,once the consumer information is submitted1 such portal shall provide the consumer with contact information for the appropriate enforcement agency to follow-up on the complaint4 4 7b7 ,employee ,retirement ,income ,security ,act of #aigd ,section #gab7;a7 of the ,employee ,retirement ,income ,security ,act of #aigd 7#bi ,u4,s4,c4 #aahe;a7a77 is amended by adding at the end the following new paragraph3 7#f7 ,disclosure and enforcement requirements 7,a7 ,disclosure requirements 7i7 ,regulations ,not later than ,december #ca1 #bjaf1 the ,secretary1 in cooperation with the ,secretaries of ,health and ,human ,services and the ,treasury1 as appropriate1 shall issue additional regulations for carrying out this section1 including an explanation of documents that must be disclosed by plans and issuers1 the process governing such disclosures by plans and issuers1 and analyses that must be conducted by plans and issuers by a group health plan 7or health insurance coverage offered in connection with such a plan7 in order for such plan or issuer to demonstrate compliance with the provisions of this section4 7ii7 ,disclosure requirements ,documents required to be disclosed by a group health plan 7or health insurance coverage offered in connection with such a plan7 under clause 7i7 shall include an annual report that details the specific analyses performed to ensure compliance of such plan or coverage with the law or regulations4 ,at a minimum1 with respect to the application of non-quantitative treatment limitations 7in this paragraph referred to as ,n,q,t,ls7 to benefits under the plan or coverage1 such report shall-- 7,i7 identify the specific factors the plan or coverage used in performing its ,,nqtl analysis2 7,,ii7 identify and define the specific evidentiary standards relied on to evaluate the factors2 7,,iii7 describe how the evidentiary standards are applied to each service category for mental health1 substance use disorders1 medical benefits1 and surgical benefits2 7,,iv7 disclose the results of the analyses of the specific evidentiary standards in each service category2 and 7,v7 disclose the specific findings of the plan or coverage in each service category and the conclusions reached with respect to whether the processes1 strategies1 evidentiary standards1 or other factors used in applying the ,,nqtl to mental health or substance use disorder benefits are comparable to1 and applied no more stringently than1 the processes1 strategies1 evidentiary standards1 or other factors used in applying the limitation with respect to medical and surgical benefits in the same classification4 7iii7 ,guidance ,the ,secretary1 in cooperation with the ,secretaries of ,health and ,human ,services and the ,treasury1 as appropriate1 shall issue guidance to group health plans 7and health insurance coverage offered in connection with such a plan7 on how to satisfy the requirements of this section with respect to making information available to current and potential participants and beneficiaries4 ,such information shall include certificate of coverage documents and instruments under which the plan or coverage involved is administered and operated that specify1 include1 or refer to procedures1 formulas1 and methodologies applied to determine a participant or beneficiary's benefit under the plan or coverage1 regardless of whether such information is contained in a document designated as the plan document4 ,such guidance shall include a disclosure of how the plan or coverage involved has provided that processes1 strategies1 evidentiary standards1 and other factors used in applying the ,,nqtl to mental health or substance use disorder benefits are comparable to1 and applied no more stringently than1 the processes1 strategies1 evidentiary standards1 or other factors used in applying the limitation with respect to medical and surgical benefits in the same classification4 7iv7 ,definitions ,in this paragraph1 the terms non-quantitative treatment limitations1 comparable to1 and applied no more stringently than have the meanings given such terms in sections #adf and #adg of title #de1 ,code of ,federal ,regulations 7or any successor regulation74 7,b7 ,enforcement 7i7 ,process for complaints ,the ,secretary1 in cooperation with the ,secretaries of ,health and ,human ,services and the ,treasury1 as appropriate1 shall1 with respect to group health plans 7and health insurance coverage offered in connection with such a plan71 issue guidance to clarify the process and timeline for current and potential participants and beneficiaries 7and authorized representatives and health care providers of such participants and beneficiaries7 with respect to such plans 7and coverage7 to file formal complaints of such plans 7or coverage7 being in violation of this