[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4974 Introduced in House (IH)]

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116th CONGRESS
  1st Session
                                H. R. 4974

To amend the Controlled Substances Act to require physicians and other 
 prescribers of controlled substances to complete training on treating 
  and managing patients with opioid and other substance use disorders 
(which shall also satisfy certain training required to receive a waiver 
    for dispensing narcotic drugs for maintenance or detoxification 
                  treatment), and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            November 1, 2019

   Mrs. Trahan (for herself, Mr. Bergman, Mr. Carter of Georgia, Mr. 
Trone, Mr. Rogers of Kentucky, Ms. Kuster of New Hampshire, Mr. Tonko, 
    Mr. Crow, Mr. Rose of New York, and Mr. Pappas) introduced the 
   following bill; which was referred to the Committee on Energy and 
  Commerce, and in addition to the Committee on the Judiciary, for a 
 period to be subsequently determined by the Speaker, in each case for 
consideration of such provisions as fall within the jurisdiction of the 
                          committee concerned

_______________________________________________________________________

                                 A BILL


 
To amend the Controlled Substances Act to require physicians and other 
 prescribers of controlled substances to complete training on treating 
  and managing patients with opioid and other substance use disorders 
(which shall also satisfy certain training required to receive a waiver 
    for dispensing narcotic drugs for maintenance or detoxification 
                  treatment), and for other purposes.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Medication Access and Training 
Expansion Act of 2019'' or the ``MATE Act of 2019''.

SEC. 2. REQUIRING PRESCRIBERS OF CONTROLLED SUBSTANCES TO COMPLETE 
              TRAINING ON TREATING AND MANAGING PATIENTS WITH OPIOID 
              AND OTHER SUBSTANCE USE DISORDERS.

