[Congressional Record Volume 162, Number 108 (Wednesday, July 6, 2016)]
[House]
[Pages H4392-H4419]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




 CONFERENCE REPORT ON S. 524, COMPREHENSIVE ADDICTION AND RECOVERY ACT 
                                OF 2016

  Mr. UPTON submitted the following conference report and statement on 
the bill (S. 524) to authorize the Attorney General to award grants to 
address the national epidemics of prescription opioid abuse and heroin 
use:

                  Conference Report (H. Rept. 114-669)

       The committee of conference on the disagreeing votes of the 
     two Houses on the amendments of the House do the bill (S. 
     524), to authorize the Attorney General to award grants to 
     address the national epidemics of prescription opioid abuse 
     and heroin use, having met, after full and free conference, 
     have agreed to recommend and do recommend to their respective 
     Houses as follows:
       That the Senate recede from its disagreement to the 
     amendment of the House to the text of the bill and agree to 
     the same with an amendment as follows:
       In lieu of the matter proposed to be inserted by the House 
     amendment, insert the following:

     SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

       (a) Short Title.--This Act may be cited as the 
     ``Comprehensive Addiction and Recovery Act of 2016''.
       (b) Table of Contents.--The table of contents for this Act 
     is as follows:

Sec. 1. Short title; table of contents.

                   TITLE I--PREVENTION AND EDUCATION

Sec. 101. Task force on pain management.
Sec. 102. Awareness campaigns.
Sec. 103. Community-based coalition enhancement grants to address local 
              drug crises.
Sec. 104. Information materials and resources to prevent addiction 
              related to youth sports injuries.
Sec. 105. Assisting veterans with military emergency medical training 
              to meet requirement for becoming civilian health care 
              professionals.
Sec. 106. FDA opioid action plan.
Sec. 107. Improving access to overdose treatment.
Sec. 108. NIH opioid research.
Sec. 109. National All Schedules Prescription Electronic Reporting 
              Reauthorization.
Sec. 110. Opioid overdose reversal medication access and education 
              grant programs.

                TITLE II--LAW ENFORCEMENT AND TREATMENT

Sec. 201. Comprehensive Opioid Abuse Grant Program.
Sec. 202. First responder training.
Sec. 203. Prescription drug take back expansion.

                   TITLE III--TREATMENT AND RECOVERY

Sec. 301. Evidence-based prescription opioid and heroin treatment and 
              interventions demonstration.
Sec. 302. Building communities of recovery.
Sec. 303. Medication-assisted treatment for recovery from addiction.

              TITLE IV--ADDRESSING COLLATERAL CONSEQUENCES

Sec. 401. GAO report on recovery and collateral consequences.

  TITLE V--ADDICTION AND TREATMENT SERVICES FOR WOMEN, FAMILIES, AND 
                                VETERANS

Sec. 501. Improving treatment for pregnant and postpartum women.
Sec. 502. Veterans treatment courts.
Sec. 503. Infant plan of safe care.
Sec. 504. GAO report on neonatal abstinence syndrome (NAS).

  TITLE VI--INCENTIVIZING STATE COMPREHENSIVE INITIATIVES TO ADDRESS 
                       PRESCRIPTION OPIOID ABUSE

Sec. 601. State demonstration grants for comprehensive opioid abuse 
              response.

                        TITLE VII--MISCELLANEOUS

Sec. 701. Grant accountability and evaluations.
Sec. 702. Partial fills of schedule II controlled substances.
Sec. 703. Good samaritan assessment.
Sec. 704. Programs to prevent prescription drug abuse under Medicare 
              parts C and D.
Sec. 705. Excluding abuse-deterrent formulations of prescription drugs 
              from the Medicaid additional rebate requirement for new 
              formulations of prescription drugs.
Sec. 706. Limiting disclosure of predictive modeling and other 
              analytics technologies to identify and prevent waste, 
              fraud, and abuse.
Sec. 707. Medicaid Improvement Fund.
Sec. 708. Sense of the Congress regarding treatment of substance abuse 
              epidemics.

              TITLE VIII--KINGPIN DESIGNATION IMPROVEMENT

Sec. 801. Protection of classified information in Federal court 
              challenges relating to designations under the Narcotics 
              Kingpin Designation Act.

                TITLE IX--DEPARTMENT OF VETERANS AFFAIRS

Sec. 901. Short title.
Sec. 902. Definitions.

             Subtitle A--Opioid Therapy and Pain Management

Sec. 911. Improvement of opioid safety measures by Department of 
              Veterans Affairs.
Sec. 912. Strengthening of joint working group on pain management of 
              the Department of Veterans Affairs and the Department of 
              Defense.
Sec. 913. Review, investigation, and report on use of opioids in 
              treatment by Department of Veterans Affairs.
Sec. 914. Mandatory disclosure of certain veteran information to State 
              controlled substance monitoring programs.
Sec. 915. Elimination of copayment requirement for veterans receiving 
              opioid antagonists or education on use of opioid 
              antagonists.

[[Page H4393]]

                      Subtitle B--Patient Advocacy

Sec. 921. Community meetings on improving care furnished by Department 
              of Veterans Affairs.
Sec. 922. Improvement of awareness of patient advocacy program and 
              patient bill of rights of Department of Veterans Affairs.
Sec. 923. Comptroller General report on patient advocacy program of 
              Department of Veterans Affairs.
Sec. 924. Establishment of Office of Patient Advocacy of the Department 
              of Veterans Affairs.

            Subtitle C--Complementary and Integrative Health

Sec. 931. Expansion of research and education on and delivery of 
              complementary and integrative health to veterans.
Sec. 932. Expansion of research and education on and delivery of 
              complementary and integrative health to veterans.
Sec. 933. Pilot program on integration of complementary and integrative 
              health and related issues for veterans and family members 
              of veterans.

              Subtitle D--Fitness of Health Care Providers

Sec. 941. Additional requirements for hiring of health care providers 
              by Department of Veterans Affairs.
Sec. 942. Provision of information on health care providers of 
              Department of Veterans Affairs to State medical boards.
Sec. 943. Report on compliance by Department of Veterans Affairs with 
              reviews of health care providers leaving the Department 
              or transferring to other facilities.

                       Subtitle E--Other Matters

Sec. 951. Modification to limitation on awards and bonuses.

                   TITLE I--PREVENTION AND EDUCATION

     SEC. 101. TASK FORCE ON PAIN MANAGEMENT.

