,,ii #aagth ,,congress #ast ,session ,s4 #ajaj ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,march #be1 #bjba ,mrs4 ,shaheen 7for herself and ,ms4 ,hassan7 introduced the following bill2 which was read twice and referred to the ,committee on ,health1 ,education1 ,labor1 and ,pensions ,a ,,bill ,to provide funding for programs and activities under the ,,support for ,patients and ,communities ,act4 #a4 ,short title ,this ,act may be cited as the ,turn the ,tide ,act4 #b4 ,controlled substance provisions of the ,,support for ,patients and ,communities ,act 7a7 ,grants ,to enhance access to substance use disorder treatment ,section #cbjc7;b7 of the ,substance ,use-,disorder ,prevention that ,promotes ,opioid ,recovery and ,treatment for ,patients and ,communities ,act 7,public ,law #aae-bga7 is amended to read as follows3 7b7 ,appropriations ,for grants under subsection 7a71 there is authorized to be appropriated1 and there is appropriated1 out of any monies in the ,treasury not otherwise appropriated1 #d1jjj1jjj for each of fiscal years #bjba through #bjbd4 4 7b7 ,access to increased drug disposal ,section #cbfj of the ,substance ,use-,disorder ,prevention that ,promotes ,opioid ,recovery and ,treatment for ,patients and ,communities ,act 7,public ,law #aae-bga7 is amended to read as follows3 #cbfj4 ,appropriations ,to carry out this chapter1 there is authorized to be appropriated1 and there is appropriated1 out of any monies in the ,treasury not otherwise appropriated1 #aj1jjj1jjj for each of fiscal years #bjba through #bjbd4 4 #c4 ,public ,health provisions of the ,,support for ,patients and ,communities ,act 7a7 ,first responder training ,section #edf7;h7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;ee-#a7;h77 is amended to read as follows3 7h7 ,appropriations ,to carry out this section1 there is authorized to be appropriated1 and there is appropriated1 out of any monies in the ,treasury not otherwise appropriated1 #cf1jjj1jjj for each of fiscal years #bjba through #bjbd4 4 7b7 ,public health laboratories pilot program ,section #gjaa7;d7 of the ,substance ,use-,disorder ,prevention that ,promotes ,opioid ,recovery and ,treatment for ,patients and ,communities ,act 7,public ,law #aae-bga7 is amended to read as follows3 7d7 ,appropriations ,to carry out this section1 there is authorized to be appropriated1 and there is appropriated1 out of any monies in the ,treasury not otherwise appropriated1 #ae1jjj1jjj for each of fiscal years #bjba through #bjbd4 4 7c7 ,national recovery housing best practices ,section #eej7;g7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;ee-#e7;g77 is amended to read as follows3 7g7 ,appropriations ,to carry out this section1 there is authorized to be appropriated1 and there is appropriated1 out of any monies in the ,treasury not otherwise appropriated1 #c1jjj1jjj for the period of fiscal years #bjba through #bjbb4 4 7d7 ,model training programs for substance use disorder patient records ,section #gjec7;e7 of the ,substance ,use-,disorder ,prevention that ,promotes ,opioid ,recovery and ,treatment for ,patients and ,communities ,act 7,public ,law #aae-bga7 is amended to read as follows3 7e7 ,appropriations ,to carry out this section1 there is authorized to be appropriated1 and there is appropriated1 out of any monies in the ,treasury not otherwise appropriated-- 7#a7 #d1jjj1jjj for fiscal years #bjba2 7#b7 #b1jjj1jjj for each of fiscal year #bjbb2 and 7#c7 #a1jjj1jjj for each of fiscal years #bjbc and #bjbd4 4 7e7 ,residential treatment programs for pregnant and postpartum women ,section #ejh7s7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;bb-#a7s77 is amended by striking the first sentence and inserting the following3 ,to carry out this section1 there is authorized to be appropriated1 and there is appropriated1 out of any monies in the ,treasury not otherwise appropriated1 #bi1ica1jjj for each of fiscal years #bjba through #bjbd44 7f7 ,mental and behavioral health education and training grants ,section #gef7;f7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bid;e-#a7;f77 is amended to read as follows3 7f7 ,appropriations ,to carry out this section1 there is authorized to be appropriated1 and there is appropriated1 out of any monies in the ,treasury not otherwise appropriated1 #ej1jjj1jjj for each of fiscal years #bjba through #bjbd4 4 7g7 ,coordination and continuation of care for drug overdose patients ,section #gjha7;f7 of the ,substance ,use-,disorder ,prevention that ,promotes ,opioid ,recovery and ,treatment for ,patients and ,communities ,act 7,public ,law #aae-bga7 is amended to read as follows3 7f7 ,appropriations ,to carry out this section1 there is authorized to be appropriated1 and there is appropriated1 out of any monies in the ,treasury not otherwise appropriated1 #aj1jjj1jjj for each of fiscal years #bjba through #bjbd4 4 7h7 ,emergency department alternatives to opioids demonstration program ,section #gjia7;g7 of the ,substance ,use-,disorder ,prevention that ,promotes ,opioid ,recovery and ,treatment for ,patients and ,communities ,act 7,public ,law #aae-bga7 is amended to read as follows3 7g7 ,appropriations ,to carry out this section1 there is authorized to be appropriated1 and there is appropriated1 out of any monies in the ,treasury not otherwise appropriated1 #aj1jjj1jjj for each of fiscal years #bjba through #bjbd4 4 7i7 ,regional centers of excellence in substance use disorder education ,section #eea7;f7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;ee-#f7;f77 is amended to read as follows3 7f7 ,appropriations ,to carry out this section1 there is authorized to be appropriated1 and there is appropriated1 out of any monies in the ,treasury not otherwise appropriated1 #d1jjj1jjj for each of fiscal years #bjba through #bjbd4 4 7j7 ,youth prevention and recovery ,section #gajb7;c77#i7 of the ,substance ,use-,disorder ,prevention that ,promotes ,opioid ,recovery and ,treatment for ,patients and ,communities ,act 7,public ,law #aae-bga7 is amended to read as follows3 7#i7 ,appropriations ,to carry out this subsection1 there is authorized to be appropriated1 and there is appropriated1 out of any monies in the ,treasury not otherwise appropriated1 #aj1jjj1jjj for each of fiscal years #bjba through #bjbd4 4 7k7 ,comprehensive opioid recovery centers ,section #eeb7;j7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;ee-#g7;j77 is amended to read as follows3 7j7 ,appropriations ,to carry out this section1 there is authorized to be appropriated1 and there is appropriated1 out of any monies in the ,treasury not otherwise appropriated1 #aj1jjj1jjj for each of fiscal years #bjba through #bjbd4 4 7l7 ,,cdc surveillance and data collection ,section #gaca7;e7 of the ,substance ,use-,disorder ,prevention that ,promotes ,opioid ,recovery and ,treatment for ,patients and ,communities ,act 7,public ,law #aae-bga7 is amended to read as follows3 7e7 ,appropriations ,to carry out this section1 there is authorized to be appropriated1 and there is appropriated1 out of any monies in the ,treasury not otherwise appropriated1 #b1jjj1jjj for each of fiscal years #bjba through #bjbd4 4 7m7 ,national child traumatic stress initiative ,section #ehb7;j7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;hh-#a7;j77 is amended to read as follows3 7j7 ,appropriations ,to carry out this section1 there is authorized to be appropriated1 and there is appropriated1 out of any monies in the ,treasury not otherwise appropriated1 #fc1hhg1jjj for each of fiscal years #bjba through #bjbd4 4 7n7 ,trauma support services and mental health care ,section #gacd7l7 of the ,substance ,use-,disorder ,prevention that ,promotes ,opioid ,recovery and ,treatment for ,patients and ,communities ,act 7,public ,law #aae-bga7 is amended to read as follows3 7l7 ,appropriations ,to carry out this section1 there is authorized to be appropriated1 and there is appropriated1 out of any monies in the ,treasury not otherwise appropriated1 #ej1jjj1jjj for each of fiscal years #bjba through #bjbd4 4 7o7 ,surveillance and education regarding infections associated with illicit drug use and other risk factors ,section #cag,n7d7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bdg;b-#ae7;d77 is amended to read as follows3 7d7 ,appropriations ,to carry out this section1 there is authorized to be appropriated1 and there is appropriated1 out of any monies in the ,treasury not otherwise appropriated1 #dj1jjj1jjj for each of fiscal years #bjba through #bjbd4 4 7p7 ,building communities of recovery ,section #edg7;f7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;ee-#b7;f77 is amended to read as follows3 7f7 ,appropriations ,to carry out this section1 there is authorized to be appropriated1 and there is appropriated1 out of any monies in the ,treasury not otherwise appropriated1 #e1jjj1jjj for each of fiscal years #bjba through #bjbd4 4 7q7 ,peer support technical assistance center ,section #edg;,a7e7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;ee-#b;a7e77 is amended to read as follows3 7e7 ,appropriations ,to carry out this section1 there is authorized to be appropriated1 and there is appropriated1 out of any monies in the ,treasury not otherwise appropriated1 #a1jjj1jjj for each of fiscal years #bjba through #bjbd4 4 7r7 ,preventing overdoses of controlled substances ,section #cib;,a7d7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bhj;b-#a7;d77 is amended to read as follows3 7d7 ,appropriations ,to carry out this section1 there is authorized to be appropriated1 and there is appropriated1 out of any monies in the ,treasury not otherwise appropriated1 #dif1jjj1jjj for each of fiscal years #bjba through #bjbd4 4 7s7 ,career ,act ,section #gahc7k7 of the ,substance ,use-,disorder ,prevention that ,promotes ,opioid ,recovery and ,treatment for ,patients and ,communities ,act 7,public ,law #aae-bga7 is amended to read as follows3 7k7 ,appropriations ,to carry out this section1 there is authorized to be appropriated1 and there is appropriated1 out of any monies in the ,treasury not otherwise appropriated1 #e1jjj1jjj for each of fiscal years #bjba through #bjbd4 4 #d4 ,housing and ,department of ,justice provisions of the ,,support for ,patients and ,communities ,act 7a7 ,assistance ,to help individuals in recovery from substance use disorder become stably housed ,section #hjga7;a7 of the ,substance ,use-,disorder ,prevention that ,promotes ,opioid ,recovery and ,treatment for ,patients and ,communities ,act 7#db ,u4,s4,c4 #ecja note2 ,public ,law #aae-bga7 is amended by striking such sums as may be necessary for each of fiscal years #bjai through #bjbc and inserting 1 and there are appropriated1 out of any monies in the ,treasury not otherwise appropriated1 #be1jjj1jjj for each of fiscal years #bjba through #bjbd4 7b7 ,building capacity for family-,focused residential treatment ,section #hjhc7;c7 of the ,substance ,use-,disorder ,prevention that ,promotes ,opioid ,recovery and ,treatment for ,patients and ,communities ,act 7,public ,law #aae-bga7 is amended to read as follows3 7c7 ,appropriations ,to carry out this section1 there is authorized to be appropriated1 and there is appropriated1 out of any monies in the ,treasury not otherwise appropriated1 #bj1jjj1jjj for fiscal years #bjbj1 which shall remain available through fiscal year #bjbc4 4 7c7 ,comprehensive ,opioid ,abuse ,grant ,program ,section #ajja7;a77#bg7 of title ,i of the ,omnibus ,crime ,control and ,safe ,streets ,act of #aifh 7#cd ,u4,s4,c4 #ajbfa7;a77#bg77 is amended to read as follows3 7#bg7 ,to carry out part ,,ll1 there is authorized to be appropriated1 and there is appropriated1 out of any monies in the ,treasury not otherwise appropriated1 #ejj1jjj1jjj for each of fiscal years #bjba through #bjbd4 4 7d7 ,office of ,national ,drug ,control ,policy ,section #gad of the ,office of ,national ,drug ,control ,policy ,reauthorization ,act of #aiih 7#ba ,u4,s4,c4 #agaa7 is amended to read as follows3 #gad4 ,authorization of appropriations2 appropriations ,to carry out this title1 except activities otherwise specified1 there is authorized to be appropriated1 and there is appropriated1 out of any monies in the ,treasury not otherwise appropriated1 #ej1jjj1jjj for each of fiscal years #bjba through #bjbd1 to remain available until expended4 4 7e7 ,drug-,free ,communities ,program ,section #ajbd of the ,anti-,drug ,abuse ,act of #aihh 7#ba ,u4,s4,c4 #aebd7 is amended-- 7#a7 in the heading1 by inserting 2 appropriations after ,authorization of appropriations2 and 7#b7 by striking subsection 7a7 and inserting the following3 7a7 ,in general ,to carry out this chapter1 there is authorized to be appropriated to the ,office of ,national ,drug ,control ,policy1 and there is appropriated1 out of any monies in the ,treasury not otherwise appropriated1 #aej1jjj1jjj for each of fiscal years #bjba through #bjbd4 4 7f7 ,high-,intensity ,drug ,trafficking ,area ,program ,section #gjg7p7 of the ,office of ,national ,drug ,control ,policy ,reauthorization ,act of #aihh 7#ba ,u4,s4,c4 #agjf7p77 is amended-- 7#a7 by redesignating paragraphs 7#a7 through 7#f7 as subparagraphs 7,a7 through 7,f71 respectively1 and adjusting the margins accordingly2 7#b7 by striking ,there is authorized and inserting the following3 7#a7 ,in general ,there is authorized 2 7#c7 in paragraph 7#a71 as so designated-- 7,a7 in subparagraph 7,e71 as so redesignated1 by striking each of2 and 7,b7 in subparagraph 7,f71 as so redesignated1 by striking #bjah through #bjbc and inserting #bjah1 #bjai1 and #bjbj2 and 7#d7 by adding at the end the following3 7#b7 ,appropriations ,to carry out this section1 there is authorized to be appropriated to the ,office of ,national ,drug ,control ,policy1 and there is appropriated1 out of any monies in the ,treasury not otherwise appropriated1 #bij1jjj1jjj for each of fiscal years #bjba through #bjbd4 4 7g7 ,drug ,court ,program ,section #ajja7;a77#be77;,a7 of title ,i of the ,omnibus ,crime ,control and ,safe ,streets ,act of #aifh 7#cd ,u4,s4,c4 #ajbfa7;a77#be77;,a77 is amended to read as follows3 7#be7 7,a7 ,except as provided in subparagraph 7,c71 to carry out part ,,ee1 there is authorized to be appropriated1 and there is appropriated1 out of any monies in the ,treasury not otherwise appropriated1 #ge1jjj1jjj for each of fiscal years #bjba through #bjbd4 4 7h7 ,drug ,court ,training and ,technical ,assistance ,section #gje7;e77#b7 of the ,office of ,national ,drug ,control ,policy ,reauthorization ,act of #aihh 7#ba ,u4,s4,c4 #agjd7;e77#b77 is amended to read as follows3 7#b7 ,authorization of appropriations2 appropriations ,to carry out this subsection1 there is authorized to be appropriated1 and there is appropriated1 out of any monies in the ,treasury not otherwise appropriated1 #b1jjj1jjj for each of fiscal years #bjba through #bjbd4 4 7i7 ,administration of the ,office of ,national ,drug ,control ,policy ,section #gjd7;i77#b7 of the ,office of ,national ,drug ,control ,policy ,reauthorization ,act of #aiih 7#ba ,u4,s4,c4 #agjc7;i77#b77 is amended to read as follows3 7#b7 ,authorization of appropriations2 appropriations ,to carry out this subsection1 there is authorized to be appropriated1 and there is appropriated1 out of any monies in the ,treasury not otherwise appropriated1 #a1bej1jjj for each of fiscal years #bjba through #bjbd4 4 7j7 ,emerging ,threats ,committee1 ,plan1 and ,media ,campaign ,section #gji7;g7 of the ,office of ,national ,drug ,control ,policy ,reauthorization ,act of #aiih 7#ba ,u4,s4,c4 #agjh7;g77 is amended to read as follows3 7g7 ,authorization of appropriations2 appropriations ,to carry out this section1 there is authorized to be appropriated to the ,office1 and there is appropriated1 out of any monies in the ,treasury not otherwise appropriated1 #be1jjj1jjj for each of fiscal years #bjba through #bjbd4 4 #e4 ,bolstering commitments to ,state grants for substance use disorder treatment and prevention 7a7 ,state opioid response grants 7#a7 ,in general ,to carry out activities under section #ajjc of the #bast ,century ,cures ,act 7#db ,u4,s4,c4 #bij;ee-#c note7 relating to opioids by the ,state agency responsible for administering the substance abuse prevention and treatment block grant under subpart ,,ii of part ,b of title ,,xix of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjjx-#ba et seq471 there is authorized to be appropriated1 and there is appropriated1 #e1ejj1jjj1jjj for each of fiscal years #bjba through #bjbe4 7#b7 ,flexibility in use of funds ,section #ajjc7;b7 of the #bast ,century ,cures ,act 7#db ,u4,s4,c4 #bij;ee-#c note7 is amended by adding at the end the following3 7#c7 ,flexibility ,states and ,indian tribes may use amounts provided under grants under this subsection to support substance use disorder treatment care and related services regardless of whether the patient involved has a primary diagnosis of opioid use disorder1 so long as the individual has a substance use disorder diagnosis4 7#d7 ,rule of construction ,nothing in this subsection shall be construed to prohibit ,states from using grant funds under this subsection to allocate amounts to local governments to establish subgrantee awards in such localities4 4 7#c7 ,substance abuse prevention and treatment block grants ,section #aice7;a7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjjx-#ce7;a77 is amended to read as follows3 7a7 ,appropriations ,to carry out this subpart1 subpart ,,iii1 and section #eje7;d71 there is authorized to be appropriated1 and there is appropriated1 out of any monies in the ,treasury not otherwise appropriated1 #c1jjj1jjj1jjj for each of fiscal years #bjba through #bjbe1 and #b1ejj1jjj1jjj for each of fiscal years #bjbf through #bjcj4 4 7b7 ,requirements ,for the purposes of carrying out activities with amounts