,i  #aae? ,,congress  #b;d ,session  ,h4
 ,r4 #eggf  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,may #aa1 #bjah,mr4   
,neal 7= himself1 ,mr4 ,hold+1 ,mr4     
,c>twright1 & ,mr4 ,taylor7 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 to      
provide = ,m$ic>e cov]age ( c]ta9       
s]vices furni%$ by opioid treatm5t      
programs1 & = o!r purposes4  #a4 ,%ort  
title ,?is ,act may be cit$ z ! ,m$ic>e 
& ,opioid ,safe ,treatm5t ,act or !     
,,mo/ ,act4  #b4 ,m$ic>e cov]age ( c]ta9
 s]vices furni%$ by opioid treatm5t     
programs  7a7 ,cov]age ,section         
#ahfa7s77#b7 ( ! ,social ,security ,act 
7#db ,u4,s4,c4 #aciex7s77#b77 is am5d$--
  7#a7 9 subp>agraph 7,,ff71 by /rik+ at
 ! end &2  7#b7 9 subp>agraph 7,,gg71 by

 ins]t+ at ! end 2 &2 &  7#c7 by add+ at
 ! end ! foll[+ new subp>agraph3  7,,hh7
 opioid use disord] treatm5t s]vices 7z 
def9$ 9 subsection 7jjj774  4  7b7      
,opioid use disord] treatm5t s]vices &  
opioid treatm5t program def9$ ,section  
#ahfa ( ! ,social ,security ,act is     
am5d$ by add+ at ! end ! foll[+ new     
subsection3  7jjj7 ,opioid use disord]  
treatm5t s]vices2 opioid treatm5t       
program  7#a7 ,opioid use disord]       
treatm5t s]vices ,! t]m opioid use      
disord] treatm5t s]vices means items &  
s]vices t are furni%$ by an opioid      
treatm5t program = ! treatm5t ( opioid  
abuse disord]1 includ+--  7,a7 opioid   
agoni/ treatm5t m$ications 7includ+ oral
 v]sions7 t are approv$ by ! ,food &    
,drug ,adm9i/ration "u section #eje ( ! 
,f$]al ,food1 ,drug & ,cosmetic ,act =  
use 9 ! treatm5t ( opioid use disord]2  
7,b7 disp5s+ & adm9i/ration ( su*       
m$ications1 if applicable2  7,c7        
sub/ance abuse c\nsel+ by a pr(essional 
to ! ext5t au?oriz$ "u ,/ate law to     

furni% su* s]vices2  7,d7 behavioral    
individual & gr\p !rapy ) physicians or 
psy*ologi/s 7or o!r m5tal heal?         
pr(essionals to ! ext5t au?oriz$ "u     
,/ate law72  7,e7 toxicology te/+2 &    
7,f7 o!r items & s]vices t ! ,secret>y  
det]m9es are appropriate4  7#b7 ,opioid 
treatm5t program ,! t]m opioid treatm5t 
program means an opioid treatm5t program
 7z def9$ 9 section #h4b ( title #db ( !
 ,code ( ,f$]al ,regulations1 or any    
successor regulation7 t--  7,a7 is      
enroll$ "u section #ahff7;j72  7,b7 has 
9 effect a c]tification by ! ,sub/ance  
,abuse & ,m5tal ,heal? ,s]vices         
,adm9i/ration = su* a program2  7,c7 is 
accr$it$ by an accr$it+ body approv$ by 
! ,sub/ance ,abuse & ,m5tal ,heal?      
,s]vices ,adm9i/ration2 &  7,d7 meets   
su* additional conditions z ! ,secret>y 
may f9d necess>y to ensure-- 7i7 ! heal?
 & safety ( individuals be+ furni%$     
s]vices "u su* program2 &  7ii7 !       
effective & effici5t furni%+ ( su*      
s]vices4  4  7c7 ,paym5t  7#a7 ,9 g5]al 

