[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4531 Introduced in House (IH)]

<DOC>






118th CONGRESS
  1st Session
                                H. R. 4531

 To reauthorize certain programs that provide for opioid use disorder 
      prevention, recovery, and treatment, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             July 11, 2023

Mr. Guthrie (for himself and Ms. Kuster) introduced the following bill; 
  which was referred to the Committee on Energy and Commerce, and in 
  addition to the Committees on the Judiciary, and Education and the 
 Workforce, 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 reauthorize certain programs that 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.

    This Act may be cited as the ``Support for Patients and Communities 
Reauthorization Act''.

SEC. 2. TABLE OF CONTENTS.

    The table of contents for this Act is as follows:

Sec. 1. Short title.
Sec. 2. Table of contents.
                         TITLE I--PUBLIC HEALTH

Sec. 101. Monitoring and education regarding infections associated with 
                            illicit drug use and other risk factors.
Sec. 102. Preventing overdoses of controlled substances.
Sec. 103. Residential treatment programs for pregnant and postpartum 
                            women.
Sec. 104. First responder training.
Sec. 105. Building communities of recovery.
Sec. 106. National Peer-Run Training and Technical Assistance Center 
                            for Addiction Recovery Support.
Sec. 107. Comprehensive opioid recovery centers.
Sec. 108. Grants to address the problems of persons who experience 
                            violence related stress.
Sec. 109. Mental and behavioral health education and training grants.
Sec. 110. Loan repayment program for the substance use disorder 
                            treatment workforce.
Sec. 111. Pilot program for public health laboratories to detect 
                            fentanyl and other synthetic opioids.
Sec. 112. Monitoring and reporting of child, youth, and adult trauma.
Sec. 113. Task force to develop best practices for trauma-informed 
                            identification, referral, and support.
Sec. 114. Treatment, recovery, and workforce support grants.
Sec. 115. Grant program for State and Tribal response to opioid use 
                            disorders.
Sec. 116. References to opioid overdose reversal agents in HHS grant 
                            programs.
Sec. 117. Addressing other concurrent substance use disorders through 
                            grant program for State and Tribal response 
                            to opioid use disorders.
Sec. 118. Providing for a study on the effects of remote monitoring on 
                            individuals who are prescribed opioids.
                    TITLE II--CONTROLLED SUBSTANCES

Sec. 201. Delivery of certain substances by a pharmacy to an 
                            administering practitioner.
Sec. 202. Reviewing the scheduling of approved products containing a 
                            combination of buprenorphine and naloxone.
Sec. 203. Combating illicit xylazine.
Sec. 204. Technical corrections.
                          TITLE III--MEDICAID

Sec. 301. Extending requirement for State Medicaid plans to provide 
                            coverage for medication-assisted treatment.
Sec. 302. Expanding required reports on T-MSIS substance use disorder 
                            data to include mental health condition 
                            data.
Sec. 303. Monitoring prescribing of antipsychotic medications.

                         TITLE I--PUBLIC HEALTH

SEC. 101. MONITORING 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--
            (1) in the section heading, by striking ``surveillance 
        and'' and inserting ``monitoring and''; and
            (2) in subsection (d), by striking ``fiscal years 2019 
        through 2023'' and inserting ``fiscal years 2024 through 
        2028''.

SEC. 102. PREVENTING OVERDOSES OF CONTROLLED SUBSTANCES.

    (a) Evidence-Based Prevention Grants.--Section 392A(a)(2)(D) of the 
Public Health Service Act (42 U.S.C. 280b-1(a)(2)(D)) is amended by 
inserting after ``new and emerging public health crises'' the 
following: ``, such as the fentanyl crisis,''.
    (b) Authorization of Appropriations.--Section 392A(e) of the Public 
Health Service Act (42 U.S.C. 280b-1(e)) is amended by striking 
``$496,000,000 for each of fiscal years 2019 through 2023'' and 
inserting ``$505,579,000 for each of fiscal years 2024 through 2028''.

SEC. 103. 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 ``$29,931,000 for each of fiscal years 
2019 through 2023'' and inserting ``$38,931,000 for each of fiscal 
years 2024 through 2028''.

SEC. 104. FIRST RESPONDER TRAINING.

