,i #aaeth ,,congress #ast ,session ,h4 ,r4 #ddhb ,,in ,,the ,,house ,,of ,,representatives ,november #bi1 #bjag,mr4 ,meadows 7for himself and ,mr4 ,renacci7 introduced the following bill2 which was referred to the ,committee on ,energy and ,commerce1 and in addition to the ,committee on the ,judiciary1 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 deter opioid abuse and addiction1 to establish additional registration requirements for prescribers of opioids1 to encourage the development of abuse-deterrent formulations1 to require a study and report on policy changes that may have contributed to the opioid epidemic1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,opioid ,abuse ,deterrence1 ,research1 and ,recovery ,act of #bjag4 #b4 ,registration requirements for prescribers ,section #cjc of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hbc7 is amended by adding at the end the following3 7k7 7#a7 ,the ,attorney ,general shall not register1 or renew the registration of1 a practitioner under subsection 7f7 who is licensed under ,state law to prescribe controlled substances in schedule ,,ii or ,,iii1 unless the practitioner submits to the ,attorney ,general1 for each such registration or renewal request1 a certification that the practitioner1 during the applicable registration period1 except as provided in paragraph 7#b71 will not prescribe any schedule ,,ii or ,,iii opioid for the initial treatment of acute pain in an amount in excess of the lesser of-- 7,a7 a #g-;day supply 7for which no refill is available72 or 7,b7 an opioid prescription limit established under the law of the ,state where the prescribing occurs4 7#b7 ,the certification required by paragraph 7#a7 shall not prohibit a practitioner from-- 7,a7 prescribing1 for the treatment of an opioid use disorder1 a schedule ,,ii or ,,iii opioid that is approved by the ,food and ,drug ,administration for such treatment2 7,b7 prescribing1 for immediate1 post-operative pain relief1 a schedule ,,ii or ,,iii opioid2 or 7,c7 prescribing a schedule ,,ii or ,,iii opioid in an amount in excess of a #g-;day supply if the practitioner-- 7i7 provides a specific reason for exceeding the #g-;day limit that is in accordance with a clear medical standard of care whose implementation necessarily exceeds such limit2 7ii7 documents such reason and medical standard of care in the patient's medical record2 and 7iii7 consults the applicable ,state's electronic health record system or prescription drug monitoring program4 7#c7 ,in this subsection1 the term acute pain-- 7,a7 means pain with abrupt onset and caused by an injury or other process that is diagnostically determined to have minimal risk of escalating in intensity2 and 7,b7 does not include-- 7i7 chronic pain2 7ii7 pain being treated as part of cancer care2 7iii7 hospice or other end-of-life care2 or 7iv7 pain being treated as part of palliative care4 4 #c4 ,encouraging development of abuse-deterrent formulations ,the ,commissioner of ,food and ,drugs shall continue to work with stakeholders to encourage the development of opioid formulations with abuse-deterrent properties4 #d4 ,,gao study and report on policy changes that may have contributed to the opioid epidemic ,not later than #b years after the date of enactment of this ,act1 the ,comptroller ,general of the ,united ,states shall complete a study and submit a report to ,congress on health care policy changes that may have contributed to the increase in opioid overdoses and deaths during the #aj years preceding the date of enactment of this ,act4 ,such study shall include-- 7#a7 a review of health care-related legislative1 administrative1 and judicial decisions by officers and employees of the ,federal ,government that have affected access to pain management strategies with an emphasis on pharmaceuticals2 7#b7 an analysis of what is known about the costs and benefits1 whether financial or non-financial1 of reversing or revising such decisions individually or in combination1 including whether the reversals or revisions would be expected to achieve a reduction in abuse of1 addiction to1 overdose on1 and death from opioids2 7#c7 an analysis of the differences among ,state-based prescription drug monitoring programs1 including an analysis of what is known about the effects of such differences on monitoring for abuse of1 addiction to1 overdose on1 and death from opioids2 7#d7 an analysis of what is known about positive and negative impacts that prescribing limitations1 both ,state and ,federal1 have on patient medical outcomes1 including for chronic pain patients2 and 7#e7 an analysis of what is known about the costs to payers of using abuse-deterrent formulations of opioid pain medications1 compared to opioid pain medications without abuse-deterrent features4 #e4 ,study on feasibility of replacing statutory limits with clinical guidelines on opioid prescribing ,the ,commissioner of ,food and ,drugs shall-- 7#a7 conduct a study on the feasibility of-- 7,a7 replacing the prescribing limits in section #cjc7k77#a7 of the ,controlled ,substances ,act1 as added by section #b of this ,act1 with evidence-based clinical guidelines to inform opioid selection1 dosage1 duration1 follow up1 and discontinuation1 including guidelines on the first opioid prescription for patients for an acute pain diagnosis to ensure that no greater quantity than needed is prescribed for the expected duration of pain severe enough to require opioids2 and 7,b7 the incorporation into routine medical visits of evidence-based screening tools for the misuse of opioids and other controlled substances2 and 7#b7 not later than the date that is #b years after the date of enactment of this ,act1 submit to the ,congress1 and post on the public website of the ,food and ,drug ,administration1 a report on the results of such study4