appropriated under this section 7and the amendment made by this section71 the ,secretary of ,health and ,human ,services shall ensure that the following requirements are complied with3 7#a7 ,of the amount appropriated for each fiscal year under subsection 7a7 7and the amendment made by such subsection71 #ej1jjj1jjj shall be made available to ,indian ,tribes or tribal organizations4 7#b7 ,of such remaining amounts for each such fiscal year1 #ae percent shall be made available to the ,states with the highest mortality rate related to opioid use disorders4 7#c7 ,of the amount made available for each fiscal year under subsections 7a77#a7 for ,state ,opioid ,response ,grants1 not more than #b percent of such amount shall be available for ,federal administrative expenses1 training1 technical assistance1 and evaluation4 7#d7 ,of the amounts not reserved under paragraphs 7#a7 through 7#c71 the ,secretary shall make allocations to ,states1 territories1 and the ,district of ,columbia according to a formula using national survey results that the ,secretary determines are the most objective and reliable measure of drug use and drug-related deaths4 7#e7 ,the formula methodology under paragraph 7#d7 shall be submitted to the ,committees on ,appropriations of the ,house of ,representatives and the ,committee on ,appropriations of the ,senate not less than #ae days prior to publishing a ,funding ,opportunity ,announcement4 7#f7 ,the prevention and treatment activities funded through grants under this section may include education1 treatment 7including the provision of medication71 behavioral health services for individuals in treatment programs1 referral to treatment services1 recovery support1 and medical screening associated with such treatment4 7#g7 ,each ,state1 including the ,district of ,columbia1 shall receive not less than #d1jjj1jjj under grants under this section4 7#h7 ,in addition to amounts appropriated under this section 7and the amendment made by this section71 the following amounts shall be available under section #bda of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bch;j73 7,a7 #gi1bjj1jjj to carry out subpart ,,ii of part ,b of title ,,xix of the ,public ,health ,service ,act to fund section #aice7;b7 7#db ,u4,s4,c4 #cjjx-#ce7 7relating to technical assistance1 national data1 data collection and evaluation activities7 and the total available under this ,act for activities under such section #aice7;b7 shall not exceed #e percent of the amounts appropriated for such subpart ,,ii of part ,b of title ,,xix4 7,b7 #b1jjj1jjj to evaluate substance abuse treatment programs4 7#i7 ,none of the funds provided for under section #aiba of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjjx-#ba7 or ,state ,opioid ,response ,grants under section #ajjc of the #bast ,century ,cures ,act 7#db ,u4,s4,c4 #bij;ee-#c note7 shall be subject to section #bda of such ,act 7#db ,u4,s4,c4 #bch;j74 #f4 ,eliminating insurance barriers to medication-assisted treatment 7a7 ,limitation on use of utilization control policies or procedures for medication-,assisted treatments ,subpart ,,ii of part ,a of title ,,xxvii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjj;gg-#aa et seq47 is amended by adding at the end the following3 #bgbi;,a4 ,eliminating barriers to medication-assisted treatment ,a group health plan 7other than a self-insured plan7 or a health insurance issuer offering group or individual health insurance coverage shall not impose any utilization control policies or procedures 7as defined by the ,secretary71 including prior authorization requirements1 with respect to medication-assisted treatment covered under the plan or coverage4 4 7b7 ,no prior authorization or other utilization restrictions under ,medicaid 7#a7 ,prohibition ,section #aijc7;i7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;b7i77 is amended-- 7,a7 in paragraph 7#bf71 by striking 2 or and inserting a semicolon2 7,b7 in paragraph 7#bg71 by striking the period at the end and inserting 2 or2 and 7,c7 by inserting after paragraph 7#bg7 the following new paragraph3 7#bh7 with respect to any amount expended for medical assistance for medication-assisted treatment 7as defined in section #aije7;ee77 if the ,state imposes any utilization control policies or procedures 7as defined by the ,secretary71 including any prior authorization requirements1 with respect to the provision of such assistance2 or 4 7#b7 ,conforming amendment ,section #aije7;a77#bi7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7a77#bi77 is amended by inserting and section #aijc7;i77#bh7 after subsection 7ee74 7#c7 ,effective date ,the amendments made by this subsection take effect on ,october #a1 #bjba4 #g4 ,limitations on cost-sharing for opioid overdose reversal medications 7a7 ,limitations on cost-,sharing ,subpart ,,ii of part ,a of title ,,xxvii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjj;gg-#aa et seq471 as amended by section #f1 is further amended by adding at the end the following3 #bgbi;,b4 ,limitations on cost-sharing for opioid overdose reversal medications 7a7 ,in general ,a group health plan 7other than a self-insured plan7 or a health insurance issuer offering group or individual health insurance coverage shall not impose any cost-sharing requirement under the plan or coverage with respect to at least one brand or generic version of opioid overdose reversal drug4 7b7 ,definition ,in this section1 the term opioid overdose reversal drug means a drug or biological product approved by the ,food and ,drug ,administration for-- 7#a7 complete or partial reversal of opioid depression1 including respiratory depression1 induced by opioids2 or 7#b7 emergency treatment of a known or suspected opioid overdose1 as manifested by respiratory or central nervous system depression4 4 7b7 ,limitations on cost-,sharing under ,medicare part ,d 7#a7 ,in general ,section #ahfj;,d-#b7;b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#ajb7;b77 