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<dc:title>114 S483 ES: Ensuring Patient Access and Effective Drug Enforcement Act of 2016</dc:title>
<dc:publisher>U.S. Senate</dc:publisher>
<dc:date></dc:date>
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<dc:language>EN</dc:language>
<dc:rights>Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.</dc:rights>
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<congress display="yes">114th CONGRESS</congress><session display="yes">2d Session</session><legis-num display="yes">S. 483</legis-num><current-chamber display="no">IN THE SENATE OF THE UNITED STATES</current-chamber><legis-type display="yes">AN ACT</legis-type><official-title display="yes">To improve enforcement efforts related to prescription drug diversion and abuse, and for other
			 purposes.</official-title></form>
	<legis-body display-enacting-clause="yes-display-enacting-clause" style="OLC">
 <section commented="no" display-inline="no-display-inline" id="idcb24991a-4621-4084-afad-e98100aa14d6" section-type="section-one"><enum>1.</enum><header display-inline="yes-display-inline">Short title</header><text display-inline="no-display-inline">This Act may be cited as the <quote><short-title>Ensuring Patient Access and Effective Drug Enforcement Act of 2016</short-title></quote>.</text> </section><section commented="no" display-inline="no-display-inline" id="idb52ae63c-cc9c-479b-9608-b3435e826287" section-type="subsequent-section"><enum>2.</enum><header display-inline="yes-display-inline">Registration process under Controlled Substances Act</header> <subsection commented="no" display-inline="no-display-inline" id="iddb1fbb75-3689-44b4-a84b-8774a8807f2c"><enum>(a)</enum><header display-inline="yes-display-inline">Definitions</header> <paragraph commented="no" display-inline="no-display-inline" id="id305f3d36-63b7-4b86-8217-77072dcf699e"><enum>(1)</enum><header display-inline="yes-display-inline">Factors as may be relevant to and consistent with the public health and safety</header><text display-inline="yes-display-inline">Section 303 of the Controlled Substances Act (<external-xref legal-doc="usc" parsable-cite="usc/21/823">21 U.S.C. 823</external-xref>) is amended by adding at the end the following:</text>
					<quoted-block display-inline="no-display-inline" id="idb94ba81b-8dd6-4fb8-828c-2be8acd03e05" style="OLC">
 <subsection commented="no" display-inline="no-display-inline" id="id91a5d7dd-56f8-4175-9e5b-32ffc483aa35"><enum>(j)</enum><text display-inline="yes-display-inline">In this section, the phrase <quote>factors as may be relevant to and consistent with the public health and safety</quote> means factors that are relevant to and consistent with the findings contained in section 101.</text></subsection><after-quoted-block>.</after-quoted-block></quoted-block> </paragraph><paragraph commented="no" display-inline="no-display-inline" id="ida27fb7fd-c666-46aa-888d-b0c7a7badde0"><enum>(2)</enum><header display-inline="yes-display-inline">Imminent danger to the public health or safety</header><text display-inline="yes-display-inline">Section 304(d) of the Controlled Substances Act (<external-xref legal-doc="usc" parsable-cite="usc/21/824">21 U.S.C. 824(d)</external-xref>) is amended—</text>
 <subparagraph commented="no" display-inline="no-display-inline" id="id10165f51-2aff-4e7c-b38d-c50fbd56221d"><enum>(A)</enum><text display-inline="yes-display-inline">by striking <quote>(d) The Attorney General</quote> and inserting <quote>(d)(1) The Attorney General</quote>; and</text> </subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id9c06cbbc-7eb3-4212-9ba4-06961221e251"><enum>(B)</enum><text display-inline="yes-display-inline">by adding at the end the following:</text>
						<quoted-block display-inline="no-display-inline" id="idE641FF86805E40D8AC331C9824CE20B9" style="OLC">
 <paragraph commented="no" display-inline="no-display-inline" id="idbfcef58f-98d5-459b-a5b6-97c7a2db1fb9" indent="up1"><enum>(2)</enum><text display-inline="yes-display-inline">In this subsection, the phrase <term>imminent danger to the public health or safety</term> means that, due to the failure of the registrant to maintain effective controls against diversion or otherwise comply with the obligations of a registrant under this title or title III, there is a substantial likelihood of an immediate threat that death, serious bodily harm, or abuse of a controlled substance will occur in the absence of an immediate suspension of the registration.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
 </subparagraph></paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="idd93a504a-7d5e-42ca-a2bc-7ff513ff485a"><enum>(b)</enum><header display-inline="yes-display-inline">Opportunity To submit corrective action plan prior to revocation or suspension</header><text display-inline="yes-display-inline">Subsection (c) of section 304 of the Controlled Substances Act (<external-xref legal-doc="usc" parsable-cite="usc/21/824">21 U.S.C. 824</external-xref>) is amended—</text> <paragraph commented="no" display-inline="no-display-inline" id="ida68e2497-3c87-47fb-8c4e-65f19cf3bad5"><enum>(1)</enum><text display-inline="yes-display-inline">by striking the last three sentences;</text>