       (a) Definitions.--In this section:
       (1) Secretary.--The term ``Secretary'' means the Secretary 
     of Health and Human Services.
       (2) Task force.--The term ``task force'' means the Pain 
     Management Best Practices Inter-Agency Task Force convened 
     under subsection (b).
       (b) Inter-Agency Task Force.--Not later than 2 years after 
     the date of enactment of this Act, the Secretary, in 
     cooperation with the Secretary of Veterans Affairs and the 
     Secretary of Defense, shall convene a Pain Management Best 
     Practices Inter-Agency Task Force.
       (c) Membership.--The task force shall be comprised of--
       (1) representatives of--
       (A) the Department of Health and Human Services and 
     relevant agencies within the Department of Health and Human 
     Services;
       (B) the Department of Veterans Affairs;
       (C) the Department of Defense; and
       (D) the Office of National Drug Control Policy;
       (2) currently licensed and practicing physicians, dentists, 
     and nonphysician prescribers;
       (3) currently licensed and practicing pharmacists and 
     pharmacies;
       (4) experts in the fields of pain research and addiction 
     research, including adolescent and young adult addiction 
     research;
       (5) representatives of--
       (A) pain management professional organizations;
       (B) the mental health treatment community;
       (C) the addiction treatment community, including 
     individuals in recovery from substance use disorder;
       (D) pain advocacy groups, including patients;
       (E) veteran service organizations;
       (F) groups with expertise on overdose reversal, including 
     first responders;
       (G) State medical boards; and
       (H) hospitals;
       (6) experts on the health of, and prescription opioid use 
     disorders in, members of the Armed Forces and veterans; and
       (7) experts in the field of minority health.
       (d) Representation.--The Secretary shall ensure that the 
     membership of the task force includes individuals 
     representing rural and underserved areas.
       (e) Duties.--The task force shall--
       (1) identify, review, and, as appropriate, determine 
     whether there are gaps in or inconsistencies between best 
     practices for pain management (including chronic and acute 
     pain) developed or adopted by Federal agencies;
       (2) not later than 1 year after the date on which the task 
     force is convened under subsection (b), propose updates to 
     best practices and recommendations on addressing gaps or 
     inconsistencies identified under paragraph (1), as 
     appropriate, and submit to relevant Federal agencies and the 
     general public such proposed updates and recommendations, 
     taking into consideration--
       (A) existing pain management research and other relevant 
     research;
       (B) recommendations from relevant conferences and existing 
     relevant evidence-based guidelines;
       (C) ongoing efforts at the State and local levels and by 
     medical professional organizations to develop improved pain 
     management strategies, including consideration of differences 
     within and between classes of opioids, the availability of 
     opioids with abuse deterrent technology, and pharmacological, 
     nonpharmacological, and medical device alternatives to 
     opioids to reduce opioid monotherapy in appropriate cases;
       (D) the management of high-risk populations who receive 
     opioids in the course of medical care, other than for pain 
     management;
       (E) the 2016 Guideline for Prescribing Opioids for Chronic 
     Pain issued by the Centers for Disease Control and 
     Prevention; and
       (F) private sector, State, and local government efforts 
     related to pain management and prescribing pain medication;
       (3) provide the public with at least 90 days to submit 
     comments on any proposed updates and recommendations under 
     paragraph (2); and
       (4) develop a strategy for disseminating information about 
     best practices for pain management (including chronic and 
     acute pain) to stakeholders, if appropriate.
       (f) Limitation.--The task force shall not have rulemaking 
     authority.
       (g) Sunset.--The task force under this section shall sunset 
     after 3 years.

     SEC. 102. AWARENESS CAMPAIGNS.

       (a) In General.--The Secretary of Health and Human 
     Services, in coordination with the heads of other departments 
     and agencies, shall, as appropriate, through existing 
     programs and activities, advance the education and awareness 
     of the public (including providers, patients, and consumers) 
     and other appropriate entities regarding the risk of abuse of 
     prescription opioids if such drugs are not taken as 
     prescribed.
       (b) Topics.--The education and awareness campaigns under 
     subsection (a) shall address--
       (1) the dangers of opioid abuse;
       (2) the prevention of opioid abuse, including through safe 
     disposal of prescription medications and other safety 
     precautions; and
       (3) the detection of early warning signs of addiction.
       (c) Other Requirements.--The education and awareness 
     campaigns under subsection (a) shall, as appropriate--
       (1) take into account any association between prescription 
     opioid abuse and heroin use;
       (2) emphasize--
       (A) the similarities between heroin and prescription 
     opioids; and
       (B) the effects of heroin and prescription opioids on the 
     human body; and
       (3) bring greater public awareness to the dangerous effects 
     of fentanyl when mixed with heroin or abused in a similar 
     manner.

     SEC. 103. COMMUNITY-BASED COALITION ENHANCEMENT GRANTS TO 
                   ADDRESS LOCAL DRUG CRISES.

       (a) Definitions.--In this section:
       (1) Administrator.--The term ``Administrator'' means the 
     Administrator of the Substance Abuse and Mental Health 
     Services Administration.
       (2) Director.--The term ``Director'' means the Director of 
     the Office of National Drug Control Policy.
       (3) Drug-free communities act of 1997.--The term ``Drug-
     Free Communities Act of 1997'' means chapter 2 of the 
     National Narcotics Leadership Act of 1988 (21 U.S.C. 1521 et 
     seq.).
       (4) Eligible entity.--The term ``eligible entity'' means an 
     organization that--
       (A) 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
       (B) has documented, using local 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 clause (i)), over a sustained 
     period of time.
       (5) Emerging drug abuse issue.--The term ``emerging drug 
     abuse issue'' means a substance use disorder within an area 
     involving--
       (A) a sudden increase in demand for particular drug abuse 
     treatment services relative to previous demand; and
       (B) a lack of resources in the area to address the emerging 
     problem.
       (6) Local drug crisis.--The term ``local drug crisis'' 
     means, with respect to the area served by an eligible 
     entity--
       (A) a sudden increase in the abuse of opioids or 
     methamphetamines, as documented by local data;
       (B) the abuse of prescription medications, specifically 
     opioids or methamphetamines, that is significantly higher 
     than the national average, over a sustained period of time, 
     as documented by local data; or
       (C) a sudden increase in opioid-related deaths, as 
     documented by local data.
       (7) Opioid.--The term ``opioid'' means any drug having an 
     addiction-forming or addiction-sustaining liability similar 
     to morphine or being capable of conversion into a drug having 
     such addiction-forming or addiction-sustaining liability.
       (b) Program Authorized.--The Director, in coordination with 
     the Administrator, may make grants to eligible entities to 
     implement comprehensive community-wide strategies that 
     address local drug crises and emerging drug abuse issues 
     within the area served by the eligible entity.
       (c) Application.--
       (1) In general.--An eligible entity seeking a grant under 
     this section shall submit an application to the Director at 
     such time, in such manner, and accompanied by such 
     information as the Director may require.
       (2) Criteria.--As part of an application for a grant under 
     this section, the Director shall require an eligible entity 
     to submit a detailed, comprehensive, multisector plan for 
     addressing the local drug crisis or emerging drug abuse issue 
     within the area served by the eligible entity.

