,,ii #aafth ,,congress #b;d ,session ,s4 #dfdj ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,september #bb1 #bjbj,mr4 ,bennet 7for himself and ,ms4 ,collins7 introduced the following bill2 which was read twice and referred to the ,committee on ,health1 ,education1 ,labor1 and ,pensions ,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 disorders1 which shall also satisfy certain training requirements to receive a waiver for dispensing narcotic drugs for maintenance or detoxification treatment1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,medication ,access and ,training ,expansion ,act of #bjbj or the ,,mate ,act of #bjbj4 #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 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 that occurs on or after the date that is #ij days after the date of enactment of the ,medication ,access and ,training ,expansion ,act of #bjbj4 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 following conditions3 7,a7 ,in the case of a practitioner who is a physician1 the physician shall meet not less than #a 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 has completed not less than #h hours of training on the treatment and management of patients with opioid and other substance use disorders that-- 7,i7 is provided through classroom situations1 seminars at professional society meetings1 electronic communication1 or other means2 7,,ii7 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 another organization that the ,secretary determines appropriate2 and 7,,iii7 includes content relating to-- 7aa7 opioid maintenance and detoxification2 7bb7 the appropriate clinical use of all drugs approved by the ,food and ,drug ,administration for the treatment of a substance use disorder2 7cc7 initial and periodic patient assessments1 including substance use monitoring2 7dd7 individualized treatment planning1 overdose reversal1 and relapse prevention2 7ee7 counseling and recovery support services2 7ff7 staffing roles and considerations1 including bias and anti-racism training to reduce racial and ethnic disparities2 7gg7 diversion control2 and 7hh7 other best practices1 such as addiction prevention1 as identified by the ,secretary 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 the approved drug4 7vi7 ,the physician has other training or experience that the medical licensing board of the ,state where the physician will provide maintenance or detoxification treatment considers demonstrative of the ability of the physician to treat and manage patients with opioid and other substance use disorders4 7vii7 7,i7 ,the physician has other training or experience that the ,secretary identifies1 in a regulation promulgated in accordance with subclause 7,,ii71 as demonstrative of the ability of the physician to treat and manage patients with opioid and other substance use disorders4 7,,ii7 7aa7 ,the ,secretary may by regulation establish criteria for purposes of subclause 7,i74 7bb7 ,subject to item 7cc71 any criteria established by the ,secretary under item 7aa7 shall be effective for a #c-year period4 7cc7 ,during the #cj-;day period preceding the expiration of a #c-year period of effectiveness of criteria established under this subclause1 the ,secretary may extend the effectiveness of the criteria for an additional #c-year period by publishing a notice of the extension in the ,federal ,register4 7viii7 ,the physician-- 7,i7 graduated in good standing from an accredited school of allopathic medicine or osteopathic medicine in the ,united ,states during the #e-year period preceding the date of the first registration or renewal of registration by the physician described in paragraph 7#a77;,b72 and 7,,ii7 has successfully completed a comprehensive allopathic or osteopathic medicine curriculum or accredited medical residency that included-- 7aa7 not less than #h hours of training on treating and managing patients with opioid and other substance use disorders2 and 7bb7 at a minimum-- 7,,aa7 the training described in items 7aa7 through 7hh7 of clause 7iv77,,iii72 and 7,,bb7 training with respect to any other best practice the ,secretary determines necessary1 which may include training on pain management1 including assessment and appropriate use of opioid and non-opioid alternatives4 7,b7 ,in the case of a practitioner who is not a physician1 the practitioner shall meet not less than #a of the following conditions3 7i7 ,the practitioner has completed not less than #h hours of initial training on the topics listed in subparagraph 7,a77iv77,,iii7 that-- 7,i7 is provided through classroom situations1 seminars at professional society meetings1 electronic communication1 or other means2 and 7,,ii7 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 ,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 appropriate4 7ii7 ,the practitioner has other training or experience that the ,secretary identifies as demonstrative of the ability of the practitioner to treat and manage patients with opioid and other substance use disorders4 7iii7 ,the practitioner-- 7,i7 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 of the first registration or renewal of registration by the practitioner described in paragraph 7#a77;,b72 and 7,,ii7 has successfully completed a comprehensive physician assistant or advanced practice nursing curriculum that includes-- 7aa7 not less than #h hours of training on treating and managing patients with opioid and other substance use disorders2 and 7bb7 at a minimum-- 7,,aa7 the training described in items 7aa7 through 7hh7 of subparagraph 7,a77iv77,,iii72 and 7,,bb7 training with respect to any other best practice the ,secretary determines necessary1 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 7i7 ,meeting conditions for prescribing ,a physician who meets one or more of the conditions listed in paragraph 7#b77;,a7 shall be deemed to meet one or more of the conditions listed in subsection 7g77#b77;,g77ii74 7ii7 ,meeting conditions for waiver for dispensing ,a physician who meets one or more of the conditions listed in subsection 7g77#b77;,g77ii7 shall be deemed to meet one or more of the conditions listed in paragraph 7#b77;,a74 7,b7 ,other practitioners 7i7 ,meeting conditions for prescribing ,a practitioner who is not a physician1 and who meets one or more of the conditions listed in paragraph 7#b77;,b71 shall be deemed to meet one or more of the conditions listed in subsection 7g77#b77;,g77iv77,,ii74 7ii7 ,meeting conditions for waiver for dispensing ,a practitioner who is not a physician1 and who meets one or more of the conditions listed in subsection 7g77#b77;,g77iv77,,ii71 shall be 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,,iv77hh77 is amended by inserting after 1 as identified by the ,secretary the following3 1 which may include best practices for addiction prevention4 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 following3 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 notification under subparagraph 7,b7 and has successfully completed a comprehensive physician assistant or advanced practice nursing curriculum that includes-- 7,,aa7 not less than #h hours of training on treating and managing opioid-dependent patients2 7,,bb7 the training described in items 7aa7 through 7hh7 of clause 7ii77,,iv72 and 7,,cc7 training with respect to any other best practice the ,secretary determines necessary1 which may include training on pain management1 including assessment and appropriate use of opioid and non-opioid alternatives4 4 7#c7 ,technical corrections ,section #cjc7;g77#b77;,g7 of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hbc7;g77#b77;,g77 is amended-- 7,a7 in clause 7ii7-- 7i7 by moving subclauses 7,i7 and 7,,ii7 #d ems to the left2 7ii7 in subclause 7,,viii7-- 7,i7 in item 7bb71 by moving subitems 7,,aa7 and 7,,bb7 #b ems to the right2 and 7,,ii7 by moving items 7aa7 and 7bb7 #b ems to the right2 and 7iii7 by moving subclause 7,,viii7 #b ems to the right2 and 7,b7 in clause 7iv77,,ii77bb71 by striking has before such other training4