[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[S. 2134 Introduced in Senate (IS)]

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115th CONGRESS
  1st Session
                                S. 2134

To require the Secretary of Veterans Affairs to establish processes to 
 ensure that non-Department of Veterans Affairs health care providers 
 are using safe practices in prescribing opioids to veterans under the 
      laws administered by the Secretary, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                           November 15, 2017

 Ms. Baldwin (for herself, Mrs. Capito, Mr. Moran, Mr. Blumenthal, Mr. 
  Manchin, Mr. Tester, and Mr. Brown) introduced the following bill; 
which was read twice and referred to the Committee on Veterans' Affairs

_______________________________________________________________________

                                 A BILL


 
To require the Secretary of Veterans Affairs to establish processes to 
 ensure that non-Department of Veterans Affairs health care providers 
 are using safe practices in prescribing opioids to veterans under the 
      laws administered by the Secretary, and for other purposes.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Andrew White Veterans Community Care 
Opioid Safety Act''.

SEC. 2. ESTABLISHMENT OF PROCESSES TO ENSURE SAFE OPIOID PRESCRIBING 
              PRACTICES BY NON-DEPARTMENT OF VETERANS AFFAIRS HEALTH 
              CARE PROVIDERS.

    (a) Receipt and Review of Guidelines.--The Secretary of Veterans 
Affairs shall ensure that all covered health care providers are 
provided a copy of and certify that they have reviewed the evidence-
based guidelines for prescribing opioids set forth by the Opioid Safety 
Initiative of the Department of Veterans Affairs under sections 
911(a)(2) and 912(c) of the Jason Simcakoski Memorial and Promise Act 
(Public Law 114-198; 38 U.S.C. 1701 note) before first providing care 
under the laws administered by the Secretary and at any time when those 
guidelines are modified thereafter.
    (b) Inclusion of Medical History and Current Medications.--The 
Secretary shall implement a process to ensure that, if care of a 
veteran by a covered health care provider is authorized under the laws 
administered by the Secretary, the document authorizing such care 
includes the relevant medical history of the veteran and a list of all 
medications prescribed to the veteran.
    (c) Submittal of Prescriptions.--
            (1) In general.--Except as provided in paragraph (2), the 
        Secretary shall require all covered health care providers who 
        prescribe opioids to veterans under the laws administered by 
        the Secretary to submit any such prescription directly to a 
        pharmacy of the Department--
                    (A) for the dispensing of such prescription;
                    (B) for the recording of such prescription in the 
                electronic health record of the veteran; and
                    (C) to enable other monitoring of such prescription 
                as outlined in the Opioid Safety Initiative of the 
                Department.
            (2) Exception.--
                    (A) In general.--A covered health care provider is 
                not required under paragraph (1) to submit an opioid 
                prescription directly to a pharmacy of the Department 
                if--
                            (i) the health care provider determines 
                        that there is an immediate medical need for the 
                        prescription, including an urgent or emergent 
                        prescription or a prescription dispensed as 
                        part of an opioid treatment program that 
                        provides office-based medications; and
                            (ii)(I) following an inquiry into the 
                        matter, a pharmacy of the Department notifies 
                        the health care provider that it cannot fill 
                        the prescription in a timely manner; or
                            (II) the health care provider determines 
                        that the requirement under paragraph (1) would 
                        impose an undue hardship on the veteran, 
                        including with respect to travel distances, as 
                        determined by the Secretary.
                    (B) Notification to department.--If a covered 
                health care provider uses an exception under 
                subparagraph (A) with respect to an opioid prescription 
                for a veteran, the health care provider shall, on the 
                same day the prescription is written, submit to the 
                Secretary for inclusion in the electronic health record 
                of the veteran a notice, in such form as the Secretary 
                may establish, providing information about the 
                prescription and describing the reason for the 
                exception.
                    (C) Report.--
                            (i) In general.--Not less frequently than 
                        quarterly, the Secretary shall submit to the 
                        Committee on Veterans' Affairs of the Senate 
                        and the Committee on Veterans' Affairs of the 
                        House of Representatives a report evaluating 
                        the compliance of covered health care providers 
                        with the requirements under this paragraph and 
                        setting forth data on the use by health care 
                        providers of exceptions under subparagraph (A) 
                        and notices under subparagraph (B).
                            (ii) Elements.--Each report required by 
                        clause (i) shall include the following with 
                        respect to the quarter covered by the report:
                                    (I) The number of exceptions used 
                                under subparagraph (A) and notices 
                                received under subparagraph (B).
                                    (II) The rate of compliance by the 
                                Department with the requirement under 
                                subparagraph (B) to include such 
                                notices in the health records of 
                                veterans.
                                    (III) The identification of any 
                                covered health care providers that, 
                                based on criteria prescribed the 
                                Secretary, are determined by the 
                                Secretary to be statistical outliers 
                                regarding the use of exceptions under 
                                subparagraph (A).
    (d) Use of Opioid Safety Initiative Guidelines.--
            (1) In general.--If a director of a medical center of the 
        Department or a Veterans Integrated Service Network determines 
        that the opioid prescribing practices of a covered health care 
        provider conflicts with or is otherwise inconsistent with the 
        standards of appropriate and safe care, as that term is used in 
        section 913(d) of the Jason Simcakoski Memorial and Promise Act 
        (Public Law 114-198; 38 U.S.C. 1701 note), the director shall 
        take such action as the director considers appropriate to 
        ensure the safety of all veterans receiving care from that 
        health care provider, including removing or directing the 
        removal of any such health care provider from provider networks 
        or otherwise refusing to authorize care of veterans by such 
        health care provider in any program authorized under the laws 
        administered by the Secretary.
            (2) Inclusion in contracts.--The Secretary shall ensure 
        that any contracts entered into by the Secretary with third 
        parties involved in administering programs that provide care in 
        the community to veterans under the laws administered by the 
        Secretary specifically grant the authority set forth in 
        paragraph (1) to such third parties and to the directors 
        described in that paragraph, as the case may be.
    (e) Denial or Revocation of Eligibility of Non-Department 
Providers.--The Secretary shall deny or revoke the eligibility of a 
non-Department health care provider to provide health care to veterans 
under the laws administered by the Secretary if the Secretary 
determines that the opioid prescribing practices of the provider--
            (1) violate the requirements of a medical license of the 
        health care provider; or
            (2) detract from the ability of the health care provider to 
        deliver safe and appropriate health care.
    (f) Covered Health Care Provider Defined.--In this section, the 
term ``covered health care provider'' means a non-Department of 
Veterans Affairs health care provider who provides health care to 
veterans under the laws administered by the Secretary of Veterans 
Affairs.
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