,i  #aae? ,,congress  #b;d ,session  ,h4
 ,r4 #efje  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,april #bd1 #bjah ,mr4
 ,ruiz introduc$ ! foll[+ bill2 :i* 0   
ref]r$ to ! ,committee on ,en]gy &      
,comm]ce1 & 9 addition to ! ,committee  
on ,ways & ,means1 = 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$  ,a ,,bill  ,to am5d title      
,,xviii ( ! ,social ,security ,act to   
provide = an opioid use disord] treatm5t
 demon/ration program4  #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 ( #e-,ye>   

demon/ration program  7#a7 ,9 g5]al ,n  
lat] ?an ,janu>y #a1 #bjba1 ! ,secret>y 
%all implem5t a #e-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$uce exp5ditures "u ?is      
title4 ,"u ! ,program1 ! ,secret>y %all 
make paym5ts "u subsection 7f7 to       
p>ticipat+ c>e teams 7z def9$ 9         
subsection 7c77#a77;,a77 = provid+      
opioid use disord] treatm5t s]vices to  
applicable b5efici>ies p>ticipat+ "u !  
,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 9 an outpati5t sett+ &--  7i7  
:i* are support$ by ! p] applicable     
b5efici>y p] mon? c>e managem5t fee "u  

subsection 7f72 or  7ii7 = :i* paym5t   
may o!rwise be made "u ?is title2 &     
7,b7 includes--  7i7 m$ication assi/$   
treatm5t2  7ii7 treatm5t plann+2  7iii7 
appropriate outpati5t psy*iatric1       
psy*ological1 or c\nsel+ s]vices 7or any
 comb9ation ( su* s]vices72  7iv7       
appropriate social support s]vices2 &   
7v7 c>e managem5t & c>e coord9ation (   
opioid use disord] s]vices1 z well z    
coord9ation ) o!r physicians & provid]s 
treat+ ! m5tal & physical conditions (  
su* b5efici>y4  7b7 ,program design     
7#a7 ,9 g5]al ,! ,secret>y %all design !
 ,program 9 su* a mann] to evaluate !   
ext5t to :i* ! ,program accompli%es !   
foll[+ purposes3  7,a7 ,r$uces          
hospitalizations & em]g5cy dep>tm5t     
visits4  7,b7 ,r$uces ! occurr5ce (     
ov]doses f opioids1 includ+ prescription
 opioid m$ications z well z illicit     
opioids4  7,c7 ,increases use (         
m$ication-assi/$ treatm5t = opioid use  
disord]s4  7,d7 ,improves heal? outcomes
 ( individuals ) opioid use disord]s1   

includ+ by r$uc+ ! incid5ce ( infecti\s 
diseases 7su* z hepatitis ,c & ,,hiv74  
7,e7 ,does n increase ! total sp5d+ on  
heal? c>e s]vices "u ?is title4  7,f7   
,r$uces dea?s f opioid poison+4  7,g7   
,r$uces ! utilization ( inpati5t        
resid5tial treatm5t4  7#b7 ,consultation
 ,9 design+ ! ,program1 ! ,secret>y     
%all1 n lat] ?an #c mon?s aft] ! date ( 
! enactm5t ( ?is section1 consult )     
speciali/s 9 ! field ( addiction &      
cl9icians 9 ! prim>y c>e community4  7c7
 ,p>ticipat+ c>e teams  7#a7 ,def9ition2
 selection  7,a7 ,def9ition ,9 ?is      
section1 ! t]m p>ticipat+ c>e team means
 an opioid use disord] c>e team 7z def9$
 9 p>agraph 7#b77 t is p>ticipat+ "u !  
,program pursuant to selection by !     
,secret>y "u subp>agraph 7,b74  7,b7    
,selection ,"u ! ,program1 ! ,secret>y  
%all provide = a process = opioid use   
disord] c>e teams to apply =            
p>ticipation "u ! ,program z p>ticipat+ 
c>e teams & = select+ su* teams = su*   
p>ticipation4  7,c7 ,pref]5ce ,9 select+

