[Congressional Record Volume 162, Number 34 (Wednesday, March 2, 2016)]
[Senate]
[Pages S1227-S1238]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                           TEXT OF AMENDMENTS

  SA 3386. Mr. COCHRAN submitted an amendment intended to be proposed 
to amendment SA 3378 proposed by Mr. Grassley (for himself, Mr. Leahy, 
Mr. Whitehouse, Mr. Portman, Ms. Klobuchar, Ms. Ayotte, Mr. Graham, Mr. 
Coons, Mr. Cornyn, and Mr. Durbin) to the bill S. 524, to authorize the 
Attorney General to award grants to address the national epidemics of 
prescription opioid abuse and heroin use; which was ordered to lie on 
the table; as follows:


[[Page S1228]]


  

       At the end of title II, add the following:

     SEC. 205. ATTORNEY GENERAL COORDINATION WITH NATIONAL GUARD.

       The Attorney General shall coordinate with the Chief of the 
     National Guard Bureau to maximize the utilization and support 
     of existing training facilities and programs of the National 
     Guard, including counterdrug training centers, in carrying 
     out this title, including by giving priority to entities 
     seeking grants made under this title that utilize the 
     National Guard training facilities and programs.
                                 ______
                                 
  SA 3387. Mr. THUNE (for himself and Mr. Barrasso) submitted an 
amendment intended to be proposed to amendment SA 3378 proposed by Mr. 
Grassley (for himself, Mr. Leahy, Mr. Whitehouse, Mr. Portman, Ms. 
Klobuchar, Ms. Ayotte, Mr. Graham, Mr. Coons, Mr. Cornyn, and Mr. 
Durbin) to the bill S. 524, to authorize the Attorney General to award 
grants to address the national epidemics of prescription opioid abuse 
and heroin use; which was ordered to lie on the table; as follows:

       At the end of title VII, add the following:

     SEC. 7__. GAO REPORT ON GRANTS TO INDIAN TRIBES.

       (a) Definitions.--In this section:
       (1) Indian tribe.--The term ``Indian tribe'' has the 
     meaning given the term in section 4 of the Indian Health Care 
     Improvement Act (25 U.S.C. 1603).
       (2) Tribal organization.--The term ``tribal organization'' 
     has the meaning given the term in section 4 of the Indian 
     Self-Determination and Education Assistance Act (25 U.S.C. 
     450b).
       (b) Report.--Not later than 250 days after the date of 
     enactment of this Act, the Comptroller General of the United 
     States shall submit to Congress a report--
       (1) listing each Federal grant relating to mental health or 
     substance abuse available to an Indian tribe or a tribal 
     organization;
       (2) describing the number of Indian tribes and tribal 
     organizations receiving a grant described in paragraph (1);
       (3) listing each Indian tribe and tribal organization that 
     received a grant described in paragraph (1) during the period 
     beginning on October 1, 2011, and ending on the date of 
     enactment of this Act;
       (4) identifying areas in which Federal agencies can 
     increase coordination and collaboration to improve the 
     ability of an Indian tribe or tribal organization to receive 
     a grant described in paragraph (1); and
       (5) identifying barriers that Indian tribes or tribal 
     organizations frequently encounter when seeking a grant 
     described in paragraph (1).
                                 ______
                                 
  SA 3388. Mr. MARKEY (for himself and Ms. Ayotte) submitted an 
amendment intended to be proposed by him to the bill S. 524, to 
authorize the Attorney General to award grants to address the national 
epidemics of prescription opioid abuse and heroin use; which was 
ordered to lie on the table; as follows:

       At the end, add the following:

               TITLE VIII--OPIOID OVERDOSE REDUCTION ACT

     SEC. 801. SHORT TITLE.

       This title may be cited as the ``Opioid Overdose Reduction 
     Act of 2016''.

     SEC. 802. FINDINGS AND PURPOSE.

       (a) Findings.--Congress finds the following:
       (1) Overdoses from opioids have increased dramatically in 
     the United States.
       (2) Deaths from drug overdose, largely from prescription 
     pain relievers, have tripled among men and increased fivefold 
     among women over the past decade.
       (3) Nationwide, drug overdoses now claim more lives than 
     car accidents.
       (4) Overdose deaths from heroin and other opioids can be 
     prevented if the person who overdosed is timely administered 
     an opioid overdose drug.
       (5) Medical personnel as well as non-medical personnel can 
     be trained to administer opioid overdose drugs safely and 
     effectively.
       (6) On April 13, 2014, the Food and Drug Administration 
     approved a prescription opioid overdose drug hand-held auto-
     injector for use by family members and caregivers to treat a 
     person known or suspected to have had an opioid overdose.
       (7) Several States, including Massachusetts, have 
     established programs allowing for the administration of 
     opioid overdose drugs by non-medical personnel, and those 
     programs have saved lives.
       (8) The willingness of medical and non-medical personnel to 
     administer opioid overdose drugs may be deterred by potential 
     civil liability, and the willingness of physicians to 
     prescribe opioid overdose drugs to persons other than a 
     patient may also be deterred by potential civil liability.
       (b) Purpose.--The purpose of this title is to save the 
     lives of people who intentionally or inadvertently overdose 
     on heroin or other opioids by providing certain protections 
     from civil liability with respect to the emergency 
     administration of opioid overdose drugs.

     SEC. 803. DEFINITIONS.

       In this title--
       (1) the term ``health care professional'' means a person 
     licensed by a State to prescribe prescription drugs;
       (2) the term ``opioid overdose drug'' means a drug that, 
     when administered, reverses in whole or part the 
     pharmacological effects of an opioid overdose in the human 
     body; and
       (3) the term ``opioid overdose program'' means a program 
     operated by a local health department, community-based 
     organization, substance abuse treatment organization, law 
     enforcement agency, fire department, other first responder 
     department, or voluntary association or a program funded by a 
     Federal, State, or local government that works to prevent 
     opioid overdoses by in part providing opioid overdose drugs 
     and education to individuals at risk of experiencing an 
     opioid overdose or to an individual in a position to assist 
     another individual at risk of experiencing an opioid 
     overdose.

     SEC. 804. PREEMPTION AND ELECTION OF STATE NONAPPLICABILITY.

       (a) Preemption.--Except as provided in subsection (b), this 
     title preempts the law of a State to the extent that such law 
     is inconsistent with this title, except that this title shall 
     not preempt any State law that provides additional protection 
     from liability relating to the administration of opioid 
     overdose drugs or that shields from liability any person who 
     provides or administers opioid overdose drugs.
       (b) Election of State Regarding Nonapplicability.--Sections 
     805, 806, and 807 shall not apply to any civil action in a 
     State court against a person who administers opioid overdose 
     drugs if--
       (1) all parties to the civil action are citizens of the 
     State in which such action is brought; and
       (2) the State enacts legislation in accordance with State 
     requirements for enacting legislation--
       (A) citing the authority of this subsection;
       (B) declaring the election of the State that such sections 
     805, 806, and 807 shall not apply, as of a date certain, to 
     any civil actions covered by this title; and
       (C) containing no other provisions.

     SEC. 805. LIMITATION ON CIVIL LIABILITY FOR HEALTH CARE 
                   PROFESSIONALS WHO PROVIDE OPIOID OVERDOSE 
                   DRUGS.

       (a) Limitation on Liability.--
       (1) In general.--Notwithstanding any other provision of 
     law, a health care professional who prescribes or provides an 
     opioid overdose drug to an individual at risk of experiencing 
     an opioid overdose, or who prescribed or provided an opioid 
     overdose drug to a family member, friend, or other individual 
     in a position to assist an individual at risk of experiencing 
     an opioid overdose, shall not be liable for harm caused by 
     the use of the opioid overdose drug if the individual to whom 
     such drug is prescribed or provided has been educated in 
     accordance with paragraph (2) about opioid overdose 
     prevention and treatment by the health care professional or 
     as part of an opioid overdose program.
       (2) Education requirements.--For purposes of paragraph (1), 
     an individual who has been educated in accordance with this 
     paragraph shall have been trained on--
       (A) when to administer the opioid overdose drug;
       (B) how to administer the opioid overdose drug; and
       (C) the steps that need to be taken after administration of 
     the opioid overdose drug.
       (b) Exception.--Subsection (a) shall not apply to a health 
     care professional if the harm was caused by the gross 
     negligence or reckless misconduct of the health care 
     professional.

     SEC. 806. LIMITATION ON CIVIL LIABILITY FOR INDIVIDUALS 
                   WORKING FOR OR VOLUNTEERING AT A STATE OR LOCAL 
                   AGENCY OPIOID OVERDOSE PROGRAM.

       (a) In General.--Notwithstanding any other provision of 
     law, except as provided in subsection (b), no individual who 
     provides an opioid overdose drug shall be liable for harm 
     caused by the emergency administration of an opioid overdose 
     drug by another individual if the individual who provides 
     such drug--
       (1) works for or volunteers at an opioid overdose program; 
     and
       (2) provides the opioid overdose drug as part of the opioid 
     overdose program to an individual authorized by the program 
     to receive an opioid overdose drug.
       (b) Exception.--Subsection (a) shall not apply if the harm 
     was caused by the gross negligence or reckless misconduct of 
     the individual who provides the drug.

     SEC. 807. LIMITATION ON CIVIL LIABILITY FOR INDIVIDUALS WHO 
                   ADMINISTER OPIOID OVERDOSE DRUGS.

       (a) In General.--Notwithstanding any other provision of 
     law, except as provided in subsection (b), no individual 
     shall be liable for harm caused by the emergency 
     administration of an opioid overdose drug to an individual 
     who has or reasonably appears to have suffered an overdose 
     from heroin or other opioid, if--
       (1) the individual who administers the opioid overdose 
     drug--
       (A) obtained the drug from a health care professional or as 
     part of an opioid overdose program; or
       (B) is doing so pursuant to a prescription for an opioid 
     overdose drug under section 505 of the Federal Food, Drug, 
     and Cosmetic Act (21 U.S.C. 355) or is licensed under section 
     351 of the Public Health Service Act (42 U.S.C. 262); and
       (2) was educated in accordance with section 805(a)(2) by 
     the health care professional or an opioid overdose program.
       (b) Exception.--Subsection (a) shall not apply to an 
     individual if the harm was

[[Page S1229]]

     caused by the gross negligence or reckless misconduct of the 
     individual who administers the drug.
                                 ______
                                 
  SA 3389. Mr. WYDEN submitted an amendment intended to be proposed by 
him to the bill S. 524, to authorize the Attorney General to award 
grants to address the national epidemics of prescription opioid abuse 
and heroin use; which was ordered to lie on the table; as follows:

       At the appropriate place, insert the following:

     SEC. __. PROGRAMS TO PREVENT PRESCRIPTION DRUG ABUSE UNDER 
                   THE MEDICARE PROGRAM.

       (a) Drug Management Program for At-Risk Beneficiaries.--
       (1) In general.--Section 1860D-4(c) of the Social Security 
     Act (42 U.S.C. 1395w-104(c)) is amended by adding at the end 
     the following:
       ``(5) Drug management program for at-risk beneficiaries.--
       ``(A) Authority to establish.--A PDP sponsor may establish 
     a drug management program for at-risk beneficiaries under 
     which, subject to subparagraph (B), the PDP sponsor may, in 
     the case of an at-risk beneficiary for prescription drug 
     abuse who is an enrollee in a prescription drug plan of such 
     PDP sponsor, limit such beneficiary's access to coverage for 
     frequently abused drugs under such plan to frequently abused 
     drugs that are prescribed for such beneficiary by a 
     prescriber (or prescribers) selected under subparagraph (D), 
     and dispensed for such beneficiary by a pharmacy (or 
     pharmacies) selected under such subparagraph.
       ``(B) Requirement for notices.--
       ``(i) In general.--A PDP sponsor may not limit the access 
     of an at-risk beneficiary for prescription drug abuse to 
     coverage for frequently abused drugs under a prescription 
     drug plan until such sponsor--

       ``(I) provides to the beneficiary an initial notice 
     described in clause (ii) and a second notice described in 
     clause (iii); and
       ``(II) verifies with the providers of the beneficiary that 
     the beneficiary is an at-risk beneficiary for prescription 
     drug abuse, as described in subparagraph (C)(iv).

