#aae? ,,congress  #b;d ,session  ,h4 ,r4
 #egif  ,,an ,,act  ,to require !       
,secret>y ( ,heal? & ,human ,s]vices to 
provide grants = eligible entities to   
provide te*nical assi/ance to outli]    
prescrib]s ( opioids1 & = o!r purposes4 
#a4 ,%ort title ,?is ,act may be cit$ z 
! ,responsible ,education ,a*ieves ,c>e 
& ,heal?y ,outcomes = ,us]s' ,treatm5t  
,act ( #bjah or ! ,,rea* ,,out ,act (   
#bjah4  #b4 ,grants to provide te*nical 
assi/ance to outli] prescrib]s ( opioids
  7a7 ,grants au?oriz$ ,! ,secret>y (   
,heal? & ,human ,s]vices 79 ?is section 
ref]r$ to z ! ,secret>y7 %all1 ?r\gh !  
,c5t]s = ,m$ic>e  ,m$icaid ,s]vices1    
aw>d grants1 contracts1 or coop]ative   
agreem5ts to eligible entities = !      
purposes describ$ 9 subsection 7b74  7b7
 ,use ( funds ,grants1 contracts1 &     
coop]ative agreem5ts aw>d$ "u subsection
 7a7 %all be us$ to support eligible    
entities ?r\gh te*nical assi/ance-- 7#a7
 to educate & provide outrea* to outli] 
prescrib]s ( opioids ab\t be/ practices 

= prescrib+ opioids2  7#b7 to educate & 
provide outrea* to outli] prescrib]s (  
opioids ab\t non-opioid pa9 managem5t   
!rapies2 &  7#c7 to r$uce ! am\nt (     
opioid prescriptions prescrib$ by outli]
 prescrib]s ( opioids4  7c7 ,application
 ,ea* eligible entity seek+ to receive a
 grant1 contract1 or coop]ative agreem5t
 "u subsection 7a7 %all submit to !     
,secret>y an application1 at su* "t1 9  
su* mann]1 & conta9+ su* in=mation z !  
,secret>y may require4  7d7 ,geographic 
di/ribution ,9 aw>d+ grants1 contracts1 
& coop]ative agreem5ts "u ?is section1 !
 ,secret>y %all prioritize e/abli%+     
te*nical assi/ance res\rces 9 ea* ,/ate4
  7e7 ,def9itions ,9 ?is section3 7#a7  
,eligible entity ,! t]m eligible entity 
means--  7,a7 an organization-- 7i7 t   
has demon/rat$ exp]i5ce provid+ te*nical
 assi/ance to heal? c>e pr(essionals on 
a ,/ate or regional basis2 &  7ii7 t has
 at lea/-- 7,i7 "o individual :o is a   
repres5tative ( consum]s on its gov]n+  
body2 &  7,,ii7 "o individual :o is a   

repres5tative ( heal? c>e provid]s on   
its gov]n+ body2 or  7,b7 an entity t is
 a quality improvem5t entity ) a        
contract "u "p ,b ( title ,,xi ( !      
,social ,security ,act 7#db ,u4,s4,c4   
#acbj;c et seq474  7#b7 ,outli]         
prescrib] ( opioids ,! t]m outli]       
prescrib] ( opioids means a prescrib]1  
id5tifi$ by ! ,secret>y ( ,heal? &      
,human ,s]vices 7?r\gh use ( prescrib]  
in=mation provid$ by prescrib] ,national
 ,provid] ,id5tifi]s includ$ pursuant to
 section #ahfj;,d-#d7;c77#d77;,a7 ( !   
,social ,security ,act 7#db ,u4,s4,c4   
#aciew-#ajd7;c77#d77;,a77 on claims =   
cov]$ "p ,d drugs = "p ,d eligible      
individuals enroll$ 9 prescription drug 
plans "u "p ,d ( title ,,xviii ( su*    
,act 7#db ,u4,s4,c4 #aciew-#aja et seq47
 & ,,ma-,,pd plans "u "p ,c ( su* title 
7#db ,u4,s4,c4 #aciew-#ba et seq477 z   
prescrib+1 z comp>$ to o!r prescrib]s 9 
! specialty ( ! prescrib] & geographic  
area1 am\nts ( opioids 9 excess ( a     
?re%old 7& o!r crit]ia7 specifi$ by !   

