[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4396 Introduced in House (IH)]

<DOC>






114th CONGRESS
  2d Session
                                H. R. 4396

  To support a comprehensive public health response to the heroin and 
                    prescription drug abuse crisis.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            January 28, 2016

 Mr. Pallone introduced the following bill; which was referred to the 
Committee on Energy and Commerce, and in addition to the Committees on 
 the Judiciary, Ways and Means, and Education and the Workforce, for a 
 period to be subsequently determined by the Speaker, in each case for 
consideration of such provisions as fall within the jurisdiction of the 
                          committee concerned

_______________________________________________________________________

                                 A BILL


 
  To support a comprehensive public health response to the heroin and 
                    prescription drug abuse crisis.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Heroin and 
Prescription Drug Abuse Prevention and Reduction Act''.
    (b) Table of Contents.--The table of contents for this Act is as 
follows:

Sec. 1. Short title; table of contents.
                          TITLE I--PREVENTION

Sec. 101. Practitioner education.
Sec. 102. Co-prescribing opioid overdose reversal drugs grant program.
Sec. 103. Opioid overdose reversal co-prescribing guidelines.
Sec. 104. Surveillance capacity building.
                            TITLE II--CRISIS

Sec. 201. Grants to support syringe exchange programs.
Sec. 202. Grant program to reduce drug overdose deaths.
                          TITLE III--TREATMENT

Sec. 301. Expansion of patient limits under waiver.
Sec. 302. Definitions.
Sec. 303. Evaluation by assistant Secretary for planning and 
                            evaluation.
Sec. 304. Reauthorization of residential treatment programs for 
                            pregnant and postpartum women.
Sec. 305. Pilot program grants for State substance abuse agencies.
Sec. 306. Evidence-based opioid and heroin treatment and interventions 
                            demonstration.
Sec. 307. Adolescent treatment and recovery services demonstration 
                            grant program.
Sec. 308. Strengthening parity in mental health and substance use 
                            disorder benefits.
Sec. 309. Study on treatment infrastructure.
Sec. 310. Substance use disorder professional loan repayment program.
                           TITLE IV--RECOVERY

Sec. 401. National youth recovery initiative.
Sec. 402. Grants to enhance and expand recovery support services.

                          TITLE I--PREVENTION

SEC. 101. PRACTITIONER EDUCATION.

    (a) Education Requirements.--
            (1) Registration consideration.--Section 303(f) of the 
        Controlled Substances Act (21 U.S.C. 823(f)) is amended by 
        inserting after paragraph (5) the following:
            ``(6) The applicant's compliance with the training 
        requirements described in subsection (g)(3) during any previous 
        period in which the applicant has been subject to such training 
        requirements.''.
            (2) Training requirements.--Section 303(g) of the 
        Controlled Substances Act (21 U.S.C. 823(g)) is amended by 
        adding at the end the following:
    ``(3)(A) To be registered to prescribe or otherwise dispense 
opioids for the treatment of pain, or pain management, a practitioner 
described in paragraph (1) shall comply with the 12-hour training 
requirement of subparagraph (B) at least once during each 3-year 
period.
    ``(B) The training requirement of this subparagraph is that the 
practitioner has completed not less than 12 hours of training (through 
classroom situations, seminars at professional society meetings, 
electronic communications, or otherwise) with respect to--
            ``(i) the treatment and management of opioid-dependent 
        patients;
            ``(ii) pain management treatment guidelines; and
            ``(iii) early detection of opioid addiction, including 
        through such methods as Screening, Brief Intervention, and 
        Referral to Treatment (SBIRT),
that is provided by the American Society of Addiction Medicine, the 
American Academy of Addiction Psychiatry, the American Medical 
Association, the American Osteopathic Association, the American 
Psychiatric Association, the American Academy of Pain Management, the 
American Pain Society, the American Academy of Pain Medicine, the 
American Board of Pain Medicine, the American Society of Interventional 
Pain Physicians, or any other organization that the Secretary 
determines is appropriate for purposes of this subparagraph.''.
    (b) Funding.--The Drug Enforcement Administration shall fund the 
enforcement of the requirements specified in section 303(g)(3) of the 
Controlled Substances Act (as added by subsection (a)) through the use 
of a portion of the licensing fees paid by controlled substance 
prescribers under the Controlled Substances Act (21 U.S.C. 801 et 
seq.).
    (c) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section $1,000,000 for each of fiscal 
years 2017 through 2021.

SEC. 102. CO-PRESCRIBING OPIOID OVERDOSE REVERSAL DRUGS GRANT PROGRAM.

    (a) Establishment.--
            (1) In general.--Not later than six months after the date 
        of the enactment of this Act, the Secretary of Health and Human 
        Services shall establish, in accordance with this section, a 
        four-year co-prescribing opioid overdose reversal drugs grant 
        program (in this title referred to as the ``grant program'') 
        under which the Secretary shall provide not more than a total 
        of 12 grants to eligible entities to carry out the activities 
        described in subsection (c).
            (2) Eligible entity.--For purposes of this section, the 
        term ``eligible entity'' means a federally qualified health 
        center (as defined in section 1861(aa) of the Social Security 
        Act (42 U.S.C. 1395x(aa))), an opioid treatment program under 
        part 8 of title 42, Code of Federal Regulations, or section 
        303(g) of the Controlled Substances Act (21 U.S.C. 823(g)), a 
        program approved by a State substance abuse agency, or any 
        other entity that the Secretary deems appropriate.
            (3) Co-prescribing.--For purposes of this title, the term 
        ``co-prescribing'' means, with respect to an opioid overdose 
        reversal drug, the practice of prescribing such drug in 
        conjunction with an opioid prescription for patients at an 
        elevated risk of overdose, or in conjunction with an opioid 
        agonist approved under section 505 of the Federal Food, Drug, 
        and Cosmetic Act (21 U.S.C. 355) for the treatment of opioid 
        abuse disorders, or in other circumstances in which a provider 
        identifies a patient at an elevated risk for an intentional or 
        unintentional drug overdose from heroin or prescription opioid 
        therapies. For purposes of the previous sentence, a patient may 
        be at an elevated risk of overdose if the patient meets the 
        criteria under the existing co-prescribing guidelines that the 
        Secretary deems appropriate, such as the criteria provided in 
        the Opioid Overdose Toolkit published by the Substance Abuse 
        and Mental Health Services Administration.
    (b) Application.--To be eligible to receive a grant under this 
section, an eligible entity shall submit to the Secretary of Health and 
Human Services, in such form and manner as specified by the Secretary, 
an application that describes--
            (1) the extent to which the area to which the entity will 
        furnish services through use of the grant is experiencing 
        significant morbidity and mortality caused by opioid abuse;
            (2) the criteria that will be used to identify eligible 
        patients to participate in such program; and
            (3) how such program will work to try to identify State, 
        local, or private funding to continue the program after 
        expiration of the grant.
    (c) Use of Funds.--An eligible entity receiving a grant under this 
section may use the grant for any of the following activities:
            (1) To establish a program for co-prescribing opioid 
        overdose reversal drugs, such as naloxone.
            (2) To train and provide resources for health care 
        providers and pharmacists on the co-prescribing of opioid 
        overdose reversal drugs.
            (3) To establish mechanisms and processes, consistent with 
        applicable Federal and State privacy rules, for tracking 
        patients participating in the program described in paragraph 
        (1) and the health outcomes of such patients.
            (4) To purchase opioid overdose reversal drugs for 
        distribution under the program described in paragraph (1).
            (5) To offset the co-pays and other cost sharing associated 
        with opioid overdose reversal drugs to ensure that cost is not 
        a limiting factor for eligible patients.
            (6) To conduct community outreach, in conjunction with 
        community-based organizations, designed to raise awareness of 
        co-prescribing practices, and the availability of opioid 
        overdose reversal drugs.
            (7) To establish protocols to connect patients who have 
        experienced a drug overdose with appropriate treatment, 
        including medication assisted treatment and appropriate 
        counseling and behavioral therapies.
    (d) Evaluations by Recipients.--As a condition of receipt of a 
grant under this section, an eligible entity shall, for each year for 
which the grant is received, submit to the Secretary of Health and 
Human Services information on appropriate outcome measures specified by 
the Secretary to assess the outcomes of the program funded by the 
grant, including--
            (1) the number of prescribers trained;
            (2) the number of prescribers who have co-prescribed an 
        opioid overdose reversal drug to at least one patient;
            (3) the total number of prescriptions written for opioid 
        overdose reversal drugs;
            (4) the percentage of patients at elevated risk who 
        received a prescription for an opioid overdose reversal drug;
            (5) the number of patients reporting use of an opioid 
        overdose reversal drug; and
            (6) any other outcome measures that the Secretary deems 
        appropriate.
    (e) Reports by Secretary.--For each year of the grant program under 
this section, the Secretary of Health and Human Services shall submit 
to the appropriate committees of the House of Representatives and of 
the Senate a report aggregating the information received from the grant 
recipients for such year under subsection (d) and evaluating the 
outcomes achieved by the programs funded by grants made under this 
section.
    (f) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section and section 103 $4,000,000 for 
each of fiscal years 2017 through 2021.