section1 including guidance1 by plan type1 on the relevant ,state1 regional1 and national offices with which such complaints should be filed4 7ii7 ,authority for public enforcement ,the ,secretary1 in consultation with the ,secretaries of ,labor and the ,treasury1 shall make available to the public on the ,consumer ,parity ,portal website established under section #bgbf7;a77#g7 of the ,public ,health ,service ,act de-identified information on audits and investigations of group health plans 7and health insurance coverage offered in connection with such a plan7 conducted under this section4 7iii7 ,audits 7,i7 ,randomized audits ,the ,secretary in cooperation with the ,secretaries of ,health and ,human ,services and the ,treasury1 is authorized to conduct randomized audits of group health plans 7and health insurance coverage offered in connection with such a plan7 to determine compliance with this section4 ,such audits shall be conducted on no fewer than twelve plans and coverage per plan year4 ,information from such audits shall be made plainly available on the ,consumer ,parity ,portal website established under section #bgbf7;a77#g7 of the ,public ,health ,service ,act4 7,,ii7 ,additional audits ,in the case of a group health plan 7or health insurance coverage offered in connection with such a plan7 with respect to which any claim has been filed during a plan year1 the ,secretary may audit the books and records of such plan 7or coverage7 to determine compliance with this section4 ,information detailing the results of the audit shall be made available on the ,consumer ,parity ,portal website established under section #bgbf7;a77#g7 of the ,public ,health ,service ,act4 7iv7 ,denial rates ,the ,secretary shall collect information on the rates of and reasons for denial by group health plans 7and health insurance coverage offered in connection with such a plan7 of claims for outpatient and inpatient mental health and substance use disorder services compared to the rates of and reasons for denial of claims for medical and surgical services4 ,for the first plan year beginning at least two years after the date of the enactment of this paragraph and each subsequent plan year1 the ,secretary shall submit to the ,committee on ,energy and ,commerce of the ,house of ,representatives and the ,committee on ,health1 ,education1 ,labor1 and ,pensions of the ,senate1 and make plainly available on the ,consumer ,parity ,portal website under section #bgbf7;a77#g7 of the ,public ,health ,service ,act1 the information collected under the previous sentence with respect to the previous plan year4 4 7c7 ,internal ,revenue ,code of #aihf ,section #ihab7;a7 of the ,internal ,revenue ,code of #aihf is amended by adding at the end the following new paragraph3 7#f7 ,disclosure and enforcement requirements 7,a7 ,disclosure requirements 7i7 ,regulations ,not later than ,december #ca1 #bjaf1 the ,secretary1 in cooperation with the ,secretaries of ,health and ,human ,services and ,labor1 as appropriate1 shall issue additional regulations for carrying out this section1 including an explanation of documents that must be disclosed by plans and issuers1 the process governing such disclosures by plans and issuers1 and analyses that must be conducted by plans and issuers by a group health plan in order for such plan to demonstrate compliance with the provisions of this section4 7ii7 ,disclosure requirements ,documents required to be disclosed by a group health plan under clause 7i7 shall include an annual report that details the specific analyses performed to ensure compliance of such plan with the law and regulations4 ,at a minimum1 with respect to the application of non-quantitative treatment limitations 7in this paragraph referred to as ,n,q,t,ls7 to benefits under the plan or coverage1 such report shall-- 7,i7 identify the specific factors the plan or coverage used in performing its ,,nqtl analysis2 7,,ii7 identify and define the specific evidentiary standards relied on to evaluate the factors2 7,,iii7 describe how the evidentiary standards are applied to each service category for mental health1 substance use disorders1 medical benefits1 and surgical benefits2 7,,iv7 disclose the results of the analyses of the specific evidentiary standards in each service category2 and 7,v7 disclose the specific findings of the plan in each service category and the conclusions reached with respect to whether the processes1 strategies1 evidentiary standards1 or other factors used in applying the ,,nqtl to mental health or substance use disorder benefits are comparable to1 and applied no more stringently than1 the processes1 strategies1 evidentiary standards1 or other factors used in applying the limitation with respect to medical and surgical benefits in the