    Section 546(h) of the Public Health Service Act (42 U.S.C. 290ee-
1(h)) is amending by striking ``$36,000,000 for each of fiscal years 
2019 through 2023'' and inserting ``$56,000,000 for each of fiscal 
years 2024 through 2028''.

SEC. 105. BUILDING COMMUNITIES OF RECOVERY.

    Section 547(f) of the Public Health Service Act (42 U.S.C. 290ee-
2(f)) is amended by striking ``$5,000,000 for each of fiscal years 2019 
through 2023'' and inserting ``$16,000,000 for each of fiscal years 
2024 through 2028''.

SEC. 106. NATIONAL PEER-RUN TRAINING AND TECHNICAL ASSISTANCE CENTER 
              FOR ADDICTION RECOVERY SUPPORT.

    Section 547A(e) of the Public Health Service Act (42 U.S.C. 290ee-
2a(e)) is amended by striking ``$1,000,000 for each of fiscal years 
2019 through 2023'' and inserting ``$2,000,000 for each of fiscal years 
2024 through 2028''.

SEC. 107. COMPREHENSIVE OPIOID RECOVERY CENTERS.

    (a) Reauthorization.--Section 552(j) of the Public Health Service 
Act (42 U.S.C. 290ee-7(j)) is amended by striking ``2019 through 2023'' 
and inserting ``2024 through 2028''.
    (b) Documentation for Evidence of Capacity To Carry Out Required 
Activities.--Section 552(d) of the Public Health Service Act (42 U.S.C. 
290ee-7(d)) is amended by adding at the end the following:
            ``(3) Documentation.--
                    ``(A) In general.--Evidence required to be provided 
                under paragraph (1) may be provided through a letter of 
                intent from partner agencies or other relevant 
                documentation (as defined by the Secretary).
                    ``(B) Partner agency defined.--In this paragraph, 
                the term `partner agency' means a non-governmental 
                organization or other public or private entity--
                            ``(i) the primary purpose of which is the 
                        delivery of mental health or substance use 
                        disorder treatment services; and
                            ``(ii) with which the applicant coordinates 
                        to provide the full continuum of treatment 
                        services (as specified in subsection (g)(1)(B)) 
                        that the applicant is unable to offer on 
                        site.''.
    (c) Center Activities Carried Out Through Third Parties.--Section 
552(g) of the Public Health Service Act (42 U.S.C. 290ee-7(g)) is 
amended in the matter preceding paragraph (1) by striking ``Each Center 
shall'' and all that follows through ``subsection (f):'' and inserting 
the following: ``Each Center shall, at a minimum, carry out the 
activities specified in this subsection directly, through referral, or 
through contractual arrangements. If a Center elects to carry out such 
activities through contractual arrangements, the Secretary may issue 
guidance on best practices to ensure that the Center is capable of 
carrying out such activities, including carrying out such activities 
through technology-enabled collaborative learning and capacity building 
models described in subsection (f) and coordinating the full continuum 
of treatment services specified in subparagraph (B). Such activities 
include the following:''.

SEC. 108. GRANTS TO ADDRESS THE PROBLEMS OF PERSONS WHO EXPERIENCE 
              VIOLENCE RELATED STRESS.

    Section 582(j) of the Public Health Service Act (42 U.S.C. 290hh-
1(j)) is amended by striking ``$63,887,000 for each of fiscal years 
2019 through 2023'' and inserting ``$93,887,000 for each of fiscal 
years 2024 through 2028''.

SEC. 109. MENTAL AND BEHAVIORAL HEALTH EDUCATION AND TRAINING GRANTS.

    Section 756(f) of the Public Health Service Act (42 U.S.C. 294e-
1(f)) is amended by striking ``fiscal years 2023 through 2027'' and 
inserting ``fiscal years 2024 through 2028''.

SEC. 110. LOAN REPAYMENT PROGRAM FOR THE SUBSTANCE USE DISORDER 
              TREATMENT WORKFORCE.

    Section 781(j) of the Public Health Service Act (42 U.S.C. 295h(j)) 
is amended by striking ``$25,000,000 for each of fiscal years 2019 
through 2023'' and inserting ``$40,000,000 for each of fiscal years 
2024 through 2028''.

SEC. 111. PILOT PROGRAM FOR PUBLIC HEALTH LABORATORIES TO DETECT 
              FENTANYL AND OTHER SYNTHETIC OPIOIDS.

