,i #aaf? ,,congress #a/ ,session ,h4 ,r4 #eagb ,,9 ,,! ,,h\se ,,( ,,repres5tatives ,novemb] #ai1 #bjai,ms4 ,sewell ( ,alabama 7= h]self1 ,mr4 ,mc,kinley1 & ,mr4 ,br9disi7 introduc$ ! foll[+ bill2 :i* 0 ref]r$ to ! ,committee on ,en]gy & ,comm]ce1 & 9 addition to ! ,committee on ,ways & ,means1 = a p]iod to be subsequ5tly det]m9$ by ! ,speak]1 9 ea* case = consid]ation ( su* provisions z fall )9 ! jurisdiction ( ! committee conc]n$ ,a ,,bill ,to am5d title ,,xviii ( ! ,social ,security ,act to combat ! opioid crisis by promot+ access to non-opioid treatm5ts 9 ! hospital outpati5t sett+4 #a4 ,%ort title ,?is ,act may be cit$ z ! ,non-,opioids ,prev5t ,addiction ,9 ! ,nation ,act or ! ,,nopa9 ,act4 #b4 ,f9d+s ,congress f9ds ! foll[+3 7#a7 ,! ,unit$ ,/ates is und]go+ an epidemic ( addiction & dea?s caus$ by prescription drug ov]doses4 ,accord+ to ! ,c5t]s = ,disease ,control & ,prev5tion 7,,cdc71 opioids are ! ma9 driv] ( drug ov]dose dea?s acc\nt+ = #dg1fjj ov]dose dea?s 9 #bjag4 ,e day1 ov] #acj p die 9 ! ,unit$ ,/ates f opioid ov]doses4 7#b7 ,additionally1 ! ,,cdc e/imates t ! economic co/s associat$ ) prescription opioid misuse exce$s #gh billion annually4 ,^! co/s include ^? associat$ ) heal?c>e1 lo/ productivity1 addiction treatm5t1 & ! crim9al ju/ice sy/em4 7#c7 ,c]ta9 non-opioid treatm5ts & s]vices c be successful 9 replac+1 delay+1 or r$uc+ ! use ( opioids to treat po/surgical pa94 7#d7 ,! ,sub/ance ,use-,disord] ,prev5tion t ,promotes ,opioid ,recov]y & ,treatm5t 7,,support7 = ,pati5ts & ,communities ,act 0 enact$ on ,octob] #bd1 #bjah4 ,?is law requires t ,,cms review paym5ts "u ,m$ic>e's ,outpati5t ,prospective ,paym5t ,sy/em 7,,opps7 & ,,asc ,paym5t ,sy/em ) a goal ( ensur+ !re are n f9ancial inc5tives to use opioids in/ead ( non-opioid alt]natives4 ,additionally1 ! bill requires ,,cms to consid] ! ext5t to :i* paym5t policy revisions 7su* z ! creation ( additional gr\ps ( cov]$ ,,opd s]vices to classify sep>ately ^? proc$ures t utilize opioids & non-opioid alt]natives = pa9 managem5t7 w\ld r$uce paym5t inc5tives to use opioids in/ead ( non-opioid alt]natives = pa9 managem5t4 7#e7 ,pursuant to section #cai ( ! ,public ,heal? ,s]vice ,act1 ! ,act+ ,secret>y = ! ,u4,s4 ,dep>tm5t ( ,heal? ,human ,s]vices det]m9$ on ,octob] #bf1 #bjag1 t a public heal? em]g5cy exi/s z a result ( ! consequ5ces ( ! opioid crisis1 & ! ,secret>y r5ew$ ?is det]m9ation on ,octob] #af1 #bjai4 7#f7 ,! ,presid5t's ,commission on ,combat+ ,drug ,addiction & ! ,opioid ,crisis 0 e/abli%$ on ,m>* #bi1 #bjag4 ,! ,commission recomm5d$ t ,,cms exam9e paym5t policies = c]ta9 drugs t function specifically z non-opioid pa9 managem5t treatm5ts4 ,accord+ to ! ,commission's report1 ''' ! curr5t ,,cms paym5t policy = supplies relat$ to surgical proc$ures creates un9t5d$ inc5tives to prescribe opioid m$ications to pati5ts = po/surgical pa9 in/ead ( adm9i/]+ non-opioid pa9 m$ications4 ,"u curr5t policies1 ,,cms provides "o all-inclusive bundl$ paym5t to hospitals = all surgical supplies1 :i* includes hospital adm9i/]$ drug products int5d$ to manage pati5ts' po/surgical pa94 ,?is policy results 9 ! hospitals receiv+ ! same fix$ fee f ,m$ic>e :e!r ! surgeon adm9i/]s a non-opioid m$ication or n4 7#g7 ,! ,pa9 ,managem5t ,be/ ,practices ,int]-,ag5cy ,task ,=ce 0 au?oriz$ by section #aja ( ! ,compreh5sive ,addiction & ,recov]y ,act ( #bjaf4 ,! ,task ,=ce consi/$ ( ,f$]al ag5cy repres5tatives z well z exp]ts & repres5tatives f a broad gr\p ( inve/$ /akehold]s & 0 conv5$ to issue recomm5dations = id5tify+ & address+ gaps & inconsi/5cies = manag+ acute pa94 ,9 ! ,task ,=ce's ,f9al ,report on ,be/ ,practices3 ,updates1 ,gaps1 ,inconsi/5cies & ,recomm5dations1 ! foll[+ gap 0 id5tifi$3 ,multimodal1 non-opioid !rapies are und]utiliz$ 9 ! p]iop]ative1 inflammatory1 musculoskeletal1 & neuropa?ic injury sett+s4 ,! report also /ates t ,non-opioids %\ld be us$ z fir/-l9e !rapy :5ev] cl9ically appropriate 9 ! inpati5t & outpati5t sett+s4 7#h7 ,rese>* %[s t despite ongo+ ef=ts to end ! opioid crisis1 pati5ts cont9ue to receive l>ge quantities ( opioids to treat po/surgical pa94 ,"o #bjah /udy %[$ t #ab p]c5t ( pati5ts :o _h a s(t tissue or or?op$ic op]ation 9 ! ye> prior report$ t !y _h become addict$ or dep5d5t on opioids4 ,fur!r rese>* %[s t pati5ts receiv+ an opioid prescription aft] %ort-/ay surg]ies h a #dd p]c5t increas$ risk ( opioid use4 7#i7 ,,cms has reit]at$ its position 9 rulemak+ t x is appropriate to pay sep>ately = c]ta9 non-opioid pa9 managem5t treatm5ts t function z surgical supplies 9 ! ,,asc sett+1 x is cle> t direction f ,congress is necess>y to modify ,m$ic>e's outpati5t policies ) ! goal ( enc\rag+ access to non-opioid treatm5ts & s]vices to address ! opioid crisis4 #c4 ,access to non-opioid treatm5ts = pa9 7a7 ,9 g5]al ,section #ahcc7t7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciel7t77 is am5d$-- 7#a7 9 p>agraph 7#b77;,e71 by ins]t+ & sep>ate paym5ts = non-opioid treatm5ts "u p>agraph 7#af77;,g71 aft] paym5ts "u p>agraph 7#f72 & 7#b7 9 p>agraph 7#af71 by add+ at ! end ! foll[+ new subp>agraph3 7,g7 ,access to non-opioid treatm5ts = pa9 7i7 ,9 g5]al ,not)/&+ any o!r provision ( ?is subsection1 ) respect to a cov]$ ,,opd s]vice 7or gr\p ( s]vices7 furni%$ on or aft] ,janu>y #a1 #bjbj1 & be=e ,janu>y #a1 #bjbe1 ! ,secret>y %all n package1 & %all make a sep>ate paym5t z specifi$ 9 clause 7ii7 =1 a non-opioid treatm5t 7z def9$ 9 clause 7iii77 furni%$ z "p ( su* s]vice 7or gr\p ( s]vices74 7ii7 ,am\nt ( paym5t ,! am\nt ( ! paym5t specifi$ 9 ?is clause is1 ) respect to a non-opioid treatm5t t is-- 7,i7 a drug or biological product1 ! am\nt ( paym5t = su* drug or biological det]m9$ "u section #ahdg;,a2 or 7,,ii7 a m$ical device1 ! am\nt ( ! hospital's *>ges = ! device1 adju/$ to co/4 7iii7 ,def9ition ( non-opioid treatm5t ,a non-opioid treatm5t means-- 7,i7 a drug or biological product t is indicat$ to produce analgesia )\t act+ ^u ! body's opioid receptors2 or 7,,ii7 an implantable1 reusable1 or disposable m$ical device cle>$ or approv$ by ! ,adm9i/rator = ,food & ,drugs = ! int5d$ use ( manag+ or treat+ pa92 t has demon/rat$ ! ability to replace or r$uce opioid consumption 9 a cl9ical trial or ?r\gh cl9ical data publi%$ 9 a pe]-review$ j\rnal1 z det]m9$ by ! ,secret>y4 4 7b7 ,ambulatory surgical c5t] paym5t sy/em ,section #ahcc7;i77#b77;,d7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciel7i77#b77;,d77 is am5d$-- 7#a7 by align+ ! m>g9s ( clause 7v7 ) ! m>g9s ( clause 7iv72 7#b7 by r$esignat+ clause 7vi7 z clause 7vii72 & 7#c7 by ins]t+ aft] clause 7v7 ! foll[+ new clause3 7vi7 ,9 ! case ( surgical s]vices furni%$ on or aft] ,janu>y #a1 #bjbj1 & be=e ,janu>y #a1 #bjbe1 ! paym5t sy/em describ$ 9 clause 7i7 %all provide = a sep>ate paym5t = a non-opioid treatm5t 7z def9$ 9 clause 7iii7 ( subsection 7t77#af77;,g77 furni%$ z "p ( su* s]vices 9 ! am\nt specifi$ 9 clause 7ii7 ( su* subsection4 4 7c7 ,evaluation ( !rapeutic s]vices = pa9 managem5t 7#a7 ,report to ,congress ,n lat] ?an #a ye> aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,heal? & ,human ,s]vices 79 ?is subsection ref]r$ to z ! ,secret>y71 act+ ?r\gh ! ,adm9i/rator ( ! ,c5t]s = ,m$ic>e ,m$icaid ,s]vices1 %all submit to ,congress a report id5tify+-- 7,a7 limitations1 gaps1 b>ri]s to access1 or deficits 9 ,m$ic>e cov]age or reimbursem5t = re/orative !rapies1 behavioral approa*es1 & complem5t>y & integrative heal? s]vices t are id5tifi$ 9 ! ,pa9 ,managem5t ,be/ ,practices ,int]-,ag5cy ,task ,=ce ,report & t h demon/rat$ ! ability to replace or r$uce opioid consumption2 & 7,b7 recomm5dations to address ! limitations1 gaps1 b>ri]s to access1 or deficits id5tifi$ "u subp>agraph 7,a7 to improve ,m$ic>e cov]age & reimbursem5t = su* !rapies1 approa*es1 & s]vices4 7#b7 ,public consultation ,9 develop+ ! report describ$ 9 p>agraph 7#a71 ! ,secret>y %all consult ) relevant /akehold]s z det]m9$ appropriate by ! ,secret>y4 7#c7 ,exclusive treatm5t ,any drug1 biological product1 or m$ical device t is a non-opioid treatm5t 7z def9$ 9 section #ahcc7t77#af77;,g77iii7 ( ! ,social ,security ,act1 z add$ by subsection 7a77 %all n be consid]$ a !rapeutic s]vice = ! purpose ( ! report describ$ 9 p>agraph 7#a74