       ``(ii) Initial notice.--An initial written notice described 
     in this clause is a notice that provides to the beneficiary--

       ``(I) notice that the PDP sponsor has identified the 
     beneficiary as potentially being an at-risk beneficiary for 
     prescription drug abuse;
       ``(II) information, when possible, describing State and 
     Federal public health resources that are designed to address 
     prescription drug abuse to which the beneficiary may have 
     access, including substance use disorder treatment services, 
     addiction treatment services, mental health services, and 
     other counseling services;
       ``(III) a request for the beneficiary to submit to the PDP 
     sponsor preferences for which prescribers and pharmacies the 
     beneficiary would prefer the PDP sponsor to select under 
     subparagraph (D) in the case that the beneficiary is 
     identified as an at-risk beneficiary for prescription drug 
     abuse as described in clause (iii)(I);
       ``(IV) an explanation of the meaning and consequences of 
     the identification of the beneficiary as potentially being an 
     at-risk beneficiary for prescription drug abuse, including an 
     explanation of the drug management program established by the 
     PDP sponsor pursuant to subparagraph (A);
       ``(V) clear instructions that explain how the beneficiary 
     can contact the PDP sponsor in order to submit to the PDP 
     sponsor the preferences described in subclause (IV) and any 
     other communications relating to the drug management program 
     for at-risk beneficiaries established by the PDP sponsor;
       ``(VI) contact information for other organizations that can 
     provide the beneficiary with information regarding drug 
     management program for at-risk beneficiaries (similar to the 
     information provided by the Secretary in other standardized 
     notices to part D eligible individuals enrolled in 
     prescription drug plans under this part); and
       ``(VII) notice that the beneficiary has a right to an 
     appeal pursuant to subparagraph (E).

       ``(iii) Second notice.--A second written notice described 
     in this clause is a notice that provides to the beneficiary 
     notice--

       ``(I) that the PDP sponsor has identified the beneficiary 
     as an at-risk beneficiary for prescription drug abuse;
       ``(II) that such beneficiary has been sent, or informed of, 
     such identification in the initial notice and is now subject 
     to the requirements of the drug management program for at-
     risk beneficiaries established by such PDP sponsor for such 
     plan;
       ``(III) of the prescriber and pharmacy selected for such 
     individual under subparagraph (D);
       ``(IV) of, and information about, the right of the 
     beneficiary to a reconsideration and an appeal under 
     subsection (h) of such identification and the prescribers and 
     pharmacies selected;
       ``(V) that the beneficiary can, in the case that the 
     beneficiary has not previously submitted to the PDP sponsor 
     preferences for which prescribers and pharmacies the 
     beneficiary would prefer the PDP sponsor select under 
     subparagraph (D), submit such preferences to the PDP sponsor; 
     and
       ``(VI) that includes clear instructions that explain how 
     the beneficiary can contact the PDP sponsor in order to 
     submit to the PDP sponsor the preferences described in 
     subclause (V).

       ``(iv) Timing of notices.--

       ``(I) In general.--Subject to subclause (II), a second 
     written notice described in clause (iii) shall be provided to 
     the beneficiary on a date that is not less than 30 days after 
     an initial notice described in clause (ii) is provided to the 
     beneficiary.
       ``(II) Exception.--In the case that the PDP sponsor, in 
     conjunction with the Secretary, determines that concerns 
     identified through rulemaking by the Secretary regarding the 
     health or safety of the beneficiary or regarding significant 
     drug diversion activities require the PDP sponsor to provide 
     a second notice described in clause (iii) to the beneficiary 
     on a date that is earlier than the date described in 
     subclause (II), the PDP sponsor may provide such second 
     notice on such earlier date.
       ``(III) Form of notice.--The written notices under clauses 
     (ii) and (iii) shall be in a format determined appropriate by 
     the Secretary, taking into account beneficiary preferences.

       ``(C) At-risk beneficiary for prescription drug abuse.--
       ``(i) In general.--For purposes of this paragraph, the term 
     `at-risk beneficiary for prescription drug abuse' means a 
     part D eligible individual who is not an exempted individual 
     described in clause (ii) and--

       ``(I) who is identified through criteria developed by the 
     Secretary in consultation with PDP sponsors and other 
     stakeholders described in subsection section __(g)(2)(A) of 
     the Comprehensive Addiction and Recovery Act of 2016 based on 
     clinical factors indicating misuse or abuse of prescription 
     drugs described in subparagraph (G), including dosage, 
     quantity, duration of use, number of and reasonable access to 
     prescribers, and number of and reasonable access to 
     pharmacies used to obtain such drug; or
       ``(II) with respect to whom the PDP sponsor of a 
     prescription drug plan, upon enrolling such individual in 
     such plan, received notice from the Secretary that such 
     individual was identified under this paragraph to be an at-
     risk beneficiary for prescription drug abuse under a 
     prescription drug plan in which such individual was 
     previously enrolled and such identification has not been 
     terminated under subparagraph (F).

       ``(ii) Exempted individual described.--An exempted 
     individual described in this clause is an individual who--

       ``(I) receives hospice care under this title;
       ``(II) resides in a long-term care facility, a facility 
     described in section 1905(d), or other facility under 
     contract with a single pharmacy; or
       ``(III) the Secretary elects to treat as an exempted 
     individual for purposes of clause (i).

       ``(iii) Program size.--The Secretary shall establish 
     policies, including the criteria developed under clause 
     (i)(I) and the exemptions under clause (ii)(III), to ensure 
     that the population of enrollees in a drug management program 
     for at-risk beneficiaries operated by a prescription drug 
     plan can be effectively managed by such plans.
       ``(iv) Clinical contact.--With respect to each at-risk 
     beneficiary for prescription drug abuse enrolled in a 
     prescription drug plan offered by a PDP sponsor, the PDP 
     sponsor shall contact the beneficiary's providers who have 
     prescribed frequently abused drugs regarding whether 
     prescribed medications are appropriate for such beneficiary's 
     medical conditions.
       ``(D) Selection of prescribers.--
       ``(i) In general.--With respect to each at-risk beneficiary 
     for prescription drug abuse enrolled in a prescription drug 
     plan offered by such sponsor, a PDP sponsor shall, based on 
     the preferences submitted to the PDP sponsor by the 
     beneficiary pursuant to clauses (ii)(III) and (iii)(V) of 
     subparagraph (B) if applicable, select--

       ``(I) one, or, if the PDP sponsor reasonably determines it 
     necessary to provide the beneficiary with reasonable access 
     under clause (ii), more than one, individual who is 
     authorized to prescribe frequently abused drugs (referred to 
     in this paragraph as a `prescriber') who may write 
     prescriptions for such drugs for such beneficiary; and
       ``(II) one, or, if the PDP sponsor reasonably determines it 
     necessary to provide the beneficiary with reasonable access 
     under clause (ii), more than one, pharmacy that may dispense 
     such drugs to such beneficiary.

       ``(ii) Reasonable access.--In making the selection under 
     this subparagraph, a PDP sponsor shall ensure, taking into 
     account geographic location, beneficiary preference, impact 
     on cost-sharing, and reasonable travel time, that the 
     beneficiary continues to have reasonable access to drugs 
     described in subparagraph (G), including--

       ``(I) for individuals with multiple residences; and
       ``(II) in the case of natural disasters and similar 
     emergency situations.

       ``(iii) Beneficiary preferences.--

       ``(I) In general.--If an at-risk beneficiary for 
     prescription drug abuse submits preferences for which in-
     network prescribers and pharmacies the beneficiary would 
     prefer the PDP sponsor select in response to a notice under 
     subparagraph (B), the PDP sponsor shall--

       ``(aa) review such preferences;
       ``(bb) select or change the selection of a prescriber or 
     pharmacy for the beneficiary based on such preferences; and
       ``(cc) inform the beneficiary of such selection or change 
     of selection.

[[Page S1230]]

       ``(II) Exception.--In the case that the PDP sponsor 
     determines that a change to the selection of a prescriber or 
     pharmacy under item (bb) by the PDP sponsor is contributing 
     or would contribute to prescription drug abuse or drug 
     diversion by the beneficiary, the PDP sponsor may change the 
     selection of a prescriber or pharmacy for the beneficiary. If 
     the PDP sponsor changes the selection pursuant to the 
     preceding sentence, the PDP sponsor shall provide the 
     beneficiary with--

       ``(aa) at least 30 days written notice of the change of 
     selection; and
       ``(bb) a rationale for the change.

       ``(III) Timing.--An at-risk beneficiary for prescription 
     drug abuse may choose to express their prescriber and 
     pharmacy preference and communicate such preference to their 
     PDP sponsor at any date while enrolled in the program, 
     including after a second notice under subparagraph (B)(iii) 
     has been provided.

       ``(iv) Confirmation.--Before selecting a prescriber or 
     pharmacy under this subparagraph, a PDP sponsor must notify 
     the prescriber and pharmacy that the beneficiary involved has 
     been identified for inclusion in the drug management program 
     for at-risk beneficiaries and that the prescriber and 
     pharmacy has been selected as the beneficiary's designated 
     prescriber and pharmacy.
       ``(E) Appeals.--The identification of an individual as an 
     at-risk beneficiary for prescription drug abuse under this 
     paragraph, a coverage determination made under a drug 
     management program for at-risk beneficiaries, and the 
     selection of a prescriber or pharmacy under subparagraph (D) 
     with respect to such individual shall be subject to an 
     expedited reconsideration and appeal pursuant to subsection 
     (h).
       ``(F) Termination of identification.--
       ``(i) In general.--The Secretary shall develop standards 
     for the termination of identification of an individual as an 
     at-risk beneficiary for prescription drug abuse under this 
     paragraph. Under such standards such identification shall 
     terminate as of the earlier of--

       ``(I) the date the individual demonstrates that the 
     individual is no longer likely, in the absence of the 
     restrictions under this paragraph, to be an at-risk 
     beneficiary for prescription drug abuse described in 
     subparagraph (C)(i); or
       ``(II) the end of such maximum period of identification as 
     the Secretary may specify.

       ``(ii) Rule of construction.--Nothing in clause (i) shall 
     be construed as preventing a plan from identifying an 
     individual as an at-risk beneficiary for prescription drug 
     abuse under subparagraph (C)(i) after such termination on the 
     basis of additional information on drug use occurring after 
     the date of notice of such termination.
       ``(G) Frequently abused drug.--For purposes of this 
     subsection, the term `frequently abused drug' means a drug 
     that is determined by the Secretary to be frequently abused 
     or diverted and that is--
       ``(i) a Controlled Drug Substance in Schedule CII; or
       ``(ii) within the same class or category of drugs as a 
     Controlled Drug Substance in Schedule CII, as determined 
     through notice and comment rulemaking.
       ``(H) Data disclosure.--
       ``(i) Data on decision to impose limitation.--In the case 
     of an at-risk beneficiary for prescription drug abuse (or an 
     individual who is a potentially at-risk beneficiary for 
     prescription drug abuse) whose access to coverage for 
     frequently abused drugs under a prescription drug plan has 
     been limited by a PDP sponsor under this paragraph, the 
     Secretary shall establish rules and procedures to require 
     such PDP sponsor to disclose data, including necessary 
     individually identifiable health information, about the 
     decision to impose such limitations and the limitations 
     imposed by the PDP sponsor under this part.
       ``(ii) Data to reduce fraud, abuse, and waste.--The 
     Secretary shall establish rules and procedures to require PDP 
     sponsors operating a drug management program for at-risk 
     beneficiaries under this paragraph to provide the Secretary 
     with such data as the Secretary determines appropriate for 
     purposes of identifying patterns of prescription drug 
     utilization for plan enrollees that are outside normal 
     patterns and that may indicate fraudulent, medically 
     unnecessary, or unsafe use.
       ``(I) Sharing of information for subsequent plan 
     enrollments.--The Secretary shall establish procedures under 
     which PDP sponsors who offer prescription drug plans shall 
     share information with respect to individuals who are at-risk 
     beneficiaries for prescription drug abuse (or individuals who 
     are potentially at-risk beneficiaries for prescription drug 
     abuse) and enrolled in a prescription drug plan and who 
     subsequently disenroll from such plan and enroll in another 
     prescription drug plan offered by another PDP sponsor.
       ``(J) Privacy issues.--Prior to the implementation of the 
     rules and procedures under this paragraph, 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 subparagraphs (H) and (I) by PDP sponsors. Such 
     clarification shall provide that the sharing of such data 
     shall be considered to be protected health information in 
     accordance with the requirements of the regulations 
     promulgated pursuant to such section 264(c).
       ``(K) Education.--The Secretary shall provide education to 
     enrollees in prescription drug plans of PDP sponsors and 
     providers regarding the drug management program for at-risk 
     beneficiaries described in this paragraph, including 
     education--
       ``(i) provided through the improper payment outreach and 
     education program described in section 1874A(h); and
       ``(ii) through current education efforts (such as State 
     health insurance assistance programs described in subsection 
     (a)(1)(A) of section 119 of the Medicare Improvements for 
     Patients and Providers Act of 2008 (42 U.S.C. 1395b-3 note)) 
     and materials directed toward such enrollees.
       ``(L) CMS compliance review.--The Secretary shall ensure 
     that existing plan sponsor compliance reviews and audit 
     processes include the drug management programs for at-risk 
     beneficiaries under this paragraph, including appeals 
     processes under such programs.''.
       (2) Information for consumers.--Section 1860D-4(a)(1)(B) of 
     the Social Security Act (42 U.S.C. 1395w-104(a)(1)(B)) is 
     amended by adding at the end the following:
       ``(v) The drug management program for at-risk beneficiaries 
     under subsection (c)(5).''.
       (3) Dual eligibles.--Section 1860D-1(b)(3)(D) of the Social 
     Security Act (42 U.S.C. 1395w-101(b)(3)(D)) is amended by 
     inserting ``, subject to such limits as the Secretary may 
     establish for individuals identified pursuant to section 
     1860D-4(c)(5)'' after ``the Secretary''.
       (b) Utilization Management Programs.--Section 1860D-4(c) of 
     the Social Security Act (42 U.S.C. 1395w-104(c)), as amended 
     by subsection (a)(1), is amended--
       (1) in paragraph (1), by inserting after subparagraph (D) 
     the following new subparagraph:
       ``(E) A utilization management tool to prevent drug abuse 
     (as described in paragraph (5)(A)).''; and
       (2) by adding at the end the following new paragraph:
       ``(6) Utilization management tool to prevent drug abuse.--
       ``(A) In general.--A tool described in this paragraph is 
     any of the following:
       ``(i) A utilization tool designed to prevent the abuse of 
     frequently abused drugs by individuals and to prevent the 
     diversion of such drugs at pharmacies.
       ``(ii) Retrospective utilization review to identify--

       ``(I) individuals that receive frequently abused drugs at a 
     frequency or in amounts that are not clinically appropriate; 
     and
       ``(II) providers of services or suppliers that may 
     facilitate the abuse or diversion of frequently abused drugs 
     by beneficiaries.