    Section 7011(d) of the SUPPORT for Patients and Communities Act (42 
U.S.C. 247d-10(d)) is amended by striking ``fiscal years 2019 through 
2023'' and inserting ``fiscal years 2024 through 2028''.

SEC. 112. MONITORING AND REPORTING OF CHILD, YOUTH, AND ADULT TRAUMA.

    Section 7131(e) of the SUPPORT for Patients and Communities Act (42 
U.S.C. 242t(e)) is amended by striking ``$2,000,000 for each of fiscal 
years 2019 through 2023'' and inserting ``$9,000,000 for each of fiscal 
years 2024 through 2028''.

SEC. 113. TASK FORCE TO DEVELOP BEST PRACTICES FOR TRAUMA-INFORMED 
              IDENTIFICATION, REFERRAL, AND SUPPORT.

    Section 7132 of the SUPPORT for Patients and Communities Act 
(Public Law 115-271) is amended--
            (1) in subsection (g)--
                    (A) in paragraph (1), by striking ``and'' at the 
                end;
                    (B) in paragraph (2), by striking the period at the 
                end and inserting ``; and''; and
                    (C) by adding at the end the following:
            ``(3) additional reports and updates to existing reports, 
        as necessary.''; and
            (2) by striking subsection (i).

SEC. 114. TREATMENT, RECOVERY, AND WORKFORCE SUPPORT GRANTS.

    Section 7183 of the SUPPORT for Patients and Communities Act (42 
U.S.C. 290ee-8) is amended--
            (1) in subsection (b), by inserting ``each'' before ``for a 
        period'';
            (2) by amending subsection (c)(2) to read as follows:
            ``(2) Rates.--The rates described in this paragraph are the 
        following:
                    ``(A) The amount by which the average rate of drug 
                overdose deaths in the State, adjusted for age, for the 
                period of 5 calendar years for which there is available 
                data, including if necessary provisional data, 
                immediately preceding the grant cycle (which shall be 
                the period of calendar years 2018 through 2022 for the 
                first grant cycle following the enactment of the 
                Support for Patients and Communities Reauthorization 
                Act) is above the average national overdose mortality 
                rate, as determined by the Director of the Centers for 
                Disease Control and Prevention, for the same period.
                    ``(B) The amount by which the average rate of 
                unemployment for the State, based on data provided by 
                the Bureau of Labor Statistics, for the period of 5 
                calendar years for which there is available data, 
                including if necessary provisional data, immediately 
                preceding the grant cycle (which shall be the period of 
                calendar years 2018 through 2022 for the first grant 
                cycle following the enactment of the Support for 
                Patients and Communities Reauthorization Act) is above 
                the national average for the same period.
                    ``(C) The amount by which the average rate of labor 
                force participation in the State, based on data 
                provided by the Bureau of Labor Statistics, for the 
                period of 5 calendar years for which there is available 
                data, including if necessary provisional data, 
                immediately preceding the grant cycle (which shall be 
                the period of calendar years 2018 through 2022 for the 
                first grant cycle following the enactment of the 
                Support for Patients and Communities Reauthorization 
                Act) is below the national average for the same 
                period.'';
            (3) in subsection (g)--
                    (A) in paragraphs (1) and (3), by redesignating 
                subparagraphs (A) and (B) as clauses (i) and (ii), 
                respectively, and adjusting the margins accordingly;
                    (B) by redesignating paragraphs (1) through (3) as 
                subparagraphs (A) through (C), respectively, and 
                adjusting the margins accordingly;
                    (C) by striking ``An entity'' and inserting the 
                following:
            ``(1) In general.--An entity''; and
                    (D) by adding at the end the following:
            ``(2) Transportation services.--An entity receiving a grant 
        under this section may use the funds for providing 
        transportation for individuals to participate in an activity 
        supported by a grant under this section, which transportation 
        shall be to or from a place of work or a place where the 
        individual is receiving vocational education or job training 
        services or receiving services directly linked to treatment of 
        or recovery from a substance use disorder.'';
            (4) in subsection (j)--
                    (A) in paragraph (1), by inserting ``for each grant 
                cycle'' after ``grant period''; and
                    (B) in paragraph (2)--
                            (i) in the matter preceding subparagraph 
                        (A)--
                                    (I) by striking ``the preliminary 
                                report'' and inserting ``each 
                                preliminary report''; and
                                    (II) by inserting ``for the grant 
                                cycle'' after ``final report''; and
                            (ii) in subparagraph (A), by striking 
                        ``(g)(3)'' and inserting ``(g)(1)(C)''; and
            (5) in subsection (k), by striking ``$5,000,000 for each of 
        fiscal years 2019 through 2023'' and inserting ``$12,000,000 
        for each of fiscal years 2024 through 2028''.