SEC. 103. OPIOID OVERDOSE REVERSAL CO-PRESCRIBING GUIDELINES.

    (a) In General.--The Secretary of Health and Human Services shall 
establish a grant program under which the Secretary shall award grants 
to eligible State entities to develop opioid overdose reversal co-
prescribing guidelines.
    (b) Eligible State Entities.--For purposes of subsection (a), 
eligible State entities are State departments of health in conjunction 
with State medical boards; city, county, and local health departments; 
and community stakeholder groups involved in reducing opioid overdose 
deaths.
    (c) Administrative Provisions.--
            (1) Grant amounts.--A grant made under this section may not 
        be for more than $200,000 per grant.
            (2) Prioritization.--In awarding grants under this section, 
        the Secretary shall give priority to eligible State entities 
        which propose to base their guidelines on existing guidelines 
        on co-prescribing to speed enactment, including guidelines of--
                    (A) the Department of Veterans Affairs;
                    (B) nationwide medical societies, such as the 
                American Society of Addiction Medicine or the American 
                Medical Association; and
                    (C) the Centers for Disease Control and Prevention.

SEC. 104. SURVEILLANCE CAPACITY BUILDING.

    (a) Program Authorized.--The Secretary of Health and Human 
Services, acting through the Director of the Centers for Disease 
Control and Prevention, shall award cooperative agreements or grants to 
eligible entities to improve fatal and nonfatal drug overdose 
surveillance and reporting capabilities, including--
            (1) providing training to improve identification of drug 
        overdose as the cause of death by coroners and medical 
        examiners;
            (2) establishing, in cooperation with the National Poison 
        Data System, coroners, and medical examiners, a comprehensive 
        national program for surveillance of, and reporting to an 
        electronic database on, drug overdose deaths in the United 
        States; and
            (3) establishing, in cooperation with the National Poison 
        Data System, a comprehensive national program for surveillance 
        of, and reporting to an electronic database on, fatal and 
        nonfatal drug overdose occurrences, including epidemiological 
        and toxicologic analysis and trends.
    (b) Eligible Entity.--To be eligible to receive a grant or 
cooperative agreement under this section, an entity shall be--
            (1) a State, local, or tribal government; or
            (2) the National Poison Data System working in conjunction 
        with a State, local, or tribal government.
    (c) Application.--
            (1) In general.--An eligible entity desiring a grant or 
        cooperative agreement under this section shall submit to the 
        Secretary an application at such time, in such manner, and 
        containing such information as the Secretary may require.
            (2) Contents.--An application described in paragraph (1) 
        shall include--
                    (A) a description of the activities to be funded 
                through the grant or cooperative agreement; and
                    (B) evidence that the eligible entity has the 
                capacity to carry out such activities.
    (d) Report.--As a condition of receipt of a grant or cooperative 
agreement under this section, an eligible entity shall agree to prepare 
and submit, not later than 90 days after the end of the grant or 
cooperative agreement period, a report to the Secretary describing the 
results of the activities supported through the grant or cooperative 
agreement.
    (e) National Poison Data System.--In this section, the term 
``National Poison Data System'' means the system operated by the 
American Association of Poison Control Centers, in partnership with the 
Centers for Disease Control and Prevention, for real-time local, State, 
and national electronic reporting, and the corresponding database 
network.
    (f) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section $5,000,000 for each of the 
fiscal years 2017 through 2021.

                            TITLE II--CRISIS

SEC. 201. GRANTS TO SUPPORT SYRINGE EXCHANGE PROGRAMS.

    (a) In General.--The Secretary of Health and Human Services may 
award grants to State, local, and tribal governments and community 
organizations to support syringe exchange programs.
    (b) Use of Funds.--Grants under subsection (a) may be used to 
support carrying out syringe exchange programs, including through--
            (1) providing outreach, counseling, health education, case 
        management, syringe disposal, and other services as determined 
        appropriate by the Secretary of Health and Human Services; and
            (2) providing technical assistance, including training and 
        capacity building, to assist the development and implementation 
        of syringe exchange programs.
    (c) Authorization of Appropriations.--There is authorized to be 
appropriated $15,000,000 for each of fiscal years 2017 through 2021 to 
carry out this section, of which--
            (1) at least 15 percent shall be for syringe exchange 
        programs that have been in operation for less than 3 years; and
            (2) 5 percent shall be for technical assistance under 
        subsection (b)(2).

SEC. 202. GRANT PROGRAM TO REDUCE DRUG OVERDOSE DEATHS.

    (a) Program Authorized.--The Secretary of Health and Human 
Services, acting through the Administrator of the Substance Abuse and 
Mental Health Services Administration, shall award grants or enter into 
cooperative agreements with eligible entities to enable the eligible 
entities to reduce deaths occurring from overdoses of drugs.
    (b) Eligible Entities.--To be eligible to receive a grant or 
cooperative agreement under this section, an entity shall be a 
partnership between any of the following: a State, local, or tribal 
government, a correctional institution, a law enforcement agency, a 
community agency, a professional organization in the field of poison 
control and surveillance, or a private nonprofit organization.
    (c) Application.--
            (1) In general.--An eligible entity desiring a grant or 
        cooperative agreement under this section shall submit to the 
        Secretary of Health and Human Services an application at such 
        time, in such manner, and containing such information as the 
        Secretary may require.
            (2) Contents.--An application under paragraph (1) shall 
        include--
                    (A) a description of the activities to be funded 
                through the grant or cooperative agreement; and
                    (B) evidence that the eligible entity has the 
                capacity to carry out such activities.
    (d) Priority.--In entering into grants and cooperative agreements 
under subsection (a), the Secretary of Health and Human Services shall 
give priority to eligible entities that--
            (1) include a public health agency or community-based 
        organization; and
            (2) have expertise in preventing deaths occurring from 
        overdoses of drugs in populations at high risk of such deaths.
    (e) Eligible Activities.--As a condition of receipt of a grant or 
cooperative agreement under this section, an eligible entity shall 
agree to use the grant or cooperative agreement to do each of the 
following:
            (1) Purchase and distribute the drug naloxone or a 
        similarly effective medication.
            (2) Carry out one or more of the following activities:
                    (A) Educating prescribers and pharmacists about 
                overdose prevention and naloxone prescription, or 
                prescriptions of a similarly effective medication.
                    (B) Training first responders, other individuals in 
                a position to respond to an overdose, and law 
                enforcement and corrections officials on the effective 
                response to individuals who have overdosed on drugs. 
                Training pursuant to this subparagraph may include any 
                activity that is educational, instructional, or 
                consultative in nature, and may include volunteer 
                training, awareness building exercises, outreach to 
                individuals who are at-risk of a drug overdose, and 
                distribution of educational materials.
                    (C) Implementing and enhancing programs to provide 
                overdose prevention, recognition, treatment, and 
                response to individuals in need of such services.
                    (D) Educating the public and providing outreach to 
                the public about overdose prevention and naloxone 
                prescriptions, or prescriptions of other similarly 
                effective medications.
    (f) Coordinating Center.--
            (1) Establishment.--The Secretary of Health and Human 
        Services shall establish and provide for the operation of a 
        coordinating center responsible for--
                    (A) collecting, compiling, and disseminating data 
                on the programs and activities under this section, 
                including tracking and evaluating the distribution and 
                use of naloxone and other similarly effective 
                medication;
                    (B) evaluating such data and, based on such 
                evaluation, developing best practices for preventing 
                deaths occurring from drug overdoses;
                    (C) making such best practices specific to the type 
                of community involved;
                    (D) coordinating and harmonizing data collection 
                measures;
                    (E) evaluating the effects of the program on 
                overdose rates; and
                    (F) education and outreach to the public about 
                overdose prevention and prescription of naloxone and 
                other similarly effective medication.
            (2) Reports to center.--As a condition on receipt of a 
        grant or cooperative agreement under this section, an eligible 
        entity shall agree to prepare and submit, not later than 90 
        days after the end of the award period, a report to such 
        coordinating center and the Secretary of Health and Human 
        Services describing the results of the activities supported 
        through the grant or cooperative agreement.
    (g) Duration.--The period of a grant or cooperative agreement under 
this section shall be 4 years.
    (h) Definition.--In this part, the term ``drug''--
            (1) means a drug, as defined in section 201 of the Federal 
        Food, Drug, and Cosmetic Act (21 U.S.C. 321); and
            (2) includes controlled substances, as defined in section 
        102 of the Controlled Substances Act (21 U.S.C. 802).
    (i) Authorization of Appropriations.--There is authorized to be 
appropriated $20,000,000 to carry out this section for each of the 
fiscal years 2017 through 2021.

