[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[S. 4640 Introduced in Senate (IS)]

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116th CONGRESS
  2d Session
                                S. 4640

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 requirements to receive a 
waiver for dispensing narcotic drugs for maintenance or detoxification 
                   treatment, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                           September 22, 2020

Mr. Bennet (for himself and Ms. Collins) introduced the following bill; 
     which was read twice and referred to the Committee on Health, 
                     Education, Labor, and Pensions

_______________________________________________________________________

                                 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 requirements 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 2020'' or the ``MATE Act of 2020''.

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) 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 that occurs on or after the date that is 90 
                days after the date of enactment of the Medication 
                Access and Training Expansion Act of 2020.
            ``(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 conditions:
                    ``(A) In the case of a practitioner who is a 
                physician, the physician shall meet not less than 1 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 completed not less 
                        than 8 hours of training on the treatment and 
                        management of patients with opioid and other 
                        substance use disorders that--
                                    ``(I) is provided through classroom 
                                situations, seminars at professional 
                                society meetings, electronic 
                                communication, or other means;
                                    ``(II) 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 another organization 
                                that the Secretary determines 
                                appropriate; and
                                    ``(III) includes content relating 
                                to--
                                            ``(aa) opioid maintenance 
                                        and detoxification;
                                            ``(bb) the appropriate 
                                        clinical use of all drugs 
                                        approved by the Food and Drug 
                                        Administration for the 
                                        treatment of a substance use 
                                        disorder;
                                            ``(cc) initial and periodic 
                                        patient assessments, including 
                                        substance use monitoring;
                                            ``(dd) individualized 
                                        treatment planning, overdose 
                                        reversal, and relapse 
                                        prevention;
                                            ``(ee) counseling and 
                                        recovery support services;
                                            ``(ff) staffing roles and 
                                        considerations, including bias 
                                        and anti-racism training to 
                                        reduce racial and ethnic 
                                        disparities;
                                            ``(gg) diversion control; 
                                        and
                                            ``(hh) other best 
                                        practices, such as addiction 
                                        prevention, 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 the approved drug.
                            ``(vi) The physician has other training or 
                        experience that the medical licensing board of 
                        the State where the physician will provide 
                        maintenance or detoxification treatment 
                        considers demonstrative of the ability of the 
                        physician to treat and manage patients with 
                        opioid and other substance use disorders.
                            ``(vii)(I) The physician has other training 
                        or experience that the Secretary identifies, in 
                        a regulation promulgated in accordance with 
                        subclause (II), as demonstrative of the ability 
                        of the physician to treat and manage patients 
                        with opioid and other substance use disorders.
                            ``(II)(aa) The Secretary may by regulation 
                        establish criteria for purposes of subclause 
                        (I).
                            ``(bb) Subject to item (cc), any criteria 
                        established by the Secretary under item (aa) 
                        shall be effective for a 3-year period.
                            ``(cc) During the 30-day period preceding 
                        the expiration of a 3-year period of 
                        effectiveness of criteria established under 
                        this subclause, the Secretary may extend the 
                        effectiveness of the criteria for an additional 
                        3-year period by publishing a notice of the 
                        extension in the Federal Register.
                            ``(viii) The physician--
                                    ``(I) graduated in good standing 
                                from an accredited school of allopathic 
                                medicine or osteopathic medicine in the 
                                United States during the 5-year period 
                                preceding the date of the first 
                                registration or renewal of registration 
                                by the physician described in paragraph 
                                (1)(B); and
                                    ``(II) has successfully completed a 
                                comprehensive allopathic or osteopathic 
                                medicine curriculum or accredited 
                                medical residency that included--
                                            ``(aa) not less than 8 
                                        hours of training on treating 
                                        and managing patients with 
                                        opioid and other substance use 
                                        disorders; and
                                            ``(bb) at a minimum--

                                                    ``(AA) the training 
                                                described in items (aa) 
                                                through (hh) of clause 
                                                (iv)(III); and

                                                    ``(BB) training 
                                                with respect to any 
                                                other best practice the 
                                                Secretary determines 
                                                necessary, which may 
                                                include training on 
                                                pain management, 
                                                including assessment 
                                                and appropriate use of 
                                                opioid and non-opioid 
                                                alternatives.