SEC. 115. GRANT PROGRAM FOR STATE AND TRIBAL RESPONSE TO OPIOID USE 
              DISORDERS.

    Section 1003(b)(4)(A) of the 21st Century Cures Act (42 U.S.C. 
290ee-3a(b)(4)(A)) is amended after ``which may include drugs or 
devices approved, cleared, or otherwise legally marketed under the 
Federal Food, Drug, and Cosmetic Act'' by inserting ``or fentanyl or 
xylazine test strips''.

SEC. 116. REFERENCES TO OPIOID OVERDOSE REVERSAL AGENTS IN HHS GRANT 
              PROGRAMS.

    (a) In General.--The Secretary of Health and Human Services shall 
ensure that, whenever the Department of Health and Human Services 
issues a regulation, guidance, or other document for any grant program 
addressing opioid misuse and use disorders, any reference to an opioid 
overdose reversal agent (such as a reference to naloxone) is inclusive 
of any opioid overdose reversal agent that has been approved or 
otherwise authorized for use by the Food and Drug Administration.
    (b) Existing References.--
            (1) Update.--Not later than the end of calendar year 2023, 
        the Secretary of Health and Human Services shall update all 
        references described in paragraph (2) to be inclusive of any 
        opioid overdose reversal agent that has been approved or 
        otherwise authorized for use by the Food and Drug 
        Administration.
            (2) References.--A reference described in this paragraph is 
        any reference to an opioid overdose reversal agent (such as 
        naloxone) in any regulation, guidance, or other document of the 
        Department of Health and Human Services that--
                    (A) was issued before the date of enactment of this 
                Act; and
                    (B) is for--
                            (i) the grant program for State and Tribal 
                        response to opioid use disorders under section 
                        1003 of the 21st Century Cures Act (42 U.S.C. 
                        290ee-3 note; commonly referred to as ``State 
                        Opioid Response Grants'' and ``Tribal Opioid 
                        Response Grants''); or
                            (ii) the grant program for priority 
                        substance use disorder prevention needs of 
                        regional and national significance under 
                        section 516 of the Public Health Service Act 
                        (42 U.S.C. 290bb-22).

SEC. 117. ADDRESSING OTHER CONCURRENT SUBSTANCE USE DISORDERS THROUGH 
              GRANT PROGRAM FOR STATE AND TRIBAL RESPONSE TO OPIOID USE 
              DISORDERS.

    (a) Additional Use of Funds.--Section 1003(b) of the 21st Century 
Cures Act (42 U.S.C. 290ee-3 note) is amended by adding at the end the 
following:
            ``(5) Other concurrent substance use disorders.--The 
        Secretary may authorize the recipient of a grant under this 
        subsection, in addition to using the grant for activities 
        described in paragraph (4) with respect to opioid misuse and 
        use disorders and stimulant misuse and use disorders, to use 
        the grant to for similar activities with respect to other 
        concurrent substance use disorders.''.
    (b) Annual Report to Congress.--Section 1003(f) of the 21st Century 
Cures Act (42 U.S.C. 290ee-3 note) is amended--
            (1) in paragraph (2), strike ``and'' at the end;
            (2) in paragraph (3), strike the period at the end and 
        insert a semicolon; and
            (3) by adding at the end the following:
            ``(4) the amount of funds each State that receiving a grant 
        under subsection (b) received for the 12-month grant cycle 
        covered by the report;
            ``(5) the amount of grant funds each such State spent for 
        such grant cycle, disaggregated by the uses for which such 
        funds were spent, including each allowable use under paragraphs 
        (4) and (5) of subsection (b);
            ``(6) how many such States for such grant cycle did not 
        spend the all of the grant funds before such grant cycle 
        expired;
            ``(7) how many such States for such grant cycle requested 
        waivers to extend the grant cycle; and
            ``(8) challenges for such States to spend all of the funds 
        allocated and the reason for such challenges, including to what 
        extent reporting requirements or other requirements placed an 
        increased burden on the ability of such States to spend all of 
        the funds.''.
    (c) Other Concurrent Substance Use Disorders Defined.--Section 
1003(h) of the 21st Century Cures Act (42 U.S.C. 290ee-3 note) is 
amended--
            (1) by redesignating paragraphs (2) through (4) as 
        paragraphs (3) through (5); and
            (2) by inserting before paragraph (3), as redesignated, the 
        following:
            ``(2) Other concurrent substance use disorders.--The term 
        `other substance use disorders' includes alcohol use disorders 
        co-occurring with opioid misuse and use disorders and alcohol 
        use disorders co-occurring with stimulant misuse and use 
        disorders, including polydrug use and alcohol use disorder.''.
    (d) Rule of Construction.--Nothing in this Act or the amendments 
made by this Act shall be construed to change the allocation of funds 
among grantees pursuant to the minimum allocations and formula 
methodology under section 1003 of the 21st Century Cures Act (42 U.S.C. 
290ee-3 note).