same classification4 7iii7 ,guidance ,the ,secretary1 in cooperation with the ,secretaries of ,health and ,human ,services and ,labor1 as appropriate1 shall issue guidance to group health plans on how to satisfy the requirements of this section with respect to making information available to current and potential participants and beneficiaries4 ,such information shall include certificate of coverage documents and instruments under which the plan involved is administered and operated that specify1 include1 or refer to procedures1 formulas1 and methodologies applied to determine a participant or beneficiary's benefit under the plan1 regardless of whether such information is contained in a document designated as the plan document4 ,such guidance shall include a disclosure of how the plan involved has provided that processes1 strategies1 evidentiary standards1 and other factors used in applying the ,,nqtl to mental health or substance use disorder benefits are comparable to1 and applied no more stringently than1 the processes1 strategies1 evidentiary standards1 or other factors used in applying the limitation with respect to medical and surgical benefits in the same classification4 7iv7 ,definitions ,in this paragraph1 the terms non-quantitative treatment limitations1 comparable to1 and applied no more stringently than have the meanings given such terms in sections #adf and #adg of title #de1 ,code of ,federal ,regulations 7or any successor regulation74 7,b7 ,enforcement 7i7 ,process for complaints ,the ,secretary1 in cooperation with the ,secretaries of ,health and ,human ,services and ,labor1 as appropriate1 shall1 with respect to group health plans1 issue guidance to clarify the process and timeline for current and potential participants and beneficiaries 7and authorized representatives and health care providers of such participants and beneficiaries7 with respect to such plans 7and coverage7 to file formal complaints of such plans being in violation of this section1 including guidance1 by plan type1 on the relevant ,state1 regional1 and national offices with which such complaints should be filed4 7ii7 ,authority for public enforcement ,the ,secretary1 in consultation with the ,secretaries of ,labor and the ,treasury1 shall make available to the public on the ,consumer ,parity ,portal website established under section #bgbf7;a77#g7 of the ,public ,health ,service ,act de-identified information on audits and investigations of group health plans conducted under this section4 7iii7 ,audits 7,i7 ,randomized audits ,the ,secretary in cooperation with the ,secretaries of ,health and ,human ,services and ,labor1 is authorized to conduct randomized audits of group health plans to determine compliance with this section4 ,such audits shall be conducted on no fewer than twelve plans per plan year4 ,information from such audits shall be made plainly available on the ,consumer ,parity ,portal website established under section #bgbf7;a77#g7 of the ,public ,health ,service ,act4 7,,ii7 ,additional audits ,in the case of a group health plan with respect to which any claim has been filed during a plan year1 the ,secretary may audit the books and records of such plan to determine compliance with this section4 ,information detailing the results of the audit shall be made available on the ,consumer ,parity ,portal website established under section #bgbf7;a77#g7 of the ,public ,health ,service ,act4 7iv7 ,denial rates ,the ,secretary shall collect information on the rates of and reasons for denial by group health plans of claims for outpatient and inpatient mental health and substance use disorder services compared to the rates of and reasons for denial of claims for medical and surgical services4 ,for the first plan year beginning at least two years after the date of the enactment of this paragraph and each subsequent plan year1 the ,secretary shall submit to the ,committee on ,energy and ,commerce of the ,house of ,representatives and the ,committee on ,health1 ,education1 ,labor1 and ,pensions of the ,senate1 and make plainly available on the ,consumer ,parity ,portal website under section #bgbf7;a77#g7 of the ,public ,health ,service ,act1 the information collected under the previous sentence with respect to the previous plan year4 4 7d7 ,authorization of appropriations ,there is authorized to be appropriated #b1jjj1jjj for each of fiscal years #bjag through #bjba to carry out this section1 including the amendments made by this section4 #cji4 ,study on treatment infrastructure ,not later than #bd months after the date of enactment of this ,act1 the ,comptroller ,general of the ,united ,states shall initiate an evaluation1 and submit to ,congress a report1 of the in-patient and outpatient treatment capacity1 availability1 and