is amended-- 7,a7 in paragraph 7#a77;,a71 by striking ,the coverage and inserting ,subject to paragraph 7#h71 the coverage2 7,b7 in paragraph 7#b77;,a71 by striking and 7,d7 and inserting and 7,d7 and paragraph 7#h72 7,c7 in paragraph 7#c77;,a71 by striking and 7#d7 and inserting 7#d71 and 7#h72 7,d7 in paragraph 7#d77;,a77i71 by striking ,the coverage and inserting ,subject to paragraph 7#h71 the coverage2 and 7,e7 by adding at the end the following new paragraph3 7#h7 ,limitations on cost-sharing for opioid overdose reversal drugs 7,a7 ,in general ,for plan year #bjbc and each subsequent plan year1 each prescription drug plan and ,,ma-,,pd plan shall not impose any cost-sharing requirement under the plan with respect to at least one brand or generic version of an opioid overdose reversal drug 7as defined in section #bgbi;,b of the ,public ,health ,service ,act74 ,the requirement under the preceding sentence shall also apply to cost-sharing applicable to subsidy eligible individuals under section #ahad;,d-#ad4 7,b7 ,cost-sharing ,for purposes of subparagraph 7,a71 the elimination of cost-sharing shall include the following3 7i7 ,no application of deductible ,the waiver of the deductible under paragraph 7#a74 7ii7 ,no application of coinsurance ,the waiver of coinsurance under paragraph 7#b74 7iii7 ,no application of initial coverage limit ,the initial coverage limit under paragraph 7#c7 shall not apply4 7iv7 ,no cost-sharing above annual out-of-pocket threshold ,the waiver of cost-sharing under paragraph 7#d74 4 7#b7 ,conforming amendments to cost-sharing for low-income individuals ,section #ahfj;,d-#ad7;a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#aad7;a77 is amended-- 7,a7 in paragraph 7#a71 in the matter preceding subparagraph 7,a71 by striking ,in the case and inserting ,subject to section #ahfj;,d-#b7;b77#h71 in the case2 and 7,b7 in paragraph 7#b71 in the matter preceding subparagraph 7,a71 by striking ,in the case and inserting ,subject to section #ahfj;,d-#b7;b77#h71 in the case4 #h4 ,targeting health workforce loan repayment assistance to hardest-hit ,states 7a7 ,loan repayment program for substance use disorder treatment workforce ,section #gha7;j7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bie;h7j77 is amended to read as follows3 7j7 ,appropriations 7#a7 ,in general ,to carry out this section 7other than paragraph 7#b771 there is authorized to be appropriated1 and there is appropriated1 out of any monies in the ,treasury not otherwise appropriated1 #be1jjj1jjj for each of fiscal years #bjba through #bjbd4 7#b7 ,states with highest drug overdose death rates 7,a7 ,in general ,to carry out the program under this section with respect to individuals who agree to provide obligated service in ,states described in subparagraph 7,b71 there is authorized to be appropriated1 and there is appropriated1 out of any monies in the ,treasury not otherwise appropriated1 #be1jjj1jjj for each of fiscal years #bjba through #bjbe4 7,b7 ,states described ,a ,state described in this subparagraph is a ,state that is in the top quintile of all ,states in terms of the highest mean drug overdose death rate per #ajj1jjj residents for the #c-year period immediately preceding the year for which the determination is being made1 as determined by the ,secretary4 7,c7 ,application of section ,except as provided in this paragraph1 the requirements of this section otherwise applicable to individuals under this section shall apply to individuals receiving assistance under this paragraph4 4 7b7 ,training demonstration program ,section #gfj7;g7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bidk7g77 is amended to read as follows3 7g7 ,appropriations 7#a7 ,in general ,to carry out this section 7other than paragraph 7#b771 there is authorized to be appropriated1 and there is appropriated1 out of any monies in the ,treasury not otherwise appropriated1 #aj1jjj1jjj for each of fiscal years #bjba through #bjbd4 7#b7 ,states with highest drug overdose death rates 7,a7 ,in general ,to carry out the program under this section with respect to grantees located in ,states described in subparagraph 7,b71 there is authorized to be appropriated1 and there is appropriated1 out of any monies in the ,treasury not otherwise appropriated1 #bj1jjj1jjj for each of fiscal years #bjba through #bjbe4 7,b7 ,states described ,a ,state described in this subparagraph is a ,state that is in the top quintile of all ,states in terms of the highest mean drug overdose death rate per #ajj1jjj residents for the #c-year period immediately preceding the year for which the determination is being made1 as determined by the ,secretary4 7,c7 ,application of section ,except as provided in this paragraph1 the requirements of this section otherwise applicable to grantees under this section shall apply to grantees receiving assistance under this paragraph4 4 #i4 ,medicaid payments for behavioral health and mental health providers 7a7 ,in general 7#a7 ,fee-for-service ,section #aijb of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7 is amended-- 7,a7 in subsection 7a77#ac7-- 7i7 by striking and at the end of subparagraph 7,b72 7ii7 by adding and at the end of subparagraph 7,c72 and 7iii7 by adding at the end the following new subparagraph3 7,d7 payment for mental health and behavioral health services 7as defined in subsection 7tt77#a77 furnished on or after ,october #a1 #bjba1 and before ,october #a1 #bjbe1 by a physician or applicable professional 7as defined in subsection 7tt77#b77 at a rate not less than #ajj percent of the payment rate that applies to such services and physician or applicable professional under part ,b of title ,,xviii 7or1 if greater1 the payment rate that would be applicable under such part if the conversion factor under section #ahdh7;d7 for the year involved were the conversion factor under such section for #bjba1 and1 if such services are not