,,ii  #aaeth ,,congress  #b;d ,session  
,s4 #cjjh  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,june #f1      
#bjah,mr4 ,young 7for himself and ,mr4  
,donnelly7 introduced the following     
bill2 which was read twice and referred 
to the ,committee on ,finance  ,a ,,bill
  ,to direct the ,secretary of ,health  
and ,human ,services to conduct a study 
and submit to ,congress a report        
containing recommendation on how to     
improve the use of non-opioid treatments
 for acute and chronic pain management  
for individuals entitled to benefits    
under part ,a or enrolled under part ,b 
of the ,medicare program1 and for other 
purposes4  #a4 ,short title ,this ,act  
may be cited as the ,dr4 ,todd ,graham  
,pain ,management ,improvement ,act of  
#bjah4  #b4 ,pain management study  7a7 
,in general ,not later than #a year     
after the date of enactment of this     
,act1 the ,secretary of ,health and     
,human ,services 7referred to in this   
section as the ,secretary7 shall conduct

 a study and submit to the ,committee on
 ,ways and ,means and the ,committee on 
,energy and ,commerce of the ,house of  
,representatives and the ,committee on  
,finance of the ,senate a report        
containing recommendations on whether   
and how reimbursement to providers and  
suppliers of services1 coverage1 and    
coding policies related to the use of   
multi-disciplinary1 evidence-based1     
non-opioid treatments for acute and     
chronic pain management for individuals 
entitled to benefits under part ,a or   
enrolled under part ,b of title ,,xviii 
of the ,social ,security ,act should be 
revised4 ,the ,secretary shall make such
 report available on the public website 
of the ,centers for ,medicare  ,medicaid
 ,services4  7b7 ,consultation ,in      
developing the report described in      
subsection 7a71 the ,secretary shall    
consult with-- 7#a7 relevant agencies   
within the ,department of ,health and   
,human ,services2  7#b7 licensed and    
practicing osteopathic and allopathic   

physicians1 physician assistants1 nurse 
practitioners1 dentists1 and            
pharmacists2  7#c7 hospitals and other  
medical facilities1 including acute care
 hospitals1 cancer hospitals1           
psychiatric hospitals1 hospital         
emergency departments1 facilities       
furnishing urgent care services1        
ambulatory surgical centers1 and        
post-acute care and long-term care      
facilities 7such as skilled nursing     
facilities1 inpatient rehabilitation    
facilities1 long-term care hospitals1   
and home health agencies72  7#d7        
substance abuse and mental health       
professional organizations2  7#e7 pain  
management professional organizations   
and advocacy entities1 including        
individuals who personally suffer       
chronic pain2  7#f7 medical professional
 organizations and medical specialty    
organizations2  7#g7 licensed health    
care providers who furnish alternative  
pain management services2  7#h7         
organizations with expertise in the     

development of innovative medical       
technologies for pain management2  7#i7 
beneficiary advocacy organizations2 and 
7#aj7 other organizations with expertise
 in the assessment1 diagnosis1          
treatment1 and management of pain1 as   
determined appropriate by the           
,secretary4  7c7 ,contents ,the report  
described in subsection 7a7 shall       
include the following3 7#a7 ,the        
recommendations described in subsection 
7d74  7#b7 ,the impact analysis         
described in subsection 7e74  7#c7 ,an  
assessment of pain management guidance  
published by the ,federal ,government   
that may be relevant to coverage        
determinations or other coverage        
requirements under title ,,xviii of the 
,social ,security ,act4  7#d7           
,recommendations for updating1 including
 expanding1 the ,,cdc ,guideline for    
,prescribing ,opioids for ,chronic      
,pain--,united ,states1 #bjaf published 
in ,march #bjaf by the ,centers for     
,disease ,control and ,prevention1      

including for purposes of management of 
pain4 ,such recommendations shall--     
7,a7 consider incorporating relevant    
elements of the ,va_/,do,d ,clinical    
,practice ,guideline for ,opioid        
,therapy for ,chronic ,pain published in
 ,february #bjag by the ,department of  
,veterans ,affairs and ,department of   
,defense1 including adoption of elements
 of the ,department of ,defense and     
,veterans ,administration pain rating   
scale2 and  7,b7 include recommendations
 on how the ,,cdc ,guideline for        
,prescribing ,opioids for ,chronic      
,pain--,united ,states1 #bjaf1 as so    
updated1 could be adopted by health care
 providers across clinical settings4    
7#e7 ,an evaluation of the following3   
7,a7 ,barriers inhibiting individuals   
entitled to benefits under part ,a or   
enrolled under part ,b of such title    
from accessing treatments and           
technologies described in subparagraphs 
7,a7 through 7,c7 of paragraph 7#f74    
7,b7 ,potential legislative and         

