#aae? ,,congress  #b;d ,session  ,h4 ,r4
 #eggd  ,,an ,,act  ,to require !       
,secret>y ( ,heal? & ,human ,s]vices to 
develop guidance on pa9 managem5t &     
opioid use disord] prev5tion = hospitals
 receiv+ paym5t "u "p ,a ( ! ,m$ic>e    
program1 provide = opioid quality       
measures developm5t1 & provide = a      
te*nical exp]t panel on r$uc+ surgical  
sett+ opioid use & data collection on   
p]iop]ative opioid use1 & = o!r         
purposes4  #a4 ,%ort title ,?is ,act may
 be cit$ z ! ,combat+ ,opioid ,abuse =  
,c>e 9 ,hospitals ,act ( #bjah or !     
,,coa* ,act ( #bjah4  #b4 ,develop+     
guidance on pa9 managem5t & opioid use  
disord] prev5tion = hospitals receiv+   
paym5t "u "p ,a ( ! ,m$ic>e program  7a7
 ,9 g5]al ,n lat] ?an ,janu>y #a1 #bjai1
 ! ,secret>y ( ,heal? & ,human ,s]vices 
79 ?is section ref]r$ to z ! ,secret>y7 
%all develop & publi% on ! public       
website ( ! ,c5t]s = ,m$ic>e  ,m$icaid  
,s]vices guidance = hospitals receiv+   
paym5t "u "p ,a ( title ,,xviii ( !     

,social ,security ,act 7#db ,u4,s4,c4   
#acie;c et seq47 on pa9 managem5t       
/rategies & opioid use disord] prev5tion
 /rategies ) respect to individuals     
entitl$ to b5efits "u su* "p4  7b7      
,consultation ,9 develop+ ! guidance    
describ$ 9 subsection 7a71 ! ,secret>y  
%all consult ) relevant /akehold]s1     
includ+-- 7#a7 m$ical pr(essional       
organizations2  7#b7 provid]s & suppli]s
 ( s]vices 7z su* t]ms are def9$ 9      
section #ahfa ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #aciex772  7#c7 heal?   
c>e consum]s or gr\ps repres5t+ su*     
consum]s2 &  7#d7 o!r entities det]m9$  
appropriate by ! ,secret>y4  7c7        
,cont5ts ,! guidance describ$ 9         
subsection 7a7 %all include1 ) respect  
to hospitals & individuals describ$ 9   
su* subsection1 ! foll[+3  7#a7 ,be/    
practices reg>d+ evid5ce-bas$ scre5+ &  
practition] education initiatives relat+
 to scre5+ & treatm5t protocols = opioid
 use disord]1 includ+-- 7,a7 me?ods to  
id5tify su* individuals at-risk ( opioid

 use disord]1 includ+ risk              
/ratification2  7,b7 ways to prev5t1    
recognize1 & treat opioid ov]doses2 &   
7,c7 res\rces available to su*          
individuals1 su* z opioid treatm5t      
programs1 pe] support gr\ps1 & o!r      
recov]y programs4  7#b7 ,be/ practices =
 su* hospitals to educate practition]s  
furni%+ items & s]vices at su* hospital 
) respect to pa9 managem5t & sub/ance   
use disord]s1 includ+ education on--    
7,a7 ! adv]se effects ( prolong$ opioid 
use2  7,b7 non-opioid1 evid5ce-bas$1    
non-ph>macological pa9 managem5t        
treatm5ts2  7,c7 monitor+ programs =    
individuals :o h be5 prescrib$ opioids2 
&  7,d7 ! prescrib+ ( naloxone along )  
an initial opioid prescription4  7#c7   
,be/ practices = su* hospitals to make  
su* individuals aw>e ( ! risks associat$
 ) opioid use 7:i* may include use ( !  
notification template describ$ 9        
p>agraph 7#d774  7#d7 ,a notification   
template develop$ by ! ,secret>y1 = use 
z appropriate1 = su* individuals :o are 

