116 HR 2922 IH: Respond to the Needs in the Opioid War Act
U.S. House of Representatives
2019-05-22
text/xml
EN
Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.
1.This Act may be cited as the Respond to the Needs in the Opioid War Act
or the Respond NOW Act
. 2.The table of contents of this Act is as follows:
Sec. 1. Short title.
Sec. 2. Table of contents.
Title I—Opioid Epidemic Response Fund
Sec. 101. Opioid Epidemic Response Fund.
Sec. 102. Substance Abuse and Mental Health Services Administration.
Sec. 103. Centers for Disease Control and Prevention.
Sec. 104. Food and Drug Administration.
Sec. 105. National Institutes of Health.
Sec. 106. Health Resources and Services Administration.
Sec. 107. Administration for Children and Families.
Title II—Additional Investments in Existing Programs To Respond to the Opioid Epidemic
Sec. 201. Increase in funding for regional partnership grants.
Sec. 202. Account for the State and Tribal Response to the Opioid Abuse Crisis.
Title III—Expanding Access to Treatment Services
Sec. 301. Eliminating time limitation for nurse practitioners, clinical nurse specialists,
certified registered nurse anesthetists, certified nurse midwives, and
physician assistants To be qualifying practitioners.
Sec. 302. Coverage of methadone under Medicare part B.
<enum>I</enum><header>Opioid Epidemic Response Fund</header>
<section id="H823203FAFDF24CE2AA401CA77943E600"><enum>101.</enum><header>Opioid Epidemic Response Fund</header>
<subsection id="H6FF37D806EB24DF1B5AD680AFF83C870"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">The Secretary of Health and Human Services (referred to in this section as the <quote>Secretary</quote>) shall use any funds appropriated pursuant to the authorization of appropriations under subsection (c) to carry out the programs and activities described in subsection (d) to address the opioid and substance use epidemic. Such funds shall be in addition to any funds which are otherwise available to carry out such programs and activities.</text>
</subsection><subsection id="H2142179F037F461A95349E64DC7B9603"><enum>(b)</enum><header>Opioid Epidemic Response Fund</header>
<paragraph id="HF265452CE7084C7B83BF74C0C86EFDE2"><enum>(1)</enum><header>Establishment of account</header><text display-inline="yes-display-inline">There is established in the Treasury an account, to be known as the Opioid Epidemic Response Fund (referred to in this section as the <quote>Fund</quote>), for purposes of funding the programs and activities described in subsection (d).</text>
</paragraph><paragraph id="HEA3D7F474C5B414497080CD5F3CC2EFB"><enum>(2)</enum><header>Transfer</header><text>For each of fiscal years 2020 through 2024, $5,000,000,000 shall be transferred to the Fund from the general fund of the Treasury.</text>
</paragraph><paragraph id="H25A98E91B40E41938249ABF462AE8119"><enum>(3)</enum><header>Amounts deposited</header><text display-inline="yes-display-inline">Any amounts transferred under paragraph (2) shall remain unavailable in the Fund until such amounts are appropriated pursuant to subsection (c).</text>
</paragraph></subsection><subsection id="H04720D1BB0974B3D9A9E9208FBCBD2E0"><enum>(c)</enum><header>Appropriations</header>
<paragraph id="H85C8B44E6FD3455D91EF06C8322FD978"><enum>(1)</enum><header>Authorization of appropriations</header><text display-inline="yes-display-inline">For the period of fiscal years 2020 through 2024, there is authorized to be appropriated from the Fund to the Department of Health and Human Services, for the purpose of carrying out the programs and activities described in subsection (d), an amount not to exceed the total amount transferred to the Fund under subsection (b)(2), to remain available until expended.</text>
