,,ib ,union ,cal5d> ,no4 #dce #aad? ,,congress #b;d ,session ,h4 ,r4 #diha ,report ,no4 #aad-efa1 ,"p ,i ,,9 ,,! ,,h\se ,,( ,,repres5tatives ,april #ah1 #bjaf ,mr4 ,buc%on 7= himself & ,mr4 ,tonko7 introduc$ ! foll[+ bill2 :i* 0 ref]r$ to ! ,committee on ,en]gy & ,comm]ce1 & 9 addition to ! ,committee on ! ,judici>y1 = a p]iod to be subsequ5tly det]m9$ by ! ,speak]1 9 ea* case = consid]ation ( su* provisions z fall )9 ! jurisdiction ( ! committee conc]n$ ,may #aj1 #bjaf;,additional sponsor3 ,mr4 ,rokita ,may #aj1 #bjaf ,report$ f ! ,committee on ,en]gy & ,comm]ce ) an am5dm5t ,/rike out all aft] ! enact+ clause & ins]t ! "p pr9t$ 9 italic ,may #aj1 #bjaf,! ,committee on ! ,judici>y dis*>g$2 committ$ to ! ,committee ( ! ,:ole ,h\se on ! ,/ate ( ! ,union & ord]$ to be printed,for text ( introduc$ bill1 see copy ( bill z introduc$ on ,april #ah1 #bjaf ,a ,,bill ,to am5d ! ,controll$ ,sub/ances ,act to improve access to opioid use disord] treatm5t4 #a4 ,%ort title ,?is ,act may be cit$ z ! ,opioid ,use ,disord] ,treatm5t ,expansion & ,mod]nization ,act4 #b4 ,f9d+ ,! ,congress f9ds t opioid use disord] has become a public heal? epidemic t mu/ be address$ by increas+ aw>5ess & access to all treatm5t options = opioid use disord]1 ov]dose rev]sal1 & relapse prev5tion4 #c4 ,opioid use disord] treatm5t mod]nization 7a7 ,9 g5]al ,section #cjc7;g77#b7 ( ! ,controll$ ,sub/ances ,act 7#ba ,u4,s4,c4 #hbc7;g77#b77 is am5d$-- 7#a7 9 subp>agraph 7,b71 by /rik+ clauses 7i71 7ii71 & 7iii7 & ins]t+ ! foll[+3 7i7 ,! practition] is a qualify+ practition] 7z def9$ 9 subp>agraph 7,g774 7ii7 ,) respect to pati5ts to :om ! practition] w provide su* drugs or comb9ations ( drugs1 ! practition] has ! capacity to provide directly1 by ref]ral1 or 9 su* o!r mann] z det]m9$ by ! ,secret>y-- 7,i7 all s*$ule ,,iii1 ,,iv1 & ,v drugs1 z well z uns*$ul$ m$ications approv$ by ! ,food & ,drug ,adm9i/ration1 = ! treatm5t ( opioid use disord]1 includ+ su* drugs & m$ications = ma9t5ance1 detoxification1 ov]dose rev]sal1 & relapse prev5tion1 z available2 & 7,,ii7 appropriate c\nsel+ & o!r appropriate ancill>y s]vices4 7iii7 7,i7 ,! total numb] ( su* pati5ts ( ! practition] at any "o "t w n exce$ ! applicable numb]4 ,except z provid$ 9 subclauses 7,,ii7 & 7,,iii71 ! applicable numb] is #cj4 7,,ii7 ,! applicable numb] is #ajj if1 n soon] ?an #a ye> aft] ! date on :i* ! practition] submitt$ ! initial notification1 ! practition] submits a second notification to ! ,secret>y ( ! ne$ & int5t ( ! practition] to treat up to #ajj pati5ts4 7,,iii7 ,! applicable numb] is #bej if ! practition] is a qualify+ physician meet+ ! requirem5t ( subclause 7,,vi7 &1 n soon] ?an #a ye> aft] ! date on :i* ! physician submitt$ a second notification "u subclause 7,,ii71 ! practition] submits a ?ird notification to ! ,secret>y ( ! ne$ & int5t ( ! physician to treat up to #bej pati5ts4 7,,iv7 ,! ,secret>y may by regulation *ange