prescrib$ an opioid t-- 7,a7 expla9s !  
risks & side effects associat$ ) opioid 
use 7includ+ ! risks ( addiction &      
ov]dose7 & ! importance ( adh]+ to !    
prescrib$ treatm5t regim51 avoid+       
m$ications t may h an adv]se int]action 
) su* opioid1 & /or+ su* opioid safely &
 securely2  7,b7 highlights multimodal &
 evid5ce-bas$ non-opioid alt]natives =  
pa9 managem5t2  7,c7 enc\rages su*      
individuals to talk to _! heal? c>e     
provid]s ab\t su* alt]natives2  7,d7    
provides = a me?od 7?r\gh signature or  
o!rwise7 = su* an individual1 or p]son  
act+ on su* individual's behalf1 to     
ackn[l$ge receipt ( su* notification    
template2  7,e7 is word$ 9 an easily    
und]/&able mann] & made available 9     
multiple languages det]m9$ appropriate  
by ! ,secret>y2 &  7,f7 includes any o!r
 in=mation det]m9$ appropriate by !     
,secret>y4  7#e7 ,be/ practices = su*   
hospital to track opioid prescrib+ tr5ds
 by practition]s furni%+ items & s]vices
 at su* hospital1 includ+--  7,a7 ways =

 su* hospital to e/abli% t>get levels1  
tak+ into acc\nt ! specialties ( su*    
practition]s & ! geographic area 9 :i*  
su* hospital is locat$1 ) respect to    
opioids prescrib$ by su* practition]s2  
7,b7 guidance on *eck+ ! m$ical records 
( su* individuals aga9/ in=mation       
includ$ 9 prescription drug monitor+    
programs2  7,c7 /rategies to r$uce      
long-t]m opioid prescriptions2 &  7,d7  
me?ods to id5tify su* practition]s :o   
may be ov]-prescrib+ opioids4  7#f7 ,o!r
 in=mation ! ,secret>y det]m9es         
appropriate1 includ+ any su* in=mation f
 ! ,opioid ,safety ,initiative e/abli%$ 
by ! ,dep>tm5t ( ,vet]ans ,affairs or ! 
,opioid ,ov]dose ,prev5tion ,toolkit    
publi%$ by ! ,sub/ance ,abuse & ,m5tal  
,heal? ,s]vices ,adm9i/ration4  #c4     
,requir+ ! review ( quality measures    
relat+ to opioids & opioid use disord]  
treatm5ts furni%$ "u ! m$ic>e program & 
o!r f$]al heal? c>e programs  7a7 ,9    
g5]al ,section #ahij;,a ( ! ,social     
,security ,act 7#db ,u4,s4,c4           

#acie;aaa-#a7 is am5d$ by add+ at ! end 
! foll[+ new subsection3  7g7 ,te*nical 
exp]t panel review ( opioid & opioid use
 disord] quality measures  7#a7 ,9 g5]al
 ,n lat] ?an #ahj days aft] ! date ( !  
enactm5t ( ?is subsection1 ! ,secret>y  
%all e/abli% a te*nical exp]t panel =   
purposes ( review+ quality measures     
relat+ to opioids & opioid use disord]s1
 includ+ c>e1 prev5tion1 diagnosis1     
heal? outcomes1 & treatm5t furni%$ to   
individuals ) opioid use disord]s4 ,!   
,secret>y may use ! entity ) a contract 
"u section #ahij7;a7 & am5d su* contract
 z necess>y to provide = ! e/abli%m5t ( 
su* te*nical exp]t panel4  7#b7 ,review 
& assessm5t ,n lat] ?an #a ye> aft] !   
date ! te*nical exp]t panel describ$ 9  
p>agraph 7#a7 is e/abli%$ 7& p]iodically
 !reaft] z ! ,secret>y det]m9es         
appropriate71 ! te*nical exp]t panel    
%all--  7,a7 review quality measures t  
relate to opioids & opioid use disord]s1
 includ+ exi/+ measures & ^? "u         
developm5t2  7,b7 id5tify gaps 9 areas (