[[Page H4394]]

       (d) Use of Funds.--An eligible entity shall use a grant 
     received under this section--
       (1) for programs designed to implement comprehensive 
     community-wide prevention strategies to address the local 
     drug crisis in the area served by the eligible entity, in 
     accordance with the plan submitted under subsection (c)(2);
       (2) to obtain specialized training and technical assistance 
     from the organization funded under section 4 of Public Law 
     107-82 (21 U.S.C. 1521 note); and
       (3) for programs designed to implement comprehensive 
     community-wide strategies to address emerging drug abuse 
     issues in the community.
       (e) Supplement Not Supplant.--An eligible entity shall use 
     Federal funds received under this section only to supplement 
     the funds that would, in the absence of those Federal funds, 
     be made available from other Federal and non-Federal sources 
     for the activities described in this section, and not to 
     supplant those funds.
       (f) Evaluation.--A grant under this section shall be 
     subject to the same evaluation requirements and procedures as 
     the evaluation requirements and procedures imposed on the 
     recipient of a grant under the Drug-Free Communities Act of 
     1997, and may also include an evaluation of the effectiveness 
     at reducing abuse of opioids or methamphetamines.
       (g) Limitation on Administrative Expenses.--Not more than 8 
     percent of the amounts made available to carry out this 
     section for a fiscal year may be used to pay for 
     administrative expenses.
       (h) Delegation Authority.--The Director may enter into an 
     interagency agreement with the Administrator to delegate 
     authority for the execution of grants and for such other 
     activities as may be necessary to carry out this section.
       (i) Authorization of Appropriations.--For the purpose of 
     carrying out this section, there are authorized to be 
     appropriated $5,000,000 for each of fiscal years 2017 through 
     2021.

     SEC. 104. INFORMATION MATERIALS AND RESOURCES TO PREVENT 
                   ADDICTION RELATED TO YOUTH SPORTS INJURIES.

       (a) Report.--The Secretary of Health and Human Services 
     (referred to in this section as the ``Secretary'') shall, not 
     later than 24 months after the date of the enactment of this 
     section, make publicly available on the appropriate website 
     of the Department of Health and Human Services a report 
     determining the extent to which informational materials and 
     resources described in subsection (c) are available to 
     teenagers and adolescents who play youth sports, families of 
     such teenagers and adolescents, nurses, youth sports groups, 
     and relevant health care provider groups.
       (b) Development of Informational Materials and Resources.--
     The Secretary may, for purposes of preventing substance use 
     disorder in teenagers and adolescents who are injured playing 
     youth sports and are subsequently prescribed an opioid, not 
     later than 12 months after the report is made publicly 
     available under subsection (a), and taking into consideration 
     the findings of such report and in coordination with relevant 
     health care provider groups, facilitate the development of 
     informational materials and resources described in subsection 
     (c) for teenagers and adolescents who play youth sports, 
     families of such teenagers and adolescents, nurses, youth 
     sports groups, and relevant health care provider groups.
       (c) Materials and Resources Described.--For purposes of 
     this section, the informational materials and resources 
     described in this subsection are informational materials and 
     resources with respect to youth sports injuries for which 
     opioids are potentially prescribed, including materials and 
     resources focused on the risks associated with opioid use and 
     misuse, treatment options for such injuries that do not 
     involve the use of opioids, and how to seek treatment for 
     addiction.
       (d) No Additional Funds.--No additional funds are 
     authorized to be appropriated for the purpose of carrying out 
     this section. This section shall be carried out using amounts 
     otherwise available for such purpose.

     SEC. 105. ASSISTING VETERANS WITH MILITARY EMERGENCY MEDICAL 
                   TRAINING TO MEET REQUIREMENT FOR BECOMING 
                   CIVILIAN HEALTH CARE PROFESSIONALS.

       Part B of title III of the Public Health Service Act (42 
     U.S.C. 243 et seq.) is amended by inserting after section 314 
     the following:

     ``SEC. 315. ASSISTING VETERANS WITH MILITARY EMERGENCY 
                   MEDICAL TRAINING TO MEET REQUIREMENTS FOR 
                   BECOMING CIVILIAN HEALTH CARE PROFESSIONALS.

       ``(a) Program.--
       ``(1) In general.--The Secretary may establish a program, 
     in consultation with the Secretary of Labor, consisting of 
     awarding demonstration grants to States to streamline State 
     requirements and procedures in order to assist veterans who 
     held certain military occupational specialties related to 
     medical care or who have completed certain medical training 
     while serving in the Armed Forces of the United States to 
     meet certification, licensure, and other requirements 
     applicable to civilian health care professions (such as 
     emergency medical technician, paramedic, licensed practical 
     nurse, registered nurse, physical therapy assistant, or 
     physician assistant professions) in the State.
       ``(2) Consultation and collaboration.--In determining the 
     eligible military occupational specialties or training 
     courses and the assistance required as described in paragraph 
     (1), the Secretary shall consult with the Secretary of 
     Defense, the Secretary of Veterans Affairs, and the Assistant 
     Secretary of Labor for Veterans' Employment and Training, and 
     shall collaborate with the initiatives carried out under 
     section 4114 of title 38, United States Code, and sections 
     1142 through 1144 of title 10, United States Code.
       ``(b) Use of Funds.--Amounts received as a demonstration 
     grant under this section shall be used to--
       ``(1) prepare and implement a plan to streamline State 
     requirements and procedures as described in subsection (a), 
     including by--
       ``(A) determining the extent to which the requirements for 
     the education, training, and skill level of civilian health 
     care professions (such as emergency medical technicians, 
     paramedics, licensed practical nurses, registered nurses, 
     physical therapy assistants, or physician assistants) in the 
     State are equivalent to requirements for the education, 
     training, and skill level of veterans who served in medical 
     related fields while a member of the Armed Forces of the 
     United States; and
       ``(B) identifying methods, such as waivers, for veterans 
     who served in medical related fields while a member of the 
     Armed Forces of the United States to forgo or meet any such 
     equivalent State requirements; and
       ``(2) if necessary to meet workforce shortages or address 
     gaps in education, training, or skill level to meet 
     certification, licensure or other requirements applicable to 
     becoming a civilian health care professional (such as an 
     emergency medical technician, paramedic, licensed practical 
     nurse, registered nurse, physical therapy assistant, or 
     physician assistant professions) in the State, develop or 
     expand career pathways at institutions of higher education to 
     support veterans in meeting such requirements.
       ``(c) Report.--Upon the completion of the demonstration 
     program under this section, the Secretary shall submit to 
     Congress a report on the program.
       ``(d) Funding.--No additional funds are authorized to be 
     appropriated for the purpose of carrying out this section. 
     This section shall be carried out using amounts otherwise 
     available for such purpose.
       ``(e) Sunset.--The demonstration program under this section 
     shall not exceed 5 years.''.