       ``(iii) Consultation with the contractor described in 
     subparagraph (B) to verify if an individual enrolling in a 
     prescription drug plan offered by a PDP sponsor has been 
     previously identified by another PDP sponsor as an individual 
     described in clause (ii)(I).
       ``(B) Reporting.--A PDP sponsor offering a prescription 
     drug plan in a State shall submit to the Secretary and the 
     Medicare drug integrity contractor with which the Secretary 
     has entered into a contract under section 1893 with respect 
     to such State a report, on a monthly basis, containing 
     information on--
       ``(i) any provider of services or supplier described in 
     subparagraph (A)(ii)(II) that is identified by such plan 
     sponsor during the 30-day period before such report is 
     submitted; and
       ``(ii) the name and prescription records of individuals 
     described in paragraph (5)(C).
       ``(C) CMS compliance review.--The Secretary shall ensure 
     that plan sponsor annual compliance reviews and program 
     audits include a certification that utilization management 
     tools under this paragraph are in compliance with the 
     requirements for such tools.''.
       (c) Treatment of Certain Complaints for Purposes of Quality 
     or Performance Assessment.--Section 1860D-42 of the Social 
     Security Act (42 U.S.C. 1395w-152) is amended by adding at 
     the end the following new subsection:
       ``(d) Treatment of Certain Complaints for Purposes of 
     Quality or Performance Assessment.--In conducting a quality 
     or performance assessment of a PDP sponsor, the Secretary 
     shall develop or utilize existing screening methods for 
     reviewing and considering complaints that are received from 
     enrollees in a prescription drug plan offered by such PDP 
     sponsor and that are complaints regarding the lack of access 
     by the individual to prescription drugs due to a drug 
     management program for at-risk beneficiaries.''.
       (d) Sense of Congress Regarding Use of Technology Tools To 
     Combat Fraud.--It is the sense of Congress that MA 
     organizations and PDP sponsors should consider using e-
     prescribing and other health information technology tools to 
     support combating fraud under MA-PD plans and prescription 
     drug plans under parts C and D of the Medicare Program.
       (e) GAO Study and Report.--
       (1) Study.--The Comptroller General of the United States 
     shall conduct a study on the implementation of the amendments 
     made by this section, including the effectiveness of the at-
     risk beneficiaries for prescription drug abuse drug 
     management programs authorized by section 1860D-4(c)(5) of 
     the Social Security Act (42 U.S.C. 1395w-10(c)(5)), as added 
     by subsection (a)(1). Such study shall include an analysis 
     of--

[[Page S1231]]

       (A) the impediments, if any, that impair the ability of 
     individuals described in subparagraph (C) of such section 
     1860D-4(c)(5) to access clinically appropriate levels of 
     prescription drugs;
       (B) the effectiveness of the reasonable access protections 
     under subparagraph (D)(ii) of such section 1860D-4(c)(5), 
     including the impact on beneficiary access and health;
       (C) how best to define the term ``designated pharmacy'', 
     including whether the definition of such term should include 
     an entity that is comprised of a number of locations that are 
     under common ownership and that electronically share a real-
     time, online database and whether such a definition would 
     help to protect and improve beneficiary access;
       (D) the types of--
       (i) individuals who, in the implementation of such section, 
     are determined to be individuals described in such 
     subparagraph; and
       (ii) prescribers and pharmacies that are selected under 
     subparagraph (D) of such section;
       (E) the extent of prescription drug abuse beyond Controlled 
     Drug Substances in Schedule CII in parts C and D of the 
     Medicare program; and
       (F) other areas determined appropriate by the Comptroller 
     General.
       (2) Report.--Not later than July 1, 2019, the Comptroller 
     General of the United States shall submit to the appropriate 
     committees of jurisdiction of Congress a report on the study 
     conducted under paragraph (1), together with recommendations 
     for such legislation and administrative action as the 
     Comptroller General determines to be appropriate.
       (f) Report by Secretary.--
       (1) In general.--Not later than 12 months after the date of 
     the enactment of this Act, the Secretary of Health and Human 
     Services shall submit to the appropriate committees of 
     jurisdiction of Congress a report on ways to improve upon the 
     appeals process for Medicare beneficiaries with respect to 
     prescription drug coverage under part D of title XVIII of the 
     Social Security Act. Such report shall include an analysis 
     comparing appeals processes under parts C and D of such title 
     XVIII.
       (2) Feedback.--In development of the report described in 
     paragraph (1), the Secretary of Health and Human Services 
     shall solicit feedback on the current appeals process from 
     stakeholders, such as beneficiaries, consumer advocates, plan 
     sponsors, pharmacy benefit managers, pharmacists, providers, 
     independent review entity evaluators, and pharmaceutical 
     manufacturers.
       (g) Effective Date.--
       (1) In general.--Except as provided in subsection (d)(2), 
     the amendments made by this section shall apply to 
     prescription drug plans for plan years beginning on or after 
     January 1, 2018.
       (2) Stakeholder meetings prior to effective date.--
       (A) In general.--Not later than January 1, 2017, the 
     Secretary of Health and Human Services shall convene 
     stakeholders, including individuals entitled to benefits 
     under part A of title XVIII of the Social Security Act or 
     enrolled under part B of such title of such Act, advocacy 
     groups representing such individuals, clinicians, plan 
     sponsors, pharmacists, retail pharmacies, entities delegated 
     by plan sponsors, and biopharmaceutical manufacturers for 
     input regarding the topics described in subparagraph (B). The 
     input described in the preceding sentence shall be provided 
     to the Secretary in sufficient time in order for the 
     Secretary to take such input into account in promulgating the 
     regulations pursuant to subparagraph (C).
       (B) Topics described.--The topics described in this 
     subparagraph are the topics of--
       (i) the impact on cost-sharing and ensuring accessibility 
     to prescription drugs for enrollees in prescription drug 
     plans of PDP sponsors who are at-risk beneficiaries for 
     prescription drug abuse (as defined in paragraph (5)(C) of 
     section 1860D-4(c) of the Social Security Act (42 U.S.C. 
     1395w-10(c)));
       (ii) the use of an expedited appeals process under which 
     such an enrollee may appeal an identification of such 
     enrollee as an at-risk beneficiary for prescription drug 
     abuse under such paragraph (similar to the processes 
     established under the Medicare Advantage program under part C 
     of title XVIII of the Social Security Act);
       (iii) the types of enrollees that should be treated as 
     exempted individuals, as described in clause (ii) of such 
     paragraph;
       (iv) the manner in which terms and definitions in paragraph 
     (5) of such section 1860D-4(c) should be applied, such as the 
     use of clinical appropriateness in determining whether an 
     enrollee is an at-risk beneficiary for prescription drug 
     abuse as defined in subparagraph (C) of such paragraph (5);
       (v) the information to be included in the notices described 
     in subparagraph (B) of such section and the standardization 
     of such notices;
       (vi) with respect to a PDP sponsor that establishes a drug 
     management program for at-risk beneficiaries under such 
     paragraph (5), the responsibilities of such PDP sponsor with 
     respect to the implementation of such program;
       (vii) notices for plan enrollees at the point of sale that 
     would explain why an at-risk beneficiary has been prohibited 
     from receiving a prescription at a location outside of the 
     designated pharmacy;
       (viii) evidence-based prescribing guidelines for opiates; 
     and
       (ix) the sharing of claims data under parts A and B with 
     PDP sponsors.
       (C) Rulemaking.--The Secretary of Health and Human Services 
     shall, taking into account the input gathered pursuant to 
     subparagraph (A) and after providing notice and an 
     opportunity to comment, promulgate regulations to carry out 
     the provisions of, and amendments made by subsections (a) and 
     (b).

     SEC. __. INCREASED ANTI-KICKBACKS PENALTIES.

       Paragraphs (1) and (2) of section 1128B(b) of the Social 
     Security Act (42 U.S.C. 1320a-7b(b)) are each amended by 
     inserting ``(or, beginning January 1, 2017, $50,000)'' after 
     ``$25,000''.

     SEC. __. CENTER FOR MEDICARE AND MEDICAID INNOVATION TESTING 
                   OF OPIOID ABUSE TREATMENT PROGRAM MODEL FOR 
                   PART D PRESCRIPTION DRUG PLAN ENROLLEES.

       Section 1115A of the Social Security Act (42 U.S.C. 1315a) 
     is amended--
       (1) in subsection (b)(2)(A), by adding at the end the 
     following new sentence: ``The models selected under this 
     subparagraph shall include the model described in subsection 
     (h).''; and
       (2) by adding at the end the following new subsection:
       ``(h) Opioid Abuse Treatment Program Model.--
       ``(1) In general.--The Secretary shall test a model 
     requiring prescription drug plans under part D of title XVIII 
     to have in place, directly or through appropriate 
     arrangements, an opioid abuse treatment program for 
     applicable enrollees in lieu of the medication therapy 
     management program under section 1860D-4(c)(2) with respect 
     to such applicable enrollees.
       ``(2) Start date.--The model under this subsection shall 
     start in plan year 2018.
       ``(3) Selection.--The Secretary shall select a limited 
     number of Medicare part D regions in which to the model, 
     giving priority to regions based on the number of total 
     opioid prescriptions in the region.
       ``(4) Requirements for program.--Under an opioid abuse 
     treatment program, the PDP sponsor offering the plan shall--
       ``(A) establish a care team that includes at least--
       ``(i) a pharmacist;
       ``(ii) a physician; and
       ``(iii) an individual licenced in a State with expertise in 
     behavioral health (as determined by the Secretary), which may 
     be the physician described in clause (ii); and
       ``(B) develop, in consultation with the applicable enrollee 
     and with input from the prescriber to the extent necessary 
     and practicable, a care plan for the applicable enrollee that 
     is intended to treat the applicable enrollee's pain and limit 
     any unnecessary opioid prescriptions when possible.
       ``(5) Payment.--
       ``(A) In general.--Under the model under this subsection, 
     the Secretary shall make a monthly payment to the PDP sponsor 
     offering the prescription drug plan for each applicable 
     enrollee who receives services under the opioid abuse 
     treatment program.
       ``(B) Shared savings.--Under the model under this 
     subsection, the Secretary shall (using a methodology 
     determined appropriate by the Secretary) make payments (in 
     addition to the payments under subparagraph (A)) to the PDP 
     sponsor offering the prescription drug plan if the Secretary 
     determines that total spending under parts A, B, and D of 
     title XVIII (and including the payments under subparagraph 
     (A)) for applicable enrollees who receive services under the 
     opioid abuse treatment program is less than a historical 
     benchmark of total spending under such parts A, B, and D for 
     such enrollees or similar enrollees. Such benchmark shall be 
     adjusted at the Secretary's discretion for changes in law or 
     regulation, unforeseen circumstances, or advances in medical 
     practice.
       ``(6) Quality.--Under the model under this subsection, the 
     Secretary shall measure the quality of care furnished by 
     opioid abuse treatment programs, including elements related 
     to access to care, the unnecessary use of opioids, pain 
     management, and the delivery of behavioral health services.
       ``(7) Applicable enrollee.--In this subsection, the term 
     `applicable enrollee' means an individual who is, with 
     respect to a prescription drug plan--
       ``(A) enrolled with the plan; and
       ``(B) an at-risk beneficiary for prescription drug abuse 
     (as defined in section 1860D-4(c)(5)(C)).
       ``(8) Model not applicable to ma-pd plans.--The model under 
     this subsection shall not apply to MA-PD plans or enrollees 
     of such plans.
       ``(9) Clarification of application.--For purposes of the 
     preceding provisions of this section (including paragraphs 
     (3) and (4) of subsection (b) and subsections (d) and (f)), 
     the model under this subsection shall be deemed to be a model 
     under subsection (b).''.
                                 ______
                                 
