[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6 Enrolled Bill (ENR)]

        H.R.6

                     One Hundred Fifteenth Congress

                                 of the

                        United States of America


                          AT THE SECOND SESSION

         Begun and held at the City of Washington on Wednesday,
           the third day of January, two thousand and eighteen


                                 An Act


 
To provide for opioid use disorder prevention, recovery, and 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; TABLE OF CONTENTS.
    (a) Short Title.--This Act may be cited as the ``Substance Use-
Disorder Prevention that Promotes Opioid Recovery and Treatment for 
Patients and Communities Act'' or the ``SUPPORT for Patients and 
Communities Act''.
    (b) Table of Contents.--The table of contents of this Act is as 
follows:

Sec. 1. Short title; table of contents.

        TITLE I--MEDICAID PROVISIONS TO ADDRESS THE OPIOID CRISIS

Sec. 1001. At-risk youth Medicaid protection.
Sec. 1002. Health insurance for former foster youth.
Sec. 1003. Demonstration project to increase substance use provider 
          capacity under the Medicaid program.
Sec. 1004. Medicaid drug review and utilization.
Sec. 1005. Guidance to improve care for infants with neonatal abstinence 
          syndrome and their mothers; GAO study on gaps in Medicaid 
          coverage for pregnant and postpartum women with substance use 
          disorder.
Sec. 1006. Medicaid health homes for substance-use-disorder Medicaid 
          enrollees.
Sec. 1007. Caring recovery for infants and babies.
Sec. 1008. Peer support enhancement and evaluation review.
Sec. 1009. Medicaid substance use disorder treatment via telehealth.
Sec. 1010. Enhancing patient access to non-opioid treatment options.
Sec. 1011. Assessing barriers to opioid use disorder treatment.
Sec. 1012. Help for moms and babies.
Sec. 1013. Securing flexibility to treat substance use disorders.
Sec. 1014. MACPAC study and report on MAT utilization controls under 
          State Medicaid programs.
Sec. 1015. Opioid addiction treatment programs enhancement.
Sec. 1016. Better data sharing to combat the opioid crisis.
Sec. 1017. Report on innovative State initiatives and strategies to 
          provide housing-related services and supports to individuals 
          struggling with substance use disorders under Medicaid.
Sec. 1018. Technical assistance and support for innovative State 
          strategies to provide housing-related supports under Medicaid.

       TITLE II--MEDICARE PROVISIONS TO ADDRESS THE OPIOID CRISIS

Sec. 2001. Expanding the use of telehealth services for the treatment of 
          opioid use disorder and other substance use disorders.
Sec. 2002. Comprehensive screenings for seniors.
Sec. 2003. Every prescription conveyed securely.
Sec. 2004. Requiring prescription drug plan sponsors under Medicare to 
          establish drug management programs for at-risk beneficiaries.
Sec. 2005. Medicare coverage of certain services furnished by opioid 
          treatment programs.
Sec. 2006. Encouraging appropriate prescribing under Medicare for 
          victims of opioid overdose.
Sec. 2007. Automatic escalation to external review under a Medicare part 
          D drug management program for at-risk beneficiaries.
Sec. 2008. Suspension of payments by Medicare prescription drug plans 
          and MA-PD plans pending investigations of credible allegations 
          of fraud by pharmacies.

           TITLE III--FDA AND CONTROLLED SUBSTANCE PROVISIONS

                       Subtitle A--FDA Provisions

                          Chapter 1--In General

Sec. 3001. Clarifying FDA regulation of non-addictive pain products.
Sec. 3002. Evidence-based opioid analgesic prescribing guidelines and 
          report.

     Chapter 2--Stop Counterfeit Drugs by Regulating and Enhancing 
                             Enforcement Now

Sec. 3011. Short title.
Sec. 3012. Notification, nondistribution, and recall of controlled 
          substances.
Sec. 3013. Single source pattern of imported illegal drugs.
Sec. 3014. Strengthening FDA and CBP coordination and capacity.

                Chapter 3--Stop Illicit Drug Importation

Sec. 3021. Short title.
Sec. 3022. Restricting entrance of illicit drugs.

    Chapter 4--Securing Opioids and Unused Narcotics With Deliberate 
                         Disposal and Packaging

Sec. 3031. Short title.
Sec. 3032. Safety-enhancing packaging and disposal features.

               Chapter 5--Postapproval Study Requirements

Sec. 3041. Clarifying FDA postmarket authorities.

               Subtitle B--Controlled Substance Provisions

    Chapter 1--More Flexibility With Respect to Medication-Assisted 
                   Treatment for Opioid Use Disorders

Sec. 3201. Allowing for more flexibility with respect to medication-
          assisted treatment for opioid use disorders.
Sec. 3202. Medication-assisted treatment for recovery from substance use 
          disorder.
Sec. 3203. Grants to enhance access to substance use disorder treatment.
Sec. 3204. Delivery of a controlled substance by a pharmacy to be 
          administered by injection or implantation.

   Chapter 2--Empowering Pharmacists in the Fight Against Opioid Abuse

Sec. 3211. Short title.
Sec. 3212. Programs and materials for training on certain circumstances 
          under which a pharmacist may decline to fill a prescription.

              Chapter 3--Safe Disposal of Unused Medication

Sec. 3221. Short title.
Sec. 3222. Disposal of controlled substances of a hospice patient by 
          employees of a qualified hospice program.
Sec. 3223. GAO study and report on hospice safe drug management.

     Chapter 4--Special Registration for Telemedicine Clarification

Sec. 3231. Short title.
Sec. 3232. Regulations relating to a special registration for 
          telemedicine.

       Chapter 5--Synthetic Abuse and Labeling of Toxic Substances

Sec. 3241. Controlled substance analogues.

              Chapter 6--Access to Increased Drug Disposal

Sec. 3251. Short title.
Sec. 3252. Definitions.
Sec. 3253. Authority to make grants.
Sec. 3254. Application.
Sec. 3255. Use of grant funds.
Sec. 3256. Eligibility for grant.
Sec. 3257. Duration of grants.
Sec. 3258. Accountability and oversight.
Sec. 3259. Duration of program.
Sec. 3260. Authorization of appropriations.

            Chapter 7--Using Data To Prevent Opioid Diversion

Sec. 3271. Short title.
Sec. 3272. Purpose.
Sec. 3273. Amendments.
Sec. 3274. Report.

                     Chapter 8--Opioid Quota Reform

Sec. 3281. Short title.
Sec. 3282. Strengthening considerations for DEA opioid quotas.

                  Chapter 9--Preventing Drug Diversion

Sec. 3291. Short title.
Sec. 3292. Improvements to prevent drug diversion.

                            TITLE IV--OFFSETS

Sec. 4001. Promoting value in Medicaid managed care.
Sec. 4002. Requiring reporting by group health plans of prescription 
          drug coverage information for purposes of identifying primary 
          payer situations under the Medicare program.
Sec. 4003. Additional religious exemption from health coverage 
          responsibility requirement.
Sec. 4004. Modernizing the reporting of biological and biosimilar 
          products.

                   TITLE V--OTHER MEDICAID PROVISIONS

Subtitle A--Mandatory Reporting With Respect to Adult Behavioral Health 
                                Measures

Sec. 5001. Mandatory reporting with respect to adult behavioral health 
          measures.

                Subtitle B--Medicaid IMD Additional Info

Sec. 5011. Short title.
Sec. 5012. MACPAC exploratory study and report on institutions for 
          mental diseases requirements and practices under Medicaid.

    Subtitle C--CHIP Mental Health and Substance Use Disorder Parity

Sec. 5021. Short title.
Sec. 5022. Ensuring access to mental health and substance use disorder 
          services for children and pregnant women under the Children's 
          Health Insurance Program.

                      Subtitle D--Medicaid Reentry

Sec. 5031. Short title.
Sec. 5032. Promoting State innovations to ease transitions integration 
          to the community for certain individuals.

                    Subtitle E--Medicaid Partnership

Sec. 5041. Short title.
Sec. 5042. Medicaid providers are required to note experiences in record 
          systems to help in-need patients.

                        Subtitle F--IMD CARE Act

Sec. 5051. Short title.
Sec. 5052. State option to provide Medicaid coverage for certain 
          individuals with substance use disorders who are patients in 
          certain institutions for mental diseases.

                  Subtitle G--Medicaid Improvement Fund

Sec. 5061. Medicaid Improvement Fund.

                   TITLE VI--OTHER MEDICARE PROVISIONS

    Subtitle A--Testing of Incentive Payments for Behavioral Health 
  Providers for Adoption and Use of Certified Electronic Health Record 
                               Technology

Sec. 6001. Testing of incentive payments for behavioral health providers 
          for adoption and use of certified electronic health record 
          technology.

                   Subtitle B--Abuse Deterrent Access

Sec. 6011. Short title.
Sec. 6012. Study on abuse-deterrent opioid formulations access barriers 
          under Medicare.

              Subtitle C--Medicare Opioid Safety Education

Sec. 6021. Medicare opioid safety education.

                Subtitle D--Opioid Addiction Action Plan

Sec. 6031. Short title.
Sec. 6032. Action plan on recommendations for changes under Medicare and 
          Medicaid to prevent opioids addictions and enhance access to 
          medication-assisted treatment.

Subtitle E--Advancing High Quality Treatment for Opioid Use Disorders in 
                                Medicare

Sec. 6041. Short title.
Sec. 6042. Opioid use disorder treatment demonstration program.

Subtitle F--Responsible Education Achieves Care and Healthy Outcomes for 
                            Users' Treatment

Sec. 6051. Short title.
Sec. 6052. Grants to provide technical assistance to outlier prescribers 
          of opioids.

        Subtitle G--Preventing Addiction for Susceptible Seniors

Sec. 6061. Short title.
Sec. 6062. Electronic prior authorization for covered part D drugs.
Sec. 6063. Program integrity transparency measures under Medicare parts 
          C and D.
Sec. 6064. Expanding eligibility for medication therapy management 
          programs under part D.
Sec. 6065. Commit to opioid medical prescriber accountability and safety 
          for seniors.
Sec. 6066. No additional funds authorized.

    Subtitle H--Expanding Oversight of Opioid Prescribing and Payment

Sec. 6071. Short title.
Sec. 6072. Medicare Payment Advisory Commission report on opioid 
          payment, adverse incentives, and data under the Medicare 
          program.
Sec. 6073. No additional funds authorized.

  Subtitle I--Dr. Todd Graham Pain Management, Treatment, and Recovery

Sec. 6081. Short title.
Sec. 6082. Review and adjustment of payments under the Medicare 
          outpatient prospective payment system to avoid financial 
          incentives to use opioids instead of non-opioid alternative 
          treatments.
Sec. 6083. Expanding access under the Medicare program to addiction 
          treatment in Federally qualified health centers and rural 
          health clinics.
Sec. 6084. Studying the availability of supplemental benefits designed 
          to treat or prevent substance use disorders under Medicare 
          Advantage plans.
Sec. 6085. Clinical psychologist services models under the Center for 
          Medicare and Medicaid Innovation; GAO study and report.
Sec. 6086. Dr. Todd Graham pain management study.

        Subtitle J--Combating Opioid Abuse for Care in Hospitals

Sec. 6091. Short title.
Sec. 6092. Developing guidance on pain management and opioid use 
          disorder prevention for hospitals receiving payment under part 
          A of the Medicare program.
Sec. 6093. Requiring the review of quality measures relating to opioids 
          and opioid use disorder treatments furnished under the 
          medicare program and other federal health care programs.
Sec. 6094. Technical expert panel on reducing surgical setting opioid 
          use; Data collection on perioperative opioid use.
Sec. 6095. Requiring the posting and periodic update of opioid 
          prescribing guidance for Medicare beneficiaries.

  Subtitle K--Providing Reliable Options for Patients and Educational 
                                Resources

Sec. 6101. Short title.
Sec. 6102. Requiring Medicare Advantage plans and part D prescription 
          drug plans to include information on risks associated with 
          opioids and coverage of nonpharmacological therapies and 
          nonopioid medications or devices used to treat pain.
Sec. 6103. Requiring Medicare Advantage plans and prescription drug 
          plans to provide information on the safe disposal of 
          prescription drugs.
Sec. 6104. Revising measures used under the Hospital Consumer Assessment 
          of Healthcare Providers and Systems survey relating to pain 
          management.

         Subtitle L--Fighting the Opioid Epidemic With Sunshine

Sec. 6111. Fighting the opioid epidemic with sunshine.

                   TITLE VII--PUBLIC HEALTH PROVISIONS

                   Subtitle A--Awareness and Training

Sec. 7001. Report on effects on public health of synthetic drug use.
Sec. 7002. First responder training.

   Subtitle B--Pilot Program for Public Health Laboratories To Detect 
                  Fentanyl and Other Synthetic Opioids

Sec. 7011. Pilot program for public health laboratories to detect 
          fentanyl and other synthetic opioids.

          Subtitle C--Indexing Narcotics, Fentanyl, and Opioids

Sec. 7021. Establishment of substance use disorder information 
          dashboard.
Sec. 7022. Interdepartmental Substance Use Disorders Coordinating 
          Committee.
Sec. 7023. National milestones to measure success in curtailing the 
          opioid crisis.
Sec. 7024. Study on prescribing limits.

           Subtitle D--Ensuring Access to Quality Sober Living

Sec. 7031. National recovery housing best practices.

               Subtitle E--Advancing Cutting Edge Research

Sec. 7041. Unique research initiatives.
Sec. 7042. Pain research.

                        Subtitle F--Jessie's Law

Sec. 7051. Inclusion of opioid addiction history in patient records.
Sec. 7052. Communication with families during emergencies.
Sec. 7053. Development and dissemination of model training programs for 
          substance use disorder patient records.

            Subtitle G--Protecting Pregnant Women and Infants

Sec. 7061. Report on addressing maternal and infant health in the opioid 
          crisis.
Sec. 7062. Protecting moms and infants.
Sec. 7063. Early interventions for pregnant women and infants.
Sec. 7064. Prenatal and postnatal health.
Sec. 7065. Plans of safe care.

         Subtitle H--Substance Use Disorder Treatment Workforce

Sec. 7071. Loan repayment program for substance use disorder treatment 
          workforce.
Sec. 7072. Clarification regarding service in schools and other 
          community-based settings.
Sec. 7073. Programs for health care workforce.

        Subtitle I--Preventing Overdoses While in Emergency Rooms

Sec. 7081. Program to support coordination and continuation of care for 
          drug overdose patients.

     Subtitle J--Alternatives to Opioids in the Emergency Department

Sec. 7091. Emergency department alternatives to opioids demonstration 
          program.

Subtitle K--Treatment, Education, and Community Help To Combat Addiction

Sec. 7101. Establishment of regional centers of excellence in substance 
          use disorder education.
Sec. 7102. Youth prevention and recovery.

 Subtitle L--Information From National Mental Health and Substance Use 
                            Policy Laboratory

Sec. 7111. Information from National Mental Health and Substance Use 
          Policy Laboratory.

            Subtitle M--Comprehensive Opioid Recovery Centers

Sec. 7121. Comprehensive opioid recovery centers.

                    Subtitle N--Trauma-Informed Care

Sec. 7131. CDC surveillance and data collection for child, youth, and 
          adult trauma.
Sec. 7132. Task force to develop best practices for trauma-informed 
          identification, referral, and support.
Sec. 7133. National Child Traumatic Stress Initiative.
Sec. 7134. Grants to improve trauma support services and mental health 
          care for children and youth in educational settings.
Sec. 7135. Recognizing early childhood trauma related to substance 
          abuse.

       Subtitle O--Eliminating Opioid Related Infectious Diseases

Sec. 7141. Reauthorization and expansion of program of surveillance and 
          education regarding infections associated with illicit drug 
          use and other risk factors.

            Subtitle P--Peer Support Communities of Recovery

Sec. 7151. Building communities of recovery.
Sec. 7152. Peer support technical assistance center.

  Subtitle Q--Creating Opportunities That Necessitate New and Enhanced 
          Connections That Improve Opioid Navigation Strategies

Sec. 7161. Preventing overdoses of controlled substances.
Sec. 7162. Prescription drug monitoring program.

    Subtitle R--Review of Substance Use Disorder Treatment Providers 
                        Receiving Federal Funding

Sec. 7171. Review of substance use disorder treatment providers 
          receiving Federal funding.

                   Subtitle S--Other Health Provisions

Sec. 7181. State response to the opioid abuse crisis.
Sec. 7182. Report on investigations regarding parity in mental health 
          and substance use disorder benefits.
Sec. 7183. CAREER Act.

                        TITLE VIII--MISCELLANEOUS

       Subtitle A--Synthetics Trafficking and Overdose Prevention

Sec. 8001. Short title.
Sec. 8002. Customs fees.
Sec. 8003. Mandatory advance electronic information for postal 
          shipments.
Sec. 8004. International postal agreements.
Sec. 8005. Cost recoupment.
Sec. 8006. Development of technology to detect illicit narcotics.
Sec. 8007. Civil penalties for postal shipments.
Sec. 8008. Report on violations of arrival, reporting, entry, and 
          clearance requirements and falsity or lack of manifest.
Sec. 8009. Effective date; regulations.

         Subtitle B--Opioid Addiction Recovery Fraud Prevention

Sec. 8021. Short title.
Sec. 8022. Definitions.
Sec. 8023. Unfair or deceptive acts or practices with respect to 
          substance use disorder treatment service and products.

  Subtitle C--Addressing Economic and Workforce Impacts of the Opioid 
                                 Crisis

Sec. 8041. Addressing economic and workforce impacts of the opioid 
          crisis.

     Subtitle D--Peer Support Counseling Program for Women Veterans

Sec. 8051. Peer support counseling program for women veterans.

               Subtitle E--Treating Barriers to Prosperity

Sec. 8061. Short title.
Sec. 8062. Drug abuse mitigation initiative.

    Subtitle F--Pilot Program to Help Individuals in Recovery From a 
               Substance Use Disorder Become Stably Housed

Sec. 8071. Pilot program to help individuals in recovery from a 
          substance use disorder become stably housed.

                       Subtitle G--Human Services

Sec. 8081. Supporting family-focused residential treatment.
Sec. 8082. Improving recovery and reunifying families.
Sec. 8083. Building capacity for family-focused residential treatment.

Subtitle H--Reauthorizing and Extending Grants for Recovery From Opioid 
                              Use Programs

Sec. 8091. Short title.
Sec. 8092. Reauthorization of the comprehensive opioid abuse grant 
          program.

           Subtitle I--Fighting Opioid Abuse in Transportation

Sec. 8101. Short title.
Sec. 8102. Alcohol and controlled substance testing of mechanical 
          employees.
Sec. 8103. Department of Transportation public drug and alcohol testing 
          database.
Sec. 8104. GAO report on Department of Transportation's collection and 
          use of drug and alcohol testing data.
Sec. 8105. Transportation Workplace Drug and Alcohol Testing Program; 
          addition of fentanyl and other substances.
Sec. 8106. Status reports on hair testing guidelines.
Sec. 8107. Mandatory Guidelines for Federal Workplace Drug Testing 
          Programs using Oral Fluid.
Sec. 8108. Electronic recordkeeping.
Sec. 8109. Status reports on Commercial Driver's License Drug and 
          Alcohol Clearinghouse.

              Subtitle J--Eliminating Kickbacks in Recovery

Sec. 8121. Short title.
Sec. 8122. Criminal penalties.

                 Subtitle K--Substance Abuse Prevention

Sec. 8201. Short title.
Sec. 8202. Reauthorization of the Office of National Drug Control 
          Policy.
Sec. 8203. Reauthorization of the Drug-Free Communities Program.
Sec. 8204. Reauthorization of the National Community Anti-Drug Coalition 
          Institute.
Sec. 8205. Reauthorization of the High-Intensity Drug Trafficking Area 
          Program.
Sec. 8206. Reauthorization of drug court program.
Sec. 8207. Drug court training and technical assistance.
Sec. 8208. Drug overdose response strategy.
Sec. 8209. Protecting law enforcement officers from accidental exposure.
Sec. 8210. COPS Anti-Meth Program.
Sec. 8211. COPS anti-heroin task force program.
Sec. 8212. Comprehensive Addiction and Recovery Act education and 
          awareness.
Sec. 8213. Reimbursement of substance use disorder treatment 
          professionals.
Sec. 8214. Sobriety Treatment and Recovery Teams (START).
Sec. 8215. Provider education.
Sec. 8216. Definitions.
Sec. 8217. Amendments to administration of the Office.
Sec. 8218. Emerging threats committee, plan, and media campaign.
Sec. 8219. Drug interdiction.
Sec. 8220. GAO Audit.
Sec. 8221. National Drug Control Strategy.
Sec. 8222. Technical and conforming amendments to the Office of National 
          Drug Control Policy Reauthorization Act of 1998.

                      Subtitle L--Budgetary Effects

Sec. 8231. Budgetary effect.

       TITLE I--MEDICAID PROVISIONS TO ADDRESS THE OPIOID CRISIS

SEC. 1001. AT-RISK YOUTH MEDICAID PROTECTION.
    (a) In General.--Section 1902 of the Social Security Act (42 U.S.C. 
1396a) is amended--
        (1) in subsection (a)--
            (A) by striking ``and'' at the end of paragraph (82);
            (B) by striking the period at the end of paragraph (83) and 
        inserting ``; and''; and
            (C) by inserting after paragraph (83) the following new 
        paragraph:
        ``(84) provide that--
            ``(A) the State shall not terminate eligibility for medical 
        assistance under the State plan for an individual who is an 
        eligible juvenile (as defined in subsection (nn)(2)) because 
        the juvenile is an inmate of a public institution (as defined 
        in subsection (nn)(3)), but may suspend coverage during the 
        period the juvenile is such an inmate;
            ``(B) in the case of an individual who is an eligible 
        juvenile described in paragraph (2)(A) of subsection (nn), the 
        State shall, prior to the individual's release from such a 
        public institution, conduct a redetermination of eligibility 
        for such individual with respect to such medical assistance 
        (without requiring a new application from the individual) and, 
        if the State determines pursuant to such redetermination that 
        the individual continues to meet the eligibility requirements 
        for such medical assistance, the State shall restore coverage 
        for such medical assistance to such an individual upon the 
        individual's release from such public institution; and
            ``(C) in the case of an individual who is an eligible 
        juvenile described in paragraph (2)(B) of subsection (nn), the 
        State shall process any application for medical assistance 
        submitted by, or on behalf of, such individual such that the 
        State makes a determination of eligibility for such individual 
        with respect to such medical assistance upon release of such 
        individual from such public institution.''; and
        (2) by adding at the end the following new subsection:
    ``(nn) Juvenile; Eligible Juvenile; Public Institution.--For 
purposes of subsection (a)(84) and this subsection:
        ``(1) Juvenile.--The term `juvenile' means an individual who 
    is--
            ``(A) under 21 years of age; or
            ``(B) described in subsection (a)(10)(A)(i)(IX).
        ``(2) Eligible juvenile.--The term `eligible juvenile' means a 
    juvenile who is an inmate of a public institution and who--
            ``(A) was determined eligible for medical assistance under 
        the State plan immediately before becoming an inmate of such a 
        public institution; or
            ``(B) is determined eligible for such medical assistance 
        while an inmate of a public institution.
        ``(3) Inmate of a public institution.--The term `inmate of a 
    public institution' has the meaning given such term for purposes of 
    applying the subdivision (A) following paragraph (30) of section 
    1905(a), taking into account the exception in such subdivision for 
    a patient of a medical institution.''.
    (b) No Change in Exclusion From Medical Assistance for Inmates of 
Public Institutions.--Nothing in this section shall be construed as 
changing the exclusion from medical assistance under the subdivision 
(A) following paragraph (30) of section 1905(a) of the Social Security 
Act (42 U.S.C. 1396d(a)), as redesignated by section 1006(b)(2)(B) of 
this Act, including any applicable restrictions on a State submitting 
claims for Federal financial participation under title XIX of such Act 
for such assistance.
    (c) No Change in Continuity of Eligibility Before Adjudication or 
Sentencing.--Nothing in this section shall be construed to mandate, 
encourage, or suggest that a State suspend or terminate coverage for 
individuals before they have been adjudicated or sentenced.
    (d) Effective Date.--
        (1) In general.--Except as provided in paragraph (2), the 
    amendments made by subsection (a) shall apply to eligibility of 
    juveniles who become inmates of public institutions on or after the 
    date that is 1 year after the date of the enactment of this Act.
        (2) Rule for changes requiring state legislation.--In the case 
    of a State plan for medical assistance under title XIX of the 
    Social Security Act which the Secretary of Health and Human 
    Services determines requires State legislation (other than 
    legislation appropriating funds) in order for the plan to meet the 
    additional requirements imposed by the amendments made by 
    subsection (a), the State plan shall not be regarded as failing to 
    comply with the requirements of such title solely on the basis of 
    its failure to meet these additional requirements before the first 
    day of the first calendar quarter beginning after the close of the 
    first regular session of the State legislature that begins after 
    the date of the enactment of this Act. For purposes of the previous 
    sentence, in the case of a State that has a 2-year legislative 
    session, each year of such session shall be deemed to be a separate 
    regular session of the State legislature.
SEC. 1002. HEALTH INSURANCE FOR FORMER FOSTER YOUTH.
    (a) Coverage Continuity for Former Foster Care Children up to Age 
26.--
        (1) In general.--Section 1902(a)(10)(A)(i)(IX) of the Social 
    Security Act (42 U.S.C. 1396a(a)(10)(A)(i)(IX)) is amended--
            (A) in item (bb), by striking ``are not described in or 
        enrolled under'' and inserting ``are not described in and are 
        not enrolled under'';
            (B) in item (cc), by striking ``responsibility of the 
        State'' and inserting ``responsibility of a State''; and
            (C) in item (dd), by striking ``the State plan under this 
        title or under a waiver of the'' and inserting ``a State plan 
        under this title or under a waiver of such a''.
        (2) Effective date.--The amendments made by this subsection 
    shall take effect with respect to foster youth who attain 18 years 
    of age on or after January 1, 2023.
    (b) Guidance.--Not later than 1 year after the date of the 
enactment of this Act, the Secretary of Health and Human Services shall 
issue guidance to States, with respect to the State Medicaid programs 
of such States--
        (1) on best practices for--
            (A) removing barriers and ensuring streamlined, timely 
        access to Medicaid coverage for former foster youth up to age 
        26; and
            (B) conducting outreach and raising awareness among such 
        youth regarding Medicaid coverage options for such youth; and
        (2) which shall include examples of States that have 
    successfully extended Medicaid coverage to former foster youth up 
    to age 26.
SEC. 1003. DEMONSTRATION PROJECT TO INCREASE SUBSTANCE USE PROVIDER 
CAPACITY UNDER THE MEDICAID PROGRAM.
    Section 1903 of the Social Security Act (42 U.S.C. 1396b) is 
amended by adding at the end the following new subsection:
    ``(aa) Demonstration Project To Increase Substance Use Provider 
Capacity.--
        ``(1) In general.--Not later than the date that is 180 days 
    after the date of the enactment of this subsection, the Secretary 
    shall, in consultation, as appropriate, with the Director of the 
    Agency for Healthcare Research and Quality and the Assistant 
    Secretary for Mental Health and Substance Use, conduct a 54-month 
    demonstration project for the purpose described in paragraph (2) 
    under which the Secretary shall--
            ``(A) for the first 18-month period of such project, award 
        planning grants described in paragraph (3); and
            ``(B) for the remaining 36-month period of such project, 
        provide to each State selected under paragraph (4) payments in 
        accordance with paragraph (5).
        ``(2) Purpose.--The purpose described in this paragraph is for 
    each State selected under paragraph (4) to increase the treatment 
    capacity of providers participating under the State plan (or a 
    waiver of such plan) to provide substance use disorder treatment or 
    recovery services under such plan (or waiver) through the following 
    activities:
            ``(A) For the purpose described in paragraph (3)(C)(i), 
        activities that support an ongoing assessment of the behavioral 
        health treatment needs of the State, taking into account the 
        matters described in subclauses (I) through (IV) of such 
        paragraph.
            ``(B) Activities that, taking into account the results of 
        the assessment described in subparagraph (A), support the 
        recruitment, training, and provision of technical assistance 
        for providers participating under the State plan (or a waiver 
        of such plan) that offer substance use disorder treatment or 
        recovery services.
            ``(C) Improved reimbursement for and expansion of, through 
        the provision of education, training, and technical assistance, 
        the number or treatment capacity of providers participating 
        under the State plan (or waiver) that--
                ``(i) are authorized to dispense drugs approved by the 
            Food and Drug Administration for individuals with a 
            substance use disorder who need withdrawal management or 
            maintenance treatment for such disorder;
                ``(ii) have in effect a registration or waiver under 
            section 303(g) of the Controlled Substances Act for 
            purposes of dispensing narcotic drugs to individuals for 
            maintenance treatment or detoxification treatment and are 
            in compliance with any regulation promulgated by the 
            Assistant Secretary for Mental Health and Substance Use for 
            purposes of carrying out the requirements of such section 
            303(g); and
                ``(iii) are qualified under applicable State law to 
            provide substance use disorder treatment or recovery 
            services.
            ``(D) Improved reimbursement for and expansion of, through 
        the provision of education, training, and technical assistance, 
        the number or treatment capacity of providers participating 
        under the State plan (or waiver) that have the qualifications 
        to address the treatment or recovery needs of--
                ``(i) individuals enrolled under the State plan (or a 
            waiver of such plan) who have neonatal abstinence syndrome, 
            in accordance with guidelines issued by the American 
            Academy of Pediatrics and American College of Obstetricians 
            and Gynecologists relating to maternal care and infant care 
            with respect to neonatal abstinence syndrome;
                ``(ii) pregnant women, postpartum women, and infants, 
            particularly the concurrent treatment, as appropriate, and 
            comprehensive case management of pregnant women, postpartum 
            women and infants, enrolled under the State plan (or a 
            waiver of such plan);
                ``(iii) adolescents and young adults between the ages 
            of 12 and 21 enrolled under the State plan (or a waiver of 
            such plan); or
                ``(iv) American Indian and Alaska Native individuals 
            enrolled under the State plan (or a waiver of such plan).
        ``(3) Planning grants.--
            ``(A) In general.--The Secretary shall, with respect to the 
        first 18-month period of the demonstration project conducted 
        under paragraph (1), award planning grants to at least 10 
        States selected in accordance with subparagraph (B) for 
        purposes of preparing an application described in paragraph 
        (4)(C) and carrying out the activities described in 
        subparagraph (C).
            ``(B) Selection.--In selecting States for purposes of this 
        paragraph, the Secretary shall--
                ``(i) select States that have a State plan (or waiver 
            of the State plan) approved under this title;
                ``(ii) select States in a manner that ensures 
            geographic diversity; and
                ``(iii) give preference to States with a prevalence of 
            substance use disorders (in particular opioid use 
            disorders) that is comparable to or higher than the 
            national average prevalence, as measured by aggregate per 
            capita drug overdoses, or any other measure that the 
            Secretary deems appropriate.
            ``(C) Activities described.--Activities described in this 
        subparagraph are, with respect to a State, each of the 
        following:
                ``(i) Activities that support the development of an 
            initial assessment of the behavioral health treatment needs 
            of the State to determine the extent to which providers are 
            needed (including the types of such providers and 
            geographic area of need) to improve the network of 
            providers that treat substance use disorders under the 
            State plan (or waiver), including the following:

                    ``(I) An estimate of the number of individuals 
                enrolled under the State plan (or a waiver of such 
                plan) who have a substance use disorder.
                    ``(II) Information on the capacity of providers to 
                provide substance use disorder treatment or recovery 
                services to individuals enrolled under the State plan 
                (or waiver), including information on providers who 
                provide such services and their participation under the 
                State plan (or waiver).
                    ``(III) Information on the gap in substance use 
                disorder treatment or recovery services under the State 
                plan (or waiver) based on the information described in 
                subclauses (I) and (II).
                    ``(IV) Projections regarding the extent to which 
                the State participating under the demonstration project 
                would increase the number of providers offering 
                substance use disorder treatment or recovery services 
                under the State plan (or waiver) during the period of 
                the demonstration project.

                ``(ii) Activities that, taking into account the results 
            of the assessment described in clause (i), support the 
            development of State infrastructure to, with respect to the 
            provision of substance use disorder treatment or recovery 
            services under the State plan (or a waiver of such plan), 
            recruit prospective providers and provide training and 
            technical assistance to such providers.
            ``(D) Funding.--For purposes of subparagraph (A), there is 
        appropriated, out of any funds in the Treasury not otherwise 
        appropriated, $50,000,000, to remain available until expended.
        ``(4) Post-planning states.--
            ``(A) In general.--The Secretary shall, with respect to the 
        remaining 36-month period of the demonstration project 
        conducted under paragraph (1), select not more than 5 States in 
        accordance with subparagraph (B) for purposes of carrying out 
        the activities described in paragraph (2) and receiving 
        payments in accordance with paragraph (5).
            ``(B) Selection.--In selecting States for purposes of this 
        paragraph, the Secretary shall--
                ``(i) select States that received a planning grant 
            under paragraph (3);
                ``(ii) select States that submit to the Secretary an 
            application in accordance with the requirements in 
            subparagraph (C), taking into consideration the quality of 
            each such application;
                ``(iii) select States in a manner that ensures 
            geographic diversity; and
                ``(iv) give preference to States with a prevalence of 
            substance use disorders (in particular opioid use 
            disorders) that is comparable to or higher than the 
            national average prevalence, as measured by aggregate per 
            capita drug overdoses, or any other measure that the 
            Secretary deems appropriate.
            ``(C) Applications.--
                ``(i) In general.--A State seeking to be selected for 
            purposes of this paragraph shall submit to the Secretary, 
            at such time and in such form and manner as the Secretary 
            requires, an application that includes such information, 
            provisions, and assurances, as the Secretary may require, 
            in addition to the following:

                    ``(I) A proposed process for carrying out the 
                ongoing assessment described in paragraph (2)(A), 
                taking into account the results of the initial 
                assessment described in paragraph (3)(C)(i).
                    ``(II) A review of reimbursement methodologies and 
                other policies related to substance use disorder 
                treatment or recovery services under the State plan (or 
                waiver) that may create barriers to increasing the 
                number of providers delivering such services.
                    ``(III) The development of a plan, taking into 
                account activities carried out under paragraph 
                (3)(C)(ii), that will result in long-term and 
                sustainable provider networks under the State plan (or 
                waiver) that will offer a continuum of care for 
                substance use disorders. Such plan shall include the 
                following:

                        ``(aa) Specific activities to increase the 
                    number of providers (including providers that 
                    specialize in providing substance use disorder 
                    treatment or recovery services, hospitals, health 
                    care systems, Federally qualified health centers, 
                    and, as applicable, certified community behavioral 
                    health clinics) that offer substance use disorder 
                    treatment, recovery, or support services, including 
                    short-term detoxification services, outpatient 
                    substance use disorder services, and evidence-based 
                    peer recovery services.
                        ``(bb) Strategies that will incentivize 
                    providers described in subparagraphs (C) and (D) of 
                    paragraph (2) to obtain the necessary training, 
                    education, and support to deliver substance use 
                    disorder treatment or recovery services in the 
                    State.
                        ``(cc) Milestones and timeliness for 
                    implementing activities set forth in the plan.
                        ``(dd) Specific measurable targets for 
                    increasing the substance use disorder treatment and 
                    recovery provider network under the State plan (or 
                    a waiver of such plan).

                    ``(IV) A proposed process for reporting the 
                information required under paragraph (6)(A), including 
                information to assess the effectiveness of the efforts 
                of the State to expand the capacity of providers to 
                deliver substance use disorder treatment or recovery 
                services during the period of the demonstration project 
                under this subsection.
                    ``(V) The expected financial impact of the 
                demonstration project under this subsection on the 
                State.
                    ``(VI) A description of all funding sources 
                available to the State to provide substance use 
                disorder treatment or recovery services in the State.
                    ``(VII) A preliminary plan for how the State will 
                sustain any increase in the capacity of providers to 
                deliver substance use disorder treatment or recovery 
                services resulting from the demonstration project under 
                this subsection after the termination of such 
                demonstration project.
                    ``(VIII) A description of how the State will 
                coordinate the goals of the demonstration project with 
                any waiver granted (or submitted by the State and 
                pending) pursuant to section 1115 for the delivery of 
                substance use services under the State plan, as 
                applicable.

                ``(ii) Consultation.--In completing an application 
            under clause (i), a State shall consult with relevant 
            stakeholders, including Medicaid managed care plans, health 
            care providers, and Medicaid beneficiary advocates, and 
            include in such application a description of such 
            consultation.
        ``(5) Payment.--
            ``(A) In general.--For each quarter occurring during the 
        period for which the demonstration project is conducted (after 
        the first 18 months of such period), the Secretary shall pay 
        under this subsection, subject to subparagraph (C), to each 
        State selected under paragraph (4) an amount equal to 80 
        percent of so much of the qualified sums expended during such 
        quarter.
            ``(B) Qualified sums defined.--For purposes of subparagraph 
        (A), the term `qualified sums' means, with respect to a State 
        and a quarter, the amount equal to the amount (if any) by which 
        the sums expended by the State during such quarter attributable 
        to substance use disorder treatment or recovery services 
        furnished by providers participating under the State plan (or a 
        waiver of such plan) exceeds 1/4 of such sums expended by the 
        State during fiscal year 2018 attributable to substance use 
        disorder treatment or recovery services.
            ``(C) Non-duplication of payment.--In the case that payment 
        is made under subparagraph (A) with respect to expenditures for 
        substance use disorder treatment or recovery services furnished 
        by providers participating under the State plan (or a waiver of 
        such plan), payment may not also be made under subsection (a) 
        with respect to expenditures for the same services so 
        furnished.
        ``(6) Reports.--
            ``(A) State reports.--A State receiving payments under 
        paragraph (5) shall, for the period of the demonstration 
        project under this subsection, submit to the Secretary a 
        quarterly report, with respect to expenditures for substance 
        use disorder treatment or recovery services for which payment 
        is made to the State under this subsection, on the following:
                ``(i) The specific activities with respect to which 
            payment under this subsection was provided.
                ``(ii) The number of providers that delivered substance 
            use disorder treatment or recovery services in the State 
            under the demonstration project compared to the estimated 
            number of providers that would have otherwise delivered 
            such services in the absence of such demonstration project.
                ``(iii) The number of individuals enrolled under the 
            State plan (or a waiver of such plan) who received 
            substance use disorder treatment or recovery services under 
            the demonstration project compared to the estimated number 
            of such individuals who would have otherwise received such 
            services in the absence of such demonstration project.
                ``(iv) Other matters as determined by the Secretary.
            ``(B) CMS reports.--
                ``(i) Initial report.--Not later than October 1, 2020, 
            the Administrator of the Centers for Medicare & Medicaid 
            Services shall, in consultation with the Director of the 
            Agency for Healthcare Research and Quality and the 
            Assistant Secretary for Mental Health and Substance Use, 
            submit to Congress an initial report on--

                    ``(I) the States awarded planning grants under 
                paragraph (3);
                    ``(II) the criteria used in such selection; and
                    ``(III) the activities carried out by such States 
                under such planning grants.

                ``(ii) Interim report.--Not later than October 1, 2022, 
            the Administrator of the Centers for Medicare & Medicaid 
            Services shall, in consultation with the Director of the 
            Agency for Healthcare Research and Quality and the 
            Assistant Secretary for Mental Health and Substance Use, 
            submit to Congress an interim report--

                    ``(I) on activities carried out under the 
                demonstration project under this subsection;
                    ``(II) on the extent to which States selected under 
                paragraph (4) have achieved the stated goals submitted 
                in their applications under subparagraph (C) of such 
                paragraph;
                    ``(III) with a description of the strengths and 
                limitations of such demonstration project; and
                    ``(IV) with a plan for the sustainability of such 
                project.

                ``(iii) Final report.--Not later than October 1, 2024, 
            the Administrator of the Centers for Medicare & Medicaid 
            Services shall, in consultation with the Director of the 
            Agency for Healthcare Research and Quality and the 
            Assistant Secretary for Mental Health and Substance Use, 
            submit to Congress a final report--

                    ``(I) providing updates on the matters reported in 
                the interim report under clause (ii);
                    ``(II) including a description of any changes made 
                with respect to the demonstration project under this 
                subsection after the submission of such interim report; 
                and
                    ``(III) evaluating such demonstration project.

            ``(C) AHRQ report.--Not later than 3 years after the date 
        of the enactment of this subsection, the Director of the Agency 
        for Healthcare Research and Quality, in consultation with the 
        Administrator of the Centers for Medicare & Medicaid Services, 
        shall submit to Congress a summary on the experiences of States 
        awarded planning grants under paragraph (3) and States selected 
        under paragraph (4).
        ``(7) Data sharing and best practices.--During the period of 
    the demonstration project under this subsection, the Secretary 
    shall, in collaboration with States selected under paragraph (4), 
    facilitate data sharing and the development of best practices 
    between such States and States that were not so selected.
        ``(8) CMS funding.--There is appropriated, out of any funds in 
    the Treasury not otherwise appropriated, $5,000,000 to the Centers 
    for Medicare & Medicaid Services for purposes of implementing this 
    subsection. Such amount shall remain available until expended.''.
SEC. 1004. MEDICAID DRUG REVIEW AND UTILIZATION.
    (a) Medicaid Drug Utilization Review.--
        (1) State plan requirement.--Section 1902(a) of the Social 
    Security Act (42 U.S.C. 1396a(a)), as amended by section 1001, is 
    further amended--
            (A) in paragraph (83), at the end, by striking ``and'';
            (B) in paragraph (84), at the end, by striking the period 
        and inserting ``; and''; and
            (C) by inserting after paragraph (84) the following new 
        paragraph:
        ``(85) provide that the State is in compliance with the drug 
    review and utilization requirements under subsection (oo)(1).''.
        (2) Drug review and utilization requirements.--Section 1902 of 
    the Social Security Act (42 U.S.C. 1396a), as amended by section 
    1001, is further amended by adding at the end the following new 
    subsection:
    ``(oo) Drug Review and Utilization Requirements.--
        ``(1) In general.--For purposes of subsection (a)(85), the drug 
    review and utilization requirements under this subsection are, 
    subject to paragraph (3) and beginning October 1, 2019, the 
    following:
            ``(A) Claims review limitations.--
                ``(i) In general.--The State has in place--

                    ``(I) safety edits (as specified by the State) for 
                subsequent fills for opioids and a claims review 
                automated process (as designed and implemented by the 
                State) that indicates when an individual enrolled under 
                the State plan (or under a waiver of the State plan) is 
                prescribed a subsequent fill of opioids in excess of 
                any limitation that may be identified by the State;
                    ``(II) safety edits (as specified by the State) on 
                the maximum daily morphine equivalent that can be 
                prescribed to an individual enrolled under the State 
                plan (or under a waiver of the State plan) for 
                treatment of chronic pain and a claims review automated 
                process (as designed and implemented by the State) that 
                indicates when an individual enrolled under the plan 
                (or waiver) is prescribed the morphine equivalent for 
                such treatment in excess of any limitation that may be 
                identified by the State; and
                    ``(III) a claims review automated process (as 
                designed and implemented by the State) that monitors 
                when an individual enrolled under the State plan (or 
                under a waiver of the State plan) is concurrently 
                prescribed opioids and--

                        ``(aa) benzodiazepines; or
                        ``(bb) antipsychotics.
                ``(ii) Managed care entities.--The State requires each 
            managed care entity (as defined in section 1932(a)(1)(B)) 
            with respect to which the State has a contract under 
            section 1903(m) or under section 1905(t)(3) to have in 
            place, subject to paragraph (3), with respect to 
            individuals who are eligible for medical assistance under 
            the State plan (or under a waiver of the State plan) and 
            who are enrolled with the entity, the limitations described 
            in subclauses (I) and (II) of clause (i) and a claims 
            review automated process described in subclause (III) of 
            such clause.
                ``(iii) Rules of construction.--Nothing in this 
            subparagraph may be construed as prohibiting a State or 
            managed care entity from designing and implementing a 
            claims review automated process under this subparagraph 
            that provides for prospective or retrospective reviews of 
            claims. Nothing in this subparagraph shall be understood as 
            prohibiting the exercise of clinical judgment from a 
            provider enrolled as a participating provider in a State 
            plan (or waiver of the State plan) or contracting with a 
            managed care entity regarding the best items and services 
            for an individual enrolled under such State plan (or 
            waiver).
            ``(B) Program to monitor antipsychotic medications by 
        children.--The State has in place a program (as designed and 
        implemented by the State) to monitor and manage the appropriate 
        use of antipsychotic medications by children enrolled under the 
        State plan (or under a waiver of the State plan) and submits 
        annually to the Secretary such information as the Secretary may 
        require on activities carried out under such program for 
        individuals not more than the age of 18 years generally and 
        children in foster care specifically.
            ``(C) Fraud and abuse identification.--The State has in 
        place a process (as designed and implemented by the State) that 
        identifies potential fraud or abuse of controlled substances by 
        individuals enrolled under the State plan (or under a waiver of 
        the State plan), health care providers prescribing drugs to 
        individuals so enrolled, and pharmacies dispensing drugs to 
        individuals so enrolled.
            ``(D) Reports.--The State shall include in the annual 
        report submitted to the Secretary under section 1927(g)(3)(D) 
        information on the limitations, requirement, program, and 
        processes applied by the State under subparagraphs (A) through 
        (C) in accordance with such manner and time as specified by the 
        Secretary.
            ``(E) Clarification.--Nothing shall prevent a State from 
        satisfying the requirement--
                ``(i) described in subparagraph (A) by having safety 
            edits or a claims review automated process described in 
            such subparagraph that was in place before October 1, 2019;
                ``(ii) described in subparagraph (B) by having a 
            program described in such subparagraph that was in place 
            before such date; or
                ``(iii) described in subparagraph (C) by having a 
            process described in such subparagraph that was in place 
            before such date.
        ``(2) Annual report by secretary.--For each fiscal year 
    beginning with fiscal year 2020, the Secretary shall submit to 
    Congress a report on the most recent information submitted by 
    States under paragraph (1)(D).
        ``(3) Exceptions.--
            ``(A) Certain individuals exempted.--The drug review and 
        utilization requirements under this subsection shall not apply 
        with respect to an individual who--
                ``(i) is receiving--

                    ``(I) hospice or palliative care; or
                    ``(II) treatment for cancer;

                ``(ii) is a resident of a long-term care facility, of a 
            facility described in section 1905(d), or of another 
            facility for which frequently abused drugs are dispensed 
            for residents through a contract with a single pharmacy; or
                ``(iii) the State elects to treat as exempted from such 
            requirements.
            ``(B)  Exception relating to ensuring access.--In order to 
        ensure reasonable access to health care, the Secretary shall 
        waive the drug review and utilization requirements under this 
        subsection, with respect to a State, in the case of natural 
        disasters and similar situations, and in the case of the 
        provision of emergency services (as defined for purposes of 
        section 1860D-4(c)(5)(D)(ii)(II)).''.
        (3) Managed care entities.--Section 1932 of the Social Security 
    Act (42 U.S.C. 1396u-2) is amended by adding at the end the 
    following new subsection:
    ``(i) Drug Utilization Review Activities and Requirements.--
Beginning not later than October 1, 2019, each contract under a State 
plan with a managed care entity (other than a primary care case 
manager) under section 1903(m) shall provide that the entity is in 
compliance with the applicable provisions of section 438.3(s)(2) of 
title 42, Code of Federal Regulations, section 483.3(s)(4)) of such 
title, and section 483.3(s)(5) of such title, as such provisions were 
in effect on March 31, 2018.''.
    (b) Identifying and Addressing Inappropriate Prescribing and 
Billing Practices Under Medicaid.--
        (1) In general.--Section 1927(g) of the Social Security Act (42 
    U.S.C. 1396r-8(g)) is amended--
            (A) in paragraph (1)(A)--
                (i) by striking ``of section 1903(i)(10)(B)'' and 
            inserting ``of section 1902(a)(54)'';
                (ii) by striking ``, by not later than January 1, 
            1993,'';
                (iii) by inserting after ``gross overuse,'' the 
            following: ``excessive utilization,''; and
                (iv) by striking ``or inappropriate or medically 
            unnecessary care'' and inserting ``inappropriate or 
            medically unnecessary care, or prescribing or billing 
            practices that indicate abuse or excessive utilization''; 
            and
            (B) in paragraph (2)(B)--
                (i) by inserting after ``gross overuse,'' the 
            following: ``excessive utilization,''; and
                (ii) by striking ``or inappropriate or medically 
            unnecessary care'' and inserting ``inappropriate or 
            medically unnecessary care, or prescribing or billing 
            practices that indicate abuse or excessive utilization''.
        (2) Effective date.--The amendments made by paragraph (1) shall 
    take effect with respect to retrospective drug use reviews 
    conducted on or after October 1, 2020.
SEC. 1005. GUIDANCE TO IMPROVE CARE FOR INFANTS WITH NEONATAL 
ABSTINENCE SYNDROME AND THEIR MOTHERS; GAO STUDY ON GAPS IN MEDICAID 
COVERAGE FOR PREGNANT AND POSTPARTUM WOMEN WITH SUBSTANCE USE DISORDER.
    (a) Guidance.--Not later than 1 year after the date of the 
enactment of this Act, the Secretary of Health and Human Services shall 
issue guidance to improve care for infants with neonatal abstinence 
syndrome and their families. Such guidance shall include--
        (1) best practices from States with respect to innovative or 
    evidenced-based payment models that focus on prevention, screening, 
    treatment, plans of safe care, and postdischarge services for 
    mothers and fathers with substance use disorders and babies with 
    neonatal abstinence syndrome that improve care and clinical 
    outcomes;
        (2) recommendations for States on available financing options 
    under the Medicaid program under title XIX of such Act and under 
    the Children's Health Insurance Program under title XXI of such Act 
    for Children's Health Insurance Program Health Services Initiative 
    funds for parents with substance use disorders, infants with 
    neonatal abstinence syndrome, and home-visiting services;
        (3) guidance and technical assistance to State Medicaid 
    agencies regarding additional flexibilities and incentives related 
    to screening, prevention, and postdischarge services, including 
    parenting supports, and infant-caregiver bonding, including 
    breastfeeding when it is appropriate; and
        (4) guidance regarding suggested terminology and ICD codes to 
    identify infants with neonatal abstinence syndrome and neonatal 
    opioid withdrawal syndrome, which could include opioid-exposure, 
    opioid withdrawal not requiring pharmacotherapy, and opioid 
    withdrawal requiring pharmacotherapy.
    (b) GAO Study.--Not later than 1 year after the date of the 
enactment of this Act, the Comptroller General of the United States 
shall conduct a study, and submit to Congress a report, addressing gaps 
in coverage for pregnant women with substance use disorder under the 
Medicaid program under title XIX of the Social Security Act, and gaps 
in coverage for postpartum women with substance use disorder who had 
coverage during their pregnancy under the Medicaid program under such 
title.
SEC. 1006. MEDICAID HEALTH HOMES FOR SUBSTANCE-USE-DISORDER MEDICAID 
ENROLLEES.
    (a) Extension of Enhanced FMAP for Certain Health Homes for 
Individuals With Substance Use Disorders.--Section 1945(c) of the 
Social Security Act (42 U.S.C. 1396w-4(c)) is amended--
        (1) in paragraph (1), by inserting ``subject to paragraph 
    (4),'' after ``except that,''; and
        (2) by adding at the end the following new paragraph:
        ``(4) Special rule relating to substance use disorder health 
    homes.--
            ``(A) In general.--In the case of a State with an SUD-
        focused State plan amendment approved by the Secretary on or 
        after October 1, 2018, the Secretary may, at the request of the 
        State, extend the application of the Federal medical assistance 
        percentage described in paragraph (1) to payments for the 
        provision of health home services to SUD-eligible individuals 
        under such State plan amendment, in addition to the first 8 
        fiscal year quarters the State plan amendment is in effect, for 
        the subsequent 2 fiscal year quarters that the State plan 
        amendment is in effect. Nothing in this section shall be 
        construed as prohibiting a State with a State plan amendment 
        that is approved under this section and that is not an SUD-
        focused State plan amendment from additionally having approved 
        on or after such date an SUD-focused State plan amendment under 
        this section, including for purposes of application of this 
        paragraph.
            ``(B) Report requirements.--In the case of a State with an 
        SUD-focused State plan amendment for which the application of 
        the Federal medical assistance percentage has been extended 
        under subparagraph (A), such State shall, at the end of the 
        period of such State plan amendment, submit to the Secretary a 
        report on the following, with respect to SUD-eligible 
        individuals provided health home services under such State plan 
        amendment:
                ``(i) The quality of health care provided to such 
            individuals, with a focus on outcomes relevant to the 
            recovery of each such individual.
                ``(ii) The access of such individuals to health care.
                ``(iii) The total expenditures of such individuals for 
            health care.
        For purposes of this subparagraph, the Secretary shall specify 
        all applicable measures for determining quality, access, and 
        expenditures.
            ``(C) Best practices.--Not later than October 1, 2020, the 
        Secretary shall make publicly available on the internet website 
        of the Centers for Medicare & Medicaid Services best practices 
        for designing and implementing an SUD-focused State plan 
        amendment, based on the experiences of States that have State 
        plan amendments approved under this section that include SUD-
        eligible individuals.
            ``(D) Definitions.--For purposes of this paragraph:
                ``(i) SUD-eligible individuals.--The term `SUD-eligible 
            individual' means, with respect to a State, an individual 
            who satisfies all of the following:

                    ``(I) The individual is an eligible individual with 
                chronic conditions.
                    ``(II) The individual is an individual with a 
                substance use disorder.
                    ``(III) The individual has not previously received 
                health home services under any other State plan 
                amendment approved for the State under this section by 
                the Secretary.

                ``(ii) SUD-focused state plan amendment.--The term 
            `SUD-focused State plan amendment' means a State plan 
            amendment under this section that is designed to provide 
            health home services primarily to SUD-eligible 
            individuals.''.
    (b) Requirement for State Medicaid Plans To Provide Coverage for 
Medication-Assisted Treatment.--
        (1) Requirement for state medicaid plans to provide coverage 
    for medication-assisted treatment.--Section 1902(a)(10)(A) of the 
    Social Security Act (42 U.S.C. 1396a(a)(10)(A)) is amended, in the 
    matter preceding clause (i), by striking ``and (28)'' and inserting 
    ``(28), and (29)''.
        (2) Inclusion of medication-assisted treatment as medical 
    assistance.--Section 1905(a) of the Social Security Act (42 U.S.C. 
    1396d(a)) is amended--
            (A) in paragraph (28), by striking ``and'' at the end;
            (B) by redesignating paragraph (29) as paragraph (30); and
            (C) by inserting after paragraph (28) the following new 
        paragraph:
        ``(29) subject to paragraph (2) of subsection (ee), for the 
    period beginning October 1, 2020, and ending September 30, 2025, 
    medication-assisted treatment (as defined in paragraph (1) of such 
    subsection); and''.
        (3) Medication-assisted treatment defined; waivers.--Section 
    1905 of the Social Security Act (42 U.S.C. 1396d) is amended by 
    adding at the end the following new subsection:
    ``(ee) Medication-Assisted Treatment.--
        ``(1) Definition.--For purposes of subsection (a)(29), the term 
    `medication-assisted treatment'--
            ``(A) means all drugs approved under section 505 of the 
        Federal Food, Drug, and Cosmetic Act (21 U.S.C. 355), including 
        methadone, and all biological products licensed under section 
        351 of the Public Health Service Act (42 U.S.C. 262) to treat 
        opioid use disorders; and
            ``(B) includes, with respect to the provision of such drugs 
        and biological products, counseling services and behavioral 
        therapy.
        ``(2) Exception.--The provisions of paragraph (29) of 
    subsection (a) shall not apply with respect to a State for the 
    period specified in such paragraph, if before the beginning of such 
    period the State certifies to the satisfaction of the Secretary 
    that implementing such provisions statewide for all individuals 
    eligible to enroll in the State plan (or waiver of the State plan) 
    would not be feasible by reason of a shortage of qualified 
    providers of medication-assisted treatment, or facilities providing 
    such treatment, that will contract with the State or a managed care 
    entity with which the State has a contract under section 1903(m) or 
    under section 1905(t)(3).''.
        (4) Effective date.--
            (A) In general.--Subject to subparagraph (B), the 
        amendments made by this subsection shall apply with respect to 
        medical assistance provided on or after October 1, 2020, and 
        before October 1, 2025.
            (B) Exception for state legislation.--In the case of a 
        State plan under title XIX of the Social Security Act (42 
        U.S.C. 1396 et seq.) that the Secretary of Health and Human 
        Services determines requires State legislation in order for the 
        respective plan to meet any requirement imposed by the 
        amendments made by this subsection, the respective plan shall 
        not be regarded as failing to comply with the requirements of 
        such title solely on the basis of its failure to meet such an 
        additional requirement before the first day of the first 
        calendar quarter beginning after the close of the first regular 
        session of the State legislature that begins after the date of 
        the enactment of this Act. For purposes of the previous 
        sentence, in the case of a State that has a 2-year legislative 
        session, each year of the session shall be considered to be a 
        separate regular session of the State legislature.
SEC. 1007. CARING RECOVERY FOR INFANTS AND BABIES.
    (a) State Plan Amendment.--Section 1902(a) of the Social Security 
Act (42 U.S.C. 1396a(a)), as amended by sections 1001 and 1004, is 
further amended--
        (1) in paragraph (84)(C), by striking ``and'' after the 
    semicolon;
        (2) in paragraph (85), by striking the period at the end and 
    inserting ``; and''; and
        (3) by inserting after paragraph (85), the following new 
    paragraph:
        ``(86) provide, at the option of the State, for making medical 
    assistance available on an inpatient or outpatient basis at a 
    residential pediatric recovery center (as defined in subsection 
    (pp)) to infants with neonatal abstinence syndrome.''.
    (b) Residential Pediatric Recovery Center Defined.--Section 1902 of 
such Act (42 U.S.C. 1396a), as amended by sections 1001 and 1004, is 
further amended by adding at the end the following new subsection:
    ``(pp) Residential Pediatric Recovery Center Defined.--
        ``(1) In general.--For purposes of section 1902(a)(86), the 
    term `residential pediatric recovery center' means a center or 
    facility that furnishes items and services for which medical 
    assistance is available under the State plan to infants with the 
    diagnosis of neonatal abstinence syndrome without any other 
    significant medical risk factors.
        ``(2) Counseling and services.--A residential pediatric 
    recovery center may offer counseling and other services to mothers 
    (and other appropriate family members and caretakers) of infants 
    receiving treatment at such centers if such services are otherwise 
    covered under the State plan under this title or under a waiver of 
    such plan. Such other services may include the following:
            ``(A) Counseling or referrals for services.
            ``(B) Activities to encourage caregiver-infant bonding.
            ``(C) Training on caring for such infants.''.
    (c) Effective Date.--The amendments made by this section take 
effect on the date of enactment of this Act and shall apply to medical 
assistance furnished on or after that date, without regard to final 
regulations to carry out such amendments being promulgated as of such 
date.
SEC. 1008. PEER SUPPORT ENHANCEMENT AND EVALUATION REVIEW.
    (a) In General.--Not later than 2 years after the date of the 
enactment of this Act, the Comptroller General of the United States 
shall submit to the Committee on Energy and Commerce of the House of 
Representatives, the Committee on Finance of the Senate, and the 
Committee on Health, Education, Labor and Pensions of the Senate a 
report on the provision of peer support services under the Medicaid 
program.
    (b) Content of Report.--
        (1) In general.--The report required under subsection (a) shall 
    include the following information:
            (A) Information on State coverage of peer support services 
        under Medicaid, including--
                (i) the mechanisms through which States may provide 
            such coverage, including through existing statutory 
            authority or through waivers;
                (ii) the populations to which States have provided such 
            coverage;
                (iii) the payment models, including any alternative 
            payment models, used by States to pay providers of such 
            services; and
                (iv) where available, information on Federal and State 
            spending under Medicaid for peer support services.
            (B) Information on selected State experiences in providing 
        medical assistance for peer support services under State 
        Medicaid plans and whether States measure the effects of 
        providing such assistance with respect to--
                (i) improving access to behavioral health services;
                (ii) improving early detection, and preventing 
            worsening, of behavioral health disorders;
                (iii) reducing chronic and comorbid conditions; and
                (iv) reducing overall health costs.
        (2) Recommendations.--The report required under subsection (a) 
    shall include recommendations, including recommendations for such 
    legislative and administrative actions related to improving 
    services, including peer support services, and access to peer 
    support services under Medicaid as the Comptroller General of the 
    United States determines appropriate.
SEC. 1009. MEDICAID SUBSTANCE USE DISORDER TREATMENT VIA TELEHEALTH.
    (a) Definitions.--In this section:
        (1) Comptroller general.--The term ``Comptroller General'' 
    means the Comptroller General of the United States.
        (2) School-based health center.--The term ``school-based health 
    center'' has the meaning given that term in section 2110(c)(9) of 
    the Social Security Act (42 U.S.C. 1397jj(c)(9)).
        (3) Secretary.--The term ``Secretary'' means the Secretary of 
    Health and Human Services.
        (4) Underserved area.--The term ``underserved area'' means a 
    health professional shortage area (as defined in section 
    332(a)(1)(A) of the Public Health Service Act (42 U.S.C. 
    254e(a)(1)(A))) and a medically underserved area (according to a 
    designation under section 330(b)(3)(A) of the Public Health Service 
    Act (42 U.S.C. 254b(b)(3)(A))).
    (b) Guidance to States Regarding Federal Reimbursement for 
Furnishing Services and Treatment for Substance Use Disorders Under 
Medicaid Using Services Delivered Via Telehealth, Including in School-
Based Health Centers.--Not later than 1 year after the date of 
enactment of this Act, the Secretary, acting through the Administrator 
of the Centers for Medicare & Medicaid Services, shall issue guidance 
to States on the following:
        (1) State options for Federal reimbursement of expenditures 
    under Medicaid for furnishing services and treatment for substance 
    use disorders, including assessment, medication-assisted treatment, 
    counseling, medication management, and medication adherence with 
    prescribed medication regimes, using services delivered via 
    telehealth. Such guidance shall also include guidance on furnishing 
    services and treatments that address the needs of high-risk 
    individuals, including at least the following groups:
            (A) American Indians and Alaska Natives.
            (B) Adults under the age of 40.
            (C) Individuals with a history of non-fatal overdose.
            (D) Individuals with a co-occurring serious mental illness 
        and substance use disorder.
        (2) State options for Federal reimbursement of expenditures 
    under Medicaid for education directed to providers serving Medicaid 
    beneficiaries with substance use disorders using the hub and spoke 
    model, through contracts with managed care entities, through 
    administrative claiming for disease management activities, and 
    under Delivery System Reform Incentive Payment (``DSRIP'') 
    programs.
        (3) State options for Federal reimbursement of expenditures 
    under Medicaid for furnishing services and treatment for substance 
    use disorders for individuals enrolled in Medicaid in a school-
    based health center using services delivered via telehealth.
    (c) GAO Evaluation of Children's Access to Services and Treatment 
for Substance Use Disorders Under Medicaid.--
        (1) Study.--The Comptroller General shall evaluate children's 
    access to services and treatment for substance use disorders under 
    Medicaid. The evaluation shall include an analysis of State options 
    for improving children's access to such services and treatment and 
    for improving outcomes, including by increasing the number of 
    Medicaid providers who offer services or treatment for substance 
    use disorders in a school-based health center using services 
    delivered via telehealth, particularly in rural and underserved 
    areas. The evaluation shall include an analysis of Medicaid 
    provider reimbursement rates for services and treatment for 
    substance use disorders.
        (2) Report.--Not later than 1 year after the date of enactment 
    of this Act, the Comptroller General shall submit to Congress a 
    report containing the results of the evaluation conducted under 
    paragraph (1), together with recommendations for such legislation 
    and administrative action as the Comptroller General determines 
    appropriate.
    (d) Report on Reducing Barriers to Using Services Delivered Via 
Telehealth and Remote Patient Monitoring for Pediatric Populations 
Under Medicaid.--
        (1) In general.--Not later than 1 year after the date of 
    enactment of this Act, the Secretary, acting through the 
    Administrator of the Centers for Medicare & Medicaid Services, 
    shall issue a report to the Committee on Finance of the Senate and 
    the Committee on Energy and Commerce of the House of 
    Representatives identifying best practices and potential solutions 
    for reducing barriers to using services delivered via telehealth to 
    furnish services and treatment for substance use disorders among 
    pediatric populations under Medicaid. The report shall include--
            (A) analyses of the best practices, barriers, and potential 
        solutions for using services delivered via telehealth to 
        diagnose and provide services and treatment for children with 
        substance use disorders, including opioid use disorder; and
            (B) identification and analysis of the differences, if any, 
        in furnishing services and treatment for children with 
        substance use disorders using services delivered via telehealth 
        and using services delivered in person, such as, and to the 
        extent feasible, with respect to--
                (i) utilization rates;
                (ii) costs;
                (iii) avoidable inpatient admissions and readmissions;
                (iv) quality of care; and
                (v) patient, family, and provider satisfaction.
        (2) Publication.--The Secretary shall publish the report 
    required under paragraph (1) on a public internet website of the 
    Department of Health and Human Services.
SEC. 1010. ENHANCING PATIENT ACCESS TO NON-OPIOID TREATMENT OPTIONS.
    Not later than January 1, 2019, the Secretary of Health and Human 
Services, acting through the Administrator of the Centers for Medicare 
& Medicaid Services, shall issue 1 or more final guidance documents, or 
update existing guidance documents, to States regarding mandatory and 
optional items and services that may be provided under a State plan 
under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.), or 
under a waiver of such a plan, for non-opioid treatment and management 
of pain, including, but not limited to, evidence-based, non-opioid 
pharmacological therapies and non-pharmacological therapies.
SEC. 1011. ASSESSING BARRIERS TO OPIOID USE DISORDER TREATMENT.
    (a) Study.--
        (1) In general.--The Comptroller General of the United States 
    (in this section referred to as the ``Comptroller General'') shall 
    conduct a study regarding the barriers to providing medication used 
    in the treatment of substance use disorders under Medicaid 
    distribution models such as the ``buy-and-bill'' model, and options 
    for State Medicaid programs to remove or reduce such barriers. The 
    study shall include analyses of each of the following models of 
    distribution of substance use disorder treatment medications, 
    particularly buprenorphine, naltrexone, and buprenorphine-naloxone 
    combinations:
            (A) The purchasing, storage, and administration of 
        substance use disorder treatment medications by providers.
            (B) The dispensing of substance use disorder treatment 
        medications by pharmacists.
            (C) The ordering, prescribing, and obtaining substance use 
        disorder treatment medications on demand from specialty 
        pharmacies by providers.
        (2) Requirements.--For each model of distribution specified in 
    paragraph (1), the Comptroller General shall evaluate how each 
    model presents barriers or could be used by selected State Medicaid 
    programs to reduce the barriers related to the provision of 
    substance use disorder treatment by examining what is known about 
    the effects of the model of distribution on--
            (A) Medicaid beneficiaries' access to substance use 
        disorder treatment medications;
            (B) the differential cost to the program between each 
        distribution model for medication-assisted treatment; and
            (C) provider willingness to provide or prescribe substance 
        use disorder treatment medications.
    (b) Report.--Not later than 15 months after the date of the 
enactment of this Act, the Comptroller General shall submit to Congress 
a report containing the results of the study conducted under subsection 
(a), together with recommendations for such legislation and 
administrative action as the Comptroller General determines 
appropriate.
SEC. 1012. HELP FOR MOMS AND BABIES.
    (a) Medicaid State Plan.--Section 1905(a) of the Social Security 
Act (42 U.S.C. 1396d(a)), as amended by section 1006, is further 
amended by adding at the end the following new sentence: ``In the case 
of a woman who is eligible for medical assistance on the basis of being 
pregnant (including through the end of the month in which the 60-day 
period beginning on the last day of her pregnancy ends), who is a 
patient in an institution for mental diseases for purposes of receiving 
treatment for a substance use disorder, and who was enrolled for 
medical assistance under the State plan immediately before becoming a 
patient in an institution for mental diseases or who becomes eligible 
to enroll for such medical assistance while such a patient, the 
exclusion from the definition of `medical assistance' set forth in the 
subdivision (B) following paragraph (30) of the first sentence of this 
subsection shall not be construed as prohibiting Federal financial 
participation for medical assistance for items or services that are 
provided to the woman outside of the institution.''.
    (b) Effective Date.--
        (1) In general.--Except as provided in paragraph (2), the 
    amendment made by subsection (a) shall take effect on the date of 
    enactment of this Act.
        (2) Rule for changes requiring state legislation.--In the case 
    of a State plan under title XIX of the Social Security Act which 
    the Secretary of Health and Human Services determines requires 
    State legislation (other than legislation appropriating funds) in 
    order for the plan to meet the additional requirements imposed by 
    the amendment made by subsection (a), the State plan shall not be 
    regarded as failing to comply with the requirements of such title 
    solely on the basis of its failure to meet these additional 
    requirements before the first day of the first calendar quarter 
    beginning after the close of the first regular session of the State 
    legislature that begins after the date of the enactment of this 
    Act. For purposes of the previous sentence, in the case of a State 
    that has a 2-year legislative session, each year of such session 
    shall be deemed to be a separate regular session of the State 
    legislature.
SEC. 1013. SECURING FLEXIBILITY TO TREAT SUBSTANCE USE DISORDERS.
    Section 1903(m) of the Social Security Act (42 U.S.C. 1396b(m)) is 
amended by adding at the end the following new paragraph:
    ``(7) Payment shall be made under this title to a State for 
expenditures for capitation payments described in section 438.6(e) of 
title 42, Code of Federal Regulations (or any successor regulation).''.
SEC. 1014. MACPAC STUDY AND REPORT ON MAT UTILIZATION CONTROLS UNDER 
STATE MEDICAID PROGRAMS.
    (a) Study.--The Medicaid and CHIP Payment and Access Commission 
shall conduct a study and analysis of utilization control policies 
applied to medication-assisted treatment for substance use disorders 
under State Medicaid programs, including policies and procedures 
applied both in fee-for-service Medicaid and in risk-based managed care 
Medicaid, which shall--
        (1) include an inventory of such utilization control policies 
    and related protocols for ensuring access to medically necessary 
    treatment;
        (2) determine whether managed care utilization control policies 
    and procedures for medication-assisted treatment for substance use 
    disorders are consistent with section 438.210(a)(4)(ii) of title 
    42, Code of Federal Regulations; and
        (3) identify policies that--
            (A) limit an individual's access to medication-assisted 
        treatment for a substance use disorder by limiting the quantity 
        of medication-assisted treatment prescriptions, or the number 
        of refills for such prescriptions, available to the individual 
        as part of a prior authorization process or similar utilization 
        protocols; and
            (B) apply without evaluating individual instances of fraud, 
        waste, or abuse.
    (b) Report.--Not later than 1 year after the date of the enactment 
of this Act, the Medicaid and CHIP Payment and Access Commission shall 
make publicly available a report containing the results of the study 
conducted under subsection (a).
SEC. 1015. OPIOID ADDICTION TREATMENT PROGRAMS ENHANCEMENT.
    (a) T-MSIS Substance Use Disorder Data Book.--
        (1) In general.--Not later than the date that is 12 months 
    after the date of enactment of this Act, the Secretary of Health 
    and Human Services (in this section referred to as the 
    ``Secretary'') shall publish on the public website of the Centers 
    for Medicare & Medicaid Services a report with comprehensive data 
    on the prevalence of substance use disorders in the Medicaid 
    beneficiary population and services provided for the treatment of 
    substance use disorders under Medicaid.
        (2) Content of report.--The report required under paragraph (1) 
    shall include, at a minimum, the following data for each State 
    (including, to the extent available, for the District of Columbia, 
    Puerto Rico, the United States Virgin Islands, Guam, the Northern 
    Mariana Islands, and American Samoa):
            (A) The number and percentage of individuals enrolled in 
        the State Medicaid plan or waiver of such plan in each of the 
        major enrollment categories (as defined in a public letter from 
        the Medicaid and CHIP Payment and Access Commission to the 
        Secretary) who have been diagnosed with a substance use 
        disorder and whether such individuals are enrolled under the 
        State Medicaid plan or a waiver of such plan, including the 
        specific waiver authority under which they are enrolled, to the 
        extent available.
            (B) A list of the substance use disorder treatment services 
        by each major type of service, such as counseling, medication-
        assisted treatment, peer support, residential treatment, and 
        inpatient care, for which beneficiaries in each State received 
        at least 1 service under the State Medicaid plan or a waiver of 
        such plan.
            (C) The number and percentage of individuals with a 
        substance use disorder diagnosis enrolled in the State Medicaid 
        plan or waiver of such plan who received substance use disorder 
        treatment services under such plan or waiver by each major type 
        of service under subparagraph (B) within each major setting 
        type, such as outpatient, inpatient, residential, and other 
        home-based and community-based settings.
            (D) The number of services provided under the State 
        Medicaid plan or waiver of such plan per individual with a 
        substance use disorder diagnosis enrolled in such plan or 
        waiver for each major type of service under subparagraph (B).
            (E) The number and percentage of individuals enrolled in 
        the State Medicaid plan or waiver, by major enrollment 
        category, who received substance use disorder treatment 
        through--
                (i) a medicaid managed care entity (as defined in 
            section 1932(a)(1)(B) of the Social Security Act (42 U.S.C. 
            1396u-2(a)(1)(B))), including the number of such 
            individuals who received such assistance through a prepaid 
            inpatient health plan or a prepaid ambulatory health plan;
                (ii) a fee-for-service payment model; or
                (iii) an alternative payment model, to the extent 
            available.
            (F) The number and percentage of individuals with a 
        substance use disorder who receive substance use disorder 
        treatment services in an outpatient or home-based and 
        community-based setting after receiving treatment in an 
        inpatient or residential setting, and the number of services 
        received by such individuals in the outpatient or home-based 
        and community-based setting.
        (3) Annual updates.--The Secretary shall issue an updated 
    version of the report required under paragraph (1) not later than 
    January 1 of each calendar year through 2024.
        (4) Use of t-msis data.--The report required under paragraph 
    (1) and updates required under paragraph (3) shall--
            (A) use data and definitions from the Transformed Medicaid 
        Statistical Information System (``T-MSIS'') data set that is no 
        more than 12 months old on the date that the report or update 
        is published; and
            (B) as appropriate, include a description with respect to 
        each State of the quality and completeness of the data and 
        caveats describing the limitations of the data reported to the 
        Secretary by the State that is sufficient to communicate the 
        appropriate uses for the information.
    (b) Making T-MSIS Data on Substance Use Disorders Available to 
Researchers.--
        (1) In general.--The Secretary shall publish in the Federal 
    Register a system of records notice for the data specified in 
    paragraph (2) for the Transformed Medicaid Statistical Information 
    System, in accordance with section 552a(e)(4) of title 5, United 
    States Code. The notice shall outline policies that protect the 
    security and privacy of the data that, at a minimum, meet the 
    security and privacy policies of SORN 09-70-0541 for the Medicaid 
    Statistical Information System.
        (2) Required data.--The data covered by the systems of records 
    notice required under paragraph (1) shall be sufficient for 
    researchers and States to analyze the prevalence of substance use 
    disorders in the Medicaid beneficiary population and the treatment 
    of substance use disorders under Medicaid across all States 
    (including the District of Columbia, Puerto Rico, the United States 
    Virgin Islands, Guam, the Northern Mariana Islands, and American 
    Samoa), forms of treatment, and treatment settings.
        (3) Initiation of data-sharing activities.--Not later than 
    January 1, 2019, the Secretary shall initiate the data-sharing 
    activities outlined in the notice required under paragraph (1).
SEC. 1016. BETTER DATA SHARING TO COMBAT THE OPIOID CRISIS.
    (a) In General.--Section 1903(m) of the Social Security Act (42 
U.S.C. 1396b(m)), as amended by section 1013, is further amended by 
adding at the end the following new paragraph:
    ``(8)(A) The State agency administering the State plan under this 
title may have reasonable access, as determined by the State, to 1 or 
more prescription drug monitoring program databases administered or 
accessed by the State to the extent the State agency is permitted to 
access such databases under State law.
    ``(B) Such State agency may facilitate reasonable access, as 
determined by the State, to 1 or more prescription drug monitoring 
program databases administered or accessed by the State, to same extent 
that the State agency is permitted under State law to access such 
databases, for--
        ``(i) any provider enrolled under the State plan to provide 
    services to Medicaid beneficiaries; and
        ``(ii) any managed care entity (as defined under section 
    1932(a)(1)(B)) that has a contract with the State under this 
    subsection or under section 1905(t)(3).
    ``(C) Such State agency may share information in such databases, to 
the same extent that the State agency is permitted under State law to 
share information in such databases, with--
        ``(i) any provider enrolled under the State plan to provide 
    services to Medicaid beneficiaries; and
        ``(ii) any managed care entity (as defined under section 
    1932(a)(1)(B)) that has a contract with the State under this 
    subsection or under section 1905(t)(3).''.
    (b) Security and Privacy.--All applicable State and Federal 
security and privacy protections and laws shall apply to any State 
agency, individual, or entity accessing 1 or more prescription drug 
monitoring program databases or obtaining information in such databases 
in accordance with section 1903(m)(8) of the Social Security Act (as 
added by subsection (a)).
    (c) Effective Date.--The amendment made by subsection (a) shall 
take effect on the date of enactment of this Act.
SEC. 1017. REPORT ON INNOVATIVE STATE INITIATIVES AND STRATEGIES TO 
PROVIDE HOUSING-RELATED SERVICES AND SUPPORTS TO INDIVIDUALS STRUGGLING 
WITH SUBSTANCE USE DISORDERS UNDER MEDICAID.
    (a) In General.--Not later than 1 year after the date of enactment 
of this Act, the Secretary of Health and Human Services shall issue a 
report to Congress describing innovative State initiatives and 
strategies for providing housing-related services and supports under a 
State Medicaid program to individuals with substance use disorders who 
are experiencing or at risk of experiencing homelessness.
    (b) Content of Report.--The report required under subsection (a) 
shall describe the following:
        (1) Existing methods and innovative strategies developed and 
    adopted by State Medicaid programs that have achieved positive 
    outcomes in increasing housing stability among Medicaid 
    beneficiaries with substance use disorders who are experiencing or 
    at risk of experiencing homelessness, including Medicaid 
    beneficiaries with substance use disorders who are--
            (A) receiving treatment for substance use disorders in 
        inpatient, residential, outpatient, or home-based and 
        community-based settings;
            (B) transitioning between substance use disorder treatment 
        settings; or
            (C) living in supportive housing or another model of 
        affordable housing.
        (2) Strategies employed by Medicaid managed care organizations, 
    primary care case managers, hospitals, accountable care 
    organizations, and other care coordination providers to deliver 
    housing-related services and supports and to coordinate services 
    provided under State Medicaid programs across different treatment 
    settings.
        (3) Innovative strategies and lessons learned by States with 
    Medicaid waivers approved under section 1115 or 1915 of the Social 
    Security Act (42 U.S.C. 1315, 1396n), including--
            (A) challenges experienced by States in designing, 
        securing, and implementing such waivers or plan amendments;
            (B) how States developed partnerships with other 
        organizations such as behavioral health agencies, State housing 
        agencies, housing providers, health care services agencies and 
        providers, community-based organizations, and health insurance 
        plans to implement waivers or State plan amendments; and
            (C) how and whether States plan to provide Medicaid 
        coverage for housing-related services and supports in the 
        future, including by covering such services and supports under 
        State Medicaid plans or waivers.
        (4) Existing opportunities for States to provide housing-
    related services and supports through a Medicaid waiver under 
    sections 1115 or 1915 of the Social Security Act (42 U.S.C. 1315, 
    1396n) or through a State Medicaid plan amendment, such as the 
    Assistance in Community Integration Service pilot program, which 
    promotes supportive housing and other housing-related supports 
    under Medicaid for individuals with substance use disorders and for 
    which Maryland has a waiver approved under such section 1115 to 
    conduct the program.
        (5) Innovative strategies and partnerships developed and 
    implemented by State Medicaid programs or other entities to 
    identify and enroll eligible individuals with substance use 
    disorders who are experiencing or at risk of experiencing 
    homelessness in State Medicaid programs.
SEC. 1018. TECHNICAL ASSISTANCE AND SUPPORT FOR INNOVATIVE STATE 
STRATEGIES TO PROVIDE HOUSING-RELATED SUPPORTS UNDER MEDICAID.
    (a) In General.--The Secretary of Health and Human Services shall 
provide technical assistance and support to States regarding the 
development and expansion of innovative State strategies (including 
through State Medicaid demonstration projects) to provide housing-
related supports and services and care coordination services under 
Medicaid to individuals with substance use disorders.
    (b) Report.--Not later than 180 days after the date of enactment of 
this Act, the Secretary shall issue a report to Congress detailing a 
plan of action to carry out the requirements of subsection (a).