     SEC. 106. FDA OPIOID ACTION PLAN.

       (a) In General.--
       (1) New drug application.--
       (A) In general.--Subject to subparagraph (B), prior to the 
     approval pursuant to an application submitted under section 
     505(b) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 
     355(b)) of a new drug that is an opioid, the Secretary of 
     Health and Human Services (referred to in this section as the 
     ``Secretary'') shall refer the application to an advisory 
     committee of the Food and Drug Administration to seek 
     recommendations from such advisory committee.
       (B) Public health exemption.--A referral to an advisory 
     committee under subparagraph (A) is not required with respect 
     to a new opioid drug or drugs if the Secretary--
       (i) finds that such a referral is not in the interest of 
     protecting and promoting public health;
       (ii) finds that such a referral is not necessary based on a 
     review of the relevant scientific information; and
       (iii) submits a notice containing the rationale for such 
     findings to the Committee on Health, Education, Labor, and 
     Pensions of the Senate and the Committee on Energy and 
     Commerce of the House of Representatives.
       (2) Pediatric opioid labeling.--The Secretary shall convene 
     the Pediatric Advisory Committee of the Food and Drug 
     Administration to seek recommendations from such Committee 
     regarding a framework for the inclusion of information in the 
     labeling of drugs that are opioids relating to the use of 
     such drugs in pediatric populations before the Secretary 
     approves any labeling or change to labeling for any drug that 
     is an opioid intended for use in a pediatric population.
       (3) Sunset.--The requirements of paragraphs (1) and (2) 
     shall cease to be effective on October 1, 2022.
       (b) Prescriber Education.--Not later than 1 year after the 
     date of the enactment of this Act, the Secretary, acting 
     through the Commissioner of Food and Drugs, as part of the 
     Food and Drug Administration's evaluation of the Extended-
     Release/Long-Acting Opioid Analgesics Risk Evaluation and 
     Mitigation Strategy, and in consultation with relevant 
     stakeholders, shall develop recommendations regarding 
     education programs for prescribers of opioids pursuant to 
     section 505-1 of the Federal Food, Drug, and Cosmetic Act (21 
     U.S.C. 355-1), including recommendations on--
       (1) which prescribers should participate in such programs; 
     and
       (2) how often participation in such programs is necessary.
       (c) Guidance on Evaluating the Abuse Deterrence of Generic 
     Solid Oral Opioid Drug Products.--Not later than 18 months 
     after the end of the period for public comment on the draft 
     guidance entitled ``General Principles for Evaluating the 
     Abuse Deterrence of Generic Solid Oral Opioid Drug Products'' 
     issued by the Center for Drug Evaluation and Research of the 
     Food and Drug Administration in March 2016, the Commissioner 
     of Food and Drugs shall publish in the Federal Register a 
     final version of such guidance.

     SEC. 107. IMPROVING ACCESS TO OVERDOSE TREATMENT.

       (a) Grants for Reducing Overdose Deaths.--Part D of title V 
     of the Public Health Service Act (42 U.S.C. 290dd et seq.) is 
     amended by adding at the end the following:

     ``SEC. 544. GRANTS FOR REDUCING OVERDOSE DEATHS.

       ``(a) Establishment.--
       ``(1) In general.--The Secretary shall award grants to 
     eligible entities to expand access to drugs or devices 
     approved or cleared under the Federal Food, Drug, and 
     Cosmetic Act for emergency treatment of known or suspected 
     opioid overdose.
       ``(2) Maximum grant amount.--A grant awarded under this 
     section may not be for more than $200,000 per grant year.

[[Page H4395]]