  SA 3390. Mr. DAINES submitted an amendment intended to be proposed to 
amendment SA 3378 proposed by Mr. Grassley (for himself, Mr. Leahy, Mr. 
Whitehouse, Mr. Portman, Ms. Klobuchar, Ms. Ayotte, Mr. Graham, Mr. 
Coons, Mr. Cornyn, and Mr. Durbin) to the bill S. 524, to authorize the 
Attorney General to award grants to address the national epidemics of 
prescription opioid abuse and heroin use; which was ordered to lie on 
the table; as follows:


[[Page S1232]]


  

       On page 8, after line 25, insert the following:
       (19) Veterans with post-traumatic stress disorder are also 
     at a high risk of substance abuse. According to the 
     Department of Veterans Affairs, more than 20 percent of 
     veterans with post-traumatic stress disorder also have a 
     substance abuse disorder.
                                 ______
                                 
  SA 3391. Mr. DAINES (for himself and Mr. Peters) submitted an 
amendment intended to be proposed to amendment SA 3378 proposed by Mr. 
Grassley (for himself, Mr. Leahy, Mr. Whitehouse, Mr. Portman, Ms. 
Klobuchar, Ms. Ayotte, Mr. Graham, Mr. Coons, Mr. Cornyn, and Mr. 
Durbin) to the bill S. 524, to authorize the Attorney General to award 
grants to address the national epidemics of prescription opioid abuse 
and heroin use; which was ordered to lie on the table; as follows:

       On page 66, strike line 5 and insert the following:

      disorder, service-connected post-traumatic stress disorder, 
     military sexual trauma, or a service-connected traumatic 
     brain injury, as determined on a case-by-case basis.''.

                                 ______
                                 
  SA 3392. Mr. BLUNT (for himself and Ms. Stabenow) submitted an 
amendment intended to be proposed to amendment SA 3378 proposed by Mr. 
Grassley (for himself, Mr. Leahy, Mr. Whitehouse, Mr. Portman, Ms. 
Klobuchar, Ms. Ayotte, Mr. Graham, Mr. Coons, Mr. Cornyn, and Mr. 
Durbin) to the bill S. 524, to authorize the Attorney General to award 
grants to address the national epidemics of prescription opioid abuse 
and heroin use; which was ordered to lie on the table; as follows:

       At the end of title VII, add the following:

     SEC. 705. EXPANSION OF THE EXCELLENCE IN MENTAL HEALTH ACT.

       Section 223(d)(3) of the Protecting Access to Medicare Act 
     of 2014 (42 U.S.C. 1396a note) is amended by striking ``8'' 
     and inserting ``24''.
                                 ______
                                 
  SA 3393. Mr. MERKLEY (for himself, Mr. Paul, Mr. Reid, Mr. Bennet, 
Mr. Wyden, Mrs. Murray, and Ms. Warren) submitted an amendment intended 
to be proposed by him to the bill S. 524, to authorize the Attorney 
General to award grants to address the national epidemics of 
prescription opioid abuse and heroin use; which was ordered to lie on 
the table; as follows:

       At the appropriate place, insert the following:

            TITLE __--MARIJUANA BUSINESSES ACCESS TO BANKING

     SEC. _01. SHORT TITLE.

       This title may be cited as the ``Marijuana Businesses 
     Access to Banking Act of 2016''.

     SEC. _02. SAFE HARBOR FOR DEPOSITORY INSTITUTIONS.

       A Federal banking regulator may not--
       (1) terminate or limit the deposit insurance or share 
     insurance of a depository institution under the Federal 
     Deposit Insurance Act (12 U.S.C. 1811 et seq.) or the Federal 
     Credit Union Act (12 U.S.C. 1751 et seq.) solely because the 
     depository institution provides or has provided financial 
     services to a marijuana-related legitimate business;
       (2) prohibit, penalize, or otherwise discourage a 
     depository institution from providing financial services to a 
     marijuana-related legitimate business;
       (3) recommend, incentivize, or encourage a depository 
     institution not to offer financial services to an individual, 
     or to downgrade or cancel the financial services offered to 
     an individual solely because--
       (A) the individual is a manufacturer or producer, or is the 
     owner or operator of a marijuana-related legitimate business;
       (B) the individual later becomes an owner or operator of a 
     marijuana-related legitimate business; or
       (C) the depository institution was not aware that the 
     individual is the owner or operator of a marijuana-related 
     legitimate business; and
       (4) take any adverse or corrective supervisory action on a 
     loan to an owner or operator of--
       (A) a marijuana-related legitimate business solely because 
     the business owner or operator is a marijuana-related 
     business; or
       (B) real estate or equipment that is leased to a marijuana-
     related legitimate business solely because the owner or 
     operator of the real estate or equipment leased the equipment 
     or real estate to a marijuana-related legitimate business.

     SEC. _03. PROTECTIONS UNDER FEDERAL LAW.

       (a) In General.--In a State or political subdivision that 
     allows the cultivation, production, manufacturing, 
     transportation, display, dispensing, distribution, sale, or 
     purchase of marijuana pursuant to a law (including 
     regulations) of the State or political subdivision, a 
     depository institution and the officers, director, and 
     employees of the depository institution that provides 
     financial services to a marijuana-related legitimate business 
     may not be held liable pursuant to any Federal law (including 
     regulations)--
       (1) solely for providing the financial services pursuant to 
     the law (including regulations) of the State or political 
     subdivision; or
       (2) for further investing any income derived from the 
     financial services.
       (b) Forfeiture.--A depository institution that has a legal 
     interest in the collateral for a loan made to an owner or 
     operator of a marijuana-related legitimate business, or to an 
     owner or operator of real estate or equipment that is leased 
     to a marijuana-related legitimate business, shall not be 
     subject to criminal, civil, or administrative forfeiture of 
     that legal interest pursuant to any Federal law for providing 
     the loan.

     SEC. _04. RULE OF CONSTRUCTION.

       Nothing in this title shall require a depository 
     institution to provide financial services to a marijuana-
     related legitimate business.

     SEC. _05. REQUIREMENTS FOR FILING SUSPICIOUS ACTIVITY 
                   REPORTS.

       Section 5318(g) of title 31, United States Code, is amended 
     by adding at the end the following:
       ``(5) Requirements for marijuana-related businesses.--A 
     financial institution or any director, officer, employee, or 
     agent of a financial institution that reports a suspicious 
     transaction pursuant to a marijuana-related legitimate 
     business (as defined in section 6 of the Marijuana Businesses 
     Access to Banking Act of 2016) shall comply with appropriate 
     guidance issued by the Financial Crimes Enforcement Network. 
     The Secretary shall ensure that the guidance is consistent 
     with the purpose and intent of the Marijuana Businesses 
     Access to Banking Act of 2016 and does not inhibit the 
     provision of financial services to a marijuana-related 
     legitimate business in a State or political subdivision of a 
     State that has allowed the cultivation, production, 
     manufacturing, transportation, display, dispensing, 
     distribution, sale, or purchase of marijuana pursuant to law 
     or regulation of the State or political subdivision.''.

     SEC. _06. DEFINITIONS.

       In this title:
       (1) Depository institution.--The term ``depository 
     institution'' means--
       (A) a depository institution as defined in section 3(c) of 
     the Federal Deposit Insurance Act (12 U.S.C. 1813(c));
       (B) a Federal credit union as defined in section 101 of the 
     Federal Credit Union Act (12 U.S.C. 1752); or
       (C) a State credit union as defined in section 101 of the 
     Federal Credit Union Act (12 U.S.C. 1752).
       (2) Federal banking regulator.--The term ``Federal banking 
     regulator'' means each of the Board of Governors of the 
     Federal Reserve System, the Bureau of Consumer Financial 
     Protection, the Federal Deposit Insurance Corporation, the 
     Office of the Comptroller of the Currency, the National 
     Credit Union Administration, or any Federal agency or 
     department that regulates banking or financial services, as 
     determined by the Secretary of the Treasury.
       (3) Financial service.--The term ``financial service'' 
     means a financial product or service as defined in section 
     1002 of the Dodd-Frank Wall Street Reform and Consumer 
     Protection Act (12 U.S.C. 5481).
       (4) Manufacturer.--The term ``manufacturer'' means a person 
     who manufactures, compounds, converts, processes, prepares, 
     or packages marijuana or marijuana products.
       (5) Marijuana-related legitimate business.--The term 
     ``marijuana-related legitimate business'' means a 
     manufacturer, producer, or any person that--
       (A) participates in any business or organized activity that 
     involves handling marijuana or marijuana products, including 
     cultivating, producing, manufacturing, selling, transporting, 
     displaying, dispensing, distributing, or purchasing marijuana 
     or marijuana products; and
       (B) engages in such activity pursuant to a law established 
     by a State or a political subdivision of a State.
       (6) Marijuana.--The term ``marijuana'' has the meaning 
     given the term ``marihuana'' in section 102 of the Controlled 
     Substances Act (21 U.S.C. 802).
       (7) Marijuana product.--The term ``marijuana product'' 
     means any article which contains marijuana, including an 
     article which is a concentrate, an edible, a tincture, a 
     marijuana-infused product, or a topical.
       (8) Producer.--The term ``producer'' means a person who 
     plants, cultivates, harvests, or in any way facilitates the 
     natural growth of marijuana.
       (9) State.--The term ``State'' means each of the several 
     States, the District of Columbia, Puerto Rico, and any 
     territory or possession of the United States.
                                 ______
                                 
  SA 3394. Mr. LEAHY submitted an amendment intended to be proposed by 
him to the bill S. 524, to authorize the Attorney General to award 
grants to address the national epidemics of prescription opioid abuse 
and heroin use; which was ordered to lie on the table; as follows:

       At the appropriate place, insert the following:

     SEC. __. OPIOID ADDICTION TREATMENT.

       Section 303(g)(2)(B)(ii) of the Controlled Substances Act 
     (21 U.S.C. 823(g)(2)(B)(ii)) is amended by adding at the end 
     the following: ``Not later than 2 years after the date of 
     enactment of the Comprehensive Addiction and Recovery Act of 
     2016, the federally regulated opioid addiction treatment 
     infrastructure shall be organized according to the hub and 
     spoke model, so that the following goals are met without 
     causing undue burden on physician practices:

[[Page S1233]]

       ``(I) Opioid addicted individuals who are patients in a 
     federally regulated opioid addiction treatment program should 
     be educated about all treatment options and strategies.
       ``(II) Each patient shall be offered an individualized 
     assessment, followed by a treatment plan developed with the 
     patient's involvement.
       ``(III) Patient compliance and progress should be monitored 
     to protect against medication diversion and to guide changes 
     to the treatment plan as needed.
       ``(IV) All practitioners participating in a federally 
     regulated opioid addiction treatment program shall offer, 
     either directly or by referral, the treatments that are most 
     appropriate for the patient.
       ``(V) Substance Abuse and Mental Health Services shall 
     ensure training on all available treatments as well as 
     treatments that may become available in the future.''.
                                 ______
                                 
  SA 3395. Mr. WYDEN (for himself, Mr. Schumer, and Mrs. Murray) 
submitted an amendment intended to be proposed to amendment SA 3378 
proposed by Mr. Grassley (for himself, Mr. Leahy, Mr. Whitehouse, Mr. 
Portman, Ms. Klobuchar, Ms. Ayotte, Mr. Graham, Mr. Coons, Mr. Cornyn, 
and Mr. Durbin) to the bill S. 524, to authorize the Attorney General 
to award grants to address the national epidemics of prescription 
opioid abuse and heroin use; as follows:

       At the appropriate place, insert the following:

     SEC. __. INCREASED ANTI-KICKBACKS PENALTIES.

       Paragraphs (1) and (2) of section 1128B(b) of the Social 
     Security Act (42 U.S.C. 1320a-7b(b)) are each amended by 
     inserting ``(or, beginning January 1, 2017, $50,000)'' after 
     ``$25,000''.