,section #ahcc7;a77#a7 ( ! ,social      
,security ,act 7#db ,u4,s4,c4           
#aciel7a77#a77 is am5d$--  7,a7 by /rik+
 & 7,,bb7 & ins]t+ 7,,bb72 &  7,b7 by   
ins]t+ be=e ! semicolon at ! end !      
foll[+ 1 & 7,,cc7 ) respect to opioid   
use disord] treatm5t s]vices furni%$    
dur+ an episode ( c>e1 ! am\nt paid %all
 be equal to ! am\nt payable 9          
accordance ) section #ahcd7w7 less any  
copaym5t requir$ z specifi$ by !        
,secret>y4  7#b7 ,paym5t det]m9ation    
,section #ahcd ( ! ,social ,security    
,act 7#db ,u4,s4,c4 #aciem7 is am5d$ by 
add+ at ! end ! foll[+ new subsection3  
7w7 ,opioid use disord] treatm5t s]vices
  7#a7 ,9 g5]al ,! ,secret>y %all pay to
 an opioid treatm5t program 7z def9$ 9  
p>agraph 7#b7 ( section #ahfa7;jjj77 an 
am\nt t is equal to #ajj p]c5t ( a      
bundl$ paym5t "u ?is "p = opioid use    
disord] treatm5t s]vices 7z def9$ 9     
p>agraph 7#a7 ( su* section7 t are      
furni%$ by su* program to an individual 
dur+ an episode ( c>e 7z def9$ by !     

,secret>y7 beg9n+ on or aft] ,janu>y #a1
 #bjbj4 ,! ,secret>y %all ensure t no   
duplicative paym5ts are made "u ?is "p  
or "p ,d to a physician1 practition]1 or
 ph>macy = items & s]vices furni%$ by an
 opioid treatm5t program4  7#b7         
,consid]ations ,! ,secret>y may implem5t
 ?is subsection ?r\gh "o or m bundles   
bas$ on ! type ( m$ication provid$ 7su* 
z bupr5orph9e1 me?adone1 naltrexone1 or 
a new innovative drug71 ! frequ5cy (    
s]vices1 ! scope ( s]vices furni%$1     
*>act]i/ics ( ! individuals furni%$ su* 
s]vices1 or o!r factors z ! ,secret>y   
det]m9e appropriate4 ,9 develop+ su*    
bundles1 ! ,secret>y may consid] paym5t 
rates paid to opioid treatm5t programs =
 comp>able s]vices "u ,/ate plans "u    
title ,,xix1 "u ! ,,tric>e program "u   
*apt] #ee ( title #aj ( ! ,unit$ ,/ates 
,code1 or by o!r heal? c>e pay]s4  7#c7 
,annual updates ,! ,secret>y %all       
provide an update ea* ye> to ! bundl$   
paym5t am\nts "u ?is subsection4  4  7d7
 ,includ+ opioid treatm5t programs z    

,m$ic>e provid]s ,section #ahff7;e7 ( ! 
,social ,security ,act 7#db ,u4,s4,c4   
#acie;cc7e77 is am5d$-- 7#a7 9 p>agraph 
7#b71 by /rik+ at ! end &2  7#b7 9      
p>agraph 7#c71 by /rik+ ! p]iod at ! end
 & ins]t+ 2 &2 &  7#c7 by add+ at ! end 
! foll[+ new p>agraph3  7#c7 opioid     
treatm5t programs 7z def9$ 9 p>agraph   
7#b7 ( section #ahfa7;jjj771 b only )   
respect to ! furni%+ ( opioid treatm5t  
program s]vices 7z def9$ 9 p>agraph 7#a7
 ( su* section74  4  #c4 ,review &      
adju/m5t ( paym5ts "u ! ,m$ic>e         
outpati5t prospective paym5t sy/em to   
avoid f9ancial inc5tives to use opioids 
in/ead ( non-opioid alt]native treatm5ts
  7a7 ,outpati5t prospective paym5t     
sy/em ,section #ahcc7t7 ( ! ,social     
,security ,act 7#db ,u4,s4,c4 #aciel7t77
 is am5d$ by add+ at ! end ! foll[+ new 
p>agraph3  7#bb7 ,review & revisions (  
paym5ts = non-opioid alt]native         
treatm5ts  7,a7 ,9 g5]al ,) respect to  
paym5ts made "u ?is subsection = cov]$  
,,opd s]vices 7or gr\ps ( s]vices71     