SEC. 118. PROVIDING FOR A STUDY ON THE EFFECTS OF REMOTE MONITORING ON 
              INDIVIDUALS WHO ARE PRESCRIBED OPIOIDS.

    (a) In General.--Not later than 18 months after the date of 
enactment of this Act, the Comptroller General of the United States 
shall conduct a study and submit to the Committee on Energy and 
Commerce of the House of Representatives and the Committee on Health, 
Education, Labor, and Pensions and the Committee on Finance of the 
Senate a report on the use of remote monitoring with respect to 
individuals who are prescribed opioids.
    (b) Report.--The report described in subsection (a) shall include--
            (1) an assessment of scientific evidence related to the 
        efficacy, individual outcomes, and potential cost savings 
        associated with remote monitoring for individuals who are 
        prescribed opioids compared to such individuals who are not so 
        monitored;
            (2) an assessment of the current prevalence of remote 
        monitoring for individuals who are prescribed opioids, 
        including the use of such monitoring for such individuals in 
        other countries; and
            (3) recommendations to improve availability, access, and 
        coverage for remote monitoring for individuals who are 
        prescribed opioids, including through changes to Federal health 
        care programs (as defined in section 1128B of the Social 
        Security Act (42 U.S.C. 1320a-7b)) and, if determined 
        appropriate by the Comptroller General, an identification of 
        cohorts of individuals who stand to benefit the most from 
        remote monitoring when prescribed opioids.

                    TITLE II--CONTROLLED SUBSTANCES

SEC. 201. DELIVERY OF CERTAIN SUBSTANCES BY A PHARMACY TO AN 
              ADMINISTERING PRACTITIONER.

    Paragraph (2) of section 309A(a) of the Controlled Substances Act 
(21 U.S.C. 829a(a)) is amended to read as follows:
            ``(2) the controlled substance is a drug in schedule III, 
        IV, or V that is, pursuant to the approval or licensure of such 
        drug under the Federal Food, Drug, and Cosmetic Act or section 
        351 of the Public Health Service Act, to be administered by, or 
        under the supervision of, the practitioner;''.

SEC. 202. REVIEWING THE SCHEDULING OF APPROVED PRODUCTS CONTAINING A 
              COMBINATION OF BUPRENORPHINE AND NALOXONE.

    (a) Secretary of HHS.--The Secretary of Health and Human Services 
shall, consistent with the requirements and procedures set forth in 
sections 201 and 202 of the Controlled Substances Act (21 U.S.C. 811; 
812)--
            (1) review the relevant data pertaining to the scheduling 
        of products containing a combination of buprenorphine and 
        naloxone that have been approved under section 505 of the 
        Federal Food, Drug, and Cosmetic Act (21 U.S.C. 355); and
            (2) if appropriate, request that the Attorney General 
        initiate rulemaking proceedings to revise the schedules 
        accordingly with respect to such products.
    (b) Attorney General.--The Attorney General shall review any 
request made by the Secretary of Health and Human Services under 
subsection (a)(2) and determine whether to initiate proceedings to 
revise the schedules in accordance with the criteria set forth in 
sections 201 and 202 of the Controlled Substances Act (21 U.S.C. 811; 
812).

