,,ii  #aaf? ,,congress  #a/ ,session    
,s4 #dbe  ,,9 ,,! ,,s5ate ,,( ,,!       
,,unit$ ,,/ates  ,febru>y #g1 #bjai,mr4 
,man*9 7= himself1 ,ms4 ,klobu*>1 ,ms4  
,baldw91 ,mr4 ,k+1 ,mr4 ,:iteh\se1 ,ms4 
,w>r51 ,mrs4 ,%ahe51 ,ms4 ,hassan1 ,mr4 
,blum5?al1 & ,ms4 ,smi?7 introduc$ !    
foll[+ bill2 :i* 0 read twice & ref]r$  
to ! ,committee on ,f9ance  ,a ,,bill   
,to am5d ! ,int]nal ,rev5ue ,code (     
#aihf to e/abli% a /ew>d%ip fee on !    
production & importation ( opioid pa9   
reliev]s1 & = o!r purposes4  #a4 ,%ort  
title ,?is ,act may be cit$ z ! ,budget+
 = ,opioid ,addiction ,treatm5t ,act4   
#b4 ,/ew>d%ip fee on opioid pa9 reliev]s
  7a7 ,9 g5]al ,sub*apt] ,e ( *apt] #cb 
( ! ,int]nal ,rev5ue ,code ( #aihf is   
am5d$ by add+ at ! end ! foll[+ new     
section3  #daib4 ,opioid pa9 reliev]s   
7a7 ,9 g5]al ,!re is h]eby impos$ on !  
sale ( any active opioid by !           
manufactur]1 produc]1 or import] a fee  
equal to #a c5t p] milligram s sold4    
7b7 ,active opioid ,= purposes ( ?is    

section-- 7#a7 ,9 g5]al ,! t]m active   
opioid means any controll$ sub/ance 7z  
def9$ 9 section #ajb ( ! ,controll$     
,sub/ances ,act1 z 9 effect on ! date ( 
! enactm5t ( ?is section7 :i* is opium1 
an opiate1 or any d]ivative !re(4  7#b7 
,exclusion = c]ta9 prescription         
m$ications ,su* t]m %all n include any  
prescrib$ drug :i* is us$ exclusively = 
! treatm5t ( opioid addiction z "p ( a  
m$ically assi/$ treatm5t ef=t4  7#c7    
,exclusion ( o!r +r$i5ts ,9 ! case ( a  
product t includes an active opioid &   
ano!r +r$i5t1 subsection 7a7 %all apply 
only to ! portion ( su* product t is an 
active opioid4  4  7b7 ,cl]ical am5dm5ts
  7#a7 ,! head+ ( sub*apt] ,e ( *apt]   
#cb ( ! ,int]nal ,rev5ue ,code ( #aihf  
is am5d$ by /rik+ ,m$ical devices &     
ins]t+ ,o!r m$ical products4  7#b7 ,!   
table ( sub*apt]s = *apt] #cb ( su*     
,code is am5d$ by /rik+ ! item relat+ to
 sub*apt] ,e & ins]t+ ! foll[+ new item3
  ,sub*apt] ,e4 ,o!r m$ical products  4 
7#c7 ,! table ( sections = sub*apt] ,e (

 *apt] #cb ( su* ,code is am5d$ by add+ 
at ! end ! foll[+ new item3  ,sec4      
#daib4 ,opioid pa9 reliev]s4  4  7c7    
,effective date ,! am5dm5ts made by ?is 
section %all apply to sales on or aft] !
 date t is #a ye> aft] ! date ( !       
enactm5t ( ?is ,act4  7d7 ,rebate or    
disc\nt program = c]ta9 canc] & hospice 
pati5ts  7#a7 ,9 g5]al ,! ,secret>y (   
,heal? & ,human ,s]vices1 9 consultation
 ) pati5t advocacy gr\ps & o!r relevant 
/akehold]s z det]m9$ by su* ,secret>y1  
%all e/abli% a me*anism by :i*--  7,a7  
any am\nt paid by an eligible pati5t 9  
connection ) ! /ew>d%ip fee "u section  
#daib ( ! ,int]nal ,rev5ue ,code ( #aihf
 7z add$ by ?is section7 %all be rebat$ 
to su* pati5t 9 z timely a mann] z      
possible2 or  7,b7 am\nts paid by an    
eligible pati5t = active opioids 7z     
def9$ 9 section #daib7;b7 ( su* ,code7  
are disc\nt$ at "t ( paym5t or pur*ase  
to ensure t su* pati5t does n pay any   
am\nt attributable to su* fee1  ) z     
little burd5 on ! pati5t z possible4 ,! 

,secret>y %all *oose :i*ev] ( ! options 
describ$ 9 subp>agraph 7,a7 or 7,b7 is1 
9 ! ,secret>y's det]m9ation1 mo/        
effective & effici5t 9 ensur+ eligible  
pati5ts face no economic burd5 f su*    
fee4  7#b7 ,eligible pati5t ,= purposes 
( ?is section1 ! t]m eligible pati5t    
means-- 7,a7 a pati5t = :om any active  
opioid 7z s def9$7 is prescrib$ to treat
 pa9 relat+ to canc] or canc] treatm5t2 
7,b7 a pati5t p>ticipat+ 9 hospice c>e2 
&  7,c7 9 ! case ( ! dea? or incapacity 
( a pati5t describ$ 9 subp>agraph 7,a7  
or 7,b7 or any simil> situation z       
det]m9$ by ! ,secret>y ( ,heal? & ,human
 ,s]vices1 ! appropriate family memb]1  
m$ical proxy1 or simil> repres5tative or
 ! e/ate ( su* pati5t4  #c4 ,block      
grants = prev5tion & treatm5t ( sub/ance
 abuse  7a7 ,grants to ,/ates ,section  
#aiba7;b7 ( ! ,public ,heal? ,s]vice    
,act 7#db ,u4,s4,c4 #cjjx-#ba7;b77 is   
am5d$ by ins]t+ 1 &1 z applicable1 =    
c>ry+ out section #aibc;,a be=e ! p]iod4
  7b7 ,nonapplicability ( prev5tion     