includ+ cov]$ ,,opd s]vices assign$ to a
 compreh5sive ambulatory paym5t         
classification1 ! ,secret>y--  7i7 %all1
 z soon z practicable1 conduct a review 
7"p ( :i* may include a reque/ =        
in=mation7 ( paym5ts = opioids &        
evid5ce-bas$ non-opioid alt]natives =   
pa9 managem5t 7includ+ drugs & devices1 
n]ve blocks1 surgical injections1 &     
neuromodulation7 ) a goal ( ensur+ t !re
 are n f9ancial inc5tives to use opioids
 in/ead ( non-opioid alt]natives2  7ii7 
may1 z ! ,secret>y det]m9es appropriate1
 conduct subsequ5t reviews ( su*        
paym5ts2 &  7iii7 %all consid] ! ext5t  
to :i* revisions "u ?is subsection to   
su* paym5ts 7su* z ! creation (         
additional gr\ps ( cov]$ ,,opd s]vices  
to classify sep>ately ^? proc$ures t    
utilize opioids & non-opioid alt]natives
 = pa9 managem5t7 w\ld r$uce paym5t     
inc5tives to use opioids in/ead (       
non-opioid alt]natives = pa9 managem5t4 
7,b7 ,priority ,9 conduct+ ! review "u  
clause 7i7 ( subp>agraph 7,a7 & consid]+

 revisions "u clause 7iii7 ( su*        
subp>agraph1 ! ,secret>y %all focus on  
cov]$ ,,opd s]vices 7or gr\ps ( s]vices7
 assign$ to a compreh5sive ambulatory   
paym5t classification1 ambulatory paym5t
 classifications t prim>ily include     
surgical s]vices1 & o!r s]vices det]m9$ 
by ! ,secret>y :i* g5]ally involve      
treatm5t = pa9 managem5t4  7,c7         
,revisions ,if ! ,secret>y id5tifies    
revisions to paym5ts pursuant to        
subp>agraph 7,a77iii71 ! ,secret>y %all1
 z det]m9$ appropriate1 beg9 mak+ su*   
revisions = s]vices furni%$ on or aft]  
,janu>y #a1 #bjbj4 ,revisions "u !      
previ\s s5t5ce %all be treat$ z         
adju/m5ts = purposes ( application (    
p>agraph 7#i77;,b74  7,d7 ,rules (      
con/ruction ,no?+ 9 ?is p>agraph %all be
 con/ru$ to preclude ! ,secret>y-- 7i7 f
 conduct+ a demon/ration be=e mak+ !    
revisions describ$ 9 subp>agraph 7,c72  
or  7ii7 prior to implem5tation ( ?is   
p>agraph1 f *ang+ paym5ts "u ?is        
subsection = cov]$ ,,opd s]vices 7or    

gr\ps ( s]vices7 :i* include opioids or 
non-opioid alt]natives = pa9 managem5t4 
4  7b7 ,ambulatory surgical c5t]s       
,section #ahcc7;i7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4 #aciel7i77 is am5d$
 by add+ at ! end ! foll[+ new p>agraph3
  7#h7 ,! ,secret>y %all apply !        
provisions ( p>agraph 7#bb7 ( section   
#ahcc7t71 includ+ ! second s5t5ce (     
subp>agraph 7,c7 ( su* p>agraph1 to     
paym5t = s]vices "u ?is subsection 9 an 
appropriate mann] 7z det]m9$ by !       
,secret>y74  4  #d4 ,exp&+ access "u !  
,m$ic>e program to addiction treatm5t 9 
,f$]ally qualifi$ heal? c5t]s & rural   
heal? cl9ics  7a7 ,f$]ally qualifi$     
heal? c5t]s ,section #ahcd7o7 ( !       
,social ,security ,act 7#db ,u4,s4,c4   
#aciem7o77 is am5d$ by add+ at ! end !  
foll[+ new p>agraph3  7#c7 ,additional  
paym5ts = c]ta9 ,f,q,h,cs ) practition]s
 receiv+ ,,data #bjjj c]tification  7,a7
 ,9 g5]al ,9 ! case ( a ,f$]ally        
qualifi$ heal? c5t] ) respect to :i*1   
beg9n+ ,janu>y #a1 #bjai1               