SEC. 203. COMBATING ILLICIT XYLAZINE.

    (a) Definitions.--
            (1) In general.--In this section, the term ``xylazine'' has 
        the meaning given the term in paragraph (60) of section 102 of 
        the Controlled Substances Act, as added by paragraph (2).
            (2) Controlled substances act.--Section 102 of the 
        Controlled Substances Act (21 U.S.C. 802) is amended--
                    (A) by redesignating the second paragraph (57) 
                (relating to serious drug felony) and paragraph (58) as 
                paragraphs (58) and (59), respectively;
                    (B) by moving the margin of paragraph (57) 2 ems to 
                the left;
                    (C) by moving the margins of paragraphs (58) and 
                (59), as redesignated, 2 ems to the left; and
                    (D) by adding at the end the following:
    ``(60)(A) The term `xylazine' means the substance xylazine as well 
as its salts, isomers, and salts of isomers whenever the existence of 
such salts, isomers, and salts of isomers is possible.
    ``(B) Except as provided in subparagraph (E), such term does not 
include a substance described in subparagraph (A) to the extent--
            ``(i) such substance is used or intended for use in animals 
        other than humans and is an animal drug that has been approved 
        by the Secretary of Health and Human Services under section 512 
        of the Federal Food, Drug, and Cosmetic Act, conditionally 
        approved under section 571 of such Act, index listed under 
        section 573 of such Act, or subject to an exemption for 
        investigational use under section 512(j) of such Act, and such 
        use or intended use conforms to the approved application or 
        index listing, including the manufacturing, importation, 
        holding, or distribution for such use;
            ``(ii) such substance is used or intended for use in 
        animals other than humans as permitted under section 512(a)(4) 
        of the Federal Food, Drug, and Cosmetic Act;
            ``(iii) such substance is manufactured, imported, held, 
        distributed, or used--
                    ``(I) as an active pharmaceutical ingredient for 
                manufacturing an animal drug approved under section 512 
                of the Federal Food, Drug, and Cosmetic Act, 
                conditionally approved under section 571 of such Act, 
                index listed under section 573 of the such Act, or 
                subject to an exemption for investigational use under 
                section 512(j) of such Act; or
                    ``(II) as a bulk chemical for pharmaceutical 
                compounding of a new animal drug (as defined in section 
                201 of the Federal Food, Drug, and Cosmetic Act) by or 
                under the direct supervision of a licensed pharmacist 
                or by or on the lawful written or oral order of a 
                licensed veterinarian within the context of a 
                veterinarian-client-patient relationship, as defined by 
                the Secretary of Health and Human Services;
            ``(iv) such substance is held or used as a compounded new 
        animal drug described in clause (iii)(II);
            ``(v) such substance is otherwise used or intended for use 
        in animals other than humans, and such use is approved or 
        otherwise authorized under the Federal Food, Drug, and Cosmetic 
        Act provided any such use conforms to such approval or 
        authorization;
            ``(vi) such substance is subject to an exemption for 
        investigational use under section 505(i) or 520(g) of the 
        Federal Food, Drug, and Cosmetic Act;
            ``(vii) such substance is imported, held, distributed, or 
        used for the development, manufacturing, or performance of 
        tests for detection of xylazine (including xylazine used as a 
        control or calibration standard) by persons who are 
        professionally, regularly, and lawfully engaged in such 
        activities; or
            ``(viii) such substance is held, distributed, or used in a 
        commercially manufactured test for the detection of xylazine, 
        provided such test does not contain xylazine in a form that can 
        be extracted.
    ``(C) Notwithstanding subparagraph (B), the Attorney General may 
place any substance listed in such subparagraph on a schedule under 
section 202 in accordance with subsections (a) through (c) of section 
201.
    ``(D) Nothing in this paragraph shall be construed as a basis for 
inferring that a compounded animal drug is not a new animal drug 
subject to the requirements of section 512(a) of the Federal Food, 
Drug, and Cosmetic Act.
    ``(E) If any person prescribes, dispenses, distributes, 
manufactures, or imports xylazine for human use, such person shall be 
considered to have prescribed, dispensed, distributed, manufactured, or 
imported xylazine not subject to an exclusion under subparagraph 
(B).''.
    (b) Placement of Xylazine on Schedule III.--Schedule III in section 
202(c) of the Controlled Substances Act (21 U.S.C. 812(c)) is amended 
by adding at the end the following:
    ``(f) Xylazine.''.
    (c) Report to Congress on Xylazine.--
            (1) Initial report.--Not later than 1 year after the date 
        of enactment of this Act, the Attorney General, acting through 
        the Administrator of the Drug Enforcement Administration and in 
        coordination with the Commissioner of Food and Drugs, shall 
        submit to Congress a report on the prevalence of illicit use of 
        xylazine in the United States and the impacts of such use, 
        including--
                    (A) where the drug is being diverted;
                    (B) where the drug is originating;
                    (C) whether any analogues to such drug present a 
                substantial risk of abuse;
                    (D) whether and to what extent the illicit supply 
                of xylazine derives from the licit supply chain; and
                    (E) recommendations for Congress with respect to 
                whether xylazine should be transferred to another 
                schedule under section 202 of the Controlled Substances 
                Act (21 U.S.C. 812).
            (2) Additional report.--Not later than 4 years after the 
        date of enactment of this Act, the Attorney General, acting 
        through the Administrator of the Drug Enforcement 
        Administration and in coordination with the Commissioner of 
        Food and Drugs, shall submit to Congress a report updating 
        Congress on the prevalence of xylazine trafficking, misuse, and 
        proliferation in the United States, including recommendations 
        for Congress with respect to whether xylazine should be 
        transferred to another schedule under section 202 of the 
        Controlled Substances Act (21 U.S.C. 812) or removed from 
        schedule III of such part.