program provision ,section #aibb7;a77#a7
 ( ! ,public ,heal? ,s]vice ,act 7#db   
,u4,s4,c4 #cjjx-#bb7;a77#a77 is am5d$ by
 ins]t+ except ) respect to am\nts made 
available z describ$ 9 section #aibc;,a1
 be=e w exp5d4  7c7 ,opioid treatm5t    
programs ,subp>t ,,ii ( "p ,b ( title   
,,xix ( ! ,public ,heal? ,s]vice ,act   
7#db ,u4,s4,c4 #cjjx-#ba et seq47 is    
am5d$ by ins]t+ aft] section #aibc !    
foll[+3  #aibc;,a4 ,additional sub/ance 
abuse treatm5t programs ,a fund+        
agreem5t = a grant "u section #aiba is t
 ! ,/ate involv$ %all provide t any     
am\nts made available by any increase 9 
rev5ues to ! ,treasury 9 ! previ\s      
fiscal ye> result+ f ! enactm5t (       
section #daib ( ! ,int]nal ,rev5ue ,code
 ( #aihf1 r$uc$ by any am\nts rebat$ or 
disc\nt$ "u section #b7;d7 ( ! ,budget+ 
= ,opioid ,addiction ,treatm5t ,act 7z  
describ$ 9 section                      
#aicc7;a77#a77;,b77i77 be us$           
exclusively = sub/ance abuse 7includ+   
opioid abuse7 treatm5t ef=ts 9 ! ,/ate1 

includ+--  7#a7 treatm5t programs-- 7,a7
 e/abli%+ new addiction treatm5t        
facilities1 resid5tial & outpati5t1     
includ+ cov]+ capital co/s2  7,b7       
e/abli%+ sob] liv+ facilities2  7,c7    
recruit+ & increas+ reimbursem5t =      
c]tifi$ m5tal heal? provid]s provid+    
sub/ance abuse treatm5t 9 m$ically      
und]s]v$ communities or communities )   
high rates ( prescription drug abuse2   
7,d7 exp&+ access to long-t]m1          
resid5tial treatm5t programs = opioid   
addicts 7includ+ #cj-1 #fj-1 & #ij-;day 
programs72  7,e7 e/abli%+ or op]at+     
support programs t (f] employm5t        
s]vices1 h\s+1 & o!r support s]vices to 
help recov]+ addicts transition back    
into society2  7,f7 e/abli%+ or op]at+  
h\s+ = *ildr5 ^: p>5ts are p>ticipat+ 9 
sub/ance abuse treatm5t programs1       
includ+ capital co/s2  7,g7 e/abli%+ or 
op]at+ facilities to provide c>e =      
babies born ) neonatal ab/95ce syndrome1
 includ+ capital co/s2 &  7,h7 o!r      
treatm5t programs1 z ! ,secret>y        

det]m9es appropriate2 &  7#b7 recruitm5t
 & tra9+ ( sub/ance use disord]         
pr(essionals to "w 9 rural & m$ically   
und]s]v$ communities4  4  7d7           
,additional fund+ ,section              
#aicc7;a77#a77;,b77i7 ( ! ,public ,heal?
 ,s]vice ,act 7#db ,u4,s4,c4            
#cjjx-#cc7;a77#a77;,b77i77 is am5d$ by  
ins]t+ 1 plus any increase 9 rev5ues to 
! ,treasury 9 ! previ\s fiscal ye>      
result+ f ! enactm5t ( section #daib ( !
 ,int]nal ,rev5ue ,code ( #aihf1 r$uc$  
by any am\nts rebat$ or disc\nt$ "u     
section #b7;d7 ( ! ,budget+ = ,opioid   
,addiction ,treatm5t ,act be=e ! p]iod4 
#d4 ,report ,n lat] ?an #b ye>s aft] !  
date describ$ 9 section #b7;c71 !       
,secret>y ( ,heal? & ,human ,s]vices    
%all submit to ,congress a report on !  
impact ( ! am5dm5ts made by sections #b 
& #c on--  7#a7 ! retail co/ ( active   
opioids 7z def9$ 9 section #daib ( !    
,int]nal ,rev5ue ,code ( #aihf1 z add$  
by section #b72  7#b7 pati5t access to  
su* opioids1 p>ticul>ly canc] & hospice 

pati5ts1 includ+ ! effect ( ! disc\nt or
 rebate on su* opioids = canc] & hospice
 pati5ts "u section #b7;d72  7#c7 h[ !  
increase 9 rev5ue to ! ,treasury result+
 f ! enactm5t ( section #daib ( !       
,int]nal ,rev5ue ,code ( #aihf is us$ to
 improve sub/ance abuse treatm5t ef=ts 9
 accordance ) section #aibc;,a ( !      
,public ,heal? ,s]vice ,act 7z add$ by  
section #c72 &  7#d7 sugge/ions =       
improv+--  7,a7 access to opioids =     
canc] & hospice pati5ts2 &  7,b7        
sub/ance abuse treatm5t ef=ts "u su*    
section #aibc;,a4