                          TITLE III--TREATMENT

SEC. 301. EXPANSION OF PATIENT LIMITS UNDER WAIVER.

    Section 303(g)(2)(B) of the Controlled Substances Act (21 U.S.C. 
823(g)(2)(B)) is amended--
            (1) in clause (i), by striking ``physician'' and inserting 
        ``practitioner'';
            (2) in clause (iii)--
                    (A) by striking ``30'' and inserting ``100''; and
                    (B) by striking ``, unless, not sooner'' and all 
                that follows through the end and inserting a period; 
                and
            (3) by inserting at the end the following new clause:
                    ``(iv) Not earlier than 1 year after the date on 
                which a qualifying practitioner obtained an initial 
                waiver pursuant to clause (iii), the qualifying 
                practitioner may submit a second notification to the 
                Secretary of the need and intent of the qualifying 
                practitioner to treat an unlimited number of patients, 
                if the qualifying practitioner--
                            ``(I)(aa) satisfies the requirements of 
                        item (aa), (bb), (cc), or (dd) of subparagraph 
                        (G)(ii)(I); and
                            ``(bb) agrees to fully participate in the 
                        Prescription Drug Monitoring Program of the 
                        State in which the qualifying practitioner is 
                        licensed, pursuant to applicable State 
                        guidelines; or
                            ``(II)(aa) satisfies the requirements of 
                        item (ee), (ff), or (gg) of subparagraph 
                        (G)(ii)(I);
                            ``(bb) agrees to fully participate in the 
                        Prescription Drug Monitoring Program of the 
                        State in which the qualifying practitioner is 
                        licensed, pursuant to applicable State 
                        guidelines;
                            ``(cc) practices in a qualified practice 
                        setting; and
                            ``(dd) has completed not less than 24 hours 
                        of training (through classroom situations, 
                        seminars at professional society meetings, 
                        electronic communications, or otherwise) with 
                        respect to the treatment and management of 
                        opiate-dependent patients for substance use 
                        disorders provided by the American Society of 
                        Addiction Medicine, the American Academy of 
                        Addiction Psychiatry, the American Medical 
                        Association, the American Osteopathic 
                        Association, the American Psychiatric 
                        Association, or any other organization that the 
                        Secretary determines is appropriate for 
                        purposes of this subclause.''.

SEC. 302. DEFINITIONS.

    Section 303(g)(2)(G) of the Controlled Substances Act (21 U.S.C. 
823(g)(2)(G)) is amended--
            (1) by striking clause (ii) and inserting the following:
                    ``(ii) The term `qualifying practitioner' means the 
                following:
                            ``(I) A physician who is licensed under 
                        State law and who meets 1 or more of the 
                        following conditions:
                                    ``(aa) The physician holds a board 
                                certification in addiction psychiatry 
                                from the American Board of Medical 
                                Specialties.
                                    ``(bb) The physician holds an 
                                addiction certification from the 
                                American Society of Addiction Medicine.
                                    ``(cc) The physician holds a board 
                                certification in addiction medicine 
                                from the American Osteopathic 
                                Association.
                                    ``(dd) The physician holds a board 
                                certification from the American Board 
                                of Addiction Medicine.
                                    ``(ee) The physician has completed 
                                not less than 8 hours of training 
                                (through classroom situations, seminar 
                                at professional society meetings, 
                                electronic communications, or 
                                otherwise) with respect to the 
                                treatment and management of opiate-
                                dependent patients for substance use 
                                disorders provided by the American 
                                Society of Addiction Medicine, the 
                                American Academy of Addiction 
                                Psychiatry, the American Medical 
                                Association, the American Osteopathic 
                                Association, the American Psychiatric 
                                Association, or any other organization 
                                that the Secretary determines is 
                                appropriate for purposes of this 
                                subclause.
                                    ``(ff) The physician has 
                                participated as an investigator in 1 or 
                                more clinical trials leading to the 
                                approval of a narcotic drug in schedule 
                                III, IV, or V for maintenance or 
                                detoxification treatment, as 
                                demonstrated by a statement submitted 
                                to the Secretary by this sponsor of 
                                such approved drug.
                                    ``(gg) The physician has such other 
                                training or experience as the Secretary 
                                determines will demonstrate the ability 
                                of the physician to treat and manage 
                                opiate-dependent patients.
                            ``(II) A nurse practitioner or physician 
                        assistant who is licensed under State law and 
                        meets all of the following conditions:
                                    ``(aa) The nurse practitioner or 
                                physician assistant is licensed under 
                                State law to prescribe schedule III, 
                                IV, or V medications for pain.
                                    ``(bb) The nurse practitioner or 
                                physician assistant satisfies 1 or more 
                                of the following:
                                            ``(AA) Has completed not 
                                        fewer than 24 hours of training 
                                        (through classroom situations, 
                                        seminar at professional society 
                                        meetings, electronic 
                                        communications, or otherwise) 
                                        with respect to the treatment 
                                        and management of opiate-
                                        dependent patients for 
                                        substance use disorders 
                                        provided by the American 
                                        Society of Addiction Medicine, 
                                        the American Academy of 
                                        Addiction Psychiatry, the 
                                        American Medical Association, 
                                        the American Osteopathic 
                                        Association, the American 
                                        Psychiatric Association, or any 
                                        other organization that the 
                                        Secretary determines is 
                                        appropriate for purposes of 
                                        this subclause.
                                            ``(BB) Has such other 
                                        training or experience as the 
                                        Secretary determines will 
                                        demonstrate the ability of the 
                                        nurse practitioner or physician 
                                        assistant to treat and manage 
                                        opiate-dependent patients.
                                    ``(cc) The nurse practitioner or 
                                physician assistant practices within 
                                the scope of their State license, 
                                including compliance with any 
                                supervision or collaboration 
                                requirements under State law.
                                    ``(dd) The nurse practitioner or 
                                physician assistant practice in a 
                                qualified practice setting.''; and
            (2) by adding at the end the following:
                    ``(iii) The term `qualified practice setting' means 
                1 or more of the following treatment settings:
                            ``(I) A National Committee for Quality 
                        Assurance-recognized Patient-Centered Medical 
                        Home or Patient-Centered Specialty Practice.
                            ``(II) A Centers for Medicaid & Medicare 
                        Services-recognized Accountable Care 
                        Organization.
                            ``(III) A clinical facility administered by 
                        the Department of Veterans Affairs, Department 
                        of Defense, or Indian Health Service.
                            ``(IV) A Behavioral Health Home accredited 
                        by the Joint Commission.
                            ``(V) A Federally-qualified health center 
                        (as defined in section 1905(l)(2)(B) of the 
                        Social Security Act (42 U.S.C. 1396d(l)(2)(B))) 
                        or a Federally-qualified health center look-
                        alike.
                            ``(VI) A Substance Abuse and Mental Health 
                        Services-certified Opioid Treatment Program.
                            ``(VII) A clinical program of a State or 
                        Federal jail, prison, or other facility where 
                        individuals are incarcerated.
                            ``(VIII) A clinic that demonstrates 
                        compliance with the Model Policy on DATA 2000 
                        and Treatment of Opioid Addiction in the 
                        Medical Office issued by the Federation of 
                        State Medical Boards.
                            ``(IX) A treatment setting that is part of 
                        an Accreditation Council for Graduate Medical 
                        Education, American Association of Colleges of 
                        Osteopathic Medicine, or American Osteopathic 
                        Association-accredited residency or fellowship 
                        training program.
                            ``(X) Any other practice setting approved 
                        by a State regulatory board, State substance 
                        abuse agency, or State Medicaid Plan to provide 
                        addiction treatment services.
                            ``(XI) Any other practice setting approved 
                        by the Secretary.''.

SEC. 303. EVALUATION BY ASSISTANT SECRETARY FOR PLANNING AND 
              EVALUATION.