 quality measurem5t t relate to opioids 
& opioid use disord]s1 & id5tify measure
 developm5t priorities = su* measure    
gaps2 &  7,c7 make recomm5dations to !  
,secret>y on quality measures ) respect 
to opioids & opioid use disord]s =      
purposes ( improv+ c>e1 prev5tion1      
diagnosis1 heal? outcomes1 & treatm5t1  
includ+ recomm5dations = revisions ( su*
 measures1 ne$ = developm5t ( new       
measures1 & recomm5dations = includ+ su*
 measures 9 ! ,m]it-,bas$ ,inc5tive     
,paym5t ,sy/em "u section #ahdh7q71 !   
alt]native paym5t models "u section     
#ahcc7z77#c77;,c71 ! %>$ sav+s program  
"u section #ahii1 ! quality report+     
requirem5ts = inpati5t hospitals "u     
section #ahhf7;b77#c77;,b77viii71 & !   
hospital value-bas$ pur*as+ program "u  
section #ahhf7o74  7#c7 ,consid]ation ( 
measures by secret>y ,! ,secret>y %all  
consid]--  7,a7 us+ opioid & opioid use 
disord] measures 7includ+ measures us$  
"u ! ,m]it-,bas$ ,inc5tive ,paym5t      
,sy/em "u section #ahdh7q71 measures    

recomm5d$ "u p>agraph 7#b77;,c71 & o!r  
su* measures id5tifi$ by ! ,secret>y7 9 
alt]native paym5t models "u section     
#ahcc7z77#c77;,c7 & 9 ! %>$ sav+s       
program "u section #ahii2 &  7,b7 us+   
opioid measures describ$ 9 subp>agraph  
7,a71 z applicable1 9 ! quality report+ 
requirem5ts = inpati5t hospitals "u     
section #ahhf7;b77#c77;,b77viii71& 9 !  
hospital value-bas$ pur*as+ program "u  
section #ahhf7o74  7#d7 ,prioritization 
( measure developm5t ,! ,secret>y %all  
prioritize = measure developm5t ! gaps 9
 quality measures id5tifi$ "u p>agraph  
7#b77;,b74  4  7b7 ,exp$it$ endorsem5t  
process = opioid measures ,section      
#ahij7;b77#b7 ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #acie;aaa7b77#b77 is    
am5d$ by add+ at ! end ! foll[+ new flu%
 s5t5ce3  ,su* endorsem5t process %all1 
z det]m9$ practicable by ! entity1      
provide = an exp$it$ process ) respect  
to ! endorsem5t ( su* measures relat+ to
 opioids & opioid use disord]s4 4  #d4  
,te*nical exp]t panel on r$uc+ surgical 

sett+ opioid use2 ,data collection on   
p]iop]ative opioid use  7a7 ,te*nical   
exp]t panel on r$uc+ surgical sett+     
opioid use  7#a7 ,9 g5]al ,n lat] ?an #f
 mon?s aft] ! date ( ! enactm5t ( ?is   
,act1 ! ,secret>y ( ,heal? & ,human     
,s]vices %all conv5e a te*nical exp]t   
panel1 includ+ m$ical & surgical        
specialty societies & hospital          
organizations1 to provide recomm5dations
 on r$uc+ opioid use 9 ! inpati5t &     
outpati5t surgical sett+s & on be/      
practices = pa9 managem5t1 includ+ )    
respect to ! foll[+3 7,a7 ,approa*es t  
limit pati5t exposure to opioids dur+ ! 
p]iop]ative p]iod1 includ+ pre-surgical 
& po/-surgical injections1 & t id5tify  
su* pati5ts at risk ( opioid use disord]
 pre-op]ation4  7,b7 ,%>$ decision mak+ 
) pati5ts & families on pa9 managem5t1  
includ+ recomm5dations = ! developm5t ( 
an evaluation & managem5t code =        
purposes ( paym5t "u ! ,m$ic>e program  
"u title ,,xviii ( ! ,social ,security  
,act t w\ld acc\nt = "t sp5t on %>$     

decision mak+4  7,c7 ,education on !    
safe use1 /orage1 & disposal ( opioids4 
7,d7 ,prev5tion ( opioid misuse & abuse 
aft] dis*>ge4  7,e7 ,developm5t ( a     
cl9ical algori?m to id5tify & treat     
at-risk1 opiate-tol]ant pati5ts & r$uce 
reliance on opioids = acute pa9 dur+ !  
p]iop]ative p]iod4  7#b7 ,report ,n lat]
 ?an #a ye> aft] ! date ( ! enactm5t (  
?is ,act1 ! ,secret>y %all submit to    
,congress & make public a report conta9+
 ! recomm5dations develop$ "u p>agraph  
7#a7 & an action plan = broad]          
implem5tation ( pa9 managem5t protocols 
t limit ! use ( opioids 9 ! p]iop]ative 
sett+ & ^u dis*>ge f su* sett+4  7b7    
,data collection on p]iop]ative opioid  
use ,n lat] ?an #a ye> aft] ! date ( !  
enactm5t ( ?is ,act1 ! ,secret>y (      
,heal? & ,human ,s]vices %all submit to 
,congress a report t conta9s ! foll[+3  
7#a7 ,! diagnosis-relat$ gr\p codes     
id5tifi$ by ! ,secret>y z hav+ ! highe/ 
volume ( surg]ies4  7#b7 ,) respect to  
ea* ( su* diagnosis-relat$ gr\p codes s 

