,,ii  #aae? ,,congress  #b;d ,session   
,s4 #cjjh  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,june #f1 #bjah,mr4 ,"y
 7= himself & ,mr4 ,donnelly7 introduc$ 
! foll[+ bill2 :i* 0 read twice & ref]r$
 to ! ,committee on ,f9ance  ,a ,,bill  
,to direct ! ,secret>y ( ,heal? & ,human
 ,s]vices to conduct a /udy & submit to 
,congress a report conta9+ recomm5dation
 on h[ to improve ! use ( non-opioid    
treatm5ts = acute & *ronic pa9 managem5t
 = individuals entitl$ to b5efits "u "p 
,a or enroll$ "u "p ,b ( ! ,m$ic>e      
program1 & = o!r purposes4  #a4 ,%ort   
title ,?is ,act may be cit$ z ! ,dr4    
,todd ,graham ,pa9 ,managem5t           
,improvem5t ,act ( #bjah4  #b4 ,pa9     
managem5t /udy  7a7 ,9 g5]al ,n lat] ?an
 #a ye> aft] ! date ( enactm5t ( ?is    
,act1 ! ,secret>y ( ,heal? & ,human     
,s]vices 7ref]r$ to 9 ?is section z !   
,secret>y7 %all conduct a /udy & submit 
to ! ,committee on ,ways & ,means & !   
,committee on ,en]gy & ,comm]ce ( !     
,h\se ( ,repres5tatives & ! ,committee  

on ,f9ance ( ! ,s5ate a report conta9+  
recomm5dations on :e!r & h[ reimbursem5t
 to provid]s & suppli]s ( s]vices1      
cov]age1 & cod+ policies relat$ to ! use
 ( multi-discipl9>y1 evid5ce-bas$1      
non-opioid treatm5ts = acute & *ronic   
pa9 managem5t = individuals entitl$ to  
b5efits "u "p ,a or enroll$ "u "p ,b (  
title ,,xviii ( ! ,social ,security ,act
 %\ld be revis$4 ,! ,secret>y %all make 
su* report available on ! public website
 ( ! ,c5t]s = ,m$ic>e  ,m$icaid         
,s]vices4  7b7 ,consultation ,9 develop+
 ! report describ$ 9 subsection 7a71 !  
,secret>y %all consult )-- 7#a7 relevant
 ag5cies )9 ! ,dep>tm5t ( ,heal? &      
,human ,s]vices2  7#b7 lic5s$ & practic+
 o/eopa?ic & allopa?ic physicians1      
physician assi/ants1 nurse practition]s1
 d5ti/s1 & ph>maci/s2  7#c7 hospitals & 
o!r m$ical facilities1 includ+ acute c>e
 hospitals1 canc] hospitals1 psy*iatric 
hospitals1 hospital em]g5cy dep>tm5ts1  
facilities furni%+ urg5t c>e s]vices1   
ambulatory surgical c5t]s1 & po/-acute  

c>e & long-t]m c>e facilities 7su* z    
skill$ nurs+ facilities1 inpati5t       
rehabilitation facilities1 long-t]m c>e 
hospitals1 & home heal? ag5cies72  7#d7 
sub/ance abuse & m5tal heal? pr(essional
 organizations2  7#e7 pa9 managem5t     
pr(essional organizations & advocacy    
entities1 includ+ individuals :o        
p]sonally suff] *ronic pa92  7#f7 m$ical
 pr(essional organizations & m$ical     
specialty organizations2  7#g7 lic5s$   
heal? c>e provid]s :o furni% alt]native 
pa9 managem5t s]vices2  7#h7            
organizations ) exp]tise 9 ! developm5t 
( innovative m$ical te*nologies = pa9   
managem5t2  7#i7 b5efici>y advocacy     
organizations2 &  7#aj7 o!r             
organizations ) exp]tise 9 ! assessm5t1 
diagnosis1 treatm5t1 & managem5t ( pa91 
z det]m9$ appropriate by ! ,secret>y4   
7c7 ,cont5ts ,! report describ$ 9       
subsection 7a7 %all include ! foll[+3   
7#a7 ,! recomm5dations describ$ 9       
subsection 7d74  7#b7 ,! impact analysis
 describ$ 9 subsection 7e74  7#c7 ,an   