    Two years after the date on which the first notification under 
clause (iv) of section 303(g)(2)(B) of the Controlled Substances Act 
(21 U.S.C. 823(g)(2)(B)), as added by section 301, is received by the 
Secretary of Health and Human Services, the Assistant Secretary for 
Planning and Evaluation shall initiate an evaluation of the 
effectiveness of the amendments made by sections 301 and 302, which 
shall include an evaluation of--
            (1) any changes in the availability and use of medication-
        assisted treatment for opioid addiction;
            (2) the quality of medication-assisted treatment programs;
            (3) the integration of medication-assisted treatment with 
        routine healthcare services;
            (4) diversion of opioid addiction treatment medication;
            (5) changes in State or local policies and legislation 
        relating to opioid addiction treatment;
            (6) the use of nurse practitioners and physician assistants 
        who prescribe opioid addiction medication;
            (7) the use of Prescription Drug Monitoring Programs by 
        waived practitioners to maximize safety of patient care and 
        prevent diversion of opioid addiction medication;
            (8) the findings of the Drug Enforcement Administration 
        inspections of waived practitioners, including the frequency 
        with which the Drug Enforcement Administration finds no 
        documentation of access to behavioral health services; and
            (9) the effectiveness of cross-agency collaboration between 
        Department of Health and Human Services and the Drug 
        Enforcement Administration for expanding effective opioid 
        addiction treatment.

SEC. 304. REAUTHORIZATION OF RESIDENTIAL TREATMENT PROGRAMS FOR 
              PREGNANT AND POSTPARTUM WOMEN.

    Section 508 of the Public Health Service Act (42 U.S.C. 290bb-1) is 
amended--
            (1) in subsection (p), by inserting ``(other than 
        subsection (r))'' after ``section''; and
            (2) in subsection (r), by striking ``such sums'' and all 
        that follows through ``2003'' and inserting ``$40,000,000 for 
        each of fiscal years 2017 through 2021''.

SEC. 305. PILOT PROGRAM GRANTS FOR STATE SUBSTANCE ABUSE AGENCIES.

    (a) In General.--Section 508 of the Public Health Service Act (42 
U.S.C. 290bb-1) is amended--
            (1) by redesignating subsection (r), as amended by section 
        304, as subsection (s); and
            (2) by inserting after subsection (q) the following new 
        subsection:
    ``(r) Pilot Program for State Substance Abuse Agencies.--
            ``(1) In general.--From amounts made available under 
        subsection (s), the Director of the Center for Substance Abuse 
        Treatment shall carry out a pilot program under which 
        competitive grants are made by the Director to State substance 
        abuse agencies to--
                    ``(A) enhance flexibility in the use of funds 
                designed to support family-based services for pregnant 
                and postpartum women with a primary diagnosis of a 
                substance use disorder, including opioid use disorders;
                    ``(B) help State substance abuse agencies address 
                identified gaps in services furnished to such women 
                along the continuum of care, including services 
                provided to women in non-residential based settings; 
                and
                    ``(C) promote a coordinated, effective, and 
                efficient State system managed by State substance abuse 
                agencies by encouraging new approaches and models of 
                service delivery.
            ``(2) Requirements.--In carrying out the pilot program 
        under this subsection, the Director shall--
                    ``(A) require State substance abuse agencies to 
                submit to the Director applications, in such form and 
                manner and containing such information as specified by 
                the Director, to be eligible to receive a grant under 
                the program;
                    ``(B) identify, based on such submitted 
                applications, State substance abuse agencies that are 
                eligible for such grants;
                    ``(C) require services proposed to be furnished 
                through such a grant to support family-based treatment 
                and other services for pregnant and postpartum women 
                with a primary diagnosis of a substance use disorder, 
                including opioid use disorders;
                    ``(D) not require that services furnished through 
                such a grant be provided solely to women that reside in 
                facilities;
                    ``(E) not require that grant recipients under the 
                program make available through use of the grant all 
                services described in subsection (d); and
                    ``(F) consider not applying requirements described 
                in paragraphs (1) and (2) of subsection (f) to 
                applicants, depending on the circumstances of the 
                applicant.
            ``(3) Required services.--
                    ``(A) In general.--The Director shall specify a 
                minimum set of services required to be made available 
                to eligible women through a grant awarded under the 
                pilot program under this subsection. Such minimum set--
                            ``(i) shall include requirements described 
                        in subsection (c) and be based on the 
                        recommendations submitted under subparagraph 
                        (B); and
                            ``(ii) may be selected from among the 
                        services described in subsection (d) and 
                        include other services as appropriate.
                    ``(B) Stakeholder input.--The Director shall 
                convene and solicit recommendations from stakeholders, 
                including State substance abuse agencies, health care 
                providers, persons in recovery from substance abuse, 
                and other appropriate individuals, for the minimum set 
                of services described in subparagraph (A).
            ``(4) Duration.--The pilot program under this subsection 
        shall not exceed 5 years.
            ``(5) Evaluation and report to congress.--The Director of 
        the Center for Behavioral Health Statistics and Quality shall 
        fund an evaluation of the pilot program at the conclusion of 
        the first grant cycle funded by the pilot program. The Director 
        of the Center for Behavioral Health Statistics and Quality, in 
        coordination with the Director of the Center for Substance 
        Abuse Treatment shall submit to the relevant committees of 
        jurisdiction of the House of Representatives and the Senate a 
        report on such evaluation. The report shall include at a 
        minimum outcomes information from the pilot program, including 
        any resulting reductions in the use of alcohol and other drugs; 
        engagement in treatment services; retention in the appropriate 
        level and duration of services; increased access to the use of 
        medications approved by the Food and Drug Administration for 
        the treatment of substance use disorders in combination with 
        counseling; and other appropriate measures.
            ``(6) State substance abuse agencies defined.--For purposes 
        of this subsection, the term `State substance abuse agency' 
        means, with respect to a State, the agency in such State that 
        manages the Substance Abuse Prevention and Treatment Block 
        Grant under part B of title XIX.''.
    (b) Funding.--Subsection (s) of section 508 of the Public Health 
Service Act (42 U.S.C. 290bb-1), as amended by section 304 and 
redesignated by subsection (a), is further amended by adding at the end 
the following new sentence: ``Of the amounts made available for a year 
pursuant to the previous sentence to carry out this section, not more 
than 25 percent of such amounts shall be made available for such year 
to carry out subsection (r), other than paragraph (5) of such 
subsection.''.

SEC. 306. EVIDENCE-BASED OPIOID AND HEROIN TREATMENT AND INTERVENTIONS 
              DEMONSTRATION.

    Subpart 1 of part B of title V of the Public Health Service Act (42 
U.S.C. 290bb et seq.) is amended--
            (1) by redesignating section 514 (42 U.S.C. 290bb-9), as 
        added by section 3632 of the Methamphetamine Anti-Proliferation 
        Act of 2000 (Public Law 106-310; 114 Stat. 1236), as section 
        514B; and
            (2) by adding at the end the following:

``SEC. 514C. EVIDENCE-BASED OPIOID AND HEROIN TREATMENT AND 
              INTERVENTIONS DEMONSTRATION.

    ``(a) Grants.--
            ``(1) Authority to make grants.--The Director of the Center 
        for Substance Abuse Treatment (referred to in this section as 
        the `Director') shall award grants to State substance abuse 
        agencies, units of local government, nonprofit organizations, 
        and Indian tribes or tribal organizations (as defined in 
        section 4 of the Indian Health Care Improvement Act (25 U.S.C. 
        1603)) that have a high rate, or have had a rapid increase, in 
        the use of heroin or other opioids, in order to permit such 
        entities to expand activities, including an expansion in the 
        availability of medication assisted treatment, evidence-based 
        counseling, or behavioral therapies with respect to the 
        treatment of addiction in the specific geographical areas of 
        such entities where there is a rate or rapid increase in the 
        use of heroin or other opioids.
            ``(2) Recipients.--The entities receiving grants under 
        paragraph (1) shall be selected by the Director.
            ``(3) Nature of activities.--The grant funds awarded under 
        paragraph (1) shall be used for activities that are based on 
        reliable scientific evidence of efficacy in the treatment of 
        problems related to heroin or other opioids.
    ``(b) Geographic Distribution.--The Director shall ensure that 
grants awarded under subsection (a) are distributed equitably among the 
various regions of the Nation and among rural, urban, and suburban 
areas that are affected by the use of heroin or other opioids.
    ``(c) Additional Activities.--The Director shall--
            ``(1) evaluate the activities supported by grants awarded 
        under subsection (a);
            ``(2) disseminate widely such significant information 
        derived from the evaluation as the Director considers 
        appropriate;
            ``(3) provide States, Indian tribes and tribal 
        organizations, and providers with technical assistance in 
        connection with the provision of treatment of problems related 
        to heroin and other opioids; and
            ``(4) fund only those applications that specifically 
        support recovery services as a critical component of the grant 
        program.
    ``(d) Definition.--The term `medication assisted treatment' means 
the use, for problems relating to heroin and other opioids, of 
medications approved by the Food and Drug Administration in combination 
with counseling and behavioral therapies.
    ``(e) Authorization of Appropriations.--
            ``(1) In general.--There is authorized to be appropriated 
        to carry out this section $300,000,000 for each of fiscal years 
        2017 through 2021.
            ``(2) Use of certain funds.--Of the funds appropriated to 
        carry out this section in any fiscal year, not more than 5 
        percent of such funds shall be available to the Director for 
        purposes of carrying out subsection (c).''.

