#aae? ,,congress  #b;d ,session  ,h4 ,r4
 #efje  ,,an ,,act  ,to am5d title      
,,xviii ( ! ,social ,security ,act to   
provide = an opioid use disord] treatm5t
 demon/ration program1 & = o!r purposes4
  #a4 ,%ort title ,?is ,act may be cit$ 
z ! ,advanc+ ,high ,quality ,treatm5t = 
,opioid ,use ,disord]s 9 ,m$ic>e ,act4  
#b4 ,opioid use disord] treatm5t        
demon/ration program ,title ,,xviii ( ! 
,social ,security ,act 7#db ,u4,s4,c4   
#acie et seq47 is am5d$ by ins]t+ aft]  
section #ahff;,e 7#db ,u4,s4,c4         
#acie;cc-#e7 ! foll[+ new section3      
#ahff;,f4 ,opioid use disord] treatm5t  
demon/ration program  7a7 ,implem5tation
 ( #d-,ye> demon/ration program  7#a7 ,9
 g5]al ,n lat] ?an ,janu>y #a1 #bjba1 ! 
,secret>y %all implem5t a #d-ye>        
demon/ration program "u ?is title 79 ?is
 section ref]r$ to z ! ,program7 to     
increase access ( applicable b5efici>ies
 to opioid use disord] treatm5t s]vices1
 improve physical & m5tal heal? outcomes
 = su* b5efici>ies1 & to ! ext5t        

possible1 r$uce exp5ditures "u ?is      
title4 ,"u ! ,program1 ! ,secret>y %all 
make paym5ts "u subsection 7e7 to       
p>ticipants 7z def9$ 9 subsection       
7c77#a77;,a77 = furni%+ opioid use      
disord] treatm5t s]vices deliv]$ ?r\gh  
opioid use disord] c>e teams1 or arrang+
 = su* s]vice to be furni%$1 to         
applicable b5efici>ies p>ticipat+ 9 !   
,program4  7#b7 ,opioid use disord]     
treatm5t s]vices ,= purposes ( ?is      
section1 ! t]m opioid use disord]       
treatm5t s]vices--  7,a7 means1 )       
respect to an applicable b5efici>y1     
s]vices t are furni%$ = ! treatm5t (    
opioid use disord]s & t utilize drugs   
approv$ "u section #eje ( ! ,f$]al      
,food1 ,drug1 & ,cosmetic ,act = !      
treatm5t ( opioid use disord]s 9 an     
outpati5t sett+2 &  7,b7 includes--  7i7
 m$ication assi/$ treatm5t2  7ii7       
treatm5t plann+2  7iii7 psy*iatric1     
psy*ological1 or c\nsel+ s]vices 7or any
 comb9ation ( su* s]vices71 z           
appropriate2  7iv7 social support       

s]vices1 z appropriate2 &  7v7 c>e      
managem5t & c>e coord9ation s]vices1    
includ+ coord9ation ) o!r provid]s (    
s]vices & suppli]s n on an opioid use   
disord] c>e team4  7b7 ,program design  
7#a7 ,9 g5]al ,! ,secret>y %all design !
 ,program 9 su* a mann] to all[ = !     
evaluation ( ! ext5t to :i* ! ,program  
accompli%es ! foll[+ purposes3  7,a7    
,r$uces hospitalizations & em]g5cy      
dep>tm5t visits4  7,b7 ,increases use ( 
m$ication-assi/$ treatm5t = opioid use  
disord]s4  7,c7 ,improves heal? outcomes
 ( individuals ) opioid use disord]s1   
includ+ by r$uc+ ! incid5ce ( infecti\s 
diseases 7su* z hepatitis ,c & ,,hiv74  
7,d7 ,does n increase ! total sp5d+ on  
items & s]vices "u ?is title4  7,e7     
,r$uces dea?s f opioid ov]dose4  7,f7   
,r$uces ! utilization ( inpati5t        
resid5tial treatm5t4  7#b7 ,consultation
 ,9 design+ ! ,program1 includ+ !       
crit]ia "u subsection 7e77#b77;,a71 !   
,secret>y %all1 n lat] ?an #c mon?s aft]
 ! date ( ! enactm5t ( ?is section1     

