,,ii ,cal5d> ,no4 #dda #aad? ,,congress 
#b;d ,session  ,s4 #adee  ,,9 ,,!       
,,s5ate ,,( ,,! ,,unit$ ,,/ates  ,may   
#bb1 #bjae,mr4 ,m>key 7= himself1 ,mr4  
,paul1 ,mrs4 ,fe9/e91 ,mr4 ,durb91 ,ms4 
,hirono1 ,mr4 ,br[n1 ,ms4 ,baldw91 ,mr4 
,frank51 ,mr4 ,casey1 ,mrs4 ,%ahe51 ,mr4
 ,k+1 ,mr4 ,leahy1 ,mr4 ,s&]s1 ,ms4     
,coll9s1 ,mr4 ,m]kley1 ,mr4 ,re$1 ,mr4  
,murphy1 ,mr4 ,m55dez1 ,mr4 ,hat*1 &    
,mrs4 ,gillibr&7 introduc$ ! foll[+     
bill2 :i* 0 read twice & ref]r$ to !    
,committee on ,heal?1 ,education1       
,labor1 & ,p5sions  ,april #bg1         
#bjaf,report$ by ,mr4 ,alex&]1 ) an     
amendment,strike out all aft] ! enact+  
clause & ins]t ! "p pr9t$ 9 italic  ,a  
,,bill  ,to provide access to           
m$ication-assi/$ !rapy1 & = o!r         
purposes4  #a4 ,%ort title ,?is ,act may
 be cit$ z ! ,recov]y ,enhancem5t =     
,addiction ,treatm5t ,act or ! ,,treat  
,act4  #b4 ,f9d+s ,congress f9ds !      
foll[+3 7#a7 ,ov]doses f opioids h      
increas$ dramatically 9 ! ,unit$ ,/ates4

  7#b7 ,dea?s f drug ov]dose1 l>gely f  
prescription pa9 reliev]s1 h tripl$     
among m5 & increas$ five-fold among wom5
 ov] ! pa/ decade4  7#c7 ,nationwide1   
drug ov]doses n[ claim m lives ?an c>   
accid5ts4  7#d7 ,opioid addiction is a  
*ronic disease t1 untreat$1 places a    
l>ge burd5 on ! heal?c>e sy/em4 ,r\ghly 
#dge1jjj em]g5cy room visits ea* ye> are
 attributable to ! misuse & abuse (     
opioid pa9 m$ication4  7#e7 ,effective  
m$ication-assi/$ treatm5t = opioid      
addiction1 9 comb9ation ) c\nsel+ &     
behavioral !rapies1 c decrease ov]dose  
dea?s1 be co/-effective1 r$uce          
transmissions ( ,,hiv & viral hepatitis1
 & r$uce o!r social h>ms su* z crim9al  
activity4  7#f7 ,effective              
m$ication-assi/$ treatm5t programs =    
opioid addiction %\ld include multiple  
compon5ts1 includ+ m$ications1 cognitive
 & behavioral supports & int]v5tions1 & 
drug te/+4  7#g7 ,effective             
m$ication-assi/$ treatm5t programs =    
opioid addiction may use a team ( /aff  

memb]s1 9 addition to a prescrib+       
provid]1 to deliv] compreh5sive c>e4    
7#h7 ,access to m$ication-assi/$        
treatm5ts1 includ+ (fice-bas$           
bupr5orph9e opioid treatm5t1 rema9s     
limit$ 9 "p due to curr5t practice      
regulations & an insuffici5t numb] (    
provid]s4  7#i7 ,m ?an #aj ye>s (       
exp]i5ce 9 ! ,unit$ ,/ates ) (fice-bas$ 
bupr5orph9e opioid treatm5t has in=m$   
be/ practices = deliv]+ successful1 high
 quality c>e4  #c4 ,expansion ( pati5t  
limits "u waiv] ,section                
#cjc7;g77#b77;,b7 ( ! ,controll$        
,sub/ances ,act 7#ba ,u4,s4,c4          
#hbc7;g77#b77;,b77 is am5d$-- 7#a7 9    
clause 7i71 by /rik+ physician & ins]t+ 
practition]2  7#b7 9 clause 7iii7-- 7,a7
 by /rik+ #cj & ins]t+ #ajj2 &  7,b7 by 
/rik+ 1 unless1 n soon] & all t foll[s  
?r\gh ! end & ins]t+ a p]iod2 &  7#c7 by
 ins]t+ at ! end ! foll[+ new clause3   
7iv7 ,n e>li] ?an #a ye> aft] ! date on 
:i* a qualify+ practition] obta9$ an    
initial waiv] pursuant to clause 7iii71 