SEC. 307. ADOLESCENT TREATMENT AND RECOVERY SERVICES DEMONSTRATION 
              GRANT PROGRAM.

    Subpart 1 of part B of title V of the Public Health Service Act (42 
U.S.C. 290bb et seq.), as amended by section 306, is further amended by 
adding at the end the following:

``SEC. 514D. GRANTS TO IMPROVE ACCESS TO TREATMENT AND RECOVERY FOR 
              ADOLESCENTS.

    ``(a) In General.--The Secretary, acting through the Director of 
the Center for Substance Abuse Treatment, shall award grants, 
contracts, or cooperative agreements to eligible State substance abuse 
agencies and other entities determined appropriate by the Director for 
the purpose of increasing the capacity of substance use disorder 
treatment and recovery services for adolescents.
    ``(b) Eligibility.--To be eligible to receive a grant, contract, or 
cooperative agreement under subsection (a) an entity shall--
            ``(1) prepare and submit to the Director an application at 
        such time, in such manner, and contain such information as the 
        Director may require, including a plan for the evaluation of 
        any activities carried out with the funds provided under this 
        section;
            ``(2) ensure that all entities receiving support under the 
        grant, contract, or cooperative agreement comply with all 
        applicable State licensure or certification requirements 
        regarding the provision of the services involved; and
            ``(3) provide the Director with periodic evaluations of the 
        progress of the activities funded under this section and an 
        evaluation at the completion of such activities, as the 
        Director determines to be appropriate.
    ``(c) Priority.--In awarding grants, contracts, and cooperative 
agreements under subsection (a), the Director shall give priority to 
applicants who propose to fill a demonstrated geographic need for 
adolescent specific residential treatment services.
    ``(d) Use of Funds.--Amounts awarded under grants, contracts, or 
cooperative agreements under this section may be used to enable health 
care providers or facilities that provide treatment and recovery 
assistance for adolescents with a substance use disorder to provide the 
following services:
            ``(1) Individualized patient centered care that is specific 
        to circumstances of the individual patient.
            ``(2) Clinically appropriate, trauma-informed, gender-
        specific and age appropriate treatment services that are based 
        on reliable scientific evidence of efficacy in the treatment of 
        problems related to substance use disorders.
            ``(3) Clinically appropriate care to address treatment for 
        substance use and any co-occurring physical and mental health 
        disorders at the same location, and through access to primary 
        care services.
            ``(4) Coordination of treatment services with recovery and 
        other social support, including educational, vocational 
        training, assistance with the juvenile justice system, child 
        welfare, and mental health agencies.
            ``(5) Aftercare and long-term recovery support, including 
        peer support services.
    ``(e) Duration of Assistance.--Grants, contracts, and cooperative 
agreements awarded under subsection (a) shall be for a period not to 
exceed 5 years.
    ``(f) Additional Activities.--The Director shall--
            ``(1) collect and evaluate the activities carried out with 
        amounts received under subsection (a);
            ``(2) disseminate widely such significant information 
        derived from the evaluation as the Secretary considers 
        appropriate; and
            ``(3) provide States, Indian tribes and tribal 
        organizations, and providers with technical assistance in 
        connection with the provision of treatment and recovery 
        services funded through this section to adolescents related to 
        the abuse of heroin and other opioids.
    ``(g) Authorization of Appropriations.--
            ``(1) In general.--There is authorized to be appropriated 
        to carry out this section, $25,000,000 for each of fiscal years 
        2017 through 2021.
            ``(2) Use of certain funds.--Of the funds appropriated to 
        carry out this section in any fiscal year, not more than 5 
        percent of such funds shall be available to the Director for 
        purposes of carrying out subsection (f).''.

SEC. 308. STRENGTHENING PARITY IN MENTAL HEALTH AND SUBSTANCE USE 
              DISORDER BENEFITS.