consult ) speciali/s 9 ! field (        
addiction1 cl9icians 9 ! prim>y c>e     
community1 & b5efici>y gr\ps4  7c7      
,p>ticipants2 opioid use disord] c>e    
teams  7#a7 ,p>ticipants  7,a7          
,def9ition ,9 ?is section1 ! t]m        
p>ticipant means an entity or           
individual--  7i7 t is o!rwise enroll$  
"u ?is title & t is-- 7,i7 a physician  
7z def9$ 9 section #ahfa7r77#a772       
7,,ii7 a gr\p practice compris$ ( at    
lea/ "o physician describ$ 9 subclause  
7,i72  7,,iii7 a hospital outpati5t     
dep>tm5t2  7,,iv7 a f$]ally qualifi$    
heal? c5t] 7z def9$ 9 section           
#ahfa7;aa77#d772  7,v7 a rural heal?    
cl9ic 7z def9$ 9 section                
#ahfa7;aa77#b772  7,,vi7 a community    
m5tal heal? c5t] 7z def9$ 9 section     
#ahfa7;ff77#c77;,b772  7,,vii7 a cl9ic  
c]tifi$ z a c]tifi$ community behavioral
 heal? cl9ic pursuant to section #bbc ( 
! ,protect+ ,access to ,m$ic>e ,act (   
#bjad2 or  7,,viii7 any o!r individual  
or entity specifi$ by ! ,secret>y2  7ii7

 t appli$ = & 0 select$ to p>ticipate 9 
! ,program pursuant to an application & 
selection process e/abli%$ by !         
,secret>y2 &  7iii7 t e/abli%es an      
opioid use disord] c>e team 7z def9$ 9  
p>agraph 7#b77 ?r\gh employ+ or         
contract+ ) heal? c>e practition]s      
describ$ 9 p>agraph 7#b77;,a71 & uses   
su* team to furni% or arrange = opioid  
use disord] treatm5t s]vices 9 !        
outpati5t sett+ "u ! ,program4  7,b7    
,pref]5ce ,9 select+ p>ticipants = !    
,program1 ! ,secret>y %all give pref]5ce
 to individuals & entities t are locat$ 
9 areas ) a preval5ce ( opioid use      
disord]s t is high] ?an ! national      
av]age preval5ce4  7#b7 ,opioid use     
disord] c>e teams  7,a7 ,9 g5]al ,=     
purposes ( ?is section1 ! t]m opioid use
 disord] c>e team means a team ( heal?  
c>e practition]s e/abli%$ by a          
p>ticipant describ$ 9 p>agraph 7#a77;,a7
 t-- 7i7 %all include--  7,i7 at lea/ "o
 physician 7z def9$ 9 section           
#ahfa7r77#a77 furni%+ prim>y c>e s]vices

 or addiction treatm5t s]vices to an    
applicable b5efici>y2 &  7,,ii7 at lea/ 
"o eligible practition] 7z def9$ 9      
p>agraph 7#c77;,a771 :o may be a        
physician :o meets ! crit]ion 9         
subclause 7,i72 &  7ii7 may include o!r 
practition]s lic5s$ "u ,/ate law to     
furni% psy*iatric1 psy*ological1        
c\nsel+1 & social s]vices to applicable 
b5efici>ies4  7,b7 ,requirem5ts =       
receipt ( paym5t "u ,program ,9 ord] to 
receive paym5ts "u subsection 7e71 ea*  
p>ticipant 9 ! ,program %all--  7i7     
furni% opioid use disord] treatm5t      
s]vices ?r\gh opioid use disord] c>e    
teams to applicable b5efici>ies :o agree
 to receive ! s]vices2  7ii7 meet m9imum
 crit]ia1 z e/abli%$ by ! ,secret>y2 &  
7iii7 submit to ! ,secret>y1 9 su* =m1  
mann]1 & frequ5cy z specifi$ by !       
,secret>y1 ) respect to ea* applicable  
b5efici>y = :om opioid use disord]      
treatm5t s]vices are furni%$ by ! opioid
 use disord] c>e team1 data & su* o!r   
in=mation z ! ,secret>y det]m9es        