,f$]ally-qualifi$ heal? c5t] s]vices 7z 
def9$ 9 section #ahfa7;aa77#c77 are     
furni%$ by a heal? c>e practition] :o   
fir/ receives on or aft] su* date a     
regi/ration or waiv] "u section #cjc7;g7
 ( ! ,controll$ ,sub/ances ,act to      
prescribe or disp5se me?adone1          
bupr5orph9e1 or suboxone = ! purpose (  
ma9t5ance or detoxification treatm5t1 ! 
,secret>y %all1 subject to availability 
( funds "u subp>agraph 7,b71 make a     
paym5t 79 accordance ) su* tim+1 me?od1 
& proc$ures z specifi$ by ! ,secret>y7  
to su* ,f$]ally qualifi$ heal? c5t] 9 an
 am\nt det]m9$ by ! ,secret>y1 bas$ on  
an approximation ( ! co/ to receive     
tra9+ = purposes ( su* regi/ration or   
waiv]1 z applicable4 ,= purposes ( !    
previ\s s5t5ce1 a ,f$]ally-qualifi$     
heal? c5t] %all apply = a paym5t        
describ$ 9 su* s5t5ce at su* "t & 9 su* 
mann] z specifi$ by ! ,secret>y & may   
apply = su* a paym5t = ea* practition]  
furni%+ su* s]vices at su* c5t] :o is   
describ$ 9 su* s5t5ce4  7,b7 ,fund+ ,=  

purposes ( mak+ paym5ts "u ?is p>agraph1
 !re are appropriat$1 out ( am\nts 9 !  
,treasury n o!rwise appropriat$1        
#f1jjj1jjj1 :i* %all rema9 available    
until exp5d$4  4  7b7 ,rural heal? cl9ic
 ,section #ahcc ( ! ,social ,security   
,act 7#db ,u4,s4,c4 #aciel7 is am5d$--  
7#a7 by r$esignat+ ! subsection 7z7     
relat+ to m$ical review ( sp9al         
subluxation s]vices z subsection 7aa72 &
  7#b7 by add+ at ! end ! foll[+ new    
subsection3  7bb7 ,additional paym5ts = 
c]ta9 rural heal? cl9ics ) practition]s 
receiv+ ,,data #bjjj c]tification  7#a7 
,9 g5]al ,9 ! case ( a rural heal? cl9ic
 ) respect to :i*1 beg9n+ ,janu>y #a1   
#bjai1 rural heal? cl9ic s]vices 7z     
def9$ 9 section #ahfa7;aa77#a77 are     
furni%$ by a heal? c>e practition] :o   
fir/ receives on or aft] su* date a     
regi/ration or waiv] "u section #cjc7;g7
 ( ! ,controll$ ,sub/ances ,act to      
prescribe or disp5se me?adone1          
bupr5orph9e1 or suboxone = ! purpose (  
ma9t5ance or detoxification treatm5t1 ! 