covered under such part1 the reasonable and customary rate the ,secretary determines would apply to such services and physician or applicable professional72 2 and 7,b7 by adding at the end the following new subsection3 7tt7 ,mental health and behavioral health services ,for purposes of subsection 7a77#ac77;,d73 7#a7 ,mental health and behavioral health services 7,a7 ,in general ,the term mental health and behavioral health services means the following services1 when provided to a patient with a diagnosis of substance use disorder 7as defined in subparagraph 7,b77 as a part of the management or treatment of the patient's substance use disorder 7as determined in accordance with regulations promulgated by the ,secretary under subparagraph 7,c773 7i7 ,evaluation and management services that are procedure codes 7for services covered under title ,,xviii7 for services in the category designated ,evaluation and ,management in the ,healthcare ,common ,procedure ,coding ,system 7established by the ,secretary under section #ahdh7;c77#e7 as of ,december #ca1 #bjbj1 and as subsequently modified74 7ii7 ,counseling services1 as defined by the ,secretary4 7iii7 ,payment codes established by the ,secretary for opioid use disorder treatment services under section #ahff;,f4 7iv7 ,any other services the ,secretary determines are necessary for the management or treatment of a patient with a diagnosis of substance use disorder4 7,b7 ,patient with a diagnosis of substance use disorder ,for purposes of subparagraph 7,a71 the term patient with a diagnosis of substance use disorder means an individual who has been diagnosed with #a or more diagnosis codes within the code set entitled the ,mental health and behavioral disorders due to psychoactive substance use under the #ajth revision of the ,international ,statistical ,classification of ,diseases and ,related ,health ,problems4 7,c7 ,regulations ,not later than #ij days after the enactment of this subsection1 the ,secretary shall promulgate regulations regarding when services are sufficiently related to part of the management or treatment of a patient's substance use disorder4 7#b7 ,applicable professional ,the term applicable professional means-- 7,a7 a clinical psychologist 7as defined for purposes of section #ahfa7;ii772 7,b7 a clinical social worker 7as defined in section #ahfa7;hh77#a772 7,c7 a medical professional approved to furnish medication-assisted treatment under section #cjc7;g77#b7 of the ,controlled ,substances ,act2 or 7,d7 a medical professional that is authorized under the ,state plan to furnish mental and behavioral health services 7as defined in paragraph 7#a774 4 7#b7 ,managed care ,section #aicb7;f7 of such ,act 7#db ,u4,s4,c4 #acifu-#b7;f77 is amended-- 7,a7 in the subsection heading1 by inserting and mental health and behavioral health services after care services2 and 7,b7 by inserting before the period at the end the following3 1 and1 in the case of mental health and behavioral health services described in section #aijb7;a77#ac77;,d71 consistent with the minimum payment rates specified in such section 7regardless of the manner in which such payments are made1 including in the form of capitation or partial capitation74 7b7 ,increased ,,fmap for additional costs ,section #aije of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7 is amended-- 7#a7 in subsection 7b71 by striking and 7ii7 and inserting 7ii71 and 7jj72 and 7#b7 by adding at the end the following new subsection3 7jj7 ,increased ,,fmap for additional expenditures for mental health and behavioral health services 7#a7 ,in general ,notwithstanding subsection 7b71 with respect to the portion of the amounts expended for medical assistance for services described in section #aijb7;a77#ac77;,d7 furnished on or after ,october #a1 #bjba1 and before ,october #a1 #bjbe1 that is attributable to the amount by which the minimum payment rate required under such section 7or1 by application1 section #aicb7;f77 exceeds the payment rate applicable to such services under the ,state plan or a waiver of such plan as of ,july #a1 #bjba1 the ,federal medical assistance percentage for a ,state shall be equal to #ajj percent4 ,the preceding sentence shall not be construed as prohibiting the payment of ,federal financial participation based on the ,federal medical assistance percentage for the portion of the amounts expended for medical assistance for such services that is attributable to the amount 7if any7 by which the payment rate applicable to such services under the ,state plan or waiver exceeds such minimum payment rate4 7#b7 ,disregard of enhanced payments for purposes of territorial limits ,the amount of any payment made for expenditures on medical assistance that is attributable to the application of the ,federal medical assistance percentage described in paragraph 7#a7 shall not be taken into account for purposes of applying payment limits under subsections 7f7 and 7g7 of section #aajh4 4 #aj4 ,,cmi demonstration to test the provision of recovery housing for individuals with opioid use disorder under ,medicaid ,section #aaae;,a of the ,social ,security ,act 7#db ,u4,s4,c4 #acae;a7 is amended-- 7#a7 in subsection 7b77#b77;,a71 by adding at the end the following new sentence3 ,the models selected under this subparagraph shall include the demonstration described in subsection 7h7 7which shall be implemented not later than #ah months after the date of enactment of such subsection742 and 7#b7 by adding at the end the following new subsection3 7h7 ,demonstration ,to test the provision of recovery housing for individuals with opioid use disorder under ,medicaid 7#a7 ,in general ,the ,,cmi1 in consultation with the ,department of ,housing and ,urban ,development and other agencies1 as the ,secretary determines appropriate1 shall conduct a demonstration project 7referred to in this subsection as the demonstration7 to test whether providing ,medicaid managed care