       TITLE II--MEDICARE PROVISIONS TO ADDRESS THE OPIOID CRISIS

SEC. 2001. EXPANDING THE USE OF TELEHEALTH SERVICES FOR THE TREATMENT 
OF OPIOID USE DISORDER AND OTHER SUBSTANCE USE DISORDERS.
    (a) In General.--Section 1834(m) of the Social Security Act (42 
U.S.C. 1395m(m)) is amended--
        (1) in paragraph (2)(B)--
            (A) in clause (i), in the matter preceding subclause (I), 
        by striking ``clause (ii)'' and inserting ``clause (ii) and 
        paragraph (6)(C)''; and
            (B) in clause (ii), in the heading, by striking ``for home 
        dialysis therapy'';
        (2) in paragraph (4)(C)--
            (A) in clause (i), by striking ``paragraph (6)'' and 
        inserting ``paragraphs (5), (6), and (7)''; and
            (B) in clause (ii)(X), by inserting ``or telehealth 
        services described in paragraph (7)'' before the period at the 
        end; and
        (3) by adding at the end the following new paragraph:
        ``(7) Treatment of substance use disorder services furnished 
    through telehealth.--The geographic requirements described in 
    paragraph (4)(C)(i) shall not apply with respect to telehealth 
    services furnished on or after July 1, 2019, to an eligible 
    telehealth individual with a substance use disorder diagnosis for 
    purposes of treatment of such disorder or co-occurring mental 
    health disorder, as determined by the Secretary, at an originating 
    site described in paragraph (4)(C)(ii) (other than an originating 
    site described in subclause (IX) of such paragraph).''.
    (b) Implementation.--The Secretary of Health and Human Services (in 
this section referred to as the ``Secretary'') may implement the 
amendments made by this section by interim final rule.
    (c) Report.--
        (1) In general.--Not later than 5 years after the date of the 
    enactment of this Act, the Secretary shall submit to Congress a 
    report on the impact of the implementation of the amendments made 
    by this section with respect to telehealth services under section 
    1834(m) of the Social Security Act (42 U.S.C. 1395m(m)) on--
            (A) the utilization of health care items and services under 
        title XVIII of such Act (42 U.S.C. 1395 et seq.) related to 
        substance use disorders, including emergency department visits; 
        and
            (B) health outcomes related to substance use disorders, 
        such as opioid overdose deaths.
        (2) Funding.--For purposes of carrying out paragraph (1), in 
    addition to funds otherwise available, the Secretary shall provide 
    for the transfer, from the Federal Supplementary Medical Insurance 
    Trust Fund under section 1841, of $3,000,000 to the Centers for 
    Medicare & Medicaid Services Program Management Account to remain 
    available until expended.
SEC. 2002. COMPREHENSIVE SCREENINGS FOR SENIORS.
    (a) Initial Preventive Physical Examination.--Section 1861(ww) of 
the Social Security Act (42 U.S.C. 1395x(ww)) is amended--
        (1) in paragraph (1)--
            (A) by striking ``paragraph (2) and'' and inserting 
        ``paragraph (2),''; and
            (B) by inserting ``and the furnishing of a review of any 
        current opioid prescriptions (as defined in paragraph (4)),'' 
        after ``upon the agreement with the individual,''; and
        (2) in paragraph (2)--
            (A) by redesignating subparagraph (N) as subparagraph (O); 
        and
            (B) by inserting after subparagraph (M) the following new 
        subparagraph:
            ``(N) Screening for potential substance use disorders.''; 
        and
        (3) by adding at the end the following new paragraph:
    ``(4) For purposes of paragraph (1), the term `a review of any 
current opioid prescriptions' means, with respect to an individual 
determined to have a current prescription for opioids--
        ``(A) a review of the potential risk factors to the individual 
    for opioid use disorder;
        ``(B) an evaluation of the individual's severity of pain and 
    current treatment plan;
        ``(C) the provision of information on non-opioid treatment 
    options; and
        ``(D) a referral to a specialist, as appropriate.''.
    (b) Annual Wellness Visit.--Section 1861(hhh)(2) of the Social 
Security Act (42 U.S.C. 1395x(hhh)(2)) is amended--
        (1) by redesignating subparagraph (G) as subparagraph (I); and
        (2) by inserting after subparagraph (F) the following new 
    subparagraphs:
            ``(G) Screening for potential substance use disorders and 
        referral for treatment as appropriate.
            ``(H) The furnishing of a review of any current opioid 
        prescriptions (as defined in subsection (ww)(4)).''.
    (c) Rule of Construction.--Nothing in the amendments made by 
subsection (a) or (b) shall be construed to prohibit separate payment 
for structured assessment and intervention services for substance abuse 
furnished to an individual on the same day as an initial preventive 
physical examination or an annual wellness visit.
    (d) Effective Date.--The amendments made by this section shall 
apply to examinations and visits furnished on or after January 1, 2020.
SEC. 2003. EVERY PRESCRIPTION CONVEYED SECURELY.
    (a) In General.--Section 1860D-4(e) of the Social Security Act (42 
U.S.C. 1395w-104(e)) is amended by adding at the end the following:
        ``(7) Requirement of e-prescribing for controlled substances.--
            ``(A) In general.--Subject to subparagraph (B), a 
        prescription for a covered part D drug under a prescription 
        drug plan (or under an MA-PD plan) for a schedule II, III, IV, 
        or V controlled substance shall be transmitted by a health care 
        practitioner electronically in accordance with an electronic 
        prescription drug program that meets the requirements of 
        paragraph (2).
            ``(B) Exception for certain circumstances.--The Secretary 
        shall, through rulemaking, specify circumstances and processes 
        by which the Secretary may waive the requirement under 
        subparagraph (A), with respect to a covered part D drug, 
        including in the case of--
                ``(i) a prescription issued when the practitioner and 
            dispensing pharmacy are the same entity;
                ``(ii) a prescription issued that cannot be transmitted 
            electronically under the most recently implemented version 
            of the National Council for Prescription Drug Programs 
            SCRIPT Standard;
                ``(iii) a prescription issued by a practitioner who 
            received a waiver or a renewal thereof for a period of time 
            as determined by the Secretary, not to exceed one year, 
            from the requirement to use electronic prescribing due to 
            demonstrated economic hardship, technological limitations 
            that are not reasonably within the control of the 
            practitioner, or other exceptional circumstance 
            demonstrated by the practitioner;
                ``(iv) a prescription issued by a practitioner under 
            circumstances in which, notwithstanding the practitioner's 
            ability to submit a prescription electronically as required 
            by this subsection, such practitioner reasonably determines 
            that it would be impractical for the individual involved to 
            obtain substances prescribed by electronic prescription in 
            a timely manner, and such delay would adversely impact the 
            individual's medical condition involved;
                ``(v) a prescription issued by a practitioner 
            prescribing a drug under a research protocol;
                ``(vi) a prescription issued by a practitioner for a 
            drug for which the Food and Drug Administration requires a 
            prescription to contain elements that are not able to be 
            included in electronic prescribing, such as a drug with 
            risk evaluation and mitigation strategies that include 
            elements to assure safe use;
                ``(vii) a prescription issued by a practitioner--

                    ``(I) for an individual who receives hospice care 
                under this title; and
                    ``(II) that is not covered under the hospice 
                benefit under this title; and

                ``(viii) a prescription issued by a practitioner for an 
            individual who is--

                    ``(I) a resident of a nursing facility (as defined 
                in section 1919(a)); and
                    ``(II) dually eligible for benefits under this 
                title and title XIX.

            ``(C) Dispensing.--(i) Nothing in this paragraph shall be 
        construed as requiring a sponsor of a prescription drug plan 
        under this part, MA organization offering an MA-PD plan under 
        part C, or a pharmacist to verify that a practitioner, with 
        respect to a prescription for a covered part D drug, has a 
        waiver (or is otherwise exempt) under subparagraph (B) from the 
        requirement under subparagraph (A).
            ``(ii) Nothing in this paragraph shall be construed as 
        affecting the ability of the plan to cover or the pharmacists' 
        ability to continue to dispense covered part D drugs from 
        otherwise valid written, oral, or fax prescriptions that are 
        consistent with laws and regulations.
            ``(iii) Nothing in this paragraph shall be construed as 
        affecting the ability of an individual who is being prescribed 
        a covered part D drug to designate a particular pharmacy to 
        dispense the covered part D drug to the extent consistent with 
        the requirements under subsection (b)(1) and under this 
        paragraph.
            ``(D) Enforcement.--The Secretary shall, through 
        rulemaking, have authority to enforce and specify appropriate 
        penalties for non-compliance with the requirement under 
        subparagraph (A).''.
    (b) Effective Date.--The amendment made by subsection (a) shall 
apply to coverage of drugs prescribed on or after January 1, 2021.
    (c) Update of Biometric Component of Multifactor Authentication.--
Not later than 1 year after the date of enactment of this Act, the 
Attorney General shall update the requirements for the biometric 
component of multifactor authentication with respect to electronic 
prescriptions of controlled substances.
SEC. 2004. REQUIRING PRESCRIPTION DRUG PLAN SPONSORS UNDER MEDICARE TO 
ESTABLISH DRUG MANAGEMENT PROGRAMS FOR AT-RISK BENEFICIARIES.
    Section 1860D-4(c) of the Social Security Act (42 U.S.C. 1395w-
104(c)) is amended--
        (1) in paragraph (1), by inserting after subparagraph (E) the 
    following new subparagraph:
            ``(F) With respect to plan years beginning on or after 
        January 1, 2022, a drug management program for at-risk 
        beneficiaries described in paragraph (5).''; and
        (2) in paragraph (5)(A), by inserting ``(and for plan years 
    beginning on or after January 1, 2022, a PDP sponsor shall)'' after 
    ``A PDP sponsor may''.
SEC. 2005. MEDICARE COVERAGE OF CERTAIN SERVICES FURNISHED BY OPIOID 
TREATMENT PROGRAMS.
    (a) Coverage.--Section 1861(s)(2) of the Social Security Act (42 
U.S.C. 1395x(s)(2)) is amended--
        (1) in subparagraph (FF), by striking at the end ``and'';
        (2) in subparagraph (GG), by inserting at the end ``and''; and
        (3) by adding at the end the following new subparagraph:
        ``(HH) opioid use disorder treatment services (as defined in 
    subsection (jjj)).''.
    (b) Opioid Use Disorder Treatment Services and Opioid Treatment 
Program Defined.--Section 1861 of the Social Security Act (42 U.S.C. 
1395x) is amended by adding at the end the following new subsection:
    ``(jjj) Opioid Use Disorder Treatment Services; Opioid Treatment 
Program.--
        ``(1) Opioid use disorder treatment services.--The term `opioid 
    use disorder treatment services' means items and services that are 
    furnished by an opioid treatment program for the treatment of 
    opioid use disorder, including--
            ``(A) opioid agonist and antagonist treatment medications 
        (including oral, injected, or implanted versions) that are 
        approved by the Food and Drug Administration under section 505 
        of the Federal Food, Drug, and Cosmetic Act for use in the 
        treatment of opioid use disorder;
            ``(B) dispensing and administration of such medications, if 
        applicable;
            ``(C) substance use counseling by a professional to the 
        extent authorized under State law to furnish such services;
            ``(D) individual and group therapy with a physician or 
        psychologist (or other mental health professional to the extent 
        authorized under State law);
            ``(E) toxicology testing, and
            ``(F) other items and services that the Secretary 
        determines are appropriate (but in no event to include meals or 
        transportation).
        ``(2) Opioid treatment program.--The term `opioid treatment 
    program' means an entity that is an opioid treatment program (as 
    defined in section 8.2 of title 42 of the Code of Federal 
    Regulations, or any successor regulation) that--
            ``(A) is enrolled under section 1866(j);
            ``(B) has in effect a certification by the Substance Abuse 
        and Mental Health Services Administration for such a program;
            ``(C) is accredited by an accrediting body approved by the 
        Substance Abuse and Mental Health Services Administration; and
            ``(D) meets such additional conditions as the Secretary may 
        find necessary to ensure--
                ``(i) the health and safety of individuals being 
            furnished services under such program; and
                ``(ii) the effective and efficient furnishing of such 
            services.''.
    (c) Payment.--
        (1) In general.--Section 1833(a)(1) of the Social Security Act 
    (42 U.S.C. 1395l(a)(1)) is amended--
            (A) by striking ``and (bb)'' and inserting ``(bb)''; and
            (B) by inserting before the semicolon at the end the 
        following ``, and (cc) with respect to opioid use disorder 
        treatment services furnished during an episode of care, the 
        amount paid shall be equal to the amount payable under section 
        1834(w) less any copayment required as specified by the 
        Secretary''.
        (2) Payment determination.--Section 1834 of the Social Security 
    Act (42 U.S.C. 1395m) is amended by adding at the end the following 
    new subsection:
    ``(w) Opioid Use Disorder Treatment Services.--
        ``(1) In general.--The Secretary shall pay to an opioid 
    treatment program (as defined in paragraph (2) of section 
    1861(jjj)) an amount that is equal to 100 percent of a bundled 
    payment under this part for opioid use disorder treatment services 
    (as defined in paragraph (1) of such section) that are furnished by 
    such program to an individual during an episode of care (as defined 
    by the Secretary) beginning on or after January 1, 2020. The 
    Secretary shall ensure, as determined appropriate by the Secretary, 
    that no duplicative payments are made under this part or part D for 
    items and services furnished by an opioid treatment program.
        ``(2) Considerations.--The Secretary may implement this 
    subsection through one or more bundles based on the type of 
    medication provided (such as buprenorphine, methadone, naltrexone, 
    or a new innovative drug), the frequency of services, the scope of 
    services furnished, characteristics of the individuals furnished 
    such services, or other factors as the Secretary determine 
    appropriate. In developing such bundles, the Secretary may consider 
    payment rates paid to opioid treatment programs for comparable 
    services under State plans under title XIX or under the TRICARE 
    program under chapter 55 of title 10 of the United States Code.
        ``(3) Annual updates.--The Secretary shall provide an update 
    each year to the bundled payment amounts under this subsection.''.
    (d) Including Opioid Treatment Programs as Medicare Providers.--
Section 1866(e) of the Social Security Act (42 U.S.C. 1395cc(e)) is 
amended--
        (1) in paragraph (1), by striking at the end ``and'';
        (2) in paragraph (2), by striking the period at the end and 
    inserting ``; and''; and
        (3) by adding at the end the following new paragraph:
        ``(3) opioid treatment programs (as defined in paragraph (2) of 
    section 1861(jjj)), but only with respect to the furnishing of 
    opioid use disorder treatment services (as defined in paragraph (1) 
    of such section).''.
SEC. 2006. ENCOURAGING APPROPRIATE PRESCRIBING UNDER MEDICARE FOR 
VICTIMS OF OPIOID OVERDOSE.
    Section 1860D-4(c)(5)(C) of the Social Security Act (42 U.S.C. 
1395w-104(c)(5)(C)) is amended--
        (1) in clause (i), in the matter preceding subclause (I), by 
    striking ``For purposes'' and inserting ``Except as provided in 
    clause (v), for purposes''; and
        (2) by adding at the end the following new clause:
                ``(v) Treatment of enrollees with a history of opioid-
            related overdose.--

                    ``(I) In general.--For plan years beginning not 
                later than January 1, 2021, a part D eligible 
                individual who is not an exempted individual described 
                in clause (ii) and who is identified under this clause 
                as a part D eligible individual with a history of 
                opioid-related overdose (as defined by the Secretary) 
                shall be included as a potentially at-risk beneficiary 
                for prescription drug abuse under the drug management 
                program under this paragraph.
                    ``(II) Identification and notice.--For purposes of 
                this clause, the Secretary shall--

                        ``(aa) identify part D eligible individuals 
                    with a history of opioid-related overdose (as so 
                    defined); and
                        ``(bb) notify the PDP sponsor of the 
                    prescription drug plan in which such an individual 
                    is enrolled of such identification.''.
SEC. 2007. AUTOMATIC ESCALATION TO EXTERNAL REVIEW UNDER A MEDICARE 
PART D DRUG MANAGEMENT PROGRAM FOR AT-RISK BENEFICIARIES.
    (a) In General.--Section 1860D-4(c)(5) of the Social Security Act 
(42 U.S.C. 1395ww-10(c)(5)) is amended--
        (1) in subparagraph (B), in each of clauses (ii)(III) and 
    (iii)(IV), by striking ``and the option of an automatic escalation 
    to external review'' and inserting ``, including notice that if on 
    reconsideration a PDP sponsor affirms its denial, in whole or in 
    part, the case shall be automatically forwarded to the independent, 
    outside entity contracted with the Secretary for review and 
    resolution''; and
        (2) in subparagraph (E), by striking ``and the option'' and all 
    that follows and inserting the following: ``and if on 
    reconsideration a PDP sponsor affirms its denial, in whole or in 
    part, the case shall be automatically forwarded to the independent, 
    outside entity contracted with the Secretary for review and 
    resolution.''.
    (b) Effective Date.--The amendments made by subsection (a) shall 
apply beginning not later January 1, 2021.
SEC. 2008. SUSPENSION OF PAYMENTS BY MEDICARE PRESCRIPTION DRUG PLANS 
AND MA-PD PLANS PENDING INVESTIGATIONS OF CREDIBLE ALLEGATIONS OF FRAUD 
BY PHARMACIES.
    (a) In General.--Section 1860D-12(b) of the Social Security Act (42 
U.S.C. 1395w-112(b)) is amended by adding at the end the following new 
paragraph:
        ``(7) Suspension of payments pending investigation of credible 
    allegations of fraud by pharmacies.--
            ``(A) In general.--Section 1862(o)(1) shall apply with 
        respect to a PDP sponsor with a contract under this part, a 
        pharmacy, and payments to such pharmacy under this part in the 
        same manner as such section applies with respect to the 
        Secretary, a provider of services or supplier, and payments to 
        such provider of services or supplier under this title. A PDP 
        sponsor shall notify the Secretary regarding the imposition of 
        any payment suspension pursuant to the previous sentence, such 
        as through the secure internet website portal (or other 
        successor technology) established under section 1859(i).
            ``(B) Rule of construction.--Nothing in this paragraph 
        shall be construed as limiting the authority of a PDP sponsor 
        to conduct postpayment review.''.
    (b) Application to MA-PD Plans.--Section 1857(f)(3) of the Social 
Security Act (42 U.S.C. 1395w-27(f)(3)) is amended by adding at the end 
the following new subparagraph:
            ``(D) Suspension of payments pending investigation of 
        credible allegations of fraud by pharmacies.--Section 1860D-
        12(b)(7).''.
    (c) Conforming Amendment.--Section 1862(o)(3) of the Social 
Security Act (42 U.S.C. 1395y(o)(3)) is amended by inserting ``, 
section 1860D-12(b)(7) (including as applied pursuant to section 
1857(f)(3)(D)),'' after ``this subsection''.
    (d) Clarification Relating to Credible Allegation of Fraud.--
Section 1862(o) of the Social Security Act (42 U.S.C. 1395y(o)) is 
amended by adding at the end the following new paragraph:
        ``(4) Credible allegation of fraud.--In carrying out this 
    subsection, section 1860D-12(b)(7) (including as applied pursuant 
    to section 1857(f)(3)(D)), and section 1903(i)(2)(C), a fraud 
    hotline tip (as defined by the Secretary) without further evidence 
    shall not be treated as sufficient evidence for a credible 
    allegation of fraud.''.
    (e) Effective Date.--The amendments made by this section shall 
apply with respect to plan years beginning on or after January 1, 2020.

           TITLE III--FDA AND CONTROLLED SUBSTANCE PROVISIONS
                       Subtitle A--FDA Provisions

                         CHAPTER 1--IN GENERAL

SEC. 3001. CLARIFYING FDA REGULATION OF NON-ADDICTIVE PAIN PRODUCTS.
    (a) Public Meetings.--Not later than one year after the date of 
enactment of this Act, the Secretary of Health and Human Services 
(referred to in this section as the ``Secretary''), acting through the 
Commissioner of Food and Drugs, shall hold not less than one public 
meeting to address the challenges and barriers of developing non-
addictive medical products intended to treat acute or chronic pain or 
addiction, which may include--
        (1) the manner by which the Secretary may incorporate the risks 
    of misuse and abuse of a controlled substance (as defined in 
    section 102 of the Controlled Substances Act (21 U.S.C. 802)) into 
    the risk benefit assessments under subsections (d) and (e) of 
    section 505 of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 
    355), section 510(k) of such Act (21 U.S.C. 360(k)), or section 
    515(c) of such Act (21 U.S.C. 360e(c)), as applicable;
        (2) the application of novel clinical trial designs (consistent 
    with section 3021 of the 21st Century Cures Act (Public Law 114-
    255)), use of real world evidence (consistent with section 505F of 
    the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 355g)), and use 
    of patient experience data (consistent with section 569C of the 
    Federal Food, Drug, and Cosmetic Act (21 U.S.C. 360bbb-8c)) for the 
    development of non-addictive medical products intended to treat 
    pain or addiction;
        (3) the evidentiary standards and the development of opioid-
    sparing data for inclusion in the labeling of medical products 
    intended to treat acute or chronic pain; and
        (4) the application of eligibility criteria under sections 506 
    and 515B of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 
    356, 360e-3) for non-addictive medical products intended to treat 
    pain or addiction.
    (b) Guidance.--Not less than one year after the public meetings are 
conducted under subsection (a) the Secretary shall issue one or more 
final guidance documents, or update existing guidance documents, to 
help address challenges to developing non-addictive medical products to 
treat pain or addiction. Such guidance documents shall include 
information regarding--
        (1) how the Food and Drug Administration may apply sections 506 
    and 515B of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 
    356, 360e-3) to non-addictive medical products intended to treat 
    pain or addiction, including the circumstances under which the 
    Secretary--
            (A) may apply the eligibility criteria under such sections 
        506 and 515B to non-addictive medical products intended to 
        treat pain or addiction;
            (B) considers the risk of addiction of controlled 
        substances approved to treat pain when establishing unmet 
        medical need; and
            (C) considers pain, pain control, or pain management in 
        assessing whether a disease or condition is a serious or life-
        threatening disease or condition;
        (2) the methods by which sponsors may evaluate acute and 
    chronic pain, endpoints for non-addictive medical products intended 
    to treat pain, the manner in which endpoints and evaluations of 
    efficacy will be applied across and within review divisions, taking 
    into consideration the etiology of the underlying disease, and the 
    manner in which sponsors may use surrogate endpoints, intermediate 
    endpoints, and real world evidence;
        (3) the manner in which the Food and Drug Administration will 
    assess evidence to support the inclusion of opioid-sparing data in 
    the labeling of non-addictive medical products intended to treat 
    acute or chronic pain, including--
            (A) alternative data collection methodologies, including 
        the use of novel clinical trial designs (consistent with 
        section 3021 of the 21st Century Cures Act (Public Law 114-
        255)) and real world evidence (consistent with section 505F of 
        the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 355g)), 
        including patient registries and patient reported outcomes, as 
        appropriate, to support product labeling;
            (B) ethical considerations of exposing subjects to 
        controlled substances in clinical trials to develop opioid-
        sparing data and considerations on data collection methods that 
        reduce harm, which may include the reduction of opioid use as a 
        clinical benefit;
            (C) endpoints, including primary, secondary, and surrogate 
        endpoints, to evaluate the reduction of opioid use;
            (D) best practices for communication between sponsors and 
        the agency on the development of data collection methods, 
        including the initiation of data collection; and
            (E) the appropriate format in which to submit such data 
        results to the Secretary; and
        (4) the circumstances under which the Food and Drug 
    Administration considers misuse and abuse of a controlled substance 
    (as defined in section 102 of the Controlled Substances Act (21 
    U.S.C. 802)) in making the risk benefit assessment under paragraphs 
    (2) and (4) of subsection (d) of section 505 of the Federal Food, 
    Drug, and Cosmetic Act (21 U.S.C. 355) and in finding that a drug 
    is unsafe under paragraph (1) or (2) of subsection (e) of such 
    section.
    (c) Definitions.--In this section--
        (1) the term ``medical product'' means a drug (as defined in 
    section 201(g)(1) of the Federal Food, Drug, and Cosmetic Act (21 
    U.S.C. 321(g)(1))), biological product (as defined in section 
    351(i) of the Public Health Service Act (42 U.S.C. 262(i))), or 
    device (as defined in section 201(h) of the Federal Food, Drug, and 
    Cosmetic Act (21 U.S.C. 321(h))); and
        (2) the term ``opioid-sparing'' means reducing, replacing, or 
    avoiding the use of opioids or other controlled substances intended 
    to treat acute or chronic pain.
SEC. 3002. EVIDENCE-BASED OPIOID ANALGESIC PRESCRIBING GUIDELINES AND 
REPORT.
    (a) Guidelines.--The Commissioner of Food and Drugs shall develop 
evidence-based opioid analgesic prescribing guidelines for the 
indication-specific treatment of acute pain only for the relevant 
therapeutic areas where such guidelines do not exist.
    (b) Public Input.--In developing the guidelines under subsection 
(a), the Commissioner of Food and Drugs shall--
        (1) consult with stakeholders, which may include conducting a 
    public meeting of medical professional societies (including any 
    State-based societies), health care providers, State medical 
    boards, medical specialties including pain medicine specialty 
    societies, patient groups, pharmacists, academic or medical 
    research entities, and other entities with experience in health 
    care, as appropriate;
        (2) collaborate with the Director of the Centers for Disease 
    Control and Prevention, as applicable and appropriate, and other 
    Federal agencies with relevant expertise as appropriate; and
        (3) provide for a notice and comment period consistent with 
    section 701(h) of the Federal Food, Drug, and Cosmetic Act (21 
    U.S.C. 371(h)) for the submission of comments by the public.
    (c) Report.--Not later than 1 year after the date of enactment of 
this Act, or, if earlier, at the time the guidelines under subsection 
(a) are finalized, the Commissioner of Food and Drugs 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 post on the public website of the Food and Drug 
Administration, a report on how the Food and Drug Administration will 
utilize the guidelines under subsection (a) to protect the public 
health and a description of the public health need with respect to each 
such indication-specific treatment guideline.
    (d) Updates.--The Commissioner of Food and Drugs shall 
periodically--
        (1) update the guidelines under subsection (a), informed by 
    public input described in subsection (b); and
        (2) submit to the committees specified in subsection (c) and 
    post on the public website of the Food and Drug Administration an 
    updated report under such subsection.
    (e) Statement To Accompany Guidelines and Recommendations.--The 
Commissioner of Food and Drugs shall ensure that opioid analgesic 
prescribing guidelines and other recommendations developed under this 
section are accompanied by a clear statement that such guidelines or 
recommendations, as applicable--
        (1) are intended to help inform clinical decisionmaking by 
    prescribers and patients; and
        (2) are not intended to be used for the purposes of 
    restricting, limiting, delaying, or denying coverage for, or access 
    to, a prescription issued for a legitimate medical purpose by an 
    individual practitioner acting in the usual course of professional 
    practice.

     CHAPTER 2--STOP COUNTERFEIT DRUGS BY REGULATING AND ENHANCING 
                            ENFORCEMENT NOW

SEC. 3011. SHORT TITLE.
    This chapter may be cited as the ``Stop Counterfeit Drugs by 
Regulating and Enhancing Enforcement Now Act'' or the ``SCREEN Act''.
SEC. 3012. NOTIFICATION, NONDISTRIBUTION, AND RECALL OF CONTROLLED 
SUBSTANCES.
    (a) Prohibited Acts.--Section 301 of the Federal Food, Drug, and 
Cosmetic Act (21 U.S.C. 331) is amended by adding at the end the 
following:
    ``(eee) The failure to comply with any order issued under section 
569D.''.
    (b) Notification, Nondistribution, and Recall of Controlled 
Substances.--Subchapter E of chapter V of the Federal Food, Drug, and 
Cosmetic Act (21 U.S.C. 360bbb et seq.) is amended by adding at the end 
the following:
``SEC. 569D. NOTIFICATION, NONDISTRIBUTION, AND RECALL OF CONTROLLED 
SUBSTANCES.
    ``(a) Order To Cease Distribution and Recall.--
        ``(1) In general.--If the Secretary determines there is a 
    reasonable probability that a controlled substance would cause 
    serious adverse health consequences or death, the Secretary may, 
    after providing the appropriate person with an opportunity to 
    consult with the agency, issue an order requiring manufacturers, 
    importers, distributors, or pharmacists, who distribute such 
    controlled substance to immediately cease distribution of such 
    controlled substance.
        ``(2) Hearing.--An order under paragraph (1) shall provide the 
    person subject to the order with an opportunity for an informal 
    hearing, to be held not later than 10 days after the date of 
    issuance of the order, on whether adequate evidence exists to 
    justify an amendment to the order, and what actions are required by 
    such amended order pursuant to subparagraph (3).
        ``(3) Order resolution.--After an order is issued according to 
    the process under paragraphs (1) and (2), the Secretary shall, 
    except as provided in paragraph (4)--
            ``(A) vacate the order, if the Secretary determines that 
        inadequate grounds exist to support the actions required by the 
        order;
            ``(B) continue the order ceasing distribution of the 
        controlled substance until a date specified in such order; or
            ``(C) amend the order to require a recall of the controlled 
        substance, including any requirements to notify appropriate 
        persons, a timetable for the recall to occur, and a schedule 
        for updates to be provided to the Secretary regarding such 
        recall.
        ``(4) Risk assessment.--If the Secretary determines that the 
    risk of recalling a controlled substance presents a greater health 
    risk than the health risk of not recalling such controlled 
    substance from use, an amended order under subparagraph (B) or (C) 
    of paragraph (3) shall not include either a recall order for, or an 
    order to cease distribution of, such controlled substance, as 
    applicable.
        ``(5) Action following order.--Any person who is subject to an 
    order pursuant to subparagraph (B) or (C) of paragraph (3) shall 
    immediately cease distribution of or recall, as applicable, the 
    controlled substance and provide notification as required by such 
    order.
    ``(b) Notice to Persons Affected.--If the Secretary determines 
necessary, the Secretary may require the person subject to an order 
pursuant to paragraph (1) or an amended order pursuant to subparagraph 
(B) or (C) of paragraph (3) to provide either a notice of a recall 
order for, or an order to cease distribution of, such controlled 
substance, as applicable, under this section to appropriate persons, 
including persons who manufacture, distribute, import, or offer for 
sale such product that is the subject of an order and to the public. In 
providing such notice, the Secretary may use the assistance of health 
professionals who prescribed or dispensed such controlled substances.
    ``(c) Nondelegation.--An order described in subsection (a)(3) shall 
be ordered by the Secretary or an official designated by the Secretary. 
An official may not be so designated under this section unless the 
official is the Director of the Center for Drug Evaluation and Research 
or an official senior to such Director.
    ``(d) Savings Clause.--Nothing contained in this section shall be 
construed as limiting--
        ``(1) the authority of the Secretary to issue an order to cease 
    distribution of, or to recall, any drug under any other provision 
    of this Act or the Public Health Service Act; or
        ``(2) the ability of the Secretary to request any person to 
    perform a voluntary activity related to any drug subject to this 
    Act or the Public Health Service Act.''.
    (c) Controlled Substances Subject to Refusal.--The third sentence 
of section 801(a) of the Federal Food, Drug, and Cosmetic Act (21 
U.S.C. 381(a)) is amended by inserting ``, or is a controlled substance 
subject to an order under section 569D'' before ``, or (4)''.
    (d) Effective Date.--Sections 301(eee) and 569D of the Federal 
Food, Drug, and Cosmetic Act, as added by subsections (a) and (b), 
shall be effective beginning on the date of enactment of this Act.
SEC. 3013. SINGLE SOURCE PATTERN OF IMPORTED ILLEGAL DRUGS.
    Section 801 of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 
381), as amended by section 3012, is further amended by adding at the 
end the following:
    ``(t) Single Source Pattern of Imported Illegal Drugs.--If the 
Secretary determines that a person subject to debarment as a result of 
engaging in a pattern of importing or offering for import controlled 
substances or drugs as described in section 306(b)(3)(D), and such 
pattern is identified by the Secretary as being offered for import from 
the same manufacturer, distributor, or importer, the Secretary may by 
order determine all drugs being offered for import from such person as 
adulterated or misbranded, unless such person can provide evidence 
otherwise.''.
SEC. 3014. STRENGTHENING FDA AND CBP COORDINATION AND CAPACITY.
    (a) In General.--The Secretary of Health and Human Services 
(referred to in this section as the ``Secretary''), acting through the 
Commissioner of Food and Drugs, shall coordinate with the Secretary of 
Homeland Security to carry out activities related to customs and border 
protection and in response to illegal controlled substances and drug 
imports, including at sites of import (such as international mail 
facilities), that will provide improvements to such facilities, 
technologies, and inspection capacity. Such Secretaries may carry out 
such activities through a memorandum of understanding between the Food 
and Drug Administration and the U.S. Customs and Border Protection.
    (b) FDA Import Facilities and Inspection Capacity.--
        (1) In general.--In carrying out this section, the Secretary 
    shall, in collaboration with the Secretary of Homeland Security and 
    the Postmaster General of the United States Postal Service, provide 
    that import facilities in which the Food and Drug Administration 
    operates or carries out activities related to drug imports within 
    the international mail facilities include--
            (A) facility upgrades and improved capacity in order to 
        increase and improve inspection and detection capabilities, 
        which may include, as the Secretary determines appropriate--
                (i) improvements to facilities, such as upgrades or 
            renovations, and support for the maintenance of existing 
            import facilities and sites to improve coordination between 
            Federal agencies;
                (ii) improvements in equipment and information 
            technology enhancement to identify unapproved, counterfeit, 
            or other unlawful controlled substances for destruction;
                (iii) the construction of, or upgrades to, laboratory 
            capacity for purposes of detection and testing of imported 
            goods;
                (iv) upgrades to the security of import facilities; and
                (v) innovative technology and equipment to facilitate 
            improved and near-real-time information sharing between the 
            Food and Drug Administration, the Department of Homeland 
            Security, and the United States Postal Service; and
            (B) innovative technology, including controlled substance 
        detection and testing equipment and other applicable 
        technology, in order to collaborate with the U.S. Customs and 
        Border Protection to share near-real-time information, 
        including information about test results, as appropriate.
        (2) Innovative technology.--Any technology used in accordance 
    with paragraph (1)(B) shall be interoperable with technology used 
    by other relevant Federal agencies, including the U.S. Customs and 
    Border Protection, as the Secretary determines appropriate and 
    practicable.
    (c) Report.--Not later than 6 months after the date of enactment of 
this Act, the Secretary, in consultation with the Secretary of Homeland 
Security and the Postmaster General of the United States Postal 
Service, shall report to the Committee on Energy and Commerce and the 
Committee on Homeland Security of the House of Representatives and the 
Committee on Health, Education, Labor, and Pensions and the Committee 
on Homeland Security and Governmental Affairs of the Senate on the 
implementation of this section, including a summary of progress made 
toward near-real-time information sharing and the interoperability of 
such technologies.

                CHAPTER 3--STOP ILLICIT DRUG IMPORTATION

SEC. 3021. SHORT TITLE.
    This chapter may be cited as the ``Stop Illicit Drug Importation 
Act of 2018''.
SEC. 3022. RESTRICTING ENTRANCE OF ILLICIT DRUGS.
    (a) Food and Drug Administration and U.S. Customs and Border 
Protection Cooperation.--
        (1) In general.--The Secretary of Health and Human Services 
    (referred to in this section as the ``Secretary''), acting through 
    the Commissioner of Food and Drugs and in consultation with the 
    U.S. Customs and Border Protection, shall develop and periodically 
    update a mutually agreed upon list of the controlled substances 
    that the Secretary will refer to U.S. Customs and Border 
    Protection, unless the Secretary and U.S. Customs and Border 
    Protection agree otherwise, when such substances are offered for 
    import via international mail and appear to violate the Controlled 
    Substances Act (21 U.S.C. 801 et seq.), the Controlled Substances 
    Import and Export Act (21 U.S.C. 951 et seq.), the Federal Food, 
    Drug, and Cosmetic Act (21 U.S.C. 301 et seq.), or any other 
    applicable law. The Secretary shall transfer controlled substances 
    on such list to the U.S. Customs and Border Protection. If the 
    Secretary identifies additional packages that appear to be the same 
    as such package containing a controlled substance, such additional 
    packages may also be transferred to U.S. Customs and Border 
    Protection. The U.S. Customs and Border Protection shall receive 
    such packages consistent with the requirements of the Controlled 
    Substances Act (21 U.S.C. 801 et seq.).
        (2) Report.--Not later than 9 months after the date of 
    enactment of this Act, the Secretary, acting through the 
    Commissioner of Food and Drugs and in consultation with the 
    Secretary of Homeland Security, shall report to the Committee on 
    Energy and Commerce of the House of Representatives and the 
    Committee on Health, Education, Labor, and Pensions of the Senate 
    on the implementation of this section.
    (b) Debarment, Temporary Denial of Approval, and Suspension.--
        (1) Prohibited act.--Section 301(cc) of the Federal Food, Drug, 
    and Cosmetic Act (21 U.S.C. 331(cc)) is amended--
            (A) by inserting ``or a drug'' after ``food''; and
            (B) by inserting ``from such activity'' after ``person 
        debarred''.
        (2) Debarment.--Section 306(b) of the Federal Food, Drug, and 
    Cosmetic Act (21 U.S.C. 335a(b)) is amended--
            (A) in paragraph (1)--
                (i) in the matter preceding subparagraph (A), by 
            inserting ``or (3)'' after ``paragraph (2)'';
                (ii) in subparagraph (A), by striking the comma at the 
            end and inserting a semicolon;
                (iii) in subparagraph (B), by striking ``, or'' and 
            inserting a semicolon;
                (iv) in subparagraph (C), by striking the period and 
            inserting ``; or''; and
                (v) by adding at the end the following:
            ``(D) a person from importing or offering for import into 
        the United States a drug.'';
            (B) in paragraph (3)--
                (i) in the heading, by inserting ``or drug'' after 
            ``Food'';
                (ii) in subparagraph (A), by striking ``; or'' and 
            inserting a semicolon;
                (iii) in subparagraph (B), by striking the period and 
            inserting a semicolon; and
                (iv) by adding at the end the following:
            ``(C) the person has been convicted of a felony for conduct 
        relating to the importation into the United States of any drug 
        or controlled substance (as defined in section 102 of the 
        Controlled Substances Act);
            ``(D) the person has engaged in a pattern of importing or 
        offering for import--
                ``(i) controlled substances that are prohibited from 
            importation under section 401(m) of the Tariff Act of 1930 
            (19 U.S.C. 1401(m)); or
                ``(ii) adulterated or misbranded drugs that are--

                    ``(I) not designated in an authorized electronic 
                data interchange system as a product that is regulated 
                by the Secretary; or
                    ``(II) knowingly or intentionally falsely 
                designated in an authorized electronic data interchange 
                system as a product that is regulated by the 
                Secretary.''; and

            (C) by adding at the end the following:
        ``(5) Definition.--For purposes of paragraph (3)(D), the term 
    `pattern of importing or offering for import' means importing or 
    offering for import a drug described in clause (i) or (ii) of 
    paragraph (3)(D) in an amount, frequency, or dosage that is 
    inconsistent with personal or household use by the importer.''.
    (c) Imports and Exports.--Section 801(a) of the Federal Food, Drug, 
and Cosmetic Act (21 U.S.C. 381(a)), as amended, is further amended--
        (1) by striking ``, then such article shall be refused 
    admission'' inserting ``or (5) such article is being imported or 
    offered for import in violation of section 301(cc), then any such 
    article described in any of clauses (1) through (5) shall be 
    refused admission'';
        (2) by inserting ``If it appears from the examination of such 
    samples or otherwise that the article is a counterfeit drug, such 
    article shall be refused admission.'' before ``With respect to an 
    article of food, if importation''; and
        (3) by striking ``Clause (2) of the third sentence'' and all 
    that follows through the period at the end and inserting the 
    following: ``Neither clause (2) nor clause (5) of the third 
    sentence of this subsection shall be construed to prohibit the 
    admission of narcotic drugs, the importation of which is permitted 
    under the Controlled Substances Import and Export Act.''.
    (d) Certain Illicit Articles.--Section 801 of the Federal Food, 
Drug, and Cosmetic Act (21 U.S.C. 381), as amended, is amended by 
adding at the end the following--
    ``(u) Illicit Articles Containing Active Pharmaceutical 
Ingredients.--
        ``(1) In general.--For purposes of this section, an article 
    that is being imported or offered for import into the United States 
    may be treated by the Secretary as a drug if the article--
            ``(A) is not--
                ``(i) accompanied by an electronic import entry for 
            such article submitted using an authorized electronic data 
            interchange system; and
                ``(ii) designated in such a system as an article 
            regulated by the Secretary (which may include regulation as 
            a drug, a device, a dietary supplement, or other product 
            that is regulated under this Act); and
            ``(B) is an ingredient that presents significant public 
        health concern and is, or contains--
                ``(i) an active ingredient in a drug--

                    ``(I) that is approved under section 505 or 
                licensed under section 351 of the Public Health Service 
                Act; or
                    ``(II) for which--

                        ``(aa) an investigational use exemption has 
                    been authorized under section 505(i) of this Act or 
                    section 351(a) of the Public Health Service Act; 
                    and
                        ``(bb) a substantial clinical investigation has 
                    been instituted, and such investigation has been 
                    made public; or
                ``(ii) a substance that has a chemical structure that 
            is substantially similar to the chemical structure of an 
            active ingredient in a drug or biological product described 
            in subclause (I) or (II) of clause (i).
        ``(2) Effect.--This subsection shall not be construed to bear 
    upon any determination of whether an article is a drug within the 
    meaning of section 201(g), other than for the purposes described in 
    paragraph (1).''.

   CHAPTER 4--SECURING OPIOIDS AND UNUSED NARCOTICS WITH DELIBERATE 
                         DISPOSAL AND PACKAGING

SEC. 3031. SHORT TITLE.
    This chapter may be cited as the ``Securing Opioids and Unused 
Narcotics with Deliberate Disposal and Packaging Act of 2018'' or the 
``SOUND Disposal and Packaging Act''.
SEC. 3032. SAFETY-ENHANCING PACKAGING AND DISPOSAL FEATURES.
     (a) Deliberate Disposal and Packaging Elements of Strategy.--
Section 505-1(e) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 
355-1(e)) is amended by adding at the end the following:
        ``(4) Packaging and disposal.--The Secretary may require a risk 
    evaluation mitigation strategy for a drug for which there is a 
    serious risk of an adverse drug experience described in 
    subparagraph (B) or (C) of subsection (b)(1), taking into 
    consideration the factors described in subparagraphs (C) and (D) of 
    subsection (f)(2) and in consultation with other relevant Federal 
    agencies with authorities over drug disposal packaging, which may 
    include requiring that--
            ``(A) the drug be made available for dispensing to certain 
        patients in unit dose packaging, packaging that provides a set 
        duration, or another packaging system that the Secretary 
        determines may mitigate such serious risk; or
            ``(B) the drug be dispensed to certain patients with a safe 
        disposal packaging or safe disposal system for purposes of 
        rendering drugs nonretrievable (as defined in section 1300.05 
        of title 21, Code of Federal Regulations (or any successor 
        regulation)) if the Secretary determines that such safe 
        disposal packaging or system may mitigate such serious risk and 
        is sufficiently available.''.
    (b) Assuring Access and Minimizing Burden.--Section 505-1(f)(2)(C) 
of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 355-1(f)(2)(C)) 
is amended--
        (1) in clause (i) by striking ``and'' at the end; and
        (2) by adding at the end the following:
                ``(iii) patients with functional limitations; and''.
    (c) Application to Abbreviated New Drug Applications.--Section 505-
1(i) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 355-1(i)) 
is amended--
        (1) in paragraph (1)--
            (A) by redesignating subparagraph (B) as subparagraph (C); 
        and
            (B) inserting after subparagraph (A) the following:
            ``(B) A packaging or disposal requirement, if required 
        under subsection (e)(4) for the applicable listed drug.''; and
        (2) in paragraph (2)--
            (A) in subparagraph (A), by striking ``and'' at the end;
            (B) by redesignating subparagraph (B) as subparagraph (C); 
        and
            (C) by inserting after subparagraph (A) the following:
            ``(B) shall permit packaging systems and safe disposal 
        packaging or safe disposal systems that are different from 
        those required for the applicable listed drug under subsection 
        (e)(4); and''.
    (d) GAO Report.--Not later than 12 months after the date of 
enactment of this Act, the Comptroller General of the United States 
shall prepare and submit to Congress a report containing--
        (1) a description of available evidence, if any, on the 
    effectiveness of site-of-use, in-home controlled substance disposal 
    products and packaging technologies;
        (2) an evaluation of existing reference standards with respect 
    to controlled substance disposal products and packaging 
    technologies, including any such standards established by a 
    standards development organization, and how such standards should 
    be considered in ensuring effectiveness of such products and 
    technologies;
        (3) identification of ways in which such disposal products 
    intended for use by patients, consumers, and other end users that 
    are not registrants under the Controlled Substances Act (21 U.S.C. 
    801 et seq.), are made available to the public and any barriers to 
    the use of such disposal products;
        (4) identification of ways in which packaging technologies are 
    made available to the public and any barriers to the use of such 
    technologies;
        (5) a description of current Federal oversight, if any, of 
    site-of-use, in-home controlled substance disposal products, 
    including--
            (A) identification of the Federal agencies that oversee 
        such products;
            (B) identification of the methods of disposal of controlled 
        substances recommended by such agencies for site-of-use, in-
        home disposal; and
            (C) a description of the effectiveness of such 
        recommendations at preventing the diversion of legally 
        prescribed controlled substances;
        (6) a description of current Federal oversight, if any, of 
    controlled substance packaging technologies, including--
            (A) identification of the Federal agencies that oversee 
        such technologies;
            (B) identification of the technologies recommended by such 
        agencies, including unit dose packaging, packaging that 
        provides a set duration, and other packaging systems that may 
        mitigate abuse or misuse; and
            (C) a description of the effectiveness of such 
        recommendations at preventing the diversion of legally 
        prescribed controlled substances; and
        (7) recommendations, as appropriate, on--
            (A) whether site-of-use, in-home controlled substance 
        disposal products and packaging technologies require Federal 
        oversight and, if so, which agency or agencies should be 
        responsible for such oversight and, as applicable, review of 
        such products or technologies; and
            (B) whether there are applicable standards that should be 
        considered to ensure the effectiveness of such products.

               CHAPTER 5--POSTAPPROVAL STUDY REQUIREMENTS

SEC. 3041. CLARIFYING FDA POSTMARKET AUTHORITIES.
    (a) Definition of Adverse Drug Experience.--Section 505-1(b)(1)(E) 
of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 355-1(b)(1)(E)) 
is amended by striking ``of the drug'' and inserting ``of the drug, 
which may include reduced effectiveness under the conditions of use 
prescribed in the labeling of such drug, but which may not include 
reduced effectiveness that is in accordance with such labeling''.
    (b) Safety Labeling Changes.--Section 505(o)(4) of the Federal 
Food, Drug, and Cosmetic Act (21 U.S.C. 355(o)(4)) is amended--
        (1) in subparagraph (A) by--
            (A) striking ``Safety information'' and inserting ``Safety 
        or new effectiveness information''; and
            (B) by striking ``If the Secretary becomes'' and all that 
        follows through ``in the labeling of the drug'' and inserting 
        ``If the Secretary becomes aware of new information, including 
        any new safety information or information related to reduced 
        effectiveness, that the Secretary determines should be included 
        in the labeling of the drug'';
        (2) in clause (i) of subparagraph (B), by inserting before the 
    semicolon ``, or new effectiveness information'';
        (3) in subparagraph (C) by striking ``safety information'' and 
    inserting ``safety or new effectiveness information''; and
        (4) in subparagraph (E) by striking ``safety information'' and 
    inserting ``safety or new effectiveness information''.
    (c) Guidance.--Not less than one year after the date of enactment 
of this Act, the Secretary of Health and Human Services shall issue 
guidance regarding the circumstances under which the Food and Drug 
Administration may require postmarket studies or clinical trials to 
assess the potential reduction in effectiveness of a drug and how such 
reduction in effectiveness could result in a change to the benefits of 
the drug and the risks to the patient. Such guidance shall also address 
how the Food and Drug Administration may apply this section and the 
amendments made thereby with respect to circumstances under which the 
Food and Drug Administration may require postmarket studies or clinical 
trials and safety labeling changes related to the use of controlled 
substances for acute or chronic pain.

              Subtitle B--Controlled Substance Provisions

    CHAPTER 1--MORE FLEXIBILITY WITH RESPECT TO MEDICATION-ASSISTED 
                   TREATMENT FOR OPIOID USE DISORDERS

SEC. 3201. ALLOWING FOR MORE FLEXIBILITY WITH RESPECT TO MEDICATION-
ASSISTED TREATMENT FOR OPIOID USE DISORDERS.
    (a) Conforming Applicable Number.--Subclause (II) of section 
303(g)(2)(B)(iii) of the Controlled Substances Act (21 U.S.C. 
823(g)(2)(B)(iii)) is amended to read as follows:
        ``(II) The applicable number is--
            ``(aa) 100 if, not sooner than 1 year after the date on 
        which the practitioner submitted the initial notification, the 
        practitioner submits a second notification to the Secretary of 
        the need and intent of the practitioner to treat up to 100 
        patients;
            ``(bb) 100 if the practitioner holds additional 
        credentialing, as defined in section 8.2 of title 42, Code of 
        Federal Regulations (or successor regulations);
            ``(cc) 100 if the practitioner provides medication-assisted 
        treatment (MAT) using covered medications (as such terms are 
        defined in section 8.2 of title 42, Code of Federal Regulations 
        (or successor regulations)) in a qualified practice setting (as 
        described in section 8.615 of title 42, Code of Federal 
        Regulations (or successor regulations)); or
            ``(dd) 275 if the practitioner meets the requirements 
        specified in sections 8.610 through 8.655 of title 42, Code of 
        Federal Regulations (or successor regulations).''.
    (b) Eliminating Any Time Limitation for Nurse Practitioners and 
Physician Assistants To Become Qualifying Practitioners.--Clause (iii) 
of section 303(g)(2)(G) of the Controlled Substances Act (21 U.S.C. 
823(g)(2)(G)) is amended--
        (1) in subclause (I), by striking ``or'' at the end; and
        (2) by amending subclause (II) to read as follows:
            ``(II) a qualifying other practitioner, as defined in 
        clause (iv), who is a nurse practitioner or physician 
        assistant; or''.
    (c) Imposing a Time Limitation for Clinical Nurse Specialists, 
Certified Registered Nurse Anesthetists, and Certified Nurse Midwifes 
To Become Qualifying Practitioners.--Clause (iii) of section 
303(g)(2)(G) of the Controlled Substances Act (21 U.S.C. 823(g)(2)(G)), 
as amended by subsection (b), is further amended by adding at the end 
the following:
            ``(III) for the period beginning on October 1, 2018, and 
        ending on October 1, 2023, a qualifying other practitioner, as 
        defined in clause (iv), who is a clinical nurse specialist, 
        certified registered nurse anesthetist, or certified nurse 
        midwife.''.
    (d) Definition of Qualifying Other Practitioner.--Section 
303(g)(2)(G)(iv) of the Controlled Substances Act (21 U.S.C. 
823(g)(2)(G)(iv)) is amended by striking ``nurse practitioner or 
physician assistant'' each place it appears and inserting ``nurse 
practitioner, clinical nurse specialist, certified registered nurse 
anesthetist, certified nurse midwife, or physician assistant''.
    (e) Report by Secretary.--Not later than 2 years after the date of 
the enactment of this Act, the Secretary of Health and Human Services, 
in consultation with the Drug Enforcement Administration, shall submit 
to Congress a report that assesses the care provided by qualifying 
practitioners (as defined in section 303(g)(2)(G)(iii) of the 
Controlled Substances Act (21 U.S.C. 823(g)(2)(G)(iii))) who are 
treating, in the case of physicians, more than 100 patients, and in the 
case of qualifying practitioners who are not physicians, more than 30 
patients. Such report shall include recommendations on future 
applicable patient number levels and limits. In preparing such report, 
the Secretary shall study, with respect to opioid use disorder 
treatment--
        (1) the average frequency with which qualifying practitioners 
    see their patients;
        (2) the average frequency with which patients receive 
    counseling, including the rates by which such counseling is 
    provided by such a qualifying practitioner directly, or by 
    referral;
        (3) the frequency of toxicology testing, including the average 
    frequency with which random toxicology testing is administered;
        (4) the average monthly patient caseload for each type of 
    qualifying practitioner;
        (5) the treatment retention rates for patients;
        (6) overdose and mortality rates; and
        (7) any available information regarding the diversion of drugs 
    by patients receiving such treatment from such a qualifying 
    practitioner.
SEC. 3202. MEDICATION-ASSISTED TREATMENT FOR RECOVERY FROM SUBSTANCE 
USE DISORDER.
    (a) Waivers for Maintenance Treatment or Detoxification.--Section 
303(g)(2)(G)(ii) of the Controlled Substances Act (21 U.S.C. 
823(g)(2)(G)(ii)) is amended by adding at the end the following:
        ``(VIII) The physician graduated in good standing from an 
    accredited school of allopathic medicine or osteopathic medicine in 
    the United States during the 5-year period immediately preceding 
    the date on which the physician submits to the Secretary a written 
    notification under subparagraph (B) and successfully completed a 
    comprehensive allopathic or osteopathic medicine curriculum or 
    accredited medical residency that--
            ``(aa) included not less than 8 hours of training on 
        treating and managing opioid-dependent patients; and
            ``(bb) included, at a minimum--
                ``(AA) the training described in items (aa) through 
            (gg) of subclause (IV); and
                ``(BB) training with respect to any other best practice 
            the Secretary determines should be included in the 
            curriculum, which may include training on pain management, 
            including assessment and appropriate use of opioid and non-
            opioid alternatives.''.
    (b) Treatment for Children.--The Secretary of Health and Human 
Services shall consider ways to ensure that an adequate number of 
qualified practitioners, as defined in subparagraph (G)(ii) of section 
303(g)(2) of the Controlled Substances Act (21 U.S.C. 823(g)(2)), who 
have a specialty in pediatrics or the treatment of children or 
adolescents, are granted a waiver under such section 303(g)(2) to treat 
children and adolescents with substance use disorders.
    (c) Technical Amendment.--Section 102(24) of the Controlled 
Substances Act (21 U.S.C. 802(24)) is amended by striking ``Health, 
Education, and Welfare'' and inserting ``Health and Human Services''.
SEC. 3203. GRANTS TO ENHANCE ACCESS TO SUBSTANCE USE DISORDER 
TREATMENT.
    (a) In General.--The Secretary of Health and Human Services shall 
establish a grant program under which the Secretary may make grants to 
accredited schools of allopathic medicine or osteopathic medicine and 
teaching hospitals located in the United States to support the 
development of curricula that meet the requirements under subclause 
(VIII) of section 303(g)(2)(G)(ii) of the Controlled Substances Act, as 
added by section 3202(a) of this Act.
    (b) Authorization of Appropriations.--There is authorized to be 
appropriated, for grants under subsection (a), $4,000,000 for each of 
fiscal years 2019 through 2023.
SEC. 3204. DELIVERY OF A CONTROLLED SUBSTANCE BY A PHARMACY TO BE 
ADMINISTERED BY INJECTION OR IMPLANTATION.
    (a) In General.--The Controlled Substances Act is amended by 
inserting after section 309 (21 U.S.C. 829) the following:


        ``delivery of a controlled substance by a pharmacy to an 
                       administering practitioner

    ``Sec. 309A.  (a) In General.--Notwithstanding section 102(10), a 
pharmacy may deliver a controlled substance to a practitioner in 
accordance with a prescription that meets the requirements of this 
title and the regulations issued by the Attorney General under this 
title, for the purpose of administering the controlled substance by the 
practitioner if--
        ``(1) the controlled substance is delivered by the pharmacy to 
    the prescribing practitioner or the practitioner administering the 
    controlled substance, as applicable, at the location listed on the 
    practitioner's certificate of registration issued under this title;
        ``(2) the controlled substance is to be administered for the 
    purpose of maintenance or detoxification treatment under section 
    303(g)(2) and--
            ``(A) the practitioner who issued the prescription is a 
        qualifying practitioner authorized under, and acting within the 
        scope of that section; and
            ``(B) the controlled substance is to be administered by 
        injection or implantation;
        ``(3) the pharmacy and the practitioner are authorized to 
    conduct the activities specified in this section under the law of 
    the State in which such activities take place;
        ``(4) the prescription is not issued to supply any practitioner 
    with a stock of controlled substances for the purpose of general 
    dispensing to patients;
        ``(5) except as provided in subsection (b), the controlled 
    substance is to be administered only to the patient named on the 
    prescription not later than 14 days after the date of receipt of 
    the controlled substance by the practitioner; and
        ``(6) notwithstanding any exceptions under section 307, the 
    prescribing practitioner, and the practitioner administering the 
    controlled substance, as applicable, maintain complete and accurate 
    records of all controlled substances delivered, received, 
    administered, or otherwise disposed of under this section, 
    including the persons to whom controlled substances were delivered 
    and such other information as may be required by regulations of the 
    Attorney General.
    ``(b) Modification of Number of Days Before Which Controlled 
Substance Shall Be Administered.--
        ``(1) Initial 2-year period.--During the 2-year period 
    beginning on the date of enactment of this section, the Attorney 
    General, in coordination with the Secretary, may reduce the number 
    of days described in subsection (a)(5) if the Attorney General 
    determines that such reduction will--
            ``(A) reduce the risk of diversion; or
            ``(B) protect the public health.
        ``(2) Modifications after submission of report.--After the date 
    on which the report described in section 3204(b) of the SUPPORT for 
    Patients and Communities Act is submitted, the Attorney General, in 
    coordination with the Secretary, may modify the number of days 
    described in subsection (a)(5).
        ``(3) Minimum number of days.--Any modification under this 
    subsection shall be for a period of not less than 7 days.''.
    (b) Study and Report.--Not later than 2 years after the date of 
enactment of this section, the Comptroller General of the United States 
shall conduct a study and submit to Congress a report on access to and 
potential diversion of controlled substances administered by injection 
or implantation.
    (c) Technical and Conforming Amendment.--The table of contents for 
the Comprehensive Drug Abuse Prevention and Control Act of 1970 is 
amended by inserting after the item relating to section 309 the 
following:

``Sec. 309A. Delivery of a controlled substance by a pharmacy to an 
          administering practitioner.''.

  CHAPTER 2--EMPOWERING PHARMACISTS IN THE FIGHT AGAINST OPIOID ABUSE

SEC. 3211. SHORT TITLE.
    This chapter may be cited as the ``Empowering Pharmacists in the 
Fight Against Opioid Abuse Act''.
SEC. 3212. PROGRAMS AND MATERIALS FOR TRAINING ON CERTAIN CIRCUMSTANCES 
UNDER WHICH A PHARMACIST MAY DECLINE TO FILL A PRESCRIPTION.
    (a) In General.--Not later than 1 year after the date of enactment 
of this Act, the Secretary of Health and Human Services, in 
consultation with the Administrator of the Drug Enforcement 
Administration, Commissioner of Food and Drugs, Director of the Centers 
for Disease Control and Prevention, and Assistant Secretary for Mental 
Health and Substance Use, shall develop and disseminate, as 
appropriate, materials for pharmacists, health care providers, and 
patients on--
        (1) circumstances under which a pharmacist may, consistent with 
    section 309 of the Controlled Substances Act (21 U.S.C. 829) and 
    regulations thereunder, including section 1306.04 of title 21, Code 
    of Federal Regulations, decline to fill a prescription for a 
    controlled substance because the pharmacist suspects the 
    prescription is fraudulent, forged, or of doubtful, questionable, 
    or suspicious origin; and
        (2) other Federal requirements pertaining to declining to fill 
    a prescription under such circumstances, including the partial fill 
    of prescriptions for certain controlled substances.
    (b) Materials Included.--In developing materials under subsection 
(a), the Secretary of Health and Human Services shall include 
information for--
        (1) pharmacists on how to decline to fill a prescription and 
    actions to take after declining to fill a prescription; and
        (2) other health care practitioners and the public on a 
    pharmacist's ability to decline to fill prescriptions in certain 
    circumstances and a description of those circumstances (as 
    described in the materials developed under subsection (a)(1)).
    (c) Stakeholder Input.--In developing the programs and materials 
required under subsection (a), the Secretary of Health and Human 
Services shall seek input from relevant national, State, and local 
associations, boards of pharmacy, medical societies, licensing boards, 
health care practitioners, and patients, including individuals with 
chronic pain.

             CHAPTER 3--SAFE DISPOSAL OF UNUSED MEDICATION

SEC. 3221. SHORT TITLE.
    This chapter may be cited as the ``Safe Disposal of Unused 
Medication Act''.
SEC. 3222. DISPOSAL OF CONTROLLED SUBSTANCES OF A HOSPICE PATIENT BY 
EMPLOYEES OF A QUALIFIED HOSPICE PROGRAM.
    (a) In General.--Subsection (g) of section 302 of the Controlled 
Substances Act (21 U.S.C. 822) is amended by adding at the end the 
following:
    ``(5)(A) In the case of a person receiving hospice care, an 
employee of a qualified hospice program, acting within the scope of 
employment, may handle, without being registered under this section, 
any controlled substance that was lawfully dispensed to the person 
receiving hospice care, for the purpose of disposal of the controlled 
substance so long as such disposal occurs onsite in accordance with all 
applicable Federal, State, Tribal, and local law and--
        ``(i) the disposal occurs after the death of a person receiving 
    hospice care;
        ``(ii) the controlled substance is expired; or
        ``(iii)(I) the employee is--
                ``(aa) the physician of the person receiving hospice 
            care; and
                ``(bb) registered under section 303(f); and
            ``(II) the hospice patient no longer requires the 
        controlled substance because the plan of care of the hospice 
        patient has been modified.
    ``(B) For the purposes of this paragraph:
        ``(i) The terms `hospice care' and `hospice program' have the 
    meanings given to those terms in section 1861(dd) of the Social 
    Security Act.
        ``(ii) The term `employee of a qualified hospice program' means 
    a physician, physician assistant, nurse, or other person who--
            ``(I) is employed by, or pursuant to arrangements made by, 
        a qualified hospice program;
            ``(II)(aa) is licensed to perform medical or nursing 
        services by the jurisdiction in which the person receiving 
        hospice care was located; and
            ``(bb) is acting within the scope of such employment in 
        accordance with applicable State law; and
            ``(III) has completed training through the qualified 
        hospice program regarding the disposal of controlled substances 
        in a secure and responsible manner so as to discourage abuse, 
        misuse, or diversion.
        ``(iii) The term `qualified hospice program' means a hospice 
    program that--
            ``(I) has written policies and procedures for assisting in 
        the disposal of the controlled substances of a person receiving 
        hospice care after the person's death;
            ``(II) at the time when the controlled substances are first 
        ordered--
                ``(aa) provides a copy of the written policies and 
            procedures to the patient or patient representative and 
            family;
                ``(bb) discusses the policies and procedures with the 
            patient or representative and the family in a language and 
            manner that they understand to ensure that these parties 
            are educated regarding the safe disposal of controlled 
            substances; and
                ``(cc) documents in the patient's clinical record that 
            the written policies and procedures were provided and 
            discussed; and
            ``(III) at the time following the disposal of the 
        controlled substances--
                ``(aa) documents in the patient's clinical record the 
            type of controlled substance, dosage, route of 
            administration, and quantity so disposed; and
                ``(bb) the time, date, and manner in which that 
            disposal occurred.''.
    (b) Guidance.--The Attorney General may issue guidance to hospice 
programs (as defined in paragraph (5) of section 302(g) of the 
Controlled Substances Act (21 U.S.C. 822(g)), as added by subsection 
(a)) to assist the programs in satisfying the requirements under such 
paragraph (5).
    (c) Rule of Construction Relating to State and Local Law.--Nothing 
in this section or the amendments made by this section shall be 
construed to prevent a State or local government from imposing 
additional controls or restrictions relating to the regulation of the 
disposal of controlled substances in hospice care or hospice programs.
SEC. 3223. GAO STUDY AND REPORT ON HOSPICE SAFE DRUG MANAGEMENT.
    (a) Study.--
        (1) In general.--The Comptroller General of the United States 
    (in this section referred to as the ``Comptroller General'') shall 
    conduct a study on the requirements applicable to, and challenges 
    of, hospice programs with regard to the management and disposal of 
    controlled substances in the home of an individual.
        (2) Contents.--In conducting the study under paragraph (1), the 
    Comptroller General shall include--
            (A) an overview of any challenges encountered by selected 
        hospice programs regarding the disposal of controlled 
        substances, such as opioids, in a home setting, including any 
        key changes in policies, procedures, or best practices for the 
        disposal of controlled substances over time; and
            (B) a description of Federal requirements, including 
        requirements under the Medicare program, for hospice programs 
        regarding the disposal of controlled substances in a home 
        setting, and oversight of compliance with those requirements.
    (b) Report.--Not later than 18 months after the date of enactment 
of this Act, the Comptroller General shall submit to Congress a report 
containing the results of the study conducted under subsection (a), 
together with recommendations, if any, for such legislation and 
administrative action as the Comptroller General determines 
appropriate.

     CHAPTER 4--SPECIAL REGISTRATION FOR TELEMEDICINE CLARIFICATION

SEC. 3231. SHORT TITLE.
    This chapter may be cited as the ``Special Registration for 
Telemedicine Clarification Act of 2018''.
SEC. 3232. REGULATIONS RELATING TO A SPECIAL REGISTRATION FOR 
TELEMEDICINE.
    Section 311(h)(2) of the Controlled Substances Act (21 U.S.C. 
831(h)(2)) is amended to read as follows:
        ``(2) Regulations.--Not later than 1 year after the date of 
    enactment of the SUPPORT for Patients and Communities Act, in 
    consultation with the Secretary, the Attorney General shall 
    promulgate final regulations specifying--
            ``(A) the limited circumstances in which a special 
        registration under this subsection may be issued; and
            ``(B) the procedure for obtaining a special registration 
        under this subsection.''.

      CHAPTER 5--SYNTHETIC ABUSE AND LABELING OF TOXIC SUBSTANCES

SEC. 3241. CONTROLLED SUBSTANCE ANALOGUES.
    Section 203 of the Controlled Substances Act (21 U.S.C. 813) is 
amended--
        (1) by striking ``A controlled'' and inserting ``(a) In 
    General.--A controlled''; and
        (2) by adding at the end the following:
    ``(b) Determination.--In determining whether a controlled substance 
analogue was intended for human consumption under subsection (a), the 
following factors may be considered, along with any other relevant 
factors:
        ``(1) The marketing, advertising, and labeling of the 
    substance.
        ``(2) The known efficacy or usefulness of the substance for the 
    marketed, advertised, or labeled purpose.
        ``(3) The difference between the price at which the substance 
    is sold and the price at which the substance it is purported to be 
    or advertised as is normally sold.
        ``(4) The diversion of the substance from legitimate channels 
    and the clandestine importation, manufacture, or distribution of 
    the substance.
        ``(5) Whether the defendant knew or should have known the 
    substance was intended to be consumed by injection, inhalation, 
    ingestion, or any other immediate means.
        ``(6) Any controlled substance analogue that is manufactured, 
    formulated, sold, distributed, or marketed with the intent to avoid 
    the provisions of existing drug laws.
    ``(c) Limitation.--For purposes of this section, evidence that a 
substance was not marketed, advertised, or labeled for human 
consumption, by itself, shall not be sufficient to establish that the 
substance was not intended for human consumption.''.

              CHAPTER 6--ACCESS TO INCREASED DRUG DISPOSAL

SEC. 3251. SHORT TITLE.
    This chapter may be cited as the ``Access to Increased Drug 
Disposal Act of 2018''.
SEC. 3252. DEFINITIONS.
    In this chapter--
        (1) the term ``Attorney General'' means the Attorney General, 
    acting through the Assistant Attorney General for the Office of 
    Justice Programs;
        (2) the term ``authorized collector'' means a narcotic 
    treatment program, a hospital or clinic with an on-site pharmacy, a 
    retail pharmacy, or a reverse distributor, that is authorized as a 
    collector under section 1317.40 of title 21, Code of Federal 
    Regulations (or any successor regulation);
        (3) the term ``covered grant'' means a grant awarded under 
    section 3003; and
        (4) the term ``eligible collector'' means a person who is 
    eligible to be an authorized collector.
SEC. 3253. AUTHORITY TO MAKE GRANTS.
    The Attorney General shall award grants to States to enable the 
States to increase the participation of eligible collectors as 
authorized collectors.
SEC. 3254. APPLICATION.
    A State desiring a covered grant shall submit to the Attorney 
General an application that, at a minimum--
        (1) identifies the single State agency that oversees 
    pharmaceutical care and will be responsible for complying with the 
    requirements of the grant;
        (2) details a plan to increase participation rates of eligible 
    collectors as authorized collectors; and
        (3) describes how the State will select eligible collectors to 
    be served under the grant.
SEC. 3255. USE OF GRANT FUNDS.
    A State that receives a covered grant, and any subrecipient of the 
grant, may use the grant amounts only for the costs of installation, 
maintenance, training, purchasing, and disposal of controlled 
substances associated with the participation of eligible collectors as 
authorized collectors.
SEC. 3256. ELIGIBILITY FOR GRANT.
    The Attorney General shall award a covered grant to 5 States, not 
less than 3 of which shall be States in the lowest quartile of States 
based on the participation rate of eligible collectors as authorized 
collectors, as determined by the Attorney General.
SEC. 3257. DURATION OF GRANTS.
    The Attorney General shall determine the period of years for which 
a covered grant is made to a State.
SEC. 3258. ACCOUNTABILITY AND OVERSIGHT.
    A State that receives a covered grant shall submit to the Attorney 
General a report, at such time and in such manner as the Attorney 
General may reasonably require, that--
        (1) lists the ultimate recipients of the grant amounts;
        (2) describes the activities undertaken by the State using the 
    grant amounts; and
        (3) contains performance measures relating to the effectiveness 
    of the grant, including changes in the participation rate of 
    eligible collectors as authorized collectors.
SEC. 3259. DURATION OF PROGRAM.
    The Attorney General may award covered grants for each of the first 
5 fiscal years beginning after the date of enactment of this Act.
SEC. 3260. AUTHORIZATION OF APPROPRIATIONS.
    There is authorized to be appropriated to the Attorney General such 
sums as may be necessary to carry out this chapter.