appropriate to-- 7,i7 monitor & evaluate
 ! ,program2  7,,ii7 det]m9e if m9imum  
crit]ia are met "u clause 7ii72 &       
7,,iii7 det]m9e ! inc5tive paym5t "u    
subsection 7e74  7#c7 ,eligible         
practition]s2 ,o!r provid]-relat$       
def9itions & application provisions     
7,a7 ,eligible practition]s ,= purposes 
( ?is section1 ! t]m eligible           
practition] means a physician or o!r    
heal? c>e practition]1 su* z a nurse    
practition]1 t-- 7i7 is enroll$ "u      
section #ahff7;j77#a72  7ii7 is au?oriz$
 to prescribe or disp5se n>cotic drugs  
to individuals = ma9t5ance treatm5t or  
detoxification treatm5t2 &  7iii7 has 9 
effect a waiv] 9 accordance ) section   
#cjc7;g7 ( ! ,controll$ ,sub/ances ,act 
= su* purpose & is o!rwise 9 compliance 
) regulations promulgat$ by ! ,sub/ance 
,abuse & ,m5tal ,heal? ,s]vices         
,adm9i/ration to c>ry out su* section4  
7,b7 ,addiction speciali/s ,= purposes (
 subsection 7e77#a77;,b77iv71 ! t]m     
addiction speciali/ means a physician t 

possesses exp]t k & skills 9 addiction  
m$ic9e1 z evid5c$ by appropriate        
c]tification f a specialty body1 a      
c]tificate ( advanc$ qualification 9    
addiction m$ic9e1 or completion ( an    
accr$it$ resid5cy or fell[%ip 9         
addiction m$ic9e or addiction psy*iatry1
 z det]m9$ by ! ,secret>y4  7d7         
,p>ticipation ( applicable b5efici>ies  
7#a7 ,applicable b5efici>y def9$ ,9 ?is 
section1 ! t]m applicable b5efici>y     
means an individual :o-- 7,a7 is entitl$
 to1 or enroll$ =1 b5efits "u "p ,a &   
enroll$ = b5efits "u "p ,b2  7,b7 is n  
enroll$ 9 a ,m$ic>e ,advantage plan "u  
"p ,c2  7,c7 has a curr5t diagnosis = an
 opioid use disord]2 &  7,d7 meets su*  
o!r crit]ia z ! ,secret>y det]m9es      
appropriate4  ,su* t]m %all include an  
individual :o is dually eligible =      
b5efits "u ?is title & title ,,xix if   
su* individual satisfies ! crit]ia      
describ$ 9 subp>agraphs 7,a7 ?r\gh 7,d74
  7#b7 ,volunt>y p>ticipation2          
limitation on numb] ( p>ticipants ,an   

applicable b5efici>y may p>ticipate 9 ! 
,program on a volunt>y basis & may      
t]m9ate p>ticipation 9 ! ,program at any
 "t4 ,n m ?an #bj1jjj applicable        
b5efici>ies may p>ticipate 9 ! ,program 
at any "t4  7#c7 ,s]vices ,9 ord] to    
p>ticipate 9 ! ,program1 an applicable  
b5efici>y %all agree to receive opioid  
use disord] treatm5t s]vices f a        
p>ticipant4 ,p>ticipation "u ! ,program 
%all n affect cov]age ( or paym5t = any 
o!r item or s]vice "u ?is title = !     
applicable b5efici>y4  7#d7 ,b5efici>y  
access to s]vices ,no?+ 9 ?is section   
%all be con/ru$ z enc\rag+ provid]s to  
limit applicable b5efici>y access to    
s]vices cov]$ "u ?is title & applicable 
b5efici>ies %all n be requir$ to        
rel9qui% access to any b5efit "u ?is    
title z a condition ( receiv+ s]vices f 
a p>ticipant 9 ! ,program4  7e7 ,paym5ts
  7#a7 ,p] applicable b5efici>y p] mon? 
c>e managem5t fee  7,a7 ,9 g5]al ,!     
,secret>y %all e/abli% a s*$ule ( p]    
applicable b5efici>y p] mon? c>e        