</paragraph><paragraph id="H6680CCCD03494160ADF2674092F32B6A"><enum>(2)</enum><header>Offsetting future appropriations</header><text display-inline="yes-display-inline">For any of fiscal years 2020 through 2024, for any discretionary appropriation to the Department of Health and Human Services (or any agency therein) pursuant to the authorization of appropriations under paragraph (1) for the purpose of carrying out the programs and activities described in subsection (d), the total amount of such appropriations for the applicable fiscal year (not to exceed the total amount remaining in the Account) shall be subtracted from the estimate of discretionary budget authority and the resulting outlays for any estimate under the Congressional Budget and Impoundment Control Act of 1974 or the Balanced Budget and Emergency Deficit Control Act of 1985, and the amount transferred to the Fund shall be reduced by the same amount.</text>
</paragraph></subsection><subsection id="H54FDFBD136F44558BE73179785430E0A"><enum>(d)</enum><header>Programs and activities</header><text display-inline="yes-display-inline">Of the total amount authorized to be appropriated from the Fund to the Department of Health and Human Services by subsection (c)(1), such amount shall be allocated as follows:</text>
<paragraph id="H3566C2BD7C8B4CAD9832028854D2C58E"><enum>(1)</enum><header>SAMHSA</header><text display-inline="yes-display-inline">For the Substance Abuse and Mental Health Services Administration to carry out programs and activities pursuant to section 102, $3,650,000,000 for each of fiscal years 2020 through 2024.</text>
</paragraph><paragraph id="H47C5A043A95F4901970C3509EF924FD5"><enum>(2)</enum><header>CDC</header><text display-inline="yes-display-inline">For the Centers for Disease Control and Prevention to carry out programs and activities pursuant to section 103, $500,000,000 for each of fiscal years 2020 through 2024.</text>
</paragraph><paragraph id="H170F03B8BD204BF9B6DD70198C0A53F0"><enum>(3)</enum><header>FDA</header><text display-inline="yes-display-inline">For the Food and Drug Administration to carry out programs and activities pursuant to section 104, $65,000,000 for each of fiscal years 2020 through 2024.</text>
</paragraph><paragraph id="H7E45FF42813E4AEC91CA7BFC18FEBE00"><enum>(4)</enum><header>NIH</header><text display-inline="yes-display-inline">For the National Institutes of Health to carry out programs and activities pursuant to section 105, $500,000,000 for each of fiscal years 2020 through 2024.</text>
</paragraph><paragraph id="HCDABE184E6DE42768D865DF0A68D429F"><enum>(5)</enum><header>HRSA</header><text display-inline="yes-display-inline">For the Health Resources and Services Administration to carry out programs and activities pursuant to section 106, $235,000,000 for each of fiscal years 2020 through 2024.</text>
</paragraph><paragraph commented="no" id="HC7172B2B4DE14553B3915F3373791443"><enum>(6)</enum><header>ACF</header><text display-inline="yes-display-inline">For the Administration for Children and Families to carry out programs and activities pursuant to section 107, $50,000,000 for each of fiscal years 2020 through 2024.</text>
</paragraph></subsection><subsection commented="no" id="HD47B61E3382C4868B647539D4024548C"><enum>(e)</enum><header>Accountability and oversight</header>
<paragraph commented="no" id="H095C738FB40C4C74A838016848DEE1CE"><enum>(1)</enum><header>Work plan</header>
<subparagraph commented="no" id="H7C0936DC307D47C6BA9A79F96F561067"><enum>(A)</enum><header>In general</header><text>Not later than 180 days after the date of enactment of this Act, the Secretary of Health and Human Services shall submit to the Committee on Health, Education, Labor, and Pensions and the Committee on Appropriations of the Senate and the Committee on Energy and Commerce and the Committee on Appropriations of the House of Representatives, a work plan including the proposed allocation of funds appropriated pursuant to the authorization of appropriations under subsection (c) for each of fiscal years 2020 through 2024 and the contents described in subparagraph (B).</text>
