#aaeth ,,congress  #b;d ,session  ,h4   
,r4 #ehab  ,,an ,,act  ,to amend the    
,public ,health ,service ,act to        
authorize the ,director of the ,centers 
for ,disease ,control and ,prevention to
 carry out certain activities to prevent
 controlled substances overdoses1 and   
for other purposes4  #a4 ,short title   
,this ,act may be cited as the ,creating
 ,opportunities that ,necessitate ,new  
and ,enhanced ,connections ,that        
,improve ,opioid ,navigation ,strategies
 ,act of #bjah or the ,,connections     
,act4  #b4 ,preventing overdoses of     
controlled substances ,part ,p of title 
,,iii of the ,public ,health ,service   
,act 7#db ,u4,s4,c4 #bhj;g et seq47 is  
amended by adding at the end the        
following new section3  #cii,v-#g4      
,preventing overdoses of controlled     
substances  7a7 ,evidence-,based        
prevention grants  7#a7 ,in general ,the
 ,director of the ,centers for ,disease 
,control and ,prevention may-- 7,a7 to  
the extent practicable1 carry out any   

evidence-based prevention activity      
described in paragraph 7#b72  7,b7      
provide training and technical          
assistance to ,states1 localities1 and  
,indian tribes for purposes of carrying 
out any such activity2 and  7,c7 award  
grants to ,states1 localities1 and      
,indian tribes for purposes of carrying 
out any such activity4  7#b7            
,evidence-based prevention activities   
,an evidence-based prevention activity  
described in this paragraph is any of   
the following activities3 7,a7 ,with    
respect to a ,state1 improving the      
efficiency and use of the ,state        
prescription drug monitoring program    
by--  7i7 encouraging all authorized    
users 7as specified by the ,state7 to   
register with and use the program and   
making the program easier to use2  7ii7 
enabling such users to access any       
updates to information collected by the 
program in as close to real-time as     
possible2  7iii7 providing for a        
mechanism for the program to            

automatically flag any potential misuse 
or abuse of controlled substances and   
any detection of inappropriate          
prescribing practices relating to such  
substances2  7iv7 enhancing             
interoperability between the program and
 any electronic health records system1  
including by integrating the use of     
electronic health records into the      
program for purposes of improving       
clinical decisionmaking2  7v7           
continually updating program            
capabilities to respond to technological
 innovation for purposes of             
appropriately addressing a controlled   
substance overdose epidemic as such     
epidemic may occur and evolve2  7vi7    
facilitating data sharing between the   
program and the prescription drug       
monitoring programs of neighboring      
,states2 and  7vii7 meeting the purpose 
of the program established under section
 #cii,o1 as described in section        
#cii,o7a74  7,b7 ,achieving community or
 health system interventions through    

activities such as--  7i7 establishing  
or improving controlled substances      
prescribing interventions for insurers  
and health systems2  7ii7 enhancing the 
use of evidence-based controlled        
substances prescribing guidelines across
 sectors and health care settings2 and  
7iii7 implementing strategies to align  
the prescription of controlled          
substances with the guidelines described
 in clause 7ii74  7,c7 ,evaluating      
interventions to better understand what 
works to prevent overdoses1 including   
those involving prescription and illicit
 controlled substances4  7,d7           
,implementing projects to advance an    
innovative prevention approach with     
respect to new and emerging public      
health crises and opportunities to      
address such crises1 such as enhancing  
public education and awareness on the   
risks associated with opioids4  7b7     
,enhanced surveillance of controlled    
substance overdose grants  7#a7 ,in     
general ,the ,director of the ,centers  

for ,disease ,control and ,prevention   
may--  7,a7 to the extent practicable1  
carry out any controlled substance      
overdose surveillance activity described
 in paragraph 7#b72  7,b7 provide       
training and technical assistance to    
,states for purposes of carrying out any
 such activity2  7,c7 award grants to   
,states for purposes of carrying out any
 such activity2 and  7,d7 coordinate    
with the ,assistant ,secretary for      
,mental ,health and ,substance ,use to  
collect data pursuant to section        
#eje7;d77#a77;,a7 7relating to the      
number of individuals admitted to the   
emergency rooms of hospitals as a result
 of the abuse of alcohol or other       
drugs74  7#b7 ,controlled substance     
overdose surveillance activities ,a     
controlled substance overdose           
surveillance activity described in this 
paragraph is any of the following       
activities3 7,a7 ,enhancing the         
timeliness of reporting data to the     
public1 including data on fatal and     

nonfatal overdoses of controlled        
substances4  7,b7 ,enhancing            
comprehensiveness of data on controlled 
substances overdoses by collecting      
information on such overdoses from      
appropriate sources such as toxicology  
reports1 autopsy reports1 death scene   
investigations1 and other risk factors4 
7,c7 ,using data to help identify risk  
factors associated with controlled      
substances overdoses4  7,d7 ,with       
respect to a ,state1 supporting entities
 involved in providing information to   
inform efforts within the ,state1 such  
as by coroners and medical examiners1 to
 improve accurate testing and reporting 
of causes and contributing factors to   
controlled substances overdoses4  7,e7  
,working to enable information sharing  
regarding controlled substances         
overdoses among data sources4  7c7      
,definitions ,in this section3 7#a7     
,controlled substance ,the term         
controlled substance has the meaning    
given that term in section #ajb of the  