managem5t fees4 ,su* a p] applicable    
b5efici>y p] mon? c>e managem5t fee %all
 be paid to a p>ticipant 9 addition to  
any o!r am\nt o!rwise payable "u ?is    
title to ! heal? c>e practition]s 9 !   
p>ticipant's opioid use disord] c>e team
 or1 if applicable1 to ! p>ticipant4 ,a 
p>ticipant may use su* p] applicable    
b5efici>y p] mon? c>e managem5t fee to  
deliv] additional s]vices to applicable 
b5efici>ies1 includ+ s]vices n o!rwise  
eligible = paym5t "u ?is title4  7,b7   
,paym5t am\nts ,9 c>ry+ out subp>agraph 
7,a71 ! ,secret>y %all-- 7i7 consid]    
paym5ts o!rwise payable "u ?is title =  
opioid use disord] treatm5t s]vices & ! 
ne$s ( applicable b5efici>ies2  7ii7 pay
 a high] p] applicable b5efici>y p] mon?
 c>e managem5t fee = an applicable      
b5efici>y :o receives m int5sive        
treatm5t s]vices f a p>ticipant & = :om 
^? s]vices are appropriate bas$ on      
cl9ical guidel9es = opioid use disord]  
c>e2  7iii7 pay a high] p] applicable   
b5efici>y p] mon? c>e managem5t fee = ! 

mon? 9 :i* ! applicable b5efici>y beg9s 
treatm5t ) a p>ticipant ?an 9 subsequ5t 
mon?s1 to reflect ! great] "t & co/s    
requir$ = ! plann+ & initiation (       
treatm5t1 z comp>$ to ma9t5ance (       
treatm5t2  7iv7 pay high] p] applicable 
b5efici>y p] mon? c>e managem5t fees =  
p>ticipants t h e/abli%$ opioid use     
disord] c>e teams t include an addiction
 speciali/ 7z def9$ 9 subsection        
7c77#c77;,b772 &  7v7 take into acc\nt  
:e!r a p>ticipant's opioid use disord]  
c>e team ref]s applicable b5efici>ies to
 o!r suppli]s or provid]s = any opioid  
use disord] treatm5t s]vices4  7,c7 ,no 
duplicate paym5t ,! ,secret>y %all make 
paym5ts "u ?is p>agraph to only "o      
p>ticipant = s]vices furni%$ to an      
applicable b5efici>y dur+ a cal5d> mon?4
  7#b7 ,inc5tive paym5ts  7,a7 ,9 g5]al 
,"u ! ,program1 ! ,secret>y %all e/abli%
 a p]=mance-bas$ inc5tive paym5t1 :i*   
%all be paid 7us+ a me?odology e/abli%$ 
& at a "t det]m9$ appropriate by !      
,secret>y7 to p>ticipants bas$ on !     

p]=mance ( p>ticipants ) respect to     
crit]ia1 z det]m9$ appropriate by !     
,secret>y1 9 accordance ) subp>agraph   
7,b74  7,b7 ,crit]ia  7i7 ,9 g5]al      
,crit]ia describ$ 9 subp>agraph 7,a7 may
 include consid]ation ( ! foll[+3 7,i7  
,pati5t engagem5t & ret5tion 9 treatm5t4
  7,,ii7 ,evid5ce-bas$ m$ication-assi/$ 
treatm5t4  7,,iii7 ,o!r crit]ia e/abli%$
 by ! ,secret>y4  7ii7 ,requir$         
consultation & consid]ation ,9 det]m9+  
crit]ia describ$ 9 subp>agraph 7,a71 !  
,secret>y %all-- 7,i7 consult )         
/akehold]s1 includ+ cl9icians 9 ! prim>y
 c>e community & 9 ! field ( addiction  
m$ic9e2 &  7,,ii7 consid] exi/+ cl9ical 
guidel9es = ! treatm5t ( opioid use     
disord]s4  7,c7 ,no duplicate paym5t ,! 
,secret>y %all ensure t no duplicate    
paym5ts "u ?is p>agraph are made )      
respect to an applicable b5efici>y4  7f7
 ,multipay] /rategy ,9 c>ry+ out !      
,program1 ! ,secret>y %all enc\rage o!r 
pay]s to provide simil> paym5ts & to use
 simil> crit]ia z appli$ "u ! ,program  