 opioid use disord] c>e teams "u        
subp>agraph 7,b7 = p>ticipation "u !    
,program1 ! ,secret>y %all give pref]5ce
 to opioid use disord] c>e teams t are  
locat$ 9 areas ) a preval5ce ( opioid   
use disord]s t is high] ?an ! national  
av]age preval5ce1 z measur$ by aggregate
 ov]doses ( opioids1 or any o!r measure 
t ! ,secret>y deems appropriate4  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 gr\p
 ( heal? c>e practition]s1 or an entity 
employ+ or contract+ ) su* heal? c>e    
practition]s1 t--  7i7 includes at lea/ 
"o physician :o is provid+ prim>y c>e   
s]vices or addiction treatm5t s]vices to
 an applicable b5efici>y dur+ ! p]iod 9 
:i* ! opioid use disord] c>e team is    
receiv+ paym5ts "u subsection 7f72  7ii7
 includes at lea/ "o eligible           
practition] 7z def9$ 9 p>agraph         
7#c77;,a771 :o may be a physician :o    
meets ! crit]ion 9 clause 7i72 &  7iii7 
includes o!r practition]s-- 7,i7 z      

necess>y to deliv] appropriate          
psy*iatric1 psy*ological1 c\nsel+1 &    
social s]vices to applicable b5efici>ies
 9 addition to ! s]vices deliv]$ by !   
eligible practition]2 &  7,,ii7 :o only 
p]=m s]vices t su* practition]s are     
legally au?oriz$ to p]=m "u ,/ate law4  
7,b7 ,requirem5ts = p>ticipation ,9 ord]
 = an opioid use disord] c>e team to    
p>ticipate 9 ! ,program z a p>ticipat+  
c>e team1 ea* ( ! practition]s          
p>ticipat+ on ! team %all agree to--    
7i7 deliv] opioid use disord] treatm5t  
s]vices to applicable b5efici>ies :o    
agree to receive ! s]vices2  7ii7 meet  
m9imum /&>ds = quality requir$ by !     
,program2 &  7iii7 submit to !          
,secret>y1 ) respect to ea* applicable  
b5efici>y = :om su* practition] provides
 opioid use disord] treatm5t s]vices1   
data ) respect to ! quality /&>ds & !   
measures def9$ 9 subsection 7d7 & su*   
o!r in=mation z ! ,secret>y det]m9es    
appropriate to monitor & evaluate !     
,program & to det]m9e ! p]=mance ( ea*  

practition] = purposes ( ! inc5tive     
paym5t "u subsection 7f71 9 su* =m1     
mann]1 & frequ5cy z specifi$ by !       
,secret>y4  7#c7 ,eligible practition]s2
 ,o!r provid]-relat$ def9itions &       
application provisions  7,a7 ,eligible  
practition]s ,= purposes ( ?is section1 
! t]m eligible practition] means1 )     
respect to an applicable b5efici>y1 a   
provid] ( s]vices t-- 7i7 p>ticipates 9 
! ,m$ic>e program "u ?is title2  7ii7   
7,i7 is au?oriz$ to prescribe or disp5se
 n>cotic drugs to individuals =         
ma9t5ance treatm5t or detoxification    
treatm5t2 &  7,,ii7 has 9 effect a      
regi/ration or 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* section2 &  7iii7 ) respect
 to furni%+ opioid use disord] treatm5t 
s]vices to ! applicable b5efici>y1      
p>ticipates 9 an opioid use disord] c>e 

team1 :i* is a p>ticipat+ c>e team4     
7,b7 ,addiction speciali/s ,= purposes (
 p>agraph 7#b77;,c71 ! t]m addiction    
speciali/ means a physician t possesses 
exp]t k & skills 9 addiction m$ic9e1 z  
evid5c$ by--  7i7 c]tification by !     
,am]ican ,society ( ,addiction ,m$ic9e  
or ! ,am]ican ,bo>d ( ,addiction        
,m$ic9e2  7ii7 subspecialty c]tification
 9 addiction m$ic9e by ! ,am]ican ,bo>d 
( ,prev5tive ,m$ic9e2  7iii7            
subspecialty c]tification 9 addiction   
psy*iatry by ! ,am]ican ,bo>d (         
,psy*iatry & ,neurology2  7iv7 a        
c]tificate ( add$ qualification 9       
addiction m$ic9e conf]r$ by ! ,am]ican  
,o/eopa?ic ,association2 or  7v7        
completion ( an accr$it$ resid5cy or    
fell[%ip 9 addiction m$ic9e or addiction
 psy*iatry4  7d7 ,quality & o!r report+ 
requirem5ts  7#a7 ,adoption & developm5t
 ( /&>ds & p]=mance measures ,n lat] ?an
 #i mon?s aft] ! date ( ! enactm5t ( ?is
 section1 ! ,secret>y1 9 conjunction )  
/akehold]s 7includ+ cl9icians 9 ! prim>y