       ``(3) Eligible entity.--For purposes of this section, the 
     term `eligible entity' means a Federally qualified health 
     center (as defined in section 1861(aa) of the Social Security 
     Act), an opioid treatment program under part 8 of title 42, 
     Code of Federal Regulations, any practitioner dispensing 
     narcotic drugs pursuant to section 303(g) of the Controlled 
     Substances Act, or any other entity that the Secretary deems 
     appropriate.
       ``(4) Prescribing.--For purposes of this section, the term 
     `prescribing' means, with respect to a drug or device 
     approved or cleared under the Federal Food, Drug, and 
     Cosmetic Act for emergency treatment of known or suspected 
     opioid overdose, the practice of prescribing such drug or 
     device--
       ``(A) in conjunction with an opioid prescription for 
     patients at an elevated risk of overdose;
       ``(B) in conjunction with an opioid agonist approved under 
     section 505 of the Federal Food, Drug, and Cosmetic Act for 
     the treatment of opioid use disorder;
       ``(C) to the caregiver or a close relative of patients at 
     an elevated risk of overdose from opioids; or
       ``(D) in other circumstances in which a provider identifies 
     a patient is at an elevated risk for an intentional or 
     unintentional drug overdose from heroin or prescription 
     opioid therapies.
       ``(b) Application.--To be eligible to receive a grant under 
     this section, an eligible entity shall submit to the 
     Secretary, in such form and manner as specified by the 
     Secretary, an application that describes--
       ``(1) the extent to which the area to which the entity will 
     furnish services through use of the grant is experiencing 
     significant morbidity and mortality caused by opioid abuse;
       ``(2) the criteria that will be used to identify eligible 
     patients to participate in such program; and
       ``(3) a plan for sustaining the program after Federal 
     support for the program has ended.
       ``(c) Use of Funds.--An eligible entity receiving a grant 
     under this section may use amounts under the grant for any of 
     the following activities, but may use not more than 20 
     percent of the grant funds for activities described in 
     paragraphs (3) and (4):
       ``(1) To establish a program for prescribing a drug or 
     device approved or cleared under the Federal Food, Drug, and 
     Cosmetic Act for emergency treatment of known or suspected 
     opioid overdose.
       ``(2) To train and provide resources for health care 
     providers and pharmacists on the prescribing of drugs or 
     devices approved or cleared under the Federal Food, Drug, and 
     Cosmetic Act for emergency treatment of known or suspected 
     opioid overdose.
       ``(3) To purchase drugs or devices approved or cleared 
     under the Federal Food, Drug, and Cosmetic Act for emergency 
     treatment of known or suspected opioid overdose, for 
     distribution under the program described in paragraph (1).
       ``(4) To offset the co-payments and other cost sharing 
     associated with drugs or devices approved or cleared under 
     the Federal Food, Drug, and Cosmetic Act for emergency 
     treatment of known or suspected opioid overdose.
       ``(5) To establish protocols to connect patients who have 
     experienced a drug overdose with appropriate treatment, 
     including medication-assisted treatment and appropriate 
     counseling and behavioral therapies.
       ``(d) Evaluations by Recipients.--As a condition of receipt 
     of a grant under this section, an eligible entity shall, for 
     each year for which the grant is received, submit to the 
     Secretary an evaluation of activities funded by the grant 
     which contains such information as the Secretary may 
     reasonably require.
       ``(e) Reports by the Secretary.--Not later than 5 years 
     after the date on which the first grant under this section is 
     awarded, the Secretary shall submit to the appropriate 
     committees of the House of Representatives and of the Senate 
     a report aggregating the information received from the grant 
     recipients for such year under subsection (d) and evaluating 
     the outcomes achieved by the programs funded by grants 
     awarded under this section.
       ``(f) Authorization of Appropriations.--There is authorized 
     to be appropriated to carry out this section, $5,000,000 for 
     the period of fiscal years 2017 through 2021.''.
       (b) Improving Access to Overdose Treatment.--
       (1) Information on best practices.--Not later than 180 days 
     after the date of enactment of this Act:
       (A) The Secretary of Health and Human Services may provide 
     information to prescribers within Federally qualified health 
     centers (as defined in paragraph (4) of section 1861(aa) of 
     the Social Security Act (42 U.S.C. 1395x(aa))), and the 
     health care facilities of the Indian Health Service, on best 
     practices for prescribing or co-prescribing a drug or device 
     approved or cleared under the Federal Food, Drug, and 
     Cosmetic Act (21 U.S.C. 301 et seq.) for emergency treatment 
     of known or suspected opioid overdose, including for patients 
     receiving chronic opioid therapy and patients being treated 
     for opioid use disorders.
       (B) The Secretary of Defense may provide information to 
     prescribers within Department of Defense medical facilities 
     on best practices for prescribing or co-prescribing a drug or 
     device approved or cleared under the Federal Food, Drug, and 
     Cosmetic Act (21 U.S.C. 301 et seq.) for emergency treatment 
     of known or suspected opioid overdose, including for patients 
     receiving chronic opioid therapy and patients being treated 
     for opioid use disorders.
       (C) The Secretary of Veterans Affairs may provide 
     information to prescribers within Department of Veterans 
     Affairs medical facilities on best practices for prescribing 
     or co-prescribing a drug or device approved or cleared under 
     the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 301 et 
     seq.) for emergency treatment of known or suspected opioid 
     overdose, including for patients receiving chronic opioid 
     therapy and patients being treated for opioid use disorders.
       (2) Rule of construction.--Nothing in this subsection 
     should be construed to establish or contribute to a medical 
     standard of care.

     SEC. 108. NIH OPIOID RESEARCH.

       (a) In General.--The Director of the National Institutes of 
     Health (referred to in this section as 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 of 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.

     SEC. 109. NATIONAL ALL SCHEDULES PRESCRIPTION ELECTRONIC 
                   REPORTING REAUTHORIZATION.

       (a) Amendment to Purpose.--Paragraph (1) of section 2 of 
     the National All Schedules Prescription Electronic Reporting 
     Act of 2005 (Public Law 109-60) is amended to read as 
     follows:
       ``(1) foster the establishment of State-administered 
     controlled substance monitoring systems in order to ensure 
     that health care providers have access to the accurate, 
     timely prescription history information that they may use as 
     a tool for the early identification of patients at risk for 
     addiction in order to initiate appropriate medical 
     interventions and avert the tragic personal, family, and 
     community consequences of untreated addiction; and''.
       (b) Amendments to Controlled Substance Monitoring 
     Program.--Section 399O of the Public Health Service Act (42 
     U.S.C. 280g-3) is amended--
       (1) in subsection (a)(1)--
       (A) in the matter preceding subparagraph (A), by inserting 
     ``, in consultation with the Administrator of the Substance 
     Abuse and Mental Health Services Administration and Director 
     of the Centers for Disease Control and Prevention,'' after 
     ``the Secretary'';
       (B) in subparagraph (A), by striking ``or'';
       (C) in subparagraph (B), by striking the period at the end 
     and inserting ``; or''; and
       (D) by adding at the end the following:
       ``(C) to maintain an existing State-controlled substance 
     monitoring program.'';
       (2) by amending subsection (b) to read as follows:
       ``(b) Minimum Requirements.--The Secretary shall maintain 
     and, as appropriate, supplement or revise (after publishing 
     proposed additions and revisions in the Federal Register and 
     receiving public comments thereon) minimum requirements for 
     criteria to be used by States for purposes of clauses (ii), 
     (v), (vi), and (vii) of subsection (c)(1)(A).'';
       (3) in subsection (c)--
       (A) in paragraph (1)(B)--
       (i) in the matter preceding clause (i), by striking 
     ``(a)(1)(B)'' and inserting ``(a)(1)(B) or (a)(1)(C)'';
       (ii) in clause (i), by striking ``program to be improved'' 
     and inserting ``program to be improved or maintained'';
       (iii) by redesignating clauses (iii) and (iv) as clauses 
     (iv) and (v), respectively;
       (iv) by inserting after clause (ii), the following:
       ``(iii) a plan to apply the latest advances in health 
     information technology, to the extent practicable, in order 
     to incorporate prescription drug monitoring program data 
     directly into the workflow of prescribers and dispensers to 
     ensure timely access to patients' controlled prescription 
     drug history;'';
       (v) in clause (iv) (as so redesignated), by striking ``; 
     and'' and inserting the following: ``and at least one health 
     information technology system such as electronic health 
     records, health information exchanges, or e-prescribing 
     systems;'';
       (vi) in clause (v) (as so redesignated)--