,secret>y1 aft] consultation )          
/akehold]s4  7#c7 ,prescrib]s ,! t]m    
prescrib] means any heal? c>e           
pr(essional1 includ+ a nurse practition]
 or physician assi/ant1 :o is lic5s$ to 
prescribe opioids by ! ,/ate or t]ritory
 9 :i* su* pr(essional practices4  7f7  
,fund+ ,= purposes ( implem5t+ ?is      
section1 #ge million %all be available f
 ! ,f$]al ,supplem5t>y ,m$ical          
,insurance ,tru/ ,fund "u section #ahda 
( ! ,social ,security ,act 7#db         
,u4,s4,c4 #aciet71 to rema9 available   
until exp5d$4  #c4 ,promot+ value 9     
,m$icaid manag$ c>e ,section #aijc7m7 ( 
! ,social ,security ,act 7#db ,u4,s4,c4 
#acif;b7m77 is am5d$ by add+ at ! end ! 
foll[+ new p>agraph3  7#g7  7,a7 ,)     
respect to exp5ditures describ$ 9       
subp>agraph 7,b7 t are incurr$ by a     
,/ate = any fiscal ye> aft] fiscal ye>  
#bjbe 7& be=e fiscal ye> #bjbi71 9      
det]m9+ ! pro rata %>e to :i* ! ,unit$  
,/ates is equitably entitl$ "u          
subsection 7d77#c71 ! ,secret>y %all    

sub/itute ! ,f$]al m$ical assi/ance     
p]c5tage t applies = su* fiscal ye> to !
 ,/ate "u section #aije7;b7 7)\t reg>d  
to any adju/m5ts to su* p]c5tage        
applicable "u su* section or any o!r    
provision ( law7 = ! p]c5tage t applies 
to su* exp5ditures "u section #aije7y74 
7,b7 ,exp5ditures describ$ 9 ?is        
subp>agraph1 ) respect to a fiscal ye>  
to :i* subp>agraph 7,a7 applies1 are    
exp5ditures incurr$ by a ,/ate = paym5t 
= m$ical assi/ance provid$ to           
individuals describ$ 9 subclause        
7,,viii7 ( section                      
#aijb7;a77#aj77;,a77i7 by a manag$ c>e  
entity1 or o!r specifi$ entity 7z def9$ 
9 subp>agraph 7,d77iii771 t are treat$ z
 remittances because ! ,/ate--  7i7 has 
satisfi$ ! requirem5t ( section #dch4h (
 title #db1 ,code ( ,f$]al ,regulations 
7or any successor regulation71 by       
elect+-- 7,i7 9 ! case ( a ,/ate        
describ$ 9 subp>agraph 7,c71 to apply a 
m9imum m$ical loss ratio 7z def9$ 9     
subp>agraph 7,d77ii77 t is at lea/ #he  

p]c5t b n great] ?an ! m9imum m$ical    
loss ratio 7z s def9$7 t su* ,/ate      
appli$ z ( ,may #ca1 #bjah2 or  7,,ii7 9
 ! case ( a ,/ate n describ$ 9          
subp>agraph 7,c71 to apply a m9imum     
m$ical loss ratio t is equal to #he     
p]c5t2 &  7ii7 recov]$ all or a portion 
( ! exp5ditures z a result ( ! entity's 
failure to meet su* ratio4  7,c7 ,=     
purposes ( subp>agraph 7,b71 a ,/ate    
describ$ 9 ?is subp>agraph is a ,/ate t 
z ( ,may #ca1 #bjah1 appli$ a m9imum    
m$ical loss ratio 7z calculat$ "u       
subsection 7d7 ( section #dch4h ( title 
#db1 ,code ( ,f$]al ,regulations 7z 9   
effect on ,june #a1 #bjah77 = paym5t =  
s]vices provid$ by entities describ$ 9  
su* subp>agraph "u ! ,/ate plan "u ?is  
title 7or a waiv] ( ! plan7 t is equal  
to or great] ?an #he p]c5t4  7,d7 ,=    
purposes ( ?is p>agraph3  7i7 ,! t]m    
manag$ c>e entity means a m$icaid manag$
 c>e organization describ$ 9 section    
#aicb7;a77#a77;,b77i74  7ii7 ,! t]m     
m9imum m$ical loss ratio means1 )       

respect to a ,/ate1 a m9imum m$ical loss
 ratio 7z calculat$ "u subsection 7d7 ( 
section #dch4h ( title #db1 ,code (     
,f$]al ,regulations 7z 9 effect on ,june
 #a1 #bjah77 = paym5t = s]vices provid$ 
by entities describ$ 9 subp>agraph 7,b7 
"u ! ,/ate plan "u ?is title 7or a waiv]
 ( ! plan74  7iii7 ,! t]m o!r specifi$  
entity means-- 7,i7 a prepaid inpati5t  
heal? plan1 z def9$ 9 section #dch4b (  
title #db1 ,code ( ,f$]al ,regulations  
7or any successor regulation72 &  7,,ii7
 a prepaid ambulatory heal? plan1 z     
def9$ 9 su* section 7or any successor   
regulation74  4  ,pass$ ! ,h\se (       
,repres5tatives ,june #ai1 #bjah4;,cl]k4