 c>e community & ! field ( addiction    
m$ic9e71 %all adopt or develop 7or an   
appropriate entity ) :i* ! ,secret>y    
contracts %all develop7 quality /&>ds & 
me?ods ( assess+ ! quality ( c>e to     
ensure a m9imum level ( quality ( c>e & 
to det]m9e :e!r ! s]vices furni%$ by    
p>ticipat+ c>e teams are a*iev+ !       
purposes describ$ 9 subsection 7b77#a74 
,= purposes ( adopt+ or develop+ /&>ds =
 paym5ts "u subsection 7f77#a7 & =      
purposes ( adopt+ or develop+ me?ods =  
assess+ p]=mance = ! inc5tive paym5ts "u
 subsection 7f77#b71 ! ,secret>y may    
consid] exi/+ cl9ical guidel9es = !     
treatm5t ( opioid use disord]s & /&>ds  
or measures appli$ = use "u ! ,m$icaid  
program "u title ,,xix4 ,/&>ds &        
assessm5t me?ods %all address ! foll[+  
outcomes & p]=mance crit]ia3  7,a7      
,pati5t engagem5t 9 treatm5t4  7,b7     
,ret5tion 9 treatm5t4  7,c7 ,provision (
 evid5ce-bas$ m$ication-assi/$ treatm5t4
  7,d7 ,any o!r crit]ia ! ,secret>y     
deems appropriate4  7#b7 ,submission    

,ea* p>ticipat+ c>e team %all submit to 
! ,secret>y1 9 su* =m1 mann]1 & frequ5cy
 specifi$ by ! ,secret>y1 data ) respect
 to su* /&>ds & assessm5t me?ods & su*  
o!r in=mation z ! ,secret>y det]m9es    
appropriate to monitor & evaluate !     
,program & to det]m9e ! p]=mance ( su*  
team = purposes ( ! inc5tive paym5t "u  
subsection 7f77#b74  7e7 ,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$
 to b5efits "u "p ,a & enroll$ = b5efits
 "u "p ,b2  7,b7 is n enroll$ 9 a       
,m$ic>e ,advantage plan "u "p ,c2  7,c7 
has a diagnosis = an opioid use disord]2
 &  7,d7 meets su* o!r crit]ia z !      
,secret>y det]m9es appropriate4  ,su*   
t]m %all include an individual :o is    
dually eligible = b5efits "u ?is title &
 title ,,xix if su* individual satisfies
 ! crit]ia describ$ 9 subp>agraphs 7,a7 
?r\gh 7,d74  7#b7 ,volunt>y p>ticipation
 ,an applicable b5efici>y may p>ticipate