id5tifi$1 a det]m9ation by ! ,secret>y (
 ! data t is bo? available & report$ on 
opioid use foll[+ su* surg]ies1 su* z ) 
respect to--  7,a7 surgical volumes1    
practices1 & opioid prescrib+ patt]ns2  
7,b7 opioid consumption1 includ+--  7i7 
p]iop]ative days ( !rapy2  7ii7 av]age  
daily dose at ! hospital1 includ+ dosage
 great] ?an #ij milligram morph9e       
equival5t2  7iii7 po/-dis*>ge           
prescriptions & o!r comb9ation drugs t  
are us$ be=e int]v5tion & aft]          
int]v5tion2  7iv7 quantity & duration ( 
opioid prescription at dis*>ge2 &  7v7  
quantity consum$ & numb] ( refills2     
7,c7 regional ane/hesia & analgesia     
practices1 includ+ pre-surgical &       
po/-surgical injections2  7,d7 naloxone 
rev]sal2  7,e7 po/-op]ative respiratory 
failure2  7,f7 in=mation ab\t /orage &  
disposal2 &  7,g7 su* o!r in=mation z ! 
,secret>y may specify4  7#c7            
,recomm5dations = improv+ data          
collection on p]iop]ative opioid use1   
includ+ an analysis to id5tify & r$uce  

b>ri]s to collect+1 report+1 & analyz+ !
 data describ$ 9 p>agraph 7#b71 includ+ 
b>ri]s relat$ to te*nological           
availability4  #e4 ,requir+ ! po/+ &    
p]iodic update ( opioid prescrib+       
guidance = ,m$ic>e b5efici>ies  7a7 ,9  
g5]al ,n lat] ?an #ahj days aft] ! date 
( ! enactm5t ( ?is ,act1 ! ,secret>y (  
,heal? & ,human ,s]vices 79 ?is section 
ref]r$ to z ! ,secret>y7 %all po/ on !  
public website ( ! ,c5t]s = ,m$ic>e     
,m$icaid ,s]vices all guidance publi%$  
by ! ,dep>tm5t ( ,heal? & ,human        
,s]vices on or aft] ,janu>y #a1 #bjaf1  
relat+ to ! prescrib+ ( opioids &       
applicable to opioid prescriptions =    
individuals entitl$ to b5efits "u "p ,a 
( title ,,xviii ( ! ,social ,security   
,act 7#db ,u4,s4,c4 #acie;c et seq47 or 
enroll$ "u "p ,b ( su* title ( su* ,act 
7#db ,u4,s4,c4 #acie;j et seq474  7b7   
,update ( guidance  7#a7 ,p]iodic update
 ,! ,secret>y %all1 9 consultation ) !  
entities specifi$ 9 p>agraph 7#b71      
p]iodically 7z det]m9$ appropriate by ! 

,secret>y7 update guidance describ$ 9   
subsection 7a7 & revise ! po/+ ( su*    
guidance on ! website describ$ 9 su*    
subsection4  7#b7 ,consultation ,!      
entities specifi$ 9 ?is p>agraph are !  
foll[+3  7,a7 ,m$ical pr(essional       
organizations4  7,b7 ,provid]s &        
suppli]s ( s]vices 7z su* t]ms are def9$
 9 section #ahfa ( ! ,social ,security  
,act 7#db ,u4,s4,c4 #aciex774  7,c7     
,heal? c>e consum]s or gr\ps repres5t+  
su* consum]s4  7,d7 ,o!r entities       
det]m9$ appropriate by ! ,secret>y4     
,pass$ ! ,h\se ( ,repres5tatives ,june  
#ai1 #bjah4;,cl]k4