           CHAPTER 7--USING DATA TO PREVENT OPIOID DIVERSION

SEC. 3271. SHORT TITLE.
    This chapter may be cited as the ``Using Data To Prevent Opioid 
Diversion Act of 2018''.
SEC. 3272. PURPOSE.
    (a) In General.--The purpose of this chapter is to provide drug 
manufacturers and distributors with access to anonymized information 
through the Automated Reports and Consolidated Orders System to help 
drug manufacturers and distributors identify, report, and stop 
suspicious orders of opioids and reduce diversion rates.
    (b) Rule of Construction.--Nothing in this chapter should be 
construed to absolve a drug manufacturer, drug distributor, or other 
Drug Enforcement Administration registrant from the responsibility of 
the manufacturer, distributor, or other registrant to--
        (1) identify, stop, and report suspicious orders; or
        (2) maintain effective controls against diversion in accordance 
    with section 303 of the Controlled Substances Act (21 U.S.C. 823) 
    or any successor law or associated regulation.
SEC. 3273. AMENDMENTS.
    (a) Records and Reports of Registrants.--Section 307 of the 
Controlled Substances Act (21 U.S.C. 827) is amended--
        (1) by redesignating subsections (f), (g), and (h) as 
    subsections (g), (h), and (i), respectively;
        (2) by inserting after subsection (e) the following:
    ``(f)(1) The Attorney General shall, not less frequently than 
quarterly, make the following information available to manufacturer and 
distributor registrants through the Automated Reports and Consolidated 
Orders System, or any subsequent automated system developed by the Drug 
Enforcement Administration to monitor selected controlled substances:
        ``(A) The total number of distributor registrants that 
    distribute controlled substances to a pharmacy or practitioner 
    registrant, aggregated by the name and address of each pharmacy and 
    practitioner registrant.
        ``(B) The total quantity and type of opioids distributed, 
    listed by Administration Controlled Substances Code Number, to each 
    pharmacy and practitioner registrant described in subparagraph (A).
    ``(2) The information required to be made available under paragraph 
(1) shall be made available not later than the 30th day of the first 
month following the quarter to which the information relates.
    ``(3)(A) All registered manufacturers and distributors shall be 
responsible for reviewing the information made available by the 
Attorney General under this subsection.
    ``(B) In determining whether to initiate proceedings under this 
title against a registered manufacturer or distributor based on the 
failure of the registrant to maintain effective controls against 
diversion or otherwise comply with the requirements of this title or 
the regulations issued thereunder, the Attorney General may take into 
account that the information made available under this subsection was 
available to the registrant.''; and
        (3) by inserting after subsection (i), as so redesignated, the 
    following:
    ``(j) All of the reports required under this section shall be 
provided in an electronic format.''.
    (b) Cooperative Arrangements.--Section 503 of the Controlled 
Substances Act (21 U.S.C. 873) is amended by striking subsection (c) 
and inserting the following:
    ``(c)(1) The Attorney General shall, once every 6 months, prepare 
and make available to regulatory, licensing, attorneys general, and law 
enforcement agencies of States a standardized report containing 
descriptive and analytic information on the actual distribution 
patterns, as gathered through the Automated Reports and Consolidated 
Orders System, or any subsequent automated system, pursuant to section 
307 and which includes detailed amounts, outliers, and trends of 
distributor and pharmacy registrants, in such States for the controlled 
substances contained in schedule II, which, in the discretion of the 
Attorney General, are determined to have the highest abuse.
    ``(2) If the Attorney General publishes the report described in 
paragraph (1) once every 6 months as required under paragraph (1), 
nothing in this subsection shall be construed to bring an action in any 
court to challenge the sufficiency of the information or to compel the 
Attorney General to produce any documents or reports referred to in 
this subsection.''.
    (c) Civil and Criminal Penalties.--Section 402 of the Controlled 
Substances Act (21 U.S.C. 842) is amended--
        (1) in subsection (a)--
            (A) in paragraph (15), by striking ``or'' at the end;
            (B) in paragraph (16), by striking the period at the end 
        and inserting ``; or''; and
            (C) by inserting after paragraph (16) the following:
        ``(17) in the case of a registered manufacturer or distributor 
    of opioids, to fail to review the most recent information, directly 
    related to the customers of the manufacturer or distributor, made 
    available by the Attorney General in accordance with section 
    307(f).''; and
        (2) in subsection (c)--
            (A) in paragraph (1), by striking subparagraph (B) and 
        inserting the following:
    ``(B)(i) Except as provided in clause (ii), in the case of a 
violation of paragraph (5), (10), or (17) of subsection (a), the civil 
penalty shall not exceed $10,000.
    ``(ii) In the case of a violation described in clause (i) committed 
by a registered manufacturer or distributor of opioids and related to 
the reporting of suspicious orders for opioids, failing to maintain 
effective controls against diversion of opioids, or failing to review 
the most recent information made available by the Attorney General in 
accordance with section 307(f), the penalty shall not exceed 
$100,000.''; and
            (B) in paragraph (2)--
                (i) in subparagraph (A), by inserting ``or (D)'' after 
            ``subparagraph (B)''; and
                (ii) by adding at the end the following:
    ``(D) In the case of a violation described in subparagraph (A) that 
was a violation of paragraph (5), (10), or (17) of subsection (a) 
committed by a registered manufacturer or distributor of opioids that 
relates to the reporting of suspicious orders for opioids, failing to 
maintain effective controls against diversion of opioids, or failing to 
review the most recent information made available by the Attorney 
General in accordance with section 307(f), the criminal fine under 
title 18, United States Code, shall not exceed $500,000.''.
SEC. 3274. REPORT.
    Not later than 1 year after the date of enactment of this Act, the 
Attorney General shall submit to Congress a report that provides 
information about how the Attorney General is using data in the 
Automation of Reports and Consolidated Orders System to identify and 
stop suspicious activity, including whether the Attorney General is 
looking at aggregate orders from individual pharmacies to multiple 
distributors that in total are suspicious, even if no individual order 
rises to the level of a suspicious order to a given distributor.

                     CHAPTER 8--OPIOID QUOTA REFORM

SEC. 3281. SHORT TITLE.
    This chapter may be cited as the ``Opioid Quota Reform Act''.
SEC. 3282. STRENGTHENING CONSIDERATIONS FOR DEA OPIOID QUOTAS.
    (a) In General.--Section 306 of the Controlled Substances Act (21 
U.S.C. 826) is amended--
        (1) in subsection (a)--
            (A) by inserting ``(1)'' after ``(a)'';
            (B) in the second sentence, by striking ``Production'' and 
        inserting ``Except as provided in paragraph (2), production''; 
        and
            (C) by adding at the end the following:
    ``(2) The Attorney General may, if the Attorney General determines 
it will assist in avoiding the overproduction, shortages, or diversion 
of a controlled substance, establish an aggregate or individual 
production quota under this subsection, or a procurement quota 
established by the Attorney General by regulation, in terms of 
pharmaceutical dosage forms prepared from or containing the controlled 
substance.'';
        (2) in subsection (b), in the first sentence, by striking 
    ``production'' and inserting ``manufacturing'';
        (3) in subsection (c), by striking ``October'' and inserting 
    ``December''; and
        (4) by adding at the end the following:
    ``(i)(1)(A) In establishing any quota under this section, or any 
procurement quota established by the Attorney General by regulation, 
for fentanyl, oxycodone, hydrocodone, oxymorphone, or hydromorphone (in 
this subsection referred to as a `covered controlled substance'), the 
Attorney General shall estimate the amount of diversion of the covered 
controlled substance that occurs in the United States.
    ``(B) In estimating diversion under this paragraph, the Attorney 
General--
        ``(i) shall consider information the Attorney General, in 
    consultation with the Secretary of Health and Human Services, 
    determines reliable on rates of overdose deaths and abuse and 
    overall public health impact related to the covered controlled 
    substance in the United States; and
        ``(ii) may take into consideration whatever other sources of 
    information the Attorney General determines reliable.
    ``(C) After estimating the amount of diversion of a covered 
controlled substance, the Attorney General shall make appropriate quota 
reductions, as determined by the Attorney General, from the quota the 
Attorney General would have otherwise established had such diversion 
not been considered.
    ``(2)(A) For any year for which the approved aggregate production 
quota for a covered controlled substance is higher than the approved 
aggregate production quota for the covered controlled substance for the 
previous year, the Attorney General, in consultation with the Secretary 
of Health and Human Services, shall include in the final order an 
explanation of why the public health benefits of increasing the quota 
clearly outweigh the consequences of having an increased volume of the 
covered controlled substance available for sale, and potential 
diversion, in the United States.
    ``(B) Not later than 1 year after the date of enactment of this 
subsection, and every year thereafter, the Attorney General shall 
submit to the Committee on the Judiciary, the Committee on Health, 
Education, Labor, and Pensions, and the Committee on Appropriations of 
the Senate and the Committee on the Judiciary, the Committee on Energy 
and Commerce, and the Committee on Appropriations of the House of 
Representatives the following information with regard to each covered 
controlled substance:
        ``(i) An anonymized count of the total number of manufacturers 
    issued individual manufacturing quotas that year for the covered 
    controlled substance.
        ``(ii) An anonymized count of how many such manufacturers were 
    issued an approved manufacturing quota that was higher than the 
    quota issued to that manufacturer for the covered controlled 
    substance in the previous year.
    ``(3) Not later than 1 year after the date of enactment of this 
subsection, the Attorney General shall submit to Congress a report on 
how the Attorney General, when fixing and adjusting production and 
manufacturing quotas under this section for covered controlled 
substances, will--
        ``(A) take into consideration changes in the accepted medical 
    use of the covered controlled substances; and
        ``(B) work with the Secretary of Health and Human Services on 
    methods to appropriately and anonymously estimate the type and 
    amount of covered controlled substances that are submitted for 
    collection from approved drug collection receptacles, mail-back 
    programs, and take-back events.''.
    (b) Conforming Change.--The Law Revision Counsel is directed to 
amend the heading for subsection (b) of section 826 of title 21, United 
States Code, by striking ``Production'' and inserting 
``Manufacturing''.

                  CHAPTER 9--PREVENTING DRUG DIVERSION

SEC. 3291. SHORT TITLE.
    This chapter may be cited as the ``Preventing Drug Diversion Act of 
2018''.
SEC. 3292. IMPROVEMENTS TO PREVENT DRUG DIVERSION.
    (a) Definition.--Section 102 of the Controlled Substances Act (21 
U.S.C. 802) is amended by adding at the end the following:
        ``(57) The term `suspicious order' may include, but is not 
    limited to--
            ``(A) an order of a controlled substance of unusual size;
            ``(B) an order of a controlled substance deviating 
        substantially from a normal pattern; and
            ``(C) orders of controlled substances of unusual 
        frequency.''.
    (b) Suspicious Orders.--Part C of the Controlled Substances Act (21 
U.S.C. 821 et seq.) is amended by adding at the end the following:
    ``SEC. 312. SUSPICIOUS ORDERS.
    ``(a) Reporting.--Each registrant shall--
        ``(1) design and operate a system to identify suspicious orders 
    for the registrant;
        ``(2) ensure that the system designed and operated under 
    paragraph (1) by the registrant complies with applicable Federal 
    and State privacy laws; and
        ``(3) upon discovering a suspicious order or series of orders, 
    notify the Administrator of the Drug Enforcement Administration and 
    the Special Agent in Charge of the Division Office of the Drug 
    Enforcement Administration for the area in which the registrant is 
    located or conducts business.
    ``(b) Suspicious Order Database.--
        ``(1) In general.--Not later than 1 year after the date of 
    enactment of this section, the Attorney General shall establish a 
    centralized database for collecting reports of suspicious orders.
        ``(2) Satisfaction of reporting requirements.--If a registrant 
    reports a suspicious order to the centralized database established 
    under paragraph (1), the registrant shall be considered to have 
    complied with the requirement under subsection (a)(3) to notify the 
    Administrator of the Drug Enforcement Administration and the 
    Special Agent in Charge of the Division Office of the Drug 
    Enforcement Administration for the area in which the registrant is 
    located or conducts business.
    ``(c) Sharing Information With the States.--
        ``(1) In general.--The Attorney General shall prepare and make 
    available information regarding suspicious orders in a State, 
    including information in the database established under subsection 
    (b)(1), to the point of contact for purposes of administrative, 
    civil, and criminal oversight relating to the diversion of 
    controlled substances for the State, as designated by the Governor 
    or chief executive officer of the State.
        ``(2) Timing.--The Attorney General shall provide information 
    in accordance with paragraph (1) within a reasonable period of time 
    after obtaining the information.
        ``(3) Coordination.--In establishing the process for the 
    provision of information under this subsection, the Attorney 
    General shall coordinate with States to ensure that the Attorney 
    General has access to information, as permitted under State law, 
    possessed by the States relating to prescriptions for controlled 
    substances that will assist in enforcing Federal law.''.
    (c) Reports to Congress.--
        (1) Definition.--In this subsection, the term ``suspicious 
    order'' has the meaning given that term in section 102 of the 
    Controlled Substances Act, as amended by this chapter.
        (2) One-time report.--Not later than 1 year after the date of 
    enactment of this Act, the Attorney General shall submit to 
    Congress a report on the reporting of suspicious orders, which 
    shall include--
            (A) a description of the centralized database established 
        under section 312 of the Controlled Substances Act, as added by 
        this section, to collect reports of suspicious orders;
            (B) a description of the system and reports established 
        under section 312 of the Controlled Substances Act, as added by 
        this section, to share information with States;
            (C) information regarding how the Attorney General used 
        reports of suspicious orders before the date of enactment of 
        this Act and after the date of enactment of this Act, including 
        how the Attorney General received the reports and what actions 
        were taken in response to the reports; and
            (D) descriptions of the data analyses conducted on reports 
        of suspicious orders to identify, analyze, and stop suspicious 
        activity.
        (3) Additional reports.--Not later than 1 year after the date 
    of enactment of this Act, and annually thereafter until the date 
    that is 5 years after the date of enactment of this Act, the 
    Attorney General shall submit to Congress a report providing, for 
    the previous year--
            (A) the number of reports of suspicious orders;
            (B) a summary of actions taken in response to reports, in 
        the aggregate, of suspicious orders; and
            (C) a description of the information shared with States 
        based on reports of suspicious orders.
        (4) One-time gao report.--Not later than 1 year after the date 
    of enactment of this Act, the Comptroller General of the United 
    States, in consultation with the Administrator of the Drug 
    Enforcement Administration, shall submit to Congress a report on 
    the reporting of suspicious orders, which shall include an 
    evaluation of the utility of real-time reporting of potential 
    suspicious orders of opioids on a national level using computerized 
    algorithms, including the extent to which such algorithms--
            (A) would help ensure that potentially suspicious orders 
        are more accurately captured, identified, and reported in real 
        time to suppliers before orders are filled;
            (B) may produce false positives of suspicious order reports 
        that could result in market disruptions for legitimate orders 
        of opioids; and
            (C) would reduce the overall length of an investigation 
        that prevents the diversion of suspicious orders of opioids.

                           TITLE IV--OFFSETS

SEC. 4001. PROMOTING VALUE IN MEDICAID MANAGED CARE.
    Section 1903(m) of the Social Security Act (42 U.S.C. 1396b(m)), as 
amended by sections 1013 and 1016, is further amended by adding at the 
end the following new paragraph:
    ``(9)(A) With respect to expenditures described in subparagraph (B) 
that are incurred by a State for any fiscal year after fiscal year 2020 
(and before fiscal year 2024), in determining the pro rata share to 
which the United States is equitably entitled under subsection (d)(3), 
the Secretary shall substitute the Federal medical assistance 
percentage that applies for such fiscal year to the State under section 
1905(b) (without regard to any adjustments to such percentage 
applicable under such section or any other provision of law) for the 
percentage that applies to such expenditures under section 1905(y).
    ``(B) Expenditures described in this subparagraph, with respect to 
a fiscal year to which subparagraph (A) applies, are expenditures 
incurred by a State for payment for medical assistance provided to 
individuals described in subclause (VIII) of section 1902(a)(10)(A)(i) 
by a managed care entity, or other specified entity (as defined in 
subparagraph (D)(iii)), that are treated as remittances because the 
State--
        ``(i) has satisfied the requirement of section 438.8 of title 
    42, Code of Federal Regulations (or any successor regulation), by 
    electing--
            ``(I) in the case of a State described in subparagraph (C), 
        to apply a minimum medical loss ratio (as defined in 
        subparagraph (D)(ii)) that is at least 85 percent but not 
        greater than the minimum medical loss ratio (as so defined) 
        that such State applied as of May 31, 2018; or
            ``(II) in the case of a State not described in subparagraph 
        (C), to apply a minimum medical loss ratio that is equal to 85 
        percent; and
        ``(ii) recovered all or a portion of the expenditures as a 
    result of the entity's failure to meet such ratio.
    ``(C) For purposes of subparagraph (B), a State described in this 
subparagraph is a State that as of May 31, 2018, applied a minimum 
medical loss ratio (as calculated under subsection (d) of section 438.8 
of title 42, Code of Federal Regulations (as in effect on June 1, 
2018)) for payment for services provided by entities described in such 
subparagraph under the State plan under this title (or a waiver of the 
plan) that is equal to or greater than 85 percent.
    ``(D) For purposes of this paragraph:
        ``(i) The term `managed care entity' means a medicaid managed 
    care organization described in section 1932(a)(1)(B)(i).
        ``(ii) The term `minimum medical loss ratio' means, with 
    respect to a State, a minimum medical loss ratio (as calculated 
    under subsection (d) of section 438.8 of title 42, Code of Federal 
    Regulations (as in effect on June 1, 2018)) for payment for 
    services provided by entities described in subparagraph (B) under 
    the State plan under this title (or a waiver of the plan).
        ``(iii) The term `other specified entity' means--
            ``(I) a prepaid inpatient health plan, as defined in 
        section 438.2 of title 42, Code of Federal Regulations (or any 
        successor regulation); and
            ``(II) a prepaid ambulatory health plan, as defined in such 
        section (or any successor regulation).''.
SEC. 4002. REQUIRING REPORTING BY GROUP HEALTH PLANS OF PRESCRIPTION 
DRUG COVERAGE INFORMATION FOR PURPOSES OF IDENTIFYING PRIMARY PAYER 
SITUATIONS UNDER THE MEDICARE PROGRAM.
    Clause (i) of section 1862(b)(7)(A) of the Social Security Act (42 
U.S.C. 1395y(b)(7)(A)) is amended to read as follows:
                ``(i) secure from the plan sponsor and plan 
            participants such information as the Secretary shall 
            specify for the purpose of identifying situations where the 
            group health plan is or has been--

                    ``(I) a primary plan to the program under this 
                title; or
                    ``(II) for calendar quarters beginning on or after 
                January 1, 2020, a primary payer with respect to 
                benefits relating to prescription drug coverage under 
                part D; and''.

SEC. 4003. ADDITIONAL RELIGIOUS EXEMPTION FROM HEALTH COVERAGE 
RESPONSIBILITY REQUIREMENT.
    (a) In General.--Section 5000A(d)(2)(A) of the Internal Revenue 
Code of 1986 is amended to read as follows:
            ``(A) Religious conscience exemptions.--
                ``(i) In general.--Such term shall not include any 
            individual for any month if such individual has in effect 
            an exemption under section 1311(d)(4)(H) of the Patient 
            Protection and Affordable Care Act which certifies that--

                    ``(I) such individual is a member of a recognized 
                religious sect or division thereof which is described 
                in section 1402(g)(1), and is adherent of established 
                tenets or teachings of such sect or division as 
                described in such section; or
                    ``(II) such individual is a member of a religious 
                sect or division thereof which is not described in 
                section 1402(g)(1), who relies solely on a religious 
                method of healing, and for whom the acceptance of 
                medical health services would be inconsistent with the 
                religious beliefs of the individual.

                ``(ii) Special rules.--

                    ``(I) Medical health services defined.--For 
                purposes of this subparagraph, the term `medical health 
                services' does not include routine dental, vision and 
                hearing services, midwifery services, vaccinations, 
                necessary medical services provided to children, 
                services required by law or by a third party, and such 
                other services as the Secretary of Health and Human 
                Services may provide in implementing section 
                1311(d)(4)(H) of the Patient Protection and Affordable 
                Care Act.
                    ``(II) Attestation required.--Clause (i)(II) shall 
                apply to an individual for months in a taxable year 
                only if the information provided by the individual 
                under section 1411(b)(5)(A) of such Act includes an 
                attestation that the individual has not received 
                medical health services during the preceding taxable 
                year.''.

    (b) Effective Date.--The amendment made by subsection (a) shall 
apply to taxable years beginning after December 31, 2018.
    (c) Construction.--Nothing in the amendment made by subsection (a) 
shall preempt any State law requiring the provision of medical 
treatment for children, especially those who are seriously ill.
SEC. 4004. MODERNIZING THE REPORTING OF BIOLOGICAL AND BIOSIMILAR 
PRODUCTS.
    Subtitle B of title XI of the Medicare Prescription Drug, 
Improvement, and Modernization Act of 2003 (Public Law 108-173) is 
amended--
        (1) in section 1111, as amended by section 3(1) of the Patient 
    Right to Know Drug Prices Act--
            (A) in the paragraph (3) inserted by such section 3(1), by 
        striking ``an application'' and inserting ``a biosimilar 
        biological product application'';
            (B) in the paragraph (4) inserted by such section 3(1), by 
        inserting ``application'' before ``under section 351(k) of the 
        Public Health Service Act'';
            (C) in the paragraph (5) inserted by such section 3(1), by 
        striking ``for licensure of a biological product under section 
        351(k) of the Public Health Service Act'' and inserting ``under 
        section 351(k) of the Public Health Service Act for licensure 
        of a biological product as biosimilar to, or interchangeable 
        with, a reference product'';
            (D) in paragraph (7), as redesignated and amended by such 
        section 3(1), by striking ``or under section 351(a) of the 
        Public Health Service Act'' and inserting ``or the owner, or 
        exclusive licensee, of a patent included in a list provided 
        under section 351(l)(3) of the Public Health Service Act''; and
            (E) in the paragraph (12) added by such section 3(1), by 
        striking ``means a brand name drug for which a license is in 
        effect under section 351(a)'' and inserting ``has the meaning 
        given such term in section 351(i)''; and
        (2) in section 1112, as amended by section 3(2) of the Patient 
    Right to Know Drug Prices Act--
            (A) in subsection (a)--
                (i) in paragraph (1), by striking ``for which a 
            statement under section 351(l)(3)(B)(ii)(I) of the Public 
            Health Service Act has been provided'';
                (ii) in paragraph (2)--

                    (I) in subparagraph (C)(i), by striking ``brand 
                name'' and inserting ``listed''; and
                    (II) by amending clause (ii) of subparagraph (C) to 
                read as follows:

                ``(ii) any of the time periods referred to in section 
            351(k)(6) of the Public Health Service Act as such period 
            applies to such biosimilar biological product application 
            or to any other biosimilar biological product application 
            based on the same reference product.'';
            (B) in subsection (b)--
                (i) in the subsection heading, by inserting ``or 
            Biosimilar Biological Product Applicant'' after 
            ``Applicant'';
                (ii) in paragraph (1)(B), by striking the first 
            sentence and inserting the following: ``A biosimilar 
            biological product applicant that has submitted a 
            biosimilar biological product application that references a 
            reference product and another biosimilar biological product 
            applicant that has submitted a biosimilar biological 
            product application that references the same reference 
            product shall each file the agreement in accordance with 
            subsection (c).''; and
                (iii) in paragraph (2)--

                    (I) by striking ``2 generic drug applicants'' and 
                inserting ``2 or more generic drug applicants''; and
                    (II) by striking ``or an agreement between 2 
                biosimilar biological product applicants regarding the 
                1-year period referred to in section 351(k)(6)(A) of 
                the Public Health Service Act as it applies to the 
                biosimilar biological product applications with which 
                the agreement is concerned'' and inserting ``, an 
                agreement between 2 or more biosimilar biological 
                product applicants regarding a time period referred to 
                in section 351(k)(6) of the Public Health Service Act 
                as it applies to the biosimilar biological product, or 
                an agreement between 2 or more biosimilar biological 
                product applicants regarding the manufacture, 
                marketing, or sale of a biosimilar biological 
                product''; and

            (C) in subsection (c)(2), by inserting ``were entered into 
        within 30 days of,'' after ``condition for,''.

                   TITLE V--OTHER MEDICAID PROVISIONS
Subtitle A--Mandatory Reporting With Respect to Adult Behavioral Health 
                                Measures

SEC. 5001. MANDATORY REPORTING WITH RESPECT TO ADULT BEHAVIORAL HEALTH 
MEASURES.
    Section 1139B of the Social Security Act (42 U.S.C. 1320b-9b) is 
amended--
        (1) in subsection (b)--
            (A) in paragraph (3)--
                (i) by striking ``Not later than January 1, 2013'' and 
            inserting the following:
            ``(A) Voluntary reporting.--Not later than January 1, 
        2013''; and
                (ii) by adding at the end the following:
            ``(B) Mandatory reporting with respect to behavioral health 
        measures.--Beginning with the State report required under 
        subsection (d)(1) for 2024, the Secretary shall require States 
        to use all behavioral health measures included in the core set 
        of adult health quality measures and any updates or changes to 
        such measures to report information, using the standardized 
        format for reporting information and procedures developed under 
        subparagraph (A), regarding the quality of behavioral health 
        care for Medicaid eligible adults.''; and
            (B) in paragraph (5), by adding at the end the following 
        new subparagraph:
            ``(C) Behavioral health measures.--Beginning with respect 
        to State reports required under subsection (d)(1) for 2024, the 
        core set of adult health quality measures maintained under this 
        paragraph (and any updates or changes to such measures) shall 
        include behavioral health measures.''; and
        (2) in subsection (d)(1)(A)--
            (A) by striking ``the such plan'' and inserting ``such 
        plan''; and
            (B) by striking ``subsection (a)(5)'' and inserting 
        ``subsection (b)(5) and, beginning with the report for 2024, 
        all behavioral health measures included in the core set of 
        adult health quality measures maintained under such subsection 
        (b)(5) and any updates or changes to such measures (as required 
        under subsection (b)(3))''.

                Subtitle B--Medicaid IMD Additional Info

SEC. 5011. SHORT TITLE.
    This subtitle may be cited as the ``Medicaid Institutes for Mental 
Disease Are Decisive in Delivering Inpatient Treatment for Individuals 
but Opportunities for Needed Access are Limited without Information 
Needed about Facility Obligations Act'' or the ``Medicaid IMD 
ADDITIONAL INFO Act''.
SEC. 5012. MACPAC EXPLORATORY STUDY AND REPORT ON INSTITUTIONS FOR 
MENTAL DISEASES REQUIREMENTS AND PRACTICES UNDER MEDICAID.
    (a) In General.--Not later than January 1, 2020, the Medicaid and 
CHIP Payment and Access Commission established under section 1900 of 
the Social Security Act (42 U.S.C. 1396) shall conduct an exploratory 
study, using data from a representative sample of States, and submit to 
Congress a report on at least the following information, with respect 
to services furnished to individuals enrolled under State plans under 
the Medicaid program under title XIX of such Act (42 U.S.C. 1396 et 
seq.) (or waivers of such plans) who are patients in institutions for 
mental diseases and for which payment is made through fee-for-service 
or managed care arrangements under such State plans (or waivers):
        (1) A description of such institutions for mental diseases in 
    each such State, including at a minimum--
            (A) the number of such institutions in the State;
            (B) the facility type of such institutions in the State; 
        and
            (C) any coverage limitations under each such State plan (or 
        waiver) on scope, duration, or frequency of such services.
        (2) With respect to each such institution for mental diseases 
    in each such State, a description of--
            (A) such services provided at such institution;
            (B) the process, including any timeframe, used by such 
        institution to clinically assess and reassess such individuals; 
        and
            (C) the discharge process used by such institution, 
        including any care continuum of relevant services or facilities 
        provided or used in such process.
        (3) A description of--
            (A) any Federal waiver that each such State has for such 
        institutions and the Federal statutory authority for such 
        waiver; and
            (B) any other Medicaid funding sources used by each such 
        State for funding such institutions, such as supplemental 
        payments.
        (4) A summary of State requirements (such as certification, 
    licensure, and accreditation) applied by each such State to such 
    institutions in order for such institutions to receive payment 
    under the State plan (or waiver) and how each such State determines 
    if such requirements have been met.
        (5) A summary of State standards (such as quality standards, 
    clinical standards, and facility standards) that such institutions 
    must meet to receive payment under such State plans (or waivers) 
    and how each such State determines if such standards have been met.
        (6) If determined appropriate by the Commission, 
    recommendations for policies and actions by Congress and the 
    Centers for Medicare & Medicaid Services, such as on how State 
    Medicaid programs may improve care and improve standards and 
    including a recommendation for how the Centers for Medicare & 
    Medicaid Services can improve data collection from such programs to 
    address any gaps in information.
    (b) Stakeholder Input.--In carrying out subsection (a), the 
Medicaid and CHIP Payment and Access Commission shall seek input from 
State Medicaid directors and stakeholders, including at a minimum the 
Substance Abuse and Mental Health Services Administration, Centers for 
Medicare & Medicaid Services, State Medicaid officials, State mental 
health authorities, Medicaid beneficiary advocates, health care 
providers, and Medicaid managed care organizations.
    (c) Definitions.--In this section:
        (1) Representative sample of states.--The term ``representative 
    sample of States'' means a non-probability sample in which at least 
    two States are selected based on the knowledge and professional 
    judgment of the selector.
        (2) State.--The term ``State'' means each of the 50 States, the 
    District of Columbia, and any commonwealth or territory of the 
    United States.
        (3) Institution for mental diseases.--The term ``institution 
    for mental diseases'' has the meaning given such term in section 
    435.1010 of title 42, Code of Federal Regulations, or any successor 
    regulation.

    Subtitle C--CHIP Mental Health and Substance Use Disorder Parity

SEC. 5021. SHORT TITLE.
    This subtitle may be cited as the ``CHIP Mental Health and 
Substance Use Disorder Parity Act''.
SEC. 5022. ENSURING ACCESS TO MENTAL HEALTH AND SUBSTANCE USE DISORDER 
SERVICES FOR CHILDREN AND PREGNANT WOMEN UNDER THE CHILDREN'S HEALTH 
INSURANCE PROGRAM.
    (a) In General.--Section 2103(c)(1) of the Social Security Act (42 
U.S.C. 1397cc(c)(1)) is amended by adding at the end the following new 
subparagraph:
            ``(E) Mental health and substance use disorder services (as 
        defined in paragraph (5)).''.
    (b) Mental Health and Substance Use Disorder Services.--
        (1) In general.--Section 2103(c) of the Social Security Act (42 
    U.S.C. 1397cc(c)) is amended--
            (A) by redesignating paragraphs (5), (6), (7), and (8) as 
        paragraphs (6), (7), (8), and (9), respectively; and
            (B) by inserting after paragraph (4) the following new 
        paragraph:
        ``(5) Mental health and substance use disorder services.--
    Regardless of the type of coverage elected by a State under 
    subsection (a), child health assistance provided under such 
    coverage for targeted low-income children and, in the case that the 
    State elects to provide pregnancy-related assistance under such 
    coverage pursuant to section 2112, such pregnancy-related 
    assistance for targeted low-income pregnant women (as defined in 
    section 2112(d)) shall--
            ``(A) include coverage of mental health services (including 
        behavioral health treatment) necessary to prevent, diagnose, 
        and treat a broad range of mental health symptoms and 
        disorders, including substance use disorders; and
            ``(B) be delivered in a culturally and linguistically 
        appropriate manner.''.
        (2) Conforming amendments.--
            (A) Section 2103(a) of the Social Security Act (42 U.S.C. 
        1397cc(a)) is amended, in the matter before paragraph (1), by 
        striking ``paragraphs (5), (6), and (7)'' and inserting 
        ``paragraphs (5), (6), (7), and (8)''.
            (B) Section 2110(a) of the Social Security Act (42 U.S.C. 
        1397jj(a)) is amended--
                (i) in paragraph (18), by striking ``substance abuse'' 
            each place it appears and inserting ``substance use''; and
                (ii) in paragraph (19), by striking ``substance abuse'' 
            and inserting ``substance use''.
            (C) Section 2110(b)(5)(A)(i) of the Social Security Act (42 
        U.S.C. 1397jj(b)(5)(A)(i)) is amended by striking ``subsection 
        (c)(5)'' and inserting ``subsection (c)(6)''.
    (c) Assuring Access to Care.--Section 2102(a)(7)(B) of the Social 
Security Act (42 U.S.C. 1397bb(c)(2)) is amended by striking ``section 
2103(c)(5)'' and inserting ``paragraphs (5) and (6) of section 
2103(c)''.
    (d) Mental Health Services Parity.--Subparagraph (A) of paragraph 
(7) of section 2103(c) of the Social Security Act (42 U.S.C. 1397cc(c)) 
(as redesignated by subsection (b)(1)) is amended to read as follows:
            ``(A) In general.--A State child health plan shall ensure 
        that the financial requirements and treatment limitations 
        applicable to mental health and substance use disorder services 
        (as described in paragraph (5)) provided under such plan comply 
        with the requirements of section 2726(a) of the Public Health 
        Service Act in the same manner as such requirements or 
        limitations apply to a group health plan under such section.''.
    (e) Effective Date.--
        (1) In general.--Subject to paragraph (2), the amendments made 
    by this section shall take effect with respect to child health 
    assistance provided on or after the date that is 1 year after the 
    date of the enactment of this Act.
        (2) Exception for state legislation.--In the case of a State 
    child health plan under title XXI of the Social Security Act (or a 
    waiver of such plan), which the Secretary of Health and Human 
    Services determines requires State legislation in order for the 
    respective plan (or waiver) to meet any requirement imposed by the 
    amendments made by this section, the respective plan (or waiver) 
    shall not be regarded as failing to comply with the requirements of 
    such title solely on the basis of its failure to meet such an 
    additional requirement before the first day of the first calendar 
    quarter beginning after the close of the first regular session of 
    the State legislature that begins after the date of enactment of 
    this section. For purposes of the previous sentence, in the case of 
    a State that has a 2-year legislative session, each year of the 
    session shall be considered to be a separate regular session of the 
    State legislature.

                      Subtitle D--Medicaid Reentry

SEC. 5031. SHORT TITLE.
    This subtitle may be cited as the ``Medicaid Reentry Act''.
SEC. 5032. PROMOTING STATE INNOVATIONS TO EASE TRANSITIONS INTEGRATION 
TO THE COMMUNITY FOR CERTAIN INDIVIDUALS.
    (a) Stakeholder Group Development of Best Practices; State Medicaid 
Program Innovation.--
        (1) Stakeholder group best practices.--Not later than 6 months 
    after the date of the enactment of this Act, the Secretary of 
    Health and Human Services shall convene a stakeholder group of 
    representatives of managed care organizations, Medicaid 
    beneficiaries, health care providers, the National Association of 
    Medicaid Directors, and other relevant representatives from local, 
    State, and Federal jail and prison systems to develop best 
    practices (and submit to the Secretary and Congress a report on 
    such best practices) for States--
            (A) to ease the health care-related transition of an 
        individual who is an inmate of a public institution from the 
        public institution to the community, including best practices 
        for ensuring continuity of health insurance coverage or 
        coverage under the State Medicaid plan under title XIX of the 
        Social Security Act, as applicable, and relevant social 
        services; and
            (B) to carry out, with respect to such an individual, such 
        health care-related transition not later than 30 days after 
        such individual is released from the public institution.
        (2) State medicaid program innovation.--The Secretary of Health 
    and Human Services shall work with States on innovative strategies 
    to help individuals who are inmates of public institutions and 
    otherwise eligible for medical assistance under the Medicaid 
    program under title XIX of the Social Security Act transition, with 
    respect to enrollment for medical assistance under such program, 
    seamlessly to the community.
    (b) Guidance on Innovative Service Delivery Systems Demonstration 
Project Opportunities.--Not later than 1 year after the date of the 
enactment of this Act, the Secretary of Health and Human Services, 
through the Administrator of the Centers for Medicare & Medicaid 
Services, shall issue a State Medicaid Director letter, based on best 
practices developed under subsection (a)(1), regarding opportunities to 
design demonstration projects under section 1115 of the Social Security 
Act (42 U.S.C. 1315) to improve care transitions for certain 
individuals who are soon-to-be former inmates of a public institution 
and who are otherwise eligible to receive medical assistance under 
title XIX of such Act, including systems for, with respect to a period 
(not to exceed 30 days) immediately prior to the day on which such 
individuals are expected to be released from such institution--
        (1) providing assistance and education for enrollment under a 
    State plan under the Medicaid program under title XIX of such Act 
    for such individuals during such period; and
        (2) providing health care services for such individuals during 
    such period.
    (c) Rule of Construction.--Nothing under title XIX of the Social 
Security Act or any other provision of law precludes a State from 
reclassifying or suspending (rather than terminating) eligibility of an 
individual for medical assistance under title XIX of the Social 
Security Act while such individual is an inmate of a public 
institution.

                    Subtitle E--Medicaid Partnership

SEC. 5041. SHORT TITLE.
    This subtitle may be cited as the ``Medicaid Providers Are Required 
To Note Experiences in Record Systems to Help In-need Patients Act'' or 
the ``Medicaid PARTNERSHIP Act''.
SEC. 5042. MEDICAID PROVIDERS ARE REQUIRED TO NOTE EXPERIENCES IN 
RECORD SYSTEMS TO HELP IN-NEED PATIENTS.
    (a) Requirements Under the Medicaid Program Relating to Qualified 
Prescription Drug Monitoring Programs and Prescribing Certain 
Controlled Substances.--Title XIX of the Social Security Act (42 U.S.C. 
1396 et seq.) is amended by inserting after section 1943 the following 
new section:
``SEC. 1944. REQUIREMENTS RELATING TO QUALIFIED PRESCRIPTION DRUG 
MONITORING PROGRAMS AND PRESCRIBING CERTAIN CONTROLLED SUBSTANCES.
    ``(a) In General.--Subject to subsection (d), beginning October 1, 
2021, a State--
        ``(1) shall require each covered provider to check, in 
    accordance with such timing, manner, and form as specified by the 
    State, the prescription drug history of a covered individual being 
    treated by the covered provider through a qualified prescription 
    drug monitoring program described in subsection (b) before 
    prescribing to such individual a controlled substance; and
        ``(2) in the case that such a provider is not able to conduct 
    such a check despite a good faith effort by such provider--
            ``(A) shall require the provider to document such good 
        faith effort, including the reasons why the provider was not 
        able to conduct the check; and
            ``(B) may require the provider to submit, upon request, 
        such documentation to the State.
    ``(b) Qualified Prescription Drug Monitoring Program Described.--A 
qualified prescription drug monitoring program described in this 
subsection is, with respect to a State, a prescription drug monitoring 
program administered by the State that, at a minimum, satisfies each of 
the following criteria:
        ``(1) The program facilitates access by a covered provider to, 
    at a minimum, the following information with respect to a covered 
    individual, in as close to real-time as possible:
            ``(A) Information regarding the prescription drug history 
        of a covered individual with respect to controlled substances.
            ``(B) The number and type of controlled substances 
        prescribed to and filled for the covered individual during at 
        least the most recent 12-month period.
            ``(C) The name, location, and contact information (or other 
        identifying number selected by the State, such as a national 
        provider identifier issued by the National Plan and Provider 
        Enumeration System of the Centers for Medicare & Medicaid 
        Services) of each covered provider who prescribed a controlled 
        substance to the covered individual during at least the most 
        recent 12-month period.
        ``(2) The program facilitates the integration of information 
    described in paragraph (1) into the workflow of a covered provider, 
    which may include the electronic system the covered provider uses 
    to prescribe controlled substances.
A qualified prescription drug monitoring program described in this 
subsection, with respect to a State, may have in place, in accordance 
with applicable State and Federal law, a data-sharing agreement with 
the State Medicaid program that allows the medical director and 
pharmacy director of such program (and any designee of such a director 
who reports directly to such director) to access the information 
described in paragraph (1) in an electronic format. The State Medicaid 
program under this title may facilitate reasonable and limited access, 
as determined by the State and ensuring documented beneficiary 
protections regarding the use of such data, to such qualified 
prescription drug monitoring program for the medical director or 
pharmacy director of any managed care entity (as defined under section 
1932(a)(1)(B)) that has a contract with the State under section 1903(m) 
or under section 1905(t)(3), or the medical director or pharmacy 
director of any entity that has a contract to manage the pharmaceutical 
benefit with respect to individuals enrolled in the State plan (or 
under a waiver of the State plan). All applicable State and Federal 
security and privacy laws shall apply to the directors or designees of 
such directors of any State Medicaid program or entity accessing a 
qualified prescription drug monitoring program under this section.
    ``(c) Application of Privacy Rules Clarification.--The Secretary 
shall clarify privacy requirements, including requirements under the 
regulations promulgated pursuant to section 264(c) of the Health 
Insurance Portability and Accountability Act of 1996 (42 U.S.C. 1320d-2 
note), related to the sharing of data under subsection (b) in the same 
manner as the Secretary is required under subparagraph (J) of section 
1860D-4(c)(5) to clarify privacy requirements related to the sharing of 
data described in such subparagraph.
    ``(d) Ensuring Access.--In order to ensure reasonable access to 
health care, the Secretary shall waive the application of the 
requirement under subsection (a), with respect to a State, in the case 
of natural disasters and similar situations, and in the case of the 
provision of emergency services (as defined for purposes of section 
1860D-4(c)(5)(D)(ii)(II)).
    ``(e) Reports.--
        ``(1) State reports.--Each State shall include in the annual 
    report submitted to the Secretary under section 1927(g)(3)(D), 
    beginning with such reports submitted for 2023, information 
    including, at a minimum, the following information for the most 
    recent 12-month period:
            ``(A) The percentage of covered providers (as determined 
        pursuant to a process established by the State) who checked the 
        prescription drug history of a covered individual through a 
        qualified prescription drug monitoring program described in 
        subsection (b) before prescribing to such individual a 
        controlled substance.
            ``(B) Aggregate trends with respect to prescribing 
        controlled substances such as--
                ``(i) the quantity of daily morphine milligram 
            equivalents prescribed for controlled substances;
                ``(ii) the number and quantity of daily morphine 
            milligram equivalents prescribed for controlled substances 
            per covered individual; and
                ``(iii) the types of controlled substances prescribed, 
            including the dates of such prescriptions, the supplies 
            authorized (including the duration of such supplies), and 
            the period of validity of such prescriptions, in different 
            populations (such as individuals who are elderly, 
            individuals with disabilities, and individuals who are 
            enrolled under both this title and title XVIII).
            ``(C) Whether or not the State requires (and a detailed 
        explanation as to why the State does or does not require) 
        pharmacists to check the prescription drug history of a covered 
        individual through a qualified prescription drug monitoring 
        program described in subsection (b) before dispensing a 
        controlled substance to such individual.
            ``(D) An accounting of any data or privacy breach of a 
        qualified prescription drug monitoring program described in 
        subsection (b), the number of covered individuals impacted by 
        each such breach, and a description of the steps the State has 
        taken to address each such breach, including, to the extent 
        required by State or Federal law or otherwise determined 
        appropriate by the State, alerting any such impacted individual 
        and law enforcement of the breach.
        ``(2) Report by cms.--Not later than October 1, 2023, the 
    Administrator of the Centers for Medicare & Medicaid Services shall 
    publish on the publicly available website of the Centers for 
    Medicare & Medicaid Services a report including the following 
    information:
            ``(A) Guidance for States on how States can increase the 
        percentage of covered providers who use qualified prescription 
        drug monitoring programs described in subsection (b).
            ``(B) Best practices for how States and covered providers 
        should use such qualified prescription drug monitoring programs 
        to reduce the occurrence of abuse of controlled substances.
    ``(f) Increase to FMAP and Federal Matching Rates for Certain 
Expenditures Relating to Qualified Prescription Drug Monitoring 
Programs.--
        ``(1) In general.--With respect to a State that meets the 
    condition described in paragraph (2) and any quarter occurring 
    during fiscal year 2019 or fiscal year 2020, the Federal medical 
    assistance percentage or Federal matching rate that would otherwise 
    apply to such State under section 1903(a) for such quarter, with 
    respect to expenditures by the State for activities under the State 
    plan (or a waiver of such plan) to design, develop, or implement a 
    prescription drug monitoring program (and to make connections to 
    such program) that satisfies the criteria described in paragraphs 
    (1) and (2) of subsection (b), shall be equal to 100 percent.
        ``(2) Condition.--The condition described in this paragraph, 
    with respect to a State, is that the State (in this paragraph 
    referred to as the `administering State') has in place agreements 
    with all States that are contiguous to such administering State 
    that, when combined, enable covered providers in all such 
    contiguous States to access, through the prescription drug 
    monitoring program, the information that is described in subsection 
    (b)(1) of covered individuals of such administering State and that 
    covered providers in such administering State are able to access 
    through such program.
    ``(g) Rule of Construction.--Nothing in this section prevents a 
State from requiring pharmacists to check the prescription drug history 
of covered individuals through a qualified prescription drug monitoring 
program before dispensing controlled substances to such individuals.
    ``(h) Definitions.--In this section:
        ``(1) Controlled substance.--The term `controlled substance' 
    means a drug that is included in schedule II of section 202(c) of 
    the Controlled Substances Act and, at the option of the State 
    involved, a drug included in schedule III or IV of such section.
        ``(2) Covered individual.--The term `covered individual' means, 
    with respect to a State, an individual who is enrolled in the State 
    plan (or under a waiver of such plan). Such term does not include 
    an individual who--
            ``(A) is receiving--
                ``(i) hospice or palliative care; or
                ``(ii) treatment for cancer;
            ``(B) is a resident of a long-term care facility, of a 
        facility described in section 1905(d), or of another facility 
        for which frequently abused drugs are dispensed for residents 
        through a contract with a single pharmacy; or
            ``(C) the State elects to treat as exempted from such term.
        ``(3) Covered provider.--
            ``(A) In general.--The term `covered provider' means, 
        subject to subparagraph (B), with respect to a State, a health 
        care provider who is participating under the State plan (or 
        waiver of the State plan) and licensed, registered, or 
        otherwise permitted by the State to prescribe a controlled 
        substance (or the designee of such provider).
            ``(B) Exceptions.--
                ``(i) In general.--Beginning October 1, 2021, for 
            purposes of this section, such term does not include a 
            health care provider included in any type of health care 
            provider determined by the Secretary to be exempt from 
            application of this section under clause (ii).
                ``(ii) Exceptions process.--Not later than October 1, 
            2020, the Secretary, after consultation with the National 
            Association of Medicaid Directors, national health care 
            provider associations, Medicaid beneficiary advocates, and 
            advocates for individuals with rare diseases, shall 
            determine, based on such consultations, the types of health 
            care providers (if any) that should be exempted from the 
            definition of the term `covered provider' for purposes of 
            this section.''.
    (b) Guidance.--Not later than October 1, 2019, the Administrator of 
the Centers for Medicare & Medicaid Services, in consultation with the 
Director of the Centers for Disease Control and Prevention, shall issue 
guidance on best practices on the uses of prescription drug monitoring 
programs required of prescribers and on protecting the privacy of 
Medicaid beneficiary information maintained in and accessed through 
prescription drug monitoring programs.
    (c) Development of Model State Practices.--
        (1) In general.--Not later than October 1, 2020, the Secretary 
    of Health and Human Services shall develop and publish model 
    practices to assist State Medicaid program operations in 
    identifying and implementing strategies to utilize data-sharing 
    agreements described in the matter following paragraph (2) of 
    section 1944(b) of the Social Security Act, as added by subsection 
    (a), for the following purposes:
            (A) Monitoring and preventing fraud, waste, and abuse.
            (B) Improving health care for individuals enrolled in a 
        State plan under title XIX of such Act (or under a waiver of 
        such plan) who--
                (i) transition in and out of coverage under such title;
                (ii) may have sources of health care coverage in 
            addition to coverage under such title; or
                (iii) pay for prescription drugs with cash.
            (C) Any other purposes specified by the Secretary.
        (2) Elements of model practices.--The model practices described 
    in paragraph (1)--
            (A) shall include strategies for assisting States in 
        allowing the medical director or pharmacy director (or 
        designees of such a director) of managed care organizations or 
        pharmaceutical benefit managers to access information with 
        respect to all covered individuals served by such managed care 
        organizations or pharmaceutical benefit managers to access as a 
        single data set, in an electronic format; and
            (B) shall include any appropriate beneficiary protections 
        and privacy guidelines.
        (3) Consultation.--In developing model practices under this 
    subsection, the Secretary shall consult with the National 
    Association of Medicaid Directors, managed care entities (as 
    defined in section 1932(a)(1)(B) of the Social Security Act) with 
    contracts with States pursuant to section 1903(m) of such Act, 
    pharmaceutical benefit managers, physicians and other health care 
    providers, beneficiary advocates, and individuals with expertise in 
    health care technology related to prescription drug monitoring 
    programs and electronic health records.
    (d) Report by Comptroller General.--Not later than October 1, 2020, 
the Comptroller General of the United States shall issue a report 
examining the operation of prescription drug monitoring programs 
administered by States, including data security and access standards 
used by such programs.

                        Subtitle F--IMD CARE Act

SEC. 5051. SHORT TITLE.
    This title may be cited as the ``Individuals in Medicaid Deserve 
Care that is Appropriate and Responsible in its Execution Act'' or the 
``IMD CARE Act''.
SEC. 5052. STATE OPTION TO PROVIDE MEDICAID COVERAGE FOR CERTAIN 
INDIVIDUALS WITH SUBSTANCE USE DISORDERS WHO ARE PATIENTS IN CERTAIN 
INSTITUTIONS FOR MENTAL DISEASES.
    (a) In General.--Title XIX of the Social Security Act (42 U.S.C. 
1396 et seq.), as amended by preceding sections of this Act, is further 
amended--
        (1) in section 1905(a), in the subdivision (B) that follows 
    paragraph (30), by inserting ``(except in the case of services 
    provided under a State plan amendment described in section 
    1915(l))'' before the period; and
        (2) in section 1915, by adding at the end the following new 
    subsection:
    ``(l) State Plan Amendment Option to Provide Medical Assistance for 
Certain Individuals Who Are Patients in Certain Institutions for Mental 
Diseases.--
        ``(1) In general.--With respect to calendar quarters beginning 
    during the period beginning October 1, 2019, and ending September 
    30, 2023, a State may elect, through a State plan amendment, to 
    provide medical assistance for items and services furnished to an 
    eligible individual who is a patient in an eligible institution for 
    mental diseases in accordance with the requirements of this 
    subsection.
        ``(2) Payments.--Subject to paragraphs (3) and (4), amounts 
    expended under a State plan amendment under paragraph (1) for 
    services described in such paragraph furnished, with respect to a 
    12-month period, to an eligible individual who is a patient in an 
    eligible institution for mental diseases shall be treated as 
    medical assistance for which payment is made under section 1903(a) 
    but only to the extent that such services are furnished for not 
    more than a period of 30 days (whether or not consecutive) during 
    such 12-month period.
        ``(3) Maintenance of effort.--
            ``(A) In general.--As a condition for a State receiving 
        payments under section 1903(a) for medical assistance provided 
        in accordance with this subsection, the State shall (during the 
        period in which it so furnished such medical assistance through 
        a State plan amendment under this subsection) maintain on an 
        annual basis a level of funding expended by the State (and 
        political subdivisions thereof) other than under this title 
        from non-Federal funds for--
                ``(i) items and services furnished to eligible 
            individuals who are patients in eligible institutions for 
            mental diseases that is not less than the level of such 
            funding for such items and services for the most recently 
            ended fiscal year as of the date of enactment of this 
            subsection or, if higher, for the most recently ended 
            fiscal year as of the date the State submits a State plan 
            amendment to the Secretary to provide such medical 
            assistance in accordance with this subsection; and
                ``(ii) items and services (including services described 
            in subparagraph (B)) furnished to eligible individuals in 
            outpatient and community-based settings that is not less 
            than the level of such funding for such items and services 
            for the most recently ended fiscal year as of the date of 
            enactment of this subsection or, if higher, for the most 
            recently ended fiscal year as of the date the State submits 
            a State plan amendment to the Secretary to provide such 
            medical assistance in accordance with this subsection.
            ``(B) Services described.--For purposes of subparagraph 
        (A)(ii), services described in this subparagraph are the 
        following:
                ``(i) Outpatient and community-based substance use 
            disorder treatment.
                ``(ii) Evidence-based recovery and support services.
                ``(iii) Clinically-directed therapeutic treatment to 
            facilitate recovery skills, relapse prevention, and 
            emotional coping strategies.
                ``(iv) Outpatient medication-assisted treatment, 
            related therapies, and pharmacology.
                ``(v) Counseling and clinical monitoring.
                ``(vi) Outpatient withdrawal management and related 
            treatment designed to alleviate acute emotional, 
            behavioral, cognitive, or biomedical distress resulting 
            from, or occurring with, an individual's use of alcohol and 
            other drugs.
                ``(vii) Routine monitoring of medication adherence.
                ``(viii) Other outpatient and community-based services 
            for the treatment of substance use disorders, as designated 
            by the Secretary.
            ``(C) State reporting requirement.--
                ``(i) In general.--Prior to approval of a State plan 
            amendment under this subsection, as a condition for a State 
            receiving payments under section 1903(a) for medical 
            assistance provided in accordance with this subsection, the 
            State shall report to the Secretary, in accordance with the 
            process established by the Secretary under clause (ii), the 
            information deemed necessary by the Secretary under such 
            clause.
                ``(ii) Process.--Not later than the date that is 8 
            months after the date of enactment of this subsection, the 
            Secretary shall establish a process for States to report to 
            the Secretary, at such time and in such manner as the 
            Secretary deems appropriate, such information as the 
            Secretary deems necessary to verify a State's compliance 
            with subparagraph (A).
        ``(4) Ensuring a continuum of services.--
            ``(A) In general.--As a condition for a State receiving 
        payments under section 1903(a) for medical assistance provided 
        in accordance with this subsection, the State shall carry out 
        each of the requirements described in subparagraphs (B) through 
        (D).
            ``(B) Notification.--Prior to approval of a State plan 
        amendment under this subsection, the State shall notify the 
        Secretary of how the State will ensure that eligible 
        individuals receive appropriate evidence-based clinical 
        screening prior to being furnished with items and services in 
        an eligible institution for mental diseases, including initial 
        and periodic assessments to determine the appropriate level of 
        care, length of stay, and setting for such care for each 
        individual.
            ``(C) Outpatient services; inpatient and residential 
        services.--
                ``(i) Outpatient services.--The State shall, at a 
            minimum, provide medical assistance for services that could 
            otherwise be covered under the State plan, consistent with 
            each of the following outpatient levels of care:

                    ``(I) Early intervention for individuals who, for a 
                known reason, are at risk of developing substance-
                related problems and for individuals for whom there is 
                not yet sufficient information to document a 
                diagnosable substance use disorder.
                    ``(II) Outpatient services for less than 9 hours 
                per week for adults, and for less than 6 hours per week 
                for adolescents, for recovery or motivational 
                enhancement therapies and strategies.
                    ``(III) Intensive outpatient services for 9 hours 
                or more per week for adults, and for 6 hours or more 
                per week for adolescents, to treat multidimensional 
                instability.
                    ``(IV) Partial hospitalization services for 20 
                hours or more per week for adults and adolescents to 
                treat multidimensional instability that does not 
                require 24-hour care.

                ``(ii) Inpatient and residential services.--The State 
            shall provide medical assistance for services that could 
            otherwise be covered under the State plan, consistent with 
            at least 2 of the following inpatient and residential 
            levels of care:

                    ``(I) Clinically managed, low-intensity residential 
                services that provide adults and adolescents with 24-
                hour living support and structure with trained 
                personnel and at least 5 hours of clinical service per 
                week per individual.
                    ``(II) Clinically managed, population-specific, 
                high-intensity residential services that provide adults 
                with 24-hour care with trained counselors to stabilize 
                multidimensional imminent danger along with less 
                intense milieu and group treatment for those with 
                cognitive or other impairments unable to use full 
                active milieu or therapeutic community.
                    ``(III) Clinically managed, medium-intensity 
                residential services for adolescents, and clinically 
                managed, high-intensity residential services for 
                adults, that provide 24-hour care with trained 
                counselors to stabilize multidimensional imminent 
                danger and preparation for outpatient treatment.
                    ``(IV) Medically monitored, high-intensity 
                inpatient services for adolescents, and medically 
                monitored, intensive inpatient services withdrawal 
                management for adults, that provide 24-hour nursing 
                care, make physicians available for significant 
                problems in Dimensions 1, 2, or 3, and provide 
                counseling services 16 hours per day.
                    ``(V) Medically managed, intensive inpatient 
                services for adolescents and adults that provide 24-
                hour nursing care and daily physician care for severe, 
                unstable problems in Dimensions 1, 2 or 3.

            ``(D) Transition of care.--In order to ensure an 
        appropriate transition for an eligible individual from 
        receiving care in an eligible institution for mental diseases 
        to receiving care at a lower level of clinical intensity within 
        the continuum of care (including outpatient services), the 
        State shall ensure that--
                ``(i) a placement in such eligible institution for 
            mental diseases would allow for an eligible individual's 
            successful transition to the community, considering such 
            factors as proximity to an individual's support network 
            (such as family members, employment, and counseling and 
            other services near an individual's residence); and
                ``(ii) all eligible institutions for mental diseases 
            that furnish items and services to individuals for which 
            medical assistance is provided under the State plan--

                    ``(I) are able to provide care at such lower level 
                of clinical intensity; or
                    ``(II) have an established relationship with 
                another facility or provider that is able to provide 
                care at such lower level of clinical intensity and 
                accepts patients receiving medical assistance under 
                this title under which the eligible institution for 
                mental diseases may arrange for individuals to receive 
                such care from such other facility or provider.

        ``(5) Application to managed care.--Payments for, and 
    limitations to, medical assistance furnished in accordance with 
    this subsection shall be in addition to and shall not be construed 
    to limit or supersede the ability of States to make monthly 
    capitation payments to managed care organizations for individuals 
    receiving treatment in institutions for mental diseases in 
    accordance with section 438.6(e) of title 42, Code of Federal 
    Regulations (or any successor regulation).
        ``(6) Other medical assistance.--The provision of medical 
    assistance for items and services furnished to an eligible 
    individual who is a patient in an eligible institution for mental 
    diseases in accordance with the requirements of this subsection 
    shall not prohibit Federal financial participation for medical 
    assistance for items or services that are provided to such eligible 
    individual in or away from the eligible institution for mental 
    disease during any period in which the eligible individual is 
    receiving items or services in accordance with this subsection.
        ``(7) Definitions.--In this subsection:
            ``(A) Dimensions 1, 2, or 3.--The term `Dimensions 1, 2, or 
        3' has the meaning given that term for purposes of the 
        publication of the American Society of Addiction Medicine 
        entitled `The ASAM Criteria: Treatment Criteria for Addictive 
        Substance-Related, and Co-Occurring Conditions, 2013'.
            ``(B) Eligible individual.--The term `eligible individual' 
        means an individual who--
                ``(i) with respect to a State, is enrolled for medical 
            assistance under the State plan or a waiver of such plan;
                ``(ii) is at least 21 years of age;
                ``(iii) has not attained 65 years of age; and
                ``(iv) has at least 1 substance use disorder.
            ``(C) Eligible institution for mental diseases.--The term 
        `eligible institution for mental diseases' means an institution 
        for mental diseases that--
                ``(i) follows reliable, evidence-based practices; and
                ``(ii) offers at least 2 forms of medication-assisted 
            treatment for substance use disorders on site, including, 
            in the case of medication-assisted treatment for opioid use 
            disorder, at least 1 antagonist and 1 partial agonist.
            ``(D) Institution for mental diseases.--The term 
        `institution for mental diseases' has the meaning given that 
        term in section 1905(i).''.
    (b) Rule of Construction.--Nothing in the amendments made by 
subsection (a) shall be construed as encouraging a State to place an 
individual in an inpatient or a residential care setting where a home 
or community-based care setting would be more appropriate for the 
individual, or as preventing a State from conducting or pursuing a 
demonstration project under section 1115 of the Social Security Act to 
improve access to, and the quality of, substance use disorder treatment 
for eligible populations.

                 Subtitle G--Medicaid Improvement Fund

SEC. 5061. MEDICAID IMPROVEMENT FUND.
    Section 1941(b)(1) of the Social Security Act (42 U.S.C. 1396w-
1(b)(1)) is amended by striking ``$0'' and inserting ``$31,000,000''.

                  TITLE VI--OTHER MEDICARE PROVISIONS
    Subtitle A--Testing of Incentive Payments for Behavioral Health 
 Providers for Adoption and Use of Certified Electronic Health Record 
                               Technology

SEC. 6001. TESTING OF INCENTIVE PAYMENTS FOR BEHAVIORAL HEALTH 
PROVIDERS FOR ADOPTION AND USE OF CERTIFIED ELECTRONIC HEALTH RECORD 
TECHNOLOGY.
    Section 1115A(b)(2)(B) of the Social Security Act (42 U.S.C. 
1315a(b)(2)(B)) is amended by adding at the end the following new 
clause:
                ``(xxv) Providing, for the adoption and use of 
            certified EHR technology (as defined in section 1848(o)(4)) 
            to improve the quality and coordination of care through the 
            electronic documentation and exchange of health 
            information, incentive payments to behavioral health 
            providers (such as psychiatric hospitals (as defined in 
            section 1861(f)), community mental health centers (as 
            defined in section 1861(ff)(3)(B)), hospitals that 
            participate in a State plan under title XIX or a waiver of 
            such plan, treatment facilities that participate in such a 
            State plan or such a waiver, mental health or substance use 
            disorder providers that participate in such a State plan or 
            such a waiver, clinical psychologists (as defined in 
            section 1861(ii)), nurse practitioners (as defined in 
            section 1861(aa)(5)) with respect to the provision of 
            psychiatric services, and clinical social workers (as 
            defined in section 1861(hh)(1))).''.

                   Subtitle B--Abuse Deterrent Access

SEC. 6011. SHORT TITLE.
    This subtitle may be cited at the ``Abuse Deterrent Access Act of 
2018''.
SEC. 6012. STUDY ON ABUSE-DETERRENT OPIOID FORMULATIONS ACCESS BARRIERS 
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 shall 
conduct a study and submit to Congress a report on--
        (1) the adequacy of access to abuse-deterrent opioid 
    formulations for individuals with chronic pain enrolled in an MA-PD 
    plan under part C of title XVIII of the Social Security Act or a 
    prescription drug plan under part D of such title of such Act, 
    taking into account any barriers preventing such individuals from 
    accessing such formulations under such MA-PD or part D plans, such 
    as cost-sharing tiers, fail-first requirements, the price of such 
    formulations, and prior authorization requirements; and
        (2) the effectiveness of abuse-deterrent opioid formulations in 
    preventing opioid abuse or misuse; the impact of the use of abuse-
    deterrent opioid formulations on the use or abuse of other 
    prescription or illicit opioids (including changes in deaths from 
    such opioids); and other public health consequences of the use of 
    abuse-deterrent opioid formulations, such as an increase in rates 
    of human immunodeficiency virus.
    (b) Definition of Abuse-Deterrent Opioid Formulation.--In this 
section, the term ``abuse-deterrent opioid formulation'' means an 
opioid that is a prodrug or that has certain abuse-deterrent 
properties, such as physical or chemical barriers, agonist or 
antagonist combinations, aversion properties, delivery system 
mechanisms, or other features designed to prevent abuse of such opioid.

              Subtitle C--Medicare Opioid Safety Education

SEC. 6021. MEDICARE OPIOID SAFETY EDUCATION.
    (a) In General.--Section 1804 of the Social Security Act (42 U.S.C. 
1395b-2) is amended by adding at the end the following new subsection:
    ``(d) The notice provided under subsection (a) shall include--
        ``(1) references to educational resources regarding opioid use 
    and pain management;
        ``(2) a description of categories of alternative, non-opioid 
    pain management treatments covered under this title; and
        ``(3) a suggestion for the beneficiary to talk to a physician 
    regarding opioid use and pain management.''.
    (b) Effective Date.--The amendment made by subsection (a) shall 
apply to notices distributed prior to each Medicare open enrollment 
period beginning after January 1, 2019.

                Subtitle D--Opioid Addiction Action Plan

SEC. 6031. SHORT TITLE.
    This subtitle may be cited as the ``Opioid Addiction Action Plan 
Act''.
SEC. 6032. 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, 2020, 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 as described in subsection (b).
    (b) Action Plan Components.--The action plan shall include a review 
by the Secretary of Medicare and Medicaid payment and coverage policies 
that may be viewed as potential obstacles to an effective response to 
the opioid crisis, and recommendations, as determined appropriate by 
the Secretary, on the following:
        (1) A review of payment and coverage policies under the 
    Medicare program under title XVIII of the Social Security Act and 
    the Medicaid program under title XIX of such Act, including a 
    review of coverage and payment under such programs of all 
    medication-assisted treatment approved by the Food and Drug 
    Administration related to the treatment of opioid use disorder and 
    other therapies that manage chronic and acute pain and treat and 
    minimize risk of opioid misuse and abuse, including in such review, 
    payment under the Medicare prospective payment system for inpatient 
    hospital 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. 1395I(t)), to determine whether those payment policies 
    resulted in incentives or disincentives that have contributed to 
    the opioid crisis.
        (2) Recommendations for payment and service delivery models to 
    be tested as appropriate 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 use disorder and 
    other therapies that manage chronic and acute pain and treat and 
    minimize risk of opioid misuse and abuse.
        (3) Recommendations for data collection that could facilitate 
    research and policy-making regarding prevention of opioid use 
    disorder as well as data that would aid the Secretary in making 
    coverage and payment decisions under the Medicare and Medicaid 
    programs related to the access to appropriate opioid dependence 
    treatments.
        (4) A review of Medicare and Medicaid beneficiaries' access to 
    the full range of medication-assisted treatment approved by the 
    Food and Drug Administration for the treatment of opioid use 
    disorder and other therapies that manage chronic and acute pain and 
    treat and minimize risk of opioid misuse and abuse, including 
    access of beneficiaries residing in rural or medically underserved 
    communities.
        (5) A review of payment and coverage policies under the 
    Medicare program and the Medicaid program related to medical 
    devices that are non-opioid based treatments approved by the Food 
    and Drug Administration for the management of acute pain and 
    chronic pain, for monitoring substance use withdrawal and 
    preventing overdoses of controlled substances, and for treating 
    substance use disorder, including barriers to patient access.
    (c) Stakeholder Meetings.--
        (1) In general.--Beginning not later than 3 months after the 
    date of the enactment of this section, the Secretary shall convene 
    a public stakeholder meeting to solicit public comment on the 
    components of the action plan 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 June 1, 2020, the Secretary 
shall submit to Congress, and make public, a report that includes--
        (1) a summary of the results of the Secretary's review and any 
    recommendations under the action plan;
        (2) the Secretary's planned next steps with respect to the 
    action plan; and
        (3) an evaluation of price trends for drugs used to reverse 
    opioid overdoses (such as naloxone), including recommendations on 
    ways to lower such prices for consumers.
    (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.

 Subtitle E--Advancing High Quality Treatment for Opioid Use Disorders 
                              in Medicare

SEC. 6041. SHORT TITLE.
    This subtitle may be cited as the ``Advancing High Quality 
Treatment for Opioid Use Disorders in Medicare Act''.
SEC. 6042. OPIOID USE DISORDER TREATMENT DEMONSTRATION PROGRAM.
    Title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.) is 
amended by inserting after section 1866E (42 U.S.C. 1395cc-5) the 
following new section:
``SEC. 1866F. OPIOID USE DISORDER TREATMENT DEMONSTRATION PROGRAM.
    ``(a) Implementation of 4-Year Demonstration Program.--
        ``(1) In general.--Not later than January 1, 2021, the 
    Secretary shall implement a 4-year demonstration program under this 
    title (in this section referred to as the `Program') to increase 
    access of applicable beneficiaries to opioid use disorder treatment 
    services, improve physical and mental health outcomes for such 
    beneficiaries, and to the extent possible, reduce expenditures 
    under this title. Under the Program, the Secretary shall make 
    payments under subsection (e) to participants (as defined in 
    subsection (c)(1)(A)) for furnishing opioid use disorder treatment 
    services delivered through opioid use disorder care teams, or 
    arranging for such services to be furnished, to applicable 
    beneficiaries participating in the Program.
        ``(2) Opioid use disorder treatment services.--For purposes of 
    this section, the term `opioid use disorder treatment services'--
            ``(A) means, with respect to an applicable beneficiary, 
        services that are furnished for the treatment of opioid use 
        disorders and that utilize drugs approved under section 505 of 
        the Federal Food, Drug, and Cosmetic Act for the treatment of 
        opioid use disorders in an outpatient setting; and
            ``(B) includes--
                ``(i) medication-assisted treatment;
                ``(ii) treatment planning;
                ``(iii) psychiatric, psychological, or counseling 
            services (or any combination of such services), as 
            appropriate;
                ``(iv) social support services, as appropriate; and
                ``(v) care management and care coordination services, 
            including coordination with other providers of services and 
            suppliers not on an opioid use disorder care team.
    ``(b) Program Design.--
        ``(1) In general.--The Secretary shall design the Program in 
    such a manner to allow for the evaluation of the extent to which 
    the Program accomplishes the following purposes:
            ``(A) Reduces hospitalizations and emergency department 
        visits.
            ``(B) Increases use of medication-assisted treatment for 
        opioid use disorders.
            ``(C) Improves health outcomes of individuals with opioid 
        use disorders, including by reducing the incidence of 
        infectious diseases (such as hepatitis C and HIV).
            ``(D) Does not increase the total spending on items and 
        services under this title.
            ``(E) Reduces deaths from opioid overdose.
            ``(F) Reduces the utilization of inpatient residential 
        treatment.
        ``(2) Consultation.--In designing the Program, including the 
    criteria under subsection (e)(2)(A), the Secretary shall, not later 
    than 3 months after the date of the enactment of this section, 
    consult with specialists in the field of addiction, clinicians in 
    the primary care community, and beneficiary groups.
    ``(c) Participants; Opioid Use Disorder Care Teams.--
        ``(1) Participants.--
            ``(A) Definition.--In this section, the term `participant' 
        means an entity or individual--
                ``(i) that is otherwise enrolled under this title and 
            that is--

                    ``(I) a physician (as defined in section 
                1861(r)(1));
                    ``(II) a group practice comprised of at least one 
                physician described in subclause (I);
                    ``(III) a hospital outpatient department;
                    ``(IV) a federally qualified health center (as 
                defined in section 1861(aa)(4));
                    ``(V) a rural health clinic (as defined in section 
                1861(aa)(2));
                    ``(VI) a community mental health center (as defined 
                in section 1861(ff)(3)(B));
                    ``(VII) a clinic certified as a certified community 
                behavioral health clinic pursuant to section 223 of the 
                Protecting Access to Medicare Act of 2014; or
                    ``(VIII) any other individual or entity specified 
                by the Secretary;

                ``(ii) that applied for and was selected to participate 
            in the Program pursuant to an application and selection 
            process established by the Secretary; and
                ``(iii) that establishes an opioid use disorder care 
            team (as defined in paragraph (2)) through employing or 
            contracting with health care practitioners described in 
            paragraph (2)(A), and uses such team to furnish or arrange 
            for opioid use disorder treatment services in the 
            outpatient setting under the Program.
            ``(B) Preference.--In selecting participants for the 
        Program, the Secretary shall give preference to individuals and 
        entities that are located in areas with a prevalence of opioid 
        use disorders that is higher than the national average 
        prevalence.
        ``(2) Opioid use disorder care teams.--
            ``(A) In general.--For purposes of this section, the term 
        `opioid use disorder care team' means a team of health care 
        practitioners established by a participant described in 
        paragraph (1)(A) that--
                ``(i) shall include--

                    ``(I) at least one physician (as defined in section 
                1861(r)(1)) furnishing primary care services or 
                addiction treatment services to an applicable 
                beneficiary; and
                    ``(II) at least one eligible practitioner (as 
                defined in paragraph (3)), who may be a physician who 
                meets the criterion in subclause (I); and

                ``(ii) may include other practitioners licensed under 
            State law to furnish psychiatric, psychological, 
            counseling, and social services to applicable 
            beneficiaries.
            ``(B) Requirements for receipt of payment under program.--
        In order to receive payments under subsection (e), each 
        participant in the Program shall--
                ``(i) furnish opioid use disorder treatment services 
            through opioid use disorder care teams to applicable 
            beneficiaries who agree to receive the services;
                ``(ii) meet minimum criteria, as established by the 
            Secretary; and
                ``(iii) submit to the Secretary, in such form, manner, 
            and frequency as specified by the Secretary, with respect 
            to each applicable beneficiary for whom opioid use disorder 
            treatment services are furnished by the opioid use disorder 
            care team, data and such other information as the Secretary 
            determines appropriate to--

                    ``(I) monitor and evaluate the Program;
                    ``(II) determine if minimum criteria are met under 
                clause (ii); and
                    ``(III) determine the incentive payment under 
                subsection (e).

        ``(3) Eligible practitioner defined.--For purposes of this 
    section, the term `eligible practitioner' means a physician or 
    other health care practitioner, such as a nurse practitioner, 
    that--
            ``(A) is enrolled under section 1866(j)(1);
            ``(B) is authorized to prescribe or dispense narcotic drugs 
        to individuals for maintenance treatment or detoxification 
        treatment; and
            ``(C) has in effect a waiver in accordance with section 
        303(g) of the Controlled Substances Act for such purpose and is 
        otherwise in compliance with regulations promulgated by the 
        Substance Abuse and Mental Health Services Administration to 
        carry out such section.
    ``(d) Participation of Applicable Beneficiaries.--
        ``(1) Applicable beneficiary defined.--In this section, the 
    term `applicable beneficiary' means an individual who--
            ``(A) is entitled to, or enrolled for, benefits under part 
        A and enrolled for benefits under part B;
            ``(B) is not enrolled in a Medicare Advantage plan under 
        part C;
            ``(C) has a current diagnosis for an opioid use disorder; 
        and
            ``(D) meets such other criteria as the Secretary determines 
        appropriate.
    Such term shall include an individual who is dually eligible for 
    benefits under this title and title XIX if such individual 
    satisfies the criteria described in subparagraphs (A) through (D).
        ``(2) Voluntary beneficiary participation; limitation on number 
    of beneficiaries.--An applicable beneficiary may participate in the 
    Program on a voluntary basis and may terminate participation in the 
    Program at any time. Not more than 20,000 applicable beneficiaries 
    may participate in the Program at any time.
        ``(3) Services.--In order to participate in the Program, an 
    applicable beneficiary shall agree to receive opioid use disorder 
    treatment services from a participant. Participation under the 
    Program shall not affect coverage of or payment for any other item 
    or service under this title for the applicable beneficiary.
        ``(4) Beneficiary access to services.--Nothing in this section 
    shall be construed as encouraging providers to limit applicable 
    beneficiary access to services covered under this title, and 
    applicable beneficiaries shall not be required to relinquish access 
    to any benefit under this title as a condition of receiving 
    services from a participant in the Program.
    ``(e) Payments.--
        ``(1) Per applicable beneficiary per month care management 
    fee.--
            ``(A) In general.--The Secretary shall establish a schedule 
        of per applicable beneficiary per month care management fees. 
        Such a per applicable beneficiary per month care management fee 
        shall be paid to a participant in addition to any other amount 
        otherwise payable under this title to the health care 
        practitioners in the participant's opioid use disorder care 
        team or, if applicable, to the participant. A participant may 
        use such per applicable beneficiary per month care management 
        fee to deliver additional services to applicable beneficiaries, 
        including services not otherwise eligible for payment under 
        this title.
            ``(B) Payment amounts.--In carrying out subparagraph (A), 
        the Secretary may--
                ``(i) consider payments otherwise payable under this 
            title for opioid use disorder treatment services and the 
            needs of applicable beneficiaries;
                ``(ii) pay a higher per applicable beneficiary per 
            month care management fee for an applicable beneficiary who 
            receives more intensive treatment services from a 
            participant and for whom those services are appropriate 
            based on clinical guidelines for opioid use disorder care;
                ``(iii) pay a higher per applicable beneficiary per 
            month care management fee for the month in which the 
            applicable beneficiary begins treatment with a participant 
            than in subsequent months, to reflect the greater time and 
            costs required for the planning and initiation of 
            treatment, as compared to maintenance of treatment; and
                ``(iv) take into account whether a participant's opioid 
            use disorder care team refers applicable beneficiaries to 
            other suppliers or providers for any opioid use disorder 
            treatment services.
            ``(C) No duplicate payment.--The Secretary shall make 
        payments under this paragraph to only one participant for 
        services furnished to an applicable beneficiary during a 
        calendar month.
        ``(2) Incentive payments.--
            ``(A) In general.--Under the Program, the Secretary shall 
        establish a performance-based incentive payment, which shall be 
        paid (using a methodology established and at a time determined 
        appropriate by the Secretary) to participants based on the 
        performance of participants with respect to criteria, as 
        determined appropriate by the Secretary, in accordance with 
        subparagraph (B).
            ``(B) Criteria.--
                ``(i) In general.--Criteria described in subparagraph 
            (A) may include consideration of the following:

                    ``(I) Patient engagement and retention in 
                treatment.
                    ``(II) Evidence-based medication-assisted 
                treatment.
                    ``(III) Other criteria established by the 
                Secretary.

                ``(ii) Required consultation and consideration.--In 
            determining criteria described in subparagraph (A), the 
            Secretary shall--

                    ``(I) consult with stakeholders, including 
                clinicians in the primary care community and in the 
                field of addiction medicine; and
                    ``(II) consider existing clinical guidelines for 
                the treatment of opioid use disorders.

            ``(C) No duplicate payment.--The Secretary shall ensure 
        that no duplicate payments under this paragraph are made with 
        respect to an applicable beneficiary.
    ``(f) Multipayer Strategy.--In carrying out the Program, the 
Secretary shall encourage other payers to provide similar payments and 
to use similar criteria as applied under the Program under subsection 
(e)(2)(C). The Secretary may enter into a memorandum of understanding 
with other payers to align the methodology for payment provided by such 
a payer related to opioid use disorder treatment services with such 
methodology for payment under the Program.
    ``(g) Evaluation.--
        ``(1) In general.--The Secretary shall conduct an intermediate 
    and final evaluation of the program. Each such evaluation shall 
    determine the extent to which each of the purposes described in 
    subsection (b) have been accomplished under the Program.
        ``(2) Reports.--The Secretary shall submit to Congress--
            ``(A) a report with respect to the intermediate evaluation 
        under paragraph (1) not later than 3 years after the date of 
        the implementation of the Program; and
            ``(B) a report with respect to the final evaluation under 
        paragraph (1) not later than 6 years after such date.
    ``(h) Funding.--
        ``(1) Administrative funding.--For the purposes of 
    implementing, administering, and carrying out the Program (other 
    than for purposes described in paragraph (2)), $5,000,000 shall be 
    available from the Federal Supplementary Medical Insurance Trust 
    Fund under section 1841.
        ``(2) Care management fees and incentives.--For the purposes of 
    making payments under subsection (e), $10,000,000 shall be 
    available from the Federal Supplementary Medical Insurance Trust 
    Fund under section 1841 for each of fiscal years 2021 through 2024.
        ``(3) Availability.--Amounts transferred under this subsection 
    for a fiscal year shall be available until expended.
    ``(i) Waivers.--The Secretary may waive any provision of this title 
as may be necessary to carry out the Program under this section.''.