,controlled ,substances ,act4  7#b7     
,indian tribe ,the term ,indian tribe   
has the meaning given that term in      
section #d of the ,indian               
,self-,determination and ,education     
,assistance ,act4  7d7 ,authorization of
 appropriations ,for purposes of        
carrying out this section and section   
#cii,o1 there is authorized to be       
appropriated #dhf1jjj1jjj for each of   
fiscal years #bjai through #bjbc4  4    
#c4 ,prescription drug monitoring       
program ,section #cii,o of the ,public  
,health ,service ,act 7#db ,u4,s4,c4    
#bhj;g-#c7 is amended to read as        
follows3  #cii,o4 ,prescription drug    
monitoring program  7a7 ,program  7#a7  
,in general ,each fiscal year1 the      
,secretary1 in consultation with the    
,director of ,national ,drug ,control   
,policy1 acting through the ,director of
 the ,centers for ,disease ,control and 
,prevention1 the ,assistant ,secretary  
for ,mental ,health and ,substance ,use1
 and the ,national ,coordinator for     

,health ,information ,technology1 shall 
support ,states for the purpose of      
improving the efficiency and use of     
,p,d,m,ps1 including--  7,a7            
establishment and implementation of a   
,,pdmp2  7,b7 maintenance of a ,,pdmp2  
7,c7 improvements to a ,,pdmp by-- 7i7  
enhancing functional components to work 
toward--  7,i7 universal use of         
,p,d,m,ps among providers and their     
delegates1 to the extent that ,state    
laws allow1 within a ,state2  7,,ii7    
more timely inclusion of data within a  
,,pdmp2  7,,iii7 active management of   
the ,,pdmp1 in part by sending proactive
 or unsolicited reports to providers to 
inform prescribing2 and  7,,iv7 ensuring
 the highest level of ease in use and   
access of ,p,d,m,ps by providers and    
their delegates1 to the extent that     
,state laws allow2  7ii7 improving the  
intrastate interoperability of ,p,d,m,ps
 by-- 7,i7 making ,p,d,m,ps more        
actionable by integrating ,p,d,m,ps     
within electronic health records and    

health information technology           
infrastructure2 and  7,,ii7 linking     
,,pdmp data to other data systems within
 the ,state1 including-- 7aa7 the data  
of pharmacy benefit managers1 medical   
examiners and coroners1 and the ,state's
 ,medicaid program2  7bb7 worker's      
compensation data2 and  7cc7 prescribing
 data of providers of the ,department of
 ,veterans ,affairs and the ,indian     
,health ,service within the ,state2     
7iii7 improving the interstate          
interoperability of ,p,d,m,ps through-- 
7,i7 sharing of dispensing data in      
near-real time across ,state lines2 and 
7,,ii7 integration of automated queries 
for multistate ,,pdmp data and analytics
 into clinical workflow to improve the  
use of such data and analytics by       
practitioners and dispensers2 or  7iv7  
improving the ability to include        
treatment availability resources and    
referral capabilities within the ,,pdmp4
  7#b7 ,state legislation ,as a         
condition on the receipt of support     

under this section1 the ,secretary shall
 require a ,state to demonstrate that   
the ,state has enacted legislation or   
regulations-- 7,a7 to provide for the   
implementation of the ,,pdmp2 and  7,b7 
to permit the imposition of appropriate 
penalties for the unauthorized use and  
disclosure of information maintained by 
the ,,pdmp4  7b7 ,,pdmp strategies ,the 
,secretary shall encourage a ,state1 in 
establishing1 improving1 or maintaining 
a ,,pdmp1 to implement strategies that  
improve--  7#a7 the reporting of        
dispensing in the ,state of a controlled
 substance to an ultimate user so the   
reporting occurs not later than #bd     
hours after the dispensing event2  7#b7 
the consultation of the ,,pdmp by each  
prescribing practitioner1 or their      
designee1 in the ,state before          
initiating treatment with a controlled  
substance1 or any substance as required 
by the ,state to be reported to the     
,,pdmp1 and over the course of ongoing  
treatment for each prescribing event2   

