,i #aah? ,,congress #b;d ,session ,h4 ,r4 #gadb ,,9 ,,! ,,h\se ,,( ,,repres5tatives ,janu>y #cj1 #bjbd ,mrs4 ,mill]-,meeks 7= h]self & ,mr4 ,crd5as7 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 ensure appropriate access to non-opioid pa9 managem5t drugs "u "p ,d ( ! ,m$ic>e program4 #a4 ,%ort title2 f9d+s 7a7 ,%ort title ,?is ,act may be cit$ z ! ,alt]natives to ,prev5t ,addiction ,9 ! ,nation ,act or ! ,alt]natives to ,,pa9 ,act4 7b7 ,f9d+s ,congress f9ds ! foll[+3 7#a7 ,9 #bjai1 approximately #aj million p misus$ prescription opioids4 7#b7 #c million ,u4,s4 citiz5s & #af million individuals worldwide h _h or curr5tly suff] f opioid use disord] 7,,oud74 7#c7 ,9 #bjba1 ! numb] ( ov]dose dea?s involv+ opioids 0 #aj times ! numb] 9 #aiii1 & ov]doses involv+ opioids kill$ m ?an #hj1jjj p 9 #bjba alone4 7#d7 ,mo/ ,m$ic>e b5efici>ies are prescrib$ opioids to manage po/-surgical pa94 7#e7 ,data f #bjag indicates t1 ( ^? prescrib$ an abundance ( opioids1 #ij did n prop]ly dispose ( ! extra4 7#f7 ,a comb9ation ( opioid ov]reliance1 improp] /orage1 & easy access to opioids c wors5 ! addiction crisis4 7#g7 #a /udy f #bjai f\nd t among "y p misus+ opioids1 ov] #ee obta9$ !m f fri5ds or relatives4 7#h7 ,"s individuals require opioids to manage _! condition includ+ = *ronic pa9 & palliative c>e4 7#i7 ,no?+ %\ld int]f]e ) ! ability ( a heal? c>e provid] to prescribe or adm9i/] a c\rse ( treatm5t t is m$ically appropriate4 #b4 ,appropriate co/-%>+ = qualify+ non-opioid pa9 managem5t drugs "u m$ic>e "p ,d 7a7 ,m$ic>e "p d ,section #ahfj;,d-#b ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#ajb7 is am5d$-- 7#a7 9 subsection 7b7-- 7,a7 9 p>agraph 7#a77;,a71 by /rik+ p>agraphs 7#h7 & 7#i7 & ins]t+ p>agraphs 7#h71 7#i71 & 7#aj72 7,b7 9 p>agraph 7#b7-- 7i7 9 subp>agraph 7,a71 by /rik+ p>agraphs 7#h7 & 7#i7 & ins]t+ p>agraphs 7#h71 7#i71 & 7#aj72 7ii7 9 subp>agraph 7,c77i71 9 ! matt] prec$+ subclause 7,i71 by /rik+ & 7#i7 & ins]t+ 1 7#i71 & 7#aj72 & 7iii7 9 subp>agraph 7,d77i71 9 ! matt] prec$+ subclause 7,i71 by /rik+ & 7#i7 & ins]t+ 1 7#i71 & 7#aj72 7,c7 9 p>agraph 7#c77;,a71 9 ! matt] prec$+ clause 7i71 by /rik+ & 7#i7 & ins]t+ 7#i71 & 7#aj72 7,d7 9 p>agraph 7#d77;,a77i71 by /rik+ p>agraphs 7#h7 & 7#i71 & ins]t+ p>agraphs 7#h71 7#i71 & 7#aj712 & 7,e7 by add+ at ! end ! foll[+ new p>agraph3 7#aj7 ,treatm5t ( co/-%>+ = qualify+ non-opioid pa9 managem5t drugs 7,a7 ,9 g5]al ,= plan ye>s beg9n+ on or aft] ,janu>y #a1 #bjbe1 ) respect to a cov]$ "p ,d drug t is a qualify+ non-opioid pa9 managem5t drug 7z def9$ 9 subp>agraph 7,b77-- 7i7 ! d$uctible "u p>agraph 7#a7 %all n apply2 & 7ii7 su* drug %all be plac$ on ! l[e/ co/-%>+ ti]1 if any1 = purposes ( det]m9+ ! maximum co-insurance or o!r co/-%>+ = su* drug4 7,b7 ,qualify+ non-opioid pa9 managem5t drugs ,9 ?is p>agraph1 ! t]m qualify+ non-opioid pa9 managem5t drug means a drug or biological product-- 7i7 t has a label indication approv$ by ! ,food & ,drug ,adm9i/ration to r$uce po/op]ative pa9 or any o!r =m ( acute pa92 7ii7 t does n act ^u ! body's opioid receptors2 7iii7 t is n a s*$ule ,i1 ,,ii1 or ,,iii controll$ sub/ance2 7iv7 = :i* !re is no o!r drug or product t is-- 7,i7 rat$ z !rapeutically equival5t 7"u ! ,food & ,drug ,adm9i/ration's mo/ rec5t publication ( ,approv$ ,drug ,products ) ,!rapeutic ,equival5ce ,evaluations72 & 7,,ii7 :i* is sold or m>ket$ 9 ! ,unit$ ,/ates2 & 7v7 = :i* ! :olesale acquisition co/ 7z def9$ 9 section #ahdg;,a7c77#f77;,b771 = a mon?ly supply does n exce$ ! mon?ly specialty-ti] co/ ?re%old z det]m9$ by ! ,secret>y f "t to "t4 2 & 7#b7 9 subsection 7c71 by add+ at ! end ! foll[+ new p>agraph3 7#g7 ,treatm5t ( co/-%>+ = qualify+ non-opioid pa9 managem5t drugs ,! cov]age is provid$ 9 accordance ) subsection 7b77#aj74 4 7b7 ,con=m+ am5dm5ts to co/-%>+ = l[-income individuals ,section #ahfj;,d-#ad7;a7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#aad7;a77 is am5d$-- 7#a7 9 p>agraph 7#a77;,d71 9 ea* ( ! clauses 7ii7 & 7iii71 by /rik+ ,subject to p>agraph 7#f7 & ins]t+ ,subject to p>agraphs 7#f7 & 7#g72 7#b7 9 p>agraph 7#b7-- 7,a7 9 subp>agraph 7,b71 by /rik+ ,subject to p>agraphs 7#h7 & 7#i7 & ins]t+ ,subject to p>agraphs 7#h71 7#i71 & 7#aj72 7,b7 9 subp>agraph 7,d71 by /rik+ ,subject to p>agraph 7#f7 & ins]t+ ,subject to p>agraphs 7#f7 & 7#g72 & 7,c7 9 subp>agraph 7,e71 by /rik+ ,subject to p>agraph 7#f7 & ins]t+ ,subject to p>agraphs 7#f7 & 7#g72 & 7#c7 by add+ at ! end ! foll[+ new p>agraph3 7#g7 ,no application ( co/-%>+ or d$uctible = qualify+ non-opioid pa9 managem5t drugs ,= plan ye>s beg9n+ on or aft] ,janu>y #a1 #bjbe1 ) respect to a cov]$ "p ,d drug t is a qualify+ non-opioid pa9 managem5t drug 7z def9$ 9 section #ahfj;,d-#b7;b77#aj77;,b77-- 7,a7 ! d$uctible "u section #ahfj;,d-#b7;b77#a7 %all n apply2 & 7,b7 su* drug %all be plac$ on ! l[e/ co/-%>+ ti]1 if any1 = purposes ( det]m9+ ! maximum co-insurance or o!r co/-%>+ = su* drug4 4 #c4 ,prohibition on ! use ( /ep !rapy & prior au?orization = qualify+ non-opioid pa9 managem5t drugs "u m$ic>e "p d ,section #ahfj;,d-#d ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#ajd7 is am5d$ 9 subsection 7c7 by add+ at ! end ! foll[+ p>agraph3 7#g7 ,prohibition on use ( /ep !rapy & prior au?orization = qualify+ non-opioid pa9 managem5t drugs 7,a7 ,9 g5]al ,a prescription drug plan may n1 ) respect to a qualify+ non-opioid pa9 managem5t drug = :i* cov]age is provid$ "u su* plan1 impose any-- 7i7 /ep !rapy requirem5t "u :i* an individual enroll$ "u su* plan is requir$ to use an opioid prior to receiv+ su* drug2 or 7ii7 prior au?orization requirem5t4 7,b7 ,/ep !rapy ,9 ?is p>agraph1 ! t]m /ep !rapy means a drug !rapy utilization managem5t protocol or program t requires use ( an alt]native1 pref]r$ prescription drug or drugs be=e ! plan approves cov]age = ! non-pref]r$ drug !rapy prescrib$4 7,c7 ,prior au?orization ,9 ?is p>agraph1 ! t]m prior au?orization means any requirem5t to obta9 approval f a prescription drug plan prior to ! furni%+ ( a drug4 7,d7 ,qualify+ non-opioid pa9 managem5t drugs ,9 ?is p>agraph1 ! t]m qualify+ non-opioid pa9 managem5t drug has ! mean+ giv5 t t]m 9 section #ahfj;,d-#b7;b77#aj77;,b74 4 #d4 ,rule ( con/ruction ,no?+ 9 ! am5dm5ts made by ?is ,act may be con/ru$ to limit or int]f]e ) ! au?ority ( a heal? c>e provid] to prescribe or adm9i/] any legally m>ket$ drug to a pati5t = any condition or disease )9 a legitimate heal? c>e practition]-pati5t relation%ip4