 Subtitle F--Responsible Education Achieves Care and Healthy Outcomes 
                          for Users' Treatment

SEC. 6051. SHORT TITLE.
    This subtitle may be cited as the ``Responsible Education Achieves 
Care and Healthy Outcomes for Users' Treatment Act of 2018'' or the 
``REACH OUT Act of 2018''.
SEC. 6052. GRANTS TO PROVIDE TECHNICAL ASSISTANCE TO OUTLIER 
PRESCRIBERS OF OPIOIDS.
    (a) Grants Authorized.--The Secretary of Health and Human Services 
(in this section referred to as the ``Secretary'') shall, through the 
Centers for Medicare & Medicaid Services, award grants, contracts, or 
cooperative agreements to eligible entities for the purposes described 
in subsection (b).
    (b) Use of Funds.--Grants, contracts, and cooperative agreements 
awarded under subsection (a) shall be used to support eligible entities 
through technical assistance--
        (1) to educate and provide outreach to outlier prescribers of 
    opioids about best practices for prescribing opioids;
        (2) to educate and provide outreach to outlier prescribers of 
    opioids about non-opioid pain management therapies; and
        (3) to reduce the amount of opioid prescriptions prescribed by 
    outlier prescribers of opioids.
    (c) Application.--Each eligible entity seeking to receive a grant, 
contract, or cooperative agreement under subsection (a) shall submit to 
the Secretary an application, at such time, in such manner, and 
containing such information as the Secretary may require.
    (d) Geographic Distribution.--In awarding grants, contracts, and 
cooperative agreements under this section, the Secretary shall 
prioritize establishing technical assistance resources in each State.
    (e) Definitions.--In this section:
        (1) Eligible entity.--The term ``eligible entity'' means--
            (A) an organization--
                (i) that has demonstrated experience providing 
            technical assistance to health care professionals on a 
            State or regional basis; and
                (ii) that has at least--

                    (I) one individual who is a representative of 
                consumers on its governing body; and
                    (II) one individual who is a representative of 
                health care providers on its governing body; or

            (B) an entity that is a quality improvement entity with a 
        contract under part B of title XI of the Social Security Act 
        (42 U.S.C. 1320c et seq.).
        (2) Outlier prescriber of opioids.--The term ``outlier 
    prescriber of opioids'' means, with respect to a period, a 
    prescriber identified by the Secretary under subparagraph (D)(ii) 
    of section 1860D-4(c)(4) of the Social Security Act (42 U.S.C. 
    1395w-104(c)(4)), as added by section 6065 of this Act, to be an 
    outlier prescriber of opioids for such period.
        (3) Prescribers.--The term ``prescriber'' means any health care 
    professional, including a nurse practitioner or physician 
    assistant, who is licensed to prescribe opioids by the State or 
    territory in which such professional practices.
    (f) Funding.--For purposes of implementing this section, 
$75,000,000 shall be available from the Federal Supplementary Medical 
Insurance Trust Fund under section 1841 of the Social Security Act (42 
U.S.C. 1395t), to remain available until expended.

        Subtitle G--Preventing Addiction for Susceptible Seniors

SEC. 6061. SHORT TITLE.
    This subtitle may be cited as the ``Preventing Addiction for 
Susceptible Seniors Act of 2018'' or the ``PASS Act of 2018''.
SEC. 6062. ELECTRONIC PRIOR AUTHORIZATION FOR COVERED PART D DRUGS.
    Section 1860D-4(e)(2) of the Social Security Act (42 U.S.C. 1395w-
104(e)(2)) is amended by adding at the end the following new 
subparagraph:
            ``(E) Electronic prior authorization.--
                ``(i) In general.--Not later than January 1, 2021, the 
            program shall provide for the secure electronic 
            transmission of--

                    ``(I) a prior authorization request from the 
                prescribing health care professional for coverage of a 
                covered part D drug for a part D eligible individual 
                enrolled in a part D plan (as defined in section 1860D-
                23(a)(5)) to the PDP sponsor or Medicare Advantage 
                organization offering such plan; and
                    ``(II) a response, in accordance with this 
                subparagraph, from such PDP sponsor or Medicare 
                Advantage organization, respectively, to such 
                professional.

                ``(ii) Electronic transmission.--

                    ``(I) Exclusions.--For purposes of this 
                subparagraph, a facsimile, a proprietary payer portal 
                that does not meet standards specified by the 
                Secretary, or an electronic form shall not be treated 
                as an electronic transmission described in clause (i).
                    ``(II) Standards.--In order to be treated, for 
                purposes of this subparagraph, as an electronic 
                transmission described in clause (i), such transmission 
                shall comply with technical standards adopted by the 
                Secretary in consultation with the National Council for 
                Prescription Drug Programs, other standard setting 
                organizations determined appropriate by the Secretary, 
                and stakeholders including PDP sponsors, Medicare 
                Advantage organizations, health care professionals, and 
                health information technology software vendors.
                    ``(III) Application.--Notwithstanding any other 
                provision of law, for purposes of this subparagraph, 
                the Secretary may require the use of such standards 
                adopted under subclause (II) in lieu of any other 
                applicable standards for an electronic transmission 
                described in clause (i) for a covered part D drug for a 
                part D eligible individual.''.

SEC. 6063. PROGRAM INTEGRITY TRANSPARENCY MEASURES UNDER MEDICARE PARTS 
C AND D.
    (a) In General.--Section 1859 of the Social Security Act (42 U.S.C. 
1395w-28) is amended by adding at the end the following new subsection:
    ``(i) Program Integrity Transparency Measures.--
        ``(1) Program integrity portal.--
            ``(A) In general.--Not later than 2 years after the date of 
        the enactment of this subsection, the Secretary shall, after 
        consultation with stakeholders, establish a secure internet 
        website portal (or other successor technology) that would allow 
        a secure path for communication between the Secretary, MA plans 
        under this part, prescription drug plans under part D, and an 
        eligible entity with a contract under section 1893 (such as a 
        Medicare drug integrity contractor or an entity responsible for 
        carrying out program integrity activities under this part and 
        part D) for the purpose of enabling through such portal (or 
        other successor technology)--
                ``(i) the referral by such plans of substantiated or 
            suspicious activities, as defined by the Secretary, of a 
            provider of services (including a prescriber) or supplier 
            related to fraud, waste, and abuse for initiating or 
            assisting investigations conducted by the eligible entity; 
            and
                ``(ii) data sharing among such MA plans, prescription 
            drug plans, and the Secretary.
            ``(B) Required uses of portal.--The Secretary shall 
        disseminate the following information to MA plans under this 
        part and prescription drug plans under part D through the 
        secure internet website portal (or other successor technology) 
        established under subparagraph (A):
                ``(i) Providers of services and suppliers that have 
            been referred pursuant to subparagraph (A)(i) during the 
            previous 12-month period.
                ``(ii) Providers of services and suppliers who are the 
            subject of an active exclusion under section 1128 or who 
            are subject to a suspension of payment under this title 
            pursuant to section 1862(o) or otherwise.
                ``(iii) Providers of services and suppliers who are the 
            subject of an active revocation of participation under this 
            title, including for not satisfying conditions of 
            participation.
                ``(iv) In the case of such a plan that makes a referral 
            under subparagraph (A)(i) through the portal (or other 
            successor technology) with respect to activities of 
            substantiated or suspicious activities of fraud, waste, or 
            abuse of a provider of services (including a prescriber) or 
            supplier, if such provider (including a prescriber) or 
            supplier has been the subject of an administrative action 
            under this title or title XI with respect to similar 
            activities, a notification to such plan of such action so 
            taken.
            ``(C) Rulemaking.--For purposes of this paragraph, the 
        Secretary shall, through rulemaking, specify what constitutes 
        substantiated or suspicious activities of fraud, waste, and 
        abuse, using guidance such as what is provided in the Medicare 
        Program Integrity Manual 4.8. In carrying out this subsection, 
        a fraud hotline tip (as defined by the Secretary) without 
        further evidence shall not be treated as sufficient evidence 
        for substantiated fraud, waste, or abuse.
            ``(D) HIPAA compliant information only.--For purposes of 
        this subsection, communications may only occur if the 
        communications are permitted under the Federal regulations 
        (concerning the privacy of individually identifiable health 
        information) promulgated under section 264(c) of the Health 
        Insurance Portability and Accountability Act of 1996.
        ``(2) Quarterly reports.--Beginning not later than 2 years 
    after the date of the enactment of this subsection, the Secretary 
    shall make available to MA plans under this part and prescription 
    drug plans under part D in a timely manner (but no less frequently 
    than quarterly) and using information submitted to an entity 
    described in paragraph (1) through the portal (or other successor 
    technology) described in such paragraph or pursuant to section 
    1893, information on fraud, waste, and abuse schemes and trends in 
    identifying suspicious activity. Information included in each such 
    report shall--
            ``(A) include administrative actions, pertinent information 
        related to opioid overprescribing, and other data determined 
        appropriate by the Secretary in consultation with stakeholders; 
        and
            ``(B) be anonymized information submitted by plans without 
        identifying the source of such information.
        ``(3) Clarification.--Nothing in this subsection shall preclude 
    or otherwise affect referrals to the Inspector General of the 
    Department of Health and Human Services or other law enforcement 
    entities.''.
    (b) Contract Requirement to Communicate Plan Corrective Actions 
Against Opioids Over-prescribers.--Section 1857(e) of the Social 
Security Act (42 U.S.C. 1395w-27(e)) is amended by adding at the end 
the following new paragraph:
        ``(5) Communicating plan corrective actions against opioids 
    over-prescribers.--
            ``(A) In general.--Beginning with plan years beginning on 
        or after January 1, 2021, a contract under this section with an 
        MA organization shall require the organization to submit to the 
        Secretary, through the process established under subparagraph 
        (B), information on the investigations, credible evidence of 
        suspicious activities of a provider of services (including a 
        prescriber) or supplier related to fraud, and other actions 
        taken by such plans related to inappropriate prescribing of 
        opioids.
            ``(B) Process.--Not later than January 1, 2021, the 
        Secretary shall, in consultation with stakeholders, establish a 
        process under which MA plans and prescription drug plans shall 
        submit to the Secretary information described in subparagraph 
        (A).
            ``(C) Regulations.--For purposes of this paragraph, 
        including as applied under section 1860D-12(b)(3)(D), the 
        Secretary shall, pursuant to rulemaking--
                ``(i) specify a definition for the term `inappropriate 
            prescribing' and a method for determining if a provider of 
            services prescribes inappropriate prescribing; and
                ``(ii) establish the process described in subparagraph 
            (B) and the types of information that shall be submitted 
            through such process.''.
    (c) Reference Under Part D to Program Integrity Transparency 
Measures.--Section 1860D-4 of the Social Security Act (42 U.S.C. 1395w-
104) is amended by adding at the end the following new subsection:
    ``(m) Program Integrity Transparency Measures.--For program 
integrity transparency measures applied with respect to prescription 
drug plan and MA plans, see section 1859(i).''.
SEC. 6064. EXPANDING ELIGIBILITY FOR MEDICATION THERAPY MANAGEMENT 
PROGRAMS UNDER PART D.
    Section 1860D-4(c)(2)(A)(ii) of the Social Security Act (42 U.S.C. 
1395w-104(c)(2)(A)(ii)) is amended--
        (1) by redesignating subclauses (I) through (III) as items (aa) 
    through (cc), respectively, and adjusting the margins accordingly;
        (2) by striking ``are part D eligible individuals who--'' and 
    inserting ``are the following:

                    ``(I) Part D eligible individuals who--''; and

        (3) by adding at the end the following new subclause:

                    ``(II) Beginning January 1, 2021, at-risk 
                beneficiaries for prescription drug abuse (as defined 
                in paragraph (5)(C)).''.

SEC. 6065. COMMIT TO OPIOID MEDICAL PRESCRIBER ACCOUNTABILITY AND 
SAFETY FOR SENIORS.
    Section 1860D-4(c)(4) of the Social Security Act (42 U.S.C. 1395w-
104(c)(4)) is amended by adding at the end the following new 
subparagraph:
            ``(D) Notification and additional requirements with respect 
        to outlier prescribers of opioids.--
                ``(i) Notification.--Not later than January 1, 2021, 
            the Secretary shall, in the case of a prescriber identified 
            by the Secretary under clause (ii) to be an outlier 
            prescriber of opioids, provide, subject to clause (iv), an 
            annual notification to such prescriber that such prescriber 
            has been so identified and that includes resources on 
            proper prescribing methods and other information as 
            specified in accordance with clause (iii).
                ``(ii) Identification of outlier prescribers of 
            opioids.--

                    ``(I) In general.--The Secretary shall, subject to 
                subclause (III), using the valid prescriber National 
                Provider Identifiers included pursuant to subparagraph 
                (A) on claims for covered part D drugs for part D 
                eligible individuals enrolled in prescription drug 
                plans under this part or MA-PD plans under part C and 
                based on the thresholds established under subclause 
                (II), identify prescribers that are outlier opioids 
                prescribers for a period of time specified by the 
                Secretary.
                    ``(II) Establishment of thresholds.--For purposes 
                of subclause (I) and subject to subclause (III), the 
                Secretary shall, after consultation with stakeholders, 
                establish thresholds, based on prescriber specialty and 
                geographic area, for identifying whether a prescriber 
                in a specialty and geographic area is an outlier 
                prescriber of opioids as compared to other prescribers 
                of opioids within such specialty and area.
                    ``(III) Exclusions.--The following shall not be 
                included in the analysis for identifying outlier 
                prescribers of opioids under this clause:

                        ``(aa) Claims for covered part D drugs for part 
                    D eligible individuals who are receiving hospice 
                    care under this title.
                        ``(bb) Claims for covered part D drugs for part 
                    D eligible individuals who are receiving oncology 
                    services under this title.
                        ``(cc) Prescribers who are the subject of an 
                    investigation by the Centers for Medicare & 
                    Medicaid Services or the Inspector General of the 
                    Department of Health and Human Services.
                ``(iii) Contents of notification.--The Secretary shall 
            include the following information in the notifications 
            provided under clause (i):

                    ``(I) Information on how such prescriber compares 
                to other prescribers within the same specialty and 
                geographic area.
                    ``(II) Information on opioid prescribing 
                guidelines, based on input from stakeholders, that may 
                include the Centers for Disease Control and Prevention 
                guidelines for prescribing opioids for chronic pain and 
                guidelines developed by physician organizations.
                    ``(III) Other information determined appropriate by 
                the Secretary.

                ``(iv) Modifications and expansions.--

                    ``(I) Frequency.--Beginning 5 years after the date 
                of the enactment of this subparagraph, the Secretary 
                may change the frequency of the notifications described 
                in clause (i) based on stakeholder input and changes in 
                opioid prescribing utilization and trends.
                    ``(II) Expansion to other prescriptions.--The 
                Secretary may expand notifications under this 
                subparagraph to include identifications and 
                notifications with respect to concurrent prescriptions 
                of covered Part D drugs used in combination with 
                opioids that are considered to have adverse side 
                effects when so used in such combination, as determined 
                by the Secretary.

                ``(v) Additional requirements for persistent outlier 
            prescribers.--In the case of a prescriber who the Secretary 
            determines is persistently identified under clause (ii) as 
            an outlier prescriber of opioids, the following shall 
            apply:

                    ``(I) Such prescriber may be required to enroll in 
                the program under this title under section 1866(j) if 
                such prescriber is not otherwise required to enroll, 
                but only after other appropriate remedies have been 
                provided, such as the provision of education funded 
                through section 6052 of the SUPPORT for Patients and 
                Communities Act, for a period determined by the 
                Secretary as sufficient to correct the prescribing 
                patterns that lead to identification of such prescriber 
                as a persistent outlier prescriber of opioids. The 
                Secretary shall determine the length of the period for 
                which such prescriber is required to maintain such 
                enrollment, which shall be the minimum period necessary 
                to correct such prescribing patterns.
                    ``(II) Not less frequently than annually (and in a 
                form and manner determined appropriate by the 
                Secretary), the Secretary, consistent with 
                clause(iv)(I), shall communicate information on such 
                prescribers to sponsors of a prescription drug plan and 
                Medicare Advantage organizations offering an MA-PD 
                plan.

                ``(vi) Public availability of information.--The 
            Secretary shall make aggregate information under this 
            subparagraph available on the internet website of the 
            Centers for Medicare & Medicaid Services. Such information 
            shall be in a form and manner determined appropriate by the 
            Secretary and shall not identify any specific prescriber. 
            In carrying out this clause, the Secretary shall consult 
            with interested stakeholders.
                ``(vii) Opioids defined.--For purposes of this 
            subparagraph, the term `opioids' has such meaning as 
            specified by the Secretary.
                ``(viii) Other activities.--Nothing in this 
            subparagraph shall preclude the Secretary from conducting 
            activities that provide prescribers with information as to 
            how they compare to other prescribers that are in addition 
            to the activities under this subparagraph, including 
            activities that were being conducted as of the date of the 
            enactment of this subparagraph.''.
SEC. 6066. NO ADDITIONAL FUNDS AUTHORIZED.
    No additional funds are authorized to be appropriated to carry out 
the requirements of this subtitle and the amendments made by this 
subtitle. Such requirements shall be carried out using amounts 
otherwise authorized to be appropriated.

   Subtitle H--Expanding Oversight of Opioid Prescribing and Payment

SEC. 6071. SHORT TITLE.
    This subtitle may be cited as the ``Expanding Oversight of Opioid 
Prescribing and Payment Act of 2018''.
SEC. 6072. MEDICARE PAYMENT ADVISORY COMMISSION REPORT ON OPIOID 
PAYMENT, ADVERSE INCENTIVES, AND DATA UNDER THE MEDICARE PROGRAM.
    Not later than March 15, 2019, the Medicare Payment Advisory 
Commission shall submit to Congress a report on, with respect to the 
Medicare program under title XVIII of the Social Security Act, the 
following:
        (1) A description of how the Medicare program pays for pain 
    management treatments (both opioid and non-opioid pain management 
    alternatives) in both inpatient and outpatient hospital settings.
        (2) The identification of incentives under the hospital 
    inpatient prospective payment system under section 1886 of the 
    Social Security Act (42 U.S.C. 1395ww) and incentives under the 
    hospital outpatient prospective payment system under section 
    1833(t) of such Act (42 U.S.C. 1395l(t)) for prescribing opioids 
    and incentives under each such system for prescribing non-opioid 
    treatments, and recommendations as the Commission deems appropriate 
    for addressing any of such incentives that are adverse incentives.
        (3) A description of how opioid use is tracked and monitored 
    through Medicare claims data and other mechanisms and the 
    identification of any areas in which further data and methods are 
    needed for improving data and understanding of opioid use.
SEC. 6073. NO ADDITIONAL FUNDS AUTHORIZED.
    No additional funds are authorized to be appropriated to carry out 
the requirements of this subtitle. Such requirements shall be carried 
out using amounts otherwise authorized to be appropriated.

  Subtitle I--Dr. Todd Graham Pain Management, Treatment, and Recovery

SEC. 6081. SHORT TITLE.
    This subtitle may be cited as the ``Dr. Todd Graham Pain 
Management, Treatment, and Recovery Act of 2018''.
SEC. 6082. REVIEW AND ADJUSTMENT OF PAYMENTS UNDER THE MEDICARE 
OUTPATIENT PROSPECTIVE PAYMENT SYSTEM TO AVOID FINANCIAL INCENTIVES TO 
USE OPIOIDS INSTEAD OF NON-OPIOID ALTERNATIVE TREATMENTS.
    (a) Outpatient Prospective Payment System.--Section 1833(t) of the 
Social Security Act (42 U.S.C. 1395l(t)) is amended by adding at the 
end the following new paragraph:
        ``(22) Review and revisions of payments for non-opioid 
    alternative treatments.--
            ``(A) In general.--With respect to payments made under this 
        subsection for covered OPD services (or groups of services), 
        including covered OPD services assigned to a comprehensive 
        ambulatory payment classification, the Secretary--
                ``(i) shall, as soon as practicable, conduct a review 
            (part of which may include a request for information) of 
            payments for opioids and evidence-based non-opioid 
            alternatives for pain management (including drugs and 
            devices, nerve blocks, surgical injections, and 
            neuromodulation) with a goal of ensuring that there are not 
            financial incentives to use opioids instead of non-opioid 
            alternatives;
                ``(ii) may, as the Secretary determines appropriate, 
            conduct subsequent reviews of such payments; and
                ``(iii) shall consider the extent to which revisions 
            under this subsection to such payments (such as the 
            creation of additional groups of covered OPD services to 
            classify separately those procedures that utilize opioids 
            and non-opioid alternatives for pain management) would 
            reduce payment incentives to use opioids instead of non-
            opioid alternatives for pain management.
            ``(B) Priority.--In conducting the review under clause (i) 
        of subparagraph (A) and considering revisions under clause 
        (iii) of such subparagraph, the Secretary shall focus on 
        covered OPD services (or groups of services) assigned to a 
        comprehensive ambulatory payment classification, ambulatory 
        payment classifications that primarily include surgical 
        services, and other services determined by the Secretary which 
        generally involve treatment for pain management.
            ``(C) Revisions.--If the Secretary identifies revisions to 
        payments pursuant to subparagraph (A)(iii), the Secretary 
        shall, as determined appropriate, begin making such revisions 
        for services furnished on or after January 1, 2020. Revisions 
        under the previous sentence shall be treated as adjustments for 
        purposes of application of paragraph (9)(B).
            ``(D) Rules of construction.--Nothing in this paragraph 
        shall be construed to preclude the Secretary--
                ``(i) from conducting a demonstration before making the 
            revisions described in subparagraph (C); or
                ``(ii) prior to implementation of this paragraph, from 
            changing payments under this subsection for covered OPD 
            services (or groups of services) which include opioids or 
            non-opioid alternatives for pain management.''.
    (b) Ambulatory Surgical Centers.--Section 1833(i) of the Social 
Security Act (42 U.S.C. 1395l(i)) is amended by adding at the end the 
following new paragraph:
    ``(8) The Secretary shall conduct a similar type of review as 
required under paragraph (22) of section 1833(t)), including the second 
sentence of subparagraph (C) of such paragraph, to payment for services 
under this subsection, and make such revisions under this paragraph, in 
an appropriate manner (as determined by the Secretary).''.
SEC. 6083. EXPANDING ACCESS UNDER THE MEDICARE PROGRAM TO ADDICTION 
TREATMENT IN FEDERALLY QUALIFIED HEALTH CENTERS AND RURAL HEALTH 
CLINICS.
    (a) Federally Qualified Health Centers.--Section 1834(o) of the 
Social Security Act (42 U.S.C. 1395m(o)) is amended by adding at the 
end the following new paragraph:
        ``(3) Additional payments for certain fqhcs with physicians or 
    other practitioners receiving data 2000 waivers.--
            ``(A) In general.--In the case of a Federally qualified 
        health center with respect to which, beginning on or after 
        January 1, 2019, Federally qualified health center services (as 
        defined in section 1861(aa)(3)) are furnished for the treatment 
        of opioid use disorder by a physician or practitioner who meets 
        the requirements described in subparagraph (C), the Secretary 
        shall, subject to availability of funds under subparagraph (D), 
        make a payment (at such time and in such manner as specified by 
        the Secretary) to such Federally qualified health center after 
        receiving and approving an application submitted by such 
        Federally qualified health center under subparagraph (B). Such 
        a payment shall be in an amount determined by the Secretary, 
        based on an estimate of the average costs of training for 
        purposes of receiving a waiver described in subparagraph 
        (C)(ii). Such a payment may be made only one time with respect 
        to each such physician or practitioner.
            ``(B) Application.--In order to receive a payment described 
        in subparagraph (A), a Federally qualified health center shall 
        submit to the Secretary an application for such a payment at 
        such time, in such manner, and containing such information as 
        specified by the Secretary. A Federally qualified health center 
        may apply for such a payment for each physician or practitioner 
        described in subparagraph (A) furnishing services described in 
        such subparagraph at such center.
            ``(C) Requirements.--For purposes of subparagraph (A), the 
        requirements described in this subparagraph, with respect to a 
        physician or practitioner, are the following:
                ``(i) The physician or practitioner is employed by or 
            working under contract with a Federally qualified health 
            center described in subparagraph (A) that submits an 
            application under subparagraph (B).
                ``(ii) The physician or practitioner first receives a 
            waiver under section 303(g) of the Controlled Substances 
            Act on or after January 1, 2019.
            ``(D) Funding.--For purposes of making payments under this 
        paragraph, there are appropriated, out of amounts in the 
        Treasury not otherwise appropriated, $6,000,000, which shall 
        remain available until expended.''.
    (b) Rural Health Clinic.--Section 1833 of the Social Security Act 
(42 U.S.C. 1395l) is amended--
        (1) by redesignating the subsection (z) relating to medical 
    review of spinal subluxation services as subsection (aa); and
        (2) by adding at the end the following new subsection:
    ``(bb) Additional Payments for Certain Rural Health Clinics With 
Physicians or Practitioners Receiving DATA 2000 Waivers.--
        ``(1) In general.--In the case of a rural health clinic with 
    respect to which, beginning on or after January 1, 2019, rural 
    health clinic services (as defined in section 1861(aa)(1)) are 
    furnished for the treatment of opioid use disorder by a physician 
    or practitioner who meets the requirements described in paragraph 
    (3), the Secretary shall, subject to availability of funds under 
    paragraph (4), make a payment (at such time and in such manner as 
    specified by the Secretary) to such rural health clinic after 
    receiving and approving an application described in paragraph (2). 
    Such payment shall be in an amount determined by the Secretary, 
    based on an estimate of the average costs of training for purposes 
    of receiving a waiver described in paragraph (3)(B). Such payment 
    may be made only one time with respect to each such physician or 
    practitioner.
        ``(2) Application.--In order to receive a payment described in 
    paragraph (1), a rural health clinic shall submit to the Secretary 
    an application for such a payment at such time, in such manner, and 
    containing such information as specified by the Secretary. A rural 
    health clinic may apply for such a payment for each physician or 
    practitioner described in paragraph (1) furnishing services 
    described in such paragraph at such clinic.
        ``(3) Requirements.--For purposes of paragraph (1), the 
    requirements described in this paragraph, with respect to a 
    physician or practitioner, are the following:
            ``(A) The physician or practitioner is employed by or 
        working under contract with a rural health clinic described in 
        paragraph (1) that submits an application under paragraph (2).
            ``(B) The physician or practitioner first receives a waiver 
        under section 303(g) of the Controlled Substances Act on or 
        after January 1, 2019.
        ``(4) Funding.--For purposes of making payments under this 
    subsection, there are appropriated, out of amounts in the Treasury 
    not otherwise appropriated, $2,000,000, which shall remain 
    available until expended.''.
SEC. 6084. STUDYING THE AVAILABILITY OF SUPPLEMENTAL BENEFITS DESIGNED 
TO TREAT OR PREVENT SUBSTANCE USE DISORDERS UNDER MEDICARE ADVANTAGE 
PLANS.
    (a) In General.--Not later than 2 years 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 submit to Congress 
a report on the availability of supplemental health care benefits (as 
described in section 1852(a)(3)(A) of the Social Security Act (42 
U.S.C. 1395w-22(a)(3)(A))) designed to treat or prevent substance use 
disorders under Medicare Advantage plans offered under part C of title 
XVIII of such Act. Such report shall include the analysis described in 
subsection (c) and any differences in the availability of such benefits 
under specialized MA plans for special needs individuals (as defined in 
section 1859(b)(6) of such Act (42 U.S.C. 1395w-28(b)(6))) offered to 
individuals entitled to medical assistance under title XIX of such Act 
and other such Medicare Advantage plans.
    (b) Consultation.--The Secretary shall develop the report described 
in subsection (a) in consultation with relevant stakeholders, 
including--
        (1) individuals entitled to benefits under part A or enrolled 
    under part B of title XVIII of the Social Security Act;
        (2) entities who advocate on behalf of such individuals;
        (3) Medicare Advantage organizations;
        (4) pharmacy benefit managers; and
        (5) providers of services and suppliers (as such terms are 
    defined in section 1861 of such Act (42 U.S.C. 1395x)).
    (c) Contents.--The report described in subsection (a) shall include 
an analysis on the following:
        (1) The extent to which plans described in such subsection 
    offer supplemental health care benefits relating to coverage of--
            (A) medication-assisted treatments for opioid use, 
        substance use disorder counseling, peer recovery support 
        services, or other forms of substance use disorder treatments 
        (whether furnished in an inpatient or outpatient setting); and
            (B) non-opioid alternatives for the treatment of pain.
        (2) Challenges associated with such plans offering supplemental 
    health care benefits relating to coverage of items and services 
    described in subparagraph (A) or (B) of paragraph (1).
        (3) The impact, if any, of increasing the applicable rebate 
    percentage determined under section 1854(b)(1)(C) of the Social 
    Security Act (42 U.S.C. 1395w-24(b)(1)(C)) for plans offering such 
    benefits relating to such coverage would have on the availability 
    of such benefits relating to such coverage offered under Medicare 
    Advantage plans.
        (4) Potential ways to improve upon such coverage or to 
    incentivize such plans to offer additional supplemental health care 
    benefits relating to such coverage.
SEC. 6085. CLINICAL PSYCHOLOGIST SERVICES MODELS UNDER THE CENTER FOR 
MEDICARE AND MEDICAID INNOVATION; GAO STUDY AND REPORT.
    (a) CMI Models.--Section 1115A(b)(2)(B) of the Social Security Act 
(42 U.S.C. 1315a(b)(2)(B)), as amended by section 6001, is further 
amended by adding at the end the following new clauses:
                ``(xxvi) Supporting ways to familiarize individuals 
            with the availability of coverage under part B of title 
            XVIII for qualified psychologist services (as defined in 
            section 1861(ii)).
                ``(xxvii) Exploring ways to avoid unnecessary 
            hospitalizations or emergency department visits for mental 
            and behavioral health services (such as for treating 
            depression) through use of a 24-hour, 7-day a week help 
            line that may inform individuals about the availability of 
            treatment options, including the availability of qualified 
            psychologist services (as defined in section 1861(ii)).''.
    (b) GAO Study and Report.--Not later than 18 months after the date 
of the enactment of this Act, the Comptroller General of the United 
States shall conduct a study, and submit to Congress a report, on 
mental and behavioral health services under the Medicare program under 
title XVIII of the Social Security Act, including an examination of the 
following:
        (1) Information about services furnished by psychiatrists, 
    clinical psychologists, and other professionals.
        (2) Information about ways that Medicare beneficiaries 
    familiarize themselves about the availability of Medicare payment 
    for qualified psychologist services (as defined in section 1861(ii) 
    of the Social Security Act (42 U.S.C. 1395x(ii)) and ways that the 
    provision of such information could be improved.
SEC. 6086. DR. TODD GRAHAM PAIN MANAGEMENT STUDY.
    (a) In General.--Not later than 1 year after the date of enactment 
of this Act, the Secretary of Health and Human Services (referred to in 
this section as the ``Secretary'') shall conduct a study analyzing best 
practices as well as payment and coverage for pain management services 
under title XVIII of the Social Security Act and submit to the 
Committee on Ways and Means and the Committee on Energy and Commerce of 
the House of Representatives and the Committee on Finance of the Senate 
a report containing options for revising payment to providers and 
suppliers of services and coverage related to the use of multi-
disciplinary, evidence-based, non-opioid treatments for acute and 
chronic pain management for individuals entitled to benefits under part 
A or enrolled under part B of title XVIII of the Social Security Act. 
The Secretary shall make such report available on the public website of 
the Centers for Medicare & Medicaid Services.
    (b) Consultation.--In developing the report described in subsection 
(a), the Secretary shall consult with--
        (1) relevant agencies within the Department of Health and Human 
    Services;
        (2) licensed and practicing osteopathic and allopathic 
    physicians, behavioral health practitioners, physician assistants, 
    nurse practitioners, dentists, pharmacists, and other providers of 
    health services;
        (3) providers and suppliers of services (as such terms are 
    defined in section 1861 of the Social Security Act (42 U.S.C. 
    1395x));
        (4) substance abuse and mental health professional 
    organizations;
        (5) pain management professional organizations and advocacy 
    entities, including individuals who personally suffer chronic pain;
        (6) medical professional organizations and medical specialty 
    organizations;
        (7) licensed health care providers who furnish alternative pain 
    management services;
        (8) organizations with expertise in the development of 
    innovative medical technologies for pain management;
        (9) beneficiary advocacy organizations; and
        (10) other organizations with expertise in the assessment, 
    diagnosis, treatment, and management of pain, as determined 
    appropriate by the Secretary.
    (c) Contents.--The report described in subsection (a) shall include 
the following:
        (1) An analysis of payment and coverage under title XVIII of 
    the Social Security Act with respect to the following:
            (A) Evidence-based treatments and technologies for chronic 
        or acute pain, including such treatments that are covered, not 
        covered, or have limited coverage under such title.
            (B) Evidence-based treatments and technologies that monitor 
        substance use withdrawal and prevent overdoses of opioids.
            (C) Evidence-based treatments and technologies that treat 
        substance use disorders.
            (D) Items and services furnished by practitioners through a 
        multi-disciplinary treatment model for pain management, 
        including the patient-centered medical home.
            (E) Items and services furnished to beneficiaries with 
        psychiatric disorders, substance use disorders, or who are at 
        risk of suicide, or have comorbidities and require consultation 
        or management of pain with one or more specialists in pain 
        management, mental health, or addiction treatment.
        (2) An evaluation of the following:
            (A) Barriers inhibiting individuals entitled to benefits 
        under part A or enrolled under part B of such title from 
        accessing treatments and technologies described in 
        subparagraphs (A) through (E) of paragraph (1).
            (B) Costs and benefits associated with potential expansion 
        of coverage under such title to include items and services not 
        covered under such title that may be used for the treatment of 
        pain, such as acupuncture, therapeutic massage, and items and 
        services furnished by integrated pain management programs.
            (C) Pain management guidance published by the Federal 
        Government that may be relevant to coverage determinations or 
        other coverage requirements under title XVIII of the Social 
        Security Act.
        (3) An assessment of all guidance published by the Department 
    of Health and Human Services on or after January 1, 2016, relating 
    to the prescribing of opioids. Such assessment shall consider 
    incorporating into such guidance relevant elements of the ``Va/DoD 
    Clinical Practice Guideline for Opioid Therapy for Chronic Pain'' 
    published in February 2017 by the Department of Veterans Affairs 
    and Department of Defense, including adoption of elements of the 
    Department of Defense and Department of Veterans Affairs pain 
    rating scale.
        (4) The options described in subsection (d).
        (5) The impact analysis described in subsection (e).
    (d) Options.--The options described in this subsection are, with 
respect to individuals entitled to benefits under part A or enrolled 
under part B of title XVIII of the Social Security Act, legislative and 
administrative options for accomplishing the following:
        (1) Improving coverage of and payment for pain management 
    therapies without the use of opioids, including interventional pain 
    therapies, and options to augment opioid therapy with other 
    clinical and complementary, integrative health services to minimize 
    the risk of substance use disorder, including in a hospital 
    setting.
        (2) Improving coverage of and payment for medical devices and 
    non-opioid based pharmacological and non-pharmacological therapies 
    approved or cleared by the Food and Drug Administration for the 
    treatment of pain as an alternative or augment to opioid therapy.
        (3) Improving and disseminating treatment strategies for 
    beneficiaries with psychiatric disorders, substance use disorders, 
    or who are at risk of suicide, and treatment strategies to address 
    health disparities related to opioid use and opioid abuse 
    treatment.
        (4) Improving and disseminating treatment strategies for 
    beneficiaries with comorbidities who require a consultation or 
    comanagement of pain with one or more specialists in pain 
    management, mental health, or addiction treatment, including in a 
    hospital setting.
        (5) Educating providers on risks of coadministration of opioids 
    and other drugs, particularly benzodiazepines.
        (6) Ensuring appropriate case management for beneficiaries who 
    transition between inpatient and outpatient hospital settings, or 
    between opioid therapy to non-opioid therapy, which may include the 
    use of care transition plans.
        (7) Expanding outreach activities designed to educate providers 
    of services and suppliers under the Medicare program and 
    individuals entitled to benefits under part A or under part B of 
    such title on alternative, non-opioid therapies to manage and treat 
    acute and chronic pain.
        (8) Creating a beneficiary education tool on alternatives to 
    opioids for chronic pain management.
    (e) Impact Analysis.--The impact analysis described in this 
subsection consists of an analysis of any potential effects 
implementing the options described in subsection (d) would have--
        (1) on expenditures under the Medicare program; and
        (2) on preventing or reducing opioid addiction for individuals 
    receiving benefits under the Medicare program.

        Subtitle J--Combating Opioid Abuse for Care in Hospitals

SEC. 6091. SHORT TITLE.
    This subtitle may be cited as the ``Combating Opioid Abuse for Care 
in Hospitals Act of 2018'' or the ``COACH Act of 2018''.
SEC. 6092. DEVELOPING GUIDANCE ON PAIN MANAGEMENT AND OPIOID USE 
DISORDER PREVENTION FOR HOSPITALS RECEIVING PAYMENT UNDER PART A OF THE 
MEDICARE PROGRAM.
    (a) In General.--Not later than July 1, 2019, the Secretary of 
Health and Human Services (in this section referred to as the 
``Secretary'') shall develop and publish on the public website of the 
Centers for Medicare & Medicaid Services guidance for hospitals 
receiving payment under part A of title XVIII of the Social Security 
Act (42 U.S.C. 1395c et seq.) on pain management strategies and opioid 
use disorder prevention strategies with respect to individuals entitled 
to benefits under such part.
    (b) Consultation.--In developing the guidance described in 
subsection (a), the Secretary shall consult with relevant stakeholders, 
including--
        (1) medical professional organizations;
        (2) providers and suppliers of services (as such terms are 
    defined in section 1861 of the Social Security Act (42 U.S.C. 
    1395x));
        (3) health care consumers or groups representing such 
    consumers; and
        (4) other entities determined appropriate by the Secretary.
    (c) Contents.--The guidance described in subsection (a) shall 
include, with respect to hospitals and individuals described in such 
subsection, the following:
        (1) Best practices regarding evidence-based screening and 
    practitioner education initiatives relating to screening and 
    treatment protocols for opioid use disorder, including--
            (A) methods to identify such individuals at-risk of opioid 
        use disorder, including risk stratification;
            (B) ways to prevent, recognize, and treat opioid overdoses; 
        and
            (C) resources available to such individuals, such as opioid 
        treatment programs, peer support groups, and other recovery 
        programs.
        (2) Best practices for such hospitals to educate practitioners 
    furnishing items and services at such hospital with respect to pain 
    management and substance use disorders, including education on--
            (A) the adverse effects of prolonged opioid use;
            (B) non-opioid, evidence-based, non-pharmacological pain 
        management treatments;
            (C) monitoring programs for individuals who have been 
        prescribed opioids; and
            (D) the prescribing of naloxone along with an initial 
        opioid prescription.
        (3) Best practices for such hospitals to make such individuals 
    aware of the risks associated with opioid use (which may include 
    use of the notification template described in paragraph (4)).
        (4) A notification template developed by the Secretary, for use 
    as appropriate, for such individuals who are prescribed an opioid 
    that--
            (A) explains the risks and side effects associated with 
        opioid use (including the risks of addiction and overdose) and 
        the importance of adhering to the prescribed treatment regimen, 
        avoiding medications that may have an adverse interaction with 
        such opioid, and storing such opioid safely and securely;
            (B) highlights multimodal and evidence-based non-opioid 
        alternatives for pain management;
            (C) encourages such individuals to talk to their health 
        care providers about such alternatives;
            (D) provides for a method (through signature or otherwise) 
        for such an individual, or person acting on such individual's 
        behalf, to acknowledge receipt of such notification template;
            (E) is worded in an easily understandable manner and made 
        available in multiple languages determined appropriate by the 
        Secretary; and
            (F) includes any other information determined appropriate 
        by the Secretary.
        (5) Best practices for such hospital to track opioid 
    prescribing trends by practitioners furnishing items and services 
    at such hospital, including--
            (A) ways for such hospital to establish target levels, 
        taking into account the specialties of such practitioners and 
        the geographic area in which such hospital is located, with 
        respect to opioids prescribed by such practitioners;
            (B) guidance on checking the medical records of such 
        individuals against information included in prescription drug 
        monitoring programs;
            (C) strategies to reduce long-term opioid prescriptions; 
        and
            (D) methods to identify such practitioners who may be over-
        prescribing opioids.
        (6) Other information the Secretary determines appropriate, 
    including any such information from the Opioid Safety Initiative 
    established by the Department of Veterans Affairs or the Opioid 
    Overdose Prevention Toolkit published by the Substance Abuse and 
    Mental Health Services Administration.
SEC. 6093. REQUIRING THE REVIEW OF QUALITY MEASURES RELATING TO OPIOIDS 
AND OPIOID USE DISORDER TREATMENTS FURNISHED UNDER THE MEDICARE PROGRAM 
AND OTHER FEDERAL HEALTH CARE PROGRAMS.
    Section 1890A of the Social Security Act (42 U.S.C. 1395aaa-1) is 
amended by adding at the end the following new subsection:
    ``(g) Technical Expert Panel Review of Opioid and Opioid Use 
Disorder Quality Measures.--
        ``(1) In general.--Not later than 180 days after the date of 
    the enactment of this subsection, the Secretary shall establish a 
    technical expert panel for purposes of reviewing quality measures 
    relating to opioids and opioid use disorders, including care, 
    prevention, diagnosis, health outcomes, and treatment furnished to 
    individuals with opioid use disorders. The Secretary may use the 
    entity with a contract under section 1890(a) and amend such 
    contract as necessary to provide for the establishment of such 
    technical expert panel.
        ``(2) Review and assessment.--Not later than 1 year after the 
    date the technical expert panel described in paragraph (1) is 
    established (and periodically thereafter as the Secretary 
    determines appropriate), the technical expert panel shall--
            ``(A) review quality measures that relate to opioids and 
        opioid use disorders, including existing measures and those 
        under development;
            ``(B) identify gaps in areas of quality measurement that 
        relate to opioids and opioid use disorders, and identify 
        measure development priorities for such measure gaps; and
            ``(C) make recommendations to the Secretary on quality 
        measures with respect to opioids and opioid use disorders for 
        purposes of improving care, prevention, diagnosis, health 
        outcomes, and treatment, including recommendations for 
        revisions of such measures, need for development of new 
        measures, and recommendations for including such measures in 
        the Merit-Based Incentive Payment System under section 1848(q), 
        the alternative payment models under section 1833(z)(3)(C), the 
        shared savings program under section 1899, the quality 
        reporting requirements for inpatient hospitals under section 
        1886(b)(3)(B)(viii), and the hospital value-based purchasing 
        program under section 1886(o).
        ``(3) Consideration of measures by secretary.--The Secretary 
    shall consider--
            ``(A) using opioid and opioid use disorder measures 
        (including measures used under the Merit-Based Incentive 
        Payment System under section 1848(q), measures recommended 
        under paragraph (2)(C), and other such measures identified by 
        the Secretary) in alternative payment models under section 
        1833(z)(3)(C) and in the shared savings program under section 
        1899; and
            ``(B) using opioid measures described in subparagraph (A), 
        as applicable, in the quality reporting requirements for 
        inpatient hospitals under section 1886(b)(3)(B)(viii), and in 
        the hospital value-based purchasing program under section 
        1886(o).
        ``(4) Prioritization of measure development.--The Secretary 
    shall prioritize for measure development the gaps in quality 
    measures identified under paragraph (2)(B).
        ``(5) Prioritization of measure endorsement.--The Secretary--
            ``(A) during the period beginning on the date of the 
        enactment of this subsection and ending on December 31, 2023, 
        shall prioritize the endorsement of measures relating to 
        opioids and opioid use disorders by the entity with a contract 
        under subsection (a) of section 1890 in connection with 
        endorsement of measures described in subsection (b)(2) of such 
        section; and
            ``(B) on and after January 1, 2024, may prioritize the 
        endorsement of such measures by such entity.''.
SEC. 6094. TECHNICAL EXPERT PANEL ON REDUCING SURGICAL SETTING OPIOID 
USE; DATA COLLECTION ON PERIOPERATIVE OPIOID USE.
    (a) Technical Expert Panel on Reducing Surgical Setting Opioid 
Use.--
        (1) In general.--Not later than 6 months after the date of the 
    enactment of this Act, the Secretary of Health and Human Services 
    shall convene a technical expert panel, including medical and 
    surgical specialty societies and hospital organizations, to provide 
    recommendations on reducing opioid use in the inpatient and 
    outpatient surgical settings and on best practices for pain 
    management, including with respect to the following:
            (A) Approaches that limit patient exposure to opioids 
        during the perioperative period, including pre-surgical and 
        post-surgical injections, and that identify such patients at 
        risk of opioid use disorder pre-operation.
            (B) Shared decision making with patients and families on 
        pain management, including a review of payment to ensure 
        payment under the Medicare program under title XVIII of the 
        Social Security Act accounts for time spent on shared decision 
        making.
            (C) Education on the safe use, storage, and disposal of 
        opioids.
            (D) Prevention of opioid misuse and abuse after discharge.
            (E) Development of a clinical algorithm to identify and 
        treat at-risk, opiate-tolerant patients and reduce reliance on 
        opioids for acute pain during the perioperative period.
        (2) Report.--Not later than 1 year after the date of the 
    enactment of this Act, the Secretary shall submit to Congress and 
    make public a report containing the recommendations developed under 
    paragraph (1) and an action plan for broader implementation of pain 
    management protocols that limit the use of opioids in the 
    perioperative setting and upon discharge from such setting.
    (b) Data Collection on Perioperative Opioid Use.--Not later than 1 
year after the date of the enactment of this Act, the Secretary of 
Health and Human Services shall submit to Congress a report that 
contains the following:
        (1) The diagnosis-related group codes identified by the 
    Secretary as having the highest volume of surgeries.
        (2) With respect to each of such diagnosis-related group codes 
    so identified, a determination by the Secretary of the data that is 
    both available and reported on opioid use following such surgeries, 
    such as with respect to--
            (A) surgical volumes, practices, and opioid prescribing 
        patterns;
            (B) opioid consumption, including--
                (i) perioperative days of therapy;
                (ii) average daily dose at the hospital, including 
            dosage greater than 90 milligram morphine equivalent;
                (iii) post-discharge prescriptions and other 
            combination drugs that are used before intervention and 
            after intervention;
                (iv) quantity and duration of opioid prescription at 
            discharge; and
                (v) quantity consumed and number of refills;
            (C) regional anesthesia and analgesia practices, including 
        pre-surgical and post-surgical injections;
            (D) naloxone reversal;
            (E) post-operative respiratory failure;
            (F) information about storage and disposal; and
            (G) such other information as the Secretary may specify.
        (3) Recommendations for improving data collection on 
    perioperative opioid use, including an analysis to identify and 
    reduce barriers to collecting, reporting, and analyzing the data 
    described in paragraph (2), including barriers related to 
    technological availability.
SEC. 6095. REQUIRING THE POSTING AND PERIODIC UPDATE OF OPIOID 
PRESCRIBING GUIDANCE FOR MEDICARE BENEFICIARIES.
    (a) In General.--Not later than 180 days 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 post on the public 
website of the Centers for Medicare & Medicaid Services all guidance 
published by the Department of Health and Human Services on or after 
January 1, 2016, relating to the prescribing of opioids and applicable 
to opioid prescriptions for individuals entitled to benefits under part 
A of title XVIII of the Social Security Act (42 U.S.C. 1395c et seq.) 
or enrolled under part B of such title of such Act (42 U.S.C. 1395j et 
seq.).
    (b) Update of Guidance.--
        (1) Periodic update.--The Secretary shall, in consultation with 
    the entities specified in paragraph (2), periodically (as 
    determined appropriate by the Secretary) update guidance described 
    in subsection (a) and revise the posting of such guidance on the 
    website described in such subsection.
        (2) Consultation.--The entities specified in this paragraph are 
    the following:
            (A) Medical professional organizations.
            (B) Providers and suppliers of services (as such terms are 
        defined in section 1861 of the Social Security Act (42 U.S.C. 
        1395x)).
            (C) Health care consumers or groups representing such 
        consumers.
            (D) Other entities determined appropriate by the Secretary.

  Subtitle K--Providing Reliable Options for Patients and Educational 
                               Resources

SEC. 6101. SHORT TITLE.
    This subtitle may be cited as the ``Providing Reliable Options for 
Patients and Educational Resources Act of 2018'' or the ``PROPER Act of 
2018''.
SEC. 6102. REQUIRING MEDICARE ADVANTAGE PLANS AND PART D PRESCRIPTION 
DRUG PLANS TO INCLUDE INFORMATION ON RISKS ASSOCIATED WITH OPIOIDS AND 
COVERAGE OF NONPHARMACOLOGICAL THERAPIES AND NONOPIOID MEDICATIONS OR 
DEVICES USED TO TREAT PAIN.
    Section 1860D-4(a)(1) of the Social Security Act (42 U.S.C. 1395w-
104(a)(1)) is amended--
        (1) in subparagraph (A), by inserting ``, subject to 
    subparagraph (C),'' before ``including'';
        (2) in subparagraph (B), by adding at the end the following new 
    clause:
                ``(vi) For plan year 2021 and each subsequent plan 
            year, subject to subparagraph (C), with respect to the 
            treatment of pain--

                    ``(I) the risks associated with prolonged opioid 
                use; and
                    ``(II) coverage of nonpharmacological therapies, 
                devices, and nonopioid medications--

                        ``(aa) in the case of an MA-PD plan under part 
                    C, under such plan; and
                        ``(bb) in the case of a prescription drug plan, 
                    under such plan and under parts A and B.''; and
        (3) by adding at the end the following new subparagraph:
            ``(C) Targeted provision of information.--A PDP sponsor of 
        a prescription drug plan may, in lieu of disclosing the 
        information described in subparagraph (B)(vi) to each enrollee 
        under the plan, disclose such information through mail or 
        electronic communications to a subset of enrollees under the 
        plan, such as enrollees who have been prescribed an opioid in 
        the previous 2-year period.''.
SEC. 6103. REQUIRING MEDICARE ADVANTAGE PLANS AND PRESCRIPTION DRUG 
PLANS TO PROVIDE INFORMATION ON THE SAFE DISPOSAL OF PRESCRIPTION 
DRUGS.
    (a) Medicare Advantage.--Section 1852 of the Social Security Act 
(42 U.S.C. 1395w-22) is amended by adding at the end the following new 
subsection:
    ``(n) Provision of Information Relating to the Safe Disposal of 
Certain Prescription Drugs.--
        ``(1) In general.--In the case of an individual enrolled under 
    an MA or MA-PD plan who is furnished an in-home health risk 
    assessment on or after January 1, 2021, such plan shall ensure that 
    such assessment includes information on the safe disposal of 
    prescription drugs that are controlled substances that meets the 
    criteria established under paragraph (2). Such information shall 
    include information on drug takeback programs that meet such 
    requirements determined appropriate by the Secretary and 
    information on in-home disposal.
        ``(2) Criteria.--The Secretary shall, through rulemaking, 
    establish criteria the Secretary determines appropriate with 
    respect to information provided to an individual to ensure that 
    such information sufficiently educates such individual on the safe 
    disposal of prescription drugs that are controlled substances.''.
    (b) Prescription Drug Plans.--Section 1860D-4(c)(2)(B) of the 
Social Security Act (42 U.S.C. 1395w-104(c)(2)(B)) is amended--
        (1) by striking ``may include elements that promote'';
        (2) by redesignating clauses (i) through (iii) as subclauses 
    (I) through (III) and adjusting the margins accordingly;
        (3) by inserting before subclause (I), as so redesignated, the 
    following new clause:
                ``(i) may include elements that promote--'';
        (4) in subclause (III), as so redesignated, by striking the 
    period at the end and inserting ``; and''; and
        (5) by adding at the end the following new clause:
                ``(ii) with respect to plan years beginning on or after 
            January 1, 2021, shall provide for--

                    ``(I) the provision of information to the enrollee 
                on the safe disposal of prescription drugs that are 
                controlled substances that meets the criteria 
                established under section 1852(n)(2), including 
                information on drug takeback programs that meet such 
                requirements determined appropriate by the Secretary 
                and information on in-home disposal; and
                    ``(II) cost-effective means by which an enrollee 
                may so safely dispose of such drugs.''.

SEC. 6104. REVISING MEASURES USED UNDER THE HOSPITAL CONSUMER 
ASSESSMENT OF HEALTHCARE PROVIDERS AND SYSTEMS SURVEY RELATING TO PAIN 
MANAGEMENT.
    (a) Restriction on the Use of Pain Questions in HCAHPS.--Section 
1886(b)(3)(B)(viii) of the Social Security Act (42 U.S.C. 
1395ww(b)(3)(B)(viii)) is amended by adding at the end the following 
new subclause:
    ``(XII)(aa) With respect to a Hospital Consumer Assessment of 
Healthcare Providers and Systems survey (or a successor survey) 
conducted on or after January 1, 2020, such survey may not include 
questions about communication by hospital staff with an individual 
about such individual's pain unless such questions take into account, 
as applicable, whether an individual experiencing pain was informed 
about risks associated with the use of opioids and about non-opioid 
alternatives for the treatment of pain.
    ``(bb) The Secretary shall not include on the Hospital Compare 
internet website any measures based on the questions appearing on the 
Hospital Consumer Assessment of Healthcare Providers and Systems survey 
in 2018 or 2019 about communication by hospital staff with an 
individual about such individual's pain.''.
    (b) Restriction on Use of 2018 and 2019 Pain Questions in the 
Hospital Value-based Purchasing Program.--Section 1886(o)(2)(B) of the 
Social Security Act (42 U.S.C. 1395ww(o)(2)(B)) is amended by adding at 
the end the following new clause:
                ``(iii) HCAHPS pain questions.--The Secretary may not 
            include under subparagraph (A) a measure that is based on 
            the questions appearing on the Hospital Consumer Assessment 
            of Healthcare Providers and Systems survey in 2018 or 2019 
            about communication by hospital staff with an individual 
            about the individual's pain.''.

         Subtitle L--Fighting the Opioid Epidemic With Sunshine

SEC. 6111. FIGHTING THE OPIOID EPIDEMIC WITH SUNSHINE.
    (a) Inclusion of Information Regarding Payments to Additional 
Practitioners.--
        (1) In general.--Section 1128G(e)(6) of the Social Security Act 
    (42 U.S.C. 1320a-7h(e)(6)) is amended--
            (A) in subparagraph (A), by adding at the end the following 
        new clauses:
                ``(iii) A physician assistant, nurse practitioner, or 
            clinical nurse specialist (as such terms are defined in 
            section 1861(aa)(5)).
                ``(iv) A certified registered nurse anesthetist (as 
            defined in section 1861(bb)(2)).
                ``(v) A certified nurse-midwife (as defined in section 
            1861(gg)(2)).''; and
            (B) in subparagraph (B), by inserting ``, physician 
        assistant, nurse practitioner, clinical nurse specialist, 
        certified nurse anesthetist, or certified nurse-midwife'' after 
        ``physician''.
        (2) Effective date.--The amendments made by this subsection 
    shall apply with respect to information required to be submitted 
    under section 1128G of the Social Security Act (42 U.S.C. 1320a-7h) 
    on or after January 1, 2022.
    (b) Sunset of Exclusion of National Provider Identifier of Covered 
Recipient in Information Made Publicly Available.--Section 
1128G(c)(1)(C)(viii) of the Social Security Act (42 U.S.C. 1320a-
7h(c)(1)(C)(viii)) is amended by striking ``does not contain'' and 
inserting ``in the case of information made available under this 
subparagraph prior to January 1, 2022, does not contain''.
    (c) Administration.--Chapter 35 of title 44, United States Code, 
shall not apply to this section or the amendments made by this section.

                  TITLE VII--PUBLIC HEALTH PROVISIONS
                   Subtitle A--Awareness and Training

SEC. 7001. REPORT ON EFFECTS ON PUBLIC HEALTH OF SYNTHETIC DRUG USE.
    (a) In General.--Not later than 3 years after the date of the 
enactment of this Act, the Secretary of Health and Human Services, in 
coordination with the Surgeon General of the Public Health Service, 
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 a report on the health effects of new 
psychoactive substances, including synthetic drugs, used by adolescents 
and young adults.
    (b) New Psychoactive Substance Defined.--For purposes of subsection 
(a), the term ``new psychoactive substance'' means a controlled 
substance analogue (as defined in section 102(32) of the Controlled 
Substances Act (21 U.S.C. 802(32)).
SEC. 7002. FIRST RESPONDER TRAINING.
    Section 546 of the Public Health Service Act (42 U.S.C. 290ee-1) is 
amended--
        (1) in subsection (c)--
            (A) in paragraph (2), by striking ``and'' at the end;
            (B) in paragraph (3), by striking the period and inserting 
        ``; and''; and
            (C) by adding at the end the following:
        ``(4) train and provide resources for first responders and 
    members of other key community sectors on safety around fentanyl, 
    carfentanil, and other dangerous licit and illicit drugs to protect 
    themselves from exposure to such drugs and respond appropriately 
    when exposure occurs.'';
        (2) in subsection (d), by striking ``and mechanisms for 
    referral to appropriate treatment for an entity receiving a grant 
    under this section'' and inserting ``mechanisms for referral to 
    appropriate treatment, and safety around fentanyl, carfentanil, and 
    other dangerous licit and illicit drugs'';
        (3) in subsection (f)--
            (A) in paragraph (3), by striking ``and'' at the end;
            (B) in paragraph (4), by striking the period and inserting 
        ``; and''; and
            (C) by adding at the end the following:
        ``(5) the number of first responders and members of other key 
    community sectors trained on safety around fentanyl, carfentanil, 
    and other dangerous licit and illicit drugs.'';
        (4) by redesignating subsection (g) as subsection (h);
        (5) by inserting after subsection (f) the following:
    ``(g) Other Key Community Sectors.--In this section, the term 
`other key community sectors' includes substance use disorder treatment 
providers, emergency medical services agencies, agencies and 
organizations working with prison and jail populations and offender 
reentry programs, health care providers, harm reduction groups, 
pharmacies, community health centers, tribal health facilities, and 
mental health providers.''; and
        (6) in subsection (h), as so redesignated, by striking 
    ``$12,000,000 for each of fiscal years 2017 through 2021'' and 
    inserting ``$36,000,000 for each of fiscal years 2019 through 
    2023''.

  Subtitle B--Pilot Program for Public Health Laboratories To Detect 
                  Fentanyl and Other Synthetic Opioids

SEC. 7011. PILOT PROGRAM FOR PUBLIC HEALTH LABORATORIES TO DETECT 
FENTANYL AND OTHER SYNTHETIC OPIOIDS.
    (a) Grants.--The Secretary of Health and Human Services (referred 
to in this section as the ``Secretary'') shall award grants to, or 
enter into cooperative agreements with, Federal, State, and local 
agencies to improve coordination between public health laboratories and 
laboratories operated by law enforcement agencies, such as Customs and 
Border Protection and the Drug Enforcement Administration, to improve 
detection of synthetic opioids, including fentanyl and its analogues, 
as described in subsection (b).
    (b) Detection Activities.--The Secretary, in consultation with the 
Director of the National Institute of Standards and Technology, the 
Director of the Centers for Disease Control and Prevention, the 
Attorney General of the United States, and the Administrator of the 
Drug Enforcement Administration, shall, for purposes of this section, 
develop or identify--
        (1) best practices for safely handling and testing synthetic 
    opioids, including fentanyl and its analogues, including with 
    respect to reference materials, instrument calibration, and quality 
    control protocols;
        (2) reference materials and quality control standards related 
    to synthetic opioids, including fentanyl and its analogues, to 
    enhance--
            (A) clinical diagnostics;
            (B) postmortem data collection; and
            (C) portable testing equipment utilized by law enforcement 
        and public health officials; and
        (3) procedures for the identification of new and emerging 
    synthetic opioid formulations and procedures for reporting those 
    findings to appropriate law enforcement agencies and Federal, 
    State, and local public health laboratories and health departments, 
    as appropriate.
    (c) Laboratories.--The Secretary shall require recipients of grants 
or cooperative agreements under subsection (a) to--
        (1) follow the best practices established under subsection (b) 
    and have the appropriate capabilities to provide laboratory testing 
    of controlled substances, such as synthetic fentanyl, and 
    biospecimens for the purposes of aggregating and reporting public 
    health information to Federal, State, and local public health 
    officials, laboratories, and other entities the Secretary deems 
    appropriate;
        (2) work with law enforcement agencies and public health 
    authorities, as practicable;
        (3) provide early warning information to Federal, State, and 
    local law enforcement agencies and public health authorities 
    regarding trends or other data related to the supply of synthetic 
    opioids, including fentanyl and its analogues;
        (4) provide biosurveillance capabilities with respect to 
    identifying trends in adverse health outcomes associated with non-
    fatal exposures; and
        (5) provide diagnostic testing, as appropriate and practicable, 
    for non-fatal exposures of emergency personnel, first responders, 
    and other individuals.
    (d) Authorization of Appropriations.--To carry out this section, 
there is authorized to be appropriated $15,000,000 for each of fiscal 
years 2019 through 2023.

         Subtitle C--Indexing Narcotics, Fentanyl, and Opioids

SEC. 7021. ESTABLISHMENT OF SUBSTANCE USE DISORDER INFORMATION 
DASHBOARD.
    Title XVII of the Public Health Service Act (42 U.S.C. 300u et 
seq.) is amended by adding at the end the following new section:
``SEC. 1711. ESTABLISHMENT OF SUBSTANCE USE DISORDER INFORMATION 
DASHBOARD.
    ``(a) In General.--Not later than 6 months after the date of the 
enactment of this section, the Secretary of Health and Human Services 
shall, in consultation with the Director of National Drug Control 
Policy, establish and periodically update, on the Internet website of 
the Department of Health and Human Services, a public information 
dashboard that--
        ``(1) provides links to information on programs within the 
    Department of Health and Human Services related to the reduction of 
    opioid and other substance use disorders;
        ``(2) provides access, to the extent practicable and 
    appropriate, to publicly available data, which may include data 
    from agencies within the Department of Health and Human Services 
    and--
            ``(A) other Federal agencies;
            ``(B) State, local, and Tribal governments;
            ``(C) nonprofit organizations;
            ``(D) law enforcement;
            ``(E) medical experts;
            ``(F) public health educators; and
            ``(G) research institutions regarding prevention, 
        treatment, recovery, and other services for opioid and other 
        substance use disorders;
        ``(3) provides data on substance use disorder prevention and 
    treatment strategies in different regions of and populations in the 
    United States;
        ``(4) identifies information on alternatives to controlled 
    substances for pain management, such as approaches studied by the 
    National Institutes of Health Pain Consortium, the National Center 
    for Complimentary and Integrative Health, and other institutes and 
    centers at the National Institutes of Health, as appropriate; and
        ``(5) identifies guidelines and best practices for health care 
    providers regarding treatment of substance use disorders.
    ``(b) Controlled Substance Defined.--In this section, the term 
`controlled substance' has the meaning given that term in section 102 
of the Controlled Substances Act (21 U.S.C. 802).''.
SEC. 7022. INTERDEPARTMENTAL SUBSTANCE USE DISORDERS COORDINATING 
COMMITTEE.
    (a) Establishment.--Not later than 3 months 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, in coordination 
with the Director of National Drug Control Policy, establish a 
committee, to be known as the Interdepartmental Substance Use Disorders 
Coordinating Committee (in this section referred to as the 
``Committee''), to coordinate Federal activities related to substance 
use disorders.
    (b) Membership.--
        (1) Federal members.--The Committee shall be composed of the 
    following Federal representatives, or the designees of such 
    representatives:
            (A) The Secretary, who shall serve as the Chair of the 
        Committee.
            (B) The Attorney General of the United States.
            (C) The Secretary of Labor.
            (D) The Secretary of Housing and Urban Development.
            (E) The Secretary of Education.
            (F) The Secretary of Veterans Affairs.
            (G) The Commissioner of Social Security.
            (H) The Assistant Secretary for Mental Health and Substance 
        Use.
            (I) The Director of National Drug Control Policy.
            (J) Representatives of other Federal agencies that support 
        or conduct activities or programs related to substance use 
        disorders, as determined appropriate by the Secretary.
        (2) Non-federal members.--The Committee shall include a minimum 
    of 15 non-Federal members appointed by the Secretary, of which--
            (A) at least two such members shall be an individual who 
        has received treatment for a diagnosis of a substance use 
        disorder;
            (B) at least two such members shall be a director of a 
        State substance abuse agency;
            (C) at least two such members shall be a representative of 
        a leading research, advocacy, or service organization for 
        adults with substance use disorder;
            (D) at least two such members shall--
                (i) be a physician, licensed mental health 
            professional, advance practice registered nurse, or 
            physician assistant; and
                (ii) have experience in treating individuals with 
            substance use disorders;
            (E) at least one such member shall be a substance use 
        disorder treatment professional who provides treatment services 
        at a certified opioid treatment program;
            (F) at least one such member shall be a substance use 
        disorder treatment professional who has research or clinical 
        experience in working with racial and ethnic minority 
        populations;
            (G) at least one such member shall be a substance use 
        disorder treatment professional who has research or clinical 
        mental health experience in working with medically underserved 
        populations;
            (H) at least one such member shall be a State-certified 
        substance use disorder peer support specialist;
            (I) at least one such member shall be a drug court judge or 
        a judge with experience in adjudicating cases related to 
        substance use disorder;
            (J) at least one such member shall be a public safety 
        officer with extensive experience in interacting with adults 
        with a substance use disorder; and
            (K) at least one such member shall be an individual with 
        experience providing services for homeless individuals with a 
        substance use disorder.
    (c) Terms.--
        (1) In general.--A member of the Committee appointed under 
    subsection (b)(2) shall be appointed for a term of 3 years and may 
    be reappointed for one or more 3-year terms.
        (2) Vacancies.--A vacancy on the Committee shall be filled in 
    the same manner in which the original appointment was made. Any 
    individual appointed to fill a vacancy for an unexpired term shall 
    be appointed for the remainder of such term and may serve after the 
    expiration of such term until a successor has been appointed.
    (d) Meetings.--The Committee shall meet not fewer than two times 
each year.
    (e) Duties.--The Committee shall--
        (1) identify areas for improved coordination of activities, if 
    any, related to substance use disorders, including research, 
    services, supports, and prevention activities across all relevant 
    Federal agencies;
        (2) identify and provide to the Secretary recommendations for 
    improving Federal programs for the prevention and treatment of, and 
    recovery from, substance use disorders, including by expanding 
    access to prevention, treatment, and recovery services;
        (3) analyze substance use disorder prevention and treatment 
    strategies in different regions of and populations in the United 
    States and evaluate the extent to which Federal substance use 
    disorder prevention and treatment strategies are aligned with State 
    and local substance use disorder prevention and treatment 
    strategies;
        (4) make recommendations to the Secretary regarding any 
    appropriate changes with respect to the activities and strategies 
    described in paragraphs (1) through (3);
        (5) make recommendations to the Secretary regarding public 
    participation in decisions relating to substance use disorders and 
    the process by which public feedback can be better integrated into 
    such decisions; and
        (6) make recommendations to ensure that substance use disorder 
    research, services, supports, and prevention activities of the 
    Department of Health and Human Services and other Federal agencies 
    are not unnecessarily duplicative.
    (f) Annual Report.--Not later than 1 year after the date of the 
enactment of this Act, and annually thereafter for the life of the 
Committee, the Committee shall publish on the Internet website of the 
Department of Health and Human Services, which may include the public 
information dashboard established under section 1711 of the Public 
Health Service Act, as added by section 7021, a report summarizing the 
activities carried out by the Committee pursuant to subsection (e), 
including any findings resulting from such activities.
    (g) Working Groups.--The Committee may establish working groups for 
purposes of carrying out the duties described in subsection (e). Any 
such working group shall be composed of members of the Committee (or 
the designees of such members) and may hold such meetings as are 
necessary to enable the working group to carry out the duties delegated 
to the working group.
    (h) Federal Advisory Committee Act.--The Federal Advisory Committee 
Act (5 U.S.C. App.) shall apply to the Committee only to the extent 
that the provisions of such Act do not conflict with the requirements 
of this section.
    (i) Sunset.--The Committee shall terminate on the date that is 6 
years after the date on which the Committee is established under 
subsection (a).
SEC. 7023. NATIONAL MILESTONES TO MEASURE SUCCESS IN CURTAILING THE 
OPIOID CRISIS.
    (a) In General.--Not later than 180 days after the date of 
enactment of this Act, the Secretary of Health and Human Services 
(referred to in this section as the ``Secretary''), in coordination 
with the Administrator of the Drug Enforcement Administration and the 
Director of the Office of National Drug Control Policy, shall develop 
or identify existing national indicators (referred to in this section 
as the ``national milestones'') to measure success in curtailing the 
opioid crisis, with the goal of significantly reversing the incidence 
and prevalence of opioid misuse and abuse, and opioid-related morbidity 
and mortality in the United States within 5 years of such date of 
enactment.
    (b) National Milestones to End the Opioid Crisis.--The national 
milestones under subsection (a) shall include the following:
        (1) Not fewer than 10 indicators or metrics to accurately and 
    expediently measure progress in meeting the goal described in 
    subsection (a), which shall, as appropriate, include, indicators or 
    metrics related to--
            (A) the number of fatal and non-fatal opioid overdoses;
            (B) the number of emergency room visits related to opioid 
        misuse and abuse;
            (C) the number of individuals in sustained recovery from 
        opioid use disorder;
            (D) the number of infections associated with illicit drug 
        use, such as HIV, viral hepatitis, and infective endocarditis, 
        and available capacity for treating such infections;
            (E) the number of providers prescribing medication-assisted 
        treatment for opioid use disorders, including in primary care 
        settings, community health centers, jails, and prisons;
            (F) the number of individuals receiving treatment for 
        opioid use disorder; and
            (G) additional indicators or metrics, as appropriate, such 
        as metrics pertaining to specific populations, including women 
        and children, American Indians and Alaskan Natives, individuals 
        living in rural and non-urban areas, and justice-involved 
        populations, that would further clarify the progress made in 
        addressing the opioid crisis.
        (2) A reasonable goal, such as a percentage decrease or other 
    specified metric, that signifies progress in meeting the goal 
    described in subsection (a), and annual targets to help achieve 
    that goal.
    (c) Consideration of Other Substance Use Disorders.--In developing 
the national milestones under subsection (b), the Secretary shall, as 
appropriate, consider other substance use disorders in addition to 
opioid use disorder.
    (d) Extension of Period.--If the Secretary determines that the goal 
described in subsection (a) will not be achieved with respect to any 
indicator or metric established under subsection (b)(2) within 5 years 
of the date of enactment of this Act, the Secretary may extend the 
timeline for meeting such goal with respect to that indicator or 
metric. The Secretary shall include with any such extension a rationale 
for why additional time is needed and information on whether 
significant changes are needed in order to achieve such goal with 
respect to the indicator or metric.
    (e) Annual Status Update.--Not later than one year after the date 
of enactment of this Act, the Secretary shall make available on the 
Internet website of the Department of Health and Human Services, and 
submit to the Committee on Health, Education, Labor, and Pensions of 
the Senate and the Committee on Energy and Commerce of the House of 
Representatives, an update on the progress, including expected progress 
in the subsequent year, in achieving the goals detailed in the national 
milestones. Each such update shall include the progress made in the 
first year or since the previous report, as applicable, in meeting each 
indicator or metric in the national milestones.
SEC. 7024. STUDY ON PRESCRIBING LIMITS.
    Not later than 2 years after the date of enactment of this Act, the 
Secretary of Health and Human Services, in consultation with the 
Attorney General of the United States, shall submit to the Committee on 
Health, Education, Labor, and Pensions of the Senate and the Committee 
on Energy and Commerce of the House of Representatives a report on the 
impact of Federal and State laws and regulations that limit the length, 
quantity, or dosage of opioid prescriptions. Such report shall 
address--
        (1) the impact of such limits on--
            (A) the incidence and prevalence of overdose related to 
        prescription opioids;
            (B) the incidence and prevalence of overdose related to 
        illicit opioids;
            (C) the prevalence of opioid use disorders;
            (D) medically appropriate use of, and access to, opioids, 
        including any impact on travel expenses and pain management 
        outcomes for patients, whether such limits are associated with 
        significantly higher rates of negative health outcomes, 
        including suicide, and whether the impact of such limits 
        differs based on the clinical indication for which opioids are 
        prescribed;
        (2) whether such limits lead to a significant increase in 
    burden for prescribers of opioids or prescribers of treatments for 
    opioid use disorder, including any impact on patient access to 
    treatment, and whether any such burden is mitigated by any factors 
    such as electronic prescribing or telemedicine; and
        (3) the impact of such limits on diversion or misuse of any 
    controlled substance in schedule II, III, or IV of section 202(c) 
    of the Controlled Substances Act (21 U.S.C. 812(c)).

          Subtitle D--Ensuring Access to Quality Sober Living

SEC. 7031. NATIONAL RECOVERY HOUSING BEST PRACTICES.
    Part D of title V of the Public Health Service Act (42 U.S.C. 290dd 
et seq.) is amended by adding at the end the following new section:
    ``SEC. 550. NATIONAL RECOVERY HOUSING BEST PRACTICES.
    ``(a) Best Practices for Operating Recovery Housing.--
        ``(1) In general.--The Secretary, in consultation with the 
    individuals and entities specified in paragraph (2), shall identify 
    or facilitate the development of best practices, which may include 
    model laws for implementing suggested minimum standards, for 
    operating recovery housing.
        ``(2) Consultation.--In carrying out the activities described 
    in paragraph (1), the Secretary shall consult with, as 
    appropriate--
            ``(A) relevant divisions of the Department of Health and 
        Human Services, including the Substance Abuse and Mental Health 
        Services Administration, the Office of Inspector General, the 
        Indian Health Service, and the Centers for Medicare & Medicaid 
        Services;
            ``(B) the Secretary of Housing and Urban Development;
            ``(C) directors or commissioners, as applicable, of State 
        health departments, tribal health departments, State Medicaid 
        programs, and State insurance agencies;
            ``(D) representatives of health insurance issuers;
            ``(E) national accrediting entities and reputable providers 
        of, and analysts of, recovery housing services, including 
        Indian tribes, tribal organizations, and tribally designated 
        housing entities that provide recovery housing services, as 
        applicable;
            ``(F) individuals with a history of substance use disorder; 
        and
            ``(G) other stakeholders identified by the Secretary.
    ``(b) Identification of Fraudulent Recovery Housing Operators.--
        ``(1) In general.--The Secretary, in consultation with the 
    individuals and entities described in paragraph (2), shall identify 
    or facilitate the development of common indicators that could be 
    used to identify potentially fraudulent recovery housing operators.
        ``(2) Consultation.--In carrying out the activities described 
    in paragraph (1), the Secretary shall consult with, as appropriate, 
    the individuals and entities specified in subsection (a)(2) and the 
    Attorney General of the United States.
        ``(3) Requirements.--
            ``(A) Practices for identification and reporting.--In 
        carrying out the activities described in paragraph (1), the 
        Secretary shall consider how law enforcement, public and 
        private payers, and the public can best identify and report 
        fraudulent recovery housing operators.
            ``(B) Factors to be considered.--In carrying out the 
        activities described in paragraph (1), the Secretary shall 
        identify or develop indicators, which may include indicators 
        related to--
                ``(i) unusual billing practices;
                ``(ii) average lengths of stays;
                ``(iii) excessive levels of drug testing (in terms of 
            cost or frequency); and
                ``(iv) unusually high levels of recidivism.
    ``(c) Dissemination.--The Secretary shall, as appropriate, 
disseminate the best practices identified or developed under subsection 
(a) and the common indicators identified or developed under subsection 
(b) to--
        ``(1) State agencies, which may include the provision of 
    technical assistance to State agencies seeking to adopt or 
    implement such best practices;
        ``(2) Indian tribes, tribal organizations, and tribally 
    designated housing entities;
        ``(3) the Attorney General of the United States;
        ``(4) the Secretary of Labor;
        ``(5) the Secretary of Housing and Urban Development;
        ``(6) State and local law enforcement agencies;
        ``(7) health insurance issuers;
        ``(8) recovery housing entities; and
        ``(9) the public.
    ``(d) Requirements.--In carrying out the activities described in 
subsections (a) and (b), the Secretary, in consultation with 
appropriate individuals and entities described in subsections (a)(2) 
and (b)(2), shall consider how recovery housing is able to support 
recovery and prevent relapse, recidivism, or overdose (including 
overdose death), including by improving access and adherence to 
treatment, including medication-assisted treatment.
    ``(e) Rule of Construction.--Nothing in this section shall be 
construed to provide the Secretary with the authority to require States 
to adhere to minimum standards in the State oversight of recovery 
housing.
    ``(f) Definitions.--In this section:
        ``(1) The term `recovery housing' means a shared living 
    environment free from alcohol and illicit drug use and centered on 
    peer support and connection to services that promote sustained 
    recovery from substance use disorders.
        ``(2) The terms `Indian tribe' and `tribal organization' have 
    the meanings given those terms in section 4 of the Indian Self-
    Determination and Education Assistance Act (25 U.S.C. 5304).
        ``(3) The term `tribally designated housing entity' has the 
    meaning given that term in section 4 of the Native American Housing 
    Assistance and Self-Determination Act of 1996 (25 U.S.C. 4103).
    ``(g) Authorization of Appropriations.--To carry out this section, 
there is authorized to be appropriated $3,000,000 for the period of 
fiscal years 2019 through 2021.''.