! qualify+ practition] may submit a     
second notification to ! ,secret>y ( !  
ne$ & int5t ( ! qualify+ practition] to 
treat an unlimit$ numb] ( pati5ts1 if ! 
qualify+ practition]--  7,i7 7aa7       
satisfies ! requirem5ts ( item 7aa71    
7bb71 7cc71 or 7dd7 ( subp>agraph       
7,g77ii77,i72 &  7bb7 agrees to fully   
p>ticipate 9 ! ,prescription ,drug      
,monitor+ ,program ( ! ,/ate 9 :i* !    
qualify+ practition] is lic5s$1 pursuant
 to applicable ,/ate guidel9es2 or      
7,,ii7 7aa7 satisfies ! requirem5ts (   
item 7ee71 7ff71 or 7gg7 ( subp>agraph  
7,g77ii77,i72  7bb7 agrees to fully     
p>ticipate 9 ! ,prescription ,drug      
,monitor+ ,program ( ! ,/ate 9 :i* !    
qualify+ practition] is lic5s$1 pursuant
 to applicable ,/ate guidel9es2  7cc7   
practices 9 a qualifi$ practice sett+2 &
  7dd7 has complet$ n less ?an #bd h\rs 
( tra9+ 7?r\gh classroom situations1    
sem9>s at pr(essional society meet+s1   
electronic communications1 or o!rwise7 )
 respect to ! treatm5t & managem5t (    

opiate-dep5d5t pati5ts = sub/ance use   
disord]s 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  4  #d4 ,def9itions ,section
 #cjc7;g77#b77;,g7 ( ! ,controll$       
,sub/ances ,act 7#ba ,u4,s4,c4          
#hbc7;g77#b77;,g77 is am5d$-- 7#a7 by   
/rik+ clause 7ii7 & ins]t+ ! foll[+3    
7ii7 ,! t]m qualify+ practition] means !
 foll[+3 7,i7 ,a physician :o is lic5s$ 
"u ,/ate law & :o meets #a or m ( !     
foll[+ conditions3  7aa7 ,! physician   
holds a bo>d c]tification 9 addiction   
psy*iatry f ! ,am]ican ,bo>d ( ,m$ical  
,specialties4  7bb7 ,! physician holds  
an addiction c]tification f ! ,am]ican  
,society ( ,addiction ,m$ic9e4  7cc7 ,! 
physician holds a bo>d c]tification 9   
addiction m$ic9e f ! ,am]ican ,o/eopa?ic

 ,association4  7dd7 ,! physician holds 
a bo>d c]tification f ! ,am]ican ,bo>d (
 ,addiction ,m$ic9e4  7ee7 ,! physician 
has complet$ n less ?an #h h\rs ( tra9+ 
7?r\gh classroom situations1 sem9>s at  
pr(essional society meet+s1 electronic  
communications1 or o!rwise7 ) respect to
 ! treatm5t & managem5t ( opiate-dep5d5t
 pati5ts = sub/ance use disord]s 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 
7ff7 ,! physician has p>ticipat$ z an   
inve/igator 9 #a or m cl9ical trials    
lead+ to ! approval ( a n>cotic drug 9  
s*$ule ,,iii1 ,,iv1 or ,v = ma9t5ance or
 detoxification treatm5t1 z demon/rat$  
by a /atem5t submitt$ to ! ,secret>y by 
?is sponsor ( su* approv$ drug4  7gg7 ,!
 physician has su* o!r tra9+ or exp]i5ce

