,,ii  #aae? ,,congress  #b;d ,session   
,s4 #bibj  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,may #bb1 #bjah ,mrs4  
,mc,caskill 7= h]self & ,mr4 ,toomey7   
introduc$ ! foll[+ bill2 :i* 0 read     
twice & ref]r$ to ! ,committee on       
,f9ance  ,a ,,bill  ,to am5d title      
,,xviii ( ! ,social ,security ,act to   
impose c]ta9 requirem5ts "u ! ,m$ic>e   
program ) respect to outli] prescrib]s (
 opioids4  #a4 ,%ort title ,?is ,act may
 be cit$ z ! ,commit to ,opioid ,m$ical 
,prescrib] ,acc\ntability & ,safety =   
,s5iors ,act ( #bjah4  #b4 ,m$ic>e      
requirem5ts ) respect to outli]         
prescrib]s ( opioids ,section           
#ahfj;,d-#d7;c77#d7 ( ! ,social         
,security ,act 7#db ,u4,s4,c4           
#aciew-#ajd7;c77#d77 is am5d$ by add+ at
 ! end ! foll[+ new subp>agraph3  7,d7  
,notification & additional requirem5ts )
 respect to outli] prescrib]s ( opioids 
7i7 ,notification ,n lat] ?an ,janu>y   
#a1 #bjba1 ! ,secret>y %all1 9 ! case ( 
a prescrib] id5tifi$ by ! ,secret>y "u  

clause 7ii7 to be an outli] prescrib] ( 
opioids1 provide1 subject to clause     
7iv71 an annual notification to su*     
prescrib] 7dur+ ! p]iod 9 :i* su*       
provid] ma9ta9s su* id5tification7 t su*
 prescrib] has be5 s id5tifi$ & includ+ 
su* res\rces on prop] prescrib+ me?ods &
 su* o!r in=mation z specifi$ 9         
accordance ) clause 7iii74  7ii7        
,id5tification ( outli] prescrib]s (    
opioids  7,i7 ,9 g5]al ,! ,secret>y     
%all1 subject to subclause 7,,iii71 us+ 
! valid prescrib] ,national ,provid]    
,id5tifi]s includ$ pursuant to          
subp>agraph 7,a7 on claims = cov]$ "p ,d
 drugs = "p ,d eligible individuals     
enroll$ 9 prescription drug plans "u ?is
 "p & ,,ma-,,pd plans "u "p ,c & bas$ on
 ! ?re%olds e/abli%$ "u subclause       
7,,ii71 id5tify prescrib]s t are outli] 
opioids prescrib]s = a p]iod ( "t       
specifi$ by ! ,secret>y4  7,,ii7        
,e/abli%m5t ( ?re%olds ,= purposes (    
subclause 7,i7 & subject to subclause   
7,,iii71 ! ,secret>y %all1 aft]         

consultation ) /akehold]s1 e/abli%      
?re%olds1 bas$ on prescrib] specialty &1
 z det]m9$ appropriate by ! ,secret>y1  
geographic area1 = id5tify+ :e!r a      
prescrib] 9 a specialty & geographic    
area is an outli] prescrib] ( opioids z 
comp>$ to o!r prescrib]s ( opioids )9   
su* specialty & area4  7,,iii7          
,exclusions ,! foll[+ %all n be includ$ 
9 ! process = id5tify+ outli] prescrib]s
 ( opioids "u ?is clause3  7aa7 ,claims 
= cov]$ "p ,d drugs = "p ,d eligible    
individuals :o are receiv+ hospice c>e  
"u ?is title4  7bb7 ,claims = cov]$ "p  
,d drugs = "p ,d eligible individuals :o
 are receiv+ oncology s]vices "u ?is    
title4  7cc7 ,prescrib]s :o are !       
subject ( an inve/igation by ! ,c5t]s = 
,m$ic>e  ,m$icaid ,s]vices or ! ,(fice (
 ! ,inspector ,g5]al ( ! ,dep>tm5t (    
,heal? & ,human ,s]vices4  7iii7        
,cont5ts ( notification ,! ,secret>y    
%all include ! foll[+ in=mation 9 !     
notifications provid$ "u clause 7i73    
7,i7 ,in=mation on h[ su* prescrib]     