              Subtitle E--Advancing Cutting Edge Research

SEC. 7041. UNIQUE RESEARCH INITIATIVES.
    Section 402(n)(1) of the Public Health Service Act (42 U.S.C. 
282(n)(1)) is amended--
        (1) in subparagraph (A), by striking ``or'';
        (2) in subparagraph (B), by striking the period and inserting 
    ``; or''; and
        (3) by adding at the end the following:
            ``(C) high impact cutting-edge research that fosters 
        scientific creativity and increases fundamental biological 
        understanding leading to the prevention, diagnosis, or 
        treatment of diseases and disorders, or research urgently 
        required to respond to a public health threat.''.
SEC. 7042. PAIN RESEARCH.
    Section 409J(b) of the Public Health Service Act (42 U.S.C. 
284q(b)) is amended--
        (1) in paragraph (5)--
            (A) in subparagraph (A), by striking ``and treatment of 
        pain and diseases and disorders associated with pain'' and 
        inserting ``treatment, and management of pain and diseases and 
        disorders associated with pain, including information on best 
        practices for the utilization of non-pharmacologic treatments, 
        non-addictive medical products, and other drugs or devices 
        approved or cleared by the Food and Drug Administration'';
            (B) in subparagraph (B), by striking ``on the symptoms and 
        causes of pain;'' and inserting the following: ``on--
                ``(i) the symptoms and causes of pain, including the 
            identification of relevant biomarkers and screening models 
            and the epidemiology of acute and chronic pain;
                ``(ii) the diagnosis, prevention, treatment, and 
            management of acute and chronic pain, including with 
            respect to non-pharmacologic treatments, non-addictive 
            medical products, and other drugs or devices approved or 
            cleared by the Food and Drug Administration; and
                ``(iii) risk factors for, and early warning signs of, 
            substance use disorders in populations with acute and 
            chronic pain; and''; and
            (C) by striking subparagraphs (C) through (E) and inserting 
        the following:
            ``(C) make recommendations to the Director of NIH--
                ``(i) to ensure that the activities of the National 
            Institutes of Health and other Federal agencies are free of 
            unnecessary duplication of effort;
                ``(ii) on how best to disseminate information on pain 
            care and epidemiological data related to acute and chronic 
            pain; and
                ``(iii) on how to expand partnerships between public 
            entities and private entities to expand collaborative, 
            cross-cutting research.'';
        (2) by redesignating paragraph (6) as paragraph (7); and
        (3) by inserting after paragraph (5) the following:
        ``(6) Report.--The Secretary shall ensure that recommendations 
    and actions taken by the Director with respect to the topics 
    discussed at the meetings described in paragraph (4) are included 
    in appropriate reports to Congress.''.

                        Subtitle F--Jessie's Law

SEC. 7051. INCLUSION OF OPIOID ADDICTION HISTORY IN PATIENT RECORDS.
    (a) Best Practices.--
        (1) In general.--Not later than 1 year after the date of 
    enactment of this Act, the Secretary of Health and Human Services 
    (in this section referred to as the ``Secretary''), in consultation 
    with appropriate stakeholders, including a patient with a history 
    of opioid use disorder, an expert in electronic health records, an 
    expert in the confidentiality of patient health information and 
    records, and a health care provider, shall identify or facilitate 
    the development of best practices regarding--
            (A) the circumstances under which information that a 
        patient has provided to a health care provider regarding such 
        patient's history of opioid use disorder should, only at the 
        patient's request, be prominently displayed in the medical 
        records (including electronic health records) of such patient;
            (B) what constitutes the patient's request for the purpose 
        described in subparagraph (A); and
            (C) the process and methods by which the information should 
        be so displayed.
        (2) Dissemination.--The Secretary shall disseminate the best 
    practices developed under paragraph (1) to health care providers 
    and State agencies.
    (b) Requirements.--In identifying or facilitating the development 
of best practices under subsection (a), as applicable, the Secretary, 
in consultation with appropriate stakeholders, shall consider the 
following:
        (1) The potential for addiction relapse or overdose, including 
    overdose death, when opioid medications are prescribed to a patient 
    recovering from opioid use disorder.
        (2) The benefits of displaying information about a patient's 
    opioid use disorder history in a manner similar to other 
    potentially lethal medical concerns, including drug allergies and 
    contraindications.
        (3) The importance of prominently displaying information about 
    a patient's opioid use disorder when a physician or medical 
    professional is prescribing medication, including methods for 
    avoiding alert fatigue in providers.
        (4) The importance of a variety of appropriate medical 
    professionals, including physicians, nurses, and pharmacists, 
    having access to information described in this section when 
    prescribing or dispensing opioid medication, consistent with 
    Federal and State laws and regulations.
        (5) The importance of protecting patient privacy, including the 
    requirements related to consent for disclosure of substance use 
    disorder information under all applicable laws and regulations.
        (6) All applicable Federal and State laws and regulations.
SEC. 7052. COMMUNICATION WITH FAMILIES DURING EMERGENCIES.
    (a)  Promoting Awareness of Authorized Disclosures During 
Emergencies.--The Secretary of Health and Human Services shall annually 
notify health care providers regarding permitted disclosures under 
Federal health care privacy law during emergencies, including 
overdoses, of certain health information to families, caregivers, and 
health care providers.
    (b) Use of Material.--For the purposes of carrying out subsection 
(a), the Secretary of Health and Human Services may use material 
produced under section 7053 of this Act or section 11004 of the 21st 
Century Cures Act (42 U.S.C. 1320d-2 note).
SEC. 7053. DEVELOPMENT AND DISSEMINATION OF MODEL TRAINING PROGRAMS FOR 
SUBSTANCE USE DISORDER PATIENT RECORDS.
    (a) Initial Programs and Materials.--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''), in 
consultation with appropriate experts, shall identify the following 
model programs and materials (or if no such programs or materials 
exist, recognize private or public entities to develop and disseminate 
such programs and materials):
        (1) Model programs and materials for training health care 
    providers (including physicians, emergency medical personnel, 
    psychiatrists, psychologists, counselors, therapists, nurse 
    practitioners, physician assistants, behavioral health facilities 
    and clinics, care managers, and hospitals, including individuals 
    such as general counsels or regulatory compliance staff who are 
    responsible for establishing provider privacy policies) concerning 
    the permitted uses and disclosures, consistent with the standards 
    and regulations governing the privacy and security of substance use 
    disorder patient records promulgated by the Secretary under section 
    543 of the Public Health Service Act (42 U.S.C. 290dd-2) for the 
    confidentiality of patient records.
        (2) Model programs and materials for training patients and 
    their families regarding their rights to protect and obtain 
    information under the standards and regulations described in 
    paragraph (1).
    (b) Requirements.--The model programs and materials described in 
paragraphs (1) and (2) of subsection (a) shall address circumstances 
under which disclosure of substance use disorder patient records is 
needed to--
        (1) facilitate communication between substance use disorder 
    treatment providers and other health care providers to promote and 
    provide the best possible integrated care;
        (2) avoid inappropriate prescribing that can lead to dangerous 
    drug interactions, overdose, or relapse; and
        (3) notify and involve families and caregivers when individuals 
    experience an overdose.
    (c) Periodic Updates.--The Secretary shall--
        (1) periodically review and update the model program and 
    materials identified or developed under subsection (a); and
        (2) disseminate such updated programs and materials to the 
    individuals described in subsection (a)(1).
    (d) Input of Certain Entities.--In identifying, reviewing, or 
updating the model programs and materials under this section, the 
Secretary shall solicit the input of relevant stakeholders.
    (e) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section--
        (1) $4,000,000 for fiscal year 2019;
        (2) $2,000,000 for each of fiscal years 2020 and 2021; and
        (3) $1,000,000 for each of fiscal years 2022 and 2023.

           Subtitle G--Protecting Pregnant Women and Infants

SEC. 7061. REPORT ON ADDRESSING MATERNAL AND INFANT HEALTH IN THE 
OPIOID CRISIS.
    (a) In General.--Not later than 18 months after the date of the 
enactment of this Act, the Secretary of Health and Human Services, in 
coordination with the Centers for Disease Control and Prevention, the 
National Institutes of Health, the Indian Health Service, and the 
Substance Abuse and Mental Health Services Administration, shall 
develop and submit to the Committee on Health, Education, Labor, and 
Pensions of the Senate and the Committee on Energy and Commerce of the 
House of Representatives a report that includes--
        (1) information on opioid, non-opioid, and non-pharmacologic 
    pain management practices during pregnancy and after pregnancy;
        (2) recommendations for increasing public awareness and 
    education about substance use disorders, including opioid use 
    disorders, during and after pregnancy, including available 
    treatment resources in urban and rural areas;
        (3) recommendations to prevent, identify, and reduce substance 
    use disorders, including opioid use disorders, during pregnancy to 
    improve care for pregnant women with substance use disorders and 
    their infants; and
        (4) an identification of areas in need of further research with 
    respect to acute and chronic pain management during and after 
    pregnancy.
    (b) No Additional Funds.--No additional funds are authorized to be 
appropriated for purposes of carrying out subsection (a).
SEC. 7062. PROTECTING MOMS AND INFANTS.
    (a) Report.--
        (1) In general.--Not later than 60 days after the date of 
    enactment of this Act, the Secretary of Health and Human Services 
    (referred to in this section as the ``Secretary'') shall submit to 
    the Committee on Health, Education, Labor, and Pensions of the 
    Senate and the Committee on Energy and Commerce of the House of 
    Representatives, and make available to the public on the Internet 
    website of the Department of Health and Human Services, a report 
    regarding the implementation of the recommendations in the strategy 
    relating to prenatal opioid use, including neonatal abstinence 
    syndrome, developed pursuant to section 2 of the Protecting Our 
    Infants Act of 2015 (Public Law 114-91). Such report shall 
    include--
            (A) an update on the implementation of the recommendations 
        in the strategy, including information regarding the agencies 
        involved in the implementation; and
            (B) information on additional funding or authority the 
        Secretary requires, if any, to implement the strategy, which 
        may include authorities needed to coordinate implementation of 
        such strategy across the Department of Health and Human 
        Services.
        (2) Periodic updates.--The Secretary shall periodically update 
    the report under paragraph (1).
    (b) Residential Treatment Programs for Pregnant and Postpartum 
Women.--Section 508(s) of the Public Health Service Act (42 U.S.C. 
290bb-1(s)) is amended by striking ``$16,900,000 for each of fiscal 
years 2017 through 2021'' and inserting ``$29,931,000 for each of 
fiscal years 2019 through 2023''.
SEC. 7063. EARLY INTERVENTIONS FOR PREGNANT WOMEN AND INFANTS.
    (a) Development of Educational Materials by Center for Substance 
Abuse Prevention.--Section 515(b) of the Public Health Service Act (42 
U.S.C. 290bb-21(b)) is amended--
        (1) in paragraph (13), by striking ``and'' at the end;
        (2) in paragraph (14), by striking the period at the end and 
    inserting ``; and''; and
        (3) by adding at the end the following:
        ``(15) in consultation with relevant stakeholders and in 
    collaboration with the Director of the Centers for Disease Control 
    and Prevention, develop educational materials for clinicians to use 
    with pregnant women for shared decision making regarding pain 
    management and the prevention of substance use disorders during 
    pregnancy.''.
    (b) Guidelines and Recommendations by Center for Substance Abuse 
Treatment.--Section 507(b) of the Public Health Service Act (42 U.S.C. 
290bb(b)) is amended--
        (1) in paragraph (13), by striking ``and'' at the end;
        (2) in paragraph (14), by striking the period at the end and 
    inserting a semicolon; and
        (3) by adding at the end the following:
        ``(15) in cooperation with the Secretary, implement and 
    disseminate, as appropriate, the recommendations in the report 
    entitled `Protecting Our Infants Act: Final Strategy' issued by the 
    Department of Health and Human Services in 2017; and''.
    (c) Support of Partnerships by Center for Substance Abuse 
Treatment.--Section 507(b) of the Public Health Service Act (42 U.S.C. 
290bb(b)), as amended by subsection (b), is further amended by adding 
at the end the following:
        ``(16) in cooperation with relevant stakeholders, and through 
    public-private partnerships, encourage education about substance 
    use disorders for pregnant women and health care providers who 
    treat pregnant women and babies.''.
SEC. 7064. PRENATAL AND POSTNATAL HEALTH.
    Section 317L of the Public Health Service Act (42 U.S.C. 247b-13) 
is amended--
        (1) in subsection (a)--
            (A) by amending paragraph (1) to read as follows:
        ``(1) to collect, analyze, and make available data on prenatal 
    smoking and alcohol and other substance abuse and misuse, 
    including--
            ``(A) data on--
                ``(i) the incidence, prevalence, and implications of 
            such activities; and
                ``(ii) the incidence and prevalence of implications and 
            outcomes, including neonatal abstinence syndrome and other 
            maternal and child health outcomes associated with such 
            activities; and
            ``(B) additional information or data, as appropriate, on 
        family health history, medication exposures during pregnancy, 
        demographic information, such as race, ethnicity, geographic 
        location, and family history, and other relevant information, 
        to inform such analysis;'';
            (B) in paragraph (2)--
                (i) by striking ``prevention of'' and inserting 
            ``prevention and long-term outcomes associated with''; and
                (ii) by striking ``illegal drug use'' and inserting 
            ``other substance abuse and misuse'';
            (C) in paragraph (3), by striking ``and cessation programs; 
        and'' and inserting ``, treatment, and cessation programs;'';
            (D) in paragraph (4), by striking ``illegal drug use.'' and 
        inserting ``other substance abuse and misuse; and''; and
            (E) by adding at the end the following:
        ``(5) to issue public reports on the analysis of data described 
    in paragraph (1), including analysis of--
            ``(A) long-term outcomes of children affected by neonatal 
        abstinence syndrome;
            ``(B) health outcomes associated with prenatal smoking, 
        alcohol, and substance abuse and misuse; and
            ``(C) relevant studies, evaluations, or information the 
        Secretary determines to be appropriate.'';
        (2) in subsection (b), by inserting ``tribal entities,'' after 
    ``local governments,'';
        (3) by redesignating subsection (c) as subsection (d);
        (4) by inserting after subsection (b) the following:
    ``(c) Coordinating Activities.--To carry out this section, the 
Secretary may--
        ``(1) provide technical and consultative assistance to entities 
    receiving grants under subsection (b);
        ``(2) ensure a pathway for data sharing between States, tribal 
    entities, and the Centers for Disease Control and Prevention;
        ``(3) ensure data collection under this section is consistent 
    with applicable State, Federal, and Tribal privacy laws; and
        ``(4) coordinate with the National Coordinator for Health 
    Information Technology, as appropriate, to assist States and Tribes 
    in implementing systems that use standards recognized by such 
    National Coordinator, as such recognized standards are available, 
    in order to facilitate interoperability between such systems and 
    health information technology systems, including certified health 
    information technology.''; and
        (5) in subsection (d), as so redesignated, by striking ``2001 
    through 2005'' and inserting ``2019 through 2023''.
SEC. 7065. PLANS OF SAFE CARE.
    (a) In General.--Section 105(a) of the Child Abuse Prevention and 
Treatment Act (42 U.S.C. 5106(a)) is amended by adding at the end the 
following:
        ``(7) Grants to states to improve and coordinate their response 
    to ensure the safety, permanency, and well-being of infants 
    affected by substance use.--
            ``(A) Program authorized.--The Secretary is authorized to 
        make grants to States for the purpose of assisting child 
        welfare agencies, social services agencies, substance use 
        disorder treatment agencies, hospitals with labor and delivery 
        units, medical staff, public health and mental health agencies, 
        and maternal and child health agencies to facilitate 
        collaboration in developing, updating, implementing, and 
        monitoring plans of safe care described in section 
        106(b)(2)(B)(iii). Section 112(a)(2) shall not apply to the 
        program authorized under this paragraph.
            ``(B) Distribution of funds.--
                ``(i) Reservations.--Of the amounts made available to 
            carry out subparagraph (A), the Secretary shall reserve--

                    ``(I) no more than 3 percent for the purposes 
                described in subparagraph (G); and
                    ``(II) up to 3 percent for grants to Indian Tribes 
                and tribal organizations to address the needs of 
                infants born with, and identified as being affected by, 
                substance abuse or withdrawal symptoms resulting from 
                prenatal drug exposure or a fetal alcohol spectrum 
                disorder and their families or caregivers, which to the 
                extent practicable, shall be consistent with the uses 
                of funds described under subparagraph (D).

                ``(ii) Allotments to states and territories.--The 
            Secretary shall allot the amount made available to carry 
            out subparagraph (A) that remains after application of 
            clause (i) to each State that applies for such a grant, in 
            an amount equal to the sum of--

                    ``(I) $500,000; and
                    ``(II) an amount that bears the same relationship 
                to any funds made available to carry out subparagraph 
                (A) and remaining after application of clause (i), as 
                the number of live births in the State in the previous 
                calendar year bears to the number of live births in all 
                States in such year.

                ``(iii) Ratable reduction.--If the amount made 
            available to carry out subparagraph (A) is insufficient to 
            satisfy the requirements of clause (ii), the Secretary 
            shall ratably reduce each allotment to a State.
            ``(C) Application.--A State desiring a grant under this 
        paragraph shall submit an application to the Secretary at such 
        time and in such manner as the Secretary may require. Such 
        application shall include--
                ``(i) a description of--

                    ``(I) the impact of substance use disorder in such 
                State, including with respect to the substance or class 
                of substances with the highest incidence of abuse in 
                the previous year in such State, including--

                        ``(aa) the prevalence of substance use disorder 
                    in such State;
                        ``(bb) the aggregate rate of births in the 
                    State of infants affected by substance abuse or 
                    withdrawal symptoms or a fetal alcohol spectrum 
                    disorder (as determined by hospitals, insurance 
                    claims, claims submitted to the State Medicaid 
                    program, or other records), if available and to the 
                    extent practicable; and
                        ``(cc) the number of infants identified, for 
                    whom a plan of safe care was developed, and for 
                    whom a referral was made for appropriate services, 
                    as reported under section 106(d)(18);

                    ``(II) the challenges the State faces in 
                developing, implementing, and monitoring plans of safe 
                care in accordance with section 106(b)(2)(B)(iii);
                    ``(III) the State's lead agency for the grant 
                program and how that agency will coordinate with 
                relevant State entities and programs, including the 
                child welfare agency, the substance use disorder 
                treatment agency, hospitals with labor and delivery 
                units, health care providers, the public health and 
                mental health agencies, programs funded by the 
                Substance Abuse and Mental Health Services 
                Administration that provide substance use disorder 
                treatment for women, the State Medicaid program, the 
                State agency administering the block grant program 
                under title V of the Social Security Act (42 U.S.C. 701 
                et seq.), the State agency administering the programs 
                funded under part C of the Individuals with 
                Disabilities Education Act (20 U.S.C. 1431 et seq.), 
                the maternal, infant, and early childhood home visiting 
                program under section 511 of the Social Security Act 
                (42 U.S.C. 711), the State judicial system, and other 
                agencies, as determined by the Secretary, and Indian 
                Tribes and tribal organizations, as appropriate, to 
                implement the activities under this paragraph;
                    ``(IV) how the State will monitor local development 
                and implementation of plans of safe care, in accordance 
                with section 106(b)(2)(B)(iii)(II), including how the 
                State will monitor to ensure plans of safe care address 
                differences between substance use disorder and 
                medically supervised substance use, including for the 
                treatment of a substance use disorder;
                    ``(V) if applicable, how the State plans to utilize 
                funding authorized under part E of title IV of the 
                Social Security Act (42 U.S.C. 670 et seq.) to assist 
                in carrying out any plan of safe care, including such 
                funding authorized under section 471(e) of such Act (as 
                in effect on October 1, 2018) for mental health and 
                substance abuse prevention and treatment services and 
                in-home parent skill-based programs and funding 
                authorized under such section 472(j) (as in effect on 
                October 1, 2018) for children with a parent in a 
                licensed residential family-based treatment facility 
                for substance abuse; and
                    ``(VI) an assessment of the treatment and other 
                services and programs available in the State to 
                effectively carry out any plan of safe care developed, 
                including identification of needed treatment, and other 
                services and programs to ensure the well-being of young 
                children and their families affected by substance use 
                disorder, such as programs carried out under part C of 
                the Individuals with Disabilities Education Act (20 
                U.S.C. 1431 et seq.) and comprehensive early childhood 
                development services and programs such as Head Start 
                programs;

                ``(ii) a description of how the State plans to use 
            funds for activities described in subparagraph (D) for the 
            purposes of ensuring State compliance with requirements 
            under clauses (ii) and (iii) of section 106(b)(2)(B); and
                ``(iii) an assurance that the State will comply with 
            requirements to refer a child identified as substance-
            exposed to early intervention services as required pursuant 
            to a grant under part C of the Individuals with 
            Disabilities Education Act (20 U.S.C. 1431 et seq.).
            ``(D) Uses of funds.--Funds awarded to a State under this 
        paragraph may be used for the following activities, which may 
        be carried out by the State directly, or through grants or 
        subgrants, contracts, or cooperative agreements:
                ``(i) Improving State and local systems with respect to 
            the development and implementation of plans of safe care, 
            which--

                    ``(I) shall include parent and caregiver 
                engagement, as required under section 
                106(b)(2)(B)(iii)(I), regarding available treatment and 
                service options, which may include resources available 
                for pregnant, perinatal, and postnatal women; and
                    ``(II) may include activities such as--

                        ``(aa) developing policies, procedures, or 
                    protocols for the administration or development of 
                    evidence-based and validated screening tools for 
                    infants who may be affected by substance use 
                    withdrawal symptoms or a fetal alcohol spectrum 
                    disorder and pregnant, perinatal, and postnatal 
                    women whose infants may be affected by substance 
                    use withdrawal symptoms or a fetal alcohol spectrum 
                    disorder;
                        ``(bb) improving assessments used to determine 
                    the needs of the infant and family;
                        ``(cc) improving ongoing case management 
                    services;
                        ``(dd) improving access to treatment services, 
                    which may be prior to the pregnant woman's delivery 
                    date; and
                        ``(ee) keeping families safely together when it 
                    is in the best interest of the child.
                ``(ii) Developing policies, procedures, or protocols in 
            consultation and coordination with health professionals, 
            public and private health facilities, and substance use 
            disorder treatment agencies to ensure that--

                    ``(I) appropriate notification to child protective 
                services is made in a timely manner, as required under 
                section 106(b)(2)(B)(ii);
                    ``(II) a plan of safe care is in place, in 
                accordance with section 106(b)(2)(B)(iii), before the 
                infant is discharged from the birth or health care 
                facility; and
                    ``(III) such health and related agency 
                professionals are trained on how to follow such 
                protocols and are aware of the supports that may be 
                provided under a plan of safe care.

                ``(iii) Training health professionals and health system 
            leaders, child welfare workers, substance use disorder 
            treatment agencies, and other related professionals such as 
            home visiting agency staff and law enforcement in relevant 
            topics including--

                    ``(I) State mandatory reporting laws established 
                under section 106(b)(2)(B)(i) and the referral and 
                process requirements for notification to child 
                protective services when child abuse or neglect 
                reporting is not mandated;
                    ``(II) the co-occurrence of pregnancy and substance 
                use disorder, and implications of prenatal exposure;
                    ``(III) the clinical guidance about treating 
                substance use disorder in pregnant and postpartum 
                women;
                    ``(IV) appropriate screening and interventions for 
                infants affected by substance use disorder, withdrawal 
                symptoms, or a fetal alcohol spectrum disorder and the 
                requirements under section 106(b)(2)(B)(iii); and
                    ``(V) appropriate multigenerational strategies to 
                address the mental health needs of the parent and child 
                together.

                ``(iv) Establishing partnerships, agreements, or 
            memoranda of understanding between the lead agency and 
            other entities (including health professionals, health 
            facilities, child welfare professionals, juvenile and 
            family court judges, substance use and mental disorder 
            treatment programs, early childhood education programs, 
            maternal and child health and early intervention 
            professionals (including home visiting providers), peer-to-
            peer recovery programs such as parent mentoring programs, 
            and housing agencies) to facilitate the implementation of, 
            and compliance with, section 106(b)(2) and clause (ii) of 
            this subparagraph, in areas which may include--

                    ``(I) developing a comprehensive, multi-
                disciplinary assessment and intervention process for 
                infants, pregnant women, and their families who are 
                affected by substance use disorder, withdrawal 
                symptoms, or a fetal alcohol spectrum disorder, that 
                includes meaningful engagement with and takes into 
                account the unique needs of each family and addresses 
                differences between medically supervised substance use, 
                including for the treatment of substance use disorder, 
                and substance use disorder;
                    ``(II) ensuring that treatment approaches for 
                serving infants, pregnant women, and perinatal and 
                postnatal women whose infants may be affected by 
                substance use, withdrawal symptoms, or a fetal alcohol 
                spectrum disorder, are designed to, where appropriate, 
                keep infants with their mothers during both inpatient 
                and outpatient treatment; and
                    ``(III) increasing access to all evidence-based 
                medication-assisted treatment approved by the Food and 
                Drug Administration, behavioral therapy, and counseling 
                services for the treatment of substance use disorders, 
                as appropriate.

                ``(v) Developing and updating systems of technology for 
            improved data collection and monitoring under section 
            106(b)(2)(B)(iii), including existing electronic medical 
            records, to measure the outcomes achieved through the plans 
            of safe care, including monitoring systems to meet the 
            requirements of this Act and submission of performance 
            measures.
            ``(E) Reporting.--Each State that receives funds under this 
        paragraph, for each year such funds are received, shall submit 
        a report to the Secretary, disaggregated by geographic 
        location, economic status, and major racial and ethnic groups, 
        except that such disaggregation shall not be required if the 
        results would reveal personally identifiable information on, 
        with respect to infants identified under section 
        106(b)(2)(B)(ii)--
                ``(i) the number who experienced removal associated 
            with parental substance use;
                ``(ii) the number who experienced removal and 
            subsequently are reunified with parents, and the length of 
            time between such removal and reunification;
                ``(iii) the number who are referred to community 
            providers without a child protection case;
                ``(iv) the number who receive services while in the 
            care of their birth parents;
                ``(v) the number who receive post-reunification 
            services within 1 year after a reunification has occurred; 
            and
                ``(vi) the number who experienced a return to out-of-
            home care within 1 year after reunification.
            ``(F) Secretary's report to congress.--The Secretary shall 
        submit an annual report to the Committee on Health, Education, 
        Labor, and Pensions and the Committee on Appropriations of the 
        Senate and the Committee on Education and the Workforce and the 
        Committee on Appropriations of the House of Representatives 
        that includes the information described in subparagraph (E) and 
        recommendations or observations on the challenges, successes, 
        and lessons derived from implementation of the grant program.
            ``(G) Assisting states' implementation.--The Secretary 
        shall use the amount reserved under subparagraph (B)(i)(I) to 
        provide written guidance and technical assistance to support 
        States in complying with and implementing this paragraph, which 
        shall include--
                ``(i) technical assistance, including programs of in-
            depth technical assistance, to additional States, 
            territories, and Indian Tribes and tribal organizations in 
            accordance with the substance-exposed infant initiative 
            developed by the National Center on Substance Abuse and 
            Child Welfare;
                ``(ii) guidance on the requirements of this Act with 
            respect to infants born with and identified as being 
            affected by substance use or withdrawal symptoms or fetal 
            alcohol spectrum disorder, as described in clauses (ii) and 
            (iii) of section 106(b)(2)(B), including by--

                    ``(I) enhancing States' understanding of 
                requirements and flexibilities under the law, including 
                by clarifying key terms;
                    ``(II) addressing state-identified challenges with 
                developing, implementing, and monitoring plans of safe 
                care, including those reported under subparagraph 
                (C)(i)(II);
                    ``(III) disseminating best practices on 
                implementation of plans of safe care, on such topics as 
                differential response, collaboration and coordination, 
                and identification and delivery of services for 
                different populations, while recognizing needs of 
                different populations and varying community approaches 
                across States; and
                    ``(IV) helping States improve the long-term safety 
                and well-being of young children and their families;

                ``(iii) supporting State efforts to develop information 
            technology systems to manage plans of safe care; and
                ``(iv) preparing the Secretary's report to Congress 
            described in subparagraph (F).
            ``(H) Sunset.--The authority under this paragraph shall 
        sunset on September 30, 2023.''.
    (b) Repeal.--The Abandoned Infants Assistance Act of 1988 (42 
U.S.C. 5117aa et seq.) is repealed.

         Subtitle H--Substance Use Disorder Treatment Workforce

SEC. 7071. LOAN REPAYMENT PROGRAM FOR SUBSTANCE USE DISORDER TREATMENT 
WORKFORCE.
    Title VII of the Public Health Service Act is amended--
        (1) by redesignating part F as part G; and
        (2) by inserting after part E (42 U.S.C. 294n et seq.) the 
    following:

          ``PART F--SUBSTANCE USE DISORDER TREATMENT WORKFORCE

    ``SEC. 781. LOAN REPAYMENT PROGRAM FOR SUBSTANCE USE DISORDER 
      TREATMENT WORKFORCE.
    ``(a) In General.--The Secretary, acting through the Administrator 
of the Health Resources and Services Administration, shall carry out a 
program under which--
        ``(1) the Secretary enters into agreements with individuals to 
    make payments in accordance with subsection (b) on the principal of 
    and interest on any eligible loan; and
        ``(2) the individuals each agree to the requirements of service 
    in substance use disorder treatment employment, as described in 
    subsection (d).
    ``(b) Payments.--For each year of obligated service by an 
individual pursuant to an agreement under subsection (a), the Secretary 
shall make a payment to such individual as follows:
        ``(1) Service in a shortage area.--The Secretary shall pay--
            ``(A) for each year of obligated service by an individual 
        pursuant to an agreement under subsection (a), \1/6\ of the 
        principal of and interest on each eligible loan of the 
        individual which is outstanding on the date the individual 
        began service pursuant to the agreement; and
            ``(B) for completion of the sixth and final year of such 
        service, the remainder of such principal and interest.
        ``(2) Maximum amount.--The total amount of payments under this 
    section to any individual shall not exceed $250,000.
    ``(c) Eligible Loans.--The loans eligible for repayment under this 
section are each of the following:
        ``(1) Any loan for education or training for a substance use 
    disorder treatment employment.
        ``(2) Any loan under part E of title VIII (relating to nursing 
    student loans).
        ``(3) Any Federal Direct Stafford Loan, Federal Direct PLUS 
    Loan, Federal Direct Unsubsidized Stafford Loan, or Federal Direct 
    Consolidation Loan (as such terms are used in section 455 of the 
    Higher Education Act of 1965).
        ``(4) Any Federal Perkins Loan under part E of title I of the 
    Higher Education Act of 1965.
        ``(5) Any other Federal loan as determined appropriate by the 
    Secretary.
    ``(d) Requirements of Service.--Any individual receiving payments 
under this program as required by an agreement under subsection (a) 
shall agree to an annual commitment to full-time employment, with no 
more than 1 year passing between any 2 years of covered employment, in 
substance use disorder treatment employment in the United States in--
        ``(1) a Mental Health Professional Shortage Area, as designated 
    under section 332; or
        ``(2) a county (or a municipality, if not contained within any 
    county) where the mean drug overdose death rate per 100,000 people 
    over the past 3 years for which official data is available from the 
    State, is higher than the most recent available national average 
    overdose death rate per 100,000 people, as reported by the Centers 
    for Disease Control and Prevention.
    ``(e) Ineligibility for Double Benefits.--No borrower may, for the 
same service, receive a reduction of loan obligations or a loan 
repayment under both--
        ``(1) this section; and
        ``(2) any Federally supported loan forgiveness program, 
    including under section 338B, 338I, or 846 of this Act, or section 
    428J, 428L, 455(m), or 460 of the Higher Education Act of 1965.
    ``(f) Breach.--
        ``(1) Liquidated damages formula.--The Secretary may establish 
    a liquidated damages formula to be used in the event of a breach of 
    an agreement entered into under subsection (a).
        ``(2) Limitation.--The failure by an individual to complete the 
    full period of service obligated pursuant to such an agreement, 
    taken alone, shall not constitute a breach of the agreement, so 
    long as the individual completed in good faith the years of service 
    for which payments were made to the individual under this section.
    ``(g) Additional Criteria.--The Secretary--
        ``(1) may establish such criteria and rules to carry out this 
    section as the Secretary determines are needed and in addition to 
    the criteria and rules specified in this section; and
        ``(2) shall give notice to the committees specified in 
    subsection (h) of any criteria and rules so established.
    ``(h) Report to Congress.--Not later than 5 years after the date of 
enactment of this section, and every other year thereafter, the 
Secretary shall prepare and 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 a report on--
        ``(1) the number and location of borrowers who have qualified 
    for loan repayments under this section; and
        ``(2) the impact of this section on the availability of 
    substance use disorder treatment employees nationally and in 
    shortage areas and counties described in subsection (d).
    ``(i) Definition.--In this section:
        ``(1) The terms `Indian tribe' and `tribal organization' have 
    the meanings given those terms in section 4 of the Indian Self-
    Determination and Education Assistance Act.
        ``(2) The term `municipality' means a city, town, or other 
    public body created by or pursuant to State law, or an Indian 
    tribe.
        ``(3) The term `substance use disorder treatment employment' 
    means full-time employment (including a fellowship)--
            ``(A) where the primary intent and function of the position 
        is the direct treatment or recovery support of patients with or 
        in recovery from a substance use disorder, including master's 
        level social workers, psychologists, counselors, marriage and 
        family therapists, psychiatric mental health practitioners, 
        occupational therapists, psychology doctoral interns, and 
        behavioral health paraprofessionals and physicians, physician 
        assistants, and nurses, who are licensed or certified in 
        accordance with applicable State and Federal laws; and
            ``(B) which is located at a substance use disorder 
        treatment program, private physician practice, hospital or 
        health system-affiliated inpatient treatment center or 
        outpatient clinic (including an academic medical center-
        affiliated treatment program), correctional facility or 
        program, youth detention center or program, inpatient 
        psychiatric facility, crisis stabilization unit, community 
        health center, community mental health or other specialty 
        community behavioral health center, recovery center, school, 
        community-based organization, telehealth platform, migrant 
        health center, health program or facility operated by an Indian 
        tribe or tribal organization, Federal medical facility, or any 
        other facility as determined appropriate for purposes of this 
        section by the Secretary.
    ``(j) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section $25,000,000 for each of fiscal 
years 2019 through 2023.''.
SEC. 7072. CLARIFICATION REGARDING SERVICE IN SCHOOLS AND OTHER 
COMMUNITY-BASED SETTINGS.
    Subpart III of part D of title III of the Public Health Service Act 
(42 U.S.C. 254l et seq.) is amended by adding at the end the following:
``SEC. 338N. CLARIFICATION REGARDING SERVICE IN SCHOOLS AND OTHER 
COMMUNITY-BASED SETTINGS.
    ``(a) Schools and Community-based Settings.--An entity to which a 
participant in the Scholarship Program or the Loan Repayment Program 
(referred to in this section as a `participant') is assigned under 
section 333 may direct such participant to provide service as a 
behavioral or mental health professional at a school or other 
community-based setting located in a health professional shortage area.
    ``(b) Obligated Service.--
        ``(1) In general.--Any service described in subsection (a) that 
    a participant provides may count towards such participant's 
    completion of any obligated service requirements under the 
    Scholarship Program or the Loan Repayment Program, subject to any 
    limitation imposed under paragraph (2).
        ``(2) Limitation.--The Secretary may impose a limitation on the 
    number of hours of service described in subsection (a) that a 
    participant may credit towards completing obligated service 
    requirements, provided that the limitation allows a member to 
    credit service described in subsection (a) for not less than 50 
    percent of the total hours required to complete such obligated 
    service requirements.
    ``(c) Rule of Construction.--The authorization under subsection (a) 
shall be notwithstanding any other provision of this subpart or subpart 
II.''.
SEC. 7073. PROGRAMS FOR HEALTH CARE WORKFORCE.
    (a) Program for Education and Training in Pain Care.--Section 759 
of the Public Health Service Act (42 U.S.C. 294i) is amended--
        (1) in subsection (a), by striking ``hospices, and other public 
    and private entities'' and inserting ``hospices, tribal health 
    programs (as defined in section 4 of the Indian Health Care 
    Improvement Act), and other public and nonprofit private 
    entities'';
        (2) in subsection (b)--
            (A) in the matter preceding paragraph (1), by striking 
        ``award may be made under subsection (a) only if the applicant 
        for the award agrees that the program carried out with the 
        award will include'' and inserting ``entity receiving an award 
        under this section shall develop a comprehensive education and 
        training plan that includes'';
            (B) in paragraph (1)--
                (i) by inserting ``preventing,'' after ``diagnosing,''; 
            and
                (ii) by inserting ``non-addictive medical products and 
            non-pharmacologic treatments and'' after ``including'';
            (C) in paragraph (2)--
                (i) by inserting ``Federal, State, and local'' after 
            ``applicable''; and
                (ii) by striking ``the degree to which'' and all that 
            follows through ``effective pain care'' and inserting 
            ``opioids'';
            (D) in paragraph (3), by inserting ``, integrated, 
        evidence-based pain management, and, as appropriate, non-
        pharmacotherapy'' before the semicolon;
            (E) in paragraph (4), by striking ``; and'' and inserting 
        ``;''; and
            (F) by striking paragraph (5) and inserting the following:
        ``(5) recent findings, developments, and advancements in pain 
    care research and the provision of pain care, which may include 
    non-addictive medical products and non-pharmacologic treatments 
    intended to treat pain; and
        ``(6) the dangers of opioid abuse and misuse, detection of 
    early warning signs of opioid use disorders (which may include best 
    practices related to screening for opioid use disorders, training 
    on screening, brief intervention, and referral to treatment), and 
    safe disposal options for prescription medications (including such 
    options provided by law enforcement or other innovative 
    deactivation mechanisms).'';
        (3) in subsection (d), by inserting ``prevention,'' after 
    ``diagnosis,''; and
        (4) in subsection (e), by striking ``2010 through 2012'' and 
    inserting ``2019 through 2023''.
    (b) Mental and Behavioral Health Education and Training Program.--
Section 756 of the Public Health Service Act (42 U.S.C. 294e-1) is 
amended--
        (1) in subsection (a)--
            (A) in paragraph (1), by inserting ``, trauma,'' after 
        ``focus on child and adolescent mental health''; and
            (B) in paragraphs (2) and (3), by inserting ``trauma-
        informed care and'' before ``substance use disorder prevention 
        and treatment services''; and
        (2) in subsection (f), by striking ``2018 through 2022'' and 
    inserting ``2019 through 2023''.

       Subtitle I--Preventing Overdoses While in Emergency Rooms

SEC. 7081. PROGRAM TO SUPPORT COORDINATION AND CONTINUATION OF CARE FOR 
DRUG OVERDOSE PATIENTS.
    (a) In General.--The Secretary of Health and Human Services 
(referred to in this section as the ``Secretary'') shall identify or 
facilitate the development of best practices for--
        (1) emergency treatment of known or suspected drug overdose;
        (2) the use of recovery coaches, as appropriate, to encourage 
    individuals who experience a non-fatal overdose to seek treatment 
    for substance use disorder and to support coordination and 
    continuation of care;
        (3) coordination and continuation of care and treatment, 
    including, as appropriate, through referrals, of individuals after 
    a drug overdose; and
        (4) the provision or prescribing of overdose reversal 
    medication, as appropriate.
    (b) Grant Establishment and Participation.--
        (1) In general.--The Secretary shall award grants on a 
    competitive basis to eligible entities to support implementation of 
    voluntary programs for care and treatment of individuals after a 
    drug overdose, as appropriate, which may include implementation of 
    the best practices described in subsection (a).
        (2) Eligible entity.--In this section, the term ``eligible 
    entity'' means--
            (A) a State substance abuse agency;
            (B) an Indian Tribe or tribal organization; or
            (C) an entity that offers treatment or other services for 
        individuals in response to, or following, drug overdoses or a 
        drug overdose, such as an emergency department, in consultation 
        with a State substance abuse agency.
        (3) Application.--An eligible entity desiring a grant under 
    this section shall submit an application to the Secretary, at such 
    time and in such manner as the Secretary may require, that 
    includes--
            (A) evidence that such eligible entity carries out, or is 
        capable of contracting and coordinating with other community 
        entities to carry out, the activities described in paragraph 
        (4);
            (B) evidence that such eligible entity will work with a 
        recovery community organization to recruit, train, hire, 
        mentor, and supervise recovery coaches and fulfill the 
        requirements described in paragraph (4)(A); and
            (C) such additional information as the Secretary may 
        require.
        (4) Use of grant funds.--An eligible entity awarded a grant 
    under this section shall use such grant funds to--
            (A) hire or utilize recovery coaches to help support 
        recovery, including by--
                (i) connecting patients to a continuum of care 
            services, such as--

                    (I) treatment and recovery support programs;
                    (II) programs that provide non-clinical recovery 
                support services;
                    (III) peer support networks;
                    (IV) recovery community organizations;
                    (V) health care providers, including physicians and 
                other providers of behavioral health and primary care;
                    (VI) education and training providers;
                    (VII) employers;
                    (VIII) housing services; and
                    (IX) child welfare agencies;

                (ii) providing education on overdose prevention and 
            overdose reversal to patients and families, as appropriate;
                (iii) providing follow-up services for patients after 
            an overdose to ensure continued recovery and connection to 
            support services;
                (iv) collecting and evaluating outcome data for 
            patients receiving recovery coaching services; and
                (v) providing other services the Secretary determines 
            necessary to help ensure continued connection with recovery 
            support services, including culturally appropriate 
            services, as applicable;
            (B) establish policies and procedures, pursuant to Federal 
        and State law, that address the provision of overdose reversal 
        medication, the administration of all drugs or devices approved 
        or cleared under the Federal Food, Drug, and Cosmetic Act (21 
        U.S.C. 301 et seq.) and all biological products licensed under 
        section 351 of the Public Health Service Act (42 U.S.C. 262) to 
        treat substance use disorder, and subsequent continuation of, 
        or referral to, evidence-based treatment for patients with a 
        substance use disorder who have experienced a non-fatal drug 
        overdose, in order to support long-term treatment, prevent 
        relapse, and reduce recidivism and future overdose; and
            (C) establish integrated models of care for individuals who 
        have experienced a non-fatal drug overdose which may include 
        patient assessment, follow up, and transportation to and from 
        treatment facilities.
        (5) Additional permissible uses.--In addition to the uses 
    described in paragraph (4), a grant awarded under this section may 
    be used, directly or through contractual arrangements, to provide--
            (A) all drugs or devices approved or cleared under the 
        Federal Food, Drug, and Cosmetic Act (21 U.S.C. 301 et seq.) 
        and all biological products licensed under section 351 of the 
        Public Health Service Act (42 U.S.C. 262) to treat substance 
        use disorders or reverse overdose, pursuant to Federal and 
        State law;
            (B) withdrawal and detoxification services that include 
        patient evaluation, stabilization, and preparation for 
        treatment of substance use disorder, including treatment 
        described in subparagraph (A), as appropriate; or
            (C) mental health services provided by a certified 
        professional who is licensed and qualified by education, 
        training, or experience to assess the psychosocial background 
        of patients, to contribute to the appropriate treatment plan 
        for patients with substance use disorder, and to monitor 
        patient progress.
        (6) Preference.--In awarding grants under this section, the 
    Secretary shall give preference to eligible entities that meet any 
    or all of the following criteria:
            (A) The eligible entity is a critical access hospital (as 
        defined in section 1861(mm)(1) of the Social Security Act (42 
        U.S.C. 1395x(mm)(1))), a low volume hospital (as defined in 
        section 1886(d)(12)(C)(i) of such Act (42 U.S.C. 
        1395ww(d)(12)(C)(i))), a sole community hospital (as defined in 
        section 1886(d)(5)(D)(iii) of such Act (42 U.S.C. 
        1395ww(d)(5)(D)(iii))), or a hospital that receives 
        disproportionate share hospital payments under section 
        1886(d)(5)(F) of the Social Security Act (42 U.S.C. 
        1395ww(d)(5)(F)).
            (B) The eligible entity is located in a State with an age-
        adjusted rate of drug overdose deaths that is above the 
        national overdose mortality rate, as determined by the Director 
        of the Centers for Disease Control and Prevention, or under the 
        jurisdiction of an Indian Tribe with an age-adjusted rate of 
        drug overdose deaths that is above the national overdose 
        mortality rate, as determined through appropriate mechanisms as 
        determined by the Secretary in consultation with Indian Tribes.
            (C) The eligible entity demonstrates that recovery coaches 
        will be placed in both health care settings and community 
        settings.
        (7) Period of grant.--A grant awarded to an eligible entity 
    under this section shall be for a period of not more than 5 years.
    (c) Definitions.--In this section:
        (1) Indian tribe; tribal organization.--The terms ``Indian 
    Tribe'' and ``tribal organization'' have the meanings given the 
    terms ``Indian tribe'' and ``tribal organization'' in section 4 of 
    the Indian Self-Determination and Education Assistance Act (25 
    U.S.C. 5304).
        (2) Recovery coach.--the term ``recovery coach'' means an 
    individual--
            (A) with knowledge of, or experience with, recovery from a 
        substance use disorder; and
            (B) who has completed training from, and is determined to 
        be in good standing by, a recovery services organization 
        capable of conducting such training and making such 
        determination.
        (3) Recovery community organization.--The term ``recovery 
    community organization'' has the meaning given such term in section 
    547(a) of the Public Health Service Act (42 U.S.C. 290ee-2(a)).
    (d) Reporting Requirements.--
        (1) Reports by grantees.--Each eligible entity awarded a grant 
    under this section shall submit to the Secretary an annual report 
    for each year for which the entity has received such grant that 
    includes information on--
            (A) the number of individuals treated by the entity for 
        non-fatal overdoses, including the number of non-fatal 
        overdoses where overdose reversal medication was administered;
            (B) the number of individuals administered medication-
        assisted treatment by the entity;
            (C) the number of individuals referred by the entity to 
        other treatment facilities after a non-fatal overdose, the 
        types of such other facilities, and the number of such 
        individuals admitted to such other facilities pursuant to such 
        referrals; and
            (D) the frequency and number of patients with 
        reoccurrences, including readmissions for non-fatal overdoses 
        and evidence of relapse related to substance use disorder.
        (2) Report by secretary.--Not later than 5 years after the date 
    of enactment of this Act, the Secretary shall submit to Congress a 
    report that includes an evaluation of the effectiveness of the 
    grant program carried out under this section with respect to long 
    term health outcomes of the population of individuals who have 
    experienced a drug overdose, the percentage of patients treated or 
    referred to treatment by grantees, and the frequency and number of 
    patients who experienced relapse, were readmitted for treatment, or 
    experienced another overdose.
    (e) Privacy.--The requirements of this section, including with 
respect to data reporting and program oversight, shall be subject to 
all applicable Federal and State privacy laws.
    (f) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section $10,000,000 for each of fiscal 
years 2019 through 2023.

    Subtitle J--Alternatives to Opioids in the Emergency Department

SEC. 7091. EMERGENCY DEPARTMENT ALTERNATIVES TO OPIOIDS DEMONSTRATION 
PROGRAM.
    (a) Demonstration Program Grants.--
        (1) In general.--The Secretary of Health and Human Services (in 
    this section referred to as the ``Secretary'') shall carry out a 
    demonstration program for purposes of awarding grants to hospitals 
    and emergency departments, including freestanding emergency 
    departments, to develop, implement, enhance, or study alternatives 
    to opioids for pain management in such settings.
        (2) Eligibility.--To be eligible to receive a grant under 
    paragraph (1), a hospital or emergency department shall submit an 
    application to the Secretary at such time, in such manner, and 
    containing such information as the Secretary may require.
        (3) Geographic distribution.--In awarding grants under this 
    section, the Secretary shall seek to ensure geographical 
    distribution among grant recipients.
        (4) Use of funds.--Grants under paragraph (1) shall be used 
    to--
            (A) target treatment approaches for painful conditions 
        frequently treated in such settings;
            (B) train providers and other hospital personnel on 
        protocols or best practices related to the use and prescription 
        of opioids and alternatives to opioids for pain management in 
        the emergency department; and
            (C) develop or continue strategies to provide alternatives 
        to opioids, as appropriate.
    (b) Additional Demonstration Program.--The Secretary may carry out 
a demonstration program similar to the program under subsection (a) for 
other acute care settings.
    (c) Consultation.--The Secretary shall implement a process for 
recipients of grants under subsection (a) or (b) to share evidence-
based and best practices and promote consultation with persons having 
robust knowledge, including emergency departments and physicians that 
have successfully implemented programs that use alternatives to opioids 
for pain management, as appropriate, such as approaches studied through 
the National Center for Complimentary and Integrative Health or other 
institutes and centers at the National Institutes of Health, as 
appropriate. The Secretary shall offer to each recipient of a grant 
under subsection (a) or (b) technical assistance as necessary.
    (d) Technical Assistance.--The Secretary shall identify or 
facilitate the development of best practices on alternatives to opioids 
for pain management and provide technical assistance to hospitals and 
other acute care settings on alternatives to opioids for pain 
management. The technical assistance provided shall be for the purpose 
of--
        (1) utilizing information from recipients of a grant under 
    subsection (a) or (b) that have successfully implemented 
    alternatives to opioids programs;
        (2) identifying or facilitating the development of best 
    practices on the use of alternatives to opioids, which may include 
    pain-management strategies that involve non-addictive medical 
    products, non-pharmacologic treatments, and technologies or 
    techniques to identify patients at risk for opioid use disorder;
        (3) identifying or facilitating the development of best 
    practices on the use of alternatives to opioids that target common 
    painful conditions and include certain patient populations, such as 
    geriatric patients, pregnant women, and children; and
        (4) disseminating information on the use of alternatives to 
    opioids to providers in acute care settings, which may include 
    emergency departments, outpatient clinics, critical access 
    hospitals, Federally qualified health centers, Indian Health 
    Service health facilities, and tribal hospitals.
    (e) Report to the Secretary.--Each recipient of a grant under this 
section shall submit to the Secretary (during the period of such grant) 
annual reports on the progress of the program funded through the grant. 
These reports shall include, in accordance with all applicable State 
and Federal privacy laws--
        (1) a description of and specific information about the opioid 
    alternative pain management programs, including the demographic 
    characteristics of patients who were treated with an alternative 
    pain management protocol, implemented in hospitals, emergency 
    departments, and other acute care settings;
        (2) data on the opioid alternative pain management strategies 
    used, including the number of opioid prescriptions written--
            (A) during a baseline period before the program began; or
            (B) at various stages of the program; and
        (3) data on patients who were eventually prescribed opioids 
    after alternative pain management protocols and treatments were 
    utilized; and
        (4) any other information the Secretary determines appropriate.
    (f) Report to Congress.--Not later than 1 year after completion of 
the demonstration program under this section, the Secretary shall 
submit a report to the Congress on the results of the demonstration 
program and include in the report--
        (1) the number of applications received and the number funded;
        (2) a summary of the reports described in subsection (e), 
    including data that allows for comparison of programs; and
        (3) recommendations for broader implementation of pain 
    management strategies that encourage the use of alternatives to 
    opioids in hospitals, emergency departments, or other acute care 
    settings.
    (g) Authorization of Appropriations.--To carry out this section, 
there is authorized to be appropriated $10,000,000 for each of fiscal 
years 2019 through 2021.

    Subtitle K--Treatment, Education, and Community Help To Combat 
                               Addiction

SEC. 7101. ESTABLISHMENT OF REGIONAL CENTERS OF EXCELLENCE IN SUBSTANCE 
USE DISORDER EDUCATION.
    Part D of title V of the Public Health Service Act, as amended by 
section 7031, is further amended by adding at the end the following new 
section:
    ``SEC. 551. REGIONAL CENTERS OF EXCELLENCE IN SUBSTANCE USE 
      DISORDER EDUCATION.
    ``(a) In General.--The Secretary, in consultation with appropriate 
agencies, shall award cooperative agreements to eligible entities for 
the designation of such entities as Regional Centers of Excellence in 
Substance Use Disorder Education for purposes of improving health 
professional training resources with respect to substance use disorder 
prevention, treatment, and recovery.
    ``(b) Eligibility.--To be eligible to receive a cooperative 
agreement under subsection (a), an entity shall--
        ``(1) be an accredited entity that offers education to students 
    in various health professions, which may include--
            ``(A) a teaching hospital;
            ``(B) a medical school;
            ``(C) a certified behavioral health clinic; or
            ``(D) any other health professions school, school of public 
        health, or Cooperative Extension Program at institutions of 
        higher education, as defined in section 101 of the Higher 
        Education Act of 1965, engaged in the prevention, treatment, or 
        recovery of substance use disorders;
        ``(2) demonstrate community engagement and partnerships with 
    community stakeholders, including entities that train health 
    professionals, mental health counselors, social workers, peer 
    recovery specialists, substance use treatment programs, community 
    health centers, physician offices, certified behavioral health 
    clinics, research institutions, and law enforcement; and
        ``(3) submit to the Secretary an application containing such 
    information, at such time, and in such manner, as the Secretary may 
    require.
    ``(c) Activities.--An entity receiving an award under this section 
shall develop, evaluate, and distribute evidence-based resources 
regarding the prevention and treatment of, and recovery from, substance 
use disorders. Such resources may include information on--
        ``(1) the neurology and pathology of substance use disorders;
        ``(2) advancements in the treatment of substance use disorders;
        ``(3) techniques and best practices to support recovery from 
    substance use disorders;
        ``(4) strategies for the prevention and treatment of, and 
    recovery from substance use disorders across patient populations; 
    and
        ``(5) other topic areas that are relevant to the objectives 
    described in subsection (a).
    ``(d) Geographic Distribution.--In awarding cooperative agreements 
under subsection (a), the Secretary shall take into account regional 
differences among eligible entities and shall make an effort to ensure 
geographic distribution.
    ``(e) Evaluation.--The Secretary shall evaluate each project 
carried out by an entity receiving an award under this section and 
shall disseminate the findings with respect to each such evaluation to 
appropriate public and private entities.
    ``(f) Funding.--There is authorized to be appropriated to carry out 
this section, $4,000,000 for each of fiscal years 2019 through 2023.''.
SEC. 7102. YOUTH PREVENTION AND RECOVERY.
    (a)  Substance Abuse Treatment Services for Children, Adolescents, 
and Young Adults.--Section 514 of the Public Health Service Act (42 
U.S.C. 290bb-7) is amended--
        (1) in the section heading, by striking ``children and 
    adolescents'' and inserting ``children, adolescents, and young 
    adults'';
        (2) in subsection (a)(2), by striking ``children, including'' 
    and inserting ``children, adolescents, and young adults, 
    including''; and
        (3) by striking ``children and adolescents'' each place it 
    appears and inserting ``children, adolescents, and young adults''.
    (b) Resource Center.--The Secretary of Health and Human Services 
(referred to in this section as the ``Secretary'', except as otherwise 
provided), in consultation with the Secretary of Education and other 
heads of agencies, including the Assistant Secretary for Mental Health 
and Substance Use and the Administrator of the Health Resources and 
Services Administration, as appropriate, shall establish a resource 
center to provide technical support to recipients of grants under 
subsection (c).
    (c) Youth Prevention and Recovery Initiative.--
        (1) In general.--The Secretary, in consultation with the 
    Secretary of Education, shall administer a program to provide 
    support for communities to support the prevention of, treatment of, 
    and recovery from, substance use disorders for children, 
    adolescents, and young adults.
        (2) Definitions.--In this subsection:
            (A) Eligible entity.--The term ``eligible entity'' means--
                (i) a local educational agency that is seeking to 
            establish or expand substance use prevention or recovery 
            support services at one or more high schools;
                (ii) a State educational agency;
                (iii) an institution of higher education (or consortia 
            of such institutions), which may include a recovery program 
            at an institution of higher education;
                (iv) a local board or one-stop operator;
                (v) a nonprofit organization with appropriate expertise 
            in providing services or programs for children, 
            adolescents, or young adults, excluding a school;
                (vi) a State, political subdivision of a State, Indian 
            tribe, or tribal organization; or
                (vii) a high school or dormitory serving high school 
            students that receives funding from the Bureau of Indian 
            Education.
            (B) Foster care.--The term ``foster care'' has the meaning 
        given such term in section 1355.20(a) of title 45, Code of 
        Federal Regulations (or any successor regulations).
            (C) High school.--The term ``high school'' has the meaning 
        given such term in section 8101 of the Elementary and Secondary 
        Education Act of 1965 (20 U.S.C. 7801).
            (D) Homeless youth.--The term ``homeless youth'' has the 
        meaning given the term ``homeless children or youths'' in 
        section 725 of the McKinney-Vento Homeless Assistance Act (42 
        U.S.C. 11434a).
            (E) Indian tribe; tribal organization.--The terms ``Indian 
        tribe'' and ``tribal organization'' have the meanings given 
        such terms in section 4 of the Indian Self-Determination and 
        Education Assistance Act (25 U.S.C. 5304).
            (F) Institution of higher education.--The term 
        ``institution of higher education'' has the meaning given such 
        term in section 101 of the Higher Education Act of 1965 (20 
        U.S.C. 1001) and includes a ``postsecondary vocational 
        institution'' as defined in section 102(c) of such Act (20 
        U.S.C. 1002(c)).
            (G) Local educational agency.--The term ``local educational 
        agency'' has the meaning given such term in section 8101 of the 
        Elementary and Secondary Education Act of 1965 (20 U.S.C. 
        7801).
            (H) Local board; one-stop operator.--The terms ``local 
        board'' and ``one-stop operator'' have the meanings given such 
        terms in section 3 of the Workforce Innovation and Opportunity 
        Act (29 U.S.C. 3102).
            (I) Out-of-school youth.--The term ``out-of-school youth'' 
        has the meaning given such term in section 129(a)(1)(B) of the 
        Workforce Innovation and Opportunity Act (29 U.S.C. 
        3164(a)(1)(B)).
            (J) Recovery program.--The term ``recovery program'' means 
        a program--
                (i) to help children, adolescents, or young adults who 
            are recovering from substance use disorders to initiate, 
            stabilize, and maintain healthy and productive lives in the 
            community; and
                (ii) that includes peer-to-peer support delivered by 
            individuals with lived experience in recovery, and communal 
            activities to build recovery skills and supportive social 
            networks.
            (K) State educational agency.--The term ``State educational 
        agency'' has the meaning given such term in section 8101 of the 
        Elementary and Secondary Education Act (20 U.S.C. 7801).
        (3) Best practices.--The Secretary, in consultation with the 
    Secretary of Education, shall--
            (A) identify or facilitate the development of evidence-
        based best practices for prevention of substance misuse and 
        abuse by children, adolescents, and young adults, including for 
        specific populations such as youth in foster care, homeless 
        youth, out-of-school youth, and youth who are at risk of or 
        have experienced trafficking that address--
                (i) primary prevention;
                (ii) appropriate recovery support services;
                (iii) appropriate use of medication-assisted treatment 
            for such individuals, if applicable, and ways of overcoming 
            barriers to the use of medication-assisted treatment in 
            such population; and
                (iv) efficient and effective communication, which may 
            include the use of social media, to maximize outreach 
            efforts;
            (B) disseminate such best practices to State educational 
        agencies, local educational agencies, schools and dormitories 
        funded by the Bureau of Indian Education, institutions of 
        higher education, recovery programs at institutions of higher 
        education, local boards, one-stop operators, family and youth 
        homeless providers, and nonprofit organizations, as 
        appropriate;
            (C) conduct a rigorous evaluation of each grant funded 
        under this subsection, particularly its impact on the 
        indicators described in paragraph (7)(B); and
            (D) provide technical assistance for grantees under this 
        subsection.
        (4) Grants authorized.--The Secretary, in consultation with the 
    Secretary of Education, shall award 3-year grants, on a competitive 
    basis, to eligible entities to enable such entities, in 
    coordination with Indian tribes, if applicable, and State agencies 
    responsible for carrying out substance use disorder prevention and 
    treatment programs, to carry out evidence-based programs for--
            (A) prevention of substance misuse and abuse by children, 
        adolescents, and young adults, which may include primary 
        prevention;
            (B) recovery support services for children, adolescents, 
        and young adults, which may include counseling, job training, 
        linkages to community-based services, family support groups, 
        peer mentoring, and recovery coaching; or
            (C) treatment or referrals for treatment of substance use 
        disorders, which may include the use of medication-assisted 
        treatment, as appropriate.
        (5) Special consideration.--In awarding grants under this 
    subsection, the Secretary shall give special consideration to the 
    unique needs of tribal, urban, suburban, and rural populations.
        (6) Application.--To be eligible for a grant under this 
    subsection, an entity shall submit to the Secretary an application 
    at such time, in such manner, and containing such information as 
    the Secretary may require. Such application shall include--
            (A) a description of--
                (i) the impact of substance use disorders in the 
            population that will be served by the grant program;
                (ii) how the eligible entity has solicited input from 
            relevant stakeholders, which may include faculty, teachers, 
            staff, families, students, and experts in substance use 
            disorder prevention, treatment, and recovery in developing 
            such application;
                (iii) the goals of the proposed project, including the 
            intended outcomes;
                (iv) how the eligible entity plans to use grant funds 
            for evidence-based activities, in accordance with this 
            subsection to prevent, provide recovery support for, or 
            treat substance use disorders amongst such individuals, or 
            a combination of such activities; and
                (v) how the eligible entity will collaborate with 
            relevant partners, which may include State educational 
            agencies, local educational agencies, institutions of 
            higher education, juvenile justice agencies, prevention and 
            recovery support providers, local service providers, 
            including substance use disorder treatment programs, 
            providers of mental health services, youth serving 
            organizations, family and youth homeless providers, child 
            welfare agencies, and primary care providers, in carrying 
            out the grant program; and
            (B) an assurance that the eligible entity will participate 
        in the evaluation described in paragraph (3)(C).
        (7) Reports to the secretary.--Each eligible entity awarded a 
    grant under this subsection shall submit to the Secretary a report 
    at such time and in such manner as the Secretary may require. Such 
    report shall include--
            (A) a description of how the eligible entity used grant 
        funds, in accordance with this subsection, including the number 
        of children, adolescents, and young adults reached through 
        programming; and
            (B) a description, including relevant data, of how the 
        grant program has made an impact on the intended outcomes 
        described in paragraph (6)(A)(iii), including--
                (i) indicators of student success, which, if the 
            eligible entity is an educational institution, shall 
            include student well-being and academic achievement;
                (ii) substance use disorders amongst children, 
            adolescents, and young adults, including the number of 
            overdoses and deaths amongst children, adolescents, and 
            young adults served by the grant during the grant period; 
            and
                (iii) other indicators, as the Secretary determines 
            appropriate.
        (8) Report to congress.--The Secretary shall, not later than 
    October 1, 2022, submit a report to the Committee on Health, 
    Education, Labor, and Pensions of the Senate and the Committee on 
    Energy and Commerce and the Committee on Education and the 
    Workforce of the House of Representatives a report summarizing the 
    effectiveness of the grant program under this subsection, based on 
    the information submitted in reports required under paragraph (7).
        (9) Authorization of appropriations.--There is authorized to be 
    appropriated $10,000,000 to carry out this subsection for each of 
    fiscal years 2019 through 2023.

 Subtitle L--Information From National Mental Health and Substance Use 
                           Policy Laboratory

SEC. 7111. INFORMATION FROM NATIONAL MENTAL HEALTH AND SUBSTANCE USE 
POLICY LABORATORY.
    Section 501A(b) of the Public Health Service Act (42 U.S.C. 290aa-
0(b)) is amended--
        (1) in paragraph (5)(C), by striking ``; and'' at the end and 
    inserting a semicolon;
        (2) by redesignating paragraph (6) as paragraph (7); and
        (3) by inserting after paragraph (5) the following:
        ``(6) issue and periodically update information for entities 
    applying for grants or cooperative agreements from the Substance 
    Abuse and Mental Health Services Administration in order to--
            ``(A) encourage the implementation and replication of 
        evidence-based practices; and
            ``(B) provide technical assistance to applicants for 
        funding, including with respect to justifications for such 
        programs and activities; and''.

           Subtitle M--Comprehensive Opioid Recovery Centers

SEC. 7121. COMPREHENSIVE OPIOID RECOVERY CENTERS.
    (a) In General.--Part D of title V of the Public Health Service Act 
(42 U.S.C. 290dd et seq.), as amended by sections 7031 and 7101, is 
further amended by adding at the end the following new section:
    ``SEC. 552. COMPREHENSIVE OPIOID RECOVERY CENTERS.
    ``(a) In General.--The Secretary shall award grants on a 
competitive basis to eligible entities to establish or operate a 
comprehensive opioid recovery center (referred to in this section as a 
`Center'). A Center may be a single entity or an integrated delivery 
network.
    ``(b) Grant Period.--
        ``(1) In general.--A grant awarded under subsection (a) shall 
    be for a period of not less than 3 years and not more than 5 years.
        ``(2) Renewal.--A grant awarded under subsection (a) may be 
    renewed, on a competitive basis, for additional periods of time, as 
    determined by the Secretary. In determining whether to renew a 
    grant under this paragraph, the Secretary shall consider the data 
    submitted under subsection (h).
    ``(c) Minimum Number of Centers.--The Secretary shall allocate the 
amounts made available under subsection (j) such that not fewer than 10 
grants may be awarded. Not more than one grant shall be made to 
entities in a single State for any one period.
    ``(d) Application.--
        ``(1) Eligible entity.--An entity is eligible for a grant under 
    this section if the entity offers treatment and other services for 
    individuals with a substance use disorder.
        ``(2) Submission of application.--In order to be eligible for a 
    grant under subsection (a), an entity shall submit an application 
    to the Secretary at such time and in such manner as the Secretary 
    may require. Such application shall include--
            ``(A) evidence that such entity carries out, or is capable 
        of coordinating with other entities to carry out, the 
        activities described in subsection (g); and
            ``(B) such other information as the Secretary may require.
    ``(e) Priority.--In awarding grants under subsection (a), the 
Secretary shall give priority to eligible entities--
        ``(1) located in a State with an age-adjusted rate of drug 
    overdose deaths that is above the national overdose mortality rate, 
    as determined by the Director of the Centers for Disease Control 
    and Prevention; or
        ``(2) serving an Indian Tribe (as defined in section 4 of the 
    Indian Self-Determination and Education Assistance Act) with an 
    age-adjusted rate of drug overdose deaths that is above the 
    national overdose mortality rate, as determined through appropriate 
    mechanisms determined by the Secretary in consultation with Indian 
    Tribes.
    ``(f) Preference.--In awarding grants under subsection (a), the 
Secretary may give preference to eligible entities utilizing 
technology-enabled collaborative learning and capacity building models, 
including such models as defined in section 2 of the Expanding Capacity 
for Health Outcomes Act (Public Law 114-270; 130 Stat. 1395), to 
conduct the activities described in this section.
    ``(g) Center Activities.--Each Center shall, at a minimum, carry 
out the following activities directly, through referral, or through 
contractual arrangements, which may include carrying out such 
activities through technology-enabled collaborative learning and 
capacity building models described in subsection (f):
        ``(1) Treatment and recovery services.--Each Center shall--
            ``(A) Ensure that intake, evaluations, and periodic patient 
        assessments meet the individualized clinical needs of patients, 
        including by reviewing patient placement in treatment settings 
        to support meaningful recovery.
            ``(B) Provide the full continuum of treatment services, 
        including--
                ``(i) all drugs and devices approved or cleared under 
            the Federal Food, Drug, and Cosmetic Act and all biological 
            products licensed under section 351 of this Act to treat 
            substance use disorders or reverse overdoses, pursuant to 
            Federal and State law;
                ``(ii) medically supervised withdrawal management, that 
            includes patient evaluation, stabilization, and readiness 
            for and entry into treatment;
                ``(iii) counseling provided by a program counselor or 
            other certified professional who is licensed and qualified 
            by education, training, or experience to assess the 
            psychological and sociological background of patients, to 
            contribute to the appropriate treatment plan for the 
            patient, and to monitor patient progress;
                ``(iv) treatment, as appropriate, for patients with co-
            occurring substance use and mental disorders;
                ``(v) testing, as appropriate, for infections commonly 
            associated with illicit drug use;
                ``(vi) residential rehabilitation, and outpatient and 
            intensive outpatient programs;
                ``(vii) recovery housing;
                ``(viii) community-based and peer recovery support 
            services;
                ``(ix) job training, job placement assistance, and 
            continuing education assistance to support reintegration 
            into the workforce; and
                ``(x) other best practices to provide the full 
            continuum of treatment and services, as determined by the 
            Secretary.
            ``(C) Ensure that all programs covered by the Center 
        include medication-assisted treatment, as appropriate, and do 
        not exclude individuals receiving medication-assisted treatment 
        from any service.
            ``(D) Periodically conduct patient assessments to support 
        sustained and clinically significant recovery, as defined by 
        the Assistant Secretary for Mental Health and Substance Use.
            ``(E) Provide onsite access to medication, as appropriate, 
        and toxicology services; for purposes of carrying out this 
        section.
            ``(F) Operate a secure, confidential, and interoperable 
        electronic health information system.
            ``(G) Offer family support services such as child care, 
        family counseling, and parenting interventions to help 
        stabilize families impacted by substance use disorder, as 
        appropriate.
        ``(2) Outreach.--Each Center shall carry out outreach 
    activities regarding the services offered through the Centers, 
    which may include--
            ``(A) training and supervising outreach staff, as 
        appropriate, to work with State and local health departments, 
        health care providers, the Indian Health Service, State and 
        local educational agencies, schools funded by the Indian Bureau 
        of Education, institutions of higher education, State and local 
        workforce development boards, State and local community action 
        agencies, public safety officials, first responders, Indian 
        Tribes, child welfare agencies, as appropriate, and other 
        community partners and the public, including patients, to 
        identify and respond to community needs;
            ``(B) ensuring that the entities described in subparagraph 
        (A) are aware of the services of the Center; and
            ``(C) disseminating and making publicly available, 
        including through the internet, evidence-based resources that 
        educate professionals and the public on opioid use disorder and 
        other substance use disorders, including co-occurring substance 
        use and mental disorders.
    ``(h) Data Reporting and Program Oversight.--With respect to a 
grant awarded under subsection (a), not later than 90 days after the 
end of the first year of the grant period, and annually thereafter for 
the duration of the grant period (including the duration of any renewal 
period for such grant), the entity shall submit data, as appropriate, 
to the Secretary regarding--
        ``(1) the programs and activities funded by the grant;
        ``(2) health outcomes of the population of individuals with a 
    substance use disorder who received services from the Center, 
    evaluated by an independent program evaluator through the use of 
    outcomes measures, as determined by the Secretary;
        ``(3) the retention rate of program participants; and
        ``(4) any other information that the Secretary may require for 
    the purpose of--ensuring that the Center is complying with all the 
    requirements of the grant, including providing the full continuum 
    of services described in subsection (g)(1)(B).
    ``(i) Privacy.--The provisions of this section, including with 
respect to data reporting and program oversight, shall be subject to 
all applicable Federal and State privacy laws.
    ``(j) Authorization of Appropriations.--There is authorized to be 
appropriated $10,000,000 for each of fiscal years 2019 through 2023 for 
purposes of carrying out this section.''.
    (b) Reports to Congress.--
        (1) Preliminary report.--Not later than 3 years after the date 
    of the enactment of this Act, the Secretary of Health and Human 
    Services shall submit to Congress a preliminary report that 
    analyzes data submitted under section 552(h) of the Public Health 
    Service Act, as added by subsection (a).
        (2) Final report.--Not later than 2 years after submitting the 
    preliminary report required under paragraph (1), the Secretary of 
    Health and Human Services shall submit to Congress a final report 
    that includes--
            (A) an evaluation of the effectiveness of the comprehensive 
        services provided by the Centers established or operated 
        pursuant to section 552 of the Public Health Service Act, as 
        added by subsection (a), with respect to health outcomes of the 
        population of individuals with substance use disorder who 
        receive services from the Center, which shall include an 
        evaluation of the effectiveness of services for treatment and 
        recovery support and to reduce relapse, recidivism, and 
        overdose; and
            (B) recommendations, as appropriate, regarding ways to 
        improve Federal programs related to substance use disorders, 
        which may include dissemination of best practices for the 
        treatment of substance use disorders to health care 
        professionals.