    (a) Public Health Service Act.--Section 2726(a) of the Public 
Health Service Act (42 U.S.C. 300gg-26(a)) is amended by adding at the 
end the following new paragraphs:
            ``(6) Disclosure and enforcement requirements.--
                    ``(A) Disclosure requirements.--
                            ``(i) Regulations.--Not later than December 
                        31, 2016, the Secretary, in cooperation with 
                        the Secretaries of Labor and the Treasury, as 
                        appropriate, shall issue additional regulations 
                        for carrying out this section, including an 
                        explanation of documents that must be disclosed 
                        by plans and issuers, the process governing 
                        such disclosures by plans and issuers, and 
                        analyses that must be conducted by plans and 
                        issuers by a group health plan or health 
                        insurance issuer offering health insurance 
                        coverage in the group or individual market in 
                        order for such plan or issuer to demonstrate 
                        compliance with the provisions of this section.
                            ``(ii) Disclosure requirements.--Documents 
                        required to be disclosed by a group health plan 
                        or health insurance issuer offering health 
                        insurance coverage in the group or individual 
                        market under clause (i) shall include an annual 
                        report that details the specific analyses 
                        performed to ensure compliance of such plan or 
                        coverage with the law and regulations. At a 
                        minimum, with respect to the application of 
                        non-quantitative treatment limitations (in this 
                        paragraph referred to as NQTLs) to benefits 
                        under the plan or coverage, such report shall--
                                    ``(I) identify the specific factors 
                                the plan or coverage used in performing 
                                its NQTL analysis;
                                    ``(II) identify and define the 
                                specific evidentiary standards relied 
                                on to evaluate the factors;
                                    ``(III) describe how the 
                                evidentiary standards are applied to 
                                each service category for mental 
                                health, substance use disorders, 
                                medical benefits, and surgical 
                                benefits;
                                    ``(IV) disclose the results of the 
                                analyses of the specific evidentiary 
                                standards in each service category; and
                                    ``(V) disclose the specific 
                                findings of the plan or coverage in 
                                each service category and the 
                                conclusions reached with respect to 
                                whether the processes, strategies, 
                                evidentiary standards, or other factors 
                                used in applying the NQTL to mental 
                                health or substance use disorder 
                                benefits are comparable to, and applied 
                                no more stringently than, the 
                                processes, strategies, evidentiary 
                                standards, or other factors used in 
                                applying the limitation with respect to 
                                medical and surgical benefits in the 
                                same classification.
                            ``(iii) Guidance.--The Secretary, in 
                        cooperation with the Secretaries of Labor and 
                        the Treasury, as appropriate, shall issue 
                        guidance to group health plans and health 
                        insurance issuers offering health insurance 
                        coverage in the group or individual markets on 
                        how to satisfy the requirements of this section 
                        with respect to making information available to 
                        current and potential participants and 
                        beneficiaries. Such information shall include 
                        certificate of coverage documents and 
                        instruments under which the plan or coverage 
                        involved is administered and operated that 
                        specify, include, or refer to procedures, 
                        formulas, and methodologies applied to 
                        determine a participant or beneficiary's 
                        benefit under the plan or coverage, regardless 
                        of whether such information is contained in a 
                        document designated as the `plan document'. 
                        Such guidance shall include a disclosure of how 
                        the plan or coverage involved has provided that 
                        processes, strategies, evidentiary standards, 
                        and other factors used in applying the NQTL to 
                        mental health or substance use disorder 
                        benefits are comparable to, and applied no more 
                        stringently than, the processes, strategies, 
                        evidentiary standards, or other factors used in 
                        applying the limitation with respect to medical 
                        and surgical benefits in the same 
                        classification.
                            ``(iv) Definitions.--In this paragraph and 
                        paragraph (7), the terms `non-quantitative 
                        treatment limitations', `comparable to', and 
                        `applied no more stringently than' have the 
                        meanings given such terms in sections 146 and 
                        147 of title 45, Code of Federal Regulations 
                        (or any successor regulation).
                    ``(B) Enforcement.--
                            ``(i) Process for complaints.--The 
                        Secretary, in cooperation with the Secretaries 
                        of Labor and the Treasury, as appropriate, 
                        shall, with respect to group health plans and 
                        health insurance issuers offering health 
                        insurance coverage in the group or individual 
                        market, issue guidance to clarify the process 
                        and timeline for current and potential 
                        participants and beneficiaries (and authorized 
                        representatives and health care providers of 
                        such participants and beneficiaries) with 
                        respect to such plans and coverage to file 
                        formal complaints of such plans or issuers 
                        being in violation of this section, including 
                        guidance, by plan type, on the relevant State, 
                        regional, and national offices with which such 
                        complaints should be filed.
                            ``(ii) Authority for public enforcement.--
                        The Secretary, in consultation with the 
                        Secretaries of Labor and the Treasury, shall 
                        make available to the public on the Consumer 
                        Parity Portal website established under 
                        paragraph (7) de-identified information on 
                        audits and investigations of group health plans 
                        and health insurance issuers conducted under 
                        this section.
                            ``(iii) Audits.--
                                    ``(I) Randomized audits.--The 
                                Secretary in cooperation with the 
                                Secretaries of Labor and the Treasury, 
                                is authorized to conduct randomized 
                                audits of group health plans and health 
                                insurance issuers offering health 
                                insurance coverage in the group or 
                                individual market to determine 
                                compliance with this section. Such 
                                audits shall be conducted on no fewer 
                                than twelve plans and issuers per plan 
                                year. Information from such audits 
                                shall be made plainly available on the 
                                Consumer Parity Portal website 
                                established under paragraph (7).
                                    ``(II) Additional audits.--In the 
                                case of a group health plan or health 
                                insurance issuer offering health 
                                insurance coverage in the group or 
                                individual market with respect to which 
                                any claim has been filed during a plan 
                                year, the Secretary may audit the books 
                                and records of such plan or issuer to 
                                determine compliance with this section. 
                                Information detailing the results of 
                                the audit shall be made available on 
                                the Consumer Parity Portal website 
                                established under paragraph (7).
                            ``(iv) Denial rates.--The Secretary shall 
                        collect information on the rates of and reasons 
                        for denial by group health plans and health 
                        insurance issuers offering health insurance 
                        coverage in the group or individual market of 
                        claims for outpatient and inpatient mental 
                        health and substance use disorder services 
                        compared to the rates of and reasons for denial 
                        of claims for medical and surgical services. 
                        For the first plan year beginning at least two 
                        years after the date of the enactment of this 
                        paragraph and each subsequent plan year, the 
                        Secretary shall submit to the Committee on 
                        Energy and Commerce of the House of 
                        Representatives and the Committee on Health, 
                        Education, Labor, and Pensions of the Senate, 
                        and make plainly available on the Consumer 
                        Parity Portal website under paragraph (7), the 
                        information collected under the previous 
                        sentence with respect to the previous plan 
                        year.
            ``(7) Consumer parity portal website.--The Secretary, in 
        consultation with the Secretaries of Labor and the Treasury, 
        shall establish a one-stop Internet website portal for--
                    ``(A) submitting complaints and violations relating 
                to this section, section 712 of the Employee Retirement 
                Income Security Act of 1974, and section 9812 of the 
                Internal Revenue Code of 1986; and
                    ``(B) for each of such Secretaries to submit 
                information in order to provide such information to 
                health care consumers pursuant to paragraph (6), 
                section 712(a)(6) of the Employee Retirement Income 
                Security Act of 1974, and section 9812(a)(6) of the 
                Internal Revenue Code of 1986.
        Such portal shall have the ability to take basic information 
        related to the complaint, including name, contact information, 
        and brief narrative, and transmit such information in a timely 
        fashion to the appropriate State or Federal enforcement agency. 
        Once the consumer information is submitted, such portal shall 
        provide the consumer with contact information for the 
        appropriate enforcement agency to follow-up on the 
        complaint.''.
    (b) Employee Retirement Income Security Act of 1974.--Section 
712(a) of the Employee Retirement Income Security Act of 1974 (29 
U.S.C. 1185a(a)) is amended by adding at the end the following new 
paragraph:
            ``(6) Disclosure and enforcement requirements.--
                    ``(A) Disclosure requirements.--
                            ``(i) Regulations.--Not later than December 
                        31, 2016, the Secretary, in cooperation with 
                        the Secretaries of Health and Human Services 
                        and the Treasury, as appropriate, shall issue 
                        additional regulations for carrying out this 
                        section, including an explanation of documents 
                        that must be disclosed by plans and issuers, 
                        the process governing such disclosures by plans 
                        and issuers, and analyses that must be 
                        conducted by plans and issuers by a group 
                        health plan (or health insurance coverage 
                        offered in connection with such a plan) in 
                        order for such plan or issuer to demonstrate 
                        compliance with the provisions of this section.
                            ``(ii) Disclosure requirements.--Documents 
                        required to be disclosed by a group health plan 
                        (or health insurance coverage offered in 
                        connection with such a plan) under clause (i) 
                        shall include an annual report that details the 
                        specific analyses performed to ensure 
                        compliance of such plan or coverage with the 
                        law or regulations. At a minimum, with respect 
                        to the application of non-quantitative 
                        treatment limitations (in this paragraph 
                        referred to as NQTLs) to benefits under the 
                        plan or coverage, such report shall--
                                    ``(I) identify the specific factors 
                                the plan or coverage used in performing 
                                its NQTL analysis;
                                    ``(II) identify and define the 
                                specific evidentiary standards relied 
                                on to evaluate the factors;
                                    ``(III) describe how the 
                                evidentiary standards are applied to 
                                each service category for mental 
                                health, substance use disorders, 
                                medical benefits, and surgical 
                                benefits;
                                    ``(IV) disclose the results of the 
                                analyses of the specific evidentiary 
                                standards in each service category; and
                                    ``(V) disclose the specific 
                                findings of the plan or coverage in 
                                each service category and the 
                                conclusions reached with respect to 
                                whether the processes, strategies, 
                                evidentiary standards, or other factors 
                                used in applying the NQTL to mental 
                                health or substance use disorder 
                                benefits are comparable to, and applied 
                                no more stringently than, the 
                                processes, strategies, evidentiary 
                                standards, or other factors used in 
                                applying the limitation with respect to 
                                medical and surgical benefits in the 
                                same classification.
                            ``(iii) Guidance.--The Secretary, in 
                        cooperation with the Secretaries of Health and 
                        Human Services and the Treasury, as 
                        appropriate, shall issue guidance to group 
                        health plans (and health insurance coverage 
                        offered in connection with such a plan) on how 
                        to satisfy the requirements of this section 
                        with respect to making information available to 
                        current and potential participants and 
                        beneficiaries. Such information shall include 
                        certificate of coverage documents and 
                        instruments under which the plan or coverage 