SEC. 204. TECHNICAL CORRECTIONS.

    Effective as if included in the enactment of Public Law 117-328--
            (1) section 1252(a) of division FF of Public Law 117-328 is 
        amended, in the matter being inserted into section 302(e) of 
        the Controlled Substances Act, by striking ``303(g)'' and 
        inserting ``303(h)'';
            (2) section 1262 of division FF of Public Law 117-328 is 
        amended--
                    (A) in subsection (a)--
                            (i) in the matter preceding paragraph (1), 
                        by striking ``303(g)'' and inserting 
                        ``303(h)'';
                            (ii) in the matter being stricken by 
                        subsection (a)(2), by striking ``(g)(1)'' and 
                        inserting ``(h)(1)''; and
                            (iii) in the matter being inserted by 
                        subsection (a)(2), by striking ``(g) 
                        Practitioners'' and inserting ``(h) 
                        Practitioners''; and
                    (B) in subsection (b)--
                            (i) in the matter being stricken by 
                        paragraph (1), by striking ``303(g)(1)'' and 
                        inserting ``303(h)(1)'';
                            (ii) in the matter being inserted by 
                        paragraph (1), by striking ``303(g)'' and 
                        inserting ``303(h)'';
                            (iii) in the matter being stricken by 
                        paragraph (2)(A), by striking ``303(g)(2)'' and 
                        inserting ``303(h)(2)'';
                            (iv) in the matter being stricken by 
                        paragraph (3), by striking ``303(g)(2)(B)'' and 
                        inserting ``303(h)(2)(B)'';
                            (v) in the matter being stricken by 
                        paragraph (5), by striking ``303(g)'' and 
                        inserting ``303(h)''; and
                            (vi) in the matter being stricken by 
                        paragraph (6), by striking ``303(g)'' and 
                        inserting ``303(h)''; and
            (3) section 1263(b) of division FF of Public Law 117-328 is 
        amended--
                    (A) by striking ``303(g)(2)'' and inserting 
                ``303(h)(2)''; and
                    (B) by striking ``(21 U.S.C. 823(g)(2))'' and 
                inserting ``(21 U.S.C. 823(h)(2))''.

                          TITLE III--MEDICAID

SEC. 301. EXTENDING REQUIREMENT FOR STATE MEDICAID PLANS TO PROVIDE 
              COVERAGE FOR MEDICATION-ASSISTED TREATMENT.