                    Subtitle N--Trauma-Informed Care

SEC. 7131. CDC SURVEILLANCE AND DATA COLLECTION FOR CHILD, YOUTH, AND 
ADULT TRAUMA.
    (a) Data Collection.--The Director of the Centers for Disease 
Control and Prevention (referred to in this section as the 
``Director'') may, in cooperation with the States, collect and report 
data on adverse childhood experiences through the Behavioral Risk 
Factor Surveillance System, the Youth Risk Behavior Surveillance 
System, and other relevant public health surveys or questionnaires.
    (b) Timing.--The collection of data under subsection (a) may occur 
biennially.
    (c) Data From Rural Areas.--The Director shall encourage each State 
that participates in collecting and reporting data under subsection (a) 
to collect and report data from rural areas within such State, in order 
to generate a statistically reliable representation of such areas.
    (d) Data From Tribal Areas.--The Director may, in cooperation with 
Indian Tribes (as defined in section 4 of the Indian Self-Determination 
and Education Assistance Act) and pursuant to a written request from an 
Indian Tribe, provide technical assistance to such Indian Tribe to 
collect and report data on adverse childhood experiences through the 
Behavioral Risk Factor Surveillance System, the Youth Risk Behavior 
Surveillance System, or another relevant public health survey or 
questionnaire.
    (e) Authorization of Appropriations.--To carry out this section, 
there is authorized to be appropriated $2,000,000 for each of fiscal 
years 2019 through 2023.
SEC. 7132. TASK FORCE TO DEVELOP BEST PRACTICES FOR TRAUMA-INFORMED 
IDENTIFICATION, REFERRAL, AND SUPPORT.
    (a) Establishment.--There is established a task force, to be known 
as the Interagency Task Force on Trauma-Informed Care (in this section 
referred to as the ``task force'') that shall identify, evaluate, and 
make recommendations regarding--
        (1) best practices with respect to children and youth, and 
    their families as appropriate, who have experienced or are at risk 
    of experiencing trauma; and
        (2) ways in which Federal agencies can better coordinate to 
    improve the Federal response to families impacted by substance use 
    disorders and other forms of trauma.
    (b) Membership.--
        (1) Composition.--The task force shall be composed of the heads 
    of the following Federal departments and agencies, or their 
    designees:
            (A) The Centers for Medicare & Medicaid Services.
            (B) The Substance Abuse and Mental Health Services 
        Administration.
            (C) The Agency for Healthcare Research and Quality.
            (D) The Centers for Disease Control and Prevention.
            (E) The Indian Health Service.
            (F) The Department of Veterans Affairs.
            (G) The National Institutes of Health.
            (H) The Food and Drug Administration.
            (I) The Health Resources and Services Administration.
            (J) The Department of Defense.
            (K) The Office of Minority Health of the Department of 
        Health and Human Services.
            (L) The Administration for Children and Families.
            (M) The Office of the Assistant Secretary for Planning and 
        Evaluation of the Department of Health and Human Services.
            (N) The Office for Civil Rights of the Department of Health 
        and Human Services.
            (O) The Office of Juvenile Justice and Delinquency 
        Prevention of the Department of Justice.
            (P) The Office of Community Oriented Policing Services of 
        the Department of Justice.
            (Q) The Office on Violence Against Women of the Department 
        of Justice.
            (R) The National Center for Education Evaluation and 
        Regional Assistance of the Department of Education.
            (S) The National Center for Special Education Research of 
        the Institute of Education Science.
            (T) The Office of Elementary and Secondary Education of the 
        Department of Education.
            (U) The Office for Civil Rights of the Department of 
        Education.
            (V) The Office of Special Education and Rehabilitative 
        Services of the Department of Education.
            (W) The Bureau of Indian Affairs of the Department of the 
        Interior.
            (X) The Veterans Health Administration of the Department of 
        Veterans Affairs.
            (Y) The Office of Special Needs Assistance Programs of the 
        Department of Housing and Urban Development.
            (Z) The Office of Head Start of the Administration for 
        Children and Families.
            (AA) The Children's Bureau of the Administration for 
        Children and Families.
            (BB) The Bureau of Indian Education of the Department of 
        the Interior.
            (CC) Such other Federal agencies as the Secretaries 
        determine to be appropriate.
        (2) Date of appointments.--The heads of Federal departments and 
    agencies shall appoint the corresponding members of the task force 
    not later than 60 days after the date of enactment of this Act.
        (3) Chairperson.--The task force shall be chaired by the 
    Assistant Secretary for Mental Health and Substance Use, or the 
    Assistant Secretary's designee.
    (c) Task Force Duties.--The task force shall--
        (1) solicit input from stakeholders, including frontline 
    service providers, educators, mental health professionals, 
    researchers, experts in infant, child, and youth trauma, child 
    welfare professionals, and the public, in order to inform the 
    activities under paragraph (2); and
        (2) identify, evaluate, make recommendations, and update such 
    recommendations not less than annually, to the general public, the 
    Secretary of Education, the Secretary of Health and Human Services, 
    the Secretary of Labor, the Secretary of the Interior, the Attorney 
    General, and other relevant cabinet Secretaries, and Congress 
    regarding--
            (A) a set of evidence-based, evidence-informed, and 
        promising best practices with respect to--
                (i) prevention strategies for individuals at risk of 
            experiencing or being exposed to trauma, including trauma 
            as a result of exposure to substance use;
                (ii) the identification of infants, children and youth, 
            and their families as appropriate, who have experienced or 
            are at risk of experiencing trauma;
                (iii) the expeditious referral to and implementation of 
            trauma-informed practices and supports that prevent and 
            mitigate the effects of trauma, which may include whole-
            family and multi-generational approaches; and
                (iv) community based or multi-generational practices 
            that support children and their families;
            (B) a national strategy on how the task force and member 
        agencies will collaborate, prioritize options for, and 
        implement a coordinated approach, which may include--
                (i) data sharing;
                (ii) providing support to infants, children, and youth, 
            and their families as appropriate, who have experienced or 
            are at risk of experiencing trauma;
                (iii) identifying options for coordinating existing 
            grants that support infants, children, and youth, and their 
            families as appropriate, who have experienced, or are at 
            risk of experiencing, exposure to substance use or other 
            trauma, including trauma related to substance use; and
                (iv) other ways to improve coordination, planning, and 
            communication within and across Federal agencies, offices, 
            and programs, to better serve children and families 
            impacted by substance use disorders; and
            (C) existing Federal authorities at the Department of 
        Education, Department of Health and Human Services, Department 
        of Justice, Department of Labor, Department of the Interior, 
        and other relevant agencies, and specific Federal grant 
        programs to disseminate best practices on, provide training in, 
        or deliver services through, trauma-informed practices, and 
        disseminate such information--
                (i) in writing to relevant program offices at such 
            agencies to encourage grant applicants in writing to use 
            such funds, where appropriate, for trauma-informed 
            practices; and
                (ii) to the general public through the internet website 
            of the task force.
    (d) Best Practices.--In identifying, evaluating, and recommending 
the set of best practices under subsection (c), the task force shall--
        (1) include guidelines for providing professional development 
    and education for front-line services providers, including school 
    personnel, early childhood education program providers, providers 
    from child- or youth-serving organizations, housing and homeless 
    providers, primary and behavioral health care providers, child 
    welfare and social services providers, juvenile and family court 
    personnel, health care providers, individuals who are mandatory 
    reporters of child abuse or neglect, trained nonclinical providers 
    (including peer mentors and clergy), and first responders, in--
            (A) understanding and identifying early signs and risk 
        factors of trauma in infants, children, and youth, and their 
        families as appropriate, including through screening processes 
        and services;
            (B) providing practices to prevent and mitigate the impact 
        of trauma, including by fostering safe and stable environments 
        and relationships; and
            (C) developing and implementing policies, procedures, or 
        systems that--
                (i) are designed to quickly refer infants, children, 
            youth, and their families as appropriate, who have 
            experienced or are at risk of experiencing trauma to the 
            appropriate trauma-informed screening and support and age-
            appropriate treatment, and to ensure such infants, 
            children, youth, and family members receive such support;
                (ii) utilize and develop partnerships with early 
            childhood education programs, local social services 
            organizations, such as organizations serving youth, and 
            clinical mental health or other health care providers with 
            expertise in providing support services and age-appropriate 
            trauma-informed and evidence-based treatment aimed at 
            preventing or mitigating the effects of trauma;
                (iii) educate children and youth to--

                    (I) understand and identify the signs, effects, or 
                symptoms of trauma; and
                    (II) build the resilience and coping skills to 
                mitigate the effects of experiencing trauma;

                (iv) promote and support multi-generational practices 
            that assist parents, foster parents, and kinship and other 
            caregivers in accessing resources related to, and 
            developing environments conducive to, the prevention and 
            mitigation of trauma; and
                (v) collect and utilize data from screenings, 
            referrals, or the provision of services and supports to 
            evaluate outcomes and improve processes for trauma-informed 
            services and supports that are culturally sensitive, 
            linguistically appropriate, and specific to age ranges and 
            sex, as applicable;
        (2) recommend best practices that are designed to avoid 
    unwarranted custody loss or criminal penalties for parents or 
    guardians in connection with infants, children, and youth who have 
    experienced or are at risk of experiencing trauma; and
        (3) recommend opportunities for local- and State-level 
    partnerships that--
            (A) are designed to quickly identify and refer children and 
        families, as appropriate, who have experienced or are at risk 
        of experiencing exposure to trauma, including related to 
        substance use;
            (B) utilize and develop partnerships with early childhood 
        education programs, local social services organizations, and 
        health care services aimed at preventing or mitigating the 
        effects of exposure to trauma, including related to substance 
        use;
            (C) offer community-based prevention activities, including 
        educating families and children on the effects of exposure to 
        trauma, such as trauma related to substance use, and how to 
        build resilience and coping skills to mitigate those effects;
            (D) in accordance with Federal privacy protections, utilize 
        non-personally-identifiable data from screenings, referrals, or 
        the provision of services and supports to evaluate and improve 
        processes addressing exposure to trauma, including related to 
        substance use; and
            (E) are designed to prevent separation and support 
        reunification of families if in the best interest of the child.
    (e) Operating Plan.--Not later than 120 days after the date of 
enactment of this Act, the task force shall hold the first meeting. Not 
later than 2 years after such date of enactment, the task force shall 
submit to the Secretary of Education, Secretary of Health and Human 
Services, Secretary of Labor, Secretary of the Interior, the Attorney 
General, and Congress an operating plan for carrying out the activities 
of the task force described in subsection (c)(2). Such operating plan 
shall include--
        (1) a list of specific activities that the task force plans to 
    carry out for purposes of carrying out duties described in 
    subsection (c)(2), which may include public engagement;
        (2) a plan for carrying out the activities under subsection 
    (c)(2);
        (3) a list of members of the task force and other individuals 
    who are not members of the task force that may be consulted to 
    carry out such activities;
        (4) an explanation of Federal agency involvement and 
    coordination needed to carry out such activities, including any 
    statutory or regulatory barriers to such coordination;
        (5) a budget for carrying out such activities;
        (6) a proposed timeline for implementing recommendations and 
    efforts identified under subsection (c); and
        (7) other information that the task force determines 
    appropriate as related to its duties.
    (f) Final Report.--Not later than 3 years after the date of the 
first meeting of the task force, the task force shall submit to the 
general public, Secretary of Education, Secretary of Health and Human 
Services, Secretary of Labor, Secretary of the Interior, the Attorney 
General, other relevant cabinet Secretaries, the Committee on Energy 
and Commerce and the Committee on Education and the Workforce of the 
House of Representatives and the Committee on Health, Education, Labor, 
and Pensions of the Senate, and Congress, a final report containing all 
of the findings and recommendations required under this section, and 
shall make such report available online in an accessible format.
    (g) Additional Reports.--In addition to the final report under 
subsection (f). the task force shall submit--
        (1) a report to Congress identifying any recommendations 
    identified under subsection (c) that require additional legislative 
    authority to implement; and
        (2) a report to the Governors describing the opportunities for 
    local- and State-level partnerships, professional development, or 
    best practices recommended under subsection (d)(3).
    (h) Definitions.--In this section--
        (1) the term ``early childhood education program'' has the 
    meaning given such term in section 103 of the Higher Education Act 
    of 1965 (20 U.S.C. 1003);
        (2) The term ``Governor'' means the chief executive officer of 
    a State; and
        (3) the term ``State'' means each of the several States, the 
    District of Columbia, the Commonwealth of Puerto Rico, the Virgin 
    Islands, Guam, American Samoa, and the Commonwealth of the Northern 
    Mariana Islands.
    (i) Sunset.--The task force shall sunset on the date that is 60 
days after the submission of the final report under subsection (f), but 
not later than September 30, 2023.
SEC. 7133. NATIONAL CHILD TRAUMATIC STRESS INITIATIVE.
    Section 582(j) of the Public Health Service Act (42 U.S.C. 290hh-
1(j)) (relating to grants to address the problems of persons who 
experience violence-related stress) is amended by striking 
``$46,887,000 for each of fiscal years 2018 through 2022'' and 
inserting ``$63,887,000 for each of fiscal years 2019 through 2023''.
SEC. 7134. GRANTS TO IMPROVE TRAUMA SUPPORT SERVICES AND MENTAL HEALTH 
CARE FOR CHILDREN AND YOUTH IN EDUCATIONAL SETTINGS.
    (a) Grants, Contracts, and Cooperative Agreements Authorized.--The 
Secretary, in coordination with the Assistant Secretary for Mental 
Health and Substance Use, is authorized to award grants to, or enter 
into contracts or cooperative agreements with, State educational 
agencies, local educational agencies, Indian Tribes (as defined in 
section 4 of the Indian Self-Determination and Education Assistance 
Act) or their tribal educational agencies, a school operated by the 
Bureau of Indian Education, a Regional Corporation, or a Native 
Hawaiian educational organization, for the purpose of increasing 
student access to evidence-based trauma support services and mental 
health care by developing innovative initiatives, activities, or 
programs to link local school systems with local trauma-informed 
support and mental health systems, including those under the Indian 
Health Service.
    (b) Duration.--With respect to a grant, contract, or cooperative 
agreement awarded or entered into under this section, the period during 
which payments under such grant, contract or agreement are made to the 
recipient may not exceed 4 years.
    (c) Use of Funds.--An entity that receives a grant, contract, or 
cooperative agreement under this section shall use amounts made 
available through such grant, contract, or cooperative agreement for 
evidence-based activities, which shall include any of the following:
        (1) Collaborative efforts between school-based service systems 
    and trauma-informed support and mental health service systems to 
    provide, develop, or improve prevention, screening, referral, and 
    treatment and support services to students, such as providing 
    trauma screenings to identify students in need of specialized 
    support.
        (2) To implement schoolwide positive behavioral interventions 
    and supports, or other trauma-informed models of support.
        (3) To provide professional development to teachers, teacher 
    assistants, school leaders, specialized instructional support 
    personnel, and mental health professionals that--
            (A) fosters safe and stable learning environments that 
        prevent and mitigate the effects of trauma, including through 
        social and emotional learning;
            (B) improves school capacity to identify, refer, and 
        provide services to students in need of trauma support or 
        behavioral health services; or
            (C) reflects the best practices for trauma-informed 
        identification, referral, and support developed by the Task 
        Force under section 7132.
        (4) Services at a full-service community school that focuses on 
    trauma-informed supports, which may include a full-time site 
    coordinator, or other activities consistent with section 4625 of 
    the Elementary and Secondary Education Act of 1965 (20 U.S.C. 
    7275).
        (5) Engaging families and communities in efforts to increase 
    awareness of child and youth trauma, which may include sharing best 
    practices with law enforcement regarding trauma-informed care and 
    working with mental health professionals to provide interventions, 
    as well as longer term coordinated care within the community for 
    children and youth who have experienced trauma and their families.
        (6) To provide technical assistance to school systems and 
    mental health agencies.
        (7) To evaluate the effectiveness of the program carried out 
    under this section in increasing student access to evidence-based 
    trauma support services and mental health care.
        (8) To establish partnerships with or provide subgrants to Head 
    Start agencies (including Early Head Start agencies), public and 
    private preschool programs, child care programs (including home-
    based providers), or other entities described in subsection (a), to 
    include such entities described in this paragraph in the evidence-
    based trauma initiatives, activities, support services, and mental 
    health systems established under this section in order to provide, 
    develop, or improve prevention, screening, referral, and treatment 
    and support services to young children and their families.
    (d) Applications.--To be eligible to receive a grant, contract, or 
cooperative agreement under this section, an entity described in 
subsection (a) shall submit an application to the Secretary at such 
time, in such manner, and containing such information as the Secretary 
may reasonably require, which shall include the following:
        (1) A description of the innovative initiatives, activities, or 
    programs to be funded under the grant, contract, or cooperative 
    agreement, including how such program will increase access to 
    evidence-based trauma support services and mental health care for 
    students, and, as applicable, the families of such students.
        (2) A description of how the program will provide 
    linguistically appropriate and culturally competent services.
        (3) A description of how the program will support students and 
    the school in improving the school climate in order to support an 
    environment conducive to learning.
        (4) An assurance that--
            (A) persons providing services under the grant, contract, 
        or cooperative agreement are adequately trained to provide such 
        services; and
            (B) teachers, school leaders, administrators, specialized 
        instructional support personnel, representatives of local 
        Indian Tribes or tribal organizations as appropriate, other 
        school personnel, and parents or guardians of students 
        participating in services under this section will be engaged 
        and involved in the design and implementation of the services.
        (5) A description of how the applicant will support and 
    integrate existing school-based services with the program in order 
    to provide mental health services for students, as appropriate.
        (6) A description of the entities in the community with which 
    the applicant will partner or to which the applicant will provide 
    subgrants in accordance with subsection (c)(8).
    (e) Interagency Agreements.--
        (1) Local interagency agreements.--To ensure the provision of 
    the services described in subsection (c), a recipient of a grant, 
    contract, or cooperative agreement under this section, or their 
    designee, shall establish a local interagency agreement among local 
    educational agencies, agencies responsible for early childhood 
    education programs, Head Start agencies (including Early Head Start 
    agencies), juvenile justice authorities, mental health agencies, 
    child welfare agencies, and other relevant agencies, authorities, 
    or entities in the community that will be involved in the provision 
    of such services.
        (2) Contents.--In ensuring the provision of the services 
    described in subsection (c), the local interagency agreement shall 
    specify with respect to each agency, authority, or entity that is a 
    party to such agreement--
            (A) the financial responsibility for the services;
            (B) the conditions and terms of responsibility for the 
        services, including quality, accountability, and coordination 
        of the services; and
            (C) the conditions and terms of reimbursement among such 
        agencies, authorities, or entities, including procedures for 
        dispute resolution.
    (f) Evaluation.--The Secretary shall reserve not more than 3 
percent of the funds made available under subsection (l) for each 
fiscal year to--
        (1) conduct a rigorous, independent evaluation of the 
    activities funded under this section; and
        (2) disseminate and promote the utilization of evidence-based 
    practices regarding trauma support services and mental health care.
    (g) Distribution of Awards.--The Secretary shall ensure that 
grants, contracts, and cooperative agreements awarded or entered into 
under this section are equitably distributed among the geographical 
regions of the United States and among tribal, urban, suburban, and 
rural populations.
    (h) Rule of Construction.--Nothing in this section shall be 
construed--
        (1) to prohibit an entity involved with a program carried out 
    under this section from reporting a crime that is committed by a 
    student to appropriate authorities; or
        (2) to prevent Federal, State, and tribal law enforcement and 
    judicial authorities from exercising their responsibilities with 
    regard to the application of Federal, tribal, and State law to 
    crimes committed by a student.
    (i) Supplement, Not Supplant.--Any services provided through 
programs carried out under this section shall supplement, and not 
supplant, existing mental health services, including any special 
education and related services provided under the Individuals with 
Disabilities Education Act (20 U.S.C. 1400 et seq.).
    (j) Consultation With Indian Tribes.--In carrying out subsection 
(a), the Secretary shall, in a timely manner, meaningfully consult with 
Indian Tribes and their representatives to ensure notice of 
eligibility.
    (k) Definitions.--In this section:
        (1) Elementary school.--The term ``elementary school'' has the 
    meaning given such term in section 8101 of the Elementary and 
    Secondary Education Act of 1965 (20 U.S.C. 7801).
        (2) Evidence-based.--The term ``evidence-based'' has the 
    meaning given such term in section 8101(21)(A)(i) of the Elementary 
    and Secondary Education Act of 1965 (20 U.S.C. 7801(21)(A)(i)).
        (3) Native hawaiian educational organization.--The term 
    ``Native Hawaiian educational organization'' has the meaning given 
    such term in section 6207 of the Elementary and Secondary Education 
    Act of 1965 (20 U.S.C. 7517).
        (4) Local educational agency.--The term ``local educational 
    agency'' has the meaning given such term in section 8101 of the 
    Elementary and Secondary Education Act of 1965 (20 U.S.C. 7801).
        (5) Regional corporation.--The term ``Regional Corporation'' 
    has the meaning given the term in section 3 of the Alaska Native 
    Claims Settlement Act (43 U.S.C. 1602)).
        (6) School.--The term ``school'' means a public elementary 
    school or public secondary school.
        (7) School leader.--The term ``school leader'' has the meaning 
    given such term in section 8101 of the Elementary and Secondary 
    Education Act of 1965 (20 U.S.C. 7801).
        (8) Secondary school.--The term ``secondary school'' has the 
    meaning given such term in section 8101 of the Elementary and 
    Secondary Education Act of 1965 (20 U.S.C. 7801).
        (9) Secretary.--The term ``Secretary'' means the Secretary of 
    Education.
        (10) Specialized instructional support personnel.--The term 
    ``specialized instructional support personnel'' has the meaning 
    given such term in section 8101 of the Elementary and Secondary 
    Education Act of 1965 (20 U.S.C. 7801).
        (11) State educational agency.--The term ``State educational 
    agency'' has the meaning given such term in section 8101 of the 
    Elementary and Secondary Education Act of 1965 (20 U.S.C. 7801).
    (l) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section, $50,000,000 for each of fiscal 
years 2019 through 2023.
SEC. 7135. RECOGNIZING EARLY CHILDHOOD TRAUMA RELATED TO SUBSTANCE 
ABUSE.
    (a) Dissemination of Information.--The Secretary of Health and 
Human Services shall disseminate information, resources, and, if 
requested, technical assistance to early childhood care and education 
providers and professionals working with young children on--
        (1) ways to properly recognize children who may be impacted by 
    trauma, including trauma related to substance use by a family 
    member or other adult; and
        (2) how to respond appropriately in order to provide for the 
    safety and well-being of young children and their families.
    (b) Goals.--The information, resources, and technical assistance 
provided under subsection (a) shall--
        (1) educate early childhood care and education providers and 
    professionals working with young children on understanding and 
    identifying the early signs and risk factors of children who might 
    be impacted by trauma, including trauma due to exposure to 
    substance use;
        (2) suggest age-appropriate communication tools, procedures, 
    and practices for trauma-informed care, including ways to prevent 
    or mitigate the effects of trauma;
        (3) provide options for responding to children impacted by 
    trauma, including due to exposure to substance use, that consider 
    the needs of the child and family, including recommending resources 
    and referrals for evidence-based services to support such family; 
    and
        (4) promote whole-family and multi-generational approaches to 
    keep families safely together when it is in the best interest of 
    the child.
    (c) Coordination.--The Secretary of Health and Human Services shall 
coordinate with the task force to develop best practices for trauma-
informed identification, referral, and support authorized under section 
7132 in disseminating the information, resources, and technical 
assistance described under subsection (b).
    (d) Rule of Construction.--Such information, resources, and if 
applicable, technical assistance, shall not be construed to amend the 
requirements under--
        (1) the Child Care and Development Block Grant Act of 1990 (42 
    U.S.C. 9858 et seq.);
        (2) the Head Start Act (42 U.S.C. 9831 et seq.); or
        (3) the Individuals with Disabilities Education Act (20 U.S.C. 
    1400 et seq.).

       Subtitle O--Eliminating Opioid Related Infectious Diseases

SEC. 7141. REAUTHORIZATION AND EXPANSION OF PROGRAM OF SURVEILLANCE AND 
EDUCATION REGARDING INFECTIONS ASSOCIATED WITH ILLICIT DRUG USE AND 
OTHER RISK FACTORS.
    Section 317N of the Public Health Service Act (42 U.S.C. 247b-15) 
is amended to read as follows:
``SEC. 317N. SURVEILLANCE AND EDUCATION REGARDING INFECTIONS ASSOCIATED 
WITH ILLICIT DRUG USE AND OTHER RISK FACTORS.
    ``(a) In General.--The Secretary, acting through the Director of 
the Centers for Disease Control and Prevention, may (directly or 
through grants to public and nonprofit private entities) provide for 
programs for the following:
        ``(1) To cooperate with States and Indian tribes in 
    implementing or maintaining a national system to determine the 
    incidence of infections commonly associated with illicit drug use, 
    such as viral hepatitis, human immunodeficiency virus, and 
    infective endocarditis, and to assist the States in determining the 
    prevalence of such infections, which may include the reporting of 
    cases of such infections.
        ``(2) To identify, counsel, and offer testing to individuals 
    who are at risk of infections described in paragraph (1) resulting 
    from illicit drug use, receiving blood transfusions prior to July 
    1992, or other risk factors.
        ``(3) To provide appropriate referrals for counseling, testing, 
    and medical treatment of individuals identified under paragraph (2) 
    and to ensure, to the extent practicable, the provision of 
    appropriate follow-up services.
        ``(4) To develop and disseminate public information and 
    education programs for the detection and control of infections 
    described in paragraph (1), with priority given to high-risk 
    populations as determined by the Secretary.
        ``(5) To improve the education, training, and skills of health 
    professionals in the detection and control of infections described 
    in paragraph (1), including to improve coordination of treatment of 
    substance use disorders and infectious diseases, with priority 
    given to substance use disorder treatment providers, pediatricians 
    and other primary care providers, obstetrician-gynecologists, and 
    infectious disease clinicians, including HIV clinicians.
    ``(b) Laboratory Procedures.--The Secretary may (directly or 
through grants to public and nonprofit private entities) carry out 
programs to provide for improvements in the quality of clinical-
laboratory procedures regarding infections described in subsection 
(a)(1).
    ``(c) Definition.--In this section, the term `Indian tribe' has the 
meaning given that term in section 4 of the Indian Self-Determination 
and Education Assistance Act.
    ``(d) Authorization of Appropriations.--For the purpose of carrying 
out this section, there are authorized to be appropriated $40,000,000 
for each of the fiscal years 2019 through 2023.''.

            Subtitle P--Peer Support Communities of Recovery

SEC. 7151. BUILDING COMMUNITIES OF RECOVERY.
    Section 547 of the Public Health Service Act (42 U.S.C. 290ee-2) is 
amended to read as follows:
    ``SEC. 547. BUILDING COMMUNITIES OF RECOVERY.
    ``(a) Definition.--In this section, the term `recovery community 
organization' means an independent nonprofit organization that--
        ``(1) mobilizes resources within and outside of the recovery 
    community, which may include through a peer support network, to 
    increase the prevalence and quality of long-term recovery from 
    substance use disorders; and
        ``(2) is wholly or principally governed by people in recovery 
    for substance use disorders who reflect the community served.
    ``(b) Grants Authorized.--The Secretary shall award grants to 
recovery community organizations to enable such organizations to 
develop, expand, and enhance recovery services.
    ``(c) Federal Share.--The Federal share of the costs of a program 
funded by a grant under this section may not exceed 85 percent.
    ``(d) Use of Funds.--Grants awarded under subsection (b)--
        ``(1) shall be used to develop, expand, and enhance community 
    and statewide recovery support services; and
        ``(2) may be used to--
            ``(A) build connections between recovery networks, 
        including between recovery community organizations and peer 
        support networks, and with other recovery support services, 
        including--
                ``(i) behavioral health providers;
                ``(ii) primary care providers and physicians;
                ``(iii) educational and vocational schools;
                ``(iv) employers;
                ``(v) housing services;
                ``(vi) child welfare agencies; and
                ``(vii) other recovery support services that facilitate 
            recovery from substance use disorders, including non-
            clinical community services;
            ``(B) reduce stigma associated with substance use 
        disorders; and
            ``(C) conduct outreach on issues relating to substance use 
        disorders and recovery, including--
                ``(i) identifying the signs of substance use disorder;
                ``(ii) the resources available to individuals with 
            substance use disorder and to families of an individual 
            with a substance use disorder, including programs that 
            mentor and provide support services to children;
                ``(iii) the resources available to help support 
            individuals in recovery; and
                ``(iv) related medical outcomes of substance use 
            disorders, the potential of acquiring an infection commonly 
            associated with illicit drug use, and neonatal abstinence 
            syndrome among infants exposed to opioids during pregnancy.
    ``(e) Special Consideration.--In carrying out this section, the 
Secretary shall give special consideration to the unique needs of rural 
areas, including areas with an age-adjusted rate of drug overdose 
deaths that is above the national average and areas with a shortage of 
prevention and treatment services.
    ``(f) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section $5,000,000 for each of fiscal 
years 2019 through 2023.''.
SEC. 7152. PEER SUPPORT TECHNICAL ASSISTANCE CENTER.
    Title V of the Public Health Service Act (42 U.S.C. 290dd et seq.) 
is amended by inserting after section 547 the following:
``SEC. 547A. PEER SUPPORT TECHNICAL ASSISTANCE CENTER.
    ``(a) Establishment.--The Secretary, acting through the Assistant 
Secretary, shall establish or operate a National Peer-Run Training and 
Technical Assistance Center for Addiction Recovery Support (referred to 
in this section as the `Center').
    ``(b) Functions.--The Center established under subsection (a) shall 
provide technical assistance and support to recovery community 
organizations and peer support networks, including such assistance and 
support related to--
        ``(1) training on identifying--
            ``(A) signs of substance use disorder;
            ``(B) resources to assist individuals with a substance use 
        disorder, or resources for families of an individual with a 
        substance use disorder; and
            ``(C) best practices for the delivery of recovery support 
        services;
        ``(2) the provision of translation services, interpretation, or 
    other such services for clients with limited English speaking 
    proficiency;
        ``(3) data collection to support research, including for 
    translational research;
        ``(4) capacity building; and
        ``(5) evaluation and improvement, as necessary, of the 
    effectiveness of such services provided by recovery community 
    organizations.
    ``(c) Best Practices.--The Center established under subsection (a) 
shall periodically issue best practices for use by recovery community 
organizations and peer support networks.
    ``(d) Recovery Community Organization.--In this section, the term 
`recovery community organization' has the meaning given such term in 
section 547.
    ``(e) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section $1,000,000 for each of fiscal 
years 2019 through 2023.''.

 Subtitle Q--Creating Opportunities That Necessitate New and Enhanced 
         Connections That Improve Opioid Navigation Strategies

SEC. 7161. PREVENTING OVERDOSES OF CONTROLLED SUBSTANCES.
    (a) In General.--Part J of title III of the Public Health Service 
Act (42 U.S.C. 280b et seq.) is amended by inserting after section 392 
(42 U.S.C. 280b-1) the following:
``SEC. 392A. PREVENTING OVERDOSES OF CONTROLLED SUBSTANCES.
    ``(a) Evidence-Based Prevention Grants.--
        ``(1) In general.--The Director of the Centers for Disease 
    Control and Prevention may--
            ``(A) to the extent practicable, carry out and expand any 
        evidence-based prevention activities described in paragraph 
        (2);
            ``(B) provide training and technical assistance to States, 
        localities, and Indian tribes for purposes of carrying out such 
        activity; and
            ``(C) award grants to States, localities, and Indian tribes 
        for purposes of carrying out such activity.
        ``(2) Evidence-based prevention activities.--An evidence-based 
    prevention activity described in this paragraph is any of the 
    following activities:
            ``(A) Improving the efficiency and use of a new or 
        currently operating prescription drug monitoring program, 
        including by--
                ``(i) encouraging all authorized users (as specified by 
            the State or other entity) to register with and use the 
            program;
                ``(ii) enabling such users to access any updates to 
            information collected by the program in as close to real-
            time as possible;
                ``(iii) improving the ease of use of such program;
                ``(iv) providing for a mechanism for the program to 
            notify authorized users of any potential misuse or abuse of 
            controlled substances and any detection of inappropriate 
            prescribing or dispensing practices relating to such 
            substances;
                ``(v) encouraging the analysis of prescription drug 
            monitoring data for purposes of providing de-identified, 
            aggregate reports based on such analysis to State public 
            health agencies, State substance abuse agencies, State 
            licensing boards, and other appropriate State agencies, as 
            permitted under applicable Federal and State law and the 
            policies of the prescription drug monitoring program and 
            not containing any protected health information, to prevent 
            inappropriate prescribing, drug diversion, or abuse and 
            misuse of controlled substances, and to facilitate better 
            coordination among agencies;
                ``(vi) enhancing interoperability between the program 
            and any health information technology (including certified 
            health information technology), including by integrating 
            program data into such technology;
                ``(vii) updating program capabilities to respond to 
            technological innovation for purposes of appropriately 
            addressing the occurrence and evolution of controlled 
            substance overdoses;
                ``(viii) facilitating and encouraging data exchange 
            between the program and the prescription drug monitoring 
            programs of other States;
                ``(ix) enhancing data collection and quality, including 
            improving patient matching and proactively monitoring data 
            quality;
                ``(x) providing prescriber and dispenser practice 
            tools, including prescriber practice insight reports for 
            practitioners to review their prescribing patterns in 
            comparison to such patterns of other practitioners in the 
            specialty; and
                ``(xi) meeting the purpose of the program established 
            under section 399O, as described in section 399O(a).
            ``(B) Promoting community or health system interventions.
            ``(C) Evaluating interventions to prevent controlled 
        substance overdoses.
            ``(D) Implementing projects to advance an innovative 
        prevention approach with respect to new and emerging public 
        health crises and opportunities to address such crises, such as 
        enhancing public education and awareness on the risks 
        associated with opioids.
        ``(3) Additional grants.--The Director may award grants to 
    States, localities, and Indian Tribes--
            ``(A) to carry out innovative projects for grantees to 
        rapidly respond to controlled substance misuse, abuse, and 
        overdoses, including changes in patterns of controlled 
        substance use; and
            ``(B) for any other evidence-based activity for preventing 
        controlled substance misuse, abuse, and overdoses as the 
        Director determines appropriate.
        ``(4) Research.--The Director, in coordination with the 
    Assistant Secretary for Mental Health and Substance Use and the 
    National Mental Health and Substance Use Policy Laboratory 
    established under section 501A, as appropriate and applicable, may 
    conduct studies and evaluations to address substance use disorders, 
    including preventing substance use disorders or other related 
    topics the Director determines appropriate.
    ``(b) Enhanced Controlled Substance Overdose Data Collection, 
Analysis, and Dissemination Grants.--
        ``(1) In general.--The Director of the Centers for Disease 
    Control and Prevention may--
            ``(A) to the extent practicable, carry out any controlled 
        substance overdose data collection activities described in 
        paragraph (2);
            ``(B) provide training and technical assistance to States, 
        localities, and Indian tribes for purposes of carrying out such 
        activity;
            ``(C) award grants to States, localities, and Indian tribes 
        for purposes of carrying out such activity; and
            ``(D) coordinate with the Assistant Secretary for Mental 
        Health and Substance Use to collect data pursuant to section 
        505(d)(1)(A) (relating to the number of individuals admitted to 
        emergency departments as a result of the abuse of alcohol or 
        other drugs).
        ``(2) Controlled substance overdose data collection and 
    analysis activities.--A controlled substance overdose data 
    collection, analysis, and dissemination activity described in this 
    paragraph is any of the following activities:
            ``(A) Improving the timeliness of reporting data to the 
        public, including data on fatal and nonfatal overdoses of 
        controlled substances.
            ``(B) Enhancing the comprehensiveness of controlled 
        substance overdose data by collecting information on such 
        overdoses from appropriate sources such as toxicology reports, 
        autopsy reports, death scene investigations, and emergency 
        departments.
            ``(C) Modernizing the system for coding causes of death 
        related to controlled substance overdoses to use an electronic-
        based system.
            ``(D) Using data to help identify risk factors associated 
        with controlled substance overdoses.
            ``(E) Supporting entities involved in providing information 
        on controlled substance overdoses, such as coroners, medical 
        examiners, and public health laboratories to improve accurate 
        testing and standardized reporting of causes and contributing 
        factors to controlled substances overdoses and analysis of 
        various opioid analogues to controlled substance overdoses.
            ``(F) Working to enable and encourage the access, exchange, 
        and use of information regarding controlled substance overdoses 
        among data sources and entities.
    ``(c) Definitions.--In this section:
        ``(1) Controlled substance.--The term `controlled substance' 
    has the meaning given that term in section 102 of the Controlled 
    Substances Act.
        ``(2) Indian tribe.--The term `Indian tribe' has the meaning 
    given that term in section 4 of the Indian Self-Determination and 
    Education Assistance Act.
    ``(d) Authorization of Appropriations.--For purposes of carrying 
out this section, section 399O of this Act, and section 102 of the 
Comprehensive Addiction and Recovery Act of 2016 (Public Law 114-198), 
there is authorized to be appropriated $496,000,000 for each of fiscal 
years 2019 through 2023.''.
    (b) Education and Awareness.--Section 102 of the Comprehensive 
Addiction and Recovery Act of 2016 (Public Law 114-198) is amended--
        (1) by amending subsection (a) to read as follows:
    ``(a) In General.--The Secretary of Health and Human Services, 
acting through the Director of the Centers for Disease Control and 
Prevention and in coordination with the heads of other departments and 
agencies, shall advance education and awareness regarding the risks 
related to misuse and abuse of opioids, as appropriate, which may 
include developing or improving existing programs, conducting 
activities, and awarding grants that advance the education and 
awareness of--
        ``(1) the public, including patients and consumers--
            ``(A) generally; and
            ``(B) regarding such risks related to unused opioids and 
        the dispensing options under section 309(f) of the Controlled 
        Substances Act, as applicable; and
        ``(2) providers, which may include--
            ``(A) providing for continuing education on appropriate 
        prescribing practices;
            ``(B) education related to applicable State or local 
        prescriber limit laws, information on the use of non-addictive 
        alternatives for pain management, and the use of overdose 
        reversal drugs, as appropriate;
            ``(C) disseminating and improving the use of evidence-based 
        opioid prescribing guidelines across relevant health care 
        settings, as appropriate, and updating guidelines as necessary;
            ``(D) implementing strategies, such as best practices, to 
        encourage and facilitate the use of prescriber guidelines, in 
        accordance with State and local law;
            ``(E) disseminating information to providers about 
        prescribing options for controlled substances, including such 
        options under section 309(f) of the Controlled Substances Act, 
        as applicable; and
            ``(F) disseminating information, as appropriate, on the 
        National Pain Strategy developed by or in consultation with the 
        Assistant Secretary for Health; and
        ``(3) other appropriate entities.''; and
        (2) in subsection (b)--
            (A) by striking ``opioid abuse'' each place such term 
        appears and inserting ``opioid misuse and abuse''; and
            (B) in paragraph (2), by striking ``safe disposal of 
        prescription medications and other'' and inserting ``non-
        addictive treatment options, safe disposal options for 
        prescription medications, and other applicable''.
SEC. 7162. PRESCRIPTION DRUG MONITORING PROGRAM.
    Section 399O of the Public Health Service Act (42 U.S.C. 280g-3) is 
amended to read as follows:
``SEC. 399O. PRESCRIPTION DRUG MONITORING PROGRAM.
    ``(a) Program.--
        ``(1) In general.--Each fiscal year, the Secretary, acting 
    through the Director of the Centers for Disease Control and 
    Prevention, in coordination with the heads of other departments and 
    agencies as appropriate, shall support States or localities for the 
    purpose of improving the efficiency and use of PDMPs, including--
            ``(A) establishment and implementation of a PDMP;
            ``(B) maintenance of a PDMP;
            ``(C) improvements to a PDMP by--
                ``(i) enhancing functional components to work toward--

                    ``(I) universal use of PDMPs among providers and 
                their delegates, to the extent that State laws allow;
                    ``(II) more timely inclusion of data within a PDMP;
                    ``(III) active management of the PDMP, in part by 
                sending proactive or unsolicited reports to providers 
                to inform prescribing; and
                    ``(IV) ensuring the highest level of ease in use of 
                and access to PDMPs by providers and their delegates, 
                to the extent that State laws allow;

                ``(ii) in consultation with the Office of the National 
            Coordinator for Health Information Technology, improving 
            the intrastate interoperability of PDMPs by--

                    ``(I) making PDMPs more actionable by integrating 
                PDMPs within electronic health records and health 
                information technology infrastructure; and
                    ``(II) linking PDMP data to other data systems 
                within the State, including--

                        ``(aa) the data of pharmacy benefit managers, 
                    medical examiners and coroners, and the State's 
                    Medicaid program;
                        ``(bb) worker's compensation data; and
                        ``(cc) prescribing data of providers of the 
                    Department of Veterans Affairs and the Indian 
                    Health Service within the State;
                ``(iii) in consultation with the Office of the National 
            Coordinator for Health Information Technology, improving 
            the interstate interoperability of PDMPs through--

                    ``(I) sharing of dispensing data in near-real time 
                across State lines; and
                    ``(II) integration of automated queries for 
                multistate PDMP data and analytics into clinical 
                workflow to improve the use of such data and analytics 
                by practitioners and dispensers; or

                ``(iv) improving the ability to include treatment 
            availability resources and referral capabilities within the 
            PDMP.
        ``(2) Legislation.--As a condition on the receipt of support 
    under this section, the Secretary shall require a State or locality 
    to demonstrate that it has enacted legislation or regulations--
            ``(A) to provide for the implementation of the PDMP; and
            ``(B) to permit the imposition of appropriate penalties for 
        the unauthorized use and disclosure of information maintained 
        by the PDMP.
    ``(b) PDMP Strategies.--The Secretary shall encourage a State or 
locality, in establishing, improving, or maintaining a PDMP, to 
implement strategies that improve--
        ``(1) the reporting of dispensing in the State or locality of a 
    controlled substance to an ultimate user so the reporting occurs 
    not later than 24 hours after the dispensing event;
        ``(2) the consultation of the PDMP by each prescribing 
    practitioner, or their designee, in the State or locality before 
    initiating treatment with a controlled substance, or any substance 
    as required by the State to be reported to the PDMP, and over the 
    course of ongoing treatment for each prescribing event;
        ``(3) the consultation of the PDMP before dispensing a 
    controlled substance, or any substance as required by the State to 
    be reported to the PDMP;
        ``(4) the proactive notification to a practitioner when 
    patterns indicative of controlled substance misuse by a patient, 
    including opioid misuse, are detected;
        ``(5) the availability of data in the PDMP to other States, as 
    allowable under State law; and
        ``(6) the availability of nonidentifiable information to the 
    Centers for Disease Control and Prevention for surveillance, 
    epidemiology, statistical research, or educational purposes.
    ``(c) Drug Misuse and Abuse.--In consultation with practitioners, 
dispensers, and other relevant and interested stakeholders, a State 
receiving support under this section--
        ``(1) shall establish a program to notify practitioners and 
    dispensers of information that will help to identify and prevent 
    the unlawful diversion or misuse of controlled substances;
        ``(2) may, to the extent permitted under State law, notify the 
    appropriate authorities responsible for carrying out drug diversion 
    investigations if the State determines that information in the PDMP 
    maintained by the State indicates an unlawful diversion or abuse of 
    a controlled substance;
        ``(3) may conduct analyses of controlled substance program data 
    for purposes of providing appropriate State agencies with aggregate 
    reports based on such analyses in as close to real-time as 
    practicable, regarding prescription patterns flagged as potentially 
    presenting a risk of misuse, abuse, addiction, overdose, and other 
    aggregate information, as appropriate and in compliance with 
    applicable Federal and State laws and provided that such reports 
    shall not include protected health information; and
        ``(4) may access information about prescriptions, such as 
    claims data, to ensure that such prescribing and dispensing history 
    is updated in as close to real-time as practicable, in compliance 
    with applicable Federal and State laws and provided that such 
    information shall not include protected health information.
    ``(d) Evaluation and Reporting.--As a condition on receipt of 
support under this section, the State shall report on interoperability 
with PDMPs of other States and Federal agencies, where appropriate, 
intrastate interoperability with health information technology systems 
such as electronic health records, health information exchanges, and e-
prescribing, where appropriate, and whether or not the State provides 
automatic, up-to-date, or daily information about a patient when a 
practitioner (or the designee of a practitioner, where permitted) 
requests information about such patient.
    ``(e) Evaluation and Reporting.--A State receiving support under 
this section shall provide the Secretary with aggregate nonidentifiable 
information, as permitted by State law, to enable the Secretary--
        ``(1) to evaluate the success of the State's program in 
    achieving the purpose described in subsection (a); or
        ``(2) to prepare and submit to the Congress the report required 
    by subsection (i)(2).
    ``(f) Education and Access to the Monitoring System.--A State 
receiving support under this section shall take steps to--
        ``(1) facilitate prescribers and dispensers, and their 
    delegates, as permitted by State law, to use the PDMP, to the 
    extent practicable; and
        ``(2) educate prescribers and dispensers, and their delegates 
    on the benefits of the use of PDMPs.
    ``(g) Electronic Format.--The Secretary may issue guidelines 
specifying a uniform electronic format for the reporting, sharing, and 
disclosure of information pursuant to PDMPs. To the extent possible, 
such guidelines shall be consistent with standards recognized by the 
Office of the National Coordinator for Health Information Technology.
    ``(h) Rules of Construction.--
        ``(1) Functions otherwise authorized by law.--Nothing in this 
    section shall be construed to restrict the ability of any 
    authority, including any local, State, or Federal law enforcement, 
    narcotics control, licensure, disciplinary, or program authority, 
    to perform functions otherwise authorized by law.
        ``(2) Additional privacy protections.--Nothing in this section 
    shall be construed as preempting any State from imposing any 
    additional privacy protections.
        ``(3) Federal privacy requirements.--Nothing in this section 
    shall be construed to supersede any Federal privacy or 
    confidentiality requirement, including the regulations promulgated 
    under section 264(c) of the Health Insurance Portability and 
    Accountability Act of 1996 (Public Law 104-191; 110 Stat. 2033) and 
    section 543 of this Act.
        ``(4) No federal private cause of action.--Nothing in this 
    section shall be construed to create a Federal private cause of 
    action.
    ``(i) Progress Report.--Not later than 3 years after the date of 
enactment of this section, the Secretary shall--
        ``(1) complete a study that--
            ``(A) determines the progress of grantees in establishing 
        and implementing PDMPs consistent with this section;
            ``(B) provides an analysis of the extent to which the 
        operation of PDMPs has--
                ``(i) reduced inappropriate use, abuse, diversion of, 
            and overdose with, controlled substances;
                ``(ii) established or strengthened initiatives to 
            ensure linkages to substance use disorder treatment 
            services; or
                ``(iii) affected patient access to appropriate care in 
            States operating PDMPs;
            ``(C) determine the progress of grantees in achieving 
        interstate interoperability and intrastate interoperability of 
        PDMPs, including an assessment of technical, legal, and 
        financial barriers to such progress and recommendations for 
        addressing these barriers;
            ``(D) determines the progress of grantees in implementing 
        near real-time electronic PDMPs;
            ``(E) provides an analysis of the privacy protections in 
        place for the information reported to the PDMP in each State or 
        locality receiving support under this section and any 
        recommendations of the Secretary for additional Federal or 
        State requirements for protection of this information;
            ``(F) determines the progress of States or localities in 
        implementing technological alternatives to centralized data 
        storage, such as peer-to-peer file sharing or data pointer 
        systems, in PDMPs and the potential for such alternatives to 
        enhance the privacy and security of individually identifiable 
        data; and
            ``(G) evaluates the penalties that States or localities 
        have enacted for the unauthorized use and disclosure of 
        information maintained in PDMPs, and the criteria used by the 
        Secretary to determine whether such penalties qualify as 
        appropriate for purposes of subsection (a)(2); and
        ``(2) submit a report to the Congress on the results of the 
    study.
    ``(j) Advisory Council.--
        ``(1) Establishment.--A State or locality may establish an 
    advisory council to assist in the establishment, improvement, or 
    maintenance of a PDMP consistent with this section.
        ``(2) Limitation.--A State or locality may not use Federal 
    funds for the operations of an advisory council to assist in the 
    establishment, improvement, or maintenance of a PDMP.
        ``(3) Sense of congress.--It is the sense of the Congress that, 
    in establishing an advisory council to assist in the establishment, 
    improvement, or maintenance of a PDMP, a State or locality should 
    consult with appropriate professional boards and other interested 
    parties.
    ``(k) Definitions.--For purposes of this section:
        ``(1) The term `controlled substance' means a controlled 
    substance (as defined in section 102 of the Controlled Substances 
    Act) in schedule II, III, or IV of section 202 of such Act.
        ``(2) The term `dispense' means to deliver a controlled 
    substance to an ultimate user by, or pursuant to the lawful order 
    of, a practitioner, irrespective of whether the dispenser uses the 
    Internet or other means to effect such delivery.
        ``(3) The term `dispenser' means a physician, pharmacist, or 
    other person that dispenses a controlled substance to an ultimate 
    user.
        ``(4) The term `interstate interoperability' with respect to a 
    PDMP means the ability of the PDMP to electronically share reported 
    information with another State if the information concerns either 
    the dispensing of a controlled substance to an ultimate user who 
    resides in such other State, or the dispensing of a controlled 
    substance prescribed by a practitioner whose principal place of 
    business is located in such other State.
        ``(5) The term `intrastate interoperability' with respect to a 
    PDMP means the integration of PDMP data within electronic health 
    records and health information technology infrastructure or linking 
    of a PDMP to other data systems within the State, including the 
    State's Medicaid program, workers' compensation programs, and 
    medical examiners or coroners.
        ``(6) The term `nonidentifiable information' means information 
    that does not identify a practitioner, dispenser, or an ultimate 
    user and with respect to which there is no reasonable basis to 
    believe that the information can be used to identify a 
    practitioner, dispenser, or an ultimate user.
        ``(7) The term `PDMP' means a prescription drug monitoring 
    program that is State-controlled.
        ``(8) The term `practitioner' means a physician, dentist, 
    veterinarian, scientific investigator, pharmacy, hospital, or other 
    person licensed, registered, or otherwise permitted, by the United 
    States or the jurisdiction in which the individual practices or 
    does research, to distribute, dispense, conduct research with 
    respect to, administer, or use in teaching or chemical analysis, a 
    controlled substance in the course of professional practice or 
    research.
        ``(9) The term `State' means each of the 50 States, the 
    District of Columbia, and any commonwealth or territory of the 
    United States.
        ``(10) The term `ultimate user' means a person who has obtained 
    from a dispenser, and who possesses, a controlled substance for the 
    person's own use, for the use of a member of the person's 
    household, or for the use of an animal owned by the person or by a 
    member of the person's household.
        ``(11) The term `clinical workflow' means the integration of 
    automated queries for prescription drug monitoring programs data 
    and analytics into health information technologies such as 
    electronic health record systems, health information exchanges, 
    and/or pharmacy dispensing software systems, thus streamlining 
    provider access through automated queries.''.

   Subtitle R--Review of Substance Use Disorder Treatment Providers 
                       Receiving Federal Funding

SEC. 7171. REVIEW OF SUBSTANCE USE DISORDER TREATMENT PROVIDERS 
RECEIVING FEDERAL FUNDING.
    (a) In General.--The Secretary of Health and Human Services (in 
this section referred to as the ``Secretary'') shall conduct a review 
of entities that receive Federal funding for the provision of substance 
use disorder treatment services. The review shall include:
        (1) The length of time the entity has provided substance use 
    disorder treatment services and the geographic area served by the 
    entity.
        (2) A detailed analysis of the patient population served by the 
    entity, including but not limited to the number of patients, types 
    of diagnosed substance use disorders and the demographic 
    information of such patients, including sex, race, ethnicity, and 
    socioeconomic status.
        (3) Detailed information on the types of substance use 
    disorders for which the entity has the experience, capability, and 
    capacity to provide such services.
        (4) An analysis of how the entity handles patients requiring 
    treatment for a substance use disorder that the organization is not 
    able to treat.
        (5) An analysis of what is needed in order to improve the 
    entity's ability to meet the addiction treatment needs of the 
    communities served by that entity.
        (6) Based on the identified needs of the communities served, a 
    description of unmet needs and inadequate services and how such 
    needs and services could be better addressed to treat individuals 
    with methamphetamine, cocaine, including crack cocaine, heroin, 
    opioid, and other substance use disorders.
    (b) Report.--Not later than 2 years after the date of the enactment 
of this Act, the Secretary shall develop and submit to Congress a plan 
to direct appropriate resources to entities that provide substance use 
disorder treatment services in order to address inadequacies in 
services or funding identified through the survey described in 
subsection (a).

                  Subtitle S--Other Health Provisions

SEC. 7181. STATE RESPONSE TO THE OPIOID ABUSE CRISIS.
    (a) In General.--Section 1003 of the 21st Century Cures Act (Public 
Law 114-255) is amended--
        (1) in subsection (a)--
            (A) by striking ``the authorization of appropriations under 
        subsection (b) to carry out the grant program described in 
        subsection (c)'' and inserting ``subsection (h) to carry out 
        the grant program described in subsection (b)''; and
            (B) by inserting ``and Indian Tribes'' after ``States'';
        (2) by striking subsection (b);
        (3) by redesignating subsections (c) through (e) as subsections 
    (b) through (d), respectively;
        (4) by redesignating subsection (f) as subsection (j);
        (5) in subsection (b), as so redesignated--
            (A) in paragraph (1)--
                (i) in the paragraph heading, by inserting ``and 
            tribal'' after ``State'';
                (ii) by striking ``States for the purpose of addressing 
            the opioid abuse crisis within such States'' and inserting 
            ``States and Indian Tribes for the purpose of addressing 
            the opioid abuse crisis within such States and Indian 
            Tribes'';
                (iii) by inserting ``or Indian Tribes'' after 
            ``preference to States''; and
                (iv) by inserting before the period of the second 
            sentence ``or other Indian Tribes, as applicable''; and
            (B) in paragraph (2)--
                (i) in the matter preceding subparagraph (A), by 
            striking ``to a State'';
                (ii) in subparagraph (A), by striking ``Improving 
            State'' and inserting ``Establishing or improving'';
                (iii) in subparagraph (C), by inserting ``preventing 
            diversion of controlled substances,'' after ``treatment 
            programs,''; and
                (iv) in subparagraph (E), by striking ``as the State 
            determines appropriate, related to addressing the opioid 
            abuse crisis within the State'' and inserting ``as the 
            State or Indian Tribe determines appropriate, related to 
            addressing the opioid abuse crisis within the State or 
            Indian Tribe, including directing resources in accordance 
            with local needs related to substance use disorders'';
        (6) in subsection (c), as so redesignated, by striking 
    ``subsection (c)'' and inserting ``subsection (b)'';
        (7) in subsection (d), as so redesignated--
            (A) in the matter preceding paragraph (1), by striking 
        ``the authorization of appropriations under subsection (b)'' 
        and inserting ``subsection (h)''; and
            (B) in paragraph (1), by striking ``subsection (c)'' and 
        inserting ``subsection (b)''; and
        (8) by inserting after subsection (d), as so redesignated, the 
    following:
    ``(e) Indian Tribes.--
        ``(1) Definition.--For purposes of this section, the term 
    `Indian Tribe' has the meaning given the term `Indian tribe' in 
    section 4 of the Indian Self-Determination and Education Assistance 
    Act (25 U.S.C. 5304).
        ``(2) Appropriate mechanisms.--The Secretary, in consultation 
    with Indian Tribes, shall identify and establish appropriate 
    mechanisms for Tribes to demonstrate or report the information as 
    required under subsections (b), (c), and (d).
    ``(f) Report to Congress.--Not later than 1 year after the date on 
which amounts are first awarded after the date of enactment of this 
subsection, pursuant to subsection (b), and annually thereafter, the 
Secretary shall submit to the Committee on Health, Education, Labor, 
and Pensions of the Senate and the Committee on Energy and Commerce of 
the House of Representatives a report summarizing the information 
provided to the Secretary in reports made pursuant to subsection (c), 
including the purposes for which grant funds are awarded under this 
section and the activities of such grant recipients.
    ``(g) Technical Assistance.--The Secretary, including through the 
Tribal Training and Technical Assistance Center of the Substance Abuse 
and Mental Health Services Administration, shall provide State agencies 
and Indian Tribes, as applicable, with technical assistance concerning 
grant application and submission procedures under this section, award 
management activities, and enhancing outreach and direct support to 
rural and underserved communities and providers in addressing the 
opioid crisis.
    ``(h) Authorization of Appropriations.--For purposes of carrying 
out the grant program under subsection (b), there is authorized to be 
appropriated $500,000,000 for each of fiscal years 2019 through 2021, 
to remain available until expended.
    ``(i) Set Aside.--Of the amounts made available for each fiscal 
year to award grants under subsection (b) for a fiscal year, 5 percent 
of such amount for such fiscal year shall be made available to Indian 
Tribes, and up to 15 percent of such amount for such fiscal year may be 
set aside for States with the highest age-adjusted rate of drug 
overdose death based on the ordinal ranking of States according to the 
Director of the Centers for Disease Control and Prevention.''.
    (b) Conforming Amendment.--Section 1004(c) of the 21st Century 
Cures Act (Public Law 114-255) is amended by striking ``, the FDA 
Innovation Account, or the Account For the State Response to the Opioid 
Abuse Crisis'' and inserting ``or the FDA Innovation Account''.
SEC. 7182. REPORT ON INVESTIGATIONS REGARDING PARITY IN MENTAL HEALTH 
AND SUBSTANCE USE DISORDER BENEFITS.
    (a) In General.--Section 13003 of the 21st Century Cures Act 
(Public Law 114-255) is amended--
        (1) in subsection (a)--
            (A) by striking ``with findings of any serious violation 
        regarding'' and inserting ``concerning''; and
            (B) by inserting ``and the Committee on Education and the 
        Workforce'' after ``Energy and Commerce''; and
        (2) in subsection (b)(1)--
            (A) by inserting ``complaints received and number of'' 
        before ``closed''; and
            (B) by inserting before the period ``, and, for each such 
        investigation closed, which agency conducted the investigation, 
        whether the health plan that is the subject of the 
        investigation is fully insured or not fully insured and a 
        summary of any coordination between the applicable State 
        regulators and the Department of Labor, the Department of 
        Health and Human Services, or the Department of the Treasury, 
        and references to any guidance provided by the agencies 
        addressing the category of violation committed''.
    (b) Applicability.--The amendments made by subsection (a) shall 
apply with respect to the second annual report required under such 
section 13003 and each such annual report thereafter.
SEC. 7183. CAREER ACT.
    (a) In General.--The Secretary of Health and Human Services 
(referred to in this section as the ``Secretary''), in consultation 
with the Secretary of Labor, shall continue or establish a program to 
support individuals in substance use disorder treatment and recovery to 
live independently and participate in the workforce.
    (b) Grants Authorized.--In carrying out the activities under this 
section, the Secretary shall, on a competitive basis, award grants for 
a period of not more than 5 years to entities to enable such entities 
to carry out evidence-based programs to help individuals in substance 
use disorder treatment and recovery to live independently and 
participate in the workforce. Such entities shall coordinate, as 
applicable, with Indian tribes or tribal organizations (as applicable), 
State boards and local boards (as defined in section 3 of the Workforce 
Innovation and Opportunity Act (29 U.S.C. 3102), lead State agencies 
with responsibility for a workforce investment activity (as defined in 
such section 3), and State agencies responsible for carrying out 
substance use disorder prevention and treatment programs.
    (c) Priority.--
        (1) In general.--In awarding grants under this section, the 
    Secretary shall give priority based on the State in which the 
    entity is located. Priority shall be given among States according 
    to a formula based on the rates described in paragraph (2) and 
    weighted as described in paragraph (3).
        (2) Rates.--The rates described in this paragraph are the 
    following:
            (A) The amount by which the rate of drug overdose deaths in 
        the State, adjusted for age, is above the national overdose 
        mortality rate, as determined by the Director of the Centers 
        for Disease Control and Prevention.
            (B) The amount by which the rate of unemployment for the 
        State, based on data provided by the Bureau of Labor Statistics 
        for the preceding 5 calendar years for which there is available 
        data, is above the national average.
            (C) The amount by which rate of labor force participation 
        in the State, based on data provided by the Bureau of Labor 
        Statistics for the preceding 5 calendar years for which there 
        is available data, is below the national average.
        (3) Weighting.--The rates described in paragraph (2) shall be 
    weighted as follows:
            (A) The rate described in paragraph (2)(A) shall be 
        weighted 70 percent.
            (B) The rate described in paragraph (2)(B) shall be 
        weighted 15 percent.
            (C) The rate described in paragraph (2)(C) shall be 
        weighted 15 percent.
    (d) Preference.--In awarding grants under this section, the 
Secretary shall give preference to entities located in areas within 
States with the greatest need, with such need based on the highest 
mortality rate related to substance use disorder.
    (e) Definitions.--In this section:
        (1) Eligible entity.--The term ``eligible entity'' means an 
    entity that offers treatment or recovery services for individuals 
    with substance use disorders, and partners with one or more local 
    or State stakeholders, which may include local employers, community 
    organizations, the local workforce development board, local and 
    State governments, and Indian Tribes or tribal organizations, to 
    support recovery, independent living, and participation in the 
    workforce.
        (2) Indian tribes; tribal organization.--The terms ``Indian 
    Tribe'' and ``tribal organization'' have the meanings given the 
    terms ``Indian tribe'' and ``tribal organization'' in section 4 of 
    the Indian Self-Determination and Education Assistance Act (25 
    U.S.C. 5304).
        (3) State.--The term ``State'' includes only the several States 
    and the District of Columbia.
    (f) Applications.--An eligible entity shall submit an application 
at such time and in such manner as the Secretary may require. In 
submitting an application, the entity shall demonstrate the ability to 
partner with local stakeholders, which may include local employers, 
community stakeholders, the local workforce development board, local 
and State governments, and Indian Tribes or tribal organizations, as 
applicable, to--
        (1) identify gaps in the workforce due to the prevalence of 
    substance use disorders;
        (2) in coordination with statewide employment and training 
    activities, including coordination and alignment of activities 
    carried out by entities provided grant funds under section 8041, 
    help individuals in recovery from a substance use disorder 
    transition into the workforce, including by providing career 
    services, training services as described in paragraph (2) of 
    section 134(c) of the Workforce Innovation and Opportunity Act (29 
    U.S.C. 3174(c)), and related services described in section 
    134(a)(3) of such Act (42 U.S.C. 3174(a)); and
        (3) assist employers with informing their employees of the 
    resources, such as resources related to substance use disorders 
    that are available to their employees.
    (g) Use of Funds.--An entity receiving a grant under this section 
shall use the funds to conduct one or more of the following activities:
        (1) Hire case managers, care coordinators, providers of peer 
    recovery support services, as described in section 547(a) of the 
    Public Health Service Act (42 U.S.C. 290ee-2(a)), or other 
    professionals, as appropriate, to provide services that support 
    treatment, recovery, and rehabilitation, and prevent relapse, 
    recidivism, and overdose, including by encouraging--
            (A) the development and strengthening of daily living 
        skills; and
            (B) the use of counseling, care coordination, and other 
        services, as appropriate, to support recovery from substance 
        use disorders.
        (2) Implement or utilize innovative technologies, which may 
    include the use of telemedicine.
        (3) In coordination with the lead State agency with 
    responsibility for a workforce investment activity or local board 
    described in subsection (b), provide--
            (A) short-term prevocational training services; and
            (B) training services that are directly linked to the 
        employment opportunities in the local area or the planning 
        region.
    (h) Support for State Strategy.--An eligible entity shall include 
in its application under subsection (f) information describing how the 
services and activities proposed in such application are aligned with 
the State, outlying area, or Tribal strategy, as applicable, for 
addressing issues described in such application and how such entity 
will coordinate with existing systems to deliver services as described 
in such application.
    (i) Data Reporting and Program Oversight.--Each eligible entity 
awarded a grant under this section shall submit to the Secretary a 
report at such time and in such manner as the Secretary may require. 
Such report shall include a description of--
        (1) the programs and activities funded by the grant;
        (2) outcomes of the population of individuals with a substance 
    use disorder the grantee served through activities described in 
    subsection (g); and
        (3) any other information that the Secretary may require for 
    the purpose of ensuring that the grantee is complying with all of 
    the requirements of the grant.
    (j) Reports to Congress.--
        (1) Preliminary report.--Not later than 2 years after the end 
    of the first year of the grant period under this section, the 
    Secretary shall submit to Congress a preliminary report that 
    analyzes reports submitted under subsection (i).
        (2) Final report.--Not later than 2 years after submitting the 
    preliminary report required under paragraph (1), the Secretary 
    shall submit to Congress a final report that includes--
            (A) a description of how the grant funding was used, 
        including the number of individuals who received services under 
        subsection (g)(3) and an evaluation of the effectiveness of the 
        activities conducted by the grantee with respect to outcomes of 
        the population of individuals with substance use disorder who 
        receive services from the grantee; and
            (B) recommendations related to best practices for health 
        care professionals to support individuals in substance use 
        disorder treatment or recovery to live independently and 
        participate in the workforce.
    (k) Authorization of Appropriations.--There is authorized to be 
appropriated $5,000,000 for each of fiscal years 2019 through 2023 for 
purposes of carrying out this section.

                       TITLE VIII--MISCELLANEOUS
       Subtitle A--Synthetics Trafficking and Overdose Prevention

SEC. 8001. SHORT TITLE.
    This subtitle may be cited as the ``Synthetics Trafficking and 
Overdose Prevention Act of 2018'' or ``STOP Act of 2018''.
SEC. 8002. CUSTOMS FEES.
    (a) In General.--Section 13031(b)(9) of the Consolidated Omnibus 
Budget Reconciliation Act of 1985 (19 U.S.C. 58c(b)(9)) is amended by 
adding at the end the following:
        ``(D)(i) With respect to the processing of items that are sent 
    to the United States through the international postal network by 
    `Inbound Express Mail service' or `Inbound EMS' (as that service is 
    described in the mail classification schedule referred to in 
    section 3631 of title 39, United States Code), the following 
    payments are required:
            ``(I) $1 per Inbound EMS item.
            ``(II) If an Inbound EMS item is formally entered, the fee 
        provided for under subsection (a)(9), if applicable.
        ``(ii) Notwithstanding section 451 of the Tariff Act of 1930 
    (19 U.S.C. 1451), the payments required by clause (i), as allocated 
    pursuant to clause (iii)(I), shall be the only payments required 
    for reimbursement of U.S. Customs and Border Protection for customs 
    services provided in connection with the processing of an Inbound 
    EMS item.
        ``(iii)(I) The payments required by clause (i)(I) shall be 
    allocated as follows:
            ``(aa) 50 percent of the amount of the payments shall be 
        paid on a quarterly basis by the United States Postal Service 
        to the Commissioner of U.S. Customs and Border Protection in 
        accordance with regulations prescribed by the Secretary of the 
        Treasury to reimburse U.S. Customs and Border Protection for 
        customs services provided in connection with the processing of 
        Inbound EMS items.
            ``(bb) 50 percent of the amount of the payments shall be 
        retained by the Postal Service to reimburse the Postal Service 
        for services provided in connection with the customs processing 
        of Inbound EMS items.
        ``(II) Payments received by U.S. Customs and Border Protection 
    under subclause (I)(aa) shall, in accordance with section 524 of 
    the Tariff Act of 1930 (19 U.S.C. 1524), be deposited in the 
    Customs User Fee Account and used to directly reimburse each 
    appropriation for the amount paid out of that appropriation for the 
    costs incurred in providing services to international mail 
    facilities. Amounts deposited in accordance with the preceding 
    sentence shall be available until expended for the provision of 
    such services.
        ``(III) Payments retained by the Postal Service under subclause 
    (I)(bb) shall be used to directly reimburse the Postal Service for 
    the costs incurred in providing services in connection with the 
    customs processing of Inbound EMS items.
        ``(iv) Beginning in fiscal year 2021, the Secretary, in 
    consultation with the Postmaster General, may adjust, not more 
    frequently than once each fiscal year, the amount described in 
    clause (i)(I) to an amount commensurate with the costs of services 
    provided in connection with the customs processing of Inbound EMS 
    items, consistent with the obligations of the United States under 
    international agreements.''.
    (b) Conforming Amendments.--Section 13031(a) of the Consolidated 
Omnibus Budget Reconciliation Act of 1985 (19 U.S.C. 58c(a)) is 
amended--
        (1) in paragraph (6), by inserting ``(other than an item 
    subject to a fee under subsection (b)(9)(D))'' after ``customs 
    officer''; and
        (2) in paragraph (10)--
            (A) in subparagraph (C), in the matter preceding clause 
        (i), by inserting ``(other than Inbound EMS items described in 
        subsection (b)(9)(D))'' after ``release''; and
            (B) in the flush at the end, by inserting ``or of Inbound 
        EMS items described in subsection (b)(9)(D),'' after ``(C),''.
    (c) Effective Date.--The amendments made by this section shall take 
effect on January 1, 2020.
SEC. 8003. MANDATORY ADVANCE ELECTRONIC INFORMATION FOR POSTAL 
SHIPMENTS.
    (a) Mandatory Advance Electronic Information.--
        (1) In general.--Section 343(a)(3)(K) of the Trade Act of 2002 
    (Public Law 107-210; 19 U.S.C. 2071 note) is amended to read as 
    follows:
            ``(K)(i) The Secretary shall prescribe regulations 
        requiring the United States Postal Service to transmit the 
        information described in paragraphs (1) and (2) to the 
        Commissioner of U.S. Customs and Border Protection for 
        international mail shipments by the Postal Service (including 
        shipments to the Postal Service from foreign postal operators 
        that are transported by private carrier) consistent with the 
        requirements of this subparagraph.
            ``(ii) In prescribing regulations under clause (i), the 
        Secretary shall impose requirements for the transmission to the 
        Commissioner of information described in paragraphs (1) and (2) 
        for mail shipments described in clause (i) that are comparable 
        to the requirements for the transmission of such information 
        imposed on similar non-mail shipments of cargo, taking into 
        account the parameters set forth in subparagraphs (A) through 
        (J).
            ``(iii) The regulations prescribed under clause (i) shall 
        require the transmission of the information described in 
        paragraphs (1) and (2) with respect to a shipment as soon as 
        practicable in relation to the transportation of the shipment, 
        consistent with subparagraph (H).
            ``(iv) Regulations prescribed under clause (i) shall allow 
        for the requirements for the transmission to the Commissioner 
        of information described in paragraphs (1) and (2) for mail 
        shipments described in clause (i) to be implemented in phases, 
        as appropriate, by--
                ``(I) setting incremental targets for increasing the 
            percentage of such shipments for which information is 
            required to be transmitted to the Commissioner; and
                ``(II) taking into consideration--

                    ``(aa) the risk posed by such shipments;
                    ``(bb) the volume of mail shipped to the United 
                States by or through a particular country; and
                    ``(cc) the capacities of foreign postal operators 
                to provide that information to the Postal Service.

            ``(v)(I) Notwithstanding clause (iv), the Postal Service 
        shall, not later than December 31, 2018, arrange for the 
        transmission to the Commissioner of the information described 
        in paragraphs (1) and (2) for not less than 70 percent of the 
        aggregate number of mail shipments, including 100 percent of 
        mail shipments from the People's Republic of China, described 
        in clause (i).
            ``(II) If the requirements of subclause (I) are not met, 
        the Comptroller General of the United States shall submit to 
        the appropriate congressional committees, not later than June 
        30, 2019, a report--
                ``(aa) assessing the reasons for the failure to meet 
            those requirements; and
                ``(bb) identifying recommendations to improve the 
            collection by the Postal Service of the information 
            described in paragraphs (1) and (2).
            ``(vi)(I) Notwithstanding clause (iv), the Postal Service 
        shall, not later than December 31, 2020, arrange for the 
        transmission to the Commissioner of the information described 
        in paragraphs (1) and (2) for 100 percent of the aggregate 
        number of mail shipments described in clause (i).
            ``(II) The Commissioner, in consultation with the 
        Postmaster General, may determine to exclude a country from the 
        requirement described in subclause (I) to transmit information 
        for mail shipments described in clause (i) from the country if 
        the Commissioner determines that the country--
                ``(aa) does not have the capacity to collect and 
            transmit such information;
                ``(bb) represents a low risk for mail shipments that 
            violate relevant United States laws and regulations; and
                ``(cc) accounts for low volumes of mail shipments that 
            can be effectively screened for compliance with relevant 
            United States laws and regulations through an alternate 
            means.
            ``(III) The Commissioner shall, at a minimum on an annual 
        basis, re-evaluate any determination made under subclause (II) 
        to exclude a country from the requirement described in 
        subclause (I). If, at any time, the Commissioner determines 
        that a country no longer meets the requirements under subclause 
        (II), the Commissioner may not further exclude the country from 
        the requirement described in subclause (I).
            ``(IV) The Commissioner shall, on an annual basis, submit 
        to the appropriate congressional committees--
                ``(aa) a list of countries with respect to which the 
            Commissioner has made a determination under subclause (II) 
            to exclude the countries from the requirement described in 
            subclause (I); and
                ``(bb) information used to support such determination 
            with respect to such countries.
            ``(vii)(I) The Postmaster General shall, in consultation 
        with the Commissioner, refuse any shipments received after 
        December 31, 2020, for which the information described in 
        paragraphs (1) and (2) is not transmitted as required under 
        this subparagraph, except as provided in subclause (II).
            ``(II) If remedial action is warranted in lieu of refusal 
        of shipments pursuant to subclause (I), the Postmaster General 
        and the Commissioner shall take remedial action with respect to 
        the shipments, including destruction, seizure, controlled 
        delivery or other law enforcement initiatives, or correction of 
        the failure to provide the information described in paragraphs 
        (1) and (2) with respect to the shipments.
            ``(viii) Nothing in this subparagraph shall be construed to 
        limit the authority of the Secretary to obtain information 
        relating to international mail shipments from private carriers 
        or other appropriate parties.
            ``(ix) In this subparagraph, the term `appropriate 
        congressional committees' means--
                ``(I) the Committee on Finance and the Committee on 
            Homeland Security and Governmental Affairs of the Senate; 
            and
                ``(II) the Committee on Ways and Means, the Committee 
            on Oversight and Government Reform, and the Committee on 
            Homeland Security of the House of Representatives.''.
        (2) Joint strategic plan on mandatory advance information.--Not 
    later than 60 days after the date of the enactment of this Act, the 
    Secretary of Homeland Security and the Postmaster General shall 
    develop and submit to the appropriate congressional committees a 
    joint strategic plan detailing specific performance measures for 
    achieving--
            (A) the transmission of information as required by section 
        343(a)(3)(K) of the Trade Act of 2002, as amended by paragraph 
        (1); and
            (B) the presentation by the Postal Service to U.S. Customs 
        and Border Protection of all mail targeted by U.S. Customs and 
        Border Protection for inspection.
    (b) Capacity Building.--
        (1) In general.--Section 343(a) of the Trade Act of 2002 
    (Public Law 107-210; 19 U.S.C. 2071 note) is amended by adding at 
    the end the following:
        ``(5) Capacity building.--
            ``(A) In general.--The Secretary, with the concurrence of 
        the Secretary of State, and in coordination with the Postmaster 
        General and the heads of other Federal agencies, as 
        appropriate, may provide technical assistance, equipment, 
        technology, and training to enhance the capacity of foreign 
        postal operators--
                ``(i) to gather and provide the information required by 
            paragraph (3)(K); and
                ``(ii) to otherwise gather and provide postal shipment 
            information related to--

                    ``(I) terrorism;
                    ``(II) items the importation or introduction of 
                which into the United States is prohibited or 
                restricted, including controlled substances; and
                    ``(III) such other concerns as the Secretary 
                determines appropriate.