       (I) by striking ``public health'' and inserting ``public 
     health or safety''; and
       (II) by striking the period and inserting ``; and''; and

       (vii) by adding at the end the following:
       ``(vi) information, where applicable, on how the controlled 
     substance monitoring program jointly works with the 
     applicant's respective State substance abuse agency to ensure 
     information collected and maintained by the controlled 
     substance monitoring program is used to inform the provision 
     of clinically appropriate substance use disorder services to 
     individuals in need.'';
       (B) in paragraph (3)--
       (i) by striking ``If a State that submits'' and inserting 
     the following:
       ``(A) In general.--If a State that submits'';
       (ii) by inserting before the period at the end ``and 
     include timelines for full implementation of such 
     interoperability. The State shall also describe the manner in 
     which it will achieve interoperability between its monitoring 
     program and health information technology systems, as 
     allowable under State law, and include timelines for the 
     implementation of such interoperability''; and
       (iii) by adding at the end the following:
       ``(B) Monitoring of efforts.--The Secretary shall monitor 
     State efforts to achieve interoperability, as described in 
     subparagraph (A).''; and

[[Page H4396]]

       (C) in paragraph (5)--
       (i) by striking ``implement or improve'' and inserting 
     ``establish, improve, or maintain''; and
       (ii) by adding at the end the following: ``The Secretary 
     shall redistribute any funds that are so returned among the 
     remaining grantees under this section in accordance with the 
     formula described in subsection (a)(2)(B).'';
       (4) in subsection (d)--
       (A) in the matter preceding paragraph (1)--
       (i) by striking ``In implementing or improving'' and all 
     that follows through ``(a)(1)(B)'' and inserting ``In 
     establishing, improving, or maintaining a controlled 
     substance monitoring program under this section, a State 
     shall comply, or with respect to a State that applies for a 
     grant under subparagraph (B) or (C) of subsection (a)(1)''; 
     and
       (ii) by striking ``public health'' and inserting ``public 
     health or safety''; and
       (B) by adding at the end the following:
       ``(5) The State shall report on interoperability with the 
     controlled substance monitoring program of Federal agencies, 
     where appropriate, interoperability with health information 
     technology systems such as electronic health records, health 
     information exchanges, and e-prescribing, where appropriate, 
     and whether or not the State provides automatic, up-to-date, 
     or daily information about a patient when a practitioner (or 
     the designee of a practitioner, where permitted) requests 
     information about such patient.'';
       (5) in subsections (e), (f)(1), and (g), by striking 
     ``implementing or improving'' each place it appears and 
     inserting ``establishing, improving, or maintaining'';
       (6) in subsection (f)--
       (A) in paragraph (1)--
       (i) in subparagraph (B), by striking ``misuse of a schedule 
     II, III, or IV substance'' and inserting ``misuse of a 
     controlled substance included in schedule II, III, or IV of 
     section 202(c) of the Controlled Substances Act''; and
       (ii) in subparagraph (D)--

       (I) by inserting ``a State substance abuse agency,'' after 
     ``State health department,''; and
       (II) by striking ``such department, program, or 
     administration'' each place it appears and inserting ``such 
     department, program, agency, or administration'' in each such 
     place; and

       (B) by adding at the end the following:
       ``(3) Evaluation and reporting.--Subject to subsection (g), 
     a State receiving a grant under subsection (a) shall provide 
     the Secretary with aggregate data to enable the Secretary--
       ``(A) to evaluate the success of the State's program in 
     achieving its purposes; or
       ``(B) to prepare and submit the report to Congress required 
     by subsection (k)(2).
       ``(4) Research by other entities.--A department, program, 
     agency, or administration receiving nonidentifiable 
     information under paragraph (1)(D) may make such information 
     available to other entities for research purposes.'';
       (7) by striking subsection (k);
       (8) by redesignating subsections (h) through (j) as 
     subsections (i) through (k), respectively;
       (9) in subsections (c)(1)(A)(iv) and (d)(4), by striking 
     ``subsection (h)'' each place it appears and inserting 
     ``subsection (i)'';
       (10) by inserting after subsection (g) the following:
       ``(h) Education and Access to the Monitoring System.--A 
     State receiving a grant under subsection (a) shall take steps 
     to--
       ``(1) facilitate prescriber and dispenser use of the 
     State's controlled substance monitoring system, to the extent 
     practicable; and
       ``(2) educate prescribers and dispensers on the benefits of 
     the system.'';
       (11) in subsection (k)(2)(A), as so redesignated--
       (A) in clause (ii), by striking ``or affected'' and 
     inserting ``, established or strengthened initiatives to 
     ensure linkages to substance use disorder services, or 
     affected''; and
       (B) in clause (iii), by striking ``including an 
     assessment'' and inserting ``and between controlled substance 
     monitoring programs and health information technology 
     systems, including an assessment'';
       (12) in subsection (l)(1), by striking ``establishment, 
     implementation, or improvement'' and inserting 
     ``establishment, improvement, or maintenance'';
       (13) in subsection (m)(8), by striking ``and the District 
     of Columbia'' and inserting ``, the District of Columbia, and 
     any commonwealth or territory of the United States''; and
       (14) by amending subsection (n) to read as follows:
       ``(n) Authorization of Appropriations.--To carry out this 
     section, there are authorized to be appropriated, $10,000,000 
     for each of fiscal years 2017 through 2021.''.

     SEC. 110. OPIOID OVERDOSE REVERSAL MEDICATION ACCESS AND 
                   EDUCATION GRANT PROGRAMS.

       (a) In General.--Part D of title V of the Public Health 
     Service Act (42 U.S.C. 290dd et seq.), as amended by section 
     107, is further amended by adding at the end the following:

     ``SEC. 545. OPIOID OVERDOSE REVERSAL MEDICATION ACCESS AND 
                   EDUCATION GRANT PROGRAMS.

