,i  #aaeth ,,congress  #b;d ,session    
,h4 ,r4 #eggh  ,,in ,,the ,,house ,,of  
,,representatives  ,may #aa1 #bjah,mr4  
,marchant 7for himself and ,mr4 ,levin7 
introduced the following bill2 which was
 referred to the ,committee on ,energy  
and ,commerce1 and in addition to the   
,committee on ,ways and ,means1 for a   
period to be subsequently determined by 
the ,speaker1 in each case for          
consideration of such provisions as fall
 within the jurisdiction of the         
committee concerned  ,a ,,bill  ,to     
amend title ,,xviii of the ,social      
,security ,act to provide for review and
 adjustment of payments under the       
,medicare outpatient prospective payment
 system to avoid financial incentives to
 use opioids instead of non-opioid      
alternative treatments1 and for other   
purposes4  #a4 ,short title ,this ,act  
may be cited as the ,promoting          
,outpatient ,access to ,non-,opioid     
,treatments ,act4  #b4 ,review and      
adjustment of payments under the        

,medicare outpatient prospective payment
 system to avoid financial incentives to
 use opioids instead of non-opioid      
alternative treatments  7a7 ,outpatient 
prospective payment system ,section     
#ahcc7t7 of the ,social ,security ,act  
7#db ,u4,s4,c4 #aciel7t77 is amended by 
adding at the end the following new     
paragraph3  7#bb7 ,review and revisions 
of payments for non-opioid alternative  
treatments  7,a7 ,in general ,with      
respect to payments made under this     
subsection for covered ,,opd services   
7or groups of services71 including      
covered ,,opd services assigned to a    
comprehensive ambulatory payment        
classification1 the ,secretary--  7i7   
shall1 as soon as practicable1 conduct a
 review 7part of which may include a    
request for information7 of payments for
 opioids and evidence-based non-opioid  
alternatives for pain management        
7including drugs and devices1 nerve     
blocks1 surgical injections1 and        
neuromodulation7 with a goal of ensuring

 that there are not financial incentives
 to use opioids instead of non-opioid   
alternatives2  7ii7 may1 as the         
,secretary determines appropriate1      
conduct subsequent reviews of such      
payments2 and  7iii7 shall consider the 
extent to which revisions under this    
subsection to such payments 7such as the
 creation of additional groups of       
covered ,,opd services to classify      
separately those procedures that utilize
 opioids and non-opioid alternatives for
 pain management7 would reduce payment  
incentives to use opioids instead of    
non-opioid alternatives for pain        
management4  7,b7 ,priority ,in         
conducting the review under clause 7i7  
of subparagraph 7,a7 and considering    
revisions under clause 7iii7 of such    
subparagraph1 the ,secretary shall focus
 on covered ,,opd services 7or groups of
 services7 assigned to a comprehensive  
ambulatory payment classification1      
ambulatory payment classifications that 
primarily include surgical services1 and

 other services determined by the       
,secretary which generally involve      
treatment for pain management4  7,c7    
,revisions ,if the ,secretary identifies
 revisions to payments pursuant to      
subparagraph 7,a77iii71 the ,secretary  
shall1 as determined appropriate1 begin 
making such revisions for services      
furnished on or after ,january #a1      
#bjbj4 ,revisions under the previous    
sentence shall be treated as adjustments
 for purposes of application of         
paragraph 7#i77;,b74  7,d7 ,rules of    
construction ,nothing in this paragraph 
shall be construed to preclude the      
,secretary-- 7i7 from conducting a      
demonstration before making the         
revisions described in subparagraph     
7,c72 or  7ii7 prior to implementation  
of this paragraph1 from changing        
payments under this subsection for      
covered ,,opd services 7or groups of    
services7 which include opioids or      
non-opioid alternatives for pain        
management4  4  7b7 ,ambulatory surgical

 centers ,section #ahcc7;i7 of the      
,social ,security ,act 7#db ,u4,s4,c4   
#aciel7i77 is amended by adding at the  
end the following new paragraph3  7#h7  
,the ,secretary shall apply the         
provisions of paragraph 7#bb7 of section
 #ahcc7t71 including the second sentence
 of subparagraph 7,c7 of such paragraph1
 to payment for services under this     
subsection in an appropriate manner 7as 
determined by the ,secretary74  4