 9 ! ,program on a volunt>y basis & may 
t]m9ate p>ticipation 9 ! ,program at any
 "t4  7#c7 ,s]vices ,9 ord] to          
p>ticipate 9 ! ,program1 an applicable  
b5efici>y mu/ agree to receive opioid   
use disord] treatm5t s]vices f a        
p>ticipat+ c>e team4 ,an applicable     
b5efici>y may only receive s]vices      
support$ by ! ,program f "o p>ticipat+  
c>e team dur+ any "o cal5d> mon?4       
,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>ticipat+ c>e team4  7f7 ,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>ticipat+ c>e team 9     
addition to any o!r am\nt o!rwise       
payable "u ?is title to ! practition]s  
p>ticipat+ ) ! team or1 if applicable1 !
 entity ) respect to su* team employ+ or
 contract+ ) su* practition]s4 ,a       
p>ticipat+ c>e team 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 ,application 
,9 c>ry+ out subp>agraph 7,a71 !        
,secret>y %all-- 7i7 consid] ! co/s t   
p>ticipat+ c>e teams are expect$ to     
incur 9 deliv]+ high-quality opioid use 
disord] c>e s]vices t are n cov]$ by    
paym5ts o!rwise payable to ! teams "u   
?is title2  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>ticipat+ c>e team & :o is         
appropriate = su* s]vices 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>ticipat+ c>e team ?an 9  
subsequ5t mon?s1 to reflect ! great] "t 
& co/s requir$ = ! team to plan &       
initiate treatm5t1 z comp>$ to ma9t5ance
 ( treatm5t2 &  7iv7 pay high] p]       
applicable b5efici>y p] mon? c>e        
managem5t fees = p>ticipat+ c>e teams t 
include an addiction speciali/ :o is    
ei!r deliv]+ s]vices directly to        
applicable b5efici>ies or provid+       
consult+ support to ^? practition]s     
p>ticipat+ ) su* teams :o are deliv]+   
s]vices to applicable b5efici>ies4  7#b7
 ,inc5tive paym5ts ,"u ! ,program1 !    
,secret>y %all e/abli% a p]=mance-bas$  
inc5tive paym5t1 :i* %all be paid to    
p>ticipat+ c>e teams bas$ on ! p]=mance 
( su* teams ) respect to /&>ds &        
assessm5t me?ods adopt$ or develop$ by !

 ,secret>y "u subsection 7d7 & ) respect
 to :i* ! teams report "u su*           
subsection4  7g7 ,multipay] /rategy ,9  
c>ry+ out ! ,program1 ! ,secret>y %all  
enc\rage o!r pay]s to provide simil>    
paym5ts & to use simil> quality /&>ds & 
me?ods ( assessm5t z appli$ "u !        
,program4 ,! ,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  7h7 ,evaluation  
7#a7 ,9 g5]al ,! ,comptroll] ,g5]al ( ! 
,unit$ ,/ates %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 ,ea*
 evaluation %all also det]m9e ! ext5t to
 :i* ! /ructure & requirem5ts ( !       
,program facilitat$ or imp$$ !          
p>ticipation ( practition]s 9 ! program1
 ! p>ticipation ( b5efici>ies ) opioid  
use disord]1 & ! deliv]y ( high-quality 

opioid use disord] treatm5t s]vices4    
7#b7 ,reports ,! ,comptroll] ,g5]al ( ! 
,unit$ ,/ates %all submit to ! ,secret>y
 & ,congress-- 7,a7 a report ) respect  
to ! int]m$iate evaluation "u p>agraph  
7#a7 n lat] ?an #c ye>s aft] ! date ( ! 
implem5tation ( ! ,program2 &  7,b7 a   
report ) respect to ! f9al evaluation "u
 p>agraph 7#a7 n lat] ?an #f ye>s aft]  
su* date4  7i7 ,fund+  7#a7             
,adm9i/rative fund+ ,= ! purposes (     
implem5t+1 adm9i/]+1 & c>ry+ out !      
,program 7o!r ?an = purposes describ$ 9 
p>agraph 7#b771 !re %all be transf]r$ to
 ! ,secret>y = ! ,c5t] = ,m$ic>e        
,m$icaid ,s]vices ,program ,managem5t   
,acc\nt f ! ,f$]al ,supplem5t>y ,m$ical 
,insurance ,tru/ ,fund "u section #ahda 
#e1jjj1jjj4  7#b7 ,c>e managem5t fees & 
inc5tives ,= ! purposes ( paym5ts "u    
subsection 7f71 !re %all be transf]r$ to
 ! ,secret>y su* sums z are necess>y f !
 ,f$]al ,supplem5t>y ,m$ical ,insurance 
,tru/ ,fund "u section #ahda = ea* (    
fiscal ye>s #bjba ?r\gh #bjbe4  7#c7    

,availability ,am\nts transf]r$ "u ?is  
subsection = a fiscal ye> %all be       
available until exp5d$4  7j7 ,waiv]s ,! 
,secret>y may waive any provision ( ?is 
title t conflicts ) or imp$es !         
implem5tation ( ! provisions ( ?is      
section4  4