[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5590 Introduced in House (IH)]
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115th CONGRESS
2d Session
H. R. 5590
To require the Secretary of Health and Human Services to provide for an
action plan on recommendations for changes under Medicare and Medicaid
to prevent opioids addictions and enhance access to medication-assisted
treatment, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
April 24, 2018
Mr. Kinzinger (for himself, Ms. Clarke of New York, Mr. LaHood, and Mr.
Danny K. Davis of Illinois) introduced the following bill; which was
referred to the Committee on Energy and Commerce, and in addition to
the Committee on Ways and Means, 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 require the Secretary of Health and Human Services to provide for an
action plan on recommendations for changes under Medicare and Medicaid
to prevent opioids addictions and enhance access to medication-assisted
treatment, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Opioid Addiction Action Plan Act''.
SEC. 2. ACTION PLAN ON RECOMMENDATIONS FOR CHANGES UNDER MEDICARE AND
MEDICAID TO PREVENT OPIOIDS ADDICTIONS AND ENHANCE ACCESS
TO MEDICATION-ASSISTED TREATMENT.
(a) In General.--Not later than January 1, 2019, the Secretary of
Health and Human Services (in this section referred to as the
``Secretary''), in collaboration with the Pain Management Best
Practices Inter-Agency Task Force convened under section 101(b) of the
Comprehensive Addiction and Recovery Act of 2016 (Public Law 114-198),
shall develop an action plan that provides recommendations described in
subsection (b).
(b) Action Plan Components.--Recommendations provided under the
action plan under subsection (a) shall include recommendations on the
following:
(1) Recommendations on changes to the Medicare program
under title XVIII of the Social Security Act and the Medicaid
program under title XIX of such Act that would enhance coverage
and reimbursement under such programs of all medication-
assisted treatment approved by the Food and Drug Administration
for the treatment of opioid addiction and other therapies that
manage chronic and acute pain and treat and minimize risk of
opioid addiction, including recommendations on changes to the
Medicare prospective payment system for hospital inpatient
department services under section 1886(d) of such Act (42
U.S.C. 1395ww(d)) and the Medicare prospective payment system
for hospital outpatient department services under section
1833(t) of such Act (42 U.S.C. 1395l(t)) that would allow for
separate reimbursement for such therapies to encourage
development and adoption of such therapies, if medically
appropriate.
(2) Recommendations for payment and service delivery models
to be tested by the Center for Medicare and Medicaid Innovation
and other federally authorized demonstration projects,
including value-based models, that may encourage the use of
appropriate medication-assisted treatment approved by the Food
and Drug Administration for the treatment of opioid addiction
and other therapies that manage chronic and acute pain and
treat and minimize risk of opioid addiction.
(3) Recommendations for data collection that can facilitate
research and policy making regarding prevention of opioid
addiction and coverage and reimbursement under the Medicare
program and the Medicaid program of appropriate opioid
addiction treatments.
(4) Recommendations for provider education that can expand
patient access to the full range of medication-assisted
treatment approved by the Food and Drug Administration for the
treatment of opioid addiction and other therapies that manage
chronic and acute pain and treat and minimize risk of opioid
addiction.
(5) Recommendations for policies under the Medicare program
and under the Medicaid program that can expand access for
rural, or medically underserved communities to the full range
of medication-assisted treatment approved by the Food and Drug
Administration for the treatment of opioid addiction and other
therapies that manage chronic and acute pain and treatment and
minimize risk of opioid addiction.
(c) Stakeholder Meetings.--
(1) In general.--Beginning not later than 3 months after
the date of the enactment of this Act, the Secretary shall
convene a public stakeholder meeting to solicit public comment
on the components of the action plan recommendations described
in subsection (b).
(2) Participants.--Participants of meetings described in
paragraph (1) shall include representatives from the Food and
Drug Administration and National Institutes of Health,
biopharmaceutical industry members, medical researchers, health
care providers, the medical device industry, the Medicare
program, the Medicaid program, and patient advocates.
(d) Request for Information.--Not later than 3 months after the
date of the enactment of this section, the Secretary shall issue a
request for information seeking public feedback regarding ways in which
the Centers for Medicare & Medicaid Services can help address the
opioid crisis through the development of and application of the action
plan.
(e) Report to Congress.--Not later than March 1, 2019, the
Secretary shall submit to Congress, and make public, a report that
includes a summary of steps taken under the action plan,
recommendations that have emerged under the action plan, and the
Secretary's planned next steps with respect to the action plan.
(f) Definition of Medication-Assisted Treatment.--In this section,
the term ``medication-assisted treatment'' includes opioid treatment
programs, behavioral therapy, and medications to treat substance abuse
disorder.
SEC. 3. REPORT ON COVERAGE, CODING, AND REIMBURSEMENT POLICIES UNDER
MEDICARE.
(a) In General.--Not later than 1 year after the date of the
enactment of this Act, the Secretary of Health and Human Services (in
this section referred to as the ``Secretary'') shall--
(1) identify--
(A) medical devices that are non-opioid based
treatments approved by the Food and Drug Administration
for the management of acute pain and chronic pain;
(B) medical devices that are non-opioid based
treatments approved by the Food and Drug Administration
that monitor substance use withdrawal and prevent
overdoses of controlled substances; and
(C) medical devices that are non-opioid based
treatments approved by the Food and Drug Administration
that treat substance use disorder; and
(2) submit to the Committee on Finance of the Senate and
the Committees on Ways and Means and Energy and Commerce of the
House of Representatives, and publish on a public Internet
website of the Department of Health and Human Services, a
report containing recommendations on ways to encourage the use
of such medical devices by individuals entitled to benefits
under part A of title XVIII of the Social Security Act and
enrolled under part B of such title (including individuals
enrolled in a Medicare Advantage plan under part C of such
title or in a prescription drug plan under part D of such
title) and individuals enrolled under a State plan under title
XIX of such Act.
(b) Contents.--The report under subsection (a) shall include an
analysis of the following, with respect to the Medicare program under
title XVIII of the Social Security Act and the Medicaid program under
title XIX of such Act:
(1) Various opioid alternatives for pain treatment that are
covered under such programs, that are not covered under such
programs, that have limited coverage under such program, or
with respect to which there are payment barriers under such
programs.
(2) Various medical devices that monitor substance use
withdrawal and prevent overdose of controlled substances that
are covered under such programs, that are not so covered, that
have such limited coverage, or with respect to which there are
such payment barriers.
(3) Various medical devices that treat substance use
disorder and opioid use disorder that are covered under such
programs, that are not so covered, that have such limited
coverage, or with respect to which there are such payment
barriers.
(4) Access to payment codes used by health care providers
that promote alternative options for pain management therapies
without the use of opioids, including minimally invasive pain
therapies.
(5) Ways to improve communications between Medicare
prescription drug plans and Medicare Advantage plans, Medicare
and Medicaid health care providers, and Medicare beneficiaries
and Medicaid beneficiaries on the potential harm associated
with the use of opioids and other controlled substances,
including the need to safely store and dispose of supplies
relating to the use of opioids and other controlled substances.
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