 z ! ,secret>y det]m9es w demon/rate !  
ability ( ! physician to treat & manage 
opiate-dep5d5t pati5ts4  7,,ii7 ,a nurse
 practition] or physician assi/ant :o is
 lic5s$ "u ,/ate law & meets all ( !    
foll[+ conditions3  7aa7 ,! nurse       
practition] or physician assi/ant is    
lic5s$ "u ,/ate law to prescribe s*$ule 
,,iii1 ,,iv1 or ,v m$ications = pa94    
7bb7 ,! nurse practition] or physician  
assi/ant satisfies #a or m ( ! foll[+3  
7,,aa7 ,has complet$ n few] ?an #bd h\rs
 ( tra9+ 7?r\gh classroom situations1   
sem9>s at pr(essional society meet+s1   
electronic communications1 or o!rwise7 )
 respect to ! treatm5t & managem5t (    
opiate-dep5d5t pati5ts = sub/ance use   
disord]s 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 7,,bb7 ,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  
7cc7 ,! nurse practition] or physician  
assi/ant practices "u ! sup]vision ( a  
lic5s$ physician :o holds an active     
waiv] to prescribe s*$ule ,,iii1 ,,iv1  
or ,v n>cotic m$ications = opioid       
addiction !rapy1 &-- 7,,aa7 ! sup]vis+  
physician satisfies ! conditions ( item 
7aa71 7bb71 7cc71 or 7dd7 ( subclause   
7,i72 or 7,,bb7 bo? ! sup]vis+ physician
 & ! nurse practition] or physician     
assi/ant practice 9 a qualifi$ practice 
sett+4  7,,iii7 ,a nurse practition] :o 
is lic5s$ "u ,/ate law & meets all ( !  
foll[+ conditions3 7aa7 ,! nurse        
practition] is lic5s$ "u ,/ate law to   
prescribe s*$ule ,,iii1 ,,iv1 or ,v     
m$ications = pa94  7bb7 ,! nurse        
practition] has tra9+ or exp]i5ce t !   
,secret>y det]m9es demon/rates          
specialization 9 ! ability to treat     

opiate-dep5d5t pati5ts1 su* z a         
c]tification 9 addiction specialty      
accr$it$ by ! ,am]ican ,bo>d ( ,nurs+   
,specialties or ! ,national ,commission 
= ,c]tify+ ,ag5cies1 or a c]tification 9
 addiction nurs+ z a ,c]tifi$ ,addiction
 ,regi/]$ ,nurse--,advanc$ ,practice4   
7cc7 ,9 accordance ) ,/ate law1 ! nurse 
practition] prescribes opioid addiction 
!rapy 9 collaboration ) a physician :o  
holds an active waiv] to prescribe      
s*$ule ,,iii1 ,,iv1 or ,v n>cotic       
m$ications = opioid addiction !rapy4    
7dd7 ,! nurse practition] practices 9 a 
qualifi$ practice sett+4  2 &  7#b7 by  
add+ at ! end ! foll[+3  7iii7 ,! t]m   
qualifi$ practice sett+ means #a or m ( 
! foll[+ treatm5t sett+s3 7,i7 ,a       
,national ,committee = ,quality         
,assurance-recogniz$ ,pati5t-,c5t]$     
,m$ical ,home or ,pati5t-,c5t]$         
,specialty ,practice4  7,,ii7 ,a ,c5t]s 
= ,m$icaid  ,m$ic>e ,s]vices-recogniz$  
,acc\ntable ,c>e ,organization4  7,,iii7
 ,a cl9ical facility adm9i/]$ by !      