assessm5t ( pa9 managem5t guidance      
publi%$ by ! ,f$]al ,gov]nm5t t may be  
relevant to cov]age det]m9ations or o!r 
cov]age requirem5ts "u title ,,xviii ( !
 ,social ,security ,act4  7#d7          
,recomm5dations = updat+1 includ+ exp&+1
 ! ,,cdc ,guidel9e = ,prescrib+ ,opioids
 = ,*ronic ,pa9--,unit$ ,/ates1 #bjaf   
publi%$ 9 ,m>* #bjaf by ! ,c5t]s =      
,disease ,control & ,prev5tion1 includ+ 
= purposes ( managem5t ( pa94 ,su*      
recomm5dations %all--  7,a7 consid]     
incorporat+ relevant elem5ts ( !        
,va_/,do,d ,cl9ical ,practice ,guidel9e 
= ,opioid ,!rapy = ,*ronic ,pa9 publi%$ 
9 ,febru>y #bjag by ! ,dep>tm5t (       
,vet]ans ,affairs & ,dep>tm5t ( ,def5se1
 includ+ adoption ( elem5ts ( !         
,dep>tm5t ( ,def5se & ,vet]ans          
,adm9i/ration pa9 rat+ scale2 &  7,b7   
include recomm5dations on h[ ! ,,cdc    
,guidel9e = ,prescrib+ ,opioids =       
,*ronic ,pa9--,unit$ ,/ates1 #bjaf1 z s 
updat$1 c\ld be adopt$ by heal? c>e     
provid]s across cl9ical sett+s4  7#e7   

,an evaluation ( ! foll[+3  7,a7 ,b>ri]s
 inhibit+ individuals entitl$ to b5efits
 "u "p ,a or enroll$ "u "p ,b ( su*     
title f access+ treatm5ts & te*nologies 
describ$ 9 subp>agraphs 7,a7 ?r\gh 7,c7 
( p>agraph 7#f74  7,b7 ,pot5tial        
legislative & adm9i/rative *anges "u su*
 title to improve individuals' access to
 items & s]vices curr5tly cov]$ "u su*  
title & us$ = ! treatm5t ( pa91 su* z   
cognitive behavioral int]v5tions1       
physical !rapy1 occupational !rapy1     
physical m$ic9e1 bi(e$back !rapy1 &     
*iropractic !rapy1 & o!r pa9 treatm5ts  
s]vices furni%$ 9 a hospital or         
po/-acute c>e sett+4  7,c7 ,co/s &      
b5efits associat$ ) pot5tial expansion (
 cov]age "u su* title to include items &
 s]vices n cov]$ "u su* title t may be  
us$ = ! treatm5t ( pa91 su* z           
acupuncture1 !rapeutic massage1 & items 
& s]vices furni%$ by integrat$ pa9      
managem5t programs4  7#f7 ,an analysis  
on reimbursem5t1 cov]age1 & cod+        
policies 7includ+ ,,drg classification1 