     SEC. __. CENTER FOR MEDICARE AND MEDICAID INNOVATION TESTING 
                   OF OPIOID ABUSE TREATMENT PROGRAM MODEL FOR 
                   PART D PRESCRIPTION DRUG PLAN ENROLLEES.

       Section 1115A of the Social Security Act (42 U.S.C. 1315a) 
     is amended--
       (1) in subsection (b)(2)(A), by adding at the end the 
     following new sentence: ``The models selected under this 
     subparagraph shall include the model described in subsection 
     (h).''; and
       (2) by adding at the end the following new subsection:
       ``(h) Opioid Abuse Treatment Program Model.--
       ``(1) In general.--The Secretary shall test a model 
     requiring prescription drug plans under part D of title XVIII 
     to have in place, directly or through appropriate 
     arrangements, an opioid abuse treatment program for 
     applicable enrollees in lieu of the medication therapy 
     management program under section 1860D-4(c)(2) with respect 
     to such applicable enrollees.
       ``(2) Start date.--The model under this subsection shall 
     start in plan year 2018.
       ``(3) Selection.--The Secretary shall select a limited 
     number of Medicare part D regions in which to the model, 
     giving priority to regions based on the number of total 
     opioid prescriptions in the region.
       ``(4) Requirements for program.--Under an opioid abuse 
     treatment program, the PDP sponsor offering the plan shall--
       ``(A) establish a care team that includes at least--
       ``(i) a pharmacist;
       ``(ii) a physician; and
       ``(iii) an individual licenced in a State with expertise in 
     behavioral health (as determined by the Secretary), which may 
     be the physician described in clause (ii); and
       ``(B) develop, in consultation with the applicable enrollee 
     and with input from the prescriber to the extent necessary 
     and practicable, a care plan for the applicable enrollee that 
     is intended to treat the applicable enrollee's pain and limit 
     any unnecessary opioid prescriptions when possible.
       ``(5) Payment.--
       ``(A) In general.--Under the model under this subsection, 
     the Secretary shall make a monthly payment to the PDP sponsor 
     offering the prescription drug plan for each applicable 
     enrollee who receives services under the opioid abuse 
     treatment program.
       ``(B) Shared savings.--Under the model under this 
     subsection, the Secretary shall (using a methodology 
     determined appropriate by the Secretary) make payments (in 
     addition to the payments under subparagraph (A)) to the PDP 
     sponsor offering the prescription drug plan if the Secretary 
     determines that total spending under parts A, B, and D of 
     title XVIII (and including the payments under subparagraph 
     (A)) for applicable enrollees who receive services under the 
     opioid abuse treatment program is less than a historical 
     benchmark of total spending under such parts A, B, and D for 
     such enrollees or similar enrollees. Such benchmark shall be 
     adjusted at the Secretary's discretion for changes in law or 
     regulation, unforeseen circumstances, or advances in medical 
     practice.
       ``(6) Quality.--Under the model under this subsection, the 
     Secretary shall measure the quality of care furnished by 
     opioid abuse treatment programs, including elements related 
     to access to care, the unnecessary use of opioids, pain 
     management, and the delivery of behavioral health services.
       ``(7) Applicable enrollee.--In this subsection, the term 
     `applicable enrollee' means an individual who is, with 
     respect to a prescription drug plan--
       ``(A) enrolled with the plan; and
       ``(B) an at-risk beneficiary for prescription drug abuse 
     (as defined in section 1860D-4(c)(5)(C)).
       ``(8) Model not applicable to ma-pd plans.--The model under 
     this subsection shall not apply to MA-PD plans or enrollees 
     of such plans.
       ``(9) Clarification of application.--For purposes of the 
     preceding provisions of this section (including paragraphs 
     (3) and (4) of subsection (b) and subsections (d) and (f)), 
     the model under this subsection shall be deemed to be a model 
     under subsection (b).''.
                                 ______
                                 
  SA 3396. Mr. WICKER (for himself, Mr. Brown, and Mr. Cochran) 
submitted an amendment intended to be proposed to amendment SA 3378 
proposed by Mr. Grassley (for himself, Mr. Leahy, Mr. Whitehouse, Mr. 
Portman, Ms. Klobuchar, Ms. Ayotte, Mr. Graham, Mr. Coons, Mr. Cornyn, 
and Mr. Durbin) to the bill S. 524, to authorize the Attorney General 
to award grants to address the national epidemics of prescription 
opioid abuse and heroin use; which was ordered to lie on the table; as 
follows:

       At the appropriate place, insert the following:

     SEC. __. MEDICARE DIRECT PAYMENT TO PHARMACIES FOR CERTAIN 
                   COMPOUNDED DRUGS THAT ARE PREPARED BY THE 
                   PHARMACIES FOR A SPECIFIC BENEFICIARY FOR USE 
                   THROUGH AN IMPLANTED INFUSION PUMP.

       (a) In General.--The first sentence of section 1842(b)(6) 
     of the Social Security Act (42 U.S.C. 1395u(b)(6)) is 
     amended--
       (1) by striking ``and'' before ``(H)''; and
       (2) by inserting before the period at the end the 
     following: ``, and (I) in the case of covered compounded 
     drugs that are prepared by a pharmacy for a specific 
     individual, are dispensed, directly or indirectly, to the 
     individual, are necessary for the effective use of, or 
     therapeutic benefit from, an implanted infusion pump 
     (regardless who refills the pump), and are billed directly by 
     the pharmacy, payment shall be made to the pharmacy''.
       (b) Effective Date.--The amendments made by subsection (a) 
     shall apply to drugs dispensed on or after the date of the 
     enactment of this Act.
                                 ______
                                 
  SA 3397. Mr. HATCH (for himself and Mr. Whitehouse) submitted an 
amendment intended to be proposed to amendment SA 3378 proposed by Mr. 
Grassley (for himself, Mr. Leahy, Mr. Whitehouse, Mr. Portman, Ms. 
Klobuchar, Ms. Ayotte, Mr. Graham, Mr. Coons, Mr. Cornyn, and Mr. 
Durbin) to the bill S. 524, to authorize the Attorney General to award 
grants to address the national epidemics of prescription opioid abuse 
and heroin use; which was ordered to lie on the table; as follows:

       At the end, add the following:

 TITLE VIII--ENSURING PATIENT ACCESS AND EFFECTIVE DRUG ENFORCEMENT ACT

     SEC. 801. SHORT TITLE.

       This title may be cited as the ``Ensuring Patient Access 
     and Effective Drug Enforcement Act of 2016''.

     SEC. 802. REGISTRATION PROCESS UNDER CONTROLLED SUBSTANCES 
                   ACT.

       (a) Definitions.--
       (1) Factors as may be relevant to and consistent with the 
     public health and safety.--Section 303 of the Controlled 
     Substances Act (21 U.S.C. 823) is amended by adding at the 
     end the following:
       ``(j) In this section, the phrase `factors as may be 
     relevant to and consistent with the public health and safety' 
     means factors that are relevant to and consistent with the 
     findings contained in section 101.''.
       (2) Imminent danger to the public health or safety.--
     Section 304(d) of the Controlled Substances Act (21 U.S.C. 
     824(d)) is amended--
       (A) by striking ``(d) The Attorney General'' and inserting 
     ``(d)(1) The Attorney General''; and
       (B) by adding at the end the following:
       ``(2) In this subsection, the phrase `imminent danger to 
     the public health or safety' means that, due to the failure 
     of the registrant to maintain effective controls against 
     diversion or otherwise comply with the obligations of a 
     registrant under this title or title III, there is a 
     substantial likelihood of an immediate threat that death, 
     serious bodily harm, or abuse of a controlled substance will 
     occur in the absence of an immediate suspension of the 
     registration.''.
       (b) Opportunity To Submit Corrective Action Plan Prior to 
     Revocation or Suspension.--Subsection (c) of section 304 of 
     the Controlled Substances Act (21 U.S.C. 824) is amended--
       (1) by striking the last three sentences;
       (2) by striking ``(c) Before'' and inserting ``(c)(1) 
     Before''; and
       (3) by adding at the end the following:
       ``(2) An order to show cause under paragraph (1) shall--
       ``(A) contain a statement of the basis for the denial, 
     revocation, or suspension, including specific citations to 
     any laws or regulations alleged to be violated by the 
     applicant or registrant;

[[Page S1234]]

       ``(B) direct the applicant or registrant to appear before 
     the Attorney General at a time and place stated in the order, 
     but not less than 30 days after the date of receipt of the 
     order; and
       ``(C) notify the applicant or registrant of the opportunity 
     to submit a corrective action plan on or before the date of 
     appearance.
       ``(3) Upon review of any corrective action plan submitted 
     by an applicant or registrant pursuant to paragraph (2), the 
     Attorney General shall determine whether denial, revocation, 
     or suspension proceedings should be discontinued, or deferred 
     for the purposes of modification, amendment, or clarification 
     to such plan.
       ``(4) Proceedings to deny, revoke, or suspend shall be 
     conducted pursuant to this section in accordance with 
     subchapter II of chapter 5 of title 5, United States Code. 
     Such proceedings shall be independent of, and not in lieu of, 
     criminal prosecutions or other proceedings under this title 
     or any other law of the United States.
       ``(5) The requirements of this subsection shall not apply 
     to the issuance of an immediate suspension order under 
     subsection (d).''.

     SEC. 803. REPORT TO CONGRESS.

       (a) In General.--Not later than 1 year after the date of 
     enactment of this Act, the Secretary of Health and Human 
     Services, acting through the Commissioner of Food and Drugs, 
     the Administrator of the Substance Abuse and Mental Health 
     Services Administration, the Director of the Agency for 
     Healthcare Research and Quality, and the Director of the 
     Centers for Disease Control and Prevention, in coordination 
     with the Administrator of the Drug Enforcement Administration 
     and in consultation with the Secretary of Defense and the 
     Secretary of Veterans Affairs, shall submit a report to the 
     Committee on the Judiciary of the House of Representatives, 
     the Committee on Energy and Commerce of the House of 
     Representatives, the Committee on the Judiciary of the 
     Senate, and the Committee on Health, Education, Labor, and 
     Pensions of the Senate identifying--
       (1) obstacles to legitimate patient access to controlled 
     substances;
       (2) issues with diversion of controlled substances;
       (3) how collaboration between Federal, State, local, and 
     tribal law enforcement agencies and the pharmaceutical 
     industry can benefit patients and prevent diversion and abuse 
     of controlled substances;
       (4) the availability of medical education, training 
     opportunities, and comprehensive clinical guidance for pain 
     management and opioid prescribing, and any gaps that should 
     be addressed;
       (5) beneficial enhancements to State prescription drug 
     monitoring programs, including enhancements to require 
     comprehensive prescriber input and to expand access to the 
     programs for appropriate authorized users; and
       (6) steps to improve reporting requirements so that the 
     public and Congress have more information regarding 
     prescription opioids, such as the volume and formulation of 
     prescription opioids prescribed annually, the dispensing of 
     such prescription opioids, and outliers and trends within 
     large data sets.
       (b) Consultation.--The report under subsection (a) shall 
     incorporate feedback and recommendations from the following:
       (1) Patient groups.
       (2) Pharmacies.
       (3) Drug manufacturers.
       (4) Common or contract carriers and warehousemen.
       (5) Hospitals, physicians, and other health care providers.
       (6) State attorneys general.
       (7) Federal, State, local, and tribal law enforcement 
     agencies.
       (8) Health insurance providers and entities that provide 
     pharmacy benefit management services on behalf of a health 
     insurance provider.
       (9) Wholesale drug distributors.
       (10) Veterinarians.
       (11) Professional medical societies and boards.
       (12) State and local public health authorities.
       (13) Health services research organizations.
                                 ______
                                 
  SA 3398. Mr. UDALL submitted an amendment intended to be proposed by 
him to the bill S. 524, to authorize the Attorney General to award 
grants to address the national epidemics of prescription opioid abuse 
and heroin use; which was ordered to lie on the table; as follows:

       At the appropriate place, insert the following:

     SEC. __. PRESCRIPTION DRUG ABUSE TRAINING AND SCREENING 
                   PROGRAMS.