       ``(a) Grants to States.--The Secretary shall make grants to 
     States to--
       ``(1) implement strategies for pharmacists to dispense a 
     drug or device approved or cleared under the Federal Food, 
     Drug, and Cosmetic Act for emergency treatment of known or 
     suspected opioid overdose, as appropriate, pursuant to a 
     standing order;
       ``(2) encourage pharmacies to dispense opioid overdose 
     reversal medication pursuant to a standing order;
       ``(3) develop or provide training materials that persons 
     authorized to prescribe or dispense a drug or device approved 
     or cleared under the Federal Food, Drug, and Cosmetic Act for 
     emergency treatment of known or suspected opioid overdose may 
     use to educate the public concerning--
       ``(A) when and how to safely administer such drug or 
     device; and
       ``(B) steps to be taken after administering such drug or 
     device; and
       ``(4) educate the public concerning the availability of 
     drugs or devices approved or cleared under the Federal Food, 
     Drug, and Cosmetic Act for emergency treatment of known or 
     suspected opioid overdose without a person-specific 
     prescription.
       ``(b) Certain Requirement.--A grant may be made under this 
     section only if the State involved has authorized standing 
     orders to be issued for drugs or devices approved or cleared 
     under the Federal Food, Drug, and Cosmetic Act for emergency 
     treatment of known or suspected opioid overdose.
       ``(c) Preference in Making Grants.--In making grants under 
     this section, the Secretary may give preference to States 
     that have a significantly higher rate of opioid overdoses 
     than the national average, and that--
       ``(1) have not implemented standing orders regarding drugs 
     or devices approved or cleared under the Federal Food, Drug, 
     and Cosmetic Act for emergency treatment of known or 
     suspected opioid overdose;
       ``(2) authorize standing orders to be issued that permit 
     community-based organizations, substance abuse programs, or 
     other nonprofit entities to acquire, dispense, or administer 
     drugs or devices approved or cleared under the Federal Food, 
     Drug, and Cosmetic Act for emergency treatment of known or 
     suspected opioid overdose; or
       ``(3) authorize standing orders to be issued that permit 
     police, fire, or emergency medical services agencies to 
     acquire and administer drugs or devices approved or cleared 
     under the Federal Food, Drug, and Cosmetic Act for emergency 
     treatment of known or suspected opioid overdose.
       ``(d) Grant Terms.--
       ``(1) Number.--A State may not receive more than one grant 
     under this section at a time.
       ``(2) Period.--A grant under this section shall be for a 
     period of 3 years.
       ``(3) Limitation.--A State may use not more than 20 percent 
     of a grant under this section for educating the public 
     pursuant to subsection (a)(4).
       ``(e) Applications.--To be eligible to receive a grant 
     under this section, a State shall submit an application to 
     the Secretary in such form and manner and containing such 
     information as the Secretary may reasonably require, 
     including detailed proposed expenditures of grant funds.
       ``(f) Reporting.--A State that receives a grant under this 
     section shall, at least annually for the duration of the 
     grant, submit a report to the Secretary evaluating the 
     progress of the activities supported through the grant. Such 
     reports shall include information on the number of pharmacies 
     in the State that dispense a drug or device approved or 
     cleared under the Federal Food, Drug, and Cosmetic Act for 
     emergency treatment of known or suspected opioid overdose 
     under a standing order, and other information as the 
     Secretary determines appropriate to evaluate the use of grant 
     funds.
       ``(g) Definitions.--In this section the term `standing 
     order' means a document prepared by a person authorized to 
     prescribe medication that permits another person to acquire, 
     dispense, or administer medication without a person-specific 
     prescription.
       ``(h) Authorization of Appropriations.--
       ``(1) In general.--To carry out this section, there are 
     authorized to be appropriated $5,000,000 for the period of 
     fiscal years 2017 through 2019.
       ``(2) Administrative costs.--Not more than 3 percent of the 
     amounts made available to carry out this section may be used 
     by the Secretary for administrative expenses of carrying out 
     this section.''.
       (b) Technical Clarification.--Effective as if included in 
     the enactment of the Children's Health Act of 2000 (Public 
     Law 106-310), section 3405(a) of such Act (114 Stat. 1221) is 
     amended by striking ``Part E of title III'' and inserting 
     ``Part E of title III of the Public Health Service Act''.

                TITLE II--LAW ENFORCEMENT AND TREATMENT

     SEC. 201. COMPREHENSIVE OPIOID ABUSE GRANT PROGRAM.

       (a) Comprehensive Opioid Abuse Grant Program.--
       (1) In general.--Title I of the Omnibus Crime Control and 
     Safe Streets Act of 1968 (42 U.S.C. 3711 et seq.) is amended 
     by adding at the end the following:

          ``PART LL--COMPREHENSIVE OPIOID ABUSE GRANT PROGRAM

     ``SEC. 3021. DESCRIPTION.

       ``(a) Grants Authorized.--From amounts made available to 
     carry out this part, the Attorney General may make grants to 
     States, units of local government, and Indian tribes, for use 
     by the State, unit of local government, or Indian tribe to 
     provide services primarily relating to opioid abuse, 
     including for any one or more of the following:
       ``(1) Developing, implementing, or expanding a treatment 
     alternative to incarceration program, which may include--
       ``(A) prebooking or postbooking components, which may 
     include the activities described in part DD or HH of this 
     title;
       ``(B) training for criminal justice agency personnel on 
     substance use disorders and co-occurring mental illness and 
     substance use disorders;
       ``(C) a mental health court, including the activities 
     described in part V of this title;
       ``(D) a drug court, including the activities described in 
     part EE of this title;
       ``(E) a veterans treatment court program, including the 
     activities described in subsection (i) of section 2991 of 
     this title;

[[Page H4397]]

