,,ii  #aafth ,,congress  #ast ,session  
,s4 #cjfg  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,december #ag1 
#bjai,mrs4 ,capito 7for herself1 ,mr4   
,jones1 ,ms4 ,ernst1 ,mrs4 ,shaheen1 and
 ,mr4 ,manchin7 introduced the following
 bill2 which was read twice and referred
 to the ,committee on ,finance  ,a      
,,bill  ,to amend title ,,xviii of the  
,social ,security ,act to combat the    
opioid crisis by promoting access to    
non-opioid treatments in the hospital   
outpatient setting4  #a4 ,short title   
,this ,act may be cited as the          
,non-,opioids ,prevent ,addiction ,in   
the ,nation ,act or the ,,nopain ,act4  
#b4 ,access to non-opioid treatments for
 pain  7a7 ,in general ,section #ahcc7t7
 of the ,social ,security ,act 7#db     
,u4,s4,c4 #aciel7t77 is amended--  7#a7 
in paragraph 7#b77;,e71 by inserting and
 separate payments for non-opioid       
treatments under paragraph 7#af77;,g71  
after payments under paragraph 7#f72 and
  7#b7 in paragraph 7#af71 by adding at 

the end the following new subparagraph3 
7,g7 ,access to non-opioid treatments   
for pain  7i7 ,in general               
,notwithstanding any other provision of 
this subsection1 with respect to a      
covered ,,opd service 7or group of      
services7 furnished on or after ,january
 #a1 #bjbj1 and before ,january #a1     
#bjbe1 the ,secretary shall not package1
 and shall make a separate payment as   
specified in clause 7ii7 for1 a         
non-opioid treatment 7as defined in     
clause 7iii77 furnished as part of such 
service 7or group of services74  7ii7   
,amount of payment ,the amount of the   
payment specified in this clause is1    
with respect to a non-opioid treatment  
that is--  7,i7 a drug or biological    
product1 the amount of payment for such 
drug or biological determined under     
section #ahdg;,a2 or  7,,ii7 a medical  
device1 the amount of the hospital's    
charges for the device1 adjusted to     
cost4  7iii7 ,definition of non-opioid  
treatment ,a non-opioid treatment       

means--  7,i7 a drug or biological      
product that is indicated to produce    
analgesia without acting upon the body's
 opioid receptors2 or  7,,ii7 an        
implantable1 reusable1 or disposable    
medical device cleared or approved by   
the ,administrator for ,food and ,drugs 
for the intended use of managing or     
treating pain1  that has demonstrated   
the ability to replace or reduce opioid 
consumption in a clinical trial or      
through clinical data published in a    
peer-reviewed journal4  4  7b7          
,ambulatory surgical center payment     
system ,section #ahcc7;i77#b77;,d7 of   
the ,social ,security ,act 7#db         
,u4,s4,c4 #aciel7i77#b77;,d77 is        
amended-- 7#a7 by aligning the margins  
of clause 7v7 with the margins of clause
 7iv72  7#b7 by redesignating clause    
7vi7 as clause 7vii72 and  7#c7 by      
inserting after clause 7v7 the following
 new clause3  7vi7 ,in the case of      
surgical services furnished on or after 
,january #a1 #bjbj1 and before ,january 

#a1 #bjbe1 the payment system described 
in clause 7i7 shall provide for a       
separate payment for a non-opioid       
treatment 7as defined in clause 7iii7 of
 subsection 7t77#af77;,g77 furnished as 
part of such services in the amount     
specified in clause 7ii7 of such        
subsection4  4  7c7 ,evaluation of      
therapeutic services for pain management
  7#a7 ,report to ,congress ,not later  
than #a year after the date of the      
enactment of this ,act1 the ,secretary  
of ,health and ,human ,services 7in this
 subsection referred to as the          
,secretary71 acting through the         
,administrator of the ,centers for      
,medicare  ,medicaid ,services1 shall   
submit to ,congress a report            
identifying--  7,a7 limitations1 gaps1  
barriers to access1 or deficits in      
,medicare coverage or reimbursement for 
restorative therapies1 behavioral       
approaches1 and complementary and       
integrative health services that are    
identified in the ,pain ,management     

,best ,practices ,inter-,agency ,task   
,force ,report and that have            
demonstrated the ability to replace or  
reduce opioid consumption2 and  7,b7    
recommendations to address the          
limitations1 gaps1 barriers to access1  
or deficits identified under            
subparagraph 7,a7 to improve ,medicare  
coverage and reimbursement for such     
therapies1 approaches1 and services4    
7#b7 ,public consultation ,in developing
 the report described in paragraph 7#a71
 the ,secretary shall consult with      
relevant stakeholders as determined     
appropriate by the ,secretary4  7#c7    
,exclusive treatment ,any drug1         
biological product1 or medical device   
that is a non-opioid treatment 7as      
defined in section                      
#ahcc7t77#af77;,g77iii7 of the ,social  
,security ,act1 as added by subsection  
7a77 shall not be considered a          
therapeutic service for the purpose of  
the report described in paragraph 7#a74