    (a) In General.--Section 1905 of the Social Security Act (42 U.S.C. 
1396d) is amended--
            (1) in subsection (a)(29), by striking ``for the period 
        beginning October 1, 2020, and ending September 30, 2025,'' and 
        inserting ``beginning on October 1, 2020,''; and
            (2) in subsection (ee)(2), by striking ``for the period 
        specified in such paragraph, if before the beginning of such 
        period the State certifies to the satisfaction of the 
        Secretary'' and inserting ``if such State certifies, not less 
        than every 5 years and to the satisfaction of the Secretary,''.
    (b) Conforming Amendment.--Section 1006(b)(4)(A) of the Substance 
Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for 
Patients and Communities Act (42 U.S.C. 1396a note) is amended by 
striking ``, and before October 1, 2025''.

SEC. 302. EXPANDING REQUIRED REPORTS ON T-MSIS SUBSTANCE USE DISORDER 
              DATA TO INCLUDE MENTAL HEALTH CONDITION DATA.

    (a) In General.--Section 1015(a) of the SUPPORT for Patients and 
Communities Act (42 U.S.C. 1320d-2 note) is amended--
            (1) in the heading, by striking ``Substance Use Disorder 
        Data Book'' and inserting ``Behavioral Health Data Book'';
            (2) in paragraph (2)--
                    (A) in the matter preceding subparagraph (A), by 
                inserting ``, including as updated in accordance with 
                paragraph (3),'' after ``paragraph (1)'';
                    (B) in subparagraph (A), by inserting ``, mental 
                health condition, or a mental health condition co-
                occurring with substance use disorder'' after 
                ``substance use disorder'';
                    (C) in subparagraph (B), by inserting ``and mental 
                health treatment services'' after ``substance use 
                disorder treatment services'';
                    (D) in subparagraph (C)--
                            (i) by inserting ``, mental health 
                        condition, or a mental health condition co-
                        occurring with a substance use disorder 
                        diagnosis'' after ``substance use disorder 
                        diagnosis''; and
                            (ii) by inserting ``or mental health 
                        treatment services, respectively,'' after 
                        ``substance use disorder treatment services'';
                    (E) in subparagraph (D), by inserting ``, mental 
                health condition, or a mental health condition co-
                occurring with substance use disorder'' after 
                ``substance use disorder diagnosis'';
                    (F) in subparagraph (E), by inserting ``or mental 
                health treatment'' after ``substance use disorder 
                treatment''; and
                    (G) in subparagraph (F), by inserting ``, 
                individuals with a mental health condition who receive 
                mental health treatment services, and individuals with 
                a co-occurring mental health condition and substance 
                use disorder who receive substance use disorder 
                treatment services and mental health treatment 
                services,'' after ``substance use disorder treatment 
                services''; and
            (3) in paragraph (3), by striking ``through 2024''.
    (b) Application.--The amendments made by subsection (a)(1) shall 
apply beginning with respect to the first update made pursuant to 
section 1015(a)(3) of the SUPPORT for Patients and Communities Act (42 
U.S.C. 1320d-2 note) after the date that is 12 months after the date of 
enactment of this Act.

SEC. 303. MONITORING PRESCRIBING OF ANTIPSYCHOTIC MEDICATIONS.

    Section 1902(oo) of the Social Security Act (42 U.S.C. 1396a(oo)) 
is amended--
            (1) in paragraph (1)(B)--
                    (A) in the subparagraph heading, by striking ``by 
                children''; and
                    (B) by inserting ``, and beginning on the date that 
                is 24 months after the date of enactment of the Support 
                for Patients and Communities Reauthorization Act, 
                individuals over the age of 18, individuals receiving 
                home and community-based services (as defined in 
                section 9817(a)(2)(B) of Public Law 117-2), and 
                individuals residing in institutional care settings 
                (including nursing facilities and intermediate care 
                facilities for individuals with intellectual 
                disabilities) enrolled,'' after ``children enrolled''; 
                and
            (2) in paragraph (3)--
                    (A) in subparagraph (A)(ii), by striking ``is a 
                resident'' and inserting ``subject to subparagraph (C), 
                is a resident''; and
                    (B) by adding at the end the following new 
                subparagraph:
                    ``(C) Application in case of program to monitor 
                antipsychotic medications.--Subparagraph (A)(ii) shall 
                not apply to the drug review and utilization 
                requirement described in paragraph (1)(B) with respect 
                to an individual to whom such subparagraph applies by 
                reason of the amendments made by section 303(1) of the 
                Support for Patients and Communities Reauthorization 
                Act.''.
                                 <all>