,,ii #aaeth ,,congress #ast ,session ,s4 #bacd ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,november #ae1 #bjag ,ms4 ,baldwin 7for herself1 ,mrs4 ,capito1 ,mr4 ,moran1 ,mr4 ,blumenthal1 ,mr4 ,manchin1 ,mr4 ,tester1 and ,mr4 ,brown7 introduced the following bill2 which was read twice and referred to the ,committee on ,veterans' ,affairs ,a ,,bill ,to require the ,secretary of ,veterans ,affairs to establish processes to ensure that non-,department of ,veterans ,affairs health care providers are using safe practices in prescribing opioids to veterans under the laws administered by the ,secretary1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,andrew ,white ,veterans ,community ,care ,opioid ,safety ,act4 #b4 ,establishment of processes to ensure safe opioid prescribing practices by non-,department of ,veterans ,affairs health care providers 7a7 ,receipt and review of guidelines ,the ,secretary of ,veterans ,affairs shall ensure that all covered health care providers are provided a copy of and certify that they have reviewed the evidence-based guidelines for prescribing opioids set forth by the ,opioid ,safety ,initiative of the ,department of ,veterans ,affairs under sections #iaa7;a77#b7 and #iab7;c7 of the ,jason ,simcakoski ,memorial and ,promise ,act 7,public ,law #aad-aih2 #ch ,u4,s4,c4 #agja note7 before first providing care under the laws administered by the ,secretary and at any time when those guidelines are modified thereafter4 7b7 ,inclusion of medical history and current medications ,the ,secretary shall implement a process to ensure that1 if care of a veteran by a covered health care provider is authorized under the laws administered by the ,secretary1 the document authorizing such care includes the relevant medical history of the veteran and a list of all medications prescribed to the veteran4 7c7 ,submittal of prescriptions 7#a7 ,in general ,except as provided in paragraph 7#b71 the ,secretary shall require all covered health care providers who prescribe opioids to veterans under the laws administered by the ,secretary to submit any such prescription directly to a pharmacy of the ,department-- 7,a7 for the dispensing of such prescription2 7,b7 for the recording of such prescription in the electronic health record of the veteran2 and 7,c7 to enable other monitoring of such prescription as outlined in the ,opioid ,safety ,initiative of the ,department4 7#b7 ,exception 7,a7 ,in general ,a covered health care provider is not required under paragraph 7#a7 to submit an opioid prescription directly to a pharmacy of the ,department if-- 7i7 the health care provider determines that there is an immediate medical need for the prescription1 including an urgent or emergent prescription or a prescription dispensed as part of an opioid treatment program that provides office-based medications2 and 7ii7 7,i7 following an inquiry into the matter1 a pharmacy of the ,department notifies the health care provider that it cannot fill the prescription in a timely manner2 or 7,,ii7 the health care provider determines that the requirement under paragraph 7#a7 would impose an undue hardship on the veteran1 including with respect to travel distances1 as determined by the ,secretary4 7,b7 ,notification to ,department ,if a covered health care provider uses an exception under subparagraph 7,a7 with respect to an opioid prescription for a veteran1 the health care provider shall1 on the same day the prescription is written1 submit to the ,secretary for inclusion in the electronic health record of the veteran a notice1 in such form as the ,secretary may establish1 providing information about the prescription and describing the reason for the exception4 7,c7 ,report 7i7 ,in general ,not less frequently than quarterly1 the ,secretary shall submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives a report evaluating the compliance of covered health care providers with the requirements under this paragraph and setting forth data on the use by health care providers of exceptions under subparagraph 7,a7 and notices under subparagraph 7,b74 7ii7 ,elements ,each report required by clause 7i7 shall include the following with respect to the quarter covered by the report3 7,i7 ,the number of exceptions used under subparagraph 7,a7 and notices received under subparagraph 7,b74 7,,ii7 ,the rate of compliance by the ,department with the requirement under subparagraph 7,b7 to include such notices in the health records of veterans4 7,,iii7 ,the identification of any covered health care providers that1 based on criteria prescribed the ,secretary1 are determined by the ,secretary to be statistical outliers regarding the use of exceptions under subparagraph 7,a74 7d7 ,use of ,opioid ,safety ,initiative guidelines 7#a7 ,in general ,if a director of a medical center of the ,department or a ,veterans ,integrated ,service ,network determines that the opioid prescribing practices of a covered health care provider conflicts with or is otherwise inconsistent with the standards of appropriate and safe care1 as that term is used in section #iac7;d7 of the ,jason ,simcakoski ,memorial and ,promise ,act 7,public ,law #aad-aih2 #ch ,u4,s4,c4 #agja note71 the director shall take such action as the director considers appropriate to ensure the safety of all veterans receiving care from that health care provider1 including removing or directing the removal of any such health care provider from provider networks or otherwise refusing to authorize care of veterans by such health care provider in any program authorized under the laws administered by the ,secretary4 7#b7 ,inclusion in contracts ,the ,secretary shall ensure that any contracts entered into by the ,secretary with third parties involved in administering programs that provide care in the community to veterans under the laws administered by the ,secretary specifically grant the authority set forth in paragraph 7#a7 to such third parties and to the directors described in that paragraph1 as the case may be4 7e7 ,denial or revocation of eligibility of non-,department providers ,the ,secretary shall deny or revoke the eligibility of a non-,department health care provider to provide health care to veterans under the laws administered by the ,secretary if the ,secretary determines that the opioid prescribing practices of the provider-- 7#a7 violate the requirements of a medical license of the health care provider2 or 7#b7 detract from the ability of the health care provider to deliver safe and appropriate health care4 7f7 ,covered health care provider defined ,in this section1 the term covered health care provider means a non-,department of ,veterans ,affairs health care provider who provides health care to veterans under the laws administered by the ,secretary of ,veterans ,affairs4