,dep>tm5t ( ,vet]ans ,affairs1 ,dep>tm5t
 ( ,def5se1 or ,indian ,heal? ,s]vice4  
7,,iv7 ,a ,behavioral ,heal? ,home      
accr$it$ by ! ,jo9t ,commission4  7,v7  
,a ,f$]ally-qualifi$ heal? c5t] 7z def9$
 9 section #aije7l77#b77;,b7 ( ! ,social
 ,security ,act 7#db ,u4,s4,c4          
#acif;d7l77#b77;,b777 or a              
,f$]ally-qualifi$ heal? c5t] look-alike4
  7,,vi7 ,a ,sub/ance ,abuse & ,m5tal   
,heal? ,s]vices-c]tifi$ ,opioid         
,treatm5t ,program4  7,,vii7 ,a cl9ical 
program ( a ,/ate or ,f$]al jail1       
prison1 or o!r facility :]e individuals 
are inc>c]at$4  7,,viii7 ,a cl9ic t     
demon/rates compliance ) ! ,model       
,policy on ,,data #bjjj & ,treatm5t (   
,opioid ,addiction 9 ! ,m$ical ,(fice   
issu$ by ! ,f$]ation ( ,/ate ,m$ical    
,bo>ds4  7,,ix7 ,a treatm5t sett+ t is  
"p ( an ,accr$itation ,c\ncil =         
,graduate ,m$ical ,education1 ,am]ican  
,association ( ,colleges ( ,o/eopa?ic   
,m$ic9e1 or ,am]ican ,o/eopa?ic         
,association-accr$it$ resid5cy or       

fell[%ip tra9+ program4  7,x7 ,any o!r  
practice sett+ approv$ by a ,/ate       
regulatory bo>d or ,/ate ,m$icaid ,plan 
to provide addiction treatm5t s]vices4  
7,,xi7 ,any o!r practice sett+ approv$  
by ! ,secret>y4  4  #e4 ,,gao           
,evaluation ,two ye>s aft] ! date on :i*
 ! fir/ notification "u clause 7iv7 (   
section #cjc7;g77#b77;,b7 ( ! ,controll$
 ,sub/ances ,act 7#ba ,u4,s4,c4         
#hbc7;g77#b77;,b771 z add$ by ?is ,act1 
is receiv$ by ! ,secret>y ( ,heal? &    
,human ,s]vices1 ! ,comptroll] ,g5]al ( 
! ,unit$ ,/ates %all initiate an        
evaluation ( ! effectiv5ess ( ! am5dm5ts
 made by ?is ,act1 :i* %all include an  
evaluation (--  7#a7 any *anges 9 !     
availability & use ( m$ication-assi/$   
treatm5t = opioid addiction2  7#b7 !    
quality ( m$ication-assi/$ treatm5t     
programs2  7#c7 ! integration (         
m$ication-assi/$ treatm5t ) r\t9e       
heal?c>e s]vices2  7#d7 div]sion (      
opioid addiction treatm5t m$ication2    
7#e7 *anges 9 ,/ate or local policies & 

legislation relat+ to opioid addiction  
treatm5t2  7#f7 ! use ( nurse           
practition]s & physician assi/ants :o   
prescribe opioid addiction m$ication2   
7#g7 ! use ( ,prescription ,drug        
,monitor+ ,programs by waiv$            
practition]s to maximize safety ( pati5t
 c>e & prev5t div]sion ( opioid         
addiction m$ication2  7#h7 ! f9d+s (    
,drug ,en=cem5t ,adm9i/ration           
inspections ( waiv$ practition]s1       
includ+ ! frequ5cy ) :i* ! ,drug        
,en=cem5t ,adm9i/ration f9ds no         
docum5tation ( access to behavioral     
heal? s]vices2 &  7#i7 ! effectiv5ess ( 
cross-ag5cy collaboration betwe5        
,dep>tm5t ( ,heal? & ,human ,s]vices & !
 ,drug ,en=cem5t ,adm9i/ration = exp&+  
effective opioid addiction treatm5t4    
#a4 ,%ort title ,?is ,act may be cit$ z 
! ,recov]y ,enhancem5t = ,addiction     
,treatm5t ,act or ! ,,treat ,act4  #b4  
,expansion ( pati5t limits "u waiv]     
,section #cjc7;g77#b77;,b7 ( !          
,controll$ ,sub/ances ,act 7#ba         