</subparagraph><subparagraph commented="no" id="H391F8F5CB6B34BB8A6FDEA9DF270BC72"><enum>(B)</enum><header>Contents</header><text>The work plan submitted under subparagraph (A) shall include—</text> <clause commented="no" id="HFA77ECE4D04C407B9DF0489EA1DDA0F1"><enum>(i)</enum><text>the amount of money to be obligated or expended out of the Fund in each fiscal year for each program and activity described in subsection (d); and</text>
</clause><clause commented="no" id="H06BBD94C391D47D7A800015DF16CB69B"><enum>(ii)</enum><text>a description and justification of each such program and activity.</text> </clause></subparagraph></paragraph><paragraph commented="no" id="H1A9AEFC4B48E49179B5CEB4E64AFF4A1"><enum>(2)</enum><header>Reports</header> <subparagraph commented="no" id="H65431CFEC6B948FB83F97434DD346CAA"><enum>(A)</enum><header>Annual reports</header><text>Not later than October 1 of each of fiscal years 2020 through 2024, the Secretary of Health and Human Services shall submit to the Committee on Health, Education, Labor, and Pensions and the Committee on Appropriations of the Senate and the Committee on Energy and Commerce and the Committee on Appropriations of the House of Representatives, a report including—</text>
<clause commented="no" id="H40B6C356208F4B558A7B85C3935694E2"><enum>(i)</enum><text display-inline="yes-display-inline">the amount of money obligated or expended out of the Fund in the prior fiscal year for each program and activity described in subsection (d);</text>
</clause><clause commented="no" id="H378EDC2EE76A43F082F1C81417BE98FF"><enum>(ii)</enum><text>a description of all programs and activities using funds provided pursuant to the authorization of appropriations under subsection (c); and</text>
</clause><clause commented="no" id="HCBC05E5A99B24370A3A849F0EFFD2662"><enum>(iii)</enum><text>how the programs and activities are responding to the opioid epidemic.</text> </clause></subparagraph><subparagraph commented="no" id="H13790A55D9E0428C914CCBC838FFB9F5"><enum>(B)</enum><header>Additional reports</header><text>At the request of the Committee on Health, Education, Labor, and Pensions or the Committee on Appropriations of the Senate, or the Committee on Energy and Commerce or the Committee on Appropriations of the House of Representatives, the Secretary of Health and Human Services shall provide an update in the form of testimony and any additional reports to the respective congressional committee regarding the allocation of funding under this section or the description of the programs and activities undertaken with such funding.</text>
</subparagraph></paragraph></subsection><subsection commented="no" id="HD09BCE3D076A44D19A709C66DB5E2884"><enum>(f)</enum><header>Limitations</header><text display-inline="yes-display-inline">Notwithstanding any transfer authority authorized by this Act or any appropriations Act, any funds made available pursuant to the authorization of appropriations under subsection (c) may not be used for any purpose other than the programs and activities described in subsection (d) to address the opioid and substance use epidemic.</text>
</subsection><subsection commented="no" id="H5D846803E2314CFD9A9A329A31C0032C"><enum>(g)</enum><header>Sunset</header><text>This section shall expire at the end of fiscal year 2029.</text> </subsection></section><section commented="no" id="H25759D697C154FEFAD2F1F64DCDDFB1B"><enum>102.</enum><header>Substance Abuse and Mental Health Services Administration</header><text display-inline="no-display-inline">The entirety of the funds made available pursuant to section 101(d)(1) shall be for carrying out subsections (b) and (c) of section 1003 of the 21st Century Cures Act (<external-xref legal-doc="usc" parsable-cite="usc/42/290ee-3">42 U.S.C. 290ee–3</external-xref> note).</text>
</section><section commented="no" id="H346725D90D1B4D3AB3BD3E36ED2DC336"><enum>103.</enum><header>Centers for Disease Control and Prevention</header>