                        involved is administered and operated that 
                        specify, include, or refer to procedures, 
                        formulas, and methodologies applied to 
                        determine a participant or beneficiary's 
                        benefit under the plan or coverage, regardless 
                        of whether such information is contained in a 
                        document designated as the `plan document'. 
                        Such guidance shall include a disclosure of how 
                        the plan or coverage involved has provided that 
                        processes, strategies, evidentiary standards, 
                        and other factors used in applying the NQTL to 
                        mental health or substance use disorder 
                        benefits are comparable to, and applied no more 
                        stringently than, the processes, strategies, 
                        evidentiary standards, or other factors used in 
                        applying the limitation with respect to medical 
                        and surgical benefits in the same 
                        classification.
                            ``(iv) Definitions.--In this paragraph, the 
                        terms `non-quantitative treatment limitations', 
                        `comparable to', and `applied no more 
                        stringently than' have the meanings given such 
                        terms in sections 146 and 147 of title 45, Code 
                        of Federal Regulations (or any successor 
                        regulation).
                    ``(B) Enforcement.--
                            ``(i) Process for complaints.--The 
                        Secretary, in cooperation with the Secretaries 
                        of Health and Human Services and the Treasury, 
                        as appropriate, shall, with respect to group 
                        health plans (and health insurance coverage 
                        offered in connection with such a plan), issue 
                        guidance to clarify the process and timeline 
                        for current and potential participants and 
                        beneficiaries (and authorized representatives 
                        and health care providers of such participants 
                        and beneficiaries) with respect to such plans 
                        (and coverage) to file formal complaints of 
                        such plans (or coverage) being in violation of 
                        this section, including guidance, by plan type, 
                        on the relevant State, regional, and national 
                        offices with which such complaints should be 
                        filed.
                            ``(ii) Authority for public enforcement.--
                        The Secretary, in consultation with the 
                        Secretaries of Labor and the Treasury, shall 
                        make available to the public on the Consumer 
                        Parity Portal website established under section 
                        2726(a)(7) of the Public Health Service Act de-
                        identified information on audits and 
                        investigations of group health plans (and 
                        health insurance coverage offered in connection 
                        with such a plan) conducted under this section.
                            ``(iii) Audits.--
                                    ``(I) Randomized audits.--The 
                                Secretary in cooperation with the 
                                Secretaries of Health and Human 
                                Services and the Treasury, is 
                                authorized to conduct randomized audits 
                                of group health plans (and health 
                                insurance coverage offered in 
                                connection with such a plan) to 
                                determine compliance with this section. 
                                Such audits shall be conducted on no 
                                fewer than twelve plans and coverage 
                                per plan year. Information from such 
                                audits shall be made plainly available 
                                on the Consumer Parity Portal website 
                                established under section 2726(a)(7) of 
                                the Public Health Service Act.
                                    ``(II) Additional audits.--In the 
                                case of a group health plan (or health 
                                insurance coverage offered in 
                                connection with such a plan) with 
                                respect to which any claim has been 
                                filed during a plan year, the Secretary 
                                may audit the books and records of such 
                                plan (or coverage) to determine 
                                compliance with this section. 
                                Information detailing the results of 
                                the audit shall be made available on 
                                the Consumer Parity Portal website 
                                established under section 2726(a)(7) of 
                                the Public Health Service Act.
                            ``(iv) Denial rates.--The Secretary shall 
                        collect information on the rates of and reasons 
                        for denial by group health plans (and health 
                        insurance coverage offered in connection with 
                        such a plan) of claims for outpatient and 
                        inpatient mental health and substance use 
                        disorder services compared to the rates of and 
                        reasons for denial of claims for medical and 
                        surgical services. For the first plan year 
                        beginning at least two years after the date of 
                        the enactment of this paragraph and each 
                        subsequent plan year, the Secretary shall 
                        submit to the Committee on Energy and Commerce 
                        of the House of Representatives and the 
                        Committee on Health, Education, Labor, and 
                        Pensions of the Senate, and make plainly 
                        available on the Consumer Parity Portal website 
                        under section 2726(a)(7) of the Public Health 
                        Service Act, the information collected under 
                        the previous sentence with respect to the 
                        previous plan year.''.
    (c) Internal Revenue Code of 1986.--Section 9812(a) of the Internal 
Revenue Code of 1986 is amended by adding at the end the following new 
paragraph:
            ``(6) Disclosure and enforcement requirements.--
                    ``(A) Disclosure requirements.--
                            ``(i) Regulations.--Not later than December 
                        31, 2016, the Secretary, in cooperation with 
                        the Secretaries of Health and Human Services 
                        and Labor, as appropriate, shall issue 
                        additional regulations for carrying out this 
                        section, including an explanation of documents 
                        that must be disclosed by plans and issuers, 
                        the process governing such disclosures by plans 
                        and issuers, and analyses that must be 
                        conducted by plans and issuers by a group 
                        health plan in order for such plan to 
                        demonstrate compliance with the provisions of 
                        this section.
                            ``(ii) Disclosure requirements.--Documents 
                        required to be disclosed by a group health plan 
                        under clause (i) shall include an annual report 
                        that details the specific analyses performed to 
                        ensure compliance of such plan with the law and 
                        regulations. At a minimum, with respect to the 
                        application of non-quantitative treatment 
                        limitations (in this paragraph referred to as 
                        NQTLs) to benefits under the plan or coverage, 
                        such report shall--
                                    ``(I) identify the specific factors 
                                the plan or coverage used in performing 
                                its NQTL analysis;
                                    ``(II) identify and define the 
                                specific evidentiary standards relied 
                                on to evaluate the factors;
                                    ``(III) describe how the 
                                evidentiary standards are applied to 
                                each service category for mental 
                                health, substance use disorders, 
                                medical benefits, and surgical 
                                benefits;
                                    ``(IV) disclose the results of the 
                                analyses of the specific evidentiary 
                                standards in each service category; and
                                    ``(V) disclose the specific 
                                findings of the plan in each service 
                                category and the conclusions reached 
                                with respect to whether the processes, 
                                strategies, evidentiary standards, or 
                                other factors used in applying the NQTL 
                                to mental health or substance use 
                                disorder benefits are comparable to, 
                                and applied no more stringently than, 
                                the processes, strategies, evidentiary 
                                standards, or other factors used in 
                                applying the limitation with respect to 
                                medical and surgical benefits in the 
                                same classification.
                            ``(iii) Guidance.--The Secretary, in 
                        cooperation with the Secretaries of Health and 
                        Human Services and Labor, as appropriate, shall 
                        issue guidance to group health plans on how to 
                        satisfy the requirements of this section with 
                        respect to making information available to 
                        current and potential participants and 
                        beneficiaries. Such information shall include 
                        certificate of coverage documents and 
                        instruments under which the plan involved is 
                        administered and operated that specify, 
                        include, or refer to procedures, formulas, and 
                        methodologies applied to determine a 
                        participant or beneficiary's benefit under the 
                        plan, regardless of whether such information is 
                        contained in a document designated as the `plan 
                        document'. Such guidance shall include a 
                        disclosure of how the plan involved has 
                        provided that processes, strategies, 
                        evidentiary standards, and other factors used 
                        in applying the NQTL to mental health or 
                        substance use disorder benefits are comparable 
                        to, and applied no more stringently than, the 
                        processes, strategies, evidentiary standards, 
                        or other factors used in applying the 
                        limitation with respect to medical and surgical 
                        benefits in the same classification.
                            ``(iv) Definitions.--In this paragraph, the 
                        terms `non-quantitative treatment limitations', 
                        `comparable to', and `applied no more 
                        stringently than' have the meanings given such 
                        terms in sections 146 and 147 of title 45, Code 
                        of Federal Regulations (or any successor 
                        regulation).
                    ``(B) Enforcement.--
                            ``(i) Process for complaints.--The 
                        Secretary, in cooperation with the Secretaries 
                        of Health and Human Services and Labor, as 
                        appropriate, shall, with respect to group 
                        health plans, issue guidance to clarify the 
                        process and timeline for current and potential 
                        participants and beneficiaries (and authorized 
                        representatives and health care providers of 
                        such participants and beneficiaries) with 
                        respect to such plans (and coverage) to file 
                        formal complaints of such plans being in 
                        violation of this section, including guidance, 
                        by plan type, on the relevant State, regional, 
                        and national offices with which such complaints 
                        should be filed.
                            ``(ii) Authority for public enforcement.--
                        The Secretary, in consultation with the 
                        Secretaries of Labor and the Treasury, shall 
                        make available to the public on the Consumer 
                        Parity Portal website established under section 
                        2726(a)(7) of the Public Health Service Act de-
                        identified information on audits and 
                        investigations of group health plans conducted 
                        under this section.
                            ``(iii) Audits.--
                                    ``(I) Randomized audits.--The 
                                Secretary in cooperation with the 
                                Secretaries of Health and Human 
                                Services and Labor, is authorized to 
                                conduct randomized audits of group 
                                health plans to determine compliance 
                                with this section. Such audits shall be 
                                conducted on no fewer than twelve plans 
                                per plan year. Information from such 
                                audits shall be made plainly available 
                                on the Consumer Parity Portal website 
                                established under section 2726(a)(7) of 
                                the Public Health Service Act.
                                    ``(II) Additional audits.--In the 
                                case of a group health plan with 
                                respect to which any claim has been 
                                filed during a plan year, the Secretary 
                                may audit the books and records of such 
                                plan to determine compliance with this 
                                section. Information detailing the 
                                results of the audit shall be made 
                                available on the Consumer Parity Portal 
                                website established under section 
                                2726(a)(7) of the Public Health Service 
                                Act.
                            ``(iv) Denial rates.--The Secretary shall 
                        collect information on the rates of and reasons 
                        for denial by group health plans of claims for 
                        outpatient and inpatient mental health and 
                        substance use disorder services compared to the 
                        rates of and reasons for denial of claims for 
                        medical and surgical services. For the first 
                        plan year beginning at least two years after 
                        the date of the enactment of this paragraph and 
                        each subsequent plan year, the Secretary shall 
                        submit to the Committee on Energy and Commerce 
                        of the House of Representatives and the 
                        Committee on Health, Education, Labor, and 
                        Pensions of the Senate, and make plainly 
                        available on the Consumer Parity Portal website 
                        under section 2726(a)(7) of the Public Health 
                        Service Act, the information collected under 
                        the previous sentence with respect to the 
                        previous plan year.''.
    (d) Authorization of Appropriations.--There is authorized to be 
appropriated $2,000,000 for each of fiscal years 2017 through 2021 to 
carry out this section, including the amendments made by this section.