,u4,s4,c4 #hbc7;g77#b77;,b77 is am5d$-- 
7#a7 9 clause 7i71 by /rik+ physician & 
ins]t+ practition]2  7#b7 9 clause      
7iii7-- 7,a7 by /rik+ ,! total numb] &  
ins]t+ 7,i7 ,! total numb]2  7,b7 by    
/rik+ #cj & ins]t+ #ajj2  7,c7 by /rik+ 
1 unless1 n soon] & all t foll[s ?r\gh (
 ?is subp>agraph2 &  7,d7 by add+ at !  
end ! foll[+3  7,,ii7 ,if a pati5t is   
ref]r$ by a qualify+ practition] t is a 
physician to ano!r qualify+ practition] 
t is a physician t provides %ort-t]m    
s]vices 7su* z induction or titration71 
! pati5t %all only be includ$ 9 ! total 
numb] ( su* pati5ts ( ! qualify+        
physician t makes ! ref]ral4  7,,iii7 ,9
 ?is clause1 ! t]m ! total numb] ( su*  
pati5ts %all n include a pati5t to :om a
 qualify+ practition] t is a physician  
meet+ ! requirem5ts describ$ 9 clause   
7iv77,i71 or an au?oriz$ ag5t ( su*     
qualify+ practition] t is a physician1  
directly adm9i/]s su* drugs or          
comb9ation drugs4  2 &  7#d7 by add+ at 
! end ! foll[+3  7iv7 ,n e>li] ?an #a   

ye> aft] ! date on :i* a qualify+       
practition] t is a physician obta9$ an  
initial waiv] pursuant to clause 7iii71 
su* qualify+ practition] may submit a   
second notification to ! ,secret>y ( !  
ne$ & int5t ( su* qualify+ practition]  
to treat up to #ejj pati5ts1 if su*     
qualify+ practition]--  7,i7 7aa7       
satisfies ! requirem5ts ( item 7aa71    
7bb71 7cc71 or 7dd7 ( subp>agraph       
7,g77ii77,i72 &  7bb7 agrees to fully   
p>ticipate 9 ! ,prescription ,drug      
,monitor+ ,program ( ! ,/ate 9 :i* !    
qualify+ practition] is lic5s$1 pursuant
 to applicable ,/ate guidel9es2 or      
7,,ii7 7aa7 satisfies ! requirem5ts (   
item 7ee71 7ff71 or 7gg7 ( subp>agraph  
7,g77ii77,i72  7bb7 agrees to fully     
p>ticipate 9 ! ,prescription ,drug      
,monitor+ ,program ( ! ,/ate 9 :i* !    
qualify+ practition] is lic5s$1 pursuant
 to applicable ,/ate guidel9es2 &  7cc7 
has complet$ n less ?an #bd h\rs ( tra9+
 7?r\gh classroom situations1 sem9>s at 
pr(essional society meet+s1 electronic  

communications1 or o!rwise7 ) respect to
 ! treatm5t & managem5t ( opiate-dep5d5t
 pati5ts = sub/ance use disord]s 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 
7v7 ,! qualify+ practition] %all ma9ta9 
records relat+ to ! disp5s+ ( drugs or  
comb9ations ( drugs to treat pati5ts "u 
?is p>agraph1 includ+--  7,i7 :e!r !    
qualify+ practition] provides c\nsel+   
s]vices on-site1 & h[ frequ5tly pati5ts 
are us+ su* s]vices2  7,,ii7 :e!r !     
qualify+ practition] ref]r$ pati5ts =   
c\nsel+ s]vices (f-site1 ! p]c5tage ( ! 
pati5ts ( ! qualify+ practition] us+ su*
 s]vices1 & h[ frequ5tly ! pati5ts are  
us+ su* s]vices2 &  7,,iii7 ! frequ5cy )
 :i* pati5ts be+ treat$ "u ?is p>agraph 
t]m9ate ! treatm5t aga9/ m$ical advice4 