7#c7 the consultation of the ,,pdmp     
before dispensing a controlled          
substance1 or any substance as required 
by the ,state to be reported to the     
,,pdmp2  7#d7 the proactive notification
 to a practitioner when patterns        
indicative of controlled substance      
misuse by a patient1 including opioid   
misuse1 are detected2  7#e7 the         
availability of data in the ,,pdmp to   
other ,states1 as allowable under ,state
 law2 and  7#f7 the availability of     
nonidentifiable information to the      
,centers for ,disease ,control and      
,prevention for surveillance1           
epidemiology1 statistical research1 or  
educational purposes4  7c7 ,drug misuse 
and abuse ,in consultation with         
practitioners1 dispensers1 and other    
relevant and interested stakeholders1 a 
,state receiving support under this     
section-- 7#a7 shall establish a program
 to notify practitioners and dispensers 
of information that will help to        
identify and prevent the unlawful       

diversion or misuse of controlled       
substances2 and  7#b7 may1 to the extent
 permitted under ,state law1 notify the 
appropriate authorities responsible for 
carrying out drug diversion             
investigations if the ,state determines 
that information in the ,,pdmp          
maintained by the ,state indicates an   
unlawful diversion or abuse of a        
controlled substance4  7d7 ,evaluation  
and reporting ,as a condition on receipt
 of support under this section1 the     
,state shall report on interoperability 
with ,p,d,m,ps of other ,states and     
,federal agencies1 where appropriate1   
intrastate interoperability with health 
information technology systems such as  
electronic health records1 health       
information exchanges1 and              
e-prescribing1 where appropriate1 and   
whether or not the ,state provides      
automatic1 up-to-date1 or daily         
information about a patient when a      
practitioner 7or the designee of a      
practitioner1 where permitted7 requests 

information about such patient4  7e7    
,evaluation and reporting ,a ,state     
receiving support under this section    
shall provide the ,secretary with       
aggregate nonidentifiable information1  
as permitted by ,state law1 to enable   
the ,secretary-- 7#a7 to evaluate the   
success of the ,state's program in      
achieving the purpose described in      
subsection 7a72 or  7#b7 to prepare and 
submit to the ,congress the report      
required by subsection 7i77#b74  7f7    
,education and access to the monitoring 
system ,a ,state receiving support under
 this section shall take steps to--     
7#a7 facilitate prescribers and         
dispensers1 and their delegates1 as     
permitted by ,state law1 to use the     
,,pdmp1 to the extent practicable2 and  
7#b7 educate prescribers and dispensers1
 and their delegates on the benefits of 
the use of ,p,d,m,ps4  7g7 ,electronic  
format ,the ,secretary may issue        
guidelines specifying a uniform         
electronic format for the reporting1    

sharing1 and disclosure of information  
pursuant to ,p,d,m,ps4  7h7 ,rules of   
construction  7#a7 ,functions otherwise 
authorized by law ,nothing in this      
section shall be construed to restrict  
the ability of any authority1 including 
any local1 ,state1 or ,federal law      
enforcement1 narcotics control1         
licensure1 disciplinary1 or program     
authority1 to perform functions         
otherwise authorized by law4  7#b7      
,additional privacy protections ,nothing
 in this section shall be construed as  
preempting any ,state from imposing any 
additional privacy protections4  7#c7   
,federal privacy requirements ,nothing  
in this section shall be construed to   
supersede any ,federal privacy or       
confidentiality requirement1 including  
the regulations promulgated under       
section #bfd7;c7 of the ,health         
,insurance ,portability and             
,accountability ,act of #aiif 7,public  
,law #ajd-aia2 #aaj ,stat4 #bjcc7 and   
section #edc of this ,act4  7#d7 ,no    

,federal private cause of action        
,nothing in this section shall be       
construed to create a ,federal private  
cause of action4  7i7 ,progress report  
,not later than #c years after the date 
of enactment of the ,,connections ,act1 
the ,secretary shall--  7#a7 complete a 
study that-- 7,a7 determines the        
progress of ,states in establishing and 
implementing ,p,d,m,ps consistent with  
this section2  7,b7 provides an analysis
 of the extent to which the operation of
 ,p,d,m,ps has-- 7i7 reduced            
inappropriate use1 abuse1 diversion of1 
and overdose with1 controlled           
substances2  7ii7 established or        
strengthened initiatives to ensure      
linkages to substance use disorder      
treatment services2 or  7iii7 affected  
patient access to appropriate care in   
,states operating ,p,d,m,ps2  7,c7      
determine the progress of ,states in    
achieving interstate interoperability   
and intrastate interoperability of      
,p,d,m,ps1 including an assessment of   