,secret>y %all1 subject to availability 
( funds "u subp>agraph 7,b71 make a     
paym5t 79 accordance ) su* tim+1 me?od1 
& proc$ures z specifi$ by ! ,secret>y7  
to su* rural heal? cl9ic 9 an am\nt     
det]m9$ by ! ,secret>y1 bas$ on an      
approximation ( ! co/ to receive tra9+ =
 purposes ( su* regi/ration or waiv]1 z 
applicable4 ,= purposes ( ! previ\s     
s5t5ce1 a rural heal? cl9ic %all apply =
 a paym5t describ$ 9 su* s5t5ce at su*  
"t & 9 su* mann] z specifi$ by !        
,secret>y & may apply = su* a paym5t =  
ea* practition] furni%+ su* s]vices at  
su* cl9ic :o is describ$ 9 su* s5t5ce4  
7#b7 ,fund+ ,= purposes ( mak+ paym5ts  
"u ?is subsection1 !re are appropriat$1 
out ( am\nts 9 ! ,treasury n o!rwise    
appropriat$1 #b1jjj1jjj1 :i* %all rema9 
available until exp5d$4  4  #e4 ,/udy+ !
 availability ( supplem5tal b5efits     
design$ to treat or prev5t sub/ance use 
disord]s "u ,m$ic>e ,advantage plans    
7a7 ,9 g5]al ,n lat] ?an #b ye>s aft] ! 
date ( ! enactm5t ( ?is ,act1 !         

,secret>y ( ,heal? & ,human ,s]vices 79 
?is section ref]r$ to z ! ,secret>y7    
%all submit to ,congress a report on !  
availability ( supplem5tal heal? c>e    
b5efits 7z describ$ 9 section           
#aheb7;a77#c77;,a7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4                    
#aciew-#bb7;a77#c77;,a777 design$ to    
treat or prev5t sub/ance use disord]s "u
 ,m$ic>e ,advantage plans (f]$ "u "p ,c 
( title ,,xviii ( su* ,act4 ,su* report 
%all include ! analysis describ$ 9      
subsection 7c7 & any diff]5ces 9 !      
availability ( su* b5efits "u specializ$
 ,,ma plans = special ne$s individuals  
7z def9$ 9 section #ahei7;b77#f7 ( su*  
,act 7#db ,u4,s4,c4 #aciew-#bh7;b77#f777
 (f]$ to individuals entitl$ to m$ical  
assi/ance "u title ,,xix ( su* ,act &   
o!r su* ,m$ic>e ,advantage plans4  7b7  
,consultation ,! ,secret>y %all develop 
! report describ$ 9 subsection 7a7 9    
consultation ) relevant /akehold]s1     
includ+--  7#a7 individuals entitl$ to  
b5efits "u "p ,a or enroll$ "u "p ,b (  

title ,,xviii ( ! ,social ,security     
,act2  7#b7 entities :o advocate on     
behalf ( su* individuals2  7#c7 ,m$ic>e 
,advantage organizations2  7#d7 ph>macy 
b5efit manag]s2 &  7#e7 provid]s (      
s]vices & suppli]s 7z su* t]ms are def9$
 9 section #ahfa ( su* ,act 7#db        
,u4,s4,c4 #aciex774  7c7 ,cont5ts ,!    
report describ$ 9 subsection 7a7 %all   
include an analysis on ! foll[+3 7#a7 ,!
 ext5t to :i* plans describ$ 9 su*      
subsection (f] supplem5tal heal? c>e    
b5efits relat+ to cov]age (--  7,a7     
m$ication-assi/$ treatm5ts = opioid use1
 sub/ance use disord] c\nsel+1 pe]      
recov]y support s]vices1 or o!r =ms (   
sub/ance use disord] treatm5ts 7:e!r    
furni%$ 9 an inpati5t or outpati5t      
sett+72 &  7,b7 non-opioid alt]natives =
 ! treatm5t ( pa94  7#b7 ,*all5ges      
associat$ ) su* plans (f]+ supplem5tal  
heal? c>e b5efits relat+ to cov]age (   
items & s]vices describ$ 9 subp>agraph  
7,a7 or 7,b7 ( p>agraph 7#a74  7#c7 ,!  
impact1 if any1 ( increas+ ! applicable 