       A practitioner who registers or renews a registration under 
     section 303(f) of the Controlled Substances Act (21 U.S.C. 
     823(f)) shall, at the time of registering, certify to the 
     Attorney General that such practitioner has completed 
     continuing medical education or nursing continuing education, 
     as applicable--
       (1) in the case of a practitioner registering for the first 
     time, with respect to prescription drug abuse; and
       (2) in the case of a practitioner renewing a registration, 
     with respect to medical understanding of the proper use of 
     all drugs listed in the schedules under section 202 of the 
     Controlled Substances Act (21 U.S.C. 812).
                                 ______
                                 
  SA 3399. Ms. HEITKAMP submitted an amendment intended to be proposed 
by her to the bill S. 524, to authorize the Attorney General to award 
grants to address the national epidemics of prescription opioid abuse 
and heroin use; which was ordered to lie on the table; as follows:

       At the end of title VI, add the following:

     SEC. 602. COORDINATION OF PRESCRIPTION DRUG MONITORING 
                   PROGRAMS WITH THE INDIAN HEALTH SERVICE.

       (a) Definition of Eligible Entity.--In this section, the 
     term ``eligible entity'' means--
       (1) a State; or
       (2) an Indian tribe (as defined in section 4 of the Indian 
     Self-Determination and Education Assistance Act (25 U.S.C. 
     450b)).
       (b) Grants for Coordination Pilot Programs.--
       (1) In general.--The Attorney General, subject to the 
     availability of appropriations, may award grants to eligible 
     entities under the Harold Rogers Prescription Drug Monitoring 
     Program established under the Departments of Commerce, 
     Justice, and State, the Judiciary, and Related Agencies 
     Appropriations Act, 2002 (Public Law 107-77; 115 Stat. 748) 
     to carry out a pilot program described in paragraph (2).
       (2) Requirements.--An eligible entity awarded a grant under 
     paragraph (1) to carry out a pilot program shall coordinate 
     with 1 or more service units of the Indian Health Service in 
     the State or on the applicable Indian land and meaningfully 
     consult and engage in a timely manner with Indian tribes 
     served by the service units to improve the connection, 
     coordination, and interoperability of each applicable Indian 
     health program (as defined in section 4 of the Indian Health 
     Care Improvement Act (25 U.S.C. 1603)) with the prescription 
     drug monitoring program of the applicable State.
       (c) GAO Study.--Not later than 1 year after the date of 
     enactment of this Act, the Comptroller General of the United 
     States shall study and submit to the Committee on Indian 
     Affairs of the Senate and the Committee on Natural Resources 
     of the House of Representatives a report identifying barriers 
     to, and potential solutions to improve, coordination 
     between--
       (1) each applicable Indian health program (as defined in 
     section 4 of the Indian Health Care Improvement Act (25 
     U.S.C. 1603)); and
       (2) prescription drug monitoring programs in the United 
     States.
                                 ______
                                 
  SA 3400. Mr. CORNYN (for himself and Mr. Kirk) submitted an amendment 
intended to be proposed to amendment SA 3378 proposed by Mr. Grassley 
(for himself, Mr. Leahy, Mr. Whitehouse, Mr. Portman, Ms. Klobuchar, 
Ms. Ayotte, Mr. Graham, Mr. Coons, Mr. Cornyn, and Mr. Durbin) to the 
bill S. 524, to authorize the Attorney General to award grants to 
address the national epidemics of prescription opioid abuse and heroin 
use; which was ordered to lie on the table; as follows:

       At the appropriate place, insert the following:

     SEC. ___. HIGH INTENSITY DRUG TRAFFICKING AREAS 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 (o)--
       (A) in paragraph (1), by inserting ``, heroin, opioid, and 
     synthetic drugs'' after ``methamphetamine''; and
       (B) in paragraph (2)--
       (i) in subparagraph (A), by inserting ``, heroin, opioid, 
     and synthetic drug'' after ``methamphetamine'';
       (ii) in subparagraph (B), by inserting ``, heroin, opioids, 
     synthetic drugs,'' after ``methamphetamine''; and
       (iii) in subparagraph (C), by inserting ``, heroin, 
     opioids, synthetic drugs,'' after ``methamphetamine'';
       (2) in subsection (p)(5), by striking ``fiscal year 2011'' 
     and inserting ``fiscal years 2016 through 2020''; and
       (3) by adding at the end the following:
       ``(r) Heroin and Opioid Response Strategy Implementation.--
     Using discretionary funds made available under this section, 
     the Director, in consultation with the official in charge of 
     each high intensity drug trafficking area, is authorized to 
     implement a heroin and opioid response strategy in high 
     intensity drug trafficking areas on a nationwide basis by--
       ``(1) coordinating multi-disciplinary efforts to address 
     the threat of heroin and opioids;
       ``(2) increasing data sharing among public safety and 
     public health officials concerning heroin and opioid abuse 
     trends and related crime; and
       ``(3) enabling collaborative deployment of intervention, 
     enforcement, and prevention resources to address heroin and 
     opioid addiction and heroin and opioid trafficking.''.
                                 ______
                                 
  SA 3401. Mr. CORNYN (for himself and Mr. Kirk) submitted an amendment 
intended to be proposed to amendment SA 3378 proposed by Mr. Grassley 
(for himself, Mr. Leahy, Mr. Whitehouse, Mr. Portman, Ms. Klobuchar, 
Ms. Ayotte, Mr. Graham, Mr.

[[Page S1235]]

Coons, Mr. Cornyn, and Mr. Durbin) to the bill S. 524, to authorize the 
Attorney General to award grants to address the national epidemics of 
prescription opioid abuse and heroin use; which was ordered to lie on 
the table; as follows:

       At the appropriate place, insert the following:

     SEC. ___. HEROIN RESPONSE STRATEGY.

       Section 707 of the Office of National Drug Control Policy 
     Reauthorization Act of 1998 (21 U.S.C. 1706) is amended--
       (1) in subsection (o)--
       (A) in paragraph (1), by inserting ``, heroin, opioid, and 
     synthetic drugs'' after ``methamphetamine''; and
       (B) in paragraph (2)--
       (i) in subparagraph (A), by inserting ``, heroin, opioid, 
     and synthetic drug'' after ``methamphetamine'';
       (ii) in subparagraph (B), by inserting ``, heroin, opioids, 
     synthetic drugs,'' after ``methamphetamine''; and
       (iii) in subparagraph (C), by inserting ``, heroin, 
     opioids, synthetic drugs,'' after ``methamphetamine''; and
       (2) by adding at the end the following:
       ``(r) Heroin and Opioid Response Strategy Implementation.--
     Using discretionary funds made available under this section, 
     the Director, in consultation with the official in charge of 
     each high intensity drug trafficking area, is authorized to 
     implement a heroin and opioid response strategy in high 
     intensity drug trafficking areas on a nationwide basis by--
       ``(1) coordinating multi-disciplinary efforts to address 
     the threat of heroin and opioids;
       ``(2) increasing data sharing among public safety and 
     public health officials concerning heroin and opioid abuse 
     trends and related crime; and
       ``(3) enabling collaborative deployment of intervention, 
     enforcement, and prevention resources to address heroin and 
     opioid addiction and heroin and opioid trafficking.''.
                                 ______
                                 
  SA 3402. Mr. WYDEN submitted an amendment intended to be proposed to 
amendment SA 3378 proposed by Mr. Grassley (for himself, Mr. Leahy, Mr. 
Whitehouse, Mr. Portman, Ms. Klobuchar, Ms. Ayotte, Mr. Graham, Mr. 
Coons, Mr. Cornyn, and Mr. Durbin) to the bill S. 524, to authorize the 
Attorney General to award grants to address the national epidemics of 
prescription opioid abuse and heroin use; which was ordered to lie on 
the table; as follows:

       At the end of title VII, add the following:

     SEC. 705. MEDICAID COVERAGE PROTECTION FOR PREGNANT AND POST-
                   PARTUM WOMEN WHILE RECEIVING INPATIENT 
                   TREATMENT FOR A SUBSTANCE USE DISORDER.

       (a) Medicaid State Plan.--Section 1905(a) of the Social 
     Security Act (42 U.S.C. 1396d(a)) is 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 (29) of the 
     first sentence 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.
                                 ______
                                 
  SA 3403. Mr. THUNE (for himself and Mr. Barrasso) submitted an 
amendment intended to be proposed to amendment SA 3378 proposed by Mr. 
Grassley (for himself, Mr. Leahy, Mr. Whitehouse, Mr. Portman, Ms. 
Klobuchar, Ms. Ayotte, Mr. Graham, Mr. Coons, Mr. Cornyn, and Mr. 
Durbin) to the bill S. 524, to authorize the Attorney General to award 
grants to address the national epidemics of prescription opioid abuse 
and heroin use; which was ordered to lie on the table; as follows:

       In section 2997(a)(2)(A) of title I of the Omnibus Crime 
     Control and Safe Streets Act of 1968, as added by section 103 
     of the bill, insert after ``1997'' the following: ``, or is 
     an Indian tribe''.
       In section 2997(a)(2)(B) of title I of the Omnibus Crime 
     Control and Safe Streets Act of 1968, as added by section 103 
     of the bill, in the matter preceding clause (i), insert ``or 
     tribal'' after ``local''.
       In section 2997(a)(3)(A) of title I of the Omnibus Crime 
     Control and Safe Streets Act of 1968, as added by section 103 
     of the bill, insert ``or tribal'' after ``local''.
       In section 2997(a)(3)(B) of title I of the Omnibus Crime 
     Control and Safe Streets Act of 1968, as added by section 103 
     of the bill, insert ``or tribal'' after ``local''.
       In section 2997 of title I of the Omnibus Crime Control and 
     Safe Streets Act of 1968, as added by section 103 of the 
     bill, redesignate subsections (e), (f), and (g) as 
     subsections (f), (g), and (h), respectively, and insert after 
     subsection (d) the following:
       ``(e) Geographic Distribution.--The Attorney General shall 
     ensure that, to the extent practicable, the geographical 
     distribution of grants under this section is equitable and 
     includes a grant to an eligible entity in--
       ``(1) each State;
       ``(2) rural, suburban, and urban areas; and
       ``(3) tribal jurisdictions.
                                 ______
                                 
  SA 3404. Mr. THUNE (for himself and Mr. Barrasso) submitted an 
amendment intended to be proposed to amendment SA 3378 proposed by Mr. 
Grassley (for himself, Mr. Leahy, Mr. Whitehouse, Mr. Portman, Ms. 
Klobuchar, Ms. Ayotte, Mr. Graham, Mr. Coons, Mr. Cornyn, and Mr. 
Durbin) to the bill S. 524, to authorize the Attorney General to award 
grants to address the national epidemics of prescription opioid abuse 
and heroin use; which was ordered to lie on the table; as follows:

       In section 201(a)(1), strike ``Indian tribe,'' and insert 
     the following: ``Indian tribe (as defined in section 901(a) 
     of title I of the Omnibus Crime Control and Safe Streets Act 
     of 1968 (42 U.S.C. 3791(a))),''.
       In section 201(b)(2), strike ``between State criminal 
     justice systems and State substance abuse systems'' and 
     insert ``between State or tribal criminal justice systems and 
     State or tribal substance abuse systems''.
       In section 201(c)(2)(A), insert ``, or in the case of an 
     Indian tribe, Federal or tribal agencies,'' after ``local 
     government agencies''.
       In section 201(c)(2)(B), insert ``if feasible,'' before 
     ``demonstrate''.
       In section 201(c)(2)(C), insert ``, or in the case of an 
     Indian tribe, a tribal criminal justice planning agency'' 
     after ``agency''.
                                 ______
                                 
  SA 3405. Mr. THUNE (for himself and Mr. Barrasso) submitted an 
amendment intended to be proposed to amendment SA 3378 proposed by Mr. 
Grassley (for himself, Mr. Leahy, Mr. Whitehouse, Mr. Portman, Ms. 
Klobuchar, Ms. Ayotte, Mr. Graham, Mr. Coons, Mr. Cornyn, and Mr. 
Durbin) to the bill S. 524, to authorize the Attorney General to award 
grants to address the national epidemics of prescription opioid abuse 
and heroin use; which was ordered to lie on the table; as follows:

       In section 201(h)(1), insert after ``between the 
     agencies,'' the following: ``or between the agencies and 
     tribal governments,''.
       In section 201(h), insert after paragraph (1) the 
     following:
       (2) a State, unit of local government, or nonprofit 
     organization that submits an application that proposes to use 
     grant funds to facilitate or enhance planning and 
     collaboration with Indian tribes; and
                                 ______
                                 
  SA 3406. Mr. THUNE (for himself and Mr. Barrasso) submitted an 
amendment intended to be proposed to amendment SA 3378 proposed by Mr. 
Grassley (for himself, Mr. Leahy, Mr. Whitehouse, Mr. Portman, Ms. 
Klobuchar, Ms. Ayotte, Mr. Graham, Mr. Coons, Mr. Cornyn, and Mr. 
Durbin) to the bill S. 524, to authorize the Attorney General to award 
grants to address the national epidemics of prescription opioid abuse 
and heroin use; which was ordered to lie on the table; as follows:

       In section 2999(b) of title I of the Omnibus Crime Control 
     and Safe Streets Act of 1968, as added by section 204, in the 
     matter preceding paragraph (1), strike ``State law 
     enforcement agencies'' and insert ``State, tribal, or local 
     law enforcement agencies, or Indian tribes served by the 
     Bureau of Indian Affairs,''.