"u subsection 7e77#b77;,c74 ,! ,secret>y
 may ent] into a memor&um ( und]/&+ )   
o!r pay]s to align ! me?odology = paym5t
 provid$ by su* a pay] relat$ to opioid 
use disord] treatm5t s]vices ) su*      
me?odology = paym5t "u ! ,program4  7g7 
,evaluation  7#a7 ,9 g5]al ,! ,secret>y 
%all conduct an int]m$iate & f9al       
evaluation ( ! program4 ,ea* su*        
evaluation %all det]m9e ! ext5t to :i*  
ea* ( ! purposes describ$ 9 subsection  
7b7 h be5 accompli%$ "u ! ,program4     
7#b7 ,reports ,! ,secret>y %all submit  
to ! ,secret>y & ,congress-- 7,a7 a     
report ) respect to ! int]m$iate        
evaluation "u p>agraph 7#a7 n lat] ?an  
#c ye>s aft] ! date ( ! implem5tation ( 
! ,program2 &  7,b7 a report ) respect  
to ! f9al evaluation "u p>agraph 7#a7 n 
lat] ?an #f ye>s aft] su* date4  7h7    
,fund+  7#a7 ,adm9i/rative fund+ ,= !   
purposes ( implem5t+1 adm9i/]+1 & c>ry+ 
out ! ,program 7o!r ?an = purposes      
describ$ 9 p>agraph 7#b771 #e million   
%all be available f ! ,f$]al            

,supplem5t>y ,m$ical ,insurance ,tru/   
,fund "u section #ahda4  7#b7 ,c>e      
managem5t fees & inc5tives ,= ! purposes
 ( mak+ paym5ts "u subsection 7e71 #aj  
million %all be available f ! ,f$]al    
,supplem5t>y ,m$ical ,insurance ,tru/   
,fund "u section #ahda = ea* ( fiscal   
ye>s #bjba ?r\gh #bjbd4  7#c7           
,availability ,am\nts transf]r$ "u ?is  
subsection = a fiscal ye> %all be       
available until exp5d$4  7i7 ,waiv]s ,! 
,secret>y may waive any provision ( ?is 
title z may be necess>y to c>ry out !   
,program "u ?is section4  4  #c4        
,requir+ e-prescrib+ = cov]age ( cov]$  
"p ,d controll$ sub/ances  7a7 ,9 g5]al 
,section #ahfj;,d-#d7;e7 ( ! ,social    
,security ,act 7#db ,u4,s4,c4           
#aciew-#ajd7;e77 is am5d$ by add+ at !  
end ! foll[+3  7#g7 ,requirem5t (       
e-prescrib+ = controll$ sub/ances  7,a7 
,9 g5]al ,subject to subp>agraph 7,b71 a
 prescription = a cov]$ "p ,d drug "u a 
prescription drug plan 7or "u an        
,,ma-,,pd plan7 = a s*$ule ,,ii1 ,,iii1 

,,iv1 or ,v controll$ sub/ance %all be  
transmitt$ by a heal? c>e practition]   
electronically 9 accordance ) an        
electronic prescription drug program t  
meets ! requirem5ts ( p>agraph 7#b74    
7,b7 ,exception = c]ta9 circum/ances ,! 
,secret>y %all1 pursuant to rulemak+1   
specify circum/ances ) respect to :i* ! 
,secret>y may waive ! requirem5t "u     
subp>agraph 7,a71 ) respect to a cov]$  
"p ,d drug1 includ+ 9 ! case (--  7i7 a 
prescription issu$ :5 ! practition] &   
disp5s] are ! same entity2  7ii7 a      
prescription issu$ t _c be transmitt$   
electronically "u ! mo/ rec5tly         
implem5t$ v]sion ( ! ,national ,c\ncil =
 ,prescription ,drug ,programs ,,script 
,/&>d2  7iii7 a prescription issu$ by a 
practition] :o has receiv$ a waiv] or a 
r5ewal !re( = a specifi$ p]iod det]m9$  
by ! ,secret>y1 n to exce$ #a ye>1 f !  
requirem5t to use electronic prescrib+1 
pursuant to a process e/abli%$ by       
regulation by ! ,secret>y1 due to       
demon/rat$ economic h>d%ip1 te*nological