    (a) In General.--Section 303 of the Controlled Substances Act (21 
U.S.C. 823) is amended by adding at the end the following:
    ``(l) Required Training for Prescribers on Treating and Managing 
Patients With Opioid and Other Substance Use Disorders.--
            ``(1) Applicability.--This subsection applies--
                    ``(A) with respect to any practitioner who is 
                licensed under State law to prescribe controlled 
                substances; and
                    ``(B) beginning with the first registration or 
                renewal of registration by the practitioner under this 
                section occurring 90 or more days after the date of 
                enactment of the Medication Access and Training 
                Expansion Act of 2019.
            ``(2) Training required.--As a condition on registration 
        under this section to dispense controlled substances in 
        schedule II, III, IV, or V, the Attorney General shall require 
        any practitioner described in paragraph (1)(A) to meet the 
        following:
                    ``(A) If the practitioner is a physician, the 
                practitioner must meet one or more of the following 
                conditions:
                            ``(i) The physician holds a board 
                        certification in addiction psychiatry or 
                        addiction medicine from the American Board of 
                        Medical Specialties.
                            ``(ii) The physician holds an addiction 
                        certification or board certification from the 
                        American Society of Addiction Medicine or the 
                        American Board of Addiction Medicine.
                            ``(iii) The physician holds a board 
                        certification in addiction medicine from the 
                        American Osteopathic Association.
                            ``(iv) The physician has, with respect to 
                        the treatment and management of patients with 
                        opioid and other substance use disorders, 
                        completed not less than 8 hours of training 
                        (through classroom situations, seminars at 
                        professional society meetings, electronic 
                        communications, or otherwise) that is provided 
                        by the American Society of Addiction Medicine, 
                        the American Academy of Addiction Psychiatry, 
                        the American Medical Association, the American 
                        Osteopathic Association, the American 
                        Psychiatric Association, or any other 
                        organization that the Secretary determines is 
                        appropriate for purposes of this clause. Such 
                        training shall include--
                                    ``(I) opioid maintenance and 
                                detoxification;
                                    ``(II) appropriate clinical use of 
                                all drugs approved by the Food and Drug 
                                Administration for the treatment of a 
                                substance use disorder;
                                    ``(III) initial and periodic 
                                patient assessments (including 
                                substance use monitoring);
                                    ``(IV) individualized treatment 
                                planning, overdose reversal, and 
                                relapse prevention;
                                    ``(V) counseling and recovery 
                                support services;
                                    ``(VI) staffing roles and 
                                considerations;
                                    ``(VII) diversion control; and
                                    ``(VIII) other best practices, such 
                                as prevention of addiction, as 
                                identified by the Secretary, after 
                                consultation with practitioners from a 
                                variety of medical specialties and who 
                                practice in different settings in which 
                                controlled substances are prescribed.
                            ``(v) The physician has participated as an 
                        investigator in one or more clinical trials 
                        leading to the approval of a narcotic drug in 
                        schedule III, IV, or V for maintenance or 
                        detoxification treatment, as demonstrated by a 
                        statement submitted to the Secretary by the 
                        sponsor of such approved drug.
                            ``(vi) The physician has such other 
                        training or experience as the State medical 
                        licensing board of the State where the 
                        physician will provide maintenance or 
                        detoxification treatment considers to 
                        demonstrate the ability of the physician to 
                        treat and manage patients with opioid and other 
                        substance use disorders.
                            ``(vii) The physician has such other 
                        training or experience as the Secretary 
                        considers to demonstrate the ability of the 
                        physician to treat and manage patients with 
                        opioid and other substance use disorders. Any 
                        criteria of the Secretary under this clause 
                        shall be established by regulation. Any such 
                        criteria are effective only for 3 years after 
                        the date on which the criteria are promulgated, 
                        but may be extended for such additional 
                        discrete 3-year periods as the Secretary 
                        considers appropriate for purposes of this 
                        clause. Such an extension of criteria may only 
                        be effectuated through a statement published in 
                        the Federal Register by the Secretary during 
                        the 30-day period preceding the end of the 3-
                        year period involved.
                            ``(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 first registers or renews under this 
                        section and has successfully completed a 
                        comprehensive allopathic or osteopathic 
                        medicine curriculum or accredited medical 
                        residency that--
                                    ``(I) included not less than 8 
                                hours of training on treating and 
                                managing patients with opioid and other 
                                substance use disorders; and
                                    ``(II) included, at a minimum--
                                            ``(aa) the training 
                                        described in subclauses (I) 
                                        through (VIII) of clause (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) If the practitioner is not a physician, the 
                practitioner must meet one or more of the following 
                conditions:
                            ``(i) Completed not fewer than 24 hours of 
                        initial training addressing each of the topics 
                        listed in subparagraph (A)(iv) (through 
                        classroom situations, seminars at professional 
                        society meetings, electronic communications, or 
                        otherwise) provided by the American Society of 
                        Addiction Medicine, the American Academy of 
                        Addiction Psychiatry, the American Medical 
                        Association, the American Osteopathic 
                        Association, the American Nurses Credentialing 
                        Center, the American Psychiatric Association, 
                        the American Association of Nurse 
                        Practitioners, the American Academy of 
                        Physician Assistants, or any other organization 
                        that the Secretary determines is appropriate 
                        for purposes of this clause.
                            ``(ii) Has such other training or 
                        experience as the Secretary determines will 
                        demonstrate the ability of the practitioner to 
                        treat and manage patients with opioid and other 
                        substance use disorders.
                            ``(iii) Graduated in good standing from an 
                        accredited physician assistant school or school 
                        of advanced practice nursing in the United 
                        States during the 5-year period immediately 
                        preceding the date on which the practitioner 
                        first registers or renews under this section 
                        and has successfully completed a comprehensive 
                        physician assistant or advanced practice 
                        nursing curriculum that includes not less than 
                        24 hours of training on treating and managing 
                        patients with opioid and other substance use 
                        disorders and, at a minimum--
                                    ``(I) the training described in 
                                subclauses (I) through (VIII) of 
                                subparagraph (A)(iv); and
                                    ``(II) 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.
            ``(3) Reciprocal treatment.--
                    ``(A) Physicians.--A physician who meets one or 
                more of the conditions listed in paragraph (2)(A) is 
                deemed to meet one or more of the conditions listed in 
                subsection (g)(2)(G)(ii), and a physician who meets one 
                or more of the conditions listed in subsection 
                (g)(2)(G)(ii) is deemed to meet one or more of the 
                conditions listed in paragraph (2)(A).
                    ``(B) Other practitioners.--A practitioner who is 
                not a physician, and who meets one or more of the 
                conditions listed in paragraph (2)(B), is deemed to 
                meet one or more of the conditions listed in subsection 
                (g)(2)(G)(iv)(II), and a practitioner who is not a 
                physician, and who meets one or more of the conditions 
                listed in subsection (g)(2)(G)(iv)(II), is deemed to 
                meet one or more of the conditions listed in paragraph 
                (2)(B).''.
    (b) Training Required.--
            (1) Physicians.--Section 303(g)(2)(G)(ii)(IV)(hh) of the 
        Controlled Substances Act (21 U.S.C. 823(g)(2)(G)(ii)(IV)) is 
        amended by inserting ``such as prevention of addiction,'' after 
        ``other best practices,''.
            (2) Other practitioners.--Section 303(g)(2)(G)(iv)(II) of 
        the Controlled Substances Act (21 U.S.C. 823(g)(2)(G)(iv)(II)) 
        is amended--
                    (A) in item (aa), by striking ``or'' at the end;
                    (B) in item (bb), by striking the period at the end 
                and inserting ``; or''; and
                    (C) by adding at the end the following new item:
                    ``(cc) graduated in good standing from an 
                accredited physician assistant school or school of 
                advanced practice nursing in the United States during 
                the 5-year period immediately preceding the date on 
                which the practitioner submits to the Secretary a 
                written notification under subparagraph (B) and has 
                successfully completed a comprehensive physician 
                assistant or advanced practice nursing curriculum that 
                includes not less than 24 hours of training on treating 
                and managing opioid-dependent patients and, at a 
                minimum--
                            ``(AA) the training described in items (aa) 
                        through (hh) of clause (ii)(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.''.
            (3) Technical correction.--Section 303(g)(2)(G)(iv)(II)(bb) 
        of the Controlled Substances Act (21 U.S.C. 
        823(g)(2)(G)(iv)(II)(bb)) is amended by striking ``has'' before 
        ``such other training''.
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