 </paragraph><paragraph commented="no" display-inline="no-display-inline" id="id3264ec31-3bfa-4c96-a05f-b650181cafe5"><enum>(2)</enum><text display-inline="yes-display-inline">by striking <quote>(c) Before</quote> and inserting <quote>(c)(1) Before</quote>; and</text> </paragraph><paragraph commented="no" display-inline="no-display-inline" id="id389db68f-e3a9-40dd-921d-9680ea5d41ea"><enum>(3)</enum><text display-inline="yes-display-inline">by adding at the end the following:</text>
					<quoted-block display-inline="no-display-inline" id="id2bd77c1c-ee67-47e6-a4dd-7638d4790151" style="OLC">
 <paragraph commented="no" display-inline="no-display-inline" id="id4a50561a-e8e0-46d2-929a-3d4b9b97d79d" indent="up1"><enum>(2)</enum><text display-inline="yes-display-inline">An order to show cause under paragraph (1) shall—</text> <subparagraph commented="no" display-inline="no-display-inline" id="idbdfb6220-a85f-4283-908e-d8267dc6733f"><enum>(A)</enum><text display-inline="yes-display-inline">contain a statement of the basis for the denial, revocation, or suspension, including specific citations to any laws or regulations alleged to be violated by the applicant or registrant;</text>
 </subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="idedda3c01-94d1-4330-8eed-b3c28525b9f3"><enum>(B)</enum><text display-inline="yes-display-inline">direct the applicant or registrant to appear before the Attorney General at a time and place stated in the order, but not less than 30 days after the date of receipt of the order; and</text>
 </subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id9a5e21ef-9e2e-475e-8830-7a7030197b65"><enum>(C)</enum><text display-inline="yes-display-inline">notify the applicant or registrant of the opportunity to submit a corrective action plan on or before the date of appearance.</text>
 </subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="id74449e38-1fa3-4c8f-a505-297643a9300f" indent="up1"><enum>(3)</enum><text display-inline="yes-display-inline">Upon review of any corrective action plan submitted by an applicant or registrant pursuant to paragraph (2), the Attorney General shall determine whether denial, revocation, or suspension proceedings should be discontinued, or deferred for the purposes of modification, amendment, or clarification to such plan.</text>
 </paragraph><paragraph commented="no" display-inline="no-display-inline" id="idc8942f97-6e37-4421-b288-d908da548617" indent="up1"><enum>(4)</enum><text display-inline="yes-display-inline">Proceedings to deny, revoke, or suspend shall be conducted pursuant to this section in accordance with subchapter II of <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/5/5">chapter 5</external-xref> of title 5, United States Code. Such proceedings shall be independent of, and not in lieu of, criminal prosecutions or other proceedings under this title or any other law of the United States.</text>
 </paragraph><paragraph commented="no" display-inline="no-display-inline" id="id28a439eb-2cdb-4b9f-bc46-09e4dd02b13f" indent="up1"><enum>(5)</enum><text display-inline="yes-display-inline">The requirements of this subsection shall not apply to the issuance of an immediate suspension order under subsection (d).</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
				</paragraph></subsection></section><section commented="no" display-inline="no-display-inline" id="id907952cd-9a96-41ba-9df7-8d09a97c08b6" section-type="subsequent-section"><enum>3.</enum><header display-inline="yes-display-inline">Report to Congress</header>
 <subsection commented="no" display-inline="no-display-inline" id="idd4845fdc-2eec-401d-9b36-a51f34c714bc"><enum>(a)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Not later than 1 year after the date of enactment of this Act, the Secretary of Health and Human Services, acting through the Commissioner of Food and Drugs, the Administrator of the Substance Abuse and Mental Health Services Administration, the Director of the Agency for Healthcare Research and Quality, and the Director of the Centers for Disease Control and Prevention, in coordination with the Administrator of the Drug Enforcement Administration and in consultation with the Secretary of Defense and the Secretary of Veterans Affairs, shall submit a report to the Committee on the Judiciary of the House of Representatives, the Committee on Energy and Commerce of the House of Representatives, the Committee on the Judiciary of the Senate, and the Committee on Health, Education, Labor, and Pensions of the Senate identifying—</text>
 <paragraph commented="no" display-inline="no-display-inline" id="id0cc36c54-f53e-44aa-b58a-3972235d6e8c"><enum>(1)</enum><text display-inline="yes-display-inline">obstacles to legitimate patient access to controlled substances;</text> </paragraph><paragraph commented="no" display-inline="no-display-inline" id="id988b68bf-b67c-470a-b7e6-556a38b0a110"><enum>(2)</enum><text display-inline="yes-display-inline">issues with diversion of controlled substances;</text>