su* total numb]4 7,v7 ,! ,secret>y may exclude f ! applicable numb] pati5ts to :om su* drugs or comb9ations ( drugs are directly adm9i/]$ by ! qualify+ practition] 9 ! (fice sett+4 7,,vi7 ,= purposes ( subclause 7,,iii71 a qualify+ physician meets ! requirem5t ( ?is subclause if ! physician-- 7aa7 holds a special c]tification 9 addiction psy*iatry or addiction m$ic9e z describ$ 9 clause 7ii7 f ! ,am]ican ,bo>d ( ,m$ical ,specialties1 ! ,am]ican ,bo>d ( ,addiction ,m$ic9e1 ! ,am]ican ,o/eopa?ic ,association1 ! ,am]ican ,society ( ,addiction ,m$ic9e1 or su* o!r organization z ! ,secret>y det]m9es to be appropriate = purposes ( ?is subclause2 or 7bb7 has complet$ n few] ?an #bd h\rs ( tra9+1 ) respect to ! treatm5t & managem5t ( opiate-dep5d5t pati5ts1 address+ ! topics li/$ 9 subp>agraph 7,g77ii77,,iv74 ,! ,secret>y may review & update ! requirem5ts ( ?is subclause4 7iv7 ,9 ! case ( a ?ird notification "u clause 7iii77,,iii71 ! qualify+ physician ma9ta9s & implem5ts a div]sion control plan t conta9s specific measures to r$uce ! likelihood ( ! div]sion ( controll$ sub/ances prescrib$ by ! physician = ! treatm5t ( opioid use disord]4 7v7 ,9 ! case ( a ?ird notification "u clause 7iii77,,iii71 ! qualify+ physician obta9s a writt5 agreem5t f ea* pati5t1 includ+ ! pati5t's signature1 t ! pati5t-- 7,i7 w receive an initial assessm5t & treatm5t plan & p]iodic assessm5ts & treatm5t plans !reaft]2 7,,ii7 w be subject to m$ication adh]5ce & sub/ance use monitor+2 7,,iii7 und]/&s available treatm5t options1 includ+ all drugs approv$ by ! ,food & ,drug ,adm9i/ration = ! treatm5t ( opioid use disord]1 includ+ _! pot5tial risks & b5efits2 & 7,,iv7 und]/&s t receiv+ regul> c\nsel+ s]vices is critical to recov]y4 7vi7 ,! practition] w comply ) ! report+ requirem5ts ( subp>agraph 7,d77i77,,iv74 2 7#b7 9 subp>agraph 7,d7-- 7,a7 9 clause 7i71 by add+ at ! end ! foll[+3 7,,iv7 ,! practition] reports to ! ,secret>y1 at su* times & 9 su* mann] z specifi$ by ! ,secret>y1 su* in=mation & assurances z ! ,secret>y det]m9es necess>y to assess :e!r ! practition] cont9ues to meet ! requirem5ts = a waiv] "u ?is p>agraph4 2 7,b7 9 clause 7ii71 by /rik+ ,^u receiv+ a notification "u subp>agraph 7,b7 & ins]t+ ,^u receiv+ a det]m9ation f ! ,secret>y "u clause 7iii7 f9d+ t a practition] meets all requirem5ts = a waiv] "u subp>agraph 7,b72 & 7,c7 9 clause 7iii7-- 7i7 by ins]t+ & %all =w>d su* det]m9ation to ! ,attorney ,g5]al be=e ! p]iod at ! end ( ! fir/ s5t5ce2 & 7ii7 by /rik+ physician & ins]t+ practition]2 7#c7 9 subp>agraph 7,g7-- 7,a7 by am5d+ clause 7ii77,,iv7 to read z foll[s3 7,,iv7 ,! physician has1 ) respect to ! treatm5t & managem5t ( opiate-dep5d5t pati5ts1 complet$ n less ?an eight h\rs ( tra9+ 7?r\gh classroom situations1 sem9>s at pr(essional society meet+s1 electronic communications1 or o!rwise7 t is provid$ by ! ,am]ican ,society ( ,addiction ,m$ic9e1 ! ,am]ican ,academy ( ,addiction ,psy*iatry1 ! ,am]ican ,m$ical ,association1 ! ,am]ican ,o/eopa?ic ,association1 ! ,am]ican ,psy*iatric ,association1 or any o!r organization t ! ,secret>y det]m9es is appropriate = purposes ( ?is subclause4 ,su* tra9+ %all address-- 7aa7 opioid ma9t5ance & detoxification2 7bb7 appropriate cl9ical use ( all drugs approv$ by ! ,food & ,drug ,adm9i/ration = ! treatm5t ( opioid use disord]2 7cc7 initial & p]iodic pati5t assessm5ts 7includ+ sub/ance use monitor+72 7dd7 individualiz$ treatm5t plann+2 ov]dose rev]sal2 relapse prev5tion2 7ee7 c\nsel+ & recov]y support s]vices2 7ff7 /aff+ roles & consid]ations2 7gg7 div]sion control2 & 7hh7 o!r be/ practices1 z id5tifi$ by ! ,secret>y4 2 & 7,b7 by add+ at ! end ! foll[+3 7iii7 ,! t]m qualify+ practition] means-- 7,i7 a qualify+ physician1 z def9$ 9 clause 7ii72 or 7,,ii7 a qualify+ o!r practition]1 z def9$ 9 clause 7iv74 7iv7 ,! t]m qualify+ o!r practition] means a nurse practition] or physician assi/ant :o satisfies ea* ( ! foll[+3 7,i7 ,! nurse practition] or physician assi/ant is lic5s$ "u ,/ate law to prescribe s*$ule ,,iii1 ,,iv1 or ,v m$ications = ! treatm5t ( pa94 7,,ii7 ,! nurse practition] or physician assi/ant satisfies #a or m ( ! foll[+3 7aa7 ,has complet$ n few] ?an #bd h\rs ( initial tra9+ address+ ea* ( ! topics li/$ 9 clause 7ii77,,iv7 7?r\gh classroom situations1 sem9>s at pr(essional society meet+s1 electronic communications1 or o!rwise7 provid$ by ! ,am]ican ,society ( ,addiction ,m$ic9e1 ! ,am]ican ,academy ( ,addiction ,psy*iatry1 ! ,am]ican ,m$ical ,association1 ! ,am]ican ,o/eopa?ic ,association1 ! ,am]ican ,nurses ,cr$5tial+ ,c5t]1 ! ,am]ican ,psy*iatric ,association1 ! ,am]ican ,association ( ,nurse ,practition]s1 ! ,am]ican ,academy ( ,physician ,assi/ants1 or any o!r organization t ! ,secret>y det]m9es is appropriate = purposes ( ?is subclause4 7bb7 ,has su* o!r tra9+ or exp]i5ce z ! ,secret>y det]m9es w demon/rate ! ability ( ! nurse practition] or physician assi/ant to treat & manage opiate-dep5d5t pati5ts4 7,,iii7 ,! nurse practition] or physician assi/ant is sup]vis$ by or works 9 collaboration ) a qualify+ physician1 if ! nurse practition] or physician assi/ant is requir$ by ,/ate law to prescribe m$ications = ! treatm5t ( opioid use disord] 9 collaboration ) or "u ! sup]vision ( a physician4 ,! ,secret>y may review & update ! requirem5ts = be+ a qualify+ o!r practition] "u ?is clause4 2 & 7#d7 9 subp>agraph 7,h7-- 7,a7 9 clause 7i71 by ins]t+ aft] subclause 7,,ii7 ! foll[+3 7,,iii7 ,su* o!r elem5ts ( ! requirem5ts "u ?is p>agraph z ! ,secret>y det]m9es necess>y = purposes ( implem5t+ su* requirem5ts4 2 & 7,b7 by am5d+ clause 7ii7 to read z foll[s3 7ii7 ,n lat] ?an "o ye> aft] ! date ( enactm5t ( ! ,opioid ,use ,disord] ,treatm5t ,expansion & ,mod]nization ,act1 ! ,secret>y %all update ! treatm5t improvem5t protocol conta9+ be/ practice guidel9es = ! treatm5t ( opioid-dep5d5t