<subsection commented="no" id="HF602B236250646BEAA923A44EF8B7E28"><enum>(a)</enum><header>Addressing opioid use disorder</header><text display-inline="yes-display-inline">The entirety of the funds made available pursuant to section 101(d)(2) shall be for the Director of the Centers for Disease Control and Prevention, pursuant to applicable authorities in the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/201">42 U.S.C. 201</external-xref> et seq.), to continue and expand programs of the Centers for Disease Control and Prevention to address opioid use disorder, including by—</text>
<paragraph commented="no" id="HE3F3810564644DCDBA28330C3554C418"><enum>(1)</enum><text display-inline="yes-display-inline">improving the timeliness and quality of data on the opioid epidemic, including improvement of—</text> <subparagraph id="H4BFD7D75B63046F580EB64434D23F6D0"><enum>(A)</enum><text>data on fatal and nonfatal overdoses;</text>
</subparagraph><subparagraph id="H1587254CF32C4654A706B11C299AE1CF"><enum>(B)</enum><text>syndromic surveillance;</text> </subparagraph><subparagraph id="HC9CA1D9B89444A44B7A4E2D15DEBD362"><enum>(C)</enum><text>data on long-term sequelae (including neonatal abstinence syndrome); and</text>
</subparagraph><subparagraph id="H610C8EB9479446B4912E470E499137BC"><enum>(D)</enum><text>cause of death reporting related to substance abuse or opioid overdose;</text> </subparagraph></paragraph><paragraph commented="no" id="H10BD8688517D4EEAB5C346C12AD3ED63"><enum>(2)</enum><text>expanding and strengthening evidence-based prevention and education strategies;</text>
</paragraph><paragraph id="H035F6A080CD5460C9CE1962BD6108BE6"><enum>(3)</enum><text>supporting responsible prescribing practices, including through development and dissemination of prescriber guidelines;</text>
</paragraph><paragraph id="H5ED570E85E694670BBBA7C21C012A34A"><enum>(4)</enum><text>improving access to and use of effective prevention, treatment, and recovery support, including through grants and the provision of technical assistance to States and localities;</text>
</paragraph><paragraph id="H031BEBE113854860A9BF9EB92B85F750"><enum>(5)</enum><text>strengthening partnerships with first responders, including to protect their safety;</text> </paragraph><paragraph id="HBE6E2F711239422FB3063AE1238EA5C2"><enum>(6)</enum><text>considering the needs of vulnerable populations;</text>
</paragraph><paragraph id="HF25AAB98A7294F17A811DE1082A21937"><enum>(7)</enum><text display-inline="yes-display-inline">addressing infectious diseases linked to the opioid crisis;</text> </paragraph><paragraph id="HB2CC7977500D44E4AC89FDC16BF50AE2"><enum>(8)</enum><text display-inline="yes-display-inline">strengthening prescription drug monitoring programs; and</text>
</paragraph><paragraph id="H3E692AF70C034617907D03EA00B9C558"><enum>(9)</enum><text display-inline="yes-display-inline">providing financial and technical assistance to State and local health department efforts to treat and prevent substance use disorder.</text>
</paragraph></subsection><subsection id="HED4EB5ECDF81489F8ABD408DCED16272"><enum>(b)</enum><header>Limitation</header><text>Of the funds made available pursuant to section 101(d)(2) for carrying out this section, not more than 20 percent may be used for intramural purposes.</text>
</subsection></section><section commented="no" id="H7F048A89F3224FDDB2DCFE57AFEFA28D"><enum>104.</enum><header>Food and Drug Administration</header><text display-inline="no-display-inline">The entirety of the funds made available pursuant to section 101(d)(3) shall be for the Commissioner of Food and Drugs, pursuant to applicable authorities in the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/201">42 U.S.C. 201</external-xref> et seq.) or the Federal Food, Drug, and Cosmetic Act (<external-xref legal-doc="usc" parsable-cite="usc/21/301">21 U.S.C. 301</external-xref> et seq.) and other applicable law, to support widespread innovation in non-opioid and non-addictive medical products for pain treatment, access to opioid addiction treatments, appropriate use of approved opioids, and efforts to reduce illicit importation of opioids. Such support may include the following:</text>