needs of the ,united ,states1 which shall include1 to the extent data is available-- 7#a7 the capacity of acute residential or inpatient detoxification programs2 7#b7 the capacity of inpatient clinical stabilization programs1 transitional residential support services1 and residential rehabilitation programs2 7#c7 the capacity of demographic specific residential or inpatient treatment programs1 such as those designed for pregnant women or adolescents2 7#d7 geographical differences of the availability of residential and outpatient treatment and recovery options for substance use disorders across the continuum of care2 7#e7 the availability of residential and outpatient treatment programs that offer treatment options based on reliable scientific evidence of efficacy for the treatment of substance use disorders1 including the use of ,food and ,drug ,administration-approved medicines and evidence-based nonpharmacological therapies2 7#f7 the number of patients in residential and specialty outpatient treatment services for substance use disorders2 and 7#g7 an assessment of the need for residential and outpatient treatment for substance use disorders across the continuum of care4 #caj4 ,substance use disorder professional loan repayment program ,subpart #c of part ,e of title ,,vii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bie;f et seq47 is amended by adding at the end the following3 #ggi4 ,substance use disorder professional loan repayment program 7a7 ,establishment ,the ,secretary shall establish and carry out a substance use disorder health professional loan repayment program under which qualified health professionals agree to be employed full-time for a specified period 7which shall be not less than #b years7 in providing substance use disorder prevention and treatment services4 7b7 ,program administration ,through the program established under this section1 the ,secretary shall enter into contracts with qualified health professionals under which-- 7#a7 a qualified health professional agrees to provide substance use disorder prevention and treatment services with respect to an area or population that 7as determined by the ,secretary7-- 7,a7 has a shortage of such services 7as defined by the ,secretary72 and 7,b7 has a sufficient population of individuals with a substance use disorder to support the provision of such services2 and 7#b7 the ,secretary agrees to make payments on the principal and interest of undergraduate1 or graduate education loans of the qualified health professional-- 7,a7 of not more than #ce1jjj for each year of service described in paragraph 7#a72 and 7,b7 for not more than #c years4 7c7 ,qualified health professional defined ,in this section1 the term qualified health professional means an individual who is 7or will be upon the completion of the individual's graduate education7 a psychiatrist1 psychologist1 nurse practitioner1 physician assistant1 clinical social worker1 substance abuse counselor1 or other substance use disorder health professional4 7d7 ,priority ,in entering into agreements under this section1 the ,secretary shall give priority to applicants who-- 7#a7 have familiarity with evidence-based methods and culturally and linguistically competent health care services2 and 7#b7 demonstrate financial need4 7e7 ,authorization of appropriations ,there is authorized to be appropriated #bj1jjj1jjj for each of fiscal years #bjag through #bjba to carry out this section4 4 ,,iv ,recovery #dja4 ,national youth recovery initiative 7a7 ,definitions ,in this section3 7#a7 ,eligible entity ,the term eligible entity means-- 7,a7 a high school that has been accredited as a recovery high school by the ,association of ,recovery ,schools2 7,b7 an accredited high school that is seeking to establish or expand recovery support services2 7,c7 an institution of higher education2 7,d7 a recovery program at a nonprofit collegiate institution2 or 7,e7 a nonprofit organization4 7#b7 ,institution of higher education ,the term institution of higher education has the meaning given the term in section #aja of the ,higher ,education ,act of #aife 7#bj ,u4,s4,c4 #ajja74 7#c7 ,recovery program ,the term recovery program-- 7,a7 means a program to help individuals who are recovering from substance use disorders to initiate1 stabilize1 and maintain healthy and productive lives in the community2 and 7,b7 includes peer-to-peer support and communal activities to build recovery skills and supportive social networks4 7b7 ,grants authorized ,the ,secretary of ,health and ,human ,services1 acting through the ,substance ,abuse and ,mental ,health ,services ,administration1 in consultation with the ,secretary of ,education1 may award grants to eligible entities to enable the entities to-- 7#a7 provide substance use