pati5ts 9 (fice-bas$ sett+s4 ,! ,secret>y %all update su* protocol 9 consultation ) exp]ts 9 opioid use disord] rese>* & treatm5t4 4 7b7 ,recomm5dation ( revocation or susp5sion ( regi/ration 9 case ( sub/antial noncompliance ,! ,secret>y ( ,heal? & ,human ,s]vices may recomm5d to ! ,attorney ,g5]al t ! regi/ration ( a practition] be revok$ or susp5d$ if ! ,secret>y det]m9es1 accord+ to su* crit]ia z ! ,secret>y e/abli%es by regulation1 t a practition] :o is regi/]$ "u section #cjc7;g77#b7 ( ! ,controll$ ,sub/ances ,act 7#ba ,u4,s4,c4 #hbc7;g77#b77 is n 9 sub/antial compliance ) ! requirem5ts ( su* section1 z am5d$ by ?is ,act4 7c7 ,opioid def9$ ,section #ajb7ah7 ( ! ,controll$ ,sub/ances ,act 7#ba ,u4,s4,c4 #hjb7ah77 is am5d$ by ins]t+ or opioid aft] ,! t]m opiate4 7d7 ,reports to ,congress 7#a7 ,9 g5]al ,n lat] ?an #b ye>s aft] ! date ( enactm5t ( ?is ,act & n less ?an ov] e #e ye>s !reaft]1 ! ,secret>y ( ,heal? & ,human ,s]vices1 9 consultation ) ! ,drug ,en=cem5t ,adm9i/ration & exp]ts 9 opioid use disord] rese>* & treatm5t1 %all-- 7,a7 p]=m a ?or\gh review ( ! provision ( opioid use disord] treatm5t s]vices 9 ! ,unit$ ,/ates1 includ+ s]vices provid$ 9 opioid treatm5t programs & o!r specialty & nonspecialty sett+s2 & 7,b7 submit a report to ! ,congress on ! f9d+s & conclusions ( su* review4 7#b7 ,cont5ts ,ea* report "u p>agraph 7#a7 %all include an assessm5t (-- 7,a7 compliance ) ! requirem5ts ( section #cjc7;g77#b7 ( ! ,controll$ ,sub/ances ,act 7#ba ,u4,s4,c4 #hbc7;g77#b771 z am5d$ by ?is ,act2 7,b7 ! measures tak5 by ! ,secret>y ( ,heal? & ,human ,s]vices to ensure su* compliance2 7,c7 :e!r !re is fur!r ne$ to increase or decrease ! numb] ( pati5ts a waiv]$ practition] is p]mitt$ to treat1 z provid$ = by ! am5dm5t made by subsection 7a77#a72 7,d7 ! ext5t to :i*1 & proportions ) :i*1 ! full range ( ,food & ,drug ,adm9i/ration-approv$ treatm5ts = opioid use disord] are us$ 9 r\t9e heal? c>e sett+s & specialty sub/ance use disord] treatm5t sett+s2 7,e7 access to1 & use (1 c\nsel+ & recov]y support s]vices1 includ+ ! p]c5tage ( pati5ts receiv+ su* s]vices2 7,f7 *anges 9 ,/ate or local policies & legislation relat+ to opioid use disord] treatm5t2 7,g7 ! use ( prescription drug monitor+ programs by practition]s :o are p]mitt$ to disp5se n>cotic drugs to individuals pursuant to a waiv] "u section #cjc7;g77#b7 ( ! ,controll$ ,sub/ances ,act 7#ba ,u4,s4,c4 #hbc7;g77#b772 7,h7 ! f9d+s result+ f inspections by ! ,drug ,en=cem5t ,adm9i/ration ( practition]s describ$ 9 subp>agraph 7,g72 & 7,i7 ! effectiv5ess ( cross-ag5cy collaboration betwe5 ,dep>tm5t ( ,heal? & ,human ,s]vices & ! ,drug ,en=cem5t ,adm9i/ration = exp&+ effective opioid use disord] treatm5t4 ,may #aj1 #bjaf ,report$ f ! ,committee on ,en]gy & ,comm]ce ) an amendment,may #aj1 #bjaf,! ,committee on ! ,judici>y dis*>g$2 committ$ to ! ,committee ( ! ,:ole ,h\se on ! ,/ate ( ! ,union & ord]$ to be pr9t$