technical1 legal1 and financial barriers
 to such progress and recommendations   
for addressing these barriers2  7,d7    
determines the progress of ,states in   
implementing near real-time electronic  
,p,d,m,ps2  7,e7 provides an analysis of
 the privacy protections in place for   
the information reported to the ,,pdmp  
in each ,state receiving support under  
this section and any recommendations of 
the ,secretary for additional ,federal  
or ,state requirements for protection of
 this information2  7,f7 determines the 
progress of ,states in implementing     
technological alternatives to           
centralized data storage1 such as       
peer-to-peer file sharing or data       
pointer systems1 in ,p,d,m,ps and the   
potential for such alternatives to      
enhance the privacy and security of     
individually identifiable data2 and     
7,g7 evaluates the penalties that       
,states have enacted for the            
unauthorized use and disclosure of      
information maintained in ,p,d,m,ps1 and

 the criteria used by the ,secretary to 
determine whether such penalties qualify
 as appropriate for purposes of         
subsection 7a77#b72 and  7#b7 submit a  
report to the ,congress on the results  
of the study4  7j7 ,advisory council    
7#a7 ,establishment ,a ,state may       
establish an advisory council to assist 
in the establishment1 improvement1 or   
maintenance of a ,,pdmp consistent with 
this section4  7#b7 ,limitation ,a      
,state may not use ,federal funds for   
the operations of an advisory council to
 assist in the establishment1           
improvement1 or maintenance of a ,,pdmp4
  7#c7 ,sense of ,congress ,it is the   
sense of the ,congress that1 in         
establishing an advisory council to     
assist in the establishment1            
improvement1 or maintenance of a ,,pdmp1
 a ,state should consult with           
appropriate professional boards and     
other interested parties4  7k7          
,definitions ,for purposes of this      
section3  7#a7 ,the term controlled     

substance means a controlled substance  
7as defined in section #ajb of the      
,controlled ,substances ,act7 in        
schedule ,,ii1 ,,iii1 or ,,iv of section
 #bjb of such ,act4  7#b7 ,the term     
dispense means to deliver a controlled  
substance to an ultimate user by1 or    
pursuant to the lawful order of1 a      
practitioner1 irrespective of whether   
the dispenser uses the internet or other
 means to effect such delivery4  7#c7   
,the term dispenser means a physician1  
pharmacist1 or other person that        
dispenses a controlled substance to an  
ultimate user4  7#d7 ,the term          
interstate interoperability with respect
 to a ,,pdmp means the ability of the   
,,pdmp to electronically share reported 
information with another ,state if the  
information concerns either the         
dispensing of a controlled substance to 
an ultimate user who resides in such    
other ,state1 or the dispensing of a    
controlled substance prescribed by a    
practitioner whose principal place of   

business is located in such other       
,state4  7#e7 ,the term intrastate      
interoperability with respect to a      
,,pdmp means the integration of ,,pdmp  
data within electronic health records   
and health information technology       
infrastructure or linking of a ,,pdmp to
 other data systems within the ,state1  
including the ,state's ,medicaid        
program1 workers' compensation programs1
 and medical examiners or coroners4     
7#f7 ,the term nonidentifiable          
information means information that does 
not identify a practitioner1 dispenser1 
or an ultimate user and with respect to 
which there is no reasonable basis to   
believe that the information can be used
 to identify a practitioner1 dispenser1 
or an ultimate user4  7#g7 ,the term    
,,pdmp means a prescription drug        
monitoring program that is              
,state-controlled4  7#h7 ,the term      
practitioner means a physician1 dentist1
 veterinarian1 scientific investigator1 
pharmacy1 hospital1 or other person     

licensed1 registered1 or otherwise      
permitted1 by the ,united ,states or the
 jurisdiction in which the individual   
practices or does research1 to          
distribute1 dispense1 conduct research  
with respect to1 administer1 or use in  
teaching or chemical analysis1 a        
controlled substance in the course of   
professional practice or research4  7#i7
 ,the term ,state means each of the #ej 
,states1 the ,district of ,columbia1 and
 any commonwealth or territory of the   
,united ,states4  7#aj7 ,the term       
ultimate user means a person who has    
obtained from a dispenser1 and who      
possesses1 a controlled substance for   
the person's own use1 for the use of a  
member of the person's household1 or for
 the use of an animal owned by the      
person or by a member of the person's   
household4  7#aa7 ,the term clinical    
workflow means the integration of       
automated queries for prescription drug 
monitoring programs data and analytics  
into health information technologies    

such as electronic health record        
systems1 health information exchanges1  
and_/or pharmacy dispensing software    
systems1 thus streamlining provider     
access through automated queries4  4    
,passed the ,house of ,representatives  
,june #ab1 #bjah4;,clerk4