recovery support services to young people in high school and enrolled in institutions of higher education2 7#b7 help build communities of support for young people in recovery through a spectrum of activities such as counseling and healthy and wellness-oriented social activities2 and 7#c7 encourage initiatives designed to help young people achieve and sustain recovery from substance use disorders4 7c7 ,use of funds ,grants awarded under subsection 7b7 may be used for activities to develop1 support1 and maintain youth recovery support services1 including-- 7#a7 the development and maintenance of a dedicated physical space for recovery programs2 7#b7 dedicated staff for the provision of recovery programs2 7#c7 healthy and wellness-oriented social activities and community engagement2 7#d7 establishment of recovery high schools2 7#e7 coordination of recovery programs with-- 7,a7 substance use disorder treatment programs and systems2 7,b7 providers of mental health services2 7,c7 primary care providers2 7,d7 the criminal justice system1 including the juvenile justice system2 7,e7 employers2 7,f7 housing services2 7,g7 child welfare services2 7,h7 institutions of secondary higher education and institutions of higher education2 and 7,i7 other programs or services related to the welfare of an individual in recovery from a substance use disorder2 7#f7 the development of peer-to-peer support programs or services2 and 7#g7 additional activities that help youths and young adults to achieve recovery from substance use disorders4 7d7 ,technical support ,the ,secretary of ,health and ,human ,services shall provide technical support to recipients of grants under this section4 7e7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section #cj1jjj1jjj for each of fiscal years #bjag through #bjba4 #djb4 ,grants to enhance and expand recovery support services ,subpart #a of part ,b of title ,v of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;bb et seq471 as amended by sections #cjf and #cjg1 is further amended by adding at the end the following3 #ead;,e4 ,grants to enhance and expand recovery support services 7a7 ,in general ,the ,secretary1 acting through the ,administrator of the ,substance ,abuse and ,mental ,health ,services ,administration1 shall award grants to ,state substance abuse agencies and nonprofit organizations to develop1 expand1 and enhance recovery support services for individuals with substance use disorders4 7b7 ,eligible entities ,in the case of an applicant that is not a ,state substance abuse agency1 to be eligible to receive a grant under this section1 the entity shall-- 7#a7 prepare and submit to the ,secretary an application at such time1 in such manner1 and contain such information as the ,secretary may require1 including a plan for the evaluation of any activities carried out with the funds provided under this section2 7#b7 demonstrate the inclusion of individuals in recovery from a substance use disorder in leadership levels or governing bodies of the entity2 7#c7 have as a primary mission the provision of long-term recovery support for substance use disorders2 and 7#d7 be accredited by the ,council on the ,accreditation of ,peer ,recovery ,support ,services or meet any applicable ,state certification requirements regarding the provision of the recovery services involved4 7c7 ,use of funds ,amounts awarded under a grant under this section shall be used to provide for the following activities3 7#a7 ,educating and mentoring that assists individuals and families with substance use disorders in navigating systems of care4 7#b7 ,peer recovery support services which include peer coaching and mentoring4 7#c7 ,recovery-focused community education and outreach programs1 including training on the use of all forms of opioid overdose antagonists used to counter the effects of an overdose4 7#d7 ,training1 mentoring1 and education to develop and enhance peer mentoring and coaching4 7#e7 ,programs aimed at identifying and reducing stigma and discriminatory practices that serve as barriers to substance use disorder recovery and treatment of these disorders4 7#f7 ,developing partnerships between networks that support recovery and other community organizations and services1 including-- 7,a7 public and private substance use disorder treatment programs and systems2 7,b7 health care providers2 7,c7 recovery-focused addiction and recovery professionals2 7,d7 faith-based organizations2 7,e7 organizations focused on criminal justice reform2 7,f7 schools2 and 7,g7 social service agencies in the community1 including educational1 juvenile justice1 child welfare1 housing1 and mental health agencies4 7d7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section1 #ajj1jjj1jjj for each of fiscal years #bjag through #bjba4 4