 </paragraph><paragraph commented="no" display-inline="no-display-inline" id="id92ead453-984a-4556-ab8e-abafaf87b11d"><enum>(3)</enum><text display-inline="yes-display-inline">how collaboration between Federal, State, local, and tribal law enforcement agencies and the pharmaceutical industry can benefit patients and prevent diversion and abuse of controlled substances;</text>
 </paragraph><paragraph commented="no" display-inline="no-display-inline" id="id4EE8D507EC9F4946B0B48FC84DC57893"><enum>(4)</enum><text display-inline="yes-display-inline">the availability of medical education, training opportunities, and comprehensive clinical guidance for pain management and opioid prescribing, and any gaps that should be addressed;</text>
 </paragraph><paragraph commented="no" display-inline="no-display-inline" id="id774b10f90e814240b94196e742ca2548"><enum>(5)</enum><text display-inline="yes-display-inline">beneficial enhancements to State prescription drug monitoring programs, including enhancements to require comprehensive prescriber input and to expand access to the programs for appropriate authorized users; and</text>
 </paragraph><paragraph commented="no" display-inline="no-display-inline" id="id485a858782084ad7906c07e092e5df4f"><enum>(6)</enum><text display-inline="yes-display-inline">steps to improve reporting requirements so that the public and Congress have more information regarding prescription opioids, such as the volume and formulation of prescription opioids prescribed annually, the dispensing of such prescription opioids, and outliers and trends within large data sets.</text>
 </paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="ide6cc7c3c-109f-49c6-9e50-c86974d6e402"><enum>(b)</enum><header display-inline="yes-display-inline">Consultation</header><text display-inline="yes-display-inline">The report under subsection (a) shall incorporate feedback and recommendations from the following:</text> <paragraph commented="no" display-inline="no-display-inline" id="id3ba38ca6-05e0-40c0-98d9-bf54463f5766"><enum>(1)</enum><text display-inline="yes-display-inline">Patient groups.</text>
 </paragraph><paragraph commented="no" display-inline="no-display-inline" id="idf050c1c2-12bb-4df7-94a2-9f98e8ac581e"><enum>(2)</enum><text display-inline="yes-display-inline">Pharmacies.</text> </paragraph><paragraph commented="no" display-inline="no-display-inline" id="id1f15eba2-e7de-4f4f-a923-9182f108aac6"><enum>(3)</enum><text display-inline="yes-display-inline">Drug manufacturers.</text>
 </paragraph><paragraph commented="no" display-inline="no-display-inline" id="id446f50af-6dc1-4f20-bbb5-ae3f25f30c9e"><enum>(4)</enum><text display-inline="yes-display-inline">Common or contract carriers and warehousemen.</text> </paragraph><paragraph commented="no" display-inline="no-display-inline" id="id2be64043-4ce9-4cac-9faf-50e8fb8c9287"><enum>(5)</enum><text display-inline="yes-display-inline">Hospitals, physicians, and other health care providers.</text>
 </paragraph><paragraph commented="no" display-inline="no-display-inline" id="id249cd71e-27b9-4b9b-9938-943cb861ad13"><enum>(6)</enum><text display-inline="yes-display-inline">State attorneys general.</text> </paragraph><paragraph commented="no" display-inline="no-display-inline" id="idf6b1c8d5-f12f-49aa-927b-1c662046e842"><enum>(7)</enum><text display-inline="yes-display-inline">Federal, State, local, and tribal law enforcement agencies.</text>
 </paragraph><paragraph commented="no" display-inline="no-display-inline" id="id3bb699e0-b752-4d82-b8b3-fe023a236e07"><enum>(8)</enum><text display-inline="yes-display-inline">Health insurance providers and entities that provide pharmacy benefit management services on behalf of a health insurance provider.</text>
 </paragraph><paragraph commented="no" display-inline="no-display-inline" id="id77108299-ca07-4c01-a177-322e2dd37137"><enum>(9)</enum><text display-inline="yes-display-inline">Wholesale drug distributors.</text> </paragraph><paragraph commented="no" display-inline="no-display-inline" id="id75e13650-71a1-48e1-ad64-ff1df29b4edd"><enum>(10)</enum><text display-inline="yes-display-inline">Veterinarians.</text>
 </paragraph><paragraph commented="no" display-inline="no-display-inline" id="id4440af92c9994f77a958a53e7f4115f0"><enum>(11)</enum><text display-inline="yes-display-inline">Professional medical societies and boards.</text> </paragraph><paragraph commented="no" display-inline="no-display-inline" id="id5450aecd0b6843f39ac5c35589e16e50"><enum>(12)</enum><text display-inline="yes-display-inline">State and local public health authorities.</text>
 </paragraph><paragraph commented="no" display-inline="no-display-inline" id="idd3eaa8a0c4cd405d8a651bfdcbdf233f"><enum>(13)</enum><text display-inline="yes-display-inline">Health services research organizations.</text></paragraph></subsection></section></legis-body><attestation><attestation-group><attestation-date chamber="Senate" date="20160317">Passed the Senate March 17, 2016.</attestation-date><attestor display="no"></attestor><role>Secretary</role></attestation-group></attestation><endorsement display="yes"></endorsement></bill> 

