,i #aafth ,,congress #ast ,session ,h4 ,r4 #digd ,,in ,,the ,,house ,,of ,,representatives ,november #a1 #bjai,mrs4 ,trahan 7for herself1 ,mr4 ,bergman1 ,mr4 ,carter of ,georgia1 ,mr4 ,trone1 ,mr4 ,rogers of ,kentucky1 ,ms4 ,kuster of ,new ,hampshire1 ,mr4 ,tonko1 ,mr4 ,crow1 ,mr4 ,rose of ,new ,york1 and ,mr4 ,pappas7 introduced the following bill2 which was referred to the ,committee on ,energy and ,commerce1 and in addition to the ,committee on the ,judiciary1 for a period to be subsequently determined by the ,speaker1 in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned ,a ,,bill ,to amend the ,controlled ,substances ,act to require physicians and other prescribers of controlled substances to complete training on treating and managing patients with opioid and other substance use disorders 7which shall also satisfy certain training required to receive a waiver for dispensing narcotic drugs for maintenance or detoxification treatment71 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,medication ,access and ,training ,expansion ,act of #bjai or the ,,mate ,act of #bjai4 #b4 ,requiring prescribers of controlled substances to complete training on treating and managing patients with opioid and other substance use disorders 7a7 ,in general ,section #cjc of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hbc7 is amended by adding at the end the following3 7l7 ,required training for prescribers on treating and managing patients with opioid and other substance use disorders 7#a7 ,applicability ,this subsection applies-- 7,a7 with respect to any practitioner who is licensed under ,state law to prescribe controlled substances2 and 7,b7 beginning with the first registration or renewal of registration by the practitioner under this section occurring #ij or more days after the date of enactment of the ,medication ,access and ,training ,expansion ,act of #bjai4 7#b7 ,training required ,as a condition on registration under this section to dispense controlled substances in schedule ,,ii1 ,,iii1 ,,iv1 or ,v1 the ,attorney ,general shall require any practitioner described in paragraph 7#a77;,a7 to meet the following3 7,a7 ,if the practitioner is a physician1 the practitioner must meet one or more of the following conditions3 7i7 ,the physician holds a board certification in addiction psychiatry or addiction medicine from the ,american ,board of ,medical ,specialties4 7ii7 ,the physician holds an addiction certification or board certification from the ,american ,society of ,addiction ,medicine or the ,american ,board of ,addiction ,medicine4 7iii7 ,the physician holds a board certification in addiction medicine from the ,american ,osteopathic ,association4 7iv7 ,the physician has1 with respect to the treatment and management of patients with opioid and other substance use disorders1 completed not less than #h hours of training 7through classroom situations1 seminars at professional society meetings1 electronic communications1 or otherwise7 that is provided by the ,american ,society of ,addiction ,medicine1 the ,american ,academy of ,addiction ,psychiatry1 the ,american ,medical ,association1 the ,american ,osteopathic ,association1 the ,american ,psychiatric ,association1 or any other organization that the ,secretary determines is appropriate for purposes of this clause4 ,such training shall include-- 7,i7 opioid maintenance and detoxification2 7,,ii7 appropriate clinical use of all drugs approved by the ,food and ,drug ,administration for the treatment of a substance use disorder2 7,,iii7 initial and periodic patient assessments 7including substance use monitoring72 7,,iv7 individualized treatment planning1 overdose reversal1 and relapse prevention2 7,v7 counseling and recovery support services2 7,,vi7 staffing roles and considerations2 7,,vii7 diversion control2 and 7,,viii7 other best practices1 such as prevention of addiction1 as identified by the ,secretary1 after consultation with practitioners from a variety of medical specialties and who practice in different settings in which controlled substances are prescribed4 7v7 ,the physician has participated as an investigator in one or more clinical trials leading to the approval of a narcotic drug in schedule ,,iii1 ,,iv1 or ,v for maintenance or detoxification treatment1 as demonstrated by a statement submitted to the ,secretary by the sponsor of such approved drug4 7vi7 ,the physician has such other training or experience as the ,state medical licensing board of the ,state where the physician will provide maintenance or detoxification treatment considers to demonstrate the ability of the physician to treat and manage patients with opioid and other substance use disorders4 7vii7 ,the physician has such other training or experience as the ,secretary considers to demonstrate the ability of the physician to treat and manage patients with opioid and other substance use disorders4 ,any criteria of the ,secretary under this clause shall be established by regulation4 ,any such criteria are effective only for #c years after the date on which the criteria are promulgated1 but may be extended for such additional discrete #c-year periods as the ,secretary considers appropriate for purposes of this clause4 ,such an extension of criteria may only be effectuated through a statement published in the ,federal ,register by the ,secretary during the #cj-;day period preceding the end of the #c-year period involved4 7viii7 ,the physician graduated in good standing from an accredited school of allopathic medicine or osteopathic medicine in the ,united ,states during the #e-year period immediately preceding the date on which the physician first registers or renews under this section and has successfully completed a comprehensive allopathic or osteopathic medicine curriculum or accredited medical residency that-- 7,i7 included not less than #h hours of training on treating and managing patients with opioid and other substance use disorders2 and 7,,ii7 included1 at a minimum-- 7aa7 the training described in subclauses 7,i7 through 7,,viii7 of clause 7iv72 and 7bb7 training with respect to any other best practice the ,secretary determines should be included in the curriculum1 which may include training on pain management1 including assessment and appropriate use of opioid and non-opioid alternatives4 7,b7 ,if the practitioner is not a physician1 the practitioner must meet one or more of the following conditions3 7i7 ,completed not fewer than #bd hours of initial training addressing each of the topics listed in subparagraph 7,a77iv7 7through classroom situations1 seminars at professional society meetings1 electronic communications1 or otherwise7 provided by the ,american ,society of ,addiction ,medicine1 the ,american ,academy of ,addiction ,psychiatry1 the ,american ,medical ,association1 the ,american ,osteopathic ,association1 the ,american ,nurses ,credentialing ,center1 the ,american ,psychiatric ,association1 the ,american ,association of ,nurse ,practitioners1 the ,american ,academy of ,physician ,assistants1 or any other organization that the ,secretary determines is appropriate for purposes of this clause4 7ii7 ,has such other training or experience as the ,secretary determines will demonstrate the ability of the practitioner to treat and manage patients with opioid and other substance use disorders4 7iii7 ,graduated in good standing from an accredited physician assistant school or school of advanced practice nursing in the ,united ,states during the #e-year period immediately preceding the date on which the practitioner first registers or renews under this section and has successfully completed a comprehensive physician assistant or advanced practice nursing curriculum that includes not less than #bd hours of training on treating and managing patients with opioid and other substance use disorders and1 at a minimum-- 7,i7 the training described in subclauses 7,i7 through 7,,viii7 of subparagraph 7,a77iv72 and 7,,ii7 training with respect to any other best practice the ,secretary determines should be included in the curriculum1 which may include training on pain management1 including assessment and appropriate use of opioid and non-opioid alternatives4 7#c7 ,reciprocal treatment 7,a7 ,physicians ,a physician who meets one or more of the conditions listed in paragraph 7#b77;,a7 is deemed to meet one or more of the conditions listed in subsection 7g77#b77;,g77ii71 and a physician who meets one or more of the conditions listed in subsection 7g77#b77;,g77ii7 is deemed to meet one or more of the conditions listed in paragraph 7#b77;,a74 7,b7 ,other practitioners ,a practitioner who is not a physician1 and who meets one or more of the conditions listed in paragraph 7#b77;,b71 is deemed to meet one or more of the conditions listed in subsection 7g77#b77;,g77iv77,,ii71 and a practitioner who is not a physician1 and who meets one or more of the conditions listed in subsection 7g77#b77;,g77iv77,,ii71 is deemed to meet one or more of the conditions listed in paragraph 7#b77;,b74 4 7b7 ,training required 7#a7 ,physicians ,section #cjc7;g77#b77;,g77ii77,,iv77hh7 of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hbc7;g77#b77;,g77ii77,,iv77 is amended by inserting such as prevention of addiction1 after other best practices14 7#b7 ,other practitioners ,section #cjc7;g77#b77;,g77iv77,,ii7 of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hbc7;g77#b77;,g77iv77,,ii77 is amended-- 7,a7 in item 7aa71 by striking or at the end2 7,b7 in item 7bb71 by striking the period at the end and inserting 2 or2 and 7,c7 by adding at the end the following new item3 7cc7 graduated in good standing from an accredited physician assistant school or school of advanced practice nursing in the ,united ,states during the #e-year period immediately preceding the date on which the practitioner submits to the ,secretary a written notification under subparagraph 7,b7 and has successfully completed a comprehensive physician assistant or advanced practice nursing curriculum that includes not less than #bd hours of training on treating and managing opioid-dependent patients and1 at a minimum-- 7,,aa7 the training described in items 7aa7 through 7hh7 of clause 7ii77,,iv72 and 7,,bb7 training with respect to any other best practice the ,secretary determines should be included in the curriculum1 which may include training on pain management1 including assessment and appropriate use of opioid and non-opioid alternatives4 4 7#c7 ,technical correction ,section #cjc7;g77#b77;,g77iv77,,ii77bb7 of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hbc7;g77#b77;,g77iv77,,ii77bb77 is amended by striking has before such other training4