<paragraph id="H4D30CB7323AC4D3180A2F8809C812F6E"><enum>(1)</enum><text>Facilitating the development of non-opioid and non-addictive pain treatments.</text> </paragraph><paragraph id="H6D82C0385824476AAE105BFFE86AF198"><enum>(2)</enum><text>Advancing guidance documents for sponsors of non-opioid pain products.</text>
</paragraph><paragraph id="H94CA234B636C4329A56822247FE0704F"><enum>(3)</enum><text>Developing evidence to inform the potential for nonprescription overdose therapies.</text> </paragraph><paragraph id="HD003EB688D7A4DA693F25B3585501A78"><enum>(4)</enum><text>Examining expanded labeling indications for medication-assisted treatment.</text>
</paragraph><paragraph id="HC5B17C987FBB4D46A885145845C7DD90"><enum>(5)</enum><text>Conducting public education and outreach, including public workshops or public meetings, regarding the benefits of medication-assisted treatment, and approved non-opioid drug and device treatment options.</text>
</paragraph><paragraph id="H6E9C53ABCAD0470F91FDF1B1F7A62739"><enum>(6)</enum><text>Exploring the expansion and possible mandatory nature of prescriber education regarding pain management and appropriate opioid prescribing through authorities under section 505–1 of the Federal Food, Drug, and Cosmetic Act (<external-xref legal-doc="usc" parsable-cite="usc/21/355-1">21 U.S.C. 355–1</external-xref>).</text>
</paragraph><paragraph id="H8558F704587E4D8D9E56A436C29CCE84"><enum>(7)</enum><text>Examining options to limit the duration of opioid prescriptions for acute pain, including through packaging options.</text>
</paragraph><paragraph id="HEC9FA90447C84E6E8E47E4AAB7ACFA7D"><enum>(8)</enum><text display-inline="yes-display-inline">Increasing staff and infrastructure capacity to inspect and analyze packages at international mail facilities and pursue criminal investigations.</text>
</paragraph></section><section commented="no" id="H8587382F58E442AE9F685EE419E17BC2"><enum>105.</enum><header>National Institutes of Health</header><text display-inline="no-display-inline">The entirety of the funds made available pursuant to section 101(d)(4) shall be for the Director of the National Institutes of Health, pursuant to applicable authorities in the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/201">42 U.S.C. 201</external-xref> et seq.), to carry out activities related to—</text>
<paragraph commented="no" id="H9F4186B5A54E47BD9BB0FA265E5B57F9"><enum>(1)</enum><text display-inline="yes-display-inline">accelerating research for addressing the opioid epidemic, including developing non-opioid medications and interventions, including non-addictive medications, to manage pain, as well as to treat and to prevent substance use disorders;</text>
</paragraph><paragraph commented="no" id="HEAA1F61AA8614BCFBD1B5632BB085225"><enum>(2)</enum><text>conducting and supporting research on which treatments (in terms of pain management as well as treating and preventing substance use disorders) are optimal for which patients; and</text>
</paragraph><paragraph commented="no" id="H36130F79CA2B4B4DB12E0AC4B327E282"><enum>(3)</enum><text>conducting and supporting research on creating longer-lasting or faster-acting antidotes for opioid overdose, particularly in response to the prevalence of fentanyl and carfentanyl overdoses.</text>
</paragraph></section><section commented="no" id="H313EED2ACF164AD0B9910932523886E1"><enum>106.</enum><header>Health Resources and Services Administration</header><text display-inline="no-display-inline">The entirety of the funds made available pursuant to section 101(d)(5) shall be for the Administrator of the Health Resources and Services Administration, pursuant to applicable authorities in titles III, VII, and VIII of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/241">42 U.S.C. 241</external-xref> et seq.), to carry out activities that increase the availability and capacity of the behavioral health workforce. Such activities may include providing loan repayment assistance for substance abuse treatment providers.</text>
