,i  #aaeth ,,congress  #b;d ,session    
,h4 ,r4 #efce  ,,in ,,the ,,house ,,of  
,,representatives  ,april #bf1 #bjah,mr4
 ,grothman introduced the following     
bill2 which was referred to the         
,committee on ,energy and ,commerce  ,a 
,,bill  ,to amend title ,,xix of the    
,social ,security ,act to impose        
restrictions under the ,medicaid program
 with respect to opioid prescriptions1  
and for other purposes4  #a4 ,short     
title ,this ,act may be cited as the    
,responsible ,opioid ,prescription ,act4
  #b4 ,medicaid restrictions relating to
 opioid prescriptions  7a7 ,in general  
,section #aibg7;d7 of the ,social       
,security ,act 7#db ,u4,s4,c4           
#acifr-#h7;d77 is amended by adding at  
the end the following new paragraph3    
7#h7 ,restrictions relating to opioids  
7,a7 ,in general ,subject to            
subparagraph 7,b71 with respect to      
calendar quarters beginning on or after 
,january #a1 #bjai1 a ,state may only   
provide coverage under the ,state plan  

7or a waiver of such plan7 for an opioid
 dispensed to an individual enrolled    
under the plan 7or waiver7 to the extent
 that--  7i7 in the case of an initial  
prescription for the opioid to the      
individual1 such prescription is limited
 to a maximum of a #g-;day supply2 and  
7ii7 in the case of a refill of such    
prescription1 such refill is limited to 
a maximum of a #cj-;day supply and      
prescribed only if a provider--  7,i7   
determines that the expected benefits of
 using the opioid to treat or improve   
the individual's pain or function1      
respectively1 outweigh the risks of such
 use2  7,,ii7 to the extent appropriate1
 combines the use of the opioid with    
non-pharmacologic therapy and non-opioid
 pharmacologic therapy2  7,,iii7        
establishes treatment goals for the     
individual and takes steps to ensure    
that the use of the opioid will be      
discontinued if the provider determines 
that the benefits of such use no longer 
outweigh the risks2 and  7,,iv7         

discusses with the individual the known 
risks of such use1 the realistic        
benefits of such use1 and the           
responsibilities of the provider and    
individual in managing such use4  7,b7  
,exception ,subparagraph 7,a7 shall not 
apply with respect to opioids dispensed 
to individuals who are-- 7i7 receiving  
treatment for cancer2  7ii7 receiving   
hospice or palliative care2 or  7iii7   
patients in a long-term care facility or
 a skilled nursing facility4  7,c7      
,definitions ,in this paragraph3 7i7    
,initial prescription ,the term initial 
prescription1 with respect to an        
individual1 includes the issuance of a  
new prescription to the individual for  
an opioid that the individual was       
previously prescribed1 provided that    
such new prescription is issued more    
than #fj days after the expiration of   
such previous prescription4  7ii7       
,opioid ,the term opioid has the meaning
 given such term in section #ajb of the 
,controlled ,substances ,act 7#ba       

,u4,s4,c4 #hjb7 and includes drugs      
included in schedules ,,ii1 ,,iii1 and  
,,iv of section #bjb7;c7 of such ,act   
7#ba ,u4,s4,c4 #hab7;c774  4  7b7       
,prohibition on payments for certain    
opioid prescriptions ,section #aijc7;i7 
of the ,social ,security ,act 7#db      
,u4,s4,c4 #acif;b7i77 is amended by     
inserting after paragraph 7#h7 the      
following new paragraph3  7#i7 with     
respect to opioids 7as defined in       
section #aibg7;d77#h77 dispensed in     
calendar quarters beginning on or after 
,january #a1 #bjai1 unless such opioids 
are dispensed in accordance with section
 #aibg7;d77#h72 or  4