entities with an elevated global capitated budget for eligible ,medicaid beneficiaries1 paired with flexibilities to allow ,states to provide medical assistance for recovery housing for such beneficiaries1 would result in reduced emergency department visits1 hospitalizations and program expenditures under per beneficiary1 or improve quality of care for the such beneficiaries without increasing expenditures under the ,medicaid program under title ,,xix4 7#b7 ,demonstration requirements 7,a7 ,in general ,under the demonstration1 each eligible ,state that is selected by the ,,cmi to participate in the demonstration shall enter into an agreement with a ,medicaid managed care entity under which the entity agrees to provide services 7including recovery housing7 to eligible ,medicaid beneficiaries under a payment model that meets the requirements of subparagraph 7,b74 7,b7 ,capitated payments 7i7 ,in general ,the ,,cmi shall establish a capitated payments system for ,medicaid managed care entities under the demonstration that is based on the demonstration budget determined under clause 7ii74 7ii7 ,demonstration budget 7,i7 ,in general ,for purposes of clause 7i71 the demonstration budget of a ,medicaid managed care entity for each year of a demonstration period shall be determined by the ,,cmi based on the number of eligible ,medicaid beneficiaries enrolled with the entity and the average annual spending under title ,,xix in the ,state involved on individuals who are enrolled in the ,state plan under such title 7or a waiver of such plan7 and who-- 7aa7 have a diagnosis of opioid use disorder2 7bb7 are in the top quartile of per beneficiary spending for such plan or waiver for the most recent year2 and 7cc7 have attained age #ba but have not attained age #fe4 7,,ii7 ,risk adjustment ,the ,,cmi may adjust the demonstration budget determined for a ,medicaid managed care entity and a year under this clause using a risk adjustment model selected by the ,,cmi to account for differences in age and clinical conditions of the eligible ,medicaid beneficiaries enrolled with the entity compared to the overall population upon which the demonstration budget is based4 7,c7 ,selection of eligible ,states ,not later than #a year after the date of enactment of this subsection1 the ,,cmi shall select not less than #b eligible ,states to participate in the demonstration4 7#c7 ,additional waiver authority ,in addition to the authority described in subsection 7d77#a71 the ,secretary may waive such requirements of title ,,xix as necessary to carry out the demonstration4 7#d7 ,definitions ,in this subsection3 7,a7 ,eligible ,medicaid beneficiary ,the term eligible ,medicaid beneficiary means an individual who-- 7i7 is eligible for medical assistance under a ,state plan under title ,,xix or a waiver of such a plan2 7ii7 has a diagnosis of opioid use disorder2 7iii7 does not have a permanent residence 7as certified by the individual72 7iv7 is currently receiving medication-assisted treatment or completed a course of medication-assisted treatment during the #c-month period preceding the individual's participation in the demonstration2 and 7v7 has attained age #ba but has not attained age #fe4 7,b7 ,eligible ,state 7i7 ,in general ,the term eligible ,state means a ,state that-- 7,i7 makes medical assistance available to all individuals described in section #aijb7;a77#aj77;,a77i77,,viii72 and 7,,ii7 agrees to participate in the demonstration4 7ii7 ,selection of eligible ,states ,in selecting eligible ,states to participate in the demonstration1 the ,,cmi shall give priority to ,states that are-- 7,i7 among the top #aj ,states in terms of highest per capita drug poisoning deaths in each of calendar years #bjag1 #bjah1 and #bjai1 based on the most recent data available from the ,centers for ,disease ,control and ,prevention2 and 7,,ii7 among the #aj ,states with the lowest physician reimbursement rates for services furnished under title ,,xix 7as determined by the ,secretary7 in each of calendar years #bjag1 #bjah1 and #bjai4 7,c7 ,managed care entity ,the term managed care entity means a medicaid managed care organization described in section #aicb7;a77#a77;,b77i74 7,d7 ,recovery housing ,the term recovery housing means a shared living environment free from alcohol and illicit drug use and centered on peer support and connection to services that promote sustained recovery from substance use disorders4 7,e7 ,state ,the term ,state includes the #ej ,states and the ,district of ,columbia4 4 #aa4 ,extension of ,medicaid delivery system reform and incentive payment waivers 7a7 ,extension of waivers ,in the case of a ,medicaid section #aaae waiver described in subsection 7b71 not later than #fj days after the date of enactment of this ,act1 the ,secretary of ,health and ,human ,services shall-- 7#a7 extend the termination date for the waiver to ,december #ca1 #bjbf 7or such earlier date as the ,state conducting the waiver may elect72 7#b7 apply the same annual dollar allotment for the period for which the waiver is extended under paragraph 7#a7 as the annual dollar allotment that applied to the waiver period in effect on the date of enactment of this ,act2 and 7#c7 allow any ,state with such a waiver to use funds provided during the period for which the waiver is extended under paragraph 7#a7 to support the training of direct service workers that provide home and community-based services4 7b7 ,medicaid section #aaae waiver described ,the ,medicaid section #aaae waiver described in this subsection is a waiver approved under section #aaae of the ,social ,security ,act 7#db ,u4,s4,c4 #acae7 relating to delivery system reform incentive payments that-- 7#a7 as of the date of enactment of this ,act1 is to terminate on or before ,december #ca1 #bjba2 7#b7 was in effect as of ,january #a1 #bjai2 and 7#c7 was approved for any ,state that ranks in the top quintile of all ,states in terms of the highest