 limitations t are n reasonably )9 !    
control ( ! practition]1 or o!r         
exceptional circum/ance demon/rat$ by ! 
practition]2  7iv7 a prescription issu$ 
by a practition] "u circum/ances 9 :i*1 
not)/&+ ! practition]'s ability to      
submit a prescription electronically z  
requir$ by ?is subsection1 su*          
practition] reasonably det]m9es t x w\ld
 be impractical = ! individual involv$  
to obta9 sub/ances prescrib$ by         
electronic prescription 9 a timely      
mann]1 & su* delay w\ld adv]sely impact 
! individual's m$ical condition involv$2
  7v7 a prescription issu$ by a         
practition] all[+ = ! disp5s+ ( a       
non-pati5t specific prescription        
pursuant to a /&+ ord]1 approv$ protocol
 = drug !rapy1 collaborative drug       
managem5t1 or compreh5sive m$ication    
managem5t1 9 response to a public heal? 
em]g5cy1 or o!r circum/ances :]e !      
practition] may issue a non-pati5t      
specific prescription2  7vi7 a          
prescription issu$ by a practition]     

prescrib+ a drug "u a rese>* protocol2  
7vii7 a prescription issu$ by a         
practition] = a drug = :i* ! ,food &    
,drug ,adm9i/ration requires a          
prescription to conta9 elem5ts t are n  
able to be includ$ 9 electronic         
prescrib+1 su* z a drug ) risk          
evaluation & mitigation /rategies t     
include elem5ts to assure safe use2 &   
7viii7 a prescription issu$ by a        
practition] = an individual :o--  7,i7  
receives hospice c>e "u ?is title2 or   
7,,ii7 is a resid5t ( a skill$ nurs+    
facility 7z def9$ 9 section #ahai7;a771 
or a m$ical in/itution or nurs+ facility
 = :i* paym5t is made = an              
in/itutionaliz$ individual "u section   
#aijb7q77#a77;,b71 = :i* frequ5tly abus$
 drugs are disp5s$ = resid5ts ?r\gh a   
contract ) a s+le ph>macy1 z det]m9$ by 
! ,secret>y 9 accordance ) ?is p>agraph4
  7,c7 ,disp5s+ ,no?+ 9 ?is p>agraph    
%all be con/ru$ z requir+ a sponsor ( a 
prescription drug plan "u ?is "p1 ,,ma  
organization (f]+ an ,,ma-,,pd plan "u  

"p ,c1 or a ph>maci/ to v]ify t a       
practition]1 ) respect to a prescription
 = a cov]$ "p ,d drug1 has a waiv] 7or  
is o!rwise exempt7 "u subp>agraph 7,b7 f
 ! requirem5t "u subp>agraph 7,a74 ,no?+
 9 ?is p>agraph %all be con/ru$ z       
affect+ ! ability ( ! plan to cov] or ! 
ph>maci/s' ability to cont9ue to disp5se
 cov]$ "p ,d drugs f o!rwise valid      
writt51 oral or fax prescriptions t are 
consi/5t ) laws & regulations4 ,no?+ 9  
?is p>agraph %all be con/ru$ z affect+ !
 ability ( ! b5efici>y involv$ to       
designate a p>ticul> ph>macy to disp5se 
a prescrib$ drug to ! ext5t consi/5t ) !
 requirem5ts "u subsection 7b77#a7 & "u 
?is p>agraph4  7,d7 ,en=cem5t ,!        
,secret>y %all1 pursuant to rulemak+1 h 
au?ority to en=ce & specify appropriate 
p5alties = non-compliance ) ! requirem5t
 "u subp>agraph 7,a74  4  7b7 ,effective
 date ,! am5dm5t made by subsection 7a7 
%all apply to cov]age ( drugs prescrib$ 
on or aft] ,janu>y #a1 #bjba4  ,pass$ ! 
,h\se ( ,repres5tatives ,june #ai1      

#bjah4;,cl]k4