            ``(B) Provision of equipment and technology.--With respect 
        to the provision of equipment and technology under subparagraph 
        (A), the Secretary may lease, loan, provide, or otherwise 
        assist in the deployment of such equipment and technology under 
        such terms and conditions as the Secretary may prescribe, 
        including nonreimbursable loans or the transfer of ownership of 
        equipment and technology.''.
        (2) Joint strategic plan on capacity building.--Not later than 
    1 year after the date of the enactment of this Act, the Secretary 
    of Homeland Security and the Postmaster General shall, in 
    consultation with the Secretary of State, jointly develop and 
    submit to the appropriate congressional committees a joint 
    strategic plan--
            (A) detailing the extent to which U.S. Customs and Border 
        Protection and the United States Postal Service are engaged in 
        capacity building efforts under section 343(a)(5) of the Trade 
        Act of 2002, as added by paragraph (1);
            (B) describing plans for future capacity building efforts; 
        and
            (C) assessing how capacity building has increased the 
        ability of U.S. Customs and Border Protection and the Postal 
        Service to advance the goals of this subtitle and the 
        amendments made by this subtitle.
    (c) Report and Consultations by Secretary of Homeland Security and 
Postmaster General.--
        (1) Report.--Not later than 180 days after the date of the 
    enactment of this Act, and annually thereafter until 3 years after 
    the Postmaster General has met the requirement under clause (vi) of 
    subparagraph (K) of section 343(a)(3) of the Trade Act of 2002, as 
    amended by subsection (a)(1), the Secretary of Homeland Security 
    and the Postmaster General shall, in consultation with the 
    Secretary of State, jointly submit to the appropriate congressional 
    committees a report on compliance with that subparagraph that 
    includes the following:
            (A) An assessment of the status of the regulations required 
        to be promulgated under that subparagraph.
            (B) An update regarding new and existing agreements reached 
        with foreign postal operators for the transmission of the 
        information required by that subparagraph.
            (C) A summary of deliberations between the United States 
        Postal Service and foreign postal operators with respect to 
        issues relating to the transmission of that information.
            (D) A summary of the progress made in achieving the 
        transmission of that information for the percentage of 
        shipments required by that subparagraph.
            (E) An assessment of the quality of that information being 
        received by foreign postal operators, as determined by the 
        Secretary of Homeland Security, and actions taken to improve 
        the quality of that information.
            (F) A summary of policies established by the Universal 
        Postal Union that may affect the ability of the Postmaster 
        General to obtain the transmission of that information.
            (G) A summary of the use of technology to detect illicit 
        synthetic opioids and other illegal substances in international 
        mail parcels and planned acquisitions and advancements in such 
        technology.
            (H) Such other information as the Secretary of Homeland 
        Security and the Postmaster General consider appropriate with 
        respect to obtaining the transmission of information required 
        by that subparagraph.
        (2) Consultations.--Not later than 180 days after the date of 
    the enactment of this Act, and every 180 days thereafter until the 
    Postmaster General has met the requirement under clause (vi) of 
    section 343(a)(3)(K) of the Trade Act of 2002, as amended by 
    subsection (a)(1), to arrange for the transmission of information 
    with respect to 100 percent of the aggregate number of mail 
    shipments described in clause (i) of that section, the Secretary of 
    Homeland Security and the Postmaster General shall provide 
    briefings to the appropriate congressional committees on the 
    progress made in achieving the transmission of that information for 
    that percentage of shipments.
    (d) Government Accountability Office Report.--Not later than June 
30, 2019, the Comptroller General of the United States shall submit to 
the appropriate congressional committees a report--
        (1) assessing the progress of the United States Postal Service 
    in achieving the transmission of the information required by 
    subparagraph (K) of section 343(a)(3) of the Trade Act of 2002, as 
    amended by subsection (a)(1), for the percentage of shipments 
    required by that subparagraph;
        (2) assessing the quality of the information received from 
    foreign postal operators for targeting purposes;
        (3) assessing the specific percentage of targeted mail 
    presented by the Postal Service to U.S. Customs and Border 
    Protection for inspection;
        (4) describing the costs of collecting the information required 
    by such subparagraph (K) from foreign postal operators and the 
    costs of implementing the use of that information;
        (5) assessing the benefits of receiving that information with 
    respect to international mail shipments;
        (6) assessing the feasibility of assessing a customs fee under 
    section 13031(b)(9) of the Consolidated Omnibus Budget 
    Reconciliation Act of 1985, as amended by section 8002, on 
    international mail shipments other than Inbound Express Mail 
    service in a manner consistent with the obligations of the United 
    States under international agreements; and
        (7) identifying recommendations, including recommendations for 
    legislation, to improve the compliance of the Postal Service with 
    such subparagraph (K), including an assessment of whether the 
    detection of illicit synthetic opioids in the international mail 
    would be improved by--
            (A) requiring the Postal Service to serve as the consignee 
        for international mail shipments containing goods; or
            (B) designating a customs broker to act as an importer of 
        record for international mail shipments containing goods.
    (e) Technical Correction.--Section 343 of the Trade Act of 2002 
(Public Law 107-210; 19 U.S.C. 2071 note) is amended in the section 
heading by striking ``advanced'' and inserting ``advance''.
    (f) Appropriate Congressional Committees Defined.--In this section, 
the term ``appropriate congressional committees'' means--
        (1) the Committee on Finance and the Committee on Homeland 
    Security and Governmental Affairs of the Senate; and
        (2) the Committee on Ways and Means, the Committee on Oversight 
    and Government Reform, and the Committee on Homeland Security of 
    the House of Representatives.
SEC. 8004. INTERNATIONAL POSTAL AGREEMENTS.
    (a) Existing Agreements.--
        (1) In general.--In the event that any provision of this 
    subtitle, or any amendment made by this subtitle, is determined to 
    be in violation of obligations of the United States under any 
    postal treaty, convention, or other international agreement related 
    to international postal services, or any amendment to such an 
    agreement, the Secretary of State should negotiate to amend the 
    relevant provisions of the agreement so that the United States is 
    no longer in violation of the agreement.
        (2) Rule of construction.--Nothing in this subsection shall be 
    construed to permit delay in the implementation of this subtitle or 
    any amendment made by this subtitle.
    (b) Future Agreements.--
        (1) Consultations.--Before entering into, on or after the date 
    of the enactment of this Act, any postal treaty, convention, or 
    other international agreement related to international postal 
    services, or any amendment to such an agreement, that is related to 
    the ability of the United States to secure the provision of advance 
    electronic information by foreign postal operators, the Secretary 
    of State should consult with the appropriate congressional 
    committees (as defined in section 8003(f)).
        (2) Expedited negotiation of new agreement.--To the extent that 
    any new postal treaty, convention, or other international agreement 
    related to international postal services would improve the ability 
    of the United States to secure the provision of advance electronic 
    information by foreign postal operators as required by regulations 
    prescribed under section 343(a)(3)(K) of the Trade Act of 2002, as 
    amended by section 8003(a)(1), the Secretary of State should 
    expeditiously conclude such an agreement.
SEC. 8005. COST RECOUPMENT.
    (a) In General.--The United States Postal Service shall, to the 
extent practicable and otherwise recoverable by law, ensure that all 
costs associated with complying with this subtitle and amendments made 
by this subtitle are charged directly to foreign shippers or foreign 
postal operators.
    (b) Costs Not Considered Revenue.--The recovery of costs under 
subsection (a) shall not be deemed revenue for purposes of subchapter I 
and II of chapter 36 of title 39, United States Code, or regulations 
prescribed under that chapter.
SEC. 8006. DEVELOPMENT OF TECHNOLOGY TO DETECT ILLICIT NARCOTICS.
    (a) In General.--The Postmaster General and the Commissioner of 
U.S. Customs and Border Protection, in coordination with the heads of 
other agencies as appropriate, shall collaborate to identify and 
develop technology for the detection of illicit fentanyl, other 
synthetic opioids, and other narcotics and psychoactive substances 
entering the United States by mail.
    (b) Outreach to Private Sector.--The Postmaster General and the 
Commissioner shall conduct outreach to private sector entities to 
gather information regarding the current state of technology to 
identify areas for innovation relating to the detection of illicit 
fentanyl, other synthetic opioids, and other narcotics and psychoactive 
substances entering the United States.
SEC. 8007. CIVIL PENALTIES FOR POSTAL SHIPMENTS.
    Section 436 of the Tariff Act of 1930 (19 U.S.C. 1436) is amended 
by adding at the end the following new subsection:
    ``(e) Civil Penalties for Postal Shipments.--
        ``(1) Civil penalty.--A civil penalty shall be imposed against 
    the United States Postal Service if the Postal Service accepts a 
    shipment in violation of section 343(a)(3)(K)(vii)(I) of the Trade 
    Act of 2002.
        ``(2) Modification of civil penalty.--
            ``(A) In general.--U.S. Customs and Border Protection shall 
        reduce or dismiss a civil penalty imposed pursuant to paragraph 
        (1) if U.S. Customs and Border Protection determines that the 
        United States Postal Service--
                ``(i) has a low error rate in compliance with section 
            343(a)(3)(K) of the Trade Act of 2002;
                ``(ii) is cooperating with U.S. Customs and Border 
            Protection with respect to the violation of section 
            343(a)(3)(K)(vii)(I) of the Trade Act of 2002; or
                ``(iii) has taken remedial action to prevent future 
            violations of section 343(a)(3)(K)(vii)(I) of the Trade Act 
            of 2002.
            ``(B) Written notification.--U.S. Customs and Border 
        Protection shall issue a written notification to the Postal 
        Service with respect to each exercise of the authority of 
        subparagraph (A) to reduce or dismiss a civil penalty imposed 
        pursuant to paragraph (1).
        ``(3) Ongoing lack of compliance.--If U.S. Customs and Border 
    Protection determines that the United States Postal Service--
            ``(A) has repeatedly committed violations of section 
        343(a)(3)(K)(vii)(I) of the Trade Act of 2002,
            ``(B) has failed to cooperate with U.S. Customs and Border 
        Protection with respect to violations of section 
        343(a)(3)(K)(vii)(I) of the Trade Act of 2002, and
            ``(C) has an increasing error rate in compliance with 
        section 343(a)(3)(K) of the Trade Act of 2002,
    civil penalties may be imposed against the United States Postal 
    Service until corrective action, satisfactory to U.S. Customs and 
    Border Protection, is taken.''.
SEC. 8008. REPORT ON VIOLATIONS OF ARRIVAL, REPORTING, ENTRY, AND 
CLEARANCE REQUIREMENTS AND FALSITY OR LACK OF MANIFEST.
    (a) In General.--The Commissioner of U.S. Customs and Border 
Protection shall submit to the appropriate congressional committees an 
annual report that contains the information described in subsection (b) 
with respect to each violation of section 436 of the Tariff Act of 1930 
(19 U.S.C. 1436), as amended by section 8007, and section 584 of such 
Act (19 U.S.C. 1584) that occurred during the previous year.
    (b) Information Described.--The information described in this 
subsection is the following:
        (1) The name and address of the violator.
        (2) The specific violation that was committed.
        (3) The location or port of entry through which the items were 
    transported.
        (4) An inventory of the items seized, including a description 
    of the items and the quantity seized.
        (5) The location from which the items originated.
        (6) The entity responsible for the apprehension or seizure, 
    organized by location or port of entry.
        (7) The amount of penalties assessed by U.S. Customs and Border 
    Protection, organized by name of the violator and location or port 
    of entry.
        (8) The amount of penalties that U.S. Customs and Border 
    Protection could have levied, organized by name of the violator and 
    location or port of entry.
        (9) The rationale for negotiating lower penalties, organized by 
    name of the violator and location or port of entry.
    (c) Appropriate Congressional Committees Defined.--In this section, 
the term ``appropriate congressional committees'' means--
        (1) the Committee on Finance and the Committee on Homeland 
    Security and Governmental Affairs of the Senate; and
        (2) the Committee on Ways and Means, the Committee on Oversight 
    and Government Reform, and the Committee on Homeland Security of 
    the House of Representatives.
SEC. 8009. EFFECTIVE DATE; REGULATIONS.
    (a) Effective Date.--This subtitle and the amendments made by this 
subtitle (other than the amendments made by section 8002) shall take 
effect on the date of the enactment of this Act.
    (b) Regulations.--Not later than 1 year after the date of the 
enactment of this Act, such regulations as are necessary to carry out 
this subtitle and the amendments made by this subtitle shall be 
prescribed.

         Subtitle B--Opioid Addiction Recovery Fraud Prevention

SEC. 8021. SHORT TITLE.
    This subtitle may be cited as the ``Opioid Addiction Recovery Fraud 
Prevention Act of 2018''.
SEC. 8022. DEFINITIONS.
    For purposes of this subtitle only, and not be construed or applied 
as to challenge or affect the characterization, definition, or 
treatment under any other statute, regulation, or rule:
        (1) Substance use disorder treatment product.--The term 
    ``substance use disorder treatment product'' means a product for 
    use or marketed for use in the treatment, cure, or prevention of a 
    substance use disorder, including an opioid use disorder.
        (2) Substance use disorder treatment service.--The term 
    ``substance use disorder treatment service'' means a service that 
    purports to provide referrals to treatment, treatment, or recovery 
    housing for people diagnosed with, having, or purporting to have a 
    substance use disorder, including an opioid use disorder.
SEC. 8023. UNFAIR OR DECEPTIVE ACTS OR PRACTICES WITH RESPECT TO 
SUBSTANCE USE DISORDER TREATMENT SERVICE AND PRODUCTS.
    (a) Unlawful Activity.--It is unlawful to engage in an unfair or 
deceptive act or practice with respect to any substance use disorder 
treatment service or substance use disorder treatment product.
    (b) Enforcement by the Federal Trade Commission.--
        (1) Unfair or deceptive acts or practices.--A violation of 
    subsection (a) shall be treated as a violation of a rule under 
    section 18 of the Federal Trade Commission Act (15 U.S.C. 57a) 
    regarding unfair or deceptive acts or practices.
        (2) Powers of the federal trade commission.--
            (A) In general.--The Federal Trade Commission shall enforce 
        this section in the same manner, by the same means, and with 
        the same jurisdiction, powers, and duties as though all 
        applicable terms and provisions of the Federal Trade Commission 
        Act (15 U.S.C. 41 et seq.) were incorporated into and made a 
        part of this section.
            (B) Privileges and immunities.--Any person who violates 
        subsection (a) shall be subject to the penalties and entitled 
        to the privileges and immunities provided in the Federal Trade 
        Commission Act as though all applicable terms and provisions of 
        the Federal Trade Commission Act (15 U.S.C. 41 et seq.) were 
        incorporated and made part of this section.
    (c) Authority Preserved.--Nothing in this subtitle shall be 
construed to limit the authority of the Federal Trade Commission or the 
Food and Drug Administration under any other provision of law.

  Subtitle C--Addressing Economic and Workforce Impacts of the Opioid 
                                 Crisis

SEC. 8041. ADDRESSING ECONOMIC AND WORKFORCE IMPACTS OF THE OPIOID 
CRISIS.
    (a) Definitions.--Except as otherwise expressly provided, in this 
section:
        (1) WIOA definitions.--The terms ``core program'', ``individual 
    with a barrier to employment'', ``local area'', ``local board'', 
    ``one-stop operator'', ``outlying area'', ``State'', ``State 
    board'', and ``supportive services'' have the meanings given the 
    terms in section 3 of the Workforce Innovation and Opportunity Act 
    (29 U.S.C. 3102).
        (2) Education provider.--The term ``education provider'' 
    means--
            (A) an institution of higher education, as defined in 
        section 101 of the Higher Education Act of 1965 (20 U.S.C. 
        1001); or
            (B) a postsecondary vocational institution, as defined in 
        section 102(c) of such Act (20 U.S.C. 1002(c)).
        (3) Eligible entity.--The term ``eligible entity'' means--
            (A) a State workforce agency;
            (B) an outlying area; or
            (C) a Tribal entity.
        (4) Participating partnership.--The term ``participating 
    partnership'' means a partnership--
            (A) evidenced by a written contract or agreement; and
            (B) including, as members of the partnership, a local board 
        receiving a subgrant under subsection (d) and 1 or more of the 
        following:
                (i) The eligible entity.
                (ii) A treatment provider.
                (iii) An employer or industry organization.
                (iv) An education provider.
                (v) A legal service or law enforcement organization.
                (vi) A faith-based or community-based organization.
                (vii) Other State or local agencies, including counties 
            or local governments.
                (viii) Other organizations, as determined to be 
            necessary by the local board.
                (ix) Indian Tribes or tribal organizations.
        (5) Program participant.--The term ``program participant'' 
    means an individual who--
            (A) is a member of a population of workers described in 
        subsection (e)(2) that is served by a participating partnership 
        through the pilot program under this section; and
            (B) enrolls with the applicable participating partnership 
        to receive any of the services described in subsection (e)(3).
        (6) Provider of peer recovery support services.--The term 
    ``provider of peer recovery support services'' means a provider 
    that delivers peer recovery support services through an 
    organization described in section 547(a) of the Public Health 
    Service Act (42 U.S.C. 290ee-2(a)).
        (7) Secretary.--The term ``Secretary'' means the Secretary of 
    Labor.
        (8) State workforce agency.--The term ``State workforce 
    agency'' means the lead State agency with responsibility for the 
    administration of a program under chapter 2 or 3 of subtitle B of 
    title I of the Workforce Innovation and Opportunity Act (29 U.S.C. 
    3161 et seq., 3171 et seq.).
        (9) Substance use disorder.--The term ``substance use 
    disorder'' has the meaning given such term by the Assistant 
    Secretary for Mental Health and Substance Use.
        (10) Treatment provider.--The term ``treatment provider''--
            (A) means a health care provider that--
                (i) offers services for treating substance use 
            disorders and is licensed in accordance with applicable 
            State law to provide such services; and
                (ii) accepts health insurance for such services, 
            including coverage under title XIX of the Social Security 
            Act (42 U.S.C. 1396 et seq.); and
            (B) may include--
                (i) a nonprofit provider of peer recovery support 
            services;
                (ii) a community health care provider;
                (iii) a Federally qualified health center (as defined 
            in section 1861(aa) of the Social Security Act (42 U.S.C. 
            1395x));
                (iv) an Indian health program (as defined in section 3 
            of the Indian Health Care Improvement Act (25 U.S.C. 
            1603)), including an Indian health program that serves an 
            urban center (as defined in such section); and
                (v) a Native Hawaiian health center (as defined in 
            section 12 of the Native Hawaiian Health Care Improvement 
            Act (42 U.S.C. 11711)).
        (11) Tribal entity.--The term ``Tribal entity'' includes any 
    Indian Tribe, tribal organization, Indian-controlled organization 
    serving Indians, Native Hawaiian organization, or Alaska Native 
    entity, as such terms are defined or used in section 166 of the 
    Workforce Innovation and Opportunity Act (29 U.S.C. 3221).
    (b) Pilot Program and Grants Authorized.--
        (1) In general.--The Secretary, in consultation with the 
    Secretary of Health and Human Services, shall carry out a pilot 
    program to address economic and workforce impacts associated with a 
    high rate of a substance use disorder. In carrying out the pilot 
    program, the Secretary shall make grants, on a competitive basis, 
    to eligible entities to enable such entities to make subgrants to 
    local boards to address the economic and workforce impacts 
    associated with a high rate of a substance use disorder.
        (2) Grant amounts.--The Secretary shall make each such grant in 
    an amount that is not less than $500,000, and not more than 
    $5,000,000, for a fiscal year.
    (c) Grant Applications.--
        (1) In general.--An eligible entity applying for a grant under 
    this section shall submit an application to the Secretary at such 
    time and in such form and manner as the Secretary may reasonably 
    require, including the information described in this subsection.
        (2) Significant impact on community by opioid and substance use 
    disorder-related problems.--
            (A) Demonstration.--An eligible entity shall include in the 
        application--
                (i) information that demonstrates significant impact on 
            the community by problems related to opioid abuse or 
            another substance use disorder, by--

                    (I) identifying the counties, communities, regions, 
                or local areas that have been significantly impacted 
                and will be served through the grant (each referred to 
                in this section as a ``service area''); and
                    (II) demonstrating for each such service area, an 
                increase equal to or greater than the national increase 
                in such problems, between--

                        (aa) 1999; and
                        (bb) 2016 or the latest year for which data are 
                    available; and
                (ii) a description of how the eligible entity will 
            prioritize support for significantly impacted service areas 
            described in clause (i)(I).
            (B) Information.--To meet the requirements described in 
        subparagraph (A)(i)(II), the eligible entity may use 
        information including data on--
                (i) the incidence or prevalence of opioid abuse and 
            other substance use disorders;
                (ii) the age-adjusted rate of drug overdose deaths, as 
            determined by the Director of the Centers for Disease 
            Control and Prevention;
                (iii) the rate of non-fatal hospitalizations related to 
            opioid abuse or other substance use disorders;
                (iv) the number of arrests or convictions, or a 
            relevant law enforcement statistic, that reasonably shows 
            an increase in opioid abuse or another substance use 
            disorder; or
                (v) in the case of an eligible entity described in 
            subsection (a)(3)(C), other alternative relevant data as 
            determined appropriate by the Secretary.
            (C) Support for state strategy.--The eligible entity may 
        include in the application information describing how the 
        proposed services and activities are aligned with the State, 
        outlying area, or Tribal strategy, as applicable, for 
        addressing problems described in subparagraph (A) in specific 
        service areas or across the State, outlying area, or Tribal 
        land.
        (3) Economic and employment conditions demonstrate additional 
    federal support needed.--
            (A) Demonstration.--An eligible entity shall include in the 
        application information that demonstrates that a high rate of a 
        substance use disorder has caused, or is coincident to--
                (i) an economic or employment downturn in the service 
            area; or
                (ii) persistent economically depressed conditions in 
            such service area.
            (B) Information.--To meet the requirements of subparagraph 
        (A), an eligible entity may use information including--
                (i) documentation of any layoff, announced future 
            layoff, legacy industry decline, decrease in an employment 
            or labor market participation rate, or economic impact, 
            whether or not the result described in this clause is 
            overtly related to a high rate of a substance use disorder;
                (ii) documentation showing decreased economic activity 
            related to, caused by, or contributing to a high rate of a 
            substance use disorder, including a description of how the 
            service area has been impacted, or will be impacted, by 
            such a decrease;
                (iii) information on economic indicators, labor market 
            analyses, information from public announcements, and 
            demographic and industry data;
                (iv) information on rapid response activities (as 
            defined in section 3 of the Workforce Innovation and 
            Opportunity Act (29 U.S.C. 3102)) that have been or will be 
            conducted, including demographic data gathered by employer 
            or worker surveys or through other methods;
                (v) data or documentation, beyond anecdotal evidence, 
            showing that employers face challenges filling job 
            vacancies due to a lack of skilled workers able to pass a 
            drug test; or
                (vi) any additional relevant data or information on the 
            economy, workforce, or another aspect of the service area 
            to support the application.
    (d) Subgrant Authorization and Application Process.--
        (1) Subgrants authorized.--
            (A) In general.--An eligible entity receiving a grant under 
        subsection (b)--
                (i) may use not more than 5 percent of the grant funds 
            for the administrative costs of carrying out the grant;
                (ii) in the case of an eligible entity described in 
            subparagraph (A) or (B) of subsection (a)(3), shall use the 
            remaining grant funds to make subgrants to local entities 
            in the service area to carry out the services and 
            activities described in subsection (e); and
                (iii) in the case of an eligible entity described in 
            subsection (a)(3)(C), shall use the remaining grant funds 
            to carry out the services and activities described in 
            subsection (e).
            (B) Equitable distribution.--In making subgrants under this 
        subsection, an eligible entity shall ensure, to the extent 
        practicable, the equitable distribution of subgrants, based 
        on--
                (i) geography (such as urban and rural distribution); 
            and
                (ii) significantly impacted service areas as described 
            in subsection (c)(2).
            (C) Timing of subgrant funds distribution.--An eligible 
        entity making subgrants under this subsection shall disburse 
        subgrant funds to a local board receiving a subgrant from the 
        eligible entity by the later of--
                (i) the date that is 90 days after the date on which 
            the Secretary makes the funds available to the eligible 
            entity; or
                (ii) the date that is 15 days after the date that the 
            eligible entity makes the subgrant under subparagraph 
            (A)(ii).
        (2) Subgrant application.--
            (A) In general.--A local board desiring to receive a 
        subgrant under this subsection from an eligible entity shall 
        submit an application at such time and in such manner as the 
        eligible entity may reasonably require, including the 
        information described in this paragraph.
            (B) Contents.--Each application described in subparagraph 
        (A) shall include--
                (i) an analysis of the estimated performance of the 
            local board in carrying out the proposed services and 
            activities under the subgrant--

                    (I) based on--

                        (aa) primary indicators of performance 
                    described in section 116(c)(1)(A)(i) of the 
                    Workforce Innovation and Opportunity Act (29 U.S.C. 
                    3141(c)(1)(A)(i), to assess estimated effectiveness 
                    of the proposed services and activities, including 
                    the estimated number of individuals with a 
                    substance use disorder who may be served by the 
                    proposed services and activities;
                        (bb) the record of the local board in serving 
                    individuals with a barrier to employment; and
                        (cc) the ability of the local board to 
                    establish a participating partnership; and

                    (II) which may include or utilize--

                        (aa) data from the National Center for Health 
                    Statistics of the Centers for Disease Control and 
                    Prevention;
                        (bb) data from the Center for Behavioral Health 
                    Statistics and Quality of the Substance Abuse and 
                    Mental Health Services Administration;
                        (cc) State vital statistics;
                        (dd) municipal police department records;
                        (ee) reports from local coroners; or
                        (ff) other relevant data; and
                (ii) in the case of a local board proposing to serve a 
            population described in subsection (e)(2)(B), a 
            demonstration of the workforce shortage in the professional 
            area to be addressed under the subgrant (which may include 
            substance use disorder treatment and related services, non-
            addictive pain therapy and pain management services, mental 
            health care treatment services, emergency response 
            services, or mental health care), which shall include 
            information that can demonstrate such a shortage, such as--

                    (I) the distance between--

                        (aa) communities affected by opioid abuse or 
                    another substance use disorder; and
                        (bb) facilities or professionals offering 
                    services in the professional area; or

                    (II) the maximum capacity of facilities or 
                professionals to serve individuals in an affected 
                community, or increases in arrests related to opioid or 
                another substance use disorder, overdose deaths, or 
                nonfatal overdose emergencies in the community.

    (e) Subgrant Services and Activities.--
        (1) In general.--Each local board that receives a subgrant 
    under subsection (d) shall carry out the services and activities 
    described in this subsection through a participating partnership.
        (2) Selection of population to be served.--A participating 
    partnership shall elect to provide services and activities under 
    the subgrant to one or both of the following populations of 
    workers:
            (A) Workers, including dislocated workers, individuals with 
        barriers to employment, new entrants in the workforce, or 
        incumbent workers (employed or underemployed), each of whom--
                (i) is directly or indirectly affected by a high rate 
            of a substance use disorder; and
                (ii) voluntarily confirms that the worker, or a friend 
            or family member of the worker, has a history of opioid 
            abuse or another substance use disorder.
            (B) Workers, including dislocated workers, individuals with 
        barriers to employment, new entrants in the workforce, or 
        incumbent workers (employed or underemployed), who--
                (i) seek to transition to professions that support 
            individuals with a substance use disorder or at risk for 
            developing such disorder, such as professions that 
            provide--

                    (I) substance use disorder treatment and related 
                services;
                    (II) services offered through providers of peer 
                recovery support services;
                    (III) non-addictive pain therapy and pain 
                management services;
                    (IV) emergency response services; or
                    (V) mental health care; and

                (ii) need new or upgraded skills to better serve such a 
            population of struggling or at-risk individuals.
        (3) Services and activities.--Each participating partnership 
    shall use funds available through a subgrant under this subsection 
    to carry out 1 or more of the following:
            (A) Engaging employers.--Engaging with employers to--
                (i) learn about the skill and hiring requirements of 
            employers;
                (ii) learn about the support needed by employers to 
            hire and retain program participants, and other individuals 
            with a substance use disorder, and the support needed by 
            such employers to obtain their commitment to testing 
            creative solutions to employing program participants and 
            such individuals;
                (iii) connect employers and workers to on-the-job or 
            customized training programs before or after layoff to help 
            facilitate reemployment;
                (iv) connect employers with an education provider to 
            develop classroom instruction to complement on-the-job 
            learning for program participants and such individuals;
                (v) help employers develop the curriculum design of a 
            work-based learning program for program participants and 
            such individuals;
                (vi) help employers employ program participants or such 
            individuals engaging in a work-based learning program for a 
            transitional period before hiring such a program 
            participant or individual for full-time employment of not 
            less than 30 hours a week; or
                (vii) connect employers to program participants 
            receiving concurrent outpatient treatment and job training 
            services.
            (B) Screening services.--Providing screening services, 
        which may include--
                (i) using an evidence-based screening method to screen 
            each individual seeking participation in the pilot program 
            to determine whether the individual has a substance use 
            disorder;
                (ii) conducting an assessment of each such individual 
            to determine the services needed for such individual to 
            obtain or retain employment, including an assessment of 
            strengths and general work readiness; or
                (iii) accepting walk-ins or referrals from employers, 
            labor organizations, or other entities recommending 
            individuals to participate in such program.
            (C) Individual treatment and employment plan.--Developing 
        an individual treatment and employment plan for each program 
        participant--
                (i) in coordination, as appropriate, with other 
            programs serving the participant such as the core programs 
            within the workforce development system under the Workforce 
            Innovation and Opportunity Act (29 U.S.C. 3101 et seq.); 
            and
                (ii) which shall include providing a case manager to 
            work with each participant to develop the plan, which may 
            include--

                    (I) identifying employment and career goals;
                    (II) exploring career pathways that lead to in-
                demand industries and sectors, as determined by the 
                State board and the head of the State workforce agency 
                or, as applicable, the Tribal entity;
                    (III) setting appropriate achievement objectives to 
                attain the employment and career goals identified under 
                subclause (I); or
                    (IV) developing the appropriate combination of 
                services to enable the participant to achieve the 
                employment and career goals identified under subclause 
                (I).

            (D) Outpatient treatment and recovery care.--In the case of 
        a participating partnership serving program participants 
        described in paragraph (2)(A) with a substance use disorder, 
        providing individualized and group outpatient treatment and 
        recovery services for such program participants that are 
        offered during the day and evening, and on weekends. Such 
        treatment and recovery services--
                (i) shall be based on a model that utilizes combined 
            behavioral interventions and other evidence-based or 
            evidence-informed interventions; and
                (ii) may include additional services such as--

                    (I) health, mental health, addiction, or other 
                forms of outpatient treatment that may impact a 
                substance use disorder and co-occurring conditions;
                    (II) drug testing for a current substance use 
                disorder prior to enrollment in career or training 
                services or prior to employment;
                    (III) linkages to community services, including 
                services offered by partner organizations designed to 
                support program participants; or
                    (IV) referrals to health care, including referrals 
                to substance use disorder treatment and mental health 
                services.

            (E) Supportive services.--Providing supportive services, 
        which shall include services such as--
                (i) coordinated wraparound services to provide maximum 
            support for program participants to assist the program 
            participants in maintaining employment and recovery for not 
            less than 12 months, as appropriate;
                (ii) assistance in establishing eligibility for 
            assistance under Federal, State, Tribal, and local programs 
            providing health services, mental health services, 
            vocational services, housing services, transportation 
            services, social services, or services through early 
            childhood education programs (as defined in section 103 of 
            the Higher Education Act of 1965 (20 U.S.C. 1003));
                (iii) services offered through providers of peer 
            recovery support services;
                (iv) networking and mentorship opportunities; or
                (v) any supportive services determined necessary by the 
            local board.
            (F) Career and job training services.--Offering career 
        services and training services, and related services, 
        concurrently or sequentially with the services provided under 
        subparagraphs (B) through (E). Such services shall include the 
        following:
                (i) Services provided to program participants who are 
            in a pre-employment stage of the program, which may 
            include--

                    (I) initial education and skills assessments;
                    (II) traditional classroom training funded through 
                individual training accounts under chapter 3 of 
                subtitle B of title I of the Workforce Innovation and 
                Opportunity Act (29 U.S.C. 3171 et seq.);
                    (III) services to promote employability skills such 
                as punctuality, personal maintenance skills, and 
                professional conduct;
                    (IV) in-depth interviewing and evaluation to 
                identify employment barriers and to develop individual 
                employment plans;
                    (V) career planning that includes--

                        (aa) career pathways leading to in-demand, 
                    high-wage jobs; and
                        (bb) job coaching, job matching, and job 
                    placement services;

                    (VI) provision of payments and fees for employment 
                and training-related applications, tests, and 
                certifications; or
                    (VII) any other appropriate career service or 
                training service described in section 134(c) of the 
                Workforce Innovation and Opportunity Act (29 U.S.C. 
                3174(c)).

                (ii) Services provided to program participants during 
            their first 6 months of employment to ensure job retention, 
            which may include--

                    (I) case management and support services, including 
                a continuation of the services described in clause (i);
                    (II) a continuation of skills training, and career 
                and technical education, described in clause (i) that 
                is conducted in collaboration with the employers of 
                such participants;
                    (III) mentorship services and job retention support 
                for such participants; or
                    (IV) targeted training for managers and workers 
                working with such participants (such as mentors), and 
                human resource representatives in the business in which 
                such participants are employed.

                (iii) Services to assist program participants in 
            maintaining employment for not less than 12 months, as 
            appropriate.
            (G) Proven and promising practices.--Leading efforts in the 
        service area to identify and promote proven and promising 
        strategies and initiatives for meeting the needs of employers 
        and program participants.
        (4) Limitations.--A participating partnership may not use--
            (A) more than 10 percent of the funds received under a 
        subgrant under subsection (d) for the administrative costs of 
        the partnership;
            (B) more than 10 percent of the funds received under such 
        subgrant for the provision of treatment and recovery services, 
        as described in paragraph (3)(D); and
            (C) more than 10 percent of the funds received under such 
        subgrant for the provision of supportive services described in 
        paragraph (3)(E) to program participants.
    (f) Performance Accountability.--
        (1) Reports.--The Secretary shall establish quarterly reporting 
    requirements for recipients of grants and subgrants under this 
    section that, to the extent practicable, are based on the 
    performance accountability system under section 116 of the 
    Workforce Innovation and Opportunity Act (29 U.S.C. 3141) and, in 
    the case of a grant awarded to an eligible entity described in 
    subsection (a)(3)(C), section 166(h) of such Act (29 U.S.C. 
    3221(h)), including the indicators described in subsection 
    (c)(1)(A)(i) of such section 116 and the requirements for local 
    area performance reports under subsection (d) of such section 116.
        (2) Evaluations.--
            (A) Authority to enter into agreements.--The Secretary 
        shall ensure that an independent evaluation is conducted on the 
        pilot program carried out under this section to determine the 
        impact of the program on employment of individuals with 
        substance use disorders. The Secretary shall enter into an 
        agreement with eligible entities receiving grants under this 
        section to pay for all or part of such evaluation.
            (B) Methodologies to be used.--The independent evaluation 
        required under this paragraph shall use experimental designs 
        using random assignment or, when random assignment is not 
        feasible, other reliable, evidence-based research methodologies 
        that allow for the strongest possible causal inferences.
    (g) Funding.--
        (1) Covered fiscal year.--In this subsection, the term 
    ``covered fiscal year'' means any of fiscal years 2019 through 
    2023.
        (2) Using funding for national dislocated worker grants.--
    Subject to paragraph (4) and notwithstanding section 132(a)(2)(A) 
    and subtitle D of the Workforce Innovation and Opportunity Act (29 
    U.S.C. 3172(a)(2)(A), 3221 et seq.), the Secretary may use, to 
    carry out the pilot program under this section for a covered fiscal 
    year--
            (A) funds made available to carry out section 170 of such 
        Act (29 U.S.C. 3225) for that fiscal year;
            (B) funds made available to carry out section 170 of such 
        Act that remain available for that fiscal year; and
            (C) funds that remain available under section 172(f) of 
        such Act (29 U.S.C. 3227(f)).
        (3) Availability of funds.--Funds appropriated under section 
    136(c) of such Act (29 U.S.C. 3181(c)) and made available to carry 
    out section 170 of such Act for a fiscal year shall remain 
    available for use under paragraph (2) for a subsequent fiscal year 
    until expended.
        (4) Limitation.--The Secretary may not use more than 
    $100,000,000 of the funds described in paragraph (2) for any 
    covered fiscal year under this section.

     Subtitle D--Peer Support Counseling Program for Women Veterans

SEC. 8051. PEER SUPPORT COUNSELING PROGRAM FOR WOMEN VETERANS.
    (a) In General.--Section 1720F(j) of title 38, United States Code, 
is amended by adding at the end the following new paragraph:
    ``(4)(A) As part of the counseling program under this subsection, 
the Secretary shall emphasize appointing peer support counselors for 
women veterans. To the degree practicable, the Secretary shall seek to 
recruit women peer support counselors with expertise in--
        ``(i) female gender-specific issues and services;
        ``(ii) the provision of information about services and benefits 
    provided under laws administered by the Secretary; or
        ``(iii) employment mentoring.
    ``(B) To the degree practicable, the Secretary shall emphasize 
facilitating peer support counseling for women veterans who are 
eligible for counseling and services under section 1720D of this title, 
have post-traumatic stress disorder or suffer from another mental 
health condition, are homeless or at risk of becoming homeless, or are 
otherwise at increased risk of suicide, as determined by the Secretary.
    ``(C) The Secretary shall conduct outreach to inform women veterans 
about the program and the assistance available under this paragraph.
    ``(D) In carrying out this paragraph, the Secretary shall 
coordinate with such community organizations, State and local 
governments, institutions of higher education, chambers of commerce, 
local business organizations, organizations that provide legal 
assistance, and other organizations as the Secretary considers 
appropriate.
    ``(E) In carrying out this paragraph, the Secretary shall provide 
adequate training for peer support counselors, including training 
carried out under the national program of training required by section 
304(c) of the Caregivers and Veterans Omnibus Health Services Act of 
2010 (38 U.S.C. 1712A note).''.
    (b) Funding.--The Secretary of Veterans Affairs shall carry out 
paragraph (4) of section 1720F(j) of title 38, United States Code, as 
added by subsection (a), using funds otherwise made available to the 
Secretary. No additional funds are authorized to be appropriated by 
reason of such paragraph.
    (c) Report to Congress.--Not later than 2 years after the date of 
the enactment of this Act, the Secretary of Veterans Affairs shall 
submit to the Committees on Veterans' Affairs of the Senate and House 
of Representatives a report on the peer support counseling program 
under section 1720F(j) of title 38, United States Code, as amended by 
this section. Such report shall include--
        (1) the number of peer support counselors in the program;
        (2) an assessment of the effectiveness of the program; and
        (3) a description of the oversight of the program.

              Subtitle E--Treating Barriers to Prosperity

SEC. 8061. SHORT TITLE.
    This subtitle may be cited as the ``Treating Barriers to Prosperity 
Act of 2018''.
SEC. 8062. DRUG ABUSE MITIGATION INITIATIVE.
    (a) In General.--Chapter 145 of title 40, United States Code, is 
amended by inserting after section 14509 the following:
``Sec. 14510. Drug abuse mitigation initiative
    ``(a) In General.--The Appalachian Regional Commission may provide 
technical assistance to, make grants to, enter into contracts with, or 
otherwise provide amounts to individuals or entities in the Appalachian 
region for projects and activities to address drug abuse, including 
opioid abuse, in the region, including projects and activities--
        ``(1) to facilitate the sharing of best practices among States, 
    counties, and other experts in the region with respect to reducing 
    such abuse;
        ``(2) to initiate or expand programs designed to eliminate or 
    reduce the harm to the workforce and economic growth of the region 
    that results from such abuse;
        ``(3) to attract and retain relevant health care services, 
    businesses, and workers; and
        ``(4) to develop relevant infrastructure, including broadband 
    infrastructure that supports the use of telemedicine.
    ``(b) Limitation on Available Amounts.--Of the cost of any activity 
eligible for a grant under this section--
        ``(1) not more than 50 percent may be provided from amounts 
    appropriated to carry out this section; and
        ``(2) notwithstanding paragraph (1)--
            ``(A) in the case of a project to be carried out in a 
        county for which a distressed county designation is in effect 
        under section 14526, not more than 80 percent may be provided 
        from amounts appropriated to carry out this section; and
            ``(B) in the case of a project to be carried out in a 
        county for which an at-risk designation is in effect under 
        section 14526, not more than 70 percent may be provided from 
        amounts appropriated to carry out this section.
    ``(c) Sources of Assistance.--Subject to subsection (b), a grant 
provided under this section may be provided from amounts made available 
to carry out this section in combination with amounts made available--
        ``(1) under any other Federal program (subject to the 
    availability of subsequent appropriations); or
        ``(2) from any other source.
    ``(d) Federal Share.--Notwithstanding any provision of law limiting 
the Federal share under any other Federal program, amounts made 
available to carry out this section may be used to increase that 
Federal share, as the Appalachian Regional Commission determines to be 
appropriate.''.
    (b) Clerical Amendment.--The analysis for chapter 145 of title 40, 
United States Code, is amended by inserting after the item relating to 
section 14509 the following:

``14510. Drug abuse mitigation initiative.''.

   Subtitle F--Pilot Program to Help Individuals in Recovery From a 
              Substance Use Disorder Become Stably Housed

SEC. 8071. PILOT PROGRAM TO HELP INDIVIDUALS IN RECOVERY FROM A 
SUBSTANCE USE DISORDER BECOME STABLY HOUSED.
    (a) Authorization of Appropriations.--There is authorized to be 
appropriated under this section such sums as may be necessary for each 
of fiscal years 2019 through 2023 for assistance to States to provide 
individuals in recovery from a substance use disorder stable, temporary 
housing for a period of not more than 2 years or until the individual 
secures permanent housing, whichever is earlier.
    (b) Allocation of Appropriated Amounts.--
        (1) In general.--The amounts appropriated or otherwise made 
    available to States under this section shall be allocated based on 
    a funding formula established by the Secretary of Housing and Urban 
    Development (referred to in this section as the ``Secretary'') not 
    later than 60 days after the date of enactment of this Act.
        (2) Criteria.--
            (A) In general.--The funding formula required under 
        paragraph (1) shall ensure that any amounts appropriated or 
        otherwise made available under this section are allocated to 
        States with an age-adjusted rate of drug overdose deaths that 
        is above the national overdose mortality rate, according to the 
        Centers for Disease Control and Prevention.
            (B) Priority.--
                (i) In general.--Among such States, priority shall be 
            given to States with the greatest need, as such need is 
            determined by the Secretary based on the following factors, 
            and weighting such factors as described in clause (ii):

                    (I) The highest average rates of unemployment based 
                on data provided by the Bureau of Labor Statistics for 
                calendar years 2013 through 2017.
                    (II) The lowest average labor force participation 
                rates based on data provided by the Bureau of Labor 
                Statistics for calendar years 2013 through 2017.
                    (III) The highest age-adjusted rates of drug 
                overdose deaths based on data from the Centers for 
                Disease Control and Prevention.

                (ii) Weighting.--The factors described in clause (i) 
            shall be weighted as follows:

                    (I) The rate described in clause (i)(I) shall be 
                weighted at 15 percent.
                    (II) The rate described in clause (i)(II) shall be 
                weighted at 15 percent.
                    (III) The rate described in clause (i)(III) shall 
                be weighted at 70 percent.

        (3) Distribution.--Amounts appropriated or otherwise made 
    available under this section shall be distributed according to the 
    funding formula established by the Secretary under paragraph (1) 
    not later than 30 days after the establishment of such formula.
    (c) Use of Funds.--
        (1) In general.--Any State that receives amounts pursuant to 
    this section shall expend at least 30 percent of such funds within 
    one year of the date funds become available to the grantee for 
    obligation.
        (2) Priority.--Any State that receives amounts pursuant to this 
    section shall distribute such amounts giving priority to entities 
    with the greatest need and ability to deliver effective assistance 
    in a timely manner.
        (3) Administrative costs.--Any State that receives amounts 
    pursuant to this section may use up to 5 percent of any grant for 
    administrative costs.
    (d) Rules of Construction.--
        (1) In general.--Except as otherwise provided by this section, 
    amounts appropriated, or amounts otherwise made available to States 
    under this section shall be treated as though such funds were 
    community development block grant funds under title I of the 
    Housing and Community Development Act of 1974 (42 U.S.C. 5301 et 
    seq.).
        (2) No match.--No matching funds shall be required in order for 
    a State to receive any amounts under this section.
    (e) Authority to Waive or Specify Alternative Requirements.--
        (1) In general.--In administering any amounts appropriated or 
    otherwise made available under this section, the Secretary may 
    waive or specify alternative requirements to any provision under 
    title I of the Housing and Community Development Act of 1974 (42 
    U.S.C. 5301 et seq.) except for requirements related to fair 
    housing, nondiscrimination, labor standards, the environment, and 
    requirements that activities benefit persons of low- and moderate-
    income, upon a finding that such a waiver is necessary to expedite 
    or facilitate the use of such funds.
        (2) Notice of intent.--The Secretary shall provide written 
    notice of its intent to exercise the authority to specify 
    alternative requirements under paragraph (1) to the Committee on 
    Banking, Housing, and Urban Affairs of the Senate and the Committee 
    on Financial Services of the House of Representatives not later 
    than 15 business days before such exercise of authority occurs.
        (3) Notice to the public.--The Secretary shall provide written 
    notice of its intent to exercise the authority to specify 
    alternative requirements under paragraph (1) to the public via 
    notice, on the internet website of the Department of Housing and 
    Urban Development, and by other appropriate means, not later than 
    15 business days before such exercise of authority occurs.
    (f) Technical Assistance.--For the 2-year period following the date 
of enactment of this Act, the Secretary may use not more than 2 percent 
of the funds made available under this section for technical assistance 
to grantees.
    (g) State.--For purposes of this section the term ``State'' 
includes any State as defined in section 102 of the Housing and 
Community Development Act of 1974 (42 U.S.C. 5302) and the District of 
Columbia.

                       Subtitle G--Human Services

SEC. 8081. SUPPORTING FAMILY-FOCUSED RESIDENTIAL TREATMENT.
    (a) Definitions.--In this section:
        (1) Family-focused residential treatment program.--The term 
    ``family-focused residential treatment program'' means a trauma-
    informed residential program primarily for substance use disorder 
    treatment for pregnant and postpartum women and parents and 
    guardians that allows children to reside with such women or their 
    parents or guardians during treatment to the extent appropriate and 
    applicable.
        (2) Medicaid program.--The term ``Medicaid program'' means the 
    program established under title XIX of the Social Security Act (42 
    U.S.C. 1396 et seq.).
        (3) Secretary.--The term ``Secretary'' means the Secretary of 
    Health and Human Services.
        (4) Title iv-e program.--The term ``title IV-E program'' means 
    the program for foster care, prevention, and permanency established 
    under part E of title IV of the Social Security Act (42 U.S.C. 670 
    et seq.).
    (b) Guidance on Family-focused Residential Treatment Programs.--
        (1) In general.--Not later than 180 days after the date of 
    enactment of this Act, the Secretary, in consultation with 
    divisions of the Department of Health and Human Services 
    administering substance use disorder or child welfare programs, 
    shall develop and issue guidance to States identifying 
    opportunities to support family-focused residential treatment 
    programs for the provision of substance use disorder treatment. 
    Before issuing such guidance, the Secretary shall solicit input 
    from representatives of States, health care providers with 
    expertise in addiction medicine, obstetrics and gynecology, 
    neonatology, child trauma, and child development, health plans, 
    recipients of family-focused treatment services, and other relevant 
    stakeholders.
        (2) Additional requirements.--The guidance required under 
    paragraph (1) shall include descriptions of the following:
            (A) Existing opportunities and flexibilities under the 
        Medicaid program, including under waivers authorized under 
        section 1115 or 1915 of the Social Security Act (42 U.S.C. 
        1315, 1396n), for States to receive Federal Medicaid funding 
        for the provision of substance use disorder treatment for 
        pregnant and postpartum women and parents and guardians and, to 
        the extent applicable, their children, in family-focused 
        residential treatment programs.
            (B) How States can employ and coordinate funding provided 
        under the Medicaid program, the title IV-E program, and other 
        programs administered by the Secretary to support the provision 
        of treatment and services provided by a family-focused 
        residential treatment facility such as substance use disorder 
        treatment and services, including medication-assisted 
        treatment, family, group, and individual counseling, case 
        management, parenting education and skills development, the 
        provision, assessment, or coordination of care and services for 
        children, including necessary assessments and appropriate 
        interventions, non-emergency transportation for necessary care 
        provided at or away from a program site, transitional services 
        and supports for families leaving treatment, and other 
        services.
            (C) How States can employ and coordinate funding provided 
        under the Medicaid program and the title IV-E program 
        (including as amended by the Family First Prevention Services 
        Act enacted under title VII of division E of Public Law 115-
        123, and particularly with respect to the authority under 
        subsections (a)(2)(C) and (j) of section 472 and section 
        474(a)(1) of the Social Security Act (42 U.S.C. 672, 674(a)(1)) 
        (as amended by section 50712 of Public Law 115-123) to provide 
        foster care maintenance payments for a child placed with a 
        parent who is receiving treatment in a licensed residential 
        family-based treatment facility for a substance use disorder) 
        to support placing children with their parents in family-
        focused residential treatment programs.
SEC. 8082. IMPROVING RECOVERY AND REUNIFYING FAMILIES.
    (a) Family Recovery and Reunification Program Replication 
Project.--Section 435 of the Social Security Act (42 U.S.C. 629e) is 
amended by adding at the end the following:
    ``(e) Family Recovery and Reunification Program Replication 
Project.--
        ``(1) Purpose.--The purpose of this subsection is to provide 
    resources to the Secretary to support the conduct and evaluation of 
    a family recovery and reunification program replication project 
    (referred to in this subsection as the `project') and to determine 
    the extent to which such programs may be appropriate for use at 
    different intervention points (such as when a child is at risk of 
    entering foster care or when a child is living with a guardian 
    while a parent is in treatment). The family recovery and 
    reunification program conducted under the project shall use a 
    recovery coach model that is designed to help reunify families and 
    protect children by working with parents or guardians with a 
    substance use disorder who have temporarily lost custody of their 
    children.
        ``(2) Program components.--The family recovery and 
    reunification program conducted under the project shall adhere 
    closely to the elements and protocol determined to be most 
    effective in other recovery coaching programs that have been 
    rigorously evaluated and shown to increase family reunification and 
    protect children and, consistent with such elements and protocol, 
    shall provide such items and services as--
            ``(A) assessments to evaluate the needs of the parent or 
        guardian;
            ``(B) assistance in receiving the appropriate benefits to 
        aid the parent or guardian in recovery;
            ``(C) services to assist the parent or guardian in 
        prioritizing issues identified in assessments, establishing 
        goals for resolving such issues that are consistent with the 
        goals of the treatment provider, child welfare agency, courts, 
        and other agencies involved with the parent or guardian or 
        their children, and making a coordinated plan for achieving 
        such goals;
            ``(D) home visiting services coordinated with the child 
        welfare agency and treatment provider involved with the parent 
        or guardian or their children;
            ``(E) case management services to remove barriers for the 
        parent or guardian to participate and continue in treatment, as 
        well as to re-engage a parent or guardian who is not 
        participating or progressing in treatment;
            ``(F) access to services needed to monitor the parent's or 
        guardian's compliance with program requirements;
            ``(G) frequent reporting between the treatment provider, 
        child welfare agency, courts, and other agencies involved with 
        the parent or guardian or their children to ensure appropriate 
        information on the parent's or guardian's status is available 
        to inform decision-making; and
            ``(H) assessments and recommendations provided by a 
        recovery coach to the child welfare caseworker responsible for 
        documenting the parent's or guardian's progress in treatment 
        and recovery as well as the status of other areas identified in 
        the treatment plan for the parent or guardian, including a 
        recommendation regarding the expected safety of the child if 
        the child is returned to the custody of the parent or guardian 
        that can be used by the caseworker and a court to make 
        permanency decisions regarding the child.
        ``(3) Responsibilities of the secretary.--
            ``(A) In general.--The Secretary shall, through a grant or 
        contract with 1 or more entities, conduct and evaluate the 
        family recovery and reunification program under the project.
            ``(B) Requirements.--In identifying 1 or more entities to 
        conduct the evaluation of the family recovery and reunification 
        program, the Secretary shall--
                ``(i) determine that the area or areas in which the 
            program will be conducted have sufficient substance use 
            disorder treatment providers and other resources (other 
            than those provided with funds made available to carry out 
            the project) to successfully conduct the program;
                ``(ii) determine that the area or areas in which the 
            program will be conducted have enough potential program 
            participants, and will serve a sufficient number of parents 
            or guardians and their children, so as to allow for the 
            formation of a control group, evaluation results to be 
            adequately powered, and preliminary results of the 
            evaluation to be available within 4 years of the program's 
            implementation;
                ``(iii) provide the entity or entities with technical 
            assistance for the program design, including by working 
            with 1 or more entities that are or have been involved in 
            recovery coaching programs that have been rigorously 
            evaluated and shown to increase family reunification and 
            protect children so as to make sure the program conducted 
            under the project adheres closely to the elements and 
            protocol determined to be most effective in such other 
            recovery coaching programs;
                ``(iv) assist the entity or entities in securing 
            adequate coaching, treatment, child welfare, court, and 
            other resources needed to successfully conduct the family 
            recovery and reunification program under the project; and
                ``(v) ensure the entity or entities will be able to 
            monitor the impacts of the program in the area or areas in 
            which it is conducted for at least 5 years after parents or 
            guardians and their children are randomly assigned to 
            participate in the program or to be part of the program's 
            control group.
        ``(4) Evaluation requirements.--
            ``(A) In general.--The Secretary, in consultation with the 
        entity or entities conducting the family recovery and 
        reunification program under the project, shall conduct an 
        evaluation to determine whether the program has been 
        implemented effectively and resulted in improvements for 
        children and families. The evaluation shall have 3 components: 
        a pilot phase, an impact study, and an implementation study.
            ``(B) Pilot phase.--The pilot phase component of the 
        evaluation shall consist of the Secretary providing technical 
        assistance to the entity or entities conducting the family 
        recovery and reunification program under the project to 
        ensure--
                ``(i) the program's implementation adheres closely to 
            the elements and protocol determined to be most effective 
            in other recovery coaching programs that have been 
            rigorously evaluated and shown to increase family 
            reunification and protect children; and
                ``(ii) random assignment of parents or guardians and 
            their children to be participants in the program or to be 
            part of the program's control group is being carried out.
            ``(C) Impact study.--The impact study component of the 
        evaluation shall determine the impacts of the family recovery 
        and reunification program conducted under the project on the 
        parents and guardians and their children participating in the 
        program. The impact study component shall--
                ``(i) be conducted using an experimental design that 
            uses a random assignment research methodology;
                ``(ii) consistent with previous studies of other 
            recovery coaching programs that have been rigorously 
            evaluated and shown to increase family reunification and 
            protect children, measure outcomes for parents and 
            guardians and their children over multiple time periods, 
            including for a period of 5 years; and
                ``(iii) include measurements of family stability and 
            parent, guardian, and child safety for program participants 
            and the program control group that are consistent with 
            measurements of such factors for participants and control 
            groups from previous studies of other recovery coaching 
            programs so as to allow results of the impact study to be 
            compared with the results of such prior studies, including 
            with respect to comparisons between program participants 
            and the program control group regarding--

                    ``(I) safe family reunification;
                    ``(II) time to reunification;
                    ``(III) permanency (such as through measures of 
                reunification, adoption, or placement with guardians);
                    ``(IV) safety (such as through measures of 
                subsequent maltreatment);
                    ``(V) parental or guardian treatment persistence 
                and engagement;
                    ``(VI) parental or guardian substance use;
                    ``(VII) juvenile delinquency;
                    ``(VIII) cost; and
                    ``(IX) other measurements agreed upon by the 
                Secretary and the entity or entities operating the 
                family recovery and reunification program under the 
                project.

            ``(D) Implementation study.--The implementation study 
        component of the evaluation shall be conducted concurrently 
        with the conduct of the impact study component and shall 
        include, in addition to such other information as the Secretary 
        may determine, descriptions and analyses of--
                ``(i) the adherence of the family recovery and 
            reunification program conducted under the project to other 
            recovery coaching programs that have been rigorously 
            evaluated and shown to increase family reunification and 
            protect children; and
                ``(ii) the difference in services received or proposed 
            to be received by the program participants and the program 
            control group.
            ``(E) Report.--The Secretary shall publish on an internet 
        website maintained by the Secretary the following information:
                ``(i) A report on the pilot phase component of the 
            evaluation.
                ``(ii) A report on the impact study component of the 
            evaluation.
                ``(iii) A report on the implementation study component 
            of the evaluation.
                ``(iv) A report that includes--

                    ``(I) analyses of the extent to which the program 
                has resulted in increased reunifications, increased 
                permanency, case closures, net savings to the State or 
                States involved (taking into account both costs borne 
                by States and the Federal government), or other 
                outcomes, or if the program did not produce such 
                outcomes, an analysis of why the replication of the 
                program did not yield such results;
                    ``(II) if, based on such analyses, the Secretary 
                determines the program should be replicated, a 
                replication plan; and
                    ``(III) such recommendations for legislation and 
                administrative action as the Secretary determines 
                appropriate.

        ``(5) Appropriation.--In addition to any amounts otherwise made 
    available to carry out this subpart, out of any money in the 
    Treasury of the United States not otherwise appropriated, there are 
    appropriated $15,000,000 for fiscal year 2019 to carry out the 
    project, which shall remain available through fiscal year 2026.''.
    (b) Clarification of Payer of Last Resort Application to Child 
Welfare Prevention and Family Services.--Section 471(e)(10) of the 
Social Security Act (42 U.S.C. 671(e)(10)), as added by section 
50711(a)(2) of division E of Public Law 115-123, is amended--
        (1) in subparagraph (A), by inserting ``, nor shall the 
    provision of such services or programs be construed to permit the 
    State to reduce medical or other assistance available to a 
    recipient of such services or programs'' after ``under this Act''; 
    and
        (2) by adding at the end the following:
            ``(C) Payer of last resort.--In carrying out its 
        responsibilities to ensure access to services or programs under 
        this subsection, the State agency shall not be considered to be 
        a legally liable third party for purposes of satisfying a 
        financial commitment for the cost of providing such services or 
        programs with respect to any individual for whom such cost 
        would have been paid for from another public or private source 
        but for the enactment of this subsection (except that whenever 
        considered necessary to prevent a delay in the receipt of 
        appropriate early intervention services by a child or family in 
        a timely fashion, funds provided under section 474(a)(6) may be 
        used to pay the provider of services or programs pending 
        reimbursement from the public or private source that has 
        ultimate responsibility for the payment).''.
    (c) Effective Date.--The amendments made by subsection (b) shall 
take effect as if included in section 50711 of division E of Public Law 
115-123.
SEC. 8083. BUILDING CAPACITY FOR FAMILY-FOCUSED RESIDENTIAL TREATMENT.
    (a) Definitions.--In this section:
        (1) Eligible entity.--The term ``eligible entity'' means a 
    State, county, local, or tribal health or child welfare agency, a 
    private nonprofit organization, a research organization, a 
    treatment service provider, an institution of higher education (as 
    defined under section 101 of the Higher Education Act of 1965 (20 
    U.S.C. 1001)), or another entity specified by the Secretary.
        (2) Family-focused residential treatment program.--The term 
    ``family-focused residential treatment program'' means a trauma-
    informed residential program primarily for substance use disorder 
    treatment for pregnant and postpartum women and parents and 
    guardians that allows children to reside with such women or their 
    parents or guardians during treatment to the extent appropriate and 
    applicable.
        (3) Secretary.--The term ``Secretary'' means the Secretary of 
    Health and Human Services.
    (b) Support for the Development of Evidence-based Family-focused 
Residential Treatment Programs.--
        (1) Authority to award grants.--The Secretary shall award 
    grants to eligible entities for purposes of developing, enhancing, 
    or evaluating family-focused residential treatment programs to 
    increase the availability of such programs that meet the 
    requirements for promising, supported, or well-supported practices 
    specified in section 471(e)(4)(C) of the Social Security Act (42 
    U.S.C. 671(e)(4)(C))) (as added by the Family First Prevention 
    Services Act enacted under title VII of division E of Public Law 
    115-123).
        (2) Evaluation requirement.--The Secretary shall require any 
    evaluation of a family-focused residential treatment program by an 
    eligible entity that uses funds awarded under this section for all 
    or part of the costs of the evaluation be designed to assist in the 
    determination of whether the program may qualify as a promising, 
    supported, or well-supported practice in accordance with the 
    requirements of such section 471(e)(4)(C).
    (c) Authorization of Appropriations.--There is authorized to be 
appropriated to the Secretary to carry out this section, $20,000,000 
for fiscal year 2019, which shall remain available through fiscal year 
2023.

Subtitle H--Reauthorizing and Extending Grants for Recovery From Opioid 
                              Use Programs

SEC. 8091. SHORT TITLE.
    This subtitle may be cited as the ``Reauthorizing and Extending 
Grants for Recovery from Opioid Use Programs Act of 2018'' or the 
``REGROUP Act of 2018''.
SEC. 8092. REAUTHORIZATION OF THE COMPREHENSIVE OPIOID ABUSE GRANT 
PROGRAM.
    Section 1001(a)(27) of the Omnibus Crime Control and Safe Streets 
Act of 1968 (34 U.S.C. 10261(a)(27)) is amended by striking ``through 
2021'' and inserting ``and 2018, and $330,000,000 for each of fiscal 
years 2019 through 2023''.

          Subtitle I--Fighting Opioid Abuse in Transportation

SEC. 8101. SHORT TITLE.
    This subtitle may be cited as the ``Fighting Opioid Abuse in 
Transportation Act''.
SEC. 8102. ALCOHOL AND CONTROLLED SUBSTANCE TESTING OF MECHANICAL 
EMPLOYEES.
    (a) In General.--Not later than 2 years after the date of enactment 
of this Act, the Secretary of Transportation shall publish a rule in 
the Federal Register revising the regulations promulgated under section 
20140 of title 49, United States Code, to cover all employees of 
railroad carriers who perform mechanical activities.
    (b) Definition of Mechanical Activities.--For the purposes of the 
rule under subsection (a), the Secretary shall define the term 
``mechanical activities'' by regulation.
SEC. 8103. DEPARTMENT OF TRANSPORTATION PUBLIC DRUG AND ALCOHOL TESTING 
DATABASE.
    (a) In General.--Subject to subsection (c), the Secretary of 
Transportation shall--
        (1) not later than March 31, 2019, establish and make publicly 
    available on its website a database of the drug and alcohol testing 
    data reported by employers for each mode of transportation; and
        (2) update the database annually.
    (b) Contents.--The database under subsection (a) shall include, for 
each mode of transportation--
        (1) the total number of drug and alcohol tests by type of 
    substance tested;
        (2) the drug and alcohol test results by type of substance 
    tested;
        (3) the reason for the drug or alcohol test, such as pre-
    employment, random, post-accident, reasonable suspicion or cause, 
    return-to-duty, or follow-up, by type of substance tested; and
        (4) the number of individuals who refused testing.
    (c) Commercially Sensitive Data.--The Department of Transportation 
shall not release any commercially sensitive data or personally 
identifiable data furnished by an employer under this section unless 
the data is aggregated or otherwise in a form that does not identify 
the employer providing the data.
    (d) Savings Clause.--Nothing in this section may be construed as 
limiting or otherwise affecting the requirements of the Secretary of 
Transportation to adhere to requirements applicable to confidential 
business information and sensitive security information, consistent 
with applicable law.
SEC. 8104. GAO REPORT ON DEPARTMENT OF TRANSPORTATION'S COLLECTION AND 
USE OF DRUG AND ALCOHOL TESTING DATA.
    (a) In General.--Not later than 2 years after the date the 
Department of Transportation public drug and alcohol testing database 
is established under section 8103, the Comptroller General of the 
United States shall--
        (1) review the Department of Transportation Drug and Alcohol 
    Testing Management Information System; and
        (2) submit to the Committee on Commerce, Science, and 
    Transportation of the Senate and the Committee on Transportation 
    and Infrastructure of the House of Representatives a report on the 
    review, including recommendations under subsection (c).
    (b) Contents.--The report under subsection (a) shall include--
        (1) a description of the process the Department of 
    Transportation uses to collect and record drug and alcohol testing 
    data submitted by employers for each mode of transportation;
        (2) an assessment of whether and, if so, how the Department of 
    Transportation uses the data described in paragraph (1) in carrying 
    out its responsibilities; and
        (3) an assessment of the Department of Transportation public 
    drug and alcohol testing database under section 8103.
    (c) Recommendations.--The report under subsection (a) may include 
recommendations regarding--
        (1) how the Department of Transportation can best use the data 
    described in subsection (b)(1);
        (2) any improvements that could be made to the process 
    described in subsection (b)(1);
        (3) whether and, if so, how the Department of Transportation 
    public drug and alcohol testing database under section 8103 could 
    be made more effective; and
        (4) such other recommendations as the Comptroller General 
    considers appropriate.
SEC. 8105. TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAM; 
ADDITION OF FENTANYL AND OTHER SUBSTANCES.
    (a) Mandatory Guidelines for Federal Workplace Drug Testing 
Programs.--
        (1) In general.--Not later than 180 days after the date of 
    enactment of this Act, the Secretary of Health and Human Services 
    shall--
            (A) determine whether a revision of the Mandatory 
        Guidelines for Federal Workplace Drug Testing Programs to 
        expand the opiate category on the list of authorized substance 
        testing to include fentanyl is justified, based on the 
        reliability and cost-effectiveness of available testing; and
            (B) consider whether to include with the determination 
        under subparagraph (A) a separate determination on whether a 
        revision of the Mandatory Guidelines for Federal Workplace Drug 
        Testing Programs to expand the list of substances authorized 
        for testing to include any other drugs or other substances 
        listed in schedule I and II of section 202 of the Controlled 
        Substances Act (21 U.S.C. 812) is justified based on the 
        criteria described in subparagraph (A).
        (2) Revision of guidelines.--If an expansion of the substance 
    list is determined to be justified under paragraph (1), the 
    Secretary of Health and Human Services shall--
            (A) notify the Committee on Commerce, Science, and 
        Transportation of the Senate and the Committee on 
        Transportation and Infrastructure of the House of 
        Representatives of the determination; and
            (B) publish in the Federal Register, not later than 18 
        months after the date of the determination under that 
        paragraph, a final notice of the revision of the Mandatory 
        Guidelines for Federal Workplace Drug Testing Programs to 
        expand the list of substances authorized to be tested to 
        include the substance or substances determined to be justified 
        for inclusion.
        (3) Report.--If an expansion of the substance list is 
    determined not to be justified under paragraph (1), the Secretary 
    of Health and Human Services shall submit to the Committee on 
    Commerce, Science, and Transportation of the Senate and the 
    Committee on Transportation and Infrastructure of the House of 
    Representatives a report explaining, in detail, the reasons the 
    expansion of the list of authorized substances is not justified.
    (b) Department of Transportation Drug-testing Panel.--If an 
expansion is determined to be justified under subsection (a)(1), the 
Secretary of Transportation shall publish in the Federal Register, not 
later than 18 months after the date the final notice is published under 
subsection (a)(2), a final rule revising part 40 of title 49, Code of 
Federal Regulations, to include such substances in the Department of 
Transportation's drug-testing panel, consistent with the Mandatory 
Guidelines for Federal Workplace Drug Testing Programs as revised by 
the Secretary of Health and Human Services under subsection (a).
    (c) Savings Provision.--Nothing in this section may be construed 
as--
        (1) delaying the publication of the notices described in 
    sections 8106 and 8107 of this Act until the Secretary of Health 
    and Human Services makes a determination or publishes a notice 
    under this section; or
        (2) limiting or otherwise affecting any authority of the 
    Secretary of Health and Human Services or the Secretary of 
    Transportation to expand the list of authorized substance testing 
    to include an additional substance.
SEC. 8106. STATUS REPORTS ON HAIR TESTING GUIDELINES.
    (a) In General.--Not later than 60 days after the date of enactment 
of this Act, and annually thereafter until the date that the Secretary 
of Health and Human Services publishes in the Federal Register a final 
notice of scientific and technical guidelines for hair testing in 
accordance with section 5402(b) of the Fixing America's Surface 
Transportation Act (Public Law 114-94; 129 Stat. 1312), the Secretary 
of Health and Human Services shall submit to the Committee on Commerce, 
Science, and Transportation of the Senate and the Committee on 
Transportation and Infrastructure of the House of Representatives a 
report on--
        (1) the status of the hair testing guidelines;
        (2) an explanation for why the hair testing guidelines have not 
    been issued; and
        (3) an estimated date of completion of the hair testing 
    guidelines.
    (b) Requirement.--To the extent practicable and consistent with the 
objective of the hair testing described in subsection (a) to detect 
illegal or unauthorized use of substances by the individual being 
tested, the final notice of scientific and technical guidelines under 
that subsection, as determined by the Secretary of Health and Human 
Services, shall eliminate the risk of positive test results, of the 
individual being tested, caused solely by the drug use of others and 
not caused by the drug use of the individual being tested.
SEC. 8107. MANDATORY GUIDELINES FOR FEDERAL WORKPLACE DRUG TESTING 
PROGRAMS USING ORAL FLUID.
    (a) Deadline.--Not later than December 31, 2018, the Secretary of 
Health and Human Services shall publish in the Federal Register a final 
notice of the Mandatory Guidelines for Federal Workplace Drug Testing 
Programs using Oral Fluid, based on the notice of proposed mandatory 
guidelines published in the Federal Register on May 15, 2015 (94 FR 
28054).
    (b) Requirement.--To the extent practicable and consistent with the 
objective of the testing described in subsection (a) to detect illegal 
or unauthorized use of substances by the individual being tested, the 
final notice of scientific and technical guidelines under that 
subsection, as determined by the Secretary of Health and Human 
Services, shall eliminate the risk of positive test results, of the 
individual being tested, caused solely by the drug use of others and 
not caused by the drug use of the individual being tested.
    (c) Rule of Construction.--Nothing in this section may be construed 
as requiring the Secretary of Health and Human Services to reissue a 
notice of proposed mandatory guidelines to carry out subsection (a).
SEC. 8108. ELECTRONIC RECORDKEEPING.
    (a) Deadline.--Not later than 1 year after the date of enactment of 
this Act, the Secretary of Health and Human Services shall--
        (1) ensure that each certified laboratory that requests 
    approval for the use of completely paperless electronic Federal 
    Drug Testing Custody and Control Forms from the National Laboratory 
    Certification Program's Electronic Custody and Control Form systems 
    receives approval for those completely paperless electronic forms 
    instead of forms that include any combination of electronic 
    traditional handwritten signatures executed on paper forms; and
        (2) establish a deadline for a certified laboratory to request 
    approval under paragraph (1).
    (b) Savings Clause.--Nothing in this section may be construed as 
limiting or otherwise affecting any authority of the Secretary of 
Health and Human Services to grant approval to a certified laboratory 
for use of completely paperless electronic Federal Drug Testing Custody 
and Control Forms, including to grant approval outside of the process 
under subsection (a).
    (c) Electronic Signatures.--Not later than 18 months after the date 
of the deadline under subsection (a)(2), the Secretary of 
Transportation shall issue a final rule revising part 40 of title 49, 
Code of Federal Regulations, to authorize, to the extent practicable, 
the use of electronic signatures or digital signatures executed to 
electronic forms instead of traditional handwritten signatures executed 
on paper forms.
SEC. 8109. STATUS REPORTS ON COMMERCIAL DRIVER'S LICENSE DRUG AND 
ALCOHOL CLEARINGHOUSE.
    (a) In General.--Not later than 60 days after the date of enactment 
of this Act, and annually thereafter until the compliance date, the 
Administrator of the Federal Motor Carrier Safety Administration shall 
submit to the Committee on Commerce, Science, and Transportation of the 
Senate and the Committee on Transportation and Infrastructure of the 
House of Representatives a status report on implementation of the final 
rule for the Commercial Driver's License Drug and Alcohol Clearinghouse 
(81 FR 87686), including--
        (1) an updated schedule, including benchmarks, for implementing 
    the final rule as soon as practicable, but not later than the 
    compliance date; and
        (2) a description of each action the Federal Motor Carrier 
    Safety Administration is taking to implement the final rule before 
    the compliance date.
    (b) Definition of Compliance Date.--In this section, the term 
``compliance date'' means the earlier of--
        (1) January 6, 2020; or
        (2) the date that the national clearinghouse required under 
    section 31306a of title 49, United States Code, is operational.

             Subtitle J--Eliminating Kickbacks in Recovery

SEC. 8121. SHORT TITLE.
    This subtitle may be cited as the ``Eliminating Kickbacks in 
Recovery Act of 2018''.
SEC. 8122. CRIMINAL PENALTIES.
    (a) In General.--Chapter 11 of title 18, United States Code, is 
amended by inserting after section 219 the following:
``Sec. 220. Illegal remunerations for referrals to recovery homes, 
   clinical treatment facilities, and laboratories
    ``(a) Offense.--Except as provided in subsection (b), whoever, with 
respect to services covered by a health care benefit program, in or 
affecting interstate or foreign commerce, knowingly and willfully--
        ``(1) solicits or receives any remuneration (including any 
    kickback, bribe, or rebate) directly or indirectly, overtly or 
    covertly, in cash or in kind, in return for referring a patient or 
    patronage to a recovery home, clinical treatment facility, or 
    laboratory; or
        ``(2) pays or offers any remuneration (including any kickback, 
    bribe, or rebate) directly or indirectly, overtly or covertly, in 
    cash or in kind--
            ``(A) to induce a referral of an individual to a recovery 
        home, clinical treatment facility, or laboratory; or
            ``(B) in exchange for an individual using the services of 
        that recovery home, clinical treatment facility, or laboratory,
shall be fined not more than $200,000, imprisoned not more than 10 
years, or both, for each occurrence.
    ``(b) Applicability.--Subsection (a) shall not apply to--
        ``(1) a discount or other reduction in price obtained by a 
    provider of services or other entity under a health care benefit 
    program if the reduction in price is properly disclosed and 
    appropriately reflected in the costs claimed or charges made by the 
    provider or entity;
        ``(2) a payment made by an employer to an employee or 
    independent contractor (who has a bona fide employment or 
    contractual relationship with such employer) for employment, if the 
    employee's payment is not determined by or does not vary by--
            ``(A) the number of individuals referred to a particular 
        recovery home, clinical treatment facility, or laboratory;
            ``(B) the number of tests or procedures performed; or
            ``(C) the amount billed to or received from, in part or in 
        whole, the health care benefit program from the individuals 
        referred to a particular recovery home, clinical treatment 
        facility, or laboratory;
        ``(3) a discount in the price of an applicable drug of a 
    manufacturer that is furnished to an applicable beneficiary under 
    the Medicare coverage gap discount program under section 1860D-
    14A(g) of the Social Security Act (42 U.S.C. 1395w-114a(g));
        ``(4) a payment made by a principal to an agent as compensation 
    for the services of the agent under a personal services and 
    management contract that meets the requirements of section 
    1001.952(d) of title 42, Code of Federal Regulations, as in effect 
    on the date of enactment of this section;
        ``(5) a waiver or discount (as defined in section 
    1001.952(h)(5) of title 42, Code of Federal Regulations, or any 
    successor regulation) of any coinsurance or copayment by a health 
    care benefit program if--
            ``(A) the waiver or discount is not routinely provided; and
            ``(B) the waiver or discount is provided in good faith;
        ``(6) a remuneration described in section 1128B(b)(3)(I) of the 
    Social Security Act (42 U.S.C. 1320a-7b(b)(3)(I));
        ``(7) a remuneration made pursuant to an alternative payment 
    model (as defined in section 1833(z)(3)(C) of the Social Security 
    Act) or pursuant to a payment arrangement used by a State, health 
    insurance issuer, or group health plan if the Secretary of Health 
    and Human Services has determined that such arrangement is 
    necessary for care coordination or value-based care; or
        ``(8) any other payment, remuneration, discount, or reduction 
    as determined by the Attorney General, in consultation with the 
    Secretary of Health and Human Services, by regulation.
    ``(c) Regulations.--The Attorney General, in consultation with the 
Secretary of Health and Human Services, may promulgate regulations to 
clarify the exceptions described in subsection (b).
    ``(d) Preemption.--
        ``(1) Federal law.--This section shall not apply to conduct 
    that is prohibited under section 1128B of the Social Security Act 
    (42 U.S.C. 1320a-7b).
        ``(2) State law.--Nothing in this section shall be construed to 
    occupy the field in which any provisions of this section operate to 
    the exclusion of State laws on the same subject matter.
    ``(e) Definitions.--In this section--
        ``(1) the terms `applicable beneficiary' and `applicable drug' 
    have the meanings given those terms in section 1860D-14A(g) of the 
    Social Security Act (42 U.S.C. 1395w-114a(g));
        ``(2) the term `clinical treatment facility' means a medical 
    setting , other than a hospital, that provides detoxification, risk 
    reduction, outpatient treatment and care, residential treatment, or 
    rehabilitation for substance use, pursuant to licensure or 
    certification under State law;
        ``(3) the term `health care benefit program' has the meaning 
    given the term in section 24(b);
        ``(4) the term `laboratory' has the meaning given the term in 
    section 353 of the Public Health Service Act (42 U.S.C. 263a); and
        ``(5) the term `recovery home' means a shared living 
    environment that is, or purports to be, free from alcohol and 
    illicit drug use and centered on peer support and connection to 
    services that promote sustained recovery from substance use 
    disorders.''.
    (b) Clerical Amendment.--The table of sections for chapter 11 of 
title 18, United States Code, is amended by inserting after the item 
related to section 219 the following:

``220. Illegal remunerations for referrals to recovery homes, clinical 
          treatment facilities, and laboratories.''.

