#aaeth ,,congress  #b;d ,session  ,h4   
,r4 #egif  ,,an ,,act  ,to require the  
,secretary of ,health and ,human        
,services to provide grants for eligible
 entities to provide technical          
assistance to outlier prescribers of    
opioids1 and for other purposes4  #a4   
,short title ,this ,act may be cited as 
the ,responsible ,education ,achieves   
,care and ,healthy ,outcomes for ,users'
 ,treatment ,act of #bjah or the ,,reach
 ,,out ,act of #bjah4  #b4 ,grants to   
provide technical assistance to outlier 
prescribers of opioids  7a7 ,grants     
authorized ,the ,secretary of ,health   
and ,human ,services 7in this section   
referred to as the ,secretary7 shall1   
through the ,centers for ,medicare      
,medicaid ,services1 award grants1      
contracts1 or cooperative agreements to 
eligible entities for the purposes      
described in subsection 7b74  7b7 ,use  
of funds ,grants1 contracts1 and        
cooperative agreements awarded under    
subsection 7a7 shall be used to support 

eligible entities through technical     
assistance-- 7#a7 to educate and provide
 outreach to outlier prescribers of     
opioids about best practices for        
prescribing opioids2  7#b7 to educate   
and provide outreach to outlier         
prescribers of opioids about non-opioid 
pain management therapies2 and  7#c7 to 
reduce the amount of opioid             
prescriptions prescribed by outlier     
prescribers of opioids4  7c7            
,application ,each eligible entity      
seeking to receive a grant1 contract1 or
 cooperative agreement under subsection 
7a7 shall submit to the ,secretary an   
application1 at such time1 in such      
manner1 and containing such information 
as the ,secretary may require4  7d7     
,geographic distribution ,in awarding   
grants1 contracts1 and cooperative      
agreements under this section1 the      
,secretary shall prioritize establishing
 technical assistance resources in each 
,state4  7e7 ,definitions ,in this      
section3 7#a7 ,eligible entity ,the term

 eligible entity means--  7,a7 an       
organization-- 7i7 that has demonstrated
 experience providing technical         
assistance to health care professionals 
on a ,state or regional basis2 and  7ii7
 that has at least-- 7,i7 one individual
 who is a representative of consumers on
 its governing body2 and  7,,ii7 one    
individual who is a representative of   
health care providers on its governing  
body2 or  7,b7 an entity that is a      
quality improvement entity with a       
contract under part ,b of title ,,xi of 
the ,social ,security ,act 7#db         
,u4,s4,c4 #acbj;c et seq474  7#b7       
,outlier prescriber of opioids ,the term
 outlier prescriber of opioids means a  
prescriber1 identified by the ,secretary
 of ,health and ,human ,services        
7through use of prescriber information  
provided by prescriber ,national        
,provider ,identifiers included pursuant
 to section #ahfj;,d-#d7;c77#d77;,a7 of 
the ,social ,security ,act 7#db         
,u4,s4,c4 #aciew-#ajd7;c77#d77;,a77 on  

claims for covered part ,d drugs for    
part ,d eligible individuals enrolled in
 prescription drug plans under part ,d  
of title ,,xviii of such ,act 7#db      
,u4,s4,c4 #aciew-#aja et seq47 and      
,,ma-,,pd plans under part ,c of such   
title 7#db ,u4,s4,c4 #aciew-#ba et      
seq477 as prescribing1 as compared to   
other prescribers in the specialty of   
the prescriber and geographic area1     
amounts of opioids in excess of a       
threshold 7and other criteria7 specified
 by the ,secretary1 after consultation  
with stakeholders4  7#c7 ,prescribers   
,the term prescriber means any health   
care professional1 including a nurse    
practitioner or physician assistant1 who
 is licensed to prescribe opioids by the
 ,state or territory in which such      
professional practices4  7f7 ,funding   
,for purposes of implementing this      
section1 #ge million shall be available 
from the ,federal ,supplementary        
,medical ,insurance ,trust ,fund under  
section #ahda of the ,social ,security  