4  #c4 ,def9itions ,section             
#cjc7;g77#b77;,g7 ( ! ,controll$        
,sub/ances ,act 7#ba ,u4,s4,c4          
#hbc7;g77#b77;,g77 is am5d$ by /rik+    
clause 7ii7 & ins]t+ ! foll[+3  7ii7 ,! 
t]m qualify+ practition] means ! foll[+3
 7,i7 ,a physician :o is lic5s$ "u ,/ate
 law & :o meets #a or m ( ! foll[+      
conditions3  7aa7 ,! physician holds a  
bo>d c]tification 9 addiction psy*iatry 
or addiction m$ic9e f ! ,am]ican ,bo>d (
 ,m$ical ,specialties4  7bb7 ,!         
physician holds an addiction            
c]tification f ! ,am]ican ,society (    
,addiction ,m$ic9e or ! ,am]ican ,bo>d (
 ,addiction ,m$ic9e4  7cc7 ,! physician 
holds a bo>d c]tification 9 addiction   
m$ic9e f ! ,am]ican ,o/eopa?ic          
,association4  7dd7 ,! physician holds a
 bo>d c]tification f ! ,am]ican ,bo>d ( 
,addiction ,m$ic9e4  7ee7 ,! physician  
has complet$ n less ?an #h h\rs ( tra9+ 
7?r\gh classroom situations1 sem9>s at  
pr(essional society meet+s1 electronic  
communications1 or o!rwise7 ) respect to

 ! treatm5t & managem5t ( opiate-dep5d5t
 pati5ts = sub/ance use disord]s 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 subclause1 
aft] notice & ! opportunity = comm5t4   
7ff7 ,! physician has p>ticipat$ z an   
inve/igator 9 #a or m cl9ical trials    
lead+ to ! approval ( a n>cotic drug 9  
s*$ule ,,iii1 ,,iv1 or ,v = ma9t5ance or
 detoxification treatm5t1 z demon/rat$  
by a /atem5t submitt$ to ! ,secret>y by 
?is sponsor ( su* approv$ drug4  7gg7 ,!
 physician has su* o!r tra9+ or exp]i5ce
 z ! ,secret>y det]m9es w demon/rate !  
ability ( ! physician to treat & manage 
opiate dep5d5t pati5ts4  7,,ii7 ,a nurse
 practition] or physician assi/ant :o is
 lic5s$ "u ,/ate law & meets all ( !    
foll[+ conditions3  7aa7 ,! nurse       

practition] or physician assi/ant is    
lic5s$ "u ,/ate law to prescribe s*$ule 
,,iii1 ,,iv1 or ,v m$ications4  7bb7 ,! 
nurse practition] or physician assi/ant 
has complet$ n few] ?an #bd h\rs ( tra9+
 7?r\gh classroom situations1 sem9>s at 
pr(essional society meet+s1 electronic  
communications1 or o!rwise7 ) respect to
 ! treatm5t & managem5t ( opiate-dep5d5t
 pati5ts = sub/ance use disord]s 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 ! ,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 subclause1 aft] notice & 
opportunity = comm5t4  7cc7 ,if requir$ 
by ,/ate law1 ! nurse practition] or    
physician assi/ant prescribes opioid    
addiction !rapy 9 collaboration ) or "u 

! sup]vision (1 z applicable1 a         
physician4  4  #d4 ,/ate flexibility    
,section #cjc7;g77#b7 ( ! ,controll$    
,sub/ances ,act 7#ba ,u4,s4,c4          
#hbc7;g77#b77 is am5d$ by /rik+         
subp>agraphs 7,i7 & 7,j71 & ins]t+ !    
foll[+3  7,i7 ,not)/&+ section #gjh1    
no?+ 9 ?is p>agraph %all be con/ru$ to  
preempt any ,/ate law t--  7i7 p]mits a 
qualify+ practition] to disp5se n>cotic 
drugs 9 s*$ule ,,iii1 ,,iv1 or ,v1 or   
comb9ations ( su* drugs1 = ma9t5ance or 
detoxification treatm5t 9 accordance )  
?is p>agraph to a total numb] ( pati5ts 
t is m ?an #cj or less ?an ! total numb]
 applicable to ! qualify+ practition] "u
 clause 7iv7 ( subp>agraph 7,b7 if a    
,/ate enacts a law modify+ su* total    
numb] & ! ,attorney ,g5]al is notifi$ by
 ! ,/ate ( su* modification2 or  7ii7   
requires a qualify+ practition] to      
comply ) additional requirem5ts relat+  
to ! disp5s+ ( n>cotic drugs 9 s*$ule   
,,iii1 ,,iv1 or ,v1 or comb9ations ( su*
 drugs1 includ+ requirem5ts relat+ to ! 