                 Subtitle K--Substance Abuse Prevention

SEC. 8201. SHORT TITLE.
    This subtitle may be cited as the ``Substance Abuse Prevention Act 
of 2018''.
SEC. 8202. REAUTHORIZATION OF THE OFFICE OF NATIONAL DRUG CONTROL 
POLICY.
    (a) Office of National Drug Control Policy Reauthorization Act of 
1998.--
        (1) In general.--The Office of National Drug Control Policy 
    Reauthorization Act of 1998 (21 U.S.C. 1701 et seq.), as in effect 
    on September 29, 2003, and as amended by the laws described in 
    paragraph (2), is revived and restored.
        (2) Laws described.--The laws described in this paragraph are:
            (A) The Office of National Drug Control Policy 
        Reauthorization Act of 2006 (Public Law 109-469; 120 Stat. 
        3502).
            (B) The Presidential Appointment Efficiency and 
        Streamlining Act of 2011 (Public Law 112-166; 126 Stat. 1283).
    (b) Reauthorization.--
        (1) In general.--Section 714 of the Office of National Drug 
    Control Policy Reauthorization Act of 1998 (21 U.S.C. 1711) is 
    amended by striking ``such sums as may be necessary for each of 
    fiscal years 2006 through 2010'' and inserting ``$18,400,000 for 
    each of fiscal years 2018 through 2023''.
        (2) Repeal of termination.--The Office of National Drug Control 
    Policy Reauthorization Act of 1998 (21 U.S.C. 1701 et seq.) is 
    amended by striking section 715 (21 U.S.C. 1712).
SEC. 8203. REAUTHORIZATION OF THE DRUG-FREE COMMUNITIES PROGRAM.
    (a) Revival of National Narcotics Leadership Act of 1988.--
        (1) In general.--Chapter 2 of the National Narcotics Leadership 
    Act of 1988 (21 U.S.C. 1521 et seq.), except for subchapter II (21 
    U.S.C. 1541 et seq.), as in effect on September 29, 1997, and as 
    amended by the laws described in paragraph (2), is revived and 
    restored.
        (2) Laws described.--The laws described in this paragraph are:
            (A) Public Law 107-82 (115 Stat. 814).
            (B) The Office of National Drug Control Policy 
        Reauthorization Act of 2006 (Public Law 109-469: 120 Stat. 
        3502), as amended by paragraph (4).
        (3) Amendment to termination provision.--Section 1009 of the 
    National Narcotics Leadership Act of 1988 (21 U.S.C. 1056) is 
    amended by inserting ``and sections 1021 through 1035'' after 
    ``section 1007''.
        (4) Technical correction.--
            (A) In general.--Title VIII of the Office of National Drug 
        Control Policy Reauthorization Act of 2006 (Public Law 109-469; 
        120 Stat. 3535) is amended by striking ``Drug-Free Communities 
        Act of 1997'' each place it appears and inserting ``National 
        Narcotics Leadership Act of 1988''.
            (B) Effective date.--The amendments made by subparagraph 
        (A) shall take effect as though enacted as part of the Office 
        of National Drug Control Policy Reauthorization Act of 2006 
        (Public Law 109-469; 120 Stat. 3502).
    (b) Amendment to National Narcotics Leadership Act of 1988.--
Chapter 2 of subtitle A of title I of the National Narcotics Leadership 
Act of 1988 (21 U.S.C. 1521 et seq.) is amended--
        (1) in section 1022 (21 U.S.C. 1522), by striking ``substance 
    abuse'' each place it appears and inserting ``substance use and 
    misuse'';
        (2) in section 1023 (21 U.S.C. 1523), by striking paragraph (9) 
    and inserting the following:
        ``(9) Substance use and misuse.--The term `substance use and 
    misuse' means--
            ``(A) the illegal use or misuse of drugs, including 
        substances for which a listing is effect under any of schedules 
        I through V under section 202 of the Controlled Substances Act 
        (21 U.S.C. 812);
            ``(B) the misuse of inhalants or over-the-counter drugs; or
            ``(C) the use of alcohol, tobacco, or other related product 
        as such use is prohibited by State or local law.'';
        (3) in section 1024 (21 U.S.C. 1524), by striking subsections 
    (a) and (b) and inserting the following:
    ``(a) In General.--There is authorized to be appropriated to the 
Office of National Drug Control Policy to carry out this chapter 
$99,000,000 for each of fiscal years 2018 through 2023.
    ``(b) Administrative Costs.--Not more than 8 percent of the funds 
appropriated to carry out this chapter may be used by the Office of 
National Drug Control Policy to pay administrative costs associated 
with the responsibilities of the Office under this chapter.'';
        (4) in subchapter I (21 U.S.C. 1531 et seq.)--
            (A) by striking ``substance abuse'' each place it appears 
        and inserting ``substance use and misuse''; and
            (B) in section 1032(b)(1)(A) (21 U.S.C. 1532(b)(1)(A)), by 
        striking clause (iii) and inserting the following:
                ``(iii) Renewal grants.--Subject to clause (iv), the 
            Administrator may award a renewal grant to a grant 
            recipient under this subparagraph for each fiscal year of 
            the 4-fiscal-year period following the first fiscal year 
            for which the initial additional grant is awarded in an 
            amount not to exceed the following:

                    ``(I) For the first and second fiscal years of the 
                4-fiscal-year period, the amount of the non-Federal 
                funds, including in-kind contributions, raised by the 
                coalition for the applicable fiscal year is not less 
                than 125 percent of the amount awarded.
                    ``(II) For the third and fourth fiscal tears of the 
                4-fiscal-year period, the amount of the non-Federal 
                funds, including in-kind contributions, raised by the 
                coalition for the applicable fiscal year is not less 
                than 150 percent of the amount awarded.''; and

        (5) by striking subchapter II (21 U.S.C. 1541 et seq.).
SEC. 8204. REAUTHORIZATION OF THE NATIONAL COMMUNITY ANTI-DRUG 
COALITION INSTITUTE.
    Section 4 of Public Law 107-82 (21 U.S.C. 1521 note) is amended to 
read as follows:
``SEC. 4. AUTHORIZATION FOR NATIONAL COMMUNITY ANTIDRUG COALITION 
INSTITUTE.
    ``(a) In General.--The Director shall, using amounts authorized to 
be appropriated by subsection (d), make a competitive grant to provide 
for the continuation of the National Community Anti-drug Coalition 
Institute.
    ``(b) Eligible Organizations.--An organization eligible for the 
grant under subsection (a) is any national nonprofit organization that 
represents, provides technical assistance and training to, and has 
special expertise and broad, national-level experience in community 
antidrug coalitions under this subchapter.
    ``(c) Use of Grant Amount.--The organization that receives the 
grant under subsection (a) shall continue a National Community Anti-
Drug Coalition Institute to--
        ``(1) provide education, training, and technical assistance for 
    coalition leaders and community teams, with emphasis on the 
    development of coalitions serving economically disadvantaged areas;
        ``(2) develop and disseminate evaluation tools, mechanisms, and 
    measures to better assess and document coalition performance 
    measures and outcomes; and
        ``(3) bridge the gap between research and practice by 
    translating knowledge from research into practical information.
    ``(d) Authorization of Appropriations.--The Director shall, using 
amounts authorized to be appropriated by section 1032 of the National 
Narcotics Leadership Act of 1988 (15 U.S.C. 1532), make a grant of $2 
million under subsection (a), for each of the fiscal years 2018 through 
2023.''.
SEC. 8205. REAUTHORIZATION OF THE HIGH-INTENSITY DRUG TRAFFICKING AREA 
PROGRAM.
    Section 707 of the Office of National Drug Control Policy 
Reauthorization Act of 1998 (21 U.S.C. 1706) is amended--
        (1) in subsection (f), by striking ``no Federal'' and all that 
    follows through ``programs.'' and inserting the following: ``not 
    more than a total of 5 percent of Federal funds appropriated for 
    the Program are expended for substance use disorder treatment 
    programs and drug prevention programs.'';
        (2) in subsection (p)--
            (A) in paragraph (4), by striking ``and'' at the end;
            (B) in paragraph (5), by striking the period at the end and 
        inserting ``; and''; and
            (C) by adding at the end the following:
        ``(6) $280,000,000 for each of fiscal years 2018 through 
    2023.''; and
        (3) in subsection (q)--
            (A) by striking paragraph (2) and inserting the following:
        ``(2) Required uses.--The funds used under paragraph (1) shall 
    be used to ensure the safety of neighborhoods and the protection of 
    communities, including the prevention of the intimidation of 
    witnesses of illegal drug distribution and related activities and 
    the establishment of, or support for, programs that provide 
    protection or assistance to witnesses in court proceedings.''; and
            (B) by adding at the end the following:
        ``(3) Best practice models.--The Director shall work with 
    HIDTAs to develop and maintain best practice models to assist 
    State, local, and Tribal governments in addressing witness safety, 
    relocation, financial and housing assistance, or any other services 
    related to witness protection or assistance in cases of illegal 
    drug distribution and related activities. The Director shall ensure 
    dissemination of the best practice models to each HIDTA.''.
SEC. 8206. REAUTHORIZATION OF DRUG COURT PROGRAM.
    Section 1001(a)(25)(A) of title I of the Omnibus Crime Control and 
Safe Streets Act of 1968 (34 U.S.C. 10261(a)(25)(A)) is amended by 
striking ``Except as provided'' and all that follows and inserting the 
following: ``Except as provided in subparagraph (C), there is 
authorized to be appropriated to carry out part EE $75,000,000 for each 
of fiscal years 2018 through 2023.''.
SEC. 8207. DRUG COURT TRAINING AND TECHNICAL ASSISTANCE.
    Section 705 of the Office of National Drug Control Policy 
Reauthorization Act of 1998 (21 U.S.C. 1704) is amended by adding at 
the end the following:
    ``(e) Drug Court Training and Technical Assistance Program.--
        ``(1) Grants authorized.--The Director may make a grant to a 
    nonprofit organization for the purpose of providing training and 
    technical assistance to drug courts.
        ``(2) Authorization of appropriations.--There is authorized to 
    be appropriated to carry out this subsection $2,000,000 for each of 
    fiscal years 2018 through 2023.''.
SEC. 8208. DRUG OVERDOSE RESPONSE STRATEGY.
    Section 707 of the Office of National Drug Control Policy 
Reauthorization Act of 1998 (21 U.S.C. 1706) is amended by adding at 
the end the following:
    ``(r) Drug Overdose Response Strategy Implementation.--The Director 
may use funds appropriated to carry out this section to implement a 
drug overdose response strategy in high intensity drug trafficking 
areas on a nationwide basis by--
        ``(1) coordinating multi-disciplinary efforts to prevent, 
    reduce, and respond to drug overdoses, including the uniform 
    reporting of fatal and non-fatal overdoses to public health and 
    safety officials;
        ``(2) increasing data sharing among public safety and public 
    health officials concerning drug-related abuse trends, including 
    new psychoactive substances, and related crime; and
        ``(3) enabling collaborative deployment of prevention, 
    intervention, and enforcement resources to address substance use 
    addiction and narcotics trafficking.''.
SEC. 8209. PROTECTING LAW ENFORCEMENT OFFICERS FROM ACCIDENTAL 
EXPOSURE.
    Section 707 of the Office of National Drug Control Policy 
Reauthorization Act of 1998 (21 U.S.C. 1706), as amended by section 
8208, is amended by adding at the end the following:
    ``(s) Supplemental Grants.--The Director is authorized to use not 
more than $10,000,000 of the amounts otherwise appropriated to carry 
out this section to provide supplemental competitive grants to high 
intensity drug trafficking areas that have experienced high seizures of 
fentanyl and new psychoactive substances for the purposes of--
        ``(1) purchasing portable equipment to test for fentanyl and 
    other substances;
        ``(2) training law enforcement officers and other first 
    responders on best practices for handling fentanyl and other 
    substances; and
        ``(3) purchasing protective equipment, including overdose 
    reversal drugs.''.
SEC. 8210. COPS ANTI-METH PROGRAM.
    Section 1701 of title I of the Omnibus Crime Control and Safe 
Streets Act of 1968 (34 U.S.C. 10381) is amended--
        (1) by redesignating subsection (k) as subsection (l); and
        (2) by inserting after subsection (j) the following:
    ``(k) COPS Anti-Meth Program.--The Attorney General shall use 
amounts otherwise appropriated to carry out this section for a fiscal 
year (beginning with fiscal year 2019) to make competitive grants, in 
amounts of not less than $1,000,000 for such fiscal year, to State law 
enforcement agencies with high seizures of precursor chemicals, 
finished methamphetamine, laboratories, and laboratory dump seizures 
for the purpose of locating or investigating illicit activities, such 
as precursor diversion, laboratories, or methamphetamine 
traffickers.''.
SEC. 8211. COPS ANTI-HEROIN TASK FORCE PROGRAM.
    Section 1701 of title I of the Omnibus Crime Control and Safe 
Streets Act of 1968 (34 U.S.C. 10381) is amended--
        (1) by redesignating subsection (l), as so redesignated by 
    section 8210, as subsection (m); and
        (2) by inserting after subsection (k), as added by section 
    8210, the following:
    ``(l) Cops Anti-heroin Task Force Program.--The Attorney General 
shall use amounts otherwise appropriated to carry out this section, or 
other amounts as appropriated, for a fiscal year (beginning with fiscal 
year 2019) to make competitive grants to State law enforcement agencies 
in States with high per capita rates of primary treatment admissions, 
for the purpose of locating or investigating illicit activities, 
through Statewide collaboration, relating to the distribution of 
heroin, fentanyl, or carfentanil or relating to the unlawful 
distribution of prescription opioids.''.
SEC. 8212. COMPREHENSIVE ADDICTION AND RECOVERY ACT EDUCATION AND 
AWARENESS.
    Title VII of the Comprehensive Addiction and Recovery Act of 2016 
(Public Law 114-198; 130 Stat. 735) is amended by adding at the end the 
following:
    ``SEC. 709. SERVICES FOR FAMILIES AND PATIENTS IN CRISIS.
    ``(a) In General.--The Secretary of Health and Human Services may 
make grants to entities that focus on addiction and substance use 
disorders and specialize in family and patient services, advocacy for 
patients and families, and educational information.
    ``(b) Allowable Uses.--A grant awarded under this section may be 
used for nonprofit national, State, or local organizations that engage 
in the following activities:
        ``(1) Expansion of resource center services with professional, 
    clinical staff that provide, for families and individuals impacted 
    by a substance use disorder, support, access to treatment 
    resources, brief assessments, medication and overdose prevention 
    education, compassionate listening services, recovery support or 
    peer specialists, bereavement and grief support, and case 
    management.
        ``(2) Continued development of health information technology 
    systems that leverage new and upcoming technology and techniques 
    for prevention, intervention, and filling resource gaps in 
    communities that are underserved.
        ``(3) Enhancement and operation of treatment and recovery 
    resources, easy-to-read scientific and evidence-based education on 
    addiction and substance use disorders, and other informational 
    tools for families and individuals impacted by a substance use 
    disorder and community stakeholders, such as law enforcement 
    agencies.
        ``(4) Provision of training and technical assistance to State 
    and local governments, law enforcement agencies, health care 
    systems, research institutions, and other stakeholders.
        ``(5) Expanding upon and implementing educational information 
    using evidence-based information on substance use disorders.
        ``(6) Expansion of training of community stakeholders, law 
    enforcement officers, and families across a broad-range of 
    addiction, health, and related topics on substance use disorders, 
    local issues and community-specific issues related to the drug 
    epidemic.
        ``(7) Program evaluation.''.
SEC. 8213. REIMBURSEMENT OF SUBSTANCE USE DISORDER TREATMENT 
PROFESSIONALS.
    Not later than January 1, 2020, the Comptroller General of the 
United States shall submit to Congress a report examining how substance 
use disorder services are reimbursed.
SEC. 8214. SOBRIETY TREATMENT AND RECOVERY TEAMS (START).
    Title V of the Public Health Service Act (42 U.S.C. 290dd et seq.) 
is amended by adding at the end the following:
    ``SEC. 550. SOBRIETY TREATMENT AND RECOVERY TEAMS.
    ``(a) In General.--The Secretary may make grants to States, units 
of local government, or tribal governments to establish or expand 
Sobriety Treatment And Recovery Team (referred to in this section as 
`START') or other similar programs to determine the effectiveness of 
pairing social workers or mentors with families that are struggling 
with a substance use disorder and child abuse or neglect in order to 
help provide peer support, intensive treatment, and child welfare 
services to such families.
    ``(b) Allowable Uses.--A grant awarded under this section may be 
used for one or more of the following activities:
        ``(1) Training eligible staff, including social workers, social 
    services coordinators, child welfare specialists, substance use 
    disorder treatment professionals, and mentors.
        ``(2) Expanding access to substance use disorder treatment 
    services and drug testing.
        ``(3) Enhancing data sharing with law enforcement agencies, 
    child welfare agencies, substance use disorder treatment providers, 
    judges, and court personnel.
        ``(4) Program evaluation and technical assistance.
    ``(c) Program Requirements.--A State, unit of local government, or 
tribal government receiving a grant under this section shall--
        ``(1) serve only families for which--
            ``(A) there is an open record with the child welfare 
        agency; and
            ``(B) substance use disorder was a reason for the record or 
        finding described in paragraph (1); and
        ``(2) coordinate any grants awarded under this section with any 
    grant awarded under section 437(f) of the Social Security Act 
    focused on improving outcomes for children affected by substance 
    abuse.
    ``(d) Technical Assistance.--The Secretary may reserve not more 
than 5 percent of funds provided under this section to provide 
technical assistance on the establishment or expansion of programs 
funded under this section from the National Center on Substance Abuse 
and Child Welfare.''.
SEC. 8215. PROVIDER EDUCATION.
    Not later than 60 days after the date of enactment of this Act, the 
Attorney General, in consultation with the Secretary of Health and 
Human Services, shall complete the plan related to medical registration 
coordination required by Senate Report 114-239, which accompanied the 
Veterans Care Financial Protection Act of 2017 (Public Law 115-131; 132 
Stat. 334).
SEC. 8216. DEFINITIONS.
    Section 702 of the Office of National Drug Control Policy 
Reauthorization Act of 1998 (21 U.S.C. 1701) is amended--
        (1) by striking paragraphs (5), (12), and (13);
        (2) by redesignating paragraph (11) as paragraph (17);
        (3) by redesignating paragraphs (9) and (10) as paragraphs (14) 
    and (15), respectively;
        (4) by redesignating paragraphs (6), (7), and (8) as paragraphs 
    (10), (11), and (12), respectively;
        (5) by redesignating paragraphs (1), (2), (3), and (4) as 
    paragraphs (3), (4), (5), and (6), respectively;
        (6) by inserting before paragraph (3), as so redesignated, the 
    following:
        ``(1) Agency.--The term `agency' has the meaning given the term 
    `executive agency' in section 102 of title 31, United States Code.
        ``(2) Appropriate congressional committees.--
            ``(A) In general.--The term `appropriate congressional 
        committees' means--
                ``(i) the Committee on the Judiciary, the Committee on 
            Appropriations, and the Committee on Health, Education, 
            Labor, and Pensions of the Senate; and
                ``(ii) the Committee on Oversight and Government 
            Reform, the Committee on the Judiciary, the Committee on 
            Energy and Commerce, and the Committee on Appropriations of 
            the House of Representatives.
            ``(B) Submission to congress.--Any submission to Congress 
        shall mean submission to the appropriate congressional 
        committees.'';
        (7) by amending paragraph (3), as so redesignated, to read as 
    follows:
        ``(3) Demand reduction.--The term `demand reduction' means any 
    activity conducted by a National Drug Control Program Agency, other 
    than an enforcement activity, that is intended to reduce or prevent 
    the use of drugs or support, expand, or provide treatment and 
    recovery efforts, including--
            ``(A) education about the dangers of illicit drug use;
            ``(B) services, programs, or strategies to prevent 
        substance use disorder, including evidence-based education 
        campaigns, community-based prevention programs, collection and 
        disposal of unused prescription drugs, and services to at-risk 
        populations to prevent or delay initial use of an illicit drug;
            ``(C) substance use disorder treatment;
            ``(D) support for long-term recovery from substance use 
        disorders;
            ``(E) drug-free workplace programs;
            ``(F) drug testing, including the testing of employees;
            ``(G) interventions for illicit drug use and dependence;
            ``(H) expanding availability of access to health care 
        services for the treatment of substance use disorders;
            ``(I) international drug control coordination and 
        cooperation with respect to activities described in this 
        paragraph;
            ``(J) pre- and post-arrest criminal justice interventions 
        such as diversion programs, drug courts, and the provision of 
        evidence-based treatment to individuals with substance use 
        disorders who are arrested or under some form of criminal 
        justice supervision, including medication assisted treatment;
            ``(K) other coordinated and joint initiatives among 
        Federal, State, local, and Tribal agencies to promote 
        comprehensive drug control strategies designed to reduce the 
        demand for, and the availability of, illegal drugs;
            ``(L) international illicit drug use education, prevention, 
        treatment, recovery, research, rehabilitation activities, and 
        interventions for illicit drug use and dependence; and
            ``(M) research related to illicit drug use and any of the 
        activities described in this paragraph.'';
        (8) by inserting after paragraph (6), as so redesignated, the 
    following:
        ``(7) Emerging drug threat.--The term `emerging drug threat' 
    means the occurrence of a new and growing trend in the use of an 
    illicit drug or class of drugs, including rapid expansion in the 
    supply of or demand for such drug.
        ``(8) Illicit drug use; illicit drugs; illegal drugs.--The 
    terms `illicit drug use', `illicit drugs', and `illegal drugs' 
    include the illegal or illicit use of prescription drugs.
        ``(9) Law enforcement.--The term `law enforcement' or `drug law 
    enforcement' means all efforts by a Federal, State, local, or 
    Tribal government agency to enforce the drug laws of the United 
    States or any State, including investigation, arrest, prosecution, 
    and incarceration or other punishments or penalties.'';
        (9) by amending paragraph (11), as so redesignated, to read as 
    follows:
        ``(11) National drug control program agency.--The term 
    `National Drug Control Program Agency' means any agency (or bureau, 
    office, independent agency, board, division, commission, 
    subdivision, unit, or other component thereof) that is responsible 
    for implementing any aspect of the National Drug Control Strategy, 
    including any agency that receives Federal funds to implement any 
    aspect of the National Drug Control Strategy, but does not include 
    any agency that receives funds for drug control activity solely 
    under the National Intelligence Program or the Joint Military 
    Intelligence Program.'';
        (10) in paragraph (12), as so redesignated--
            (A) by inserting ``or `Strategy''' before ``means''; and
            (B) by inserting ``, including any report, plan, or 
        strategy required to be incorporated into or issued 
        concurrently with such strategy'' before the period at the end;
        (11) by inserting after paragraph (12), as so redesignated, the 
    following:
        ``(13) Nonprofit organization.--The term `nonprofit 
    organization' means an organization that is described in section 
    501(c)(3) of the Internal Revenue Code of 1986 and exempt from tax 
    under section 501(a) of such Code.'';
        (12) in paragraph (14), as so redesignated, by striking 
    ``Unless the context clearly indicates otherwise, the'' and 
    inserting ``The'';
        (13) by inserting after paragraph (15), as so redesignated, the 
    following:
        ``(16) Substance use disorder treatment.--The term `substance 
    use disorder treatment' means an evidence-based, professionally 
    directed, deliberate, and planned regimen including evaluation, 
    observation, medical monitoring, and rehabilitative services and 
    interventions such as pharmacotherapy, behavioral therapy, and 
    individual and group counseling, on an inpatient or outpatient 
    basis, to help patients with substance use disorder reach 
    recovery.''; and
        (14) in paragraph (17), as so redesignated--
            (A) by redesignating subparagraphs (B), (C), (D), and (E), 
        as subparagraphs (C), (D), (E), and (F), respectively;
            (B) by inserting after subparagraph (A) the following:
            ``(B) domestic law enforcement;'';
            (C) in subparagraph (E), as so redesignated, by striking 
        ``and'' at the end;
            (D) in subparagraph (F), as so redesignated, by striking 
        the period at the end and inserting a semicolon; and
            (E) by adding at the end the following:
            ``(G) activities to prevent the diversion of drugs for 
        their illicit use; and
            ``(H) research related to any of the activities described 
        in this paragraph.''.
SEC. 8217. AMENDMENTS TO ADMINISTRATION OF THE OFFICE.
    (a) Responsibilities of Office.--Section 703(a) of the Office of 
National Drug Control Policy Reauthorization Act of 1998 (21 U.S.C. 
1702(a)) is amended--
        (1) by striking paragraph (1) and inserting the following:
        ``(1) lead the national drug control effort, including 
    coordinating with the National Drug Control Program Agencies;'';
        (2) in paragraph (2), by inserting before the semicolon the 
    following: ``, including the National Drug Control Strategy'';
        (3) in paragraph (3), by striking ``and'' at the end; and
        (4) by striking paragraph (4) and all that follows through 
    ``the National Academy of Sciences.'' and inserting the following:
        ``(4) evaluate the effectiveness of national drug control 
    policy efforts, including the National Drug Control Program 
    Agencies' program, by developing and applying specific goals and 
    performance measurements and monitoring the agencies' program-level 
    spending;
        ``(5) identify and respond to emerging drug threats related to 
    illicit drug use;
        ``(6) administer the Drug-Free Communities Program, the High-
    Intensity Drug Trafficking Areas Program, and other grant programs 
    directly authorized to be administered by the Office in furtherance 
    of the National Drug Control Strategy; and
        ``(7) facilitate broad-scale information sharing and data 
    standardization among Federal, State, and local entities to support 
    the national drug control efforts.''.
    (b) Ethics Guidelines.--Section 703(d) of the Office of National 
Drug Control Policy Reauthorization Act of 1998 (21 U.S.C. 1702(d)) is 
amended by adding at the end the following:
        ``(4) Ethics guidelines.--The Director shall establish written 
    guidelines setting forth the criteria to be used in determining 
    whether a gift or donation should be declined under this subsection 
    because the acceptance of the gift or donation would--
            ``(A) reflect unfavorably upon the ability of the Director 
        or the Office, or any employee of the Office, to carry out 
        responsibilities or official duties under this chapter in a 
        fair and objective manner; or
            ``(B) compromise the integrity or the appearance of 
        integrity of programs or services provided under this chapter 
        or of any official involved in those programs or services.
        ``(5) Registry of gifts.--The Director shall maintain a list 
    of--
            ``(A) the source and amount of each gift or donation 
        accepted by the Office; and
            ``(B) the source and amount of each gift or donation 
        accepted by a contractor to be used in its performance of a 
        contract for the Office.
        ``(6) Report to congress.--The Director shall include in the 
    annual assessment under section 706(g) a copy of the registry 
    maintained under paragraph (5).''.
    (c) Appointment of Director and Deputy Director.--Section 704(a) of 
the Office of National Drug Control Policy Reauthorization Act of 1998 
(21 U.S.C. 1703(a)) is amended--
        (1) in paragraph (1), by striking subparagraphs (A), (B), and 
    (C), and inserting the following:
            ``(A) Director.--
                ``(i) In general.--There shall be at the head of the 
            Office a Director who shall hold the same rank and status 
            as the head of an executive department listed in section 
            101 of title 5, United States Code.
                ``(ii) Appointment.--The Director shall be appointed by 
            the President, by and with the advice and consent of the 
            Senate, and shall serve at the pleasure of the President.
            ``(B) Deputy director.--There shall be a Deputy Director 
        who shall report directly to the Director, and who shall be 
        appointed by the President, and shall serve at the pleasure of 
        the President.
            ``(C) Coordinators.--The following coordinators shall be 
        appointed by the Director:
                ``(i) Performance Budget Coordinator, as described in 
            section 704(c)(4).
                ``(ii) Interdiction Coordinator, as described in 
            section 711.
                ``(iii) Emerging and Continuing Threats Coordinator, as 
            described in section 709.
                ``(iv) State, Local, and Tribal Affairs Coordinator, to 
            carry out the activities described in section 704(j).
                ``(v) Demand Reduction Coordinator, as described in 
            subparagraph (D).
            ``(D) Demand reduction coordinator.--The Director shall 
        designate or appoint a United States Demand Reduction 
        Coordinator to be responsible for the activities described in 
        section 702(3). The Director shall determine whether the 
        coordinator position is a noncareer appointee in the Senior 
        Executive Service or a career appointee in a position at level 
        15 of the General Schedule (or equivalent).'';
        (2) in paragraph (5), by striking ``such official'' and 
    inserting ``such officer or employee''; and
        (3) by adding at the end the following:
        ``(6) Prohibition on the use of funds for ballot initiatives.--
    No funds authorized under this title may be obligated for the 
    purpose of expressly advocating the passage or defeat of a State or 
    local ballot initiative.''.
    (d) Consultation.--Section 704(b) of the Office of National Drug 
Control Policy Reauthorization Act of 1998 (21 U.S.C. 1703(b)) is 
amended--
        (1) in paragraph (19), by striking ``; and'' and inserting a 
    semicolon;
        (2) in paragraph (20), by striking the period at the end and 
    inserting ``; and''; and
        (3) by adding at the end the following:
        ``(21) in order to formulate the national drug control 
    policies, goals, objectives, and priorities--
            ``(A) shall consult with and assist--
                ``(i) State and local governments;
                ``(ii) National Drug Control Program Agencies;
                ``(iii) each committee, working group, council, or 
            other entity established under this chapter, as 
            appropriate;
                ``(iv) the public;
                ``(v) appropriate congressional committees; and
                ``(vi) any other person in the discretion of the 
            Director; and
            ``(B) may--
                ``(i) establish advisory councils;
                ``(ii) acquire data from agencies; and
                ``(iii) request data from any other entity.''.
    (e) National Drug Control Program Budget.--Section 704(c) of the 
Office of National Drug Control Policy Reauthorization Act of 1998 (21 
U.S.C. 1703(c)) is amended--
        (1) in paragraph (2)--
            (A) in subparagraph (A), by striking ``paragraph (1)(C);'' 
        and inserting the following: ``paragraph (1)(C) and include--
                ``(i) the funding level for each National Drug Control 
            Program agency; and
                ``(ii) alternative funding structures that could 
            improve progress on achieving the goals fo the National 
            Drug Control Strategy; and'';
            (B) in subparagraph (B), strike ``the President; and'' and 
        inserting ``the President and Congress.''; and
            (C) by striking subparagraph (C);
        (2) in paragraph (3)(E), by striking clause (ii) and inserting 
    the following:
                ``(ii) Certification.--The Director shall--

                    ``(I) review each budget submission submitted under 
                subparagraph (A);
                    ``(II) based on the review under clause (i), make a 
                determination as to whether the budget submission of a 
                National Drug Control Program agency includes the 
                funding levels and initiatives described in 
                subparagraph (B); and
                    ``(III) submit to the appropriate congressional 
                committees--

                        ``(aa) a written statement that either--
                            ``(AA) certifies that the budget submission 
                        includes sufficient funding; or
                            ``(BB) decertifies the budget submission as 
                        not including sufficient funding;
                        ``(bb) a copy of the description made under 
                    subparagraph (B); and
                        ``(cc) the budget recommendations made under 
                    subsection (b)(8).''; and
        (3) by adding at the end the following:
        ``(5) Performance-budget coordinator.--
            ``(A) Designation.--The Director shall designate or appoint 
        a United States Performance-Budget Coordinator to--
                ``(i) ensure the Director has sufficient information 
            necessary to analyze the performance of each National Drug 
            Control Program Agency, the impact Federal funding has had 
            on the goals in the Strategy, and the likely contributions 
            to the goals of the Strategy based on funding levels of 
            each National Drug Control Program Agency, to make an 
            independent assessment of the budget request of each agency 
            under this subsection;
                ``(ii) advise the Director on agency budgets, 
            performance measures and targets, and additional data and 
            research needed to make informed policy decisions under 
            this section and section 706; and
                ``(iii) other duties as may be determined by the 
            Director with respect to measuring or assessing performance 
            or agency budgets.
            ``(B) Determination of position.--The Director shall 
        determine whether the coordinator position is a noncareer 
        appointee in the Senior Executive Service or a career appointee 
        in a position at level 15 of the General Schedule (or 
        equivalent).
        ``(6) Budget estimate or request submission to congress.--
    Whenever the Director submits any budget estimate or request to the 
    President or the Office of Management and Budget, the Director 
    shall concurrently transmit to the appropriate congressional 
    committees a detailed statement of the budgetary needs of the 
    Office to execute its mission based on the good-faith assessment of 
    the Director.''.
    (f) Powers and Responsibilities of the Director.--Section 704 of 
the Office of National Drug Control Policy Reauthorization Act of 1998 
(21 U.S.C. 1703) is amended--
        (1) in subsection (d)(8)--
            (A) in subparagraph (D), by striking ``and'' at the end;
            (B) in subparagraph (E)--
                (i) in clause (i)--

                    (I) by striking ``Congress, including to the 
                Committees on Appropriations of the Senate and the 
                House of Representatives, the authorizing committees 
                for the Office,'' and inserting ``the appropriate 
                congressional committees''; and
                    (II) by striking ``or agencies'';

                (ii) in clause (ii)--

                    (I) by striking ``Congress'' and inserting ``the 
                appropriate congressional committees''; and
                    (II) by adding ``and'' at the end; and

                (iii) by adding at the end the following:
                ``(iii) funds may only be used for--

                    ``(I) expansion of demand reduction activities;
                    ``(II) interdiction of illicit drugs on the high 
                seas, in United States territorial waters, and at 
                United States ports of entry by officers and employees 
                of National Drug Control Program Agencies and domestic 
                and foreign law enforcement officers;
                    ``(III) accurate assessment and monitoring of 
                international drug production and interdiction programs 
                and policies;
                    ``(IV) activities to facilitate and enhance the 
                sharing of domestic and foreign intelligence 
                information among National Drug Control Program 
                Agencies related to the production and trafficking of 
                drugs in the United States and foreign countries; and
                    ``(V) research related to any of these 
                activities.'';

        (2) in subsection (e)(2)(A), by striking ``Notwithstanding any 
    other provision of law'' and inserting ``Subject to the 
    availability of appropriations''; and
        (3) by adding at the end the following:
    ``(i) Model Acts Program.--
        ``(1) In general.--The Director shall provide for or shall 
    enter into an agreement with a nonprofit organization to--
            ``(A) advise States on establishing laws and policies to 
        address illicit drug use issues; and
            ``(B) revise such model State drug laws and draft 
        supplementary model State laws to take into consideration 
        changes in illicit drug use issues in the State involved.
        ``(2) Authorization of appropriations.--There is authorized to 
    be appropriated to carry out this subsection $1,250,000 for each of 
    fiscal years 2018 through 2023.
    ``(j) State, Local, and Tribal Affairs Coordinator.--The Director 
shall designate or appoint a United States State, Local, and Tribal 
Affairs Coordinator to perform the duties of the Office outlined in 
this section and 706 and such other duties as may be determined by the 
Director with respect to coordination of drug control efforts between 
agencies and State, local, and Tribal governments. The Director shall 
determine whether the coordinator position is a noncareer appointee in 
the Senior Executive Service or a career appointee in a position at 
level 15 of the General Schedule (or equivalent).
    ``(k) Harm Reduction Programs.--When developing the national drug 
control policy, any policy of the Director, including policies relating 
to syringe exchange programs for intravenous drug users, shall be based 
on the best available medical and scientific evidence regarding the 
effectiveness of such policy in promoting individual health and 
preventing the spread of infectious disease and the impact of such 
policy on drug addiction and use. In making any policy relating to harm 
reduction programs, the Director shall consult with the National 
Institutes of Health and the National Academy of Sciences.''.
    (g) Accounting of Funds Expended.--Section 705 of the Office of 
National Drug Control Policy Reauthorization Act of 1998 (21 U.S.C. 
1704(d)), as amended by section 8207 is further amended--
        (1) by amending subsection (d) to read as follows:
    ``(d) Accounting of Funds Expended.--
        ``(1) In general.--Not later than February 1 of each year, in 
    accordance with guidance issued by the Director, the head of each 
    National Drug Control Program Agency shall submit to the Director a 
    detailed accounting of all funds expended by the agency for 
    National Drug Control Program activities during the previous fiscal 
    year and shall ensure such detailed accounting is authenticated for 
    the previous fiscal year by the Inspector General for such agency 
    prior to the submission to the Director as frequently as determined 
    by the Inspector General but not less frequently that every 3 
    years.
        ``(2) Submission to congress.--The Director shall submit to 
    Congress not later than April 1 of each year the information 
    submitted to the Director under paragraph (1).''; and
        (2) by adding at the end the following:
    ``(f) Tracking System for Federally Funded Grant Programs.--
        ``(1) Establishment.--The Director, or the head of an agency 
    designated by the Director, in coordination with the Secretary of 
    Health and Human Services, shall track federally-funded grant 
    programs to--
            ``(A) ensure the public has electronic access to 
        information identifying:
                ``(i) all drug control grants and pertinent identifying 
            information for each grant;
                ``(ii) any available performance metrics, evaluations, 
            or other information indicating the effectiveness of such 
            programs;
            ``(B) facilitate efforts to identify duplication, overlap, 
        or gaps in funding to provide increased accountability of 
        Federally-funded grants for substance use disorder treatment, 
        prevention, and enforcement; and
            ``(C) identify barriers in the grant application process 
        impediments that applicants currently have in the grant 
        application process with applicable agencies.
        ``(2) National drug control agencies.--The head of each 
    National Drug Control Program Agency shall provide to the Director 
    a complete list of all drug control program grant programs and any 
    other relevant information for inclusion in the system developed 
    under paragraph (1) and annually update such list.
        ``(3) Updating existing systems.--The Director may meet the 
    requirements of this subsection by utilizing, updating, or 
    improving existing Federal information systems to ensure they meet 
    the requirements of this subsection.
        ``(4) Report.--Not later than 3 years after the date of 
    enactment of this subsection, the Comptroller General of the United 
    States shall submit to Congress a report examining implementation 
    of this subsection.''.
    (h) Technical and Conforming Amendment.--Section 1105 of the Office 
of National Drug Control Policy Reauthorization Act of 2006 (21 U.S.C. 
1701 note) is repealed.
SEC. 8218. EMERGING THREATS COMMITTEE, PLAN, AND MEDIA CAMPAIGN.
    (a) In General.--Section 709 of the Office of National Drug Control 
Policy Reauthorization Act of 1998 (21 U.S.C. 1708) is amended to read 
as follows:
    ``SEC. 709. EMERGING THREATS COMMITTEE, PLAN, AND MEDIA CAMPAIGN.
    ``(a) Emerging Threats Coordinator.--The Director shall designate 
or appoint a United States Emerging and Continuing Threats Coordinator 
to perform the duties of that position described in this section and 
such other duties as may be determined by the Director. The Director 
shall determine whether the coordinator position is a noncareer 
appointee in the Senior Executive Service or a career appointee in a 
position at level 15 of the General Schedule (or equivalent).
    ``(b) Emerging Threats Committee.--
        ``(1) In general.--The Emerging Threats Committee shall--
            ``(A) monitor evolving and emerging drug threats in the 
        United States;
            ``(B) identify and discuss evolving and emerging drug 
        trends in the United States using the criteria required to be 
        established under paragraph (6);
            ``(C) assist in the formulation of and oversee 
        implementation of any plan described in subsection (d);
            ``(D) provide such other advice to the Coordinator and 
        Director concerning strategy and policies for emerging drug 
        threats and trends as the Committee determines to be 
        appropriate; and
            ``(E) disseminate and facilitate the sharing with Federal, 
        State, local, and Tribal officials and other entities as 
        determined by the Director of pertinent information and data 
        relating to--
                ``(i) recent trends in drug supply and demand;
                ``(ii) fatal and nonfatal overdoses;
                ``(iii) demand for and availability of evidence-based 
            substance use disorder treatment, including the extent of 
            the unmet treatment need, and treatment admission trends;
                ``(iv) recent trends in drug interdiction, supply, and 
            demand from State, local, and Tribal law enforcement 
            agencies; and
                ``(v) other subject matter as determined necessary by 
            the Director.
        ``(2) Chairperson.--The Director shall designate one of the 
    members of the Emerging Threats Committee to serve as Chairperson.
        ``(3) Members.--The Director shall appoint other members of the 
    Committee, which shall include--
            ``(A) representatives from National Drug Control Program 
        Agencies or other agencies;
            ``(B) representatives from State, local, and Tribal 
        governments; and
            ``(C) representatives from other entities as designated by 
        the Director.
        ``(4) Meetings.--The members of the Emerging Threats Committee 
    shall meet, in person and not through any delegate or 
    representative, not less frequently than once per calendar year, 
    before June 1. At the call of the Director or the Chairperson, the 
    Emerging Threats Committee may hold additional meetings as the 
    members may choose.
        ``(5) Contract, agreement, and other authority.--The Director 
    may award contracts, enter into interagency agreements, manage 
    individual projects, and conduct other activities in support of the 
    identification of emerging drug threats and in support of the 
    development, implementation, and assessment of any Emerging Threat 
    Response Plan.
        ``(6) Criteria to identify emerging drug threats.--Not later 
    than 180 days after the date on which the Committee first meets, 
    the Committee shall develop and recommend to the Director criteria 
    to be used to identify an emerging drug threat or the termination 
    of an emerging drug threat designation based on information 
    gathered by the Committee, statistical data, and other evidence.
    ``(c) Designation.--
        ``(1) In general.--The Director, in consultation with the 
    Coordinator, the Committee, and the head of each National Drug 
    Control Program Agency, may designate an emerging drug threat in 
    the United States.
        ``(2) Standards for designation.--The Director, in consultation 
    with the Coordinator, shall promulgate and make publicly available 
    standards by which a designation under paragraph (1) and the 
    termination of such designation may be made. In developing such 
    standards, the Director shall consider the recommendations of the 
    committee and other criteria the Director considers to be 
    appropriate.
        ``(3) Public statement required.--The Director shall publish a 
    public written statement on the portal of the Office explaining the 
    designation of an emerging drug threat or the termination of such 
    designation and shall notify the appropriate congressional 
    committees of the availability of such statement when a designation 
    or termination of such designation has been made.
    ``(d) Plan.--
        ``(1) Public availability of plan.--Not later than 90 days 
    after making a designation under subsection (c), the Director shall 
    publish and make publicly available an Emerging Threat Response 
    Plan and notify the President and the appropriate congressional 
    committees of such plan's availability.
        ``(2) Timing.--Concurrently with the annual submissions under 
    section 706(g), the Director shall update the plan and report on 
    implementation of the plan, until the Director issues the public 
    statement required under subsection (c)(3) to terminate the 
    emerging drug threat designation.
        ``(3) Contents of an emerging threat response plan.--The 
    Director shall include in the plan required under this subsection--
            ``(A) a comprehensive strategic assessment of the emerging 
        drug threat, including the current availability of, demand for, 
        and effectiveness of evidence-based prevention, treatment, and 
        enforcement programs and efforts to respond to the emerging 
        drug threat;
            ``(B) comprehensive, research-based, short- and long-term, 
        quantifiable goals for addressing the emerging drug threat, 
        including for reducing the supply of the drug designated as the 
        emerging drug threat and for expanding the availability and 
        effectiveness of evidence-based substance use disorder 
        treatment and prevention programs to reduce the demand for the 
        emerging drug threat;
            ``(C) performance measures pertaining to the plan's goals, 
        including quantifiable and measurable objectives and specific 
        targets;
            ``(D) the level of funding needed to implement the plan, 
        including whether funding is available to be reprogrammed or 
        transferred to support implementation of the plan or whether 
        additional appropriations are necessary to implement the plan;
            ``(E) an implementation strategy for the media campaign 
        under subsection (f), including goals as described under 
        subparagraph (B) of this paragraph and performance measures, 
        objectives, and targets, as described under subparagraph (C) of 
        this paragraph; and
            ``(F) any other information necessary to inform the public 
        of the status, progress, or response of an emerging drug 
        threat.
        ``(4) Implementation.--
            ``(A) In general.--Not later than 120 days after the date 
        on which a designation is made under subsection (c), the 
        Director, in consultation with the President, the appropriate 
        congressional committees, and the head of each National Drug 
        Control Program Agency, shall issue guidance on implementation 
        of the plan described in this subsection to the National Drug 
        Control Program Agencies and any other relevant agency 
        determined to be necessary by the Director.
            ``(B) Coordinator's responsibilities.--The Coordinator 
        shall--
                ``(i) direct the implementation of the plan among the 
            agencies identified in the plan, State, local, and Tribal 
            governments, and other relevant entities;
                ``(ii) facilitate information-sharing between agencies 
            identified in the plan, State, local, and Tribal 
            governments, and other relevant entities; and
                ``(iii) monitor implementation of the plan by 
            coordinating the development and implementation of 
            collection and reporting systems to support performance 
            measurement and adherence to the plan by agencies 
            identified in plan, where appropriate.
            ``(C) Reporting.--Not later than 180 days after the date on 
        which a designation is made under subsection (c) and in 
        accordance with subparagraph (A), the head of each agency 
        identified in the plan shall submit to the Coordinator a report 
        on implementation of the plan.
    ``(e) Evaluation of Media Campaign.--Upon designation of an 
emerging drug threat, the Director shall evaluate whether a media 
campaign would be appropriate to address that threat.
    ``(f) National Anti-drug Media Campaign.--
        ``(1) In general.--The Director shall, to the extent feasible 
    and appropriate, conduct a national anti-drug media campaign 
    (referred to in this subtitle as the `national media campaign') in 
    accordance with this subsection for the purposes of--
            ``(A) preventing substance abuse among people in the United 
        States;
            ``(B) educating the public about the dangers and negative 
        consequences of substance use and abuse, including patient and 
        family education about the characteristics and hazards of 
        substance abuse and methods to safeguard against substance use, 
        to include the safe disposal of prescription medications;
            ``(C) supporting evidence-based prevention programs 
        targeting the attitudes, perception, and beliefs of persons 
        concerning substance use and intentions to initiate or continue 
        such use;
            ``(D) encouraging individuals affected by substance use 
        disorders to seek treatment and providing such individuals with 
        information on--
                ``(i) how to recognize addiction issues;
                ``(ii) what forms of evidence-based treatment options 
            are available; and
                ``(iii) how to access such treatment;
            ``(E) combating the stigma of addiction and substance use 
        disorders, including the stigma of treating such disorders with 
        medication-assisted treatment therapies; and
            ``(F) informing the public about the dangers of any drug 
        identified by the Director as an emerging drug threat as 
        appropriate.
        ``(2) Use of funds.--
            ``(A) In general.--Amounts made available to carry out this 
        subsection for the national media campaign may only be used for 
        the following:
                ``(i) The purchase of media time and space, including 
            the strategic planning for, tracking, and accounting of, 
            such purchases.
                ``(ii) Creative and talent costs, consistent with 
            subparagraph (B)(i).
                ``(iii) Advertising production costs, which may include 
            television, radio, internet, social media, and other 
            commercial marketing venues.
                ``(iv) Testing and evaluation of advertising.
                ``(v) Evaluation of the effectiveness of the national 
            media campaign.
                ``(vi) Costs of contracts to carry out activities 
            authorized by this subsection.
                ``(vii) Partnerships with professional and civic 
            groups, community-based organizations, including faith-
            based organizations, and government organizations related 
            to the national media campaign.
                ``(viii) Entertainment industry outreach, interactive 
            outreach, media projects and activities, public 
            information, news media outreach, and corporate sponsorship 
            and participation.
                ``(ix) Operational and management expenses.
            ``(B) Specific requirements.--
                ``(i) Creative services.--In using amounts for creative 
            and talent costs under subparagraph (A)(ii), the Director 
            shall use creative services donated at no cost to the 
            Government wherever feasible and may only procure creative 
            services for advertising--

                    ``(I) responding to high-priority or emergent 
                campaign needs that cannot timely be obtained at no 
                cost; or
                    ``(II) intended to reach a minority, ethnic, or 
                other special audience that cannot reasonably be 
                obtained at no cost.

                ``(ii) Testing and evaluation of advertising.--In using 
            amounts for testing and evaluation of advertising under 
            subparagraph (A)(iv), the Director shall test all 
            advertisements prior to use in the national media campaign 
            to ensure that the advertisements are effective with the 
            target audience and meet industry-accepted standards. The 
            Director may waive this requirement for advertisements 
            using no more than 10 percent of the purchase of 
            advertising time purchased under this subsection in a 
            fiscal year and no more than 10 percent of the advertising 
            space purchased under this subsection in a fiscal year, if 
            the advertisements respond to emergent and time-sensitive 
            campaign needs or the advertisements will not be widely 
            utilized in the national media campaign.
                ``(iii) Consultation.--For the planning of the campaign 
            under paragraph (1), the Director may consult with--

                    ``(I) the head of any appropriate National Drug 
                Control Program Agency;
                    ``(II) experts on the designated drug;
                    ``(III) State, local, and Tribal government 
                officials and relevant agencies;
                    ``(IV) communications professionals;
                    ``(V) the public; and
                    ``(VI) appropriate congressional committees.

                ``(iv) Evaluation of effectiveness of national media 
            campaign.--In using amounts for the evaluation of the 
            effectiveness of the national media campaign under 
            subparagraph (A)(v), the Director shall--

                    ``(I) designate an independent entity to evaluate 
                by April 20 of each year the effectiveness of the 
                national media campaign based on data from--

                        ``(aa) the Monitoring the Future Study 
                    published by the Department of Health and Human 
                    Services;
                        ``(bb) the National Survey on Drug Use and 
                    Health; and
                        ``(cc) other relevant studies or publications, 
                    as determined by the Director, including tracking 
                    and evaluation data collected according to 
                    marketing and advertising industry standards; and

                    ``(II) ensure that the effectiveness of the 
                national media campaign is evaluated in a manner that 
                enables consideration of whether the national media 
                campaign has contributed to changes in attitude or 
                behaviors among the target audience with respect to 
                substance use and such other measures of evaluation as 
                the Director determines are appropriate.

        ``(3) Advertising.--In carrying out this subsection, the 
    Director shall ensure that sufficient funds are allocated to meet 
    the stated goals of the national media campaign.
        ``(4) Responsibilities and functions under the program.--
            ``(A) In general.--The Director shall determine the overall 
        purposes and strategy of the national media campaign.
            ``(B) Director.--
                ``(i) In general.--The Director shall approve--

                    ``(I) the strategy of the national media campaign;
                    ``(II) all advertising and promotional material 
                used in the national media campaign; and
                    ``(III) the plan for the purchase of advertising 
                time and space for the national media campaign.

                ``(ii) Implementation.--The Director shall be 
            responsible for implementing a focused national media 
            campaign to meet the purposes set forth in paragraph (1) 
            and shall ensure--

                    ``(I) information disseminated through the campaign 
                is accurate and scientifically valid; and
                    ``(II) the campaign is designed using strategies 
                demonstrated to be the most effective at achieving the 
                goals and requirements of paragraph (1), which may 
                include--

                        ``(aa) a media campaign, as described in 
                    paragraph (2);
                        ``(bb) local, regional, or population specific 
                    messaging;
                        ``(cc) the development of websites to publicize 
                    and disseminate information;
                        ``(dd) conducting outreach and providing 
                    educational resources for parents;
                        ``(ee) collaborating with law enforcement 
                    agencies; and
                        ``(ff) providing support for school-based 
                    public health education classes to improve teen 
                    knowledge about the effects of substance use.
        ``(5) Prohibitions.--None of the amounts made available under 
    paragraph (2) may be obligated or expended for any of the 
    following:
            ``(A) To supplant current anti-drug community-based 
        coalitions.
            ``(B) To supplant pro bono public service time donated by 
        national and local broadcasting networks for other public 
        service campaigns.
            ``(C) For partisan political purposes, or to express 
        advocacy in support of or to defeat any clearly identified 
        candidate, clearly identified ballot initiative, or clearly 
        identified legislative or regulatory proposal.
            ``(D) To fund advertising that features any elected 
        officials, persons seeking elected office, cabinet level 
        officials, or other Federal officials employed pursuant to 
        section 213 of Schedule C of title 5, Code of Federal 
        Regulations.
            ``(E) To fund advertising that does not contain a primary 
        message intended to reduce or prevent substance use.
            ``(F) To fund advertising containing a primary message 
        intended to promote support for the national media campaign or 
        private sector contributions to the national media campaign.
        ``(6) Matching requirement.--
            ``(A) In general.--Amounts made available under paragraph 
        (2) for media time and space shall be matched by an equal 
        amount of non-Federal funds for the national media campaign, or 
        be matched with in-kind contributions of the same value.
            ``(B) No-cost match advertising direct relationship 
        requirement.--The Director shall ensure that not less than 85 
        percent of no-cost match advertising directly relates to 
        substance abuse prevention consistent with the specific 
        purposes of the national media campaign.
            ``(C) No-cost match advertising not directly related.--The 
        Director shall ensure that no-cost match advertising that does 
        not directly relate to substance abuse prevention consistent 
        with the purposes of the national media campaign includes a 
        clear anti-drug message. Such message is not required to be the 
        primary message of the match advertising.
        ``(7) Financial and performance accountability.--The Director 
    shall cause to be performed--
            ``(A) audits and reviews of costs of the national media 
        campaign pursuant to section 4706 of title 41, United States 
        Code; and
            ``(B) an audit to determine whether the costs of the 
        national media campaign are allowable under chapter 43 of title 
        41, United States Code.
        ``(8) Report to congress.--The Director shall submit on an 
    annual basis a report to Congress that describes--
            ``(A) the strategy of the national media campaign and 
        whether specific objectives of the national media campaign were 
        accomplished;
            ``(B) steps taken to ensure that the national media 
        campaign operates in an effective and efficient manner 
        consistent with the overall strategy and focus of the national 
        media campaign;
            ``(C) plans to purchase advertising time and space;
            ``(D) policies and practices implemented to ensure that 
        Federal funds are used responsibly to purchase advertising time 
        and space and eliminate the potential for waste, fraud, and 
        abuse;
            ``(E) all contracts entered into with a corporation, 
        partnership, or individual working on behalf of the national 
        media campaign;
            ``(F) the results of any financial audit of the national 
        media campaign;
            ``(G) a description of any evidence used to develop the 
        national media campaign;
            ``(H) specific policies and steps implemented to ensure 
        compliance with this section;
            ``(I) a detailed accounting of the amount of funds 
        obligated during the previous fiscal year for carrying out the 
        national media campaign, including each recipient of funds, the 
        purpose of each expenditure, the amount of each expenditure, 
        any available outcome information, and any other information 
        necessary to provide a complete accounting of the funds 
        expended; and
            ``(J) a review and evaluation of the effectiveness of the 
        national media campaign strategy for the past year.
        ``(9) Required notice for communication from the office.--Any 
    communication, including an advertisement, paid for or otherwise 
    disseminated by the Office directly or through a contract awarded 
    by the Office shall include a prominent notice informing the 
    audience that the communication was paid for by the Office.
    ``(g) Authorization of Appropriations.--There is authorized to be 
appropriated to the Office to carry out this section, $25,000,000 for 
each of fiscal years 2018 through 2023.''.
    (b) Technical and Conforming Amendment.--Subsection (a) of section 
203 of the Office of National Drug Control Policy Reauthorization Act 
of 2006 (21 U.S.C. 1708a) is repealed.
SEC. 8219. DRUG INTERDICTION.
    (a) Repeal.--This first section 711 of the Office of National Drug 
Control Policy Reauthorization Act of 1998 (21 U.S.C. 1710) is 
repealed.
    (b) Amendments.--Section 711 of the Office of National Drug Control 
Policy Reauthorization Act of 1998 (21 U.S.C. 1710), as added by Public 
Law 109-469 (120 Stat. 3507), is amended--
        (1) in subsection (a)--
            (A) in paragraph (1)--
                (i) by striking ``The United'' and inserting ``The 
            Director shall designate or appoint an appointee in the 
            Senior Executive Service or an appointee in a position at 
            level 15 of the General Schedule (or equivalent) as the 
            United''; and
                (ii) by striking ``shall'' and inserting ``to'';
            (B) in paragraph (2)(B)--
                (i) by striking ``March 1'' and inserting ``September 
            1''; and
                (ii) by striking ``paragraph (3)'' and inserting 
            ``paragraph (4)'';
            (C) in paragraph (3)--
                (i) by striking ``also, at his discretion,''; and
                (ii) by striking ``the Office of Supply Reduction for 
            that purpose'' and inserting ``assist in carrying out such 
            responsibilities''; and
            (D) in paragraph (4)--
                (i) in subparagraph (B), by striking ``The United'' and 
            inserting ``Before submission of the National Drug Control 
            Strategy or annual assessment required under section 706, 
            as applicable, the United'';
                (ii) by striking subparagraphs (C) and (E);
                (iii) by redesignating subparagraph (D) as subparagraph 
            (C);
                (iv) in subparagraph (C), as so redesignated--

                    (I) in the matter preceding clause (i)--

                        (aa) by striking ``March 1'' and inserting 
                    ``September 1'';
                        (bb) by inserting ``the Director, acting 
                    through'' before ``the United States'';
                        (cc) by inserting a comma after 
                    ``Coordinator'';
                        (dd) by striking ``a report on behalf of the 
                    Director''; and
                        (ee) by striking ``, which shall include'' and 
                    inserting ``a report that'';

                    (II) by redesignating clauses (i), (ii), and (iii) 
                as subclauses (I), (II), and (III), and adjusting the 
                margins accordingly;
                    (III) by inserting before subclause (I), as so 
                redesignated, the following:

                ``(i) includes--'';

                    (IV) in clause (i), as so redesignated--

                        (aa) in subclause (I), as so redesignated, by 
                    inserting ``, including information about how each 
                    National Drug Control Program agency conducting 
                    drug interdiction activities is engaging with 
                    relevant international partners'' after ``Plan'';
                        (bb) in subclause (II), as so redesignated, by 
                    striking ``, as well as'' and inserting ``and'';
                        (cc) in subclause III, as so redesignated--
                            (AA) by striking ``, as well as'' and 
                        inserting ``and''; and
                            (BB) by striking the period at the end and 
                        inserting ``; and''; and

                    (V) by adding at the end the following:

                ``(ii) may include recommendations for changes to 
            existing agency authorities or laws governing interagency 
            relationships.''; and
                (v) by adding at the end the following:
            ``(D) Classified annex.--Each report required to be 
        submitted under subparagraph (C) shall be in unclassified form, 
        but may include a classified annex.'';
        (2) in subsection (b)--
            (A) in paragraph (1)(B), by inserting ``and how to 
        strengthen international partnerships to better achieve the 
        goals of that plan'' after ``that plan'';
            (B) in paragraph (2)--
                (i) in the paragraph heading, by striking ``Chairman'' 
            and inserting ``Chairperson''; and
                (ii) by striking ``chairman'' and inserting 
            ``Chairperson'';
            (C) in paragraph (3)--
                (i) by striking ``prior to March 1'' and inserting 
            ``before June 1'';
                (ii) by striking ``either'' each place it appears;
                (iii) by striking ``current chairman'' and inserting 
            ``Chairperson''; and
                (iv) by striking ``they'' and inserting ``the 
            members''; and
            (D) in paragraph (4)--
                (i) by striking ``chairman'' each place it appears and 
            inserting ``Chairperson'';
                (ii) in the first sentence, by striking ``a report'';
                (iii) by inserting ``a report'' after ``committees''; 
            and
                (iv) by striking the second sentence and inserting the 
            following: ``The report required under this paragraph shall 
            be in unclassified form, but may include a classified 
            annex.''; and
        (3) by adding at the end the following:
    ``(c) International Coordination.--The Director may facilitate 
international drug control coordination efforts.''.
SEC. 8220. GAO AUDIT.
    Not later than 4 years after the date of enactment of this Act, and 
every 4 years thereafter, the Comptroller General of the United States 
shall--
        (1) conduct an audit relating to the programs and operations 
    of--
            (A) the Office; and
            (B) certain programs within the Office, including--
                (i) the High Intensity Drug Trafficking Areas Program;
                (ii) the Drug-Free Communities Program; and
                (iii) the campaign under section 709(f) of the Office 
            of National Drug Control Policy Reauthorization Act of 1998 
            (21 U.S.C. 1708(f)); and
        (2) submit to the Director and the appropriate congressional 
    committees a report containing an evaluation of and recommendations 
    on the--
            (A) policies and activities of the programs and operations 
        subject to the audit;
            (B) economy, efficiency, and effectiveness in the 
        administration of the reviewed programs and operations; and
            (C) policy or management changes needed to prevent and 
        detect fraud and abuse in such programs and operations.
SEC. 8221. NATIONAL DRUG CONTROL STRATEGY.
    (a) In General.--Section 706 of the Office of National Drug Control 
Policy Reauthorization Act of 1998 (21 U.S.C. 1705) is amended to read 
as follows:
    ``SEC. 706. NATIONAL DRUG CONTROL STRATEGY.
    ``(a) In General.--
        ``(1) Statement of drug policy priorities.--The Director shall 
    release a statement of drug control policy priorities in the 
    calendar year of a Presidential inauguration following the 
    inauguration, but not later than April 1.
        ``(2) National drug control strategy submitted by the 
    president.--Not later than the first Monday in February following 
    the year in which the term of the President commences, and every 2 
    years thereafter, the President shall submit to Congress a National 
    Drug Control Strategy.
    ``(b) Development of the National Drug Control Strategy.--
        ``(1) Promulgation.--The Director shall promulgate the National 
    Drug Control Strategy, which shall set forth a comprehensive plan 
    to reduce illicit drug use and the consequences of such illicit 
    drug use in the United States by limiting the availability of and 
    reducing the demand for illegal drugs and promoting prevention, 
    early intervention, treatment, and recovery support for individuals 
    with substance use disorders.
        ``(2) State and local commitment.--The Director shall seek the 
    support and commitment of State, local, and Tribal officials in the 
    formulation and implementation of the National Drug Control 
    Strategy.
        ``(3) Strategy based on evidence.--The Director shall ensure 
    the National Drug Control Strategy is based on the best available 
    evidence regarding the policies that are most effective in reducing 
    the demand for and supply of illegal drugs.
        ``(4) Process for development and submission of national drug 
    control strategy.--In developing and effectively implementing the 
    National Drug Control Strategy, the Director--
            ``(A) shall consult with--
                ``(i) the heads of the National Drug Control Program 
            Agencies;
                ``(ii) each Coordinator listed in section 704;
                ``(iii) the Interdiction Committee and the Emerging 
            Threats Committee;
                ``(iv) the appropriate congressional committees and any 
            other committee of jurisdiction;
                ``(v) State, local, and Tribal officials;
                ``(vi) private citizens and organizations, including 
            community and faith-based organizations, with experience 
            and expertise in demand reduction;
                ``(vii) private citizens and organizations with 
            experience and expertise in supply reduction; and
                ``(viii) appropriate representatives of foreign 
            governments; and
            ``(B) in satisfying the requirements of subparagraph (A), 
        shall ensure, to the maximum extent possible, that State, 
        local, and Tribal officials and relevant private organizations 
        commit to support and take steps to achieve the goals and 
        objectives of the National Drug Control Strategy.
    ``(c) Contents of the National Drug Control Strategy.--
        ``(1) In general.--The National Drug Control Strategy submitted 
    under subsection (a)(2) shall include the following:
            ``(A) A mission statement detailing the major functions of 
        the National Drug Control Program.
            ``(B) Comprehensive, research-based, long-range, 
        quantifiable goals for reducing illicit drug use, and the 
        consequences of illicit drug use in the United States.
            ``(C) Annual quantifiable and measurable objectives and 
        specific targets to accomplish long-term quantifiable goals 
        that the Director determines may be achieved during each year 
        beginning on the date on which the National Drug Control 
        Strategy is submitted.
            ``(D) A 5-year projection for the National Drug Control 
        Program and budget priorities.
            ``(E) A review of international, State, local, and private 
        sector drug control activities to ensure that the United States 
        pursues coordinated and effective drug control at all levels of 
        government.
            ``(F) A description of how each goal established under 
        subparagraph (B) will be achieved, including for each goal--
                ``(i) a list of each relevant National Drug Control 
            Program Agency and each such agency's related programs, 
            activities, and available assets and the role of each such 
            program, activity, and asset in achieving such goal;
                ``(ii) a list of relevant stakeholders and each such 
            stakeholder's role in achieving such goal;
                ``(iii) an estimate of Federal funding and other 
            resources needed to achieve such goal;
                ``(iv) a list of each existing or new coordinating 
            mechanism needed to achieve such goal; and
                ``(v) a description of the Office's role in 
            facilitating the achievement of such goal.
            ``(G) For each year covered by the Strategy, a performance 
        evaluation plan for each goal established under subparagraph 
        (B) for each National Drug Control Program Agency, including--
                ``(i) specific performance measures for each National 
            Drug Control Program Agency;
                ``(ii) annual and, to the extent practicable, quarterly 
            objectives and targets for each performance measure; and
                ``(iii) an estimate of Federal funding and other 
            resources needed to achieve each performance objective and 
            target.
            ``(H) A list identifying existing data sources or a 
        description of data collection needed to evaluate performance, 
        including a description of how the Director will obtain such 
        data.
            ``(I) A list of any anticipated challenges to achieving the 
        National Drug Control Strategy goals and planned actions to 
        address such challenges.
            ``(J) A description of how each goal established under 
        subparagraph (B) was determined, including--
                ``(i) a description of each required consultation and a 
            description of how such consultation was incorporated; and
                ``(ii) data, research, or other information used to 
            inform the determination to establish the goal.
            ``(K) A description of the current prevalence of illicit 
        drug use in the United States, including both the availability 
        of illicit drugs and the prevalence of substance use disorders.
            ``(L) Such other statistical data and information as the 
        Director considers appropriate to demonstrate and assess trends 
        relating to illicit drug use, the effects and consequences of 
        illicit drug use (including the effects on children), supply 
        reduction, demand reduction, drug-related law enforcement, and 
        the implementation of the National Drug Control Strategy.
            ``(M) A systematic plan for increasing data collection to 
        enable real time surveillance of drug control threats, 
        developing analysis and monitoring capabilities, and 
        identifying and addressing policy questions related to the 
        National Drug Control Strategy and Program, which shall 
        include--
                ``(i) a list of policy-relevant questions for which the 
            Director and each National Drug Control Program Agency 
            intends to develop evidence to support the National Drug 
            Control Program and Strategy;
                ``(ii) a list of data the Director and each National 
            Drug Control Program Agency intends to collect, use, or 
            acquire to facilitate the use of evidence in drug control 
            policymaking and monitoring;
                ``(iii) a list of methods and analytical approaches 
            that may be used to develop evidence to support the 
            National Drug Control Program and Strategy and related 
            policy;
                ``(iv) a list of any challenges to developing evidence 
            to support policymaking, including any barriers to 
            accessing, collecting, or using relevant data;
                ``(v) a description of the steps the Director and the 
            head of each National Drug Control Program Agency will take 
            to effectuate the plan; and
                ``(vi) any other relevant information as determined by 
            the Director.
            ``(N) A plan to expand treatment of substance use 
        disorders, which shall--
                ``(i) identify unmet needs for treatment for substance 
            use disorders and a strategy for closing the gap between 
            available and needed treatment;
                ``(ii) describe the specific roles and responsibilities 
            of the relevant National Drug Control Programs for 
            implementing the plan;
                ``(iii) identify the specific resources required to 
            enable the relevant National Drug Control Agencies to 
            implement that strategy; and
                ``(iv) identify the resources, including private 
            sources, required to eliminate the unmet need for evidence-
            based substance use disorder treatment.
        ``(2) Consultation.--In developing the plan required under 
    paragraph (1), the Director shall consult with the following:
            ``(A) The public.
            ``(B) Any evaluation or analysis units and personnel of the 
        Office.
            ``(C) Office officials responsible for implementing privacy 
        policy.
            ``(D) Office officials responsible for data governance.
            ``(E) The appropriate congressional committees.
            ``(F) Any other individual or entity as determined by the 
        Director.
        ``(3) Additional strategies.--
            ``(A) In general.--The Director shall include in the 
        National Drug Control Strategy the additional strategies 
        described under this paragraph and shall comply with the 
        following:
                ``(i) Provide a copy of the additional strategies to 
            the appropriate congressional committees and to the 
            Committee on Armed Services and the Committee on Homeland 
            Security of the House of Representatives, and the Committee 
            on Homeland Security and Governmental Affairs and the 
            Committee on Armed Services of the Senate.
                ``(ii) Issue the additional strategies in consultation 
            with the head of each relevant National Drug Control 
            Program Agency, any relevant official of a State, local, or 
            Tribal government, and the government of other relevant 
            countries.
                ``(iii) Not change any existing agency authority or 
            construe any strategy described under this paragraph to 
            amend or modify any law governing interagency relationship 
            but may include recommendations about changes to such 
            authority or law.
                ``(iv) Present separately from the rest of any strategy 
            described under this paragraph any information classified 
            under criteria established by an Executive order, or whose 
            public disclosure, as determined by the Director or the 
            head of any relevant National Drug Control Program Agency, 
            would be detrimental to the law enforcement or national 
            security activities of any Federal, State, local, or Tribal 
            agency.
            ``(B) Requirement for southwest border counternarcotics 
        strategy.--
                ``(i) Purposes.--The Southwest Border Counternarcotics 
            Strategy shall--

                    ``(I) set forth the Government's strategy for 
                preventing the illegal trafficking of drugs across the 
                international border between the United States and 
                Mexico, including through ports of entry and between 
                ports of entry on that border;
                    ``(II) state the specific roles and 
                responsibilities of the relevant National Drug Control 
                Program Agencies for implementing that strategy; and
                    ``(III) identify the specific resources required to 
                enable the relevant National Drug Control Program 
                Agencies to implement that strategy.

                ``(ii) Specific content related to drug tunnels between 
            the united states and mexico.--The Southwest Border 
            Counternarcotics Strategy shall include--

                    ``(I) a strategy to end the construction and use of 
                tunnels and subterranean passages that cross the 
                international border between the United States and 
                Mexico for the purpose of illegal trafficking of drugs 
                across such border; and
                    ``(II) recommendations for criminal penalties for 
                persons who construct or use such a tunnel or 
                subterranean passage for such a purpose.

            ``(C) Requirement for northern border counternarcotics 
        strategy.--
                ``(i) Purposes.--The Northern Border Counternarcotics 
            Strategy shall--

                    ``(I) set forth the strategy of the Federal 
                Government for preventing the illegal trafficking of 
                drugs across the international border between the 
                United States and Canada, including through ports of 
                entry and between ports of entry on the border;
                    ``(II) state the specific roles and 
                responsibilities of each relevant National Drug Control 
                Program Agency for implementing the strategy;
                    ``(III) identify the specific resources required to 
                enable the relevant National Drug Control Program 
                Agencies to implement the strategy;
                    ``(IV) be designed to promote, and not hinder, 
                legitimate trade and travel; and
                    ``(V) reflect the unique nature of small 
                communities along the international border between the 
                United States and Canada, ongoing cooperation and 
                coordination with Canadian law, enforcement 
                authorities, and variations in the volumes of vehicles 
                and pedestrians crossing through ports of entry along 
                the international border between the United States and 
                Canada.

                ``(ii) Specific content related to cross-border indian 
            reservations.--The Northern Border Counternarcotics 
            Strategy shall include--

                    ``(I) a strategy to end the illegal trafficking of 
                drugs to or through Indian reservations on or near the 
                international border between the United States and 
                Canada; and
                    ``(II) recommendations for additional assistance, 
                if any, needed by Tribal law enforcement agencies 
                relating to the strategy, including an evaluation of 
                Federal technical and financial assistance, 
                infrastructure capacity building, and interoperability 
                deficiencies.

        ``(4) Classified information.--Any contents of the National 
    Drug Control Strategy that involve information properly classified 
    under criteria established by an Executive order shall be presented 
    to Congress separately from the rest of the National Drug Control 
    Strategy.
        ``(5) Selection of data and information.--In selecting data and 
    information for inclusion in the Strategy, the Director shall 
    ensure--
            ``(A) the inclusion of data and information that will 
        permit analysis of current trends against previously compiled 
        data and information where the Director believes such analysis 
        enhances long-term assessment of the National Drug Control 
        Strategy; and
            ``(B) the inclusion of data and information to permit a 
        standardized and uniform assessment of the effectiveness of 
        drug treatment programs in the United States.
    ``(d) Submission of Revised Strategy.--The President may submit to 
Congress a revised National Drug Control Strategy that meets the 
requirements of this section--
        ``(1) at any time, upon a determination of the President, in 
    consultation with the Director, that the National Drug Control 
    Strategy in effect is not sufficiently effective; or
        ``(2) if a new President or Director takes office.
    ``(e) Failure of Director to Submit National Drug Control 
Strategy.--If the Director does not submit a National Drug Control 
Strategy to Congress in accordance with subsection (a)(2), not later 
than five days after the first Monday in February following the year in 
which the term of the President commences, the Director shall send a 
notification to the appropriate congressional committees--
        ``(1) explaining why the Strategy was not submitted; and
        ``(2) specifying the date by which the Strategy will be 
    submitted.
    ``(f) Drug Control Data Dashboard.--
        ``(1) In general.--The Director shall collect and disseminate, 
    as appropriate, such information as the Director determines is 
    appropriate, but not less than the information described in this 
    subsection. The data shall be publicly available in a machine-
    readable format on the online portal of the Office, and to the 
    extent practicable on the Drug Control Data Dashboard.
        ``(2) Establishment.--The Director shall publish to the online 
    portal of the office in a machine-readable, sortable, and 
    searchable format, or to the extent practicable, establish and 
    maintain a data dashboard on the online portal of the Office to be 
    known as the `Drug Control Data Dashboard'. To the extent 
    practicable, when establishing the Drug Control Dashboard, the 
    Director shall ensure the user interface of the dashboard is 
    constructed with modern design standards. To the extent 
    practicable, the data made available on the dashboard shall be 
    publicly available in a machine-readable format and searchable by 
    year, agency, drug, and location.
        ``(3) Data.--The data included in the Drug Control Data 
    Dashboard shall be updated quarterly to the extent practicable, but 
    not less frequently than annually and shall include, at a minimum, 
    the following:
            ``(A) For each substance identified by the Director as 
        having a significant impact on the prevalence of illicit drug 
        use--
                ``(i) data sufficient to show the quantities of such 
            substance available in the United States, including--

                    ``(I) the total amount seized and disrupted in the 
                calendar year and each of the previous 3 calendar 
                years, including to the extent practicable the amount 
                seized by State, local, and Tribal governments;
                    ``(II) the known and estimated flows into the 
                United States from all sources in the calendar year and 
                each of the previous 3 calendar years;
                    ``(III) the total amount of known flows that could 
                not be interdicted or disrupted in the calendar year 
                and each of the previous 3 calendar years;
                    ``(IV) the known and estimated levels of domestic 
                production in the calendar year and each of the 
                previous three calendar years, including the levels of 
                domestic production if the drug is a prescription drug, 
                as determined under the Federal Food, Drug, and 
                Cosmetic Act, for which a listing is in effect under 
                section 202 of the Controlled Substances Act (21 U.S.C. 
                812);
                    ``(V) the average street price for the calendar 
                year and the highest known street price during the 
                preceding 10-year period; and
                    ``(VI) to the extent practicable, related 
                prosecutions by State, local, and Tribal governments;

                ``(ii) data sufficient to show the frequency of use of 
            such substance, including--

                    ``(I) use of such substance in the workplace and 
                productivity lost by such use;
                    ``(II) use of such substance by arrestees, 
                probationers, and parolees;
                    ``(III) crime and criminal activity related to such 
                substance;
                    ``(IV) to the extent practicable, related 
                prosecutions by State, local, and Tribal governments;

            ``(B) For the calendar year and each of the previous three 
        years data sufficient to show, disaggregated by State and, to 
        the extent feasible, by region within a State, county, or city, 
        the following:
                ``(i) The number of fatal and non-fatal overdoses 
            caused by each drug identified under subparagraph (A)(i).
                ``(ii) The prevalence of substance use disorders.
                ``(iii) The number of individuals who have received 
            substance use disorder treatment, including medication 
            assisted treatment, for a substance use disorder, including 
            treatment provided through publicly-financed health care 
            programs.
                ``(iv) The extent of the unmet need for substance use 
            disorder treatment, including the unmet need for 
            medication-assisted treatment.
            ``(C) Data sufficient to show the extent of prescription 
        drug diversion, trafficking, and misuse in the calendar year 
        and each of the previous 3 calendar years.
            ``(D) Any quantifiable measures the Director determines to 
        be appropriate to detail progress toward the achievement of the 
        goals of the National Drug Control Strategy.
    ``(g) Development of an Annual National Drug Control Assessment.--
        ``(1) Timing.--Not later than the first Monday in February of 
    each year, the Director shall submit to the President, Congress, 
    and the appropriate congressional committees, a report assessing 
    the progress of each National Drug Control Program Agency toward 
    achieving each goal, objective, and target contained in the 
    National Drug Control Strategy applicable to the prior fiscal year.
        ``(2) Process for development of the annual assessment.--Not 
    later than November 1 of each year, the head of each National Drug 
    Control Program Agency shall submit, in accordance with guidance 
    issued by the Director, to the Director an evaluation of progress 
    by the agency with respect to the National Drug Control Strategy 
    goals using the performance measures for the agency developed under 
    this title, including progress with respect to--
            ``(A) success in achieving the goals of the National Drug 
        Control Strategy;
            ``(B) success in reducing domestic and foreign sources of 
        illegal drugs;
            ``(C) success in expanding access to and increasing the 
        effectiveness of substance use disorder treatment;
            ``(D) success in protecting the borders of the United 
        States (and in particular the Southwestern border of the United 
        States) from penetration by illegal narcotics;
            ``(E) success in reducing crime associated with drug use in 
        the United States;
            ``(F) success in reducing the negative health and social 
        consequences of drug use in the United States;
            ``(G) implementation of evidence-based substance use 
        disorder treatment and prevention programs in the United States 
        and improvements in the adequacy and effectiveness of such 
        programs; and
            ``(H) success in increasing the prevention of illicit drug 
        use.
        ``(3) Contents of the annual assessment.--The Director shall 
    include in the annual assessment required under paragraph (1)--
            ``(A) a summary of each evaluation received by the Director 
        under paragraph (2);
            ``(B) a summary of the progress of each National Drug 
        Control Program Agency toward the National Drug Control 
        Strategy goals of the agency using the performance measures for 
        the agency developed under this chapter;
            ``(C) an assessment of the effectiveness of each National 
        Drug Control Program Agency and program in achieving the 
        National Drug Control Strategy for the previous year, including 
        a specific evaluation of whether the applicable goals, 
        measures, objectives, and targets for the previous year were 
        met; and
            ``(D) the assessments required under this subsection shall 
        be based on the Performance Measurement System.''.
    (b) Technical and Conforming Amendments.--
        (1) Section 704(b) of the Office of National Drug Control 
    Policy Reauthorization Act of 1998 (21 U.S.C. 1703(b)) is amended--
            (A) by striking paragraphs (13) and (17); and
            (B) in paragraph (14)(A), by striking ``paragraph (13)'' 
        and inserting ``section 706(g)(2)''.
        (2) The Office of National Drug Control Policy Reauthorization 
    Act of 2006 (Public Law 109-469; 120 Stat. 3502) is amended by 
    striking sections 1110 and 1110A.
SEC. 8222. TECHNICAL AND CONFORMING AMENDMENTS TO THE OFFICE OF 
NATIONAL DRUG CONTROL POLICY REAUTHORIZATION ACT OF 1998.
    The Office of National Drug Control Policy Reauthorization Act of 
1998 (21 U.S.C. 1701 et seq.) is amended--
        (1) by striking section 703(b) (21 U.S.C. 1702(b));
        (2) in section 704 (21 U.S.C. 1703)--
            (A) in subsection (c)--
                (i) in paragraph (3)(C)--

                    (I) in the matter before clause (i), by inserting 
                ``requests a level of funding that will not enable 
                achievement of the goals of the National Drug Control 
                Strategy, including'' after ``request that'';
                    (II) in clause (iii)--

                        (aa) by striking ``drug treatment'' and 
                    inserting ``substance use disorder prevention and 
                    treatment''; and
                        (bb) by striking the semicolon at the end and 
                    inserting ``; and'';

                    (III) by striking clauses (iv), (vi), and (vii);
                    (IV) by redesignating clause (v) as clause (iv); 
                and
                    (V) in clause (iv), as so redesignated, by striking 
                the semicolon and inserting a period;

                (ii) in paragraph (4)(A), by striking ``$1,000,000'' 
            and inserting ``$5,000,000 or 10 percent of a specific 
            program or account''; and
            (B) in subsection (f)--
                (i) by striking the first paragraph (5); and
                (ii) by striking the second paragraph (4); and
        (3) by striking section 708 (21 U.S.C. 1707).

                     Subtitle L--Budgetary Effects

SEC. 8231. BUDGETARY EFFECT.
    (a) In General.--The budgetary effects of this Act shall not be 
entered on either PAYGO scorecard maintained pursuant to section 4(d) 
of the Statutory Pay-As-You-Go Act of 2010 (2 U.S.C. 933(d)).
    (b) Senate PAYGO Scorecards.--The budgetary effects of this Act 
shall not be entered on any PAYGO scorecard maintained for purposes of 
section 4106 of H. Con. Res. 71 (115th Congress).

                               Speaker of the House of Representatives.

                            Vice President of the United States and    
                                               President of the Senate.