rebate p]c5tage det]m9$ "u section      
#ahed7;b77#a77;,c7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4                    
#aciew-#bd7;b77#a77;,c77 = plans (f]+   
su* b5efits relat+ to su* cov]age w\ld h
 on ! availability ( su* b5efits relat+ 
to su* cov]age (f]$ "u ,m$ic>e          
,advantage plans4  7#d7 ,pot5tial ways  
to improve ^u su* cov]age or to         
inc5tivize su* plans to (f] additional  
supplem5tal heal? c>e b5efits relat+ to 
su* cov]age4  #f4 ,cl9ical psy*ologi/   
s]vices models "u ! ,c5t] = ,m$ic>e &   
,m$icaid ,innovation2 ,,gao /udy &      
report  7a7 ,,cmi models ,section       
#aaae;,a7b77#b77;,b7 ( ! ,social        
,security ,act 7#db ,u4,s4,c4           
#acae;a7b77#b77;,b77 is am5d$ by add+ at
 ! end ! foll[+ new clauses3  7xxv7     
,support+ ways to famili>ize individuals
 ) ! availability ( cov]age "u "p ,b (  
title ,,xviii = qualifi$ psy*ologi/     
s]vices 7z def9$ 9 section #ahfa7;ii774 
7xxvi7 ,explor+ ways to avoid unnecess>y
 hospitalizations or em]g5cy dep>tm5t   

visits = m5tal & behavioral heal?       
s]vices 7su* z = treat+ depression7     
?r\gh use ( a #bd-;h\r1 #g-;day a week  
help l9e t may in=m individuals ab\t !  
availability ( treatm5t options1 includ+
 ! availability ( qualifi$ psy*ologi/   
s]vices 7z def9$ 9 section #ahfa7;ii774 
4  7b7 ,,gao /udy & report ,n lat] ?an  
#ah mon?s aft] ! date ( ! enactm5t ( ?is
 ,act1 ! ,comptroll] ,g5]al ( ! ,unit$  
,/ates %all conduct a /udy1 & submit to 
,congress a report1 on m5tal &          
behavioral heal? s]vices "u ! ,m$ic>e   
program "u title ,,xviii ( ! ,social    
,security ,act1 includ+ an exam9ation ( 
! foll[+3  7#a7 ,in=mation ab\t s]vices 
furni%$ by psy*iatri/s1 cl9ical         
psy*ologi/s1 & o!r pr(essionals4  7#b7  
,in=mation ab\t ways t ,m$ic>e          
b5efici>ies famili>ize !mselves ab\t !  
availability ( ,m$ic>e paym5t = qualifi$
 psy*ologi/ s]vices 7z def9$ 9 section  
#ahfa7;ii7 ( ! ,social ,security ,act   
7#db ,u4,s4,c4 #aciex7ii777 & ways t !  
provision ( su* in=mation c\ld be       

improv$4  #g4 ,pa9 managem5t /udy  7a7  
,9 g5]al ,n lat] ?an #a ye> aft] ! date 
( enactm5t ( ?is ,act1 ! ,secret>y (    
,heal? & ,human ,s]vices 7ref]r$ to 9   
?is section z ! ,secret>y7 %all conduct 
a /udy & submit to ! ,committee on ,ways
 & ,means & ! ,committee on ,en]gy &    
,comm]ce ( ! ,h\se ( ,repres5tatives & !
 ,committee on ,f9ance ( ! ,s5ate a     
report conta9+ recomm5dations on :e!r & 
h[ paym5t to provid]s & suppli]s (      
s]vices & cov]age relat$ to ! use (     
multi-discipl9>y1 evid5ce-bas$1         
non-opioid treatm5ts = acute & *ronic   
pa9 managem5t = individuals entitl$ to  
b5efits "u "p ,a or enroll$ "u "p ,b (  
title ,,xviii ( ! ,social ,security ,act
 %\ld be revis$4 ,! ,secret>y %all make 
su* report available on ! public website
 ( ! ,c5t]s = ,m$ic>e  ,m$icaid         
,s]vices4  7b7 ,consultation ,9 develop+
 ! report describ$ 9 subsection 7a71 !  
,secret>y %all consult )-- 7#a7 relevant
 ag5cies )9 ! ,dep>tm5t ( ,heal? &      
,human ,s]vices2  7#b7 lic5s$ & practic+