,act 7#db ,u4,s4,c4 #aciet71 to remain  
available until expended4  #c4          
,promoting value in ,medicaid managed   
care ,section #aijc7m7 of the ,social   
,security ,act 7#db ,u4,s4,c4           
#acif;b7m77 is amended by adding at the 
end the following new paragraph3  7#g7  
7,a7 ,with respect to expenditures      
described in subparagraph 7,b7 that are 
incurred by a ,state for any fiscal year
 after fiscal year #bjbe 7and before    
fiscal year #bjbi71 in determining the  
pro rata share to which the ,united     
,states is equitably entitled under     
subsection 7d77#c71 the ,secretary shall
 substitute the ,federal medical        
assistance percentage that applies for  
such fiscal year to the ,state under    
section #aije7;b7 7without regard to any
 adjustments to such percentage         
applicable under such section or any    
other provision of law7 for the         
percentage that applies to such         
expenditures under section #aije7y74    
7,b7 ,expenditures described in this    

subparagraph1 with respect to a fiscal  
year to which subparagraph 7,a7 applies1
 are expenditures incurred by a ,state  
for payment for medical assistance      
provided to individuals described in    
subclause 7,,viii7 of section           
#aijb7;a77#aj77;,a77i7 by a managed care
 entity1 or other specified entity 7as  
defined in subparagraph 7,d77iii771 that
 are treated as remittances because the 
,state--  7i7 has satisfied the         
requirement of section #dch4h of title  
#db1 ,code of ,federal ,regulations 7or 
any successor regulation71 by electing--
 7,i7 in the case of a ,state described 
in subparagraph 7,c71 to apply a minimum
 medical loss ratio 7as defined in      
subparagraph 7,d77ii77 that is at least 
#he percent but not greater than the    
minimum medical loss ratio 7as so       
defined7 that such ,state applied as of 
,may #ca1 #bjah2 or  7,,ii7 in the case 
of a ,state not described in            
subparagraph 7,c71 to apply a minimum   
medical loss ratio that is equal to #he 

percent2 and  7ii7 recovered all or a   
portion of the expenditures as a result 
of the entity's failure to meet such    
ratio4  7,c7 ,for purposes of           
subparagraph 7,b71 a ,state described in
 this subparagraph is a ,state that as  
of ,may #ca1 #bjah1 applied a minimum   
medical loss ratio 7as calculated under 
subsection 7d7 of section #dch4h of     
title #db1 ,code of ,federal            
,regulations 7as in effect on ,june #a1 
#bjah77 for payment for services        
provided by entities described in such  
subparagraph under the ,state plan under
 this title 7or a waiver of the plan7   
that is equal to or greater than #he    
percent4  7,d7 ,for purposes of this    
paragraph3  7i7 ,the term managed care  
entity means a medicaid managed care    
organization described in section       
#aicb7;a77#a77;,b77i74  7ii7 ,the term  
minimum medical loss ratio means1 with  
respect to a ,state1 a minimum medical  
loss ratio 7as calculated under         
subsection 7d7 of section #dch4h of     

title #db1 ,code of ,federal            
,regulations 7as in effect on ,june #a1 
#bjah77 for payment for services        
provided by entities described in       
subparagraph 7,b7 under the ,state plan 
under this title 7or a waiver of the    
plan74  7iii7 ,the term other specified 
entity means-- 7,i7 a prepaid inpatient 
health plan1 as defined in section      
#dch4b of title #db1 ,code of ,federal  
,regulations 7or any successor          
regulation72 and  7,,ii7 a prepaid      
ambulatory health plan1 as defined in   
such section 7or any successor          
regulation74  4  ,passed the ,house of  
,representatives ,june #ai1             
#bjah4;,clerk4