comp>es to o!r prescrib]s )9 ! same     
specialty &1 if det]m9$ appropriate by !
 ,secret>y1 geographic area4  7,,ii7    
,in=mation on opioid prescrib+          
guidel9es1 bas$ on input f /akehold]s1 t
 may include ! ,c5t]s = ,disease        
,control & ,prev5tion guidel9es =       
prescrib+ opioids = *ronic pa9 &        
guidel9es develop$ by physician         
organizations4  7,,iii7 ,o!r in=mation  
det]m9$ appropriate by ! ,secret>y4     
7iv7 ,modifications & expansions  7,i7  
,frequ5cy ,beg9n+ #e ye>s aft] ! date ( 
! enactm5t ( ?is subp>agraph1 !         
,secret>y may *ange ! frequ5cy ( !      
notifications describ$ 9 clause 7i7 bas$
 on /akehold] input & *anges 9 opioid   
prescrib+ utilization & tr5ds4  7,,ii7  
,expansion to o!r prescriptions ,!      
,secret>y may exp& notifications "u ?is 
subp>agraph to include id5tifications & 
notifications ) respect to concurr5t    
prescriptions ( cov]$ "p ,d drugs us$ 9 
comb9ation ) opioids t are consid]$ to h
 adv]se side effects :5 s us$ 9 su*     

comb9ation4  7v7 ,additional requirem5ts
 = p]si/5t outli] prescrib]s ,9 ! case (
 a prescrib] :o ! ,secret>y det]m9es is 
p]si/5tly id5tifi$ "u clause 7ii7 z an  
outli] prescrib] ( opioids1 ! foll[+    
%all apply3  7,i7 ,! ,secret>y %all     
connect su* prescrib] ) an entity t     
provides te*nical or educational        
res\rces on opioid prescrib+ guidel9es  
7su* z ! guidel9es describ$ 9 clause    
7iii77,,ii771 :i* may include a quality 
improvem5t organization "u "p ,b ( title
 ,,xi1 z available & appropriate4       
7,,ii7 ,su* prescrib] may be requir$ to 
enroll 9 ! program "u ?is title "u      
section #ahff7;j7 if su* prescrib] is n 
o!rwise requir$ to enroll4 ,! ,secret>y 
%all det]m9e ! l5g? ( ! p]iod = :i* su* 
prescrib] is requir$ to ma9ta9 su*      
enrollm5t4  7,,iii7 ,n less frequ5tly   
?an annually 7& 9 a =m & mann] det]m9$  
appropriate by ! ,secret>y71 ! ,secret>y
 %all communicate in=mation on su*      
prescrib]s to sponsors ( a prescription 
drug plan & ,m$ic>e ,advantage          

organizations (f]+ an ,,ma-,,pd plan4   
7vi7 ,public availability ( in=mation ,!
 ,secret>y %all make aggregate in=mation
 "u ?is subp>agraph available on !      
,int]net website ( ! ,c5t]s = ,m$ic>e   
,m$icaid ,s]vices4 ,su* in=mation %all  
be 9 a =m & mann] det]m9$ appropriate by
 ! ,secret>y & %all n id5tify any       
specific prescrib]4 ,9 c>ry+ out ?is    
clause1 ! ,secret>y %all consult )      
int]e/$ /akehold]s4  7vii7 ,opioids     
def9$ ,= purposes ( ?is subp>agraph1 !  
t]m opioids has su* mean+ z specifi$ by 
! ,secret>y4  7viii7 ,o!r activities    
,no?+ 9 ?is subp>agraph %all preclude ! 
,secret>y f conduct+ activities t       
provide prescrib]s ) in=mation z to h[  
!y comp>e to o!r prescrib]s t are 9     
addition to ! activities "u ?is         
subp>agraph1 includ+ activities t 7 be+ 
conduct$ z ( ! date ( ! enactm5t ( ?is  
subp>agraph4  4