                    ``(B) In the case of a practitioner who is not a 
                physician, the practitioner shall meet not less than 1 
                of the following conditions:
                            ``(i) The practitioner has completed not 
                        less than 8 hours of initial training on the 
                        topics listed in subparagraph (A)(iv)(III) 
                        that--
                                    ``(I) is provided through classroom 
                                situations, seminars at professional 
                                society meetings, electronic 
                                communication, or other means; and
                                    ``(II) 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 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 
                                appropriate.
                            ``(ii) The practitioner has other training 
                        or experience that the Secretary identifies as 
                        demonstrative of the ability of the 
                        practitioner to treat and manage patients with 
                        opioid and other substance use disorders.
                            ``(iii) The practitioner--
                                    ``(I) 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 of the first registration or 
                                renewal of registration by the 
                                practitioner described in paragraph 
                                (1)(B); and
                                    ``(II) has successfully completed a 
                                comprehensive physician assistant or 
                                advanced practice nursing curriculum 
                                that includes--
                                            ``(aa) not less than 8 
                                        hours of training on treating 
                                        and managing patients with 
                                        opioid and other substance use 
                                        disorders; and
                                            ``(bb) at a minimum--

                                                    ``(AA) the training 
                                                described in items (aa) 
                                                through (hh) of 
                                                subparagraph 
                                                (A)(iv)(III); and

                                                    ``(BB) training 
                                                with respect to any 
                                                other best practice the 
                                                Secretary determines 
                                                necessary, which may 
                                                include training on 
                                                pain management, 
                                                including assessment 
                                                and appropriate use of 
                                                opioid and non-opioid 
                                                alternatives.

            ``(3) Reciprocal treatment.--
                    ``(A) Physicians.--
                            ``(i) Meeting conditions for prescribing.--
                        A physician who meets one or more of the 
                        conditions listed in paragraph (2)(A) shall be 
                        deemed to meet one or more of the conditions 
                        listed in subsection (g)(2)(G)(ii).
                            ``(ii) Meeting conditions for waiver for 
                        dispensing.--A physician who meets one or more 
                        of the conditions listed in subsection 
                        (g)(2)(G)(ii) shall be deemed to meet one or 
                        more of the conditions listed in paragraph 
                        (2)(A).
                    ``(B) Other practitioners.--
                            ``(i) Meeting conditions for prescribing.--
                        A practitioner who is not a physician, and who 
                        meets one or more of the conditions listed in 
                        paragraph (2)(B), shall be deemed to meet one 
                        or more of the conditions listed in subsection 
                        (g)(2)(G)(iv)(II).
                            ``(ii) Meeting conditions for waiver for 
                        dispensing.--A practitioner who is not a 
                        physician, and who meets one or more of the 
                        conditions listed in subsection 
                        (g)(2)(G)(iv)(II), shall be 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)(hh)) 
        is amended by inserting after ``, as identified by the 
        Secretary'' the following: ``, which may include best practices 
        for addiction prevention''.
            (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:
                    ``(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 
                notification under subparagraph (B) and has 
                successfully completed a comprehensive physician 
                assistant or advanced practice nursing curriculum that 
                includes--
                            ``(AA) not less than 8 hours of training on 
                        treating and managing opioid-dependent 
                        patients;
                            ``(BB) the training described in items (aa) 
                        through (hh) of clause (ii)(IV); and
                            ``(CC) training with respect to any other 
                        best practice the Secretary determines 
                        necessary, which may include training on pain 
                        management, including assessment and 
                        appropriate use of opioid and non-opioid 
                        alternatives.''.
            (3) Technical corrections.--Section 303(g)(2)(G) of the 
        Controlled Substances Act (21 U.S.C. 823(g)(2)(G)) is amended--
                    (A) in clause (ii)--
                            (i) by moving subclauses (I) and (II) 4 ems 
                        to the left;
                            (ii) in subclause (VIII)--
                                    (I) in item (bb), by moving 
                                subitems (AA) and (BB) 2 ems to the 
                                right; and
                                    (II) by moving items (aa) and (bb) 
                                2 ems to the right; and
                            (iii) by moving subclause (VIII) 2 ems to 
                        the right; and
                    (B) in clause (iv)(II)(bb), by striking ``has'' 
                before ``such other training''.
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