mean drug overdose death rate per #ajj1jjj residents for the most recent #c-year period preceding the date of enactment of this ,act for which data is available4 #ab4 ,separate ambulatory payment classifications 7,,apc7 codes under the ,medicare hospital outpatient department prospective payment system and the ,medicare ambulatory surgical center payment system for surgeries utilizing non-opioid pain management drugs 7a7 ,hospital outpatient department prospective payment system ,section #ahcc7t7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciel7t77 is amended-- 7#a7 in paragraph 7#b77;,a71 by striking the ,secretary and inserting subject to paragraph 7#bc71 the ,secretary2 and 7#b7 by adding at the end the following new paragraph3 7#bc7 ,separate ,a,p,cs for surgeries using non-opioid pain management drugs 7,a7 ,in general ,in the case of covered ,,opd services furnished on or after ,january #a1 #bjbc1 the classification system developed under paragraph 7#b77;,a7 shall provide for separate ambulatory payment classification codes for-- 7i7 surgeries that utilize non-opioid drugs1 including such drugs delivered using an external infusion pump and the delivery mechanisms necessary for the delivery of such drugs1 to treat pain after the surgery2 and 7ii7 surgeries that utilize opioid drugs to treat pain after the surgery4 7,b7 ,application ,for purposes of this paragraph1 the ,secretary shall-- 7i7 treat any drug with a ,food and ,drug ,administration indication for pain management during and after surgery that is also non-opioid as a non-opioid drug2 and 7ii7 establish a clear definition for non-opioid pain management drugs that do not have a ,food and ,drug ,administration indication for pain management during or after the surgery4 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 #bjbc1 the payment system described in clause 7i7 shall provide for separate ambulatory payment classification codes for-- 7,i7 consistent with subsection 7t77#bc71 surgeries that utilize non-opioid drugs1 including such drugs delivered using an external infusion pump and the delivery mechanisms necessary for the delivery of such drugs1 to treat pain after the surgery2 and 7,,ii7 surgeries that utilize opioid drugs to treat pain after the surgery4 4 #ac4 ,expanding ,drug-,free ,communities support grants ,section #ajcb of the ,anti-,drug ,abuse ,act of #aihh 7#ba ,u4,s4,c4 #aecb7 is amended-- 7#a7 in subsection 7b7-- 7,a7 in paragraph 7#c7-- 7i7 in subparagraph 7,a71 by striking subparagraph 7,f7 and inserting subparagraph 7,h72 7ii7 by redesignating subparagraphs 7,d71 7,e71 and 7,f7 as subparagraphs 7,f71 7,g71 and 7,h71 respectively2 7iii7 by inserting after subparagraph 7,c7 the following3 7,d7 ,subsequent additional grants ,subject to subparagraph 7,h71 the ,administrator may award a subsequent additional grant to a grant recipient under subparagraph 7,a71 for each fiscal year during the #d-;fiscal-year period following the fiscal year for which the initial additional grant under subparagraph 7,a7 is awarded1 in an amount not to exceed the amount of non-,federal funds1 including in-kind contributions1 raised by the grant recipient for the fiscal year for which the subsequent additional grant is awarded4 7,e7 ,renewal grants ,subject to subparagraph 7,h71 the ,administrator may award a renewal grant to a grant recipient under subparagraph 7,d71 for the first fiscal year following the #d-;fiscal-year period for which the subsequent additional grant under subparagraph 7,d7 is awarded1 in an amount not to exceed the amount of non-,federal funds1 including in-kind contributions1 raised by the grant recipient for the fiscal year for which the renewal grant is awarded4 2 and 7iv7 in subparagraph 7,f71 as so redesignated-- 7,i7 in the subparagraph heading1 by striking renewal and inserting subsequent renewal2 and 7,,ii7 in the matter preceding clause 7i7-- 7aa7 by striking clause 7iv7 and inserting subparagraph 7,h72 7bb7 by striking renewal grant to a grant recipient under this subparagraph and inserting subsequent renewal grant to a grant recipient under subparagraph 7,e72 and 7cc7 by striking initial additional grant under subparagraph 7,a7 and inserting renewal grant under subparagraph 7,e72 and 7,b7 in paragraph 7#d71 by striking 7#c77;,e7 and inserting 7#c77;,g72 7#b7 in subsection 7d7-- 7,a7 by striking ,in awarding and inserting the following3 7#a7 ,priority for economically disadvantaged areas ,in awarding 2 and 7,b7 by adding at the end the following3 7#b7 ,priority for states demonstrating high mortality rates relating to opioid use disorder 7,a7 ,grants to more than #a eligible coalition representing a community ,in awarding grants under subsection 7b77#a77;,b77ii71 the ,administrator shall give priority to eligible coalitions that serve #a or more communities in a ,state that has a high mortality rate relating to opioid use disorder4 7,b7 ,subsequent additional grants ,in awarding subsequent additional grants under subsection 7b77#c77;,d71 the ,administrator shall give priority to an eligible coalition that serves #a or more communities in a ,state that has a high mortality rate relating to opioid use disorder4 2 and 7#c7 by adding at the end the following3 7e7 ,limitation on subsequent renewal grants ,a recipient of a subsequent renewal grant awarded under subsection 7b77#c77;,f7 may not be awarded any further grant under this section4 4 #ad4 ,support for law enforcement mental health and wellness ,there is authorized to be appropriated1 and there is appropriated1 out of any monies in the ,treasury not otherwise appropriated1 #aj1jjj1jjj for each of fiscal years #bjba through #bjbd for grants under section #agja7;b77#bc7 of title ,i of the ,omnibus ,crime ,control and ,safe ,streets ,act of #aifh 7#cd ,u4,s4,c4 #ajcha7;b77#bc77 to establish peer mentoring mental health and wellness pilot programs within ,state1 tribal1 and local law enforcement agencies4