 o/eopa?ic & allopa?ic physicians1      
behavioral heal? practition]s1 physician
 assi/ants1 nurse practition]s1 d5ti/s1 
ph>maci/s1 & o!r provid]s ( heal?       
s]vices2  7#c7 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#d7 sub/ance abuse
 & m5tal heal? pr(essional              
organizations2  7#e7 pa9 managem5t      
pr(essional organizations & advocacy    
entities1 includ+ individuals :o        
p]sonally suff] *ronic pa92  7#f7 m$ical
 pr(essional organizations & m$ical     
specialty organizations2  7#g7 lic5s$   
heal? c>e provid]s :o furni% alt]native 
pa9 managem5t s]vices2  7#h7            
organizations ) exp]tise 9 ! developm5t 
( innovative m$ical te*nologies = pa9   
managem5t2  7#i7 b5efici>y advocacy     
organizations2 &  7#aj7 o!r             
organizations ) exp]tise 9 ! assessm5t1 
diagnosis1 treatm5t1 & managem5t ( pa91 
z det]m9$ appropriate by ! ,secret>y4   
7c7 ,cont5ts ,! report describ$ 9       

subsection 7a7 %all include ! foll[+3   
7#a7 ,! recomm5dations describ$ 9       
subsection 7d74  7#b7 ,! impact analysis
 describ$ 9 subsection 7e74  7#c7 ,an   
assessm5t ( pa9 managem5t guidance      
publi%$ by ! ,f$]al ,gov]nm5t t may be  
relevant to cov]age det]m9ations or o!r 
cov]age requirem5ts "u title ,,xviii ( !
 ,social ,security ,act4 ,su* assessm5t 
%all consid] incorporat+ into su*       
guidance relevant elem5ts ( ! ,va_/,do,d
 ,cl9ical ,practice ,guidel9e = ,opioid 
,!rapy = ,*ronic ,pa9 publi%$ 9 ,febru>y
 #bjag by ! ,dep>tm5t ( ,vet]ans        
,affairs & ,dep>tm5t ( ,def5se1 includ+ 
adoption ( elem5ts ( ! ,dep>tm5t (      
,def5se & ,vet]ans ,adm9i/ration pa9    
rat+ scale4  7#d7 ,an evaluation ( !    
foll[+3 7,a7 ,b>ri]s inhibit+           
individuals entitl$ to b5efits "u "p ,a 
or enroll$ "u "p ,b ( su* title f       
access+ treatm5ts & te*nologies describ$
 9 subp>agraphs 7,a7 ?r\gh 7,f7 (       
p>agraph 7#f74  7,b7 ,pot5tial          
legislative & adm9i/rative *anges "u su*

 title to improve individuals' access to
 items & s]vices curr5tly cov]$ "u su*  
title & us$ = ! treatm5t ( pa91 su* z   
cognitive behavioral int]v5tions1       
physical !rapy1 occupational !rapy1     
physical m$ic9e1 bi(e$back !rapy1 &     
*iropractic !rapy1 & o!r pa9 treatm5ts  
s]vices furni%$ 9 a hospital or         
po/-acute c>e sett+4  7,c7 ,co/s &      
b5efits associat$ ) pot5tial expansion (
 cov]age "u su* title to include items &
 s]vices n cov]$ "u su* title t may be  
us$ = ! treatm5t ( pa91 su* z           
acupuncture1 !rapeutic massage1 & items 
& s]vices furni%$ by integrat$ pa9      
managem5t programs4  7#e7 ,an analysis  
on paym5t & cov]age "u title ,,xviii ( !
 ,social ,security ,act ) respect to !  
foll[+3  7,a7 ,evid5ce-bas$ treatm5ts & 
te*nologies = *ronic or acute pa91      
includ+ su* treatm5ts t are cov]$1 n    
cov]$1 or h limit$ cov]age "u su* title4
  7,b7 ,evid5ce-bas$ treatm5ts &        
te*nologies t monitor sub/ance use      
)drawal & prev5t ov]doses ( opioids4    