administrative changes under such title 
to improve individuals' access to items 
and services currently covered under    
such title and used for the treatment of
 pain1 such as cognitive behavioral     
interventions1 physical therapy1        
occupational therapy1 physical medicine1
 biofeedback therapy1 and chiropractic  
therapy1 and other pain treatments      
services furnished in a hospital or     
post-acute care setting4  7,c7 ,costs   
and benefits associated with potential  
expansion of coverage under such title  
to include items and services not       
covered under such title that may be    
used for the treatment of pain1 such as 
acupuncture1 therapeutic massage1 and   
items and services furnished by         
integrated pain management programs4    
7#f7 ,an analysis on reimbursement1     
coverage1 and coding policies 7including
 ,,drg classification1 ,,cpt1 ,,hcpcs1  
,,ndc1 and other applicable codes7 under
 title ,,xviii of the ,social ,security 
,act with respect to the following3     

7,a7 ,non-opioid based treatments and   
technologies for chronic or acute pain1 
including such treatments that are      
covered1 not covered1 or have limited   
coverage under such title4  7,b7        
,non-opioid based treatments and        
technologies that monitor substance use 
withdrawal and prevent overdoses of     
opioids4  7,c7 ,non-opioid based        
treatments and technologies that treat  
substance use disorders4  7,d7 ,items   
and services furnished by practitioners 
through a multi-disciplinary treatment  
model for pain management4  7,e7        
,medical devices1 non-opioid based      
drugs1 and other therapies 7including   
interventional and integrative pain     
therapies7 approved or cleared by the   
,food and ,drug ,administration for the 
treatment of pain4  7,f7 ,items and     
services furnished to beneficiaries with
 psychiatric disorders1 substance use   
disorders1 or who are at risk of        
suicide1 or have comorbidities and      
require consultation or management of   

pain with one or more specialists in    
pain management1 mental health1 or      
addiction treatment4  7d7               
,recommendations ,the recommendations   
described in this subsection are1 with  
respect to individuals entitled to      
benefits under part ,a or enrolled under
 part ,b of title ,,xviii of the ,social
 ,security ,act1 legislative and        
administrative recommendations on the   
following3  7#a7 ,options for additional
 coverage of pain management therapies  
without the use of opioids1 including   
interventional pain therapies1 and      
options to augment opioid therapy with  
other clinical and complementary1       
integrative health services to minimize 
the risk of substance use disorder1     
including in a hospital setting4  7#b7  
,options for coverage and reimbursement 
modifications of medical devices and    
non-opioid based pharmacological and    
non-pharmacological therapies 7including
 interventional and integrative pain    
therapies7 approved or cleared by the   

,food and ,drug ,administration for the 
treatment of pain as an alternative or  
augment to opioid therapy4  7#c7        
,treatment strategies for beneficiaries 
with psychiatric disorders1 substance   
use disorders1 or who are at risk of    
suicide1 and treatment strategies to    
address health disparities related to   
opioid use and opioid abuse treatment4  
7#d7 ,treatment strategies for          
beneficiaries with comorbidities who    
require a consultation or comanagement  
of pain with one or more specialists in 
pain management1 mental health1 or      
addiction treatment1 including in a     
hospital setting4  7#e7                 
,coadministration of opioids and other  
drugs1 particularly benzodiazepines4    
7#f7 ,appropriate case management for   
beneficiaries who transition between    
inpatient and outpatient hospital       
settings1 or between opioid therapy to  
non-opioid therapy1 which may include   
the use of care transition plans4  7#g7 
,outreach activities designed to educate

 providers of services and suppliers    
under the ,medicare program and         
individuals entitled to benefits under  
part ,a or under part ,b of such title  
on alternative1 non-opioid therapies to 
manage and treat acute and chronic pain4
  7#h7 ,creation of a beneficiary       
education tool on alternatives to       
opioids for chronic pain management4    
7e7 ,impact analysis ,the impact        
analysis described in this subsection   
consists of an analysis of any potential
 effects implementing the               
recommendations described in subsection 
7d7 would have--  7#a7 on expenditures  
under the ,medicare program2 and  7#b7  
on preventing or reducing opioid        
addiction for individuals receiving     
benefits under the ,medicare program4