</section><section commented="no" id="H0DF2FD542A5B4425AA42DA9C6441BF31"><enum>107.</enum><header>Administration for Children and Families</header><text display-inline="no-display-inline">Of the funds made available pursuant to section 101(d)(6) for each of fiscal years 2020 through 2024—</text>
<paragraph commented="no" id="HDC83BC62A02F462CA0F6C45A821ECBE9"><enum>(1)</enum><text>$25,000,000 for each such fiscal year shall be for the Secretary of Health and Human Services to carry out title I of the Child Abuse Prevention and Treatment Act (<external-xref legal-doc="usc" parsable-cite="usc/42/5101">42 U.S.C. 5101</external-xref> et seq.); and</text>
</paragraph><paragraph commented="no" id="H64EC1A7A18C447F786708A30E6230C6E"><enum>(2)</enum><text display-inline="yes-display-inline">$25,000,000 for each such fiscal year shall be for the Secretary of Health and Human Services to carry out title II of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/5116">42 U.S.C. 5116</external-xref> et seq.).</text>
</paragraph></section><enum>II</enum><header>Additional Investments in Existing Programs To Respond to the Opioid Epidemic</header>
<section commented="no" id="HD91720B8902B4DC699D418FC4B72FE59" section-type="subsequent-section"><enum>201.</enum><header>Increase in funding for regional partnership grants</header><text display-inline="no-display-inline">Section 436 of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/629f">42 U.S.C. 629f</external-xref>) is amended—</text> <paragraph commented="no" id="HC854EE855BEC4738B4575E94BCD2FB64"><enum>(1)</enum><text>in subsection (a), by striking <quote>$345,000,000 for each of fiscal years 2017 through 2021</quote> and inserting <quote>$385,000,000 for each of fiscal years 2018 through 2024</quote>; and</text>
</paragraph><paragraph commented="no" id="HD29161D86CB84B9487248B9BC053DB1B"><enum>(2)</enum><text>in subsection (b)—</text> <subparagraph commented="no" id="H4D2AF80B94DE441688CF5863AF3C26A4"><enum>(A)</enum><text>in paragraph (4)(A), by striking <quote>2017 through 2021</quote> and inserting <quote>2018 through 2024</quote>; and</text>
</subparagraph><subparagraph commented="no" id="H04DAFF0A20F447E6AE9FF3907CC93F2F"><enum>(B)</enum><text>in paragraph (5), by striking <quote>$20,000,000 for each of fiscal years 2017 through 2021</quote> and inserting <quote>$60,000,000 for each of fiscal years 2018 through 2024</quote>.</text> </subparagraph></paragraph></section><section commented="no" id="H8071BDE6515F4A38A2429A6EFA81F51F"><enum>202.</enum><header>Account for the State and Tribal response to the opioid abuse crisis</header><text display-inline="no-display-inline">Section 1003(h) of the 21st Century Cures Act (<external-xref legal-doc="usc" parsable-cite="usc/42/290ee-3">42 U.S.C. 290ee–3</external-xref> note) is amended by striking <quote>$500,000,000 for each of fiscal years 2019 through 2021</quote> and inserting <quote>$500,000,000 for fiscal years 2019 and $3,750,000,000 for each of fiscal years 2020 through 2023</quote>.</text>
</section><enum>III</enum><header>Expanding Access to Treatment Services</header>
<section commented="no" id="HB60F34A38152456CAD4A81C015183D98"><enum>301.</enum><header>Eliminating time limitation for nurse practitioners, clinical nurse specialists, certified
registered nurse anesthetists, certified nurse midwives, and physician
assistants To be qualifying practitioners</header><text display-inline="no-display-inline">Section 303(g)(2)(G)(iii)(III) of the Controlled Substances Act (<external-xref legal-doc="usc" parsable-cite="usc/21/823">21 U.S.C. 823(g)(2)(G)(iii)(III)</external-xref>) is amended by striking <quote>for the period beginning on October 1, 2018, and ending on October 1, 2023,</quote>.</text>