7,c7 ,evid5ce-bas$ treatm5ts &          
te*nologies t treat sub/ance use        
disord]s4  7,d7 ,items & s]vices furni%$
 by practition]s ?r\gh a                
multi-discipl9>y treatm5t model = pa9   
managem5t1 includ+ ! pati5t-c5t]$ m$ical
 home4  7,e7 ,m$ical devices1 non-opioid
 bas$ drugs1 & o!r !rapies 7includ+     
int]v5tional & integrative pa9 !rapies7 
approv$ or cle>$ by ! ,food & ,drug     
,adm9i/ration = ! treatm5t ( pa94  7,f7 
,items & s]vices furni%$ to b5efici>ies 
) psy*iatric disord]s1 sub/ance use     
disord]s1 or :o are at risk ( suicide1  
or h comorbidities & require            
consultation or managem5t ( pa9 ) "o or 
m speciali/s 9 pa9 managem5t1 m5tal     
heal?1 or addiction treatm5t4  7d7      
,recomm5dations ,! recomm5dations       
describ$ 9 ?is subsection are1 ) respect
 to individuals entitl$ to b5efits "u "p
 ,a or enroll$ "u "p ,b ( title ,,xviii 
( ! ,social ,security ,act1 legislative 
& adm9i/rative recomm5dations on !      
foll[+3  7#a7 ,options = additional     

cov]age ( pa9 managem5t !rapies )\t !   
use ( opioids1 includ+ int]v5tional pa9 
!rapies1 & options to augm5t opioid     
!rapy ) o!r cl9ical & complem5t>y1      
integrative heal? s]vices to m9imize !  
risk ( sub/ance use disord]1 includ+ 9 a
 hospital sett+4  7#b7 ,options =       
cov]age & paym5t modifications ( m$ical 
devices & non-opioid bas$ ph>macological
 & non-ph>macological !rapies 7includ+  
int]v5tional & integrative pa9 !rapies7 
approv$ or cle>$ by ! ,food & ,drug     
,adm9i/ration = ! treatm5t ( pa9 z an   
alt]native or augm5t to opioid !rapy4   
7#c7 ,treatm5t /rategies = b5efici>ies )
 psy*iatric disord]s1 sub/ance use      
disord]s1 or :o are at risk ( suicide1 &
 treatm5t /rategies to address heal?    
disp>ities relat$ to opioid use & opioid
 abuse treatm5t4  7#d7 ,treatm5t        
/rategies = b5efici>ies ) comorbidities 
:o require a consultation or comanagem5t
 ( pa9 ) "o or m speciali/s 9 pa9       
managem5t1 m5tal heal?1 or addiction    
treatm5t1 includ+ 9 a hospital sett+4   

7#e7 ,coadm9i/ration ( opioids & o!r    
drugs1 p>ticul>ly b5zodiazep9es4  7#f7  
,appropriate case managem5t =           
b5efici>ies :o transition betwe5        
inpati5t & outpati5t hospital sett+s1 or
 betwe5 opioid !rapy to non-opioid      
!rapy1 :i* may include ! use ( c>e      
transition plans4  7#g7 ,outrea*        
activities design$ to educate provid]s (
 s]vices & suppli]s "u ! ,m$ic>e program
 & individuals entitl$ to b5efits "u "p 
,a or "u "p ,b ( su* title on           
alt]native1 non-opioid !rapies to manage
 & treat acute & *ronic pa94  7#h7      
,creation ( a b5efici>y education tool  
on alt]natives to opioids = *ronic pa9  
managem5t4  7e7 ,impact analysis ,!     
impact analysis describ$ 9 ?is          
subsection consi/s ( an analysis ( any  
pot5tial effects implem5t+ !            
recomm5dations describ$ 9 subsection 7d7
 w\ld h--  7#a7 on exp5ditures "u !     
,m$ic>e program2 &  7#b7 on prev5t+ or  
r$uc+ opioid addiction = individuals    
receiv+ b5efits "u ! ,m$ic>e program4