practice sett+ 9 :i* ! qualify+         
practition] practices & education1      
tra9+1 & report+ requirem5ts4  4  #e4   
,update regulations ,n lat] ?an #a ye>  
aft] ! date ( enactm5t ( ?is ,act1 !    
,attorney ,g5]al %all update regulations
 reg>d+ waiv$ practition]s 7z am5d$ by  
?is ,act7 to include nurse practition]s 
& physician assi/ants to ensure !       
quality ( pati5t c>e & prev5t div]sion4 
#f4 ,evaluations  7a7 ,def9ition ,9 ?is 
section1 ! t]m appropriate committees ( 
,congress means-- 7#a7 ! ,committee on  
,heal?1 ,education1 ,labor1 & ,p5sions &
 ! ,committee on ! ,judici>y ( ! ,s5ate2
 &  7#b7 ! ,committee on ,en]gy &       
,comm]ce & ! ,committee on ! ,judici>y (
 ! ,h\se ( ,repres5tatives4  7b7 ,,hhs  
,n lat] ?an #b ye>s aft] ! date (       
enactm5t ( ?is ,act1 ! ,secret>y (      
,heal? & ,human ,s]vices1 9 coord9ation 
) ! ,attorney ,g5]al1 %all submit to !  
appropriate committees ( ,congress a    
report on ! effect on ! am5dm5ts made by
 ?is title on ! availability (          

evid5ce-bas$ treatm5t & any increas$    
risk 9 div]sion1 includ+ ! impact (     
nurse practition]s & physician assi/ants
 z qualify+ practition]s4  7c7 ,,gao    
7#a7 ,9 g5]al ,f\r ye>s aft] ! date on  
:i* ! fir/ notification "u clause 7iv7 (
 section #cjc7;g77#b77;,b7 ( !          
,controll$ ,sub/ances ,act 7#ba         
,u4,s4,c4 #hbc7;g77#b77;,b771 z add$ by 
?is ,act1 is receiv$ by ! ,secret>y (   
,heal? & ,human ,s]vices1 ! ,comptroll] 
,g5]al ( ! ,unit$ ,/ates %all initiate  
an evaluation ( ! effectiv5ess ( !      
am5dm5ts made by ?is ,act1 :i* %all     
include an evaluation (--  7,a7 any     
*anges 9 ! availability & use (         
m$ication-assi/$ treatm5t = opioid      
addiction2  7,b7 ! quality (            
m$ication-assi/$ treatm5t programs2     
7,c7 ! integration ( m$ication-assi/$   
treatm5t ) r\t9e heal?c>e s]vices2  7,d7
 div]sion ( opioid addiction treatm5t   
m$ication2  7,e7 *anges 9 ,/ate or local
 policies & legislation relat+ to opioid
 addiction treatm5t2  7,f7 ! use ( nurse

 practition]s & physician assi/ants :o  
prescribe opioid addiction m$ication2   
7,g7 ! use ( ,prescription ,drug        
,monitor+ ,programs by waiv$            
practition]s to maximize safety ( pati5t
 c>e & prev5t div]sion ( opioid         
addiction m$ication2  7,h7 ! f9d+s (    
,drug ,en=cem5t ,ag5cy inspections (    
waiv$ practition]s1 includ+ ! frequ5cy )
 :i* ! ,drug ,en=cem5t ,ag5cy f9ds no   
docum5tation ( access to behavioral     
heal? s]vices2 &  7,i7 ! effectiv5ess ( 
cross-ag5cy collaboration betwe5        
,dep>tm5t ( ,heal? & ,human ,s]vices & !
 ,drug ,en=cem5t ,ag5cy = exp&+         
effective opioid addiction treatm5t4    
7#b7 ,report ,! ,comptroll] ,g5]al %all 
submit to ! appropriate committees (    
,congress a report reg>d+ ! evaluation  
conduct$ "u p>agraph 7#a74  ,april #bg1 
#bjaf,report$ ) an am5dm5t