                                 ______
                                 
  SA 3407. Mr. McCAIN submitted an amendment intended to be proposed to 
amendment SA 3378 proposed by Mr. Grassley (for himself, Mr. Leahy, Mr. 
Whitehouse, Mr. Portman, Ms. Klobuchar, Ms. Ayotte, Mr. Graham, Mr. 
Coons, Mr. Cornyn, and Mr. Durbin) to the bill S. 524, to authorize the 
Attorney General to award grants to address the national epidemics of 
prescription opioid abuse and heroin use; which was ordered to lie on 
the table; as follows:


[[Page S1236]]


  

       At the end of title VII, add the following:

     SEC. 705. REFUGEES AND UNACCOMPANIED ALIEN CHILDREN.

       (a) Equitable Treatment of Unaccompanied Alien Children.--
       (1) In general.--Section 235(a)(2) of the William 
     Wilberforce Trafficking Victims Protection Reauthorization 
     Act of 2008 (8 U.S.C. 1232(a)) is amended--
       (A) by striking the paragraph heading and inserting ``Rules 
     for unaccompanied alien children.--'';
       (B) in subparagraph (A), by striking ``who is a national or 
     habitual resident of a country that is contiguous with the 
     United States''; and
       (C) in subparagraph (C)--
       (i) by striking the subparagraph heading and inserting 
     ``Agreements with foreign countries.--''; and
       (ii) by striking ``countries contiguous to the United 
     States'' and inserting ``Canada, El Salvador, Guatemala, 
     Honduras, Mexico, and any other foreign country that the 
     Secretary determines appropriate''.
       (2) Applicability.--The amendments made by subsection (a) 
     shall apply to any unaccompanied alien child who was 
     apprehended on or after October 1, 2015.
       (b) Expedited Removal Authority for Unaccompanied Alien 
     Children From Certain Countries.--Section 235(a)(5)(D) of the 
     William Wilberforce Trafficking Victims Protection 
     Reauthorization Act of 2008 (8 U.S.C. 1232(a)(5)(D)) is 
     amended--
       (1) by striking the subparagraph heading and inserting 
     ``Expedited removal for unaccompanied alien children.--'';
       (2) in the matter preceding clause (i)--
       (A) by inserting ``described in paragraph (2)(A) who is'' 
     after ``Any unaccompanied alien child''; and
       (B) by striking ``, except for an unaccompanied alien child 
     from a contiguous country subject to exceptions under 
     subsection (a)(2),''; and
       (3) by amending clause (i) to read as follows:
       ``(i) placed in an expedited removal proceeding in 
     accordance with section 235 of the Immigration and 
     Nationality Act (8 U.S.C. 1225);''.
       (c) Increasing the Number of Refugee Admissions From 
     Certain Countries.--Notwithstanding any other provision of 
     law, the President, in determining the number of refugees who 
     may be admitted under section 207(a) for fiscal years 2016 
     and 2017, shall authorize the admission, in each such fiscal 
     year, of--
       (1) up to 5,000 refugees from El Salvador;
       (2) up to 5,000 refugees from Guatemala; and
       (3) up to 5,000 refugees from Honduras.
                                 ______
                                 
  SA 3408. Mr. McCAIN submitted an amendment intended to be proposed by 
him to the bill S. 524, to authorize the Attorney General to award 
grants to address the national epidemics of prescription opioid abuse 
and heroin use; which was ordered to lie on the table; as follows:

       At the end of the amendment, add the following:

     SEC. 705. UNLAWFULLY HINDERING IMMIGRATION, BORDER, AND 
                   CUSTOMS CONTROLS.

       (a) Short Title.--This section may be cited as the 
     ``Transnational Criminal Organization Illicit Spotter 
     Prevention and Elimination Act''.
       (b) Enhanced Penalties.--
       (1) In general.--Chapter 9 of title II of the Immigration 
     and Nationality Act (8 U.S.C. 1351 et seq.) is amended by 
     adding at the end the following:

     ``SEC. 295. UNLAWFULLY HINDERING IMMIGRATION, BORDER, AND 
                   CUSTOMS CONTROLS.

       ``(a) Illicit Spotting.--Any person who knowingly 
     transmits, by any means, to another person the location, 
     movement, or activities of any Federal, State, local, or 
     tribal law enforcement agency with the intent to further a 
     Federal crime relating to United States immigration, customs, 
     controlled substances, agriculture, monetary instruments, or 
     other border controls shall be fined under title 18, 
     imprisoned not more than 10 years, or both.
       ``(b) Destruction of United States Border Controls.--Any 
     person who knowingly and without lawful authorization 
     destroys, alters, or damages any fence, barrier, sensor, 
     camera, or other physical or electronic device deployed by 
     the Federal Government to control the border or a port of 
     entry or otherwise seeks to construct, excavate, or make any 
     structure intended to defeat, circumvent, or evade any such 
     fence, barrier, sensor camera, or other physical or 
     electronic device deployed by the Federal Government to 
     control the border or a port of entry--
       ``(1) shall be fined under title 18, imprisoned not more 
     than 10 years, or both; and
       ``(2) if, at the time of the offense, the person uses or 
     carries a firearm or who, in furtherance of any such crime, 
     possesses a firearm, that person shall be fined under title 
     18, imprisoned not more than 20 years, or both.
       ``(c) Conspiracy and Attempt.--Any person who attempts or 
     conspires to violate subsection (a) or (b) shall be punished 
     in the same manner as a person who completes a violation of 
     such subsection.''.
       (2) Clerical amendment.--The table of contents in the first 
     section of the Immigration and Nationality Act is amended by 
     inserting after the item relating to section 294 the 
     following:

``Sec. 295. Unlawfully hindering immigration, border, and customs 
              controls.''.
       (c) Prohibiting Carrying or Use of a Firearm During and in 
     Relation to an Alien Smuggling Crime.--Section 924(c) of 
     title 18, United States Code, is amended--
       (1) in paragraph (1)--
       (A) in subparagraph (A), by inserting ``, alien smuggling 
     crime,'' after ``crime of violence'' each place that term 
     appears; and
       (B) in subparagraph (D)(ii), by inserting ``, alien 
     smuggling crime,'' after ``crime of violence''; and
       (2) by adding at the end the following:
       ``(6) For purposes of this subsection, the term `alien 
     smuggling crime' means any felony punishable under section 
     274(a), 277, or 278 of the Immigration and Nationality Act (8 
     U.S.C. 1324(a), 1327, and 1328).''.
       (d) Statute of Limitations.--Section 3298 of title 18, 
     United States Code, is amended by inserting ``, 295, 296, or 
     297'' after ``274(a)''.
                                 ______
                                 
  SA 3409. Ms. COLLINS (for herself and Mr. Lankford) submitted an 
amendment intended to be proposed to amendment SA 3378 proposed by Mr. 
Grassley (for himself, Mr. Leahy, Mr. Whitehouse, Mr. Portman, Ms. 
Klobuchar, Ms. Ayotte, Mr. Graham, Mr. Coons, Mr. Cornyn, and Mr. 
Durbin) to the bill S. 524, to authorize the Attorney General to award 
grants to address the national epidemics of prescription opioid abuse 
and heroin use; which was ordered to lie on the table; as follows:

       At the appropriate place, insert the following:

     SEC. __. EVALUATION OF THE HOSPITAL CONSUMER ASSESSMENT OF 
                   HEALTHCARE PROVIDERS AND SYSTEMS (HCAHPS) 
                   SURVEY; MORATORIUM ON THE USE OF PAIN 
                   MANAGEMENT MEASURES TO ASSESS HOSPITAL 
                   PERFORMANCE SCORES UNDER THE MEDICARE VBP 
                   PROGRAM IN ORDER TO ALLOW TIME FOR EVALUATION.

       (a) Evaluation.--The Secretary of Health and Human Services 
     (in this section referred to as the ``Secretary'') shall 
     conduct an evaluation of the Hospital Consumer Assessment of 
     Healthcare Providers and Systems (HCAHPS) survey, including 
     items on such survey related to pain management. Such 
     evaluation shall include an analysis of--
       (1) any implications of using such survey under the 
     Medicare hospital value-based purchasing program under 
     section 1886(o) of the Social Security Act (42 U.S.C. 1395ww) 
     on opioid prescribing practices;
       (2) how best to revise such survey and any effect that such 
     revisions may have on quality of care; and
       (3) other areas determined appropriate by the Secretary.
       (b) Input.--As part of conducting the evaluation under 
     subsection (a), the Secretary shall convene a group that 
     includes the Interagency Pain Research Coordinating 
     Committee, hospital representatives, physicians and other 
     health care providers, experts in the fields of pain research 
     and addiction research, and representatives of the addiction 
     community, pain management professional organizations, and 
     pain advocacy groups to provide the Secretary with input on 
     the items to be evaluated.
       (c) Report.--Not later than March 1, 2017, the Secretary 
     shall submit to Congress a report on the evaluation conducted 
     under subsection (a), together with recommendations for such 
     legislation and administrative action as the Secretary 
     determines to be appropriate.
       (d) Moratorium on the Use of Pain Management Measures to 
     Assess Hospital Performance Scores Under the Medicare VBP 
     Program in Order to Allow Time for Evaluation.--Section 
     1886(o)(5)of the Social Security Act (42 U.S.C. 1395ww(o)(5)) 
     is amended--
       (1) in the first sentence of subparagraph (A), by striking 
     ``subparagraph (B)'' and inserting ``subparagraphs (B) and 
     (C)''; and
       (2) by adding at the end the following new subparagraph:
       ``(C) Moratorium on use measures of pain management to 
     assess hospital performance scores.--
       ``(i) In general.--With respect to payments for discharges 
     occurring during fiscal year 2017, the performance of a 
     hospital on measures of pain management during the 
     performance period for such fiscal year shall not be used in 
     assessing the hospital performance score of the hospital for 
     such performance period.
       ``(ii) No affect on reporting of selected measures.--
     Nothing in the clause (i) shall affect the requirement for a 
     hospital to report measures selected under paragraph (2), 
     including any measures related to pain management.''.
                                 ______
                                 
  SA 3410. Mr. REID submitted an amendment intended to be proposed to 
amendment SA 3378 proposed by Mr. Grassley (for himself, Mr. Leahy, Mr. 
Whitehouse, Mr. Portman, Ms. Klobuchar, Ms. Ayotte, Mr. Graham, Mr. 
Coons, Mr. Cornyn, and Mr. Durbin) to the bill S. 524, to authorize the 
Attorney General to award grants to address the national epidemics of 
prescription opioid abuse and heroin use; which was ordered to lie on 
the table; as follows:


[[Page S1237]]


  

       At the end of title I, add the following:

     SEC. __. SUPPORT FOR STATE RESPONSE TO SUBSTANCE ABUSE PUBLIC 
                   HEALTH CRISIS AND URGENT MENTAL HEALTH NEEDS.