</section><section id="H56988F2E73D947B58DA9D28C5B268979" section-type="subsequent-section"><enum>302.</enum><header>Coverage of methadone under Medicare part B</header>
<subsection id="H47CCDA9F5C964DF283173EB5F2C48BFF"><enum>(a)</enum><header>Coverage</header><text display-inline="yes-display-inline">Section 1861(s)(2) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395x">42 U.S.C. 1395x(s)(2)</external-xref>) is amended—</text> <paragraph id="H43966B4FC4CF40959DD80A0A3E2FDED5"><enum>(1)</enum><text>by striking <quote>and</quote> at the end of subparagraph (GG);</text>
</paragraph><paragraph id="H58FBF6536E9349339DE76626DB3DCBB5"><enum>(2)</enum><text>by adding <quote>and</quote> at the end of subparagraph (HH); and</text> </paragraph><paragraph id="H2D53CC9A17484557B93EB5157FAB9B42"><enum>(3)</enum><text>by inserting after subparagraph (HH) the following new subparagraph:</text>
<quoted-block display-inline="no-display-inline" id="HEDD0CF7EC9594873BBA75AB90777890D" style="OLC">
<subparagraph id="HD5DF912D2B26471A8BC9C0526521EACB"><enum>(II)</enum><text display-inline="yes-display-inline">methadone, if furnished or dispensed (including by prescription) in an oral form on or after January 1, 2019, to an individual for the purpose of maintenance or detoxification treatment by a physician or other practitioner who has in effect a registration or waiver under section 303(g) of such Act (<external-xref legal-doc="usc" parsable-cite="usc/21/823">21 U.S.C. 823(g)</external-xref>) to dispense methadone for such purpose;</text></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="H1EF6541CCA64453A95D44739B1C9DD6A"><enum>(b)</enum><header>Payment</header>
<paragraph id="H4AFEDDADFA114D26AB0B0CA105B94DF8"><enum>(1)</enum><header>In connection with physician and supplier service</header><text display-inline="yes-display-inline">Section 1842(o)(1) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395u">42 U.S.C. 1395u(o)(1)</external-xref>) is amended by adding at the end the following new subparagraph:</text>
<quoted-block display-inline="no-display-inline" id="HC8510248ED774FDA91451A96C388ABBD" style="OLC">
<subparagraph id="H214CDA9D37D34C57AA92F777CDB0E3D4"><enum>(H)</enum><text display-inline="yes-display-inline">In the case of methadone (as described in section 1861(s)(2)(II)), the amount provided under section 1847A for such drug.</text></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph id="H8A1BC775E4324D93BA14C40B9A5D7324"><enum>(2)</enum><header>Covered OPD service</header><text display-inline="yes-display-inline">Section 1833(t)(1)(B)(iii) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395l">42 U.S.C. 1395l(t)(1)(B)(iii)</external-xref>) is amended by inserting <quote>and methadone described in paragraph (2)(II) of such section</quote> after <quote>section 1861(s)</quote>.</text>
</paragraph></subsection><subsection id="H45CD7CC5E1B64ED6BC620D22FC6EF6F5"><enum>(c)</enum><header>Budget neutrality</header><text>The Secretary of Health and Human Services shall implement the amendments made by this section in a manner such that—</text>
<paragraph id="H833FB20DF2684E96ADAB2ACA9D0DA969"><enum>(1)</enum><text>estimated expenditures under the physician fee schedule under section 1848 of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395w-4">42 U.S.C. 1395w–4</external-xref>) with application of such amendments are equal to estimated expenditures under such schedule without application of such amendments; and</text>
</paragraph><paragraph id="HDA36AFBEF26D43059CB475ECD567C3E7"><enum>(2)</enum><text display-inline="yes-display-inline">estimated expenditures under the prospective payment system under section 1833(t) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395l">42 U.S.C. 1395l(t)</external-xref>) with application of such amendments made by this section are equal to estimated expenditures under such system without application of such amendments.</text>
</paragraph></subsection></section>