,,cpt1 ,,hcpcs1 ,,ndc1 & o!r applicable 
codes7 "u title ,,xviii ( ! ,social     
,security ,act ) respect to ! foll[+3   
7,a7 ,non-opioid bas$ treatm5ts &       
te*nologies = *ronic or acute pa91      
includ+ su* treatm5ts t are cov]$1 n    
cov]$1 or h limit$ cov]age "u su* title4
  7,b7 ,non-opioid bas$ treatm5ts &     
te*nologies t monitor sub/ance use      
)drawal & prev5t ov]doses ( opioids4    
7,c7 ,non-opioid bas$ treatm5ts &       
te*nologies t treat sub/ance use        
disord]s4  7,d7 ,items & s]vices furni%$
 by practition]s ?r\gh a                
multi-discipl9>y treatm5t model = pa9   
managem5t4  7,e7 ,m$ical devices1       
non-opioid bas$ drugs1 & o!r !rapies    
7includ+ int]v5tional & integrative pa9 
!rapies7 approv$ or cle>$ by ! ,food &  
,drug ,adm9i/ration = ! treatm5t ( pa94 
7,f7 ,items & s]vices furni%$ to        
b5efici>ies ) psy*iatric disord]s1      
sub/ance use disord]s1 or :o are at risk
 ( suicide1 or h comorbidities & require
 consultation or managem5t ( pa9 ) "o or

 m speciali/s 9 pa9 managem5t1 m5tal    
heal?1 or addiction treatm5t4  7d7      
,recomm5dations ,! recomm5dations       
describ$ 9 ?is subsection are1 ) respect
 to individuals entitl$ to b5efits "u "p
 ,a or enroll$ "u "p ,b ( title ,,xviii 
( ! ,social ,security ,act1 legislative 
& adm9i/rative recomm5dations on !      
foll[+3  7#a7 ,options = additional     
cov]age ( pa9 managem5t !rapies )\t !   
use ( opioids1 includ+ int]v5tional pa9 
!rapies1 & options to augm5t opioid     
!rapy ) o!r cl9ical & complem5t>y1      
integrative heal? s]vices to m9imize !  
risk ( sub/ance use disord]1 includ+ 9 a
 hospital sett+4  7#b7 ,options =       
cov]age & reimbursem5t modifications (  
m$ical devices & non-opioid bas$        
ph>macological & non-ph>macological     
!rapies 7includ+ int]v5tional &         
integrative pa9 !rapies7 approv$ or     
cle>$ by ! ,food & ,drug ,adm9i/ration =
 ! treatm5t ( pa9 z an alt]native or    
augm5t to opioid !rapy4  7#c7 ,treatm5t 
/rategies = b5efici>ies ) psy*iatric    

disord]s1 sub/ance use disord]s1 or :o  
are at risk ( suicide1 & treatm5t       
/rategies to address heal? disp>ities   
relat$ to opioid use & opioid abuse     
treatm5t4  7#d7 ,treatm5t /rategies =   
b5efici>ies ) comorbidities :o require a
 consultation or comanagem5t ( pa9 ) "o 
or m speciali/s 9 pa9 managem5t1 m5tal  
heal?1 or addiction treatm5t1 includ+ 9 
a hospital sett+4  7#e7 ,coadm9i/ration 
( opioids & o!r drugs1 p>ticul>ly       
b5zodiazep9es4  7#f7 ,appropriate case  
managem5t = b5efici>ies :o transition   
betwe5 inpati5t & outpati5t hospital    
sett+s1 or betwe5 opioid !rapy to       
non-opioid !rapy1 :i* may include ! use 
( c>e transition plans4  7#g7 ,outrea*  
activities design$ to educate provid]s (
 s]vices & suppli]s "u ! ,m$ic>e program
 & individuals entitl$ to b5efits "u "p 
,a or "u "p ,b ( su* title on           
alt]native1 non-opioid !rapies to manage
 & treat acute & *ronic pa94  7#h7      
,creation ( a b5efici>y education tool  
on alt]natives to opioids = *ronic pa9  

managem5t4  7e7 ,impact analysis ,!     
impact analysis describ$ 9 ?is          
subsection consi/s ( an analysis ( any  
pot5tial effects implem5t+ !            
recomm5dations describ$ 9 subsection 7d7
 w\ld h--  7#a7 on exp5ditures "u !     
,m$ic>e program2 &  7#b7 on prev5t+ or  
r$uc+ opioid addiction = individuals    
receiv+ b5efits "u ! ,m$ic>e program4