       (a) In General.--There are authorized to be appropriated, 
     and are appropriated, out of monies in the Treasury not 
     otherwise obligated, $750,000,000 for each of fiscal years 
     2016 and 2017, to the Secretary of Health and Human Services 
     (referred to in this section as the ``Secretary'') to award 
     grants to States to address the substance abuse public health 
     crisis or to respond to urgent mental health needs within the 
     State. In awarding grants under this section, the Secretary 
     may give preference to States with an incidence or prevalence 
     of substance use disorders that is substantial relative to 
     other States or to States that identify mental health needs 
     within their communities that are urgent relative to such 
     needs of other States. Funds appropriated under this 
     subsection shall remain available until expended.
       (b) Use of Funds.--Grants awarded to a State under 
     subsection (a) shall be used for one or more of the following 
     public health-related activities:
       (1) Improving State prescription drug monitoring programs.
       (2) Implementing prevention activities, and evaluating such 
     activities to identify effective strategies to prevent 
     substance abuse.
       (3) Training for health care practitioners, such as best 
     practices for prescribing opioids, pain management, 
     recognizing potential cases of substance abuse, referral of 
     patients to treatment programs, and overdose prevention.
       (4) Supporting access to health care services provided by 
     Federally certified opioid treatment programs or other 
     appropriate health care providers to treat substance use 
     disorders or mental health needs.
       (5) Other public health-related activities, as the State 
     determines appropriate, related to addressing the substance 
     abuse public health crisis or responding to urgent mental 
     health needs within the State.
                                 ______
                                 
  SA 3411. Mr. TESTER submitted an amendment intended to be proposed to 
amendment SA 3378 proposed by Mr. Grassley (for himself, Mr. Leahy, Mr. 
Whitehouse, Mr. Portman, Ms. Klobuchar, Ms. Ayotte, Mr. Graham, Mr. 
Coons, Mr. Cornyn, and Mr. Durbin) to the bill S. 524, to authorize the 
Attorney General to award grants to address the national epidemics of 
prescription opioid abuse and heroin use; which was ordered to lie on 
the table; as follows:

       In section 101(c)(1), strike subparagraphs (H) and (I) and 
     insert the following:
       (H) the National Institutes of Health;
       (I) the Office of National Drug Control Policy; and
       (J) the Indian Health Service;
       In section 101(d)(1)(C), strike ``State and'' and insert 
     ``State, tribal, and''.
       In section 101(f)(2), strike the period at the end and 
     insert ``and the Indian Health Service.''.
       In section 2997(a) of the Omnibus Crime Control and Safe 
     Streets Act of 1968 (42 U.S.C. 3797cc et seq.) (as amended by 
     section 103), strike paragraph (2) and insert the following:
       (2) the term ``eligible entity'' means an organization 
     that--
       (A)(i) on or before the date of submitting an application 
     for a grant under this section, receives or has received a 
     grant under the Drug-Free Communities Act of 1997; and
       (ii) has documented, using local or tribal data, rates of 
     abuse of opioids or methamphetamines at levels that are--
       (I) significantly higher than the national average as 
     determined by the Secretary (including appropriate 
     consideration of the results of the Monitoring the Future 
     Survey published by the National Institute on Drug Abuse and 
     the National Survey on Drug Use and Health published by the 
     Substance Abuse and Mental Health Services Administration); 
     or
       (II) higher than the national average, as determined by the 
     Secretary (including appropriate consideration of the results 
     of the surveys described in subclause (I)), over a sustained 
     period of time; or
       (B) is a tribal organization (as defined in section 4 of 
     the Indian Health Care Improvement Act (25 U.S.C. 1603));
       In section 201(b)(1)(B)(vii), strike ``and veterans 
     treatment courts'' and insert ``veterans treatment courts, 
     and tribal courts''.
       In section 201(b)(2), insert ``and tribal'' after ``State 
     criminal''.
       In section 201(c)(2)(A), strike ``State and'' and insert 
     ``State, tribal, and''.
       In section 201(c)(2)(D), strike ``and'' at the end.
       In section 201(c)(2)(E), strike the period at the end and 
     insert ``; and''.
       At the end of section 201(c)(2), add the following:
       (F) demonstrate consultation with affected Indian tribes.
       At the end of section 201, add the following:
       (k) Tribal Set-aside.--Not less than 5 percent of the 
     amounts made available to carry out this section for a fiscal 
     year shall be made available to Indian tribes and tribal 
     organizations (as defined in section 4 of the Indian Health 
     Care Improvement Act (25 U.S.C. 1603)).
       At the end of section 203, add the following:
       (c) Tribal Set-aside.--Not less than 5 percent of the 
     amounts made available to carry out this section for a fiscal 
     year shall be made available to Indian tribes and tribal 
     organizations (as defined in section 4 of the Indian Health 
     Care Improvement Act (25 U.S.C. 1603)).
       In section 2999(b) of the Omnibus Crime Control and Safe 
     Streets Act of 1968 (42 U.S.C. 3797cc et seq.) (as added by 
     section 204), in the matter preceding paragraph (1), insert 
     ``and tribal'' after ``State''.
       In section 302(e)(1), strike ``and'' at the end.
       In section 302(e)(2)(B), strike the period at the end and 
     insert ``; and''.
       At the end of section 302(e), add the following:
       (3) consults with affected Indian tribes.
       At the end of section 302, add the following:
       (i) Tribal Set-aside.--Not less than 5 percent of the 
     amounts made available to carry out this section for a fiscal 
     year shall be made available to Indian tribes and tribal 
     organizations (as defined in section 4 of the Indian Health 
     Care Improvement Act (25 U.S.C. 1603)).
       In section 2999B(a)(1)(D) of the Omnibus Crime Control and 
     Safe Streets Act of 1968 (42 U.S.C. 3797cc et seq.) (as added 
     by section 303), strike ``or'' at the end.
       In section 2999B(a)(1)(E) of the Omnibus Crime Control and 
     Safe Streets Act of 1968 (42 U.S.C. 3797cc et seq.) (as added 
     by section 303), strike the period at the end and insert ``; 
     or''.
       At the end of section 2999B(a)(1) of the Omnibus Crime 
     Control and Safe Streets Act of 1968 (42 U.S.C. 3797cc et 
     seq.) (as added by section 303), add the following:
       (F) a Bureau of Indian Education-funded school.
       In section 2999D(a) of the Omnibus Crime Control and Safe 
     Streets Act of 1968 (42 U.S.C. 3797cc et seq.) (as added by 
     section 401), strike the period at the end and insert ``or 
     tribal organization.''.
       In section 2999D(b)(5) of the Omnibus Crime Control and 
     Safe Streets Act of 1968 (42 U.S.C. 3797cc et seq.) (as added 
     by section 401), insert ``Tribal Colleges and Universities 
     (as defined in section 316(b) of the Higher Education Act of 
     1965 (20 U.S.C. 1059c(b)))'' after ``universities,''.
       In section 402(b)(2)(B)(i), insert ``Indian affairs,'' 
     after ``employment,''.
       In subsection (r)(3)(B) of section 508 of the Public Health 
     Service Act (42 U.S.C. 290bb-1) (as amended by section 
     501(b)(2)), insert ``Indian tribes and tribal 
     organizations,'' after ``agencies,''.
       In section 2999E of the Omnibus Crime Control and Safe 
     Streets Act of 1968 (42 U.S.C. 3797cc et seq.) (as added by 
     section 702), strike the period at the end and insert ``, of 
     which not less than 5 percent shall be made available to 
     Indian tribes and tribal organizations (as defined in section 
     4 of the Indian Health Care Improvement Act (25 U.S.C. 
     1603)).''.
                                 ______
                                 
  SA 3412. Mr. MERKLEY submitted an amendment intended to be proposed 
to amendment SA 3378 proposed by Mr. Grassley (for himself, Mr. Leahy, 
Mr. Whitehouse, Mr. Portman, Ms. Klobuchar, Ms. Ayotte, Mr. Graham, Mr. 
Coons, Mr. Cornyn, and Mr. Durbin) to the bill S. 524, to authorize the 
Attorney General to award grants to address the national epidemics of 
prescription opioid abuse and heroin use; which was ordered to lie on 
the table; as follows:

       At the appropriate place, insert the following:

     SEC. __. IMPROVING MEDICARE COVERAGE FOR BENEFICIARIES WITH 
                   DRUG AND ALCOHOL ADDICTIONS.

       (a) Ensuring Coverage of Opioid Detoxification Under 
     Medicare Part A.--
       (1) In general.--Section 1812 of the Social Security Act 
     (42 U.S.C. 1395d) is amended by adding at the end the 
     following new subsection:
       ``(h) Coverage for opioid detoxification (as defined by the 
     Secretary) shall be available under this part in a similar 
     manner as the coverage for alcohol detoxification is 
     available under this part.''.
       (2) Effective date.--The amendment made by paragraph (1) 
     shall apply to discharges occurring on or after October 1, 
     2016.
       (b) Inclusion of Methadone as a Covered Part D Drug.--
       (1) In general.--Section 1860D-2(e)(1) of the Social 
     Security Act (42 U.S.C. 1395w-102(e)(1)) is amended--
       (A) in subparagraph (A), by striking ``or'' at the end;
       (B) in subparagraph (B), by striking the comma at the end 
     and inserting ``; or''; and
       (C) by inserting after subparagraph (B) the following new 
     subparagraph:
       ``(C) methadone for the treatment of opioid dependence,''.
       (2) Effective date.--The amendments made by paragraph (1) 
     shall apply to plan year 2017 and subsequent plan years.
       (c) Permitting Substance Abuse Counselors to Furnish 
     Alcohol and Drug Abuse Therapy Services Under Medicare Part 
     B.--
       (1) In general.--Section 1842(b)(18)(C) of the Social 
     Security Act (42 U.S.C. 1395u(b)(18)(C)) is amended by adding 
     at the end the following new clause:
       ``(vii) A substance abuse counselor (as defined by the 
     Secretary) with respect to the furnishing of alcohol and drug 
     abuse therapy services (as defined by the Secretary) that

[[Page S1238]]

     such counselor is authorized to furnish under State law.''.
       (2) Effective date.--The amendment made by paragraph (1) 
     shall apply to items and services furnished on or after 
     January 1, 2017.
                                 ______
                                 
  SA 3413. Mr. SCHATZ (for himself, Mr. Hatch, Mr. Tester, Mr. Cochran, 
and Ms. Collins) submitted an amendment intended to be proposed by him 
to the bill S. 524, to authorize the Attorney General to award grants 
to address the national epidemics of prescription opioid abuse and 
heroin use; which was ordered to lie on the table; as follows:

       At the end of title I of the bill, add the following:

     SEC. 104. ENHANCING BASIC AND APPLIED RESEARCH ON PAIN TO 
                   DISCOVER THERAPIES, INCLUDING ALTERNATIVES TO 
                   OPIOIDS, FOR EFFECTIVE PAIN MANAGEMENT.

       (a) In General.--Out of any money appropriated to the 
     National Institutes of Health (referred to in this section as 
     the ``NIH'') not otherwise obligated, the Director of the NIH 
     may intensify and coordinate fundamental, translational, and 
     clinical research of the NIH with respect to--
       (1) the understanding of pain;
       (2) the discovery and development of therapies for chronic 
     pain; and
       (3) the development of alternatives to opioids for 
     effective pain treatments.
       (b) Priority and Direction.--The prioritization and 
     direction of the Federally funded portfolio of pain research 
     studies shall consider recommendations made by the 
     Interagency Pain Research Coordinating Committee in concert 
     with the Pain Management Best Practices Inter-Agency Task 
     Force, and in accordance with the National Pain Strategy, the 
     Federal Pain Research Strategy, and the NIH-Wide Strategic 
     Plan for Fiscal Years 2016-2020, the latter which calls for 
     the relative burdens of individual diseases and medical 
     disorders to be regarded as crucial considerations in 
     balancing the priorities of the Federal research portfolio.
                                 ______
                                 
  SA 3414. Mr. BARRASSO submitted an amendment intended to be proposed 
by him to the bill S. 524, to authorize the Attorney General to award 
grants to address the national epidemics of prescription opioid abuse 
and heroin use; which was ordered to lie on the table; as follows:

       In section 101(d)(1)(C), strike ``and local'' and insert 
     ``, tribal, and local''.
       In section 101(f)(2), insert ``and the Indian Health 
     Service'' before the period at the end.
                                 ______
                                 
  SA 3415. Mr. BARRASSO submitted an amendment intended to be proposed 
by him to the bill S. 524, to authorize the Attorney General to award 
grants to address the national epidemics of prescription opioid abuse 
and heroin use; which was ordered to lie on the table; as follows:

       In section 302(c)(2)(A), insert ``or, in the case of an 
     Indian tribe, Federal or tribal agencies'' before ``; and''.
       In section 302(e)(1), strike ``and'' at the end.
       In section 302(e)(2), strike subparagraph (B) and insert 
     the following:
       (B) concluded that the law described in subparagraph (A) 
     provides adequate civil liability protection applicable to 
     such persons; and
       (3) consults with affected Indian tribes.
       In section 508(r)(3)(B) of the Public Health Service Act 
     (42 U.S.C. 290bb-1) (as amended by section 501(b)(2)), insert 
     ``Indian tribes,'' after ``agencies,''.
       In section 601(b)(4)(C)(vi), insert ``and affected Indian 
     tribes'' before ``; and''.
       In section 601(b)(5)(E), strike ``and'' at the end.
       In section 601(b)(5)(F), strike the period at the end and 
     insert ``; and''.
       In section 601(b)(5), add at the end the following:
       (G) ensures consultation with affected Indian tribes.
                                 ______
                                 
  SA 3416. Mr. BARRASSO submitted an amendment intended to be proposed 
by him to the bill S. 524, to authorize the Attorney General to award 
grants to address the national epidemics of prescription opioid abuse 
and heroin use; which was ordered to lie on the table; as follows:

       In section 402(a), strike ``or State'' and insert ``, 
     State, or tribal''.
       In section 402(b)(2)(B)(iii), strike ``State and'' and 
     insert ``State, tribal, and''.
       In section 402(c)(1)(A), strike ``or State'' and insert ``, 
     State, or tribal''.

                          ____________________