SEC. 309. STUDY ON TREATMENT INFRASTRUCTURE.

    Not later than 24 months after the date of enactment of this Act, 
the Comptroller General of the United States shall initiate an 
evaluation, and submit to Congress a report, of the in-patient and 
outpatient treatment capacity, availability, and needs of the United 
States, which shall include, to the extent data is available--
            (1) the capacity of acute residential or inpatient 
        detoxification programs;
            (2) the capacity of inpatient clinical stabilization 
        programs, transitional residential support services, and 
        residential rehabilitation programs;
            (3) the capacity of demographic specific residential or 
        inpatient treatment programs, such as those designed for 
        pregnant women or adolescents;
            (4) geographical differences of the availability of 
        residential and outpatient treatment and recovery options for 
        substance use disorders across the continuum of care;
            (5) the availability of residential and outpatient 
        treatment programs that offer treatment options based on 
        reliable scientific evidence of efficacy for the treatment of 
        substance use disorders, including the use of Food and Drug 
        Administration-approved medicines and evidence-based 
        nonpharmacological therapies;
            (6) the number of patients in residential and specialty 
        outpatient treatment services for substance use disorders; and
            (7) an assessment of the need for residential and 
        outpatient treatment for substance use disorders across the 
        continuum of care.

SEC. 310. SUBSTANCE USE DISORDER PROFESSIONAL LOAN REPAYMENT PROGRAM.

    Subpart 3 of part E of title VII of the Public Health Service Act 
(42 U.S.C. 295f et seq.) is amended by adding at the end the following:

``SEC. 779. SUBSTANCE USE DISORDER PROFESSIONAL LOAN REPAYMENT PROGRAM.

    ``(a) Establishment.--The Secretary shall establish and carry out a 
substance use disorder health professional loan repayment program under 
which qualified health professionals agree to be employed full-time for 
a specified period (which shall be not less than 2 years) in providing 
substance use disorder prevention and treatment services.
    ``(b) Program Administration.--Through the program established 
under this section, the Secretary shall enter into contracts with 
qualified health professionals under which--
            ``(1) a qualified health professional agrees to provide 
        substance use disorder prevention and treatment services with 
        respect to an area or population that (as determined by the 
        Secretary)--
                    ``(A) has a shortage of such services (as defined 
                by the Secretary); and
                    ``(B) has a sufficient population of individuals 
                with a substance use disorder to support the provision 
                of such services; and
            ``(2) the Secretary agrees to make payments on the 
        principal and interest of undergraduate, or graduate education 
        loans of the qualified health professional--
                    ``(A) of not more than $35,000 for each year of 
                service described in paragraph (1); and
                    ``(B) for not more than 3 years.
    ``(c) Qualified Health Professional Defined.--In this section, the 
term `qualified health professional' means an individual who is (or 
will be upon the completion of the individual's graduate education) a 
psychiatrist, psychologist, nurse practitioner, physician assistant, 
clinical social worker, substance abuse counselor, or other substance 
use disorder health professional.
    ``(d) Priority.--In entering into agreements under this section, 
the Secretary shall give priority to applicants who--
            ``(1) have familiarity with evidence-based methods and 
        culturally and linguistically competent health care services; 
        and
            ``(2) demonstrate financial need.
    ``(e) Authorization of Appropriations.--There is authorized to be 
appropriated $20,000,000 for each of fiscal years 2017 through 2021 to 
carry out this section.''.

                           TITLE IV--RECOVERY

SEC. 401. NATIONAL YOUTH RECOVERY INITIATIVE.

    (a) Definitions.--In this section:
            (1) Eligible entity.--The term ``eligible entity'' means--
                    (A) a high school that has been accredited as a 
                recovery high school by the Association of Recovery 
                Schools;
                    (B) an accredited high school that is seeking to 
                establish or expand recovery support services;
                    (C) an institution of higher education;
                    (D) a recovery program at a nonprofit collegiate 
                institution; or
                    (E) a nonprofit organization.
            (2) Institution of higher education.--The term 
        ``institution of higher education'' has the meaning given the 
        term in section 101 of the Higher Education Act of 1965 (20 
        U.S.C. 1001).
            (3) Recovery program.--The term ``recovery program''--
                    (A) means a program to help individuals who are 
                recovering from substance use disorders to initiate, 
                stabilize, and maintain healthy and productive lives in 
                the community; and
                    (B) includes peer-to-peer support and communal 
                activities to build recovery skills and supportive 
                social networks.
    (b) Grants Authorized.--The Secretary of Health and Human Services, 
acting through the Substance Abuse and Mental Health Services 
Administration, in consultation with the Secretary of Education, may 
award grants to eligible entities to enable the entities to--
            (1) provide substance use recovery support services to 
        young people in high school and enrolled in institutions of 
        higher education;
            (2) help build communities of support for young people in 
        recovery through a spectrum of activities such as counseling 
        and healthy and wellness-oriented social activities; and
            (3) encourage initiatives designed to help young people 
        achieve and sustain recovery from substance use disorders.
    (c) Use of Funds.--Grants awarded under subsection (b) may be used 
for activities to develop, support, and maintain youth recovery support 
services, including--
            (1) the development and maintenance of a dedicated physical 
        space for recovery programs;
            (2) dedicated staff for the provision of recovery programs;
            (3) healthy and wellness-oriented social activities and 
        community engagement;
            (4) establishment of recovery high schools;
            (5) coordination of recovery programs with--
                    (A) substance use disorder treatment programs and 
                systems;
                    (B) providers of mental health services;
                    (C) primary care providers;
                    (D) the criminal justice system, including the 
                juvenile justice system;
                    (E) employers;
                    (F) housing services;
                    (G) child welfare services;
                    (H) institutions of secondary higher education and 
                institutions of higher education; and
                    (I) other programs or services related to the 
                welfare of an individual in recovery from a substance 
                use disorder;
            (6) the development of peer-to-peer support programs or 
        services; and
            (7) additional activities that help youths and young adults 
        to achieve recovery from substance use disorders.
    (d) Technical Support.--The Secretary of Health and Human Services 
shall provide technical support to recipients of grants under this 
section.
    (e) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section $30,000,000 for each of fiscal 
years 2017 through 2021.

SEC. 402. GRANTS TO ENHANCE AND EXPAND RECOVERY SUPPORT SERVICES.

    Subpart 1 of part B of title V of the Public Health Service Act (42 
U.S.C. 290bb et seq.), as amended by sections 306 and 307, is further 
amended by adding at the end the following:

``SEC. 514E. GRANTS TO ENHANCE AND EXPAND RECOVERY SUPPORT SERVICES.

    ``(a) In General.--The Secretary, acting through the Administrator 
of the Substance Abuse and Mental Health Services Administration, shall 
award grants to State substance abuse agencies and nonprofit 
organizations to develop, expand, and enhance recovery support services 
for individuals with substance use disorders.
    ``(b) Eligible Entities.--In the case of an applicant that is not a 
State substance abuse agency, to be eligible to receive a grant under 
this section, the entity shall--
            ``(1) prepare and submit to the Secretary an application at 
        such time, in such manner, and contain such information as the 
        Secretary may require, including a plan for the evaluation of 
        any activities carried out with the funds provided under this 
        section;
            ``(2) demonstrate the inclusion of individuals in recovery 
        from a substance use disorder in leadership levels or governing 
        bodies of the entity;
            ``(3) have as a primary mission the provision of long-term 
        recovery support for substance use disorders; and
            ``(4) be accredited by the Council on the Accreditation of 
        Peer Recovery Support Services or meet any applicable State 
        certification requirements regarding the provision of the 
        recovery services involved.
    ``(c) Use of Funds.--Amounts awarded under a grant under this 
section shall be used to provide for the following activities:
            ``(1) Educating and mentoring that assists individuals and 
        families with substance use disorders in navigating systems of 
        care.
            ``(2) Peer recovery support services which include peer 
        coaching and mentoring.
            ``(3) Recovery-focused community education and outreach 
        programs, including training on the use of all forms of opioid 
        overdose antagonists used to counter the effects of an 
        overdose.
            ``(4) Training, mentoring, and education to develop and 
        enhance peer mentoring and coaching.
            ``(5) Programs aimed at identifying and reducing stigma and 
        discriminatory practices that serve as barriers to substance 
        use disorder recovery and treatment of these disorders.
            ``(6) Developing partnerships between networks that support 
        recovery and other community organizations and services, 
        including--
                    ``(A) public and private substance use disorder 
                treatment programs and systems;
                    ``(B) health care providers;
                    ``(C) recovery-focused addiction and recovery 
                professionals;
                    ``(D) faith-based organizations;
                    ``(E) organizations focused on criminal justice 
                reform;
                    ``(F) schools; and
                    ``(G) social service agencies in the community, 
                including educational, juvenile justice, child welfare, 
                housing, and mental health agencies.
    ``(d) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section, $100,000,000 for each of fiscal 
years 2017 through 2021.''.
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