       ``(F) a focus on parents whose incarceration could result 
     in their children entering the child welfare system; and
       ``(G) a community-based substance use diversion program 
     sponsored by a law enforcement agency.
       ``(2) In the case of a State, facilitating or enhancing 
     planning and collaboration between State criminal justice 
     agencies and State substance abuse agencies in order to more 
     efficiently and effectively carry out activities or services 
     described in any paragraph of this subsection that address 
     problems related to opioid abuse.
       ``(3) Providing training and resources for first responders 
     on carrying and administering an opioid overdose reversal 
     drug or device approved or cleared by the Food and Drug 
     Administration, and purchasing such a drug or device for 
     first responders who have received such training to so carry 
     and administer.
       ``(4) Locating or investigating illicit activities related 
     to the unlawful distribution of opioids.
       ``(5) Developing, implementing, or expanding a medication-
     assisted treatment program used or operated by a criminal 
     justice agency, which may include training criminal justice 
     agency personnel on medication-assisted treatment, and 
     carrying out the activities described in part S of this 
     title.
       ``(6) In the case of a State, developing, implementing, or 
     expanding a prescription drug monitoring program to collect 
     and analyze data related to the prescribing of schedules II, 
     III, and IV controlled substances through a centralized 
     database administered by an authorized State agency, which 
     includes tracking the dispensation of such substances, and 
     providing for interoperability and data sharing with each 
     other such program in each other State, and with any 
     interstate entity that shares information between such 
     programs.
       ``(7) Developing, implementing, or expanding a program to 
     prevent and address opioid abuse by juveniles.
       ``(8) Developing, implementing, or expanding a program 
     (which may include demonstration projects) to utilize 
     technology that provides a secure container for prescription 
     drugs that would prevent or deter individuals, particularly 
     adolescents, from gaining access to opioid medications that 
     are lawfully prescribed for other individuals.
       ``(9) Developing, implementing, or expanding a prescription 
     drug take-back program.
       ``(10) Developing, implementing, or expanding an integrated 
     and comprehensive opioid abuse response program.
       ``(b) Contracts and Subawards.--A State, unit of local 
     government, or Indian tribe may, in using a grant under this 
     part for purposes authorized by subsection (a), use all or a 
     portion of that grant to contract with, or make one or more 
     subawards to, one or more--
       ``(1) local or regional organizations that are private and 
     nonprofit, including faith-based organizations;
       ``(2) units of local government; or
       ``(3) tribal organizations.
       ``(c) Program Assessment Component; Waiver.--
       ``(1) Program assessment component.--Each program funded 
     under this part shall contain a program assessment component, 
     developed pursuant to guidelines established by the Attorney 
     General, in coordination with the National Institute of 
     Justice.
       ``(2) Waiver.--The Attorney General may waive the 
     requirement of paragraph (1) with respect to a program if, in 
     the opinion of the Attorney General, the program is not of 
     sufficient size to justify a full program assessment.
       ``(d) Administrative Costs.--Not more than 10 percent of a 
     grant made under this part may be used for costs incurred to 
     administer such grant.
       ``(e) Period.--The period of a grant made under this part 
     may not be longer than 4 years, except that renewals and 
     extensions beyond that period may be granted at the 
     discretion of the Attorney General.

     ``SEC. 3022. APPLICATIONS.

       ``To request a grant under this part, the chief executive 
     officer of a State, unit of local government, or Indian tribe 
     shall submit an application to the Attorney General at such 
     time and in such form as the Attorney General may require. 
     Such application shall include the following:
       ``(1) A certification that Federal funds made available 
     under this part will not be used to supplant State, local, or 
     tribal funds, but will be used to increase the amounts of 
     such funds that would, in the absence of Federal funds, be 
     made available for the activities described in section 
     3021(a).
       ``(2) An assurance that, for each fiscal year covered by an 
     application, the applicant shall maintain and report such 
     data, records, and information (programmatic and financial) 
     as the Attorney General may reasonably require.
       ``(3) A certification, made in a form acceptable to the 
     Attorney General and executed by the chief executive officer 
     of the applicant (or by another officer of the applicant, if 
     qualified under regulations promulgated by the Attorney 
     General), that--
       ``(A) the activities or services to be funded by the grant 
     meet all the requirements of this part;
       ``(B) all the information contained in the application is 
     correct;
       ``(C) there has been appropriate coordination with affected 
     agencies; and
       ``(D) the applicant will comply with all provisions of this 
     part and all other applicable Federal laws.
       ``(4) An assurance that the applicant will work with the 
     Drug Enforcement Administration to develop an integrated and 
     comprehensive strategy to address opioid abuse.

     ``SEC. 3023. REVIEW OF APPLICATIONS.

       ``The Attorney General shall not finally disapprove any 
     application (or any amendment to that application) submitted 
     under this part without first affording the applicant 
     reasonable notice of any deficiencies in the application and 
     an opportunity for correction of any such deficiencies and 
     reconsideration.

     ``SEC. 3024. EQUITABLE DISTRIBUTION OF FUNDS.

       ``In awarding grants under this part, the Attorney General 
     shall distribute funds in a manner that--
       ``(1) equitably addresses the needs of underserved 
     populations, including rural and tribal communities; and
       ``(2) focuses on communities that have been 
     disproportionately impacted by opioid abuse as evidenced in 
     part by--
       ``(A) high rates of primary treatment admissions for heroin 
     and other opioids;
       ``(B) high rates of drug poisoning deaths from heroin and 
     other opioids; and
       ``(C) a lack of accessibility to treatment providers and 
     facilities and to emergency medical services.

     ``SEC. 3025. DEFINITIONS.

       ``In this part:
       ``(1) The term `first responder' includes a firefighter, 
     law enforcement officer, paramedic, emergency medical 
     technician, or other individual (including an employee of a 
     legally organized and recognized volunteer organization, 
     whether compensated or not), who, in the course of his or her 
     professional duties, responds to fire, medical, hazardous 
     material, or other similar emergencies.
       ``(2) The term `medication-assisted treatment' means the 
     use of medications approved by the Food and Drug 
     Administration for the treatment of opioid abuse.
       ``(3) The term `opioid' means any drug, including heroin, 
     having an addiction-forming or addiction-sustaining liability 
     similar to morphine or being capable of conversion into a 
     drug having such addiction-forming or addiction-sustaining 
     liability.
       ``(4) The term `schedule II, III, or IV controlled 
     substance' means a controlled substance that is listed on 
     schedule II, schedule III, or schedule IV of section 202(c) 
     of the Controlled Substances Act (21 U.S.C. 812(c)).
       ``(5) The terms `drug' and `device' have the meanings given 
     those terms in section 201 of the Federal Food, Drug, and 
     Cosmetic Act (21 U.S.C. 321).
       ``(6) The term `criminal justice agency' means a State, 
     local, or tribal--
       ``(A) court;
       ``(B) prison;
       ``(C) jail;
       ``(D) law enforcement agency; or
       ``(E) other agency that performs the administration of 
     criminal justice, including prosecution, pretrial services, 
     and community supervision.
       ``(7) The term `tribal organization' has the meaning given 
     that term in section 4 of the Indian Self-Determination and 
     Education Assistance Act (25 U.S.C. 450b).
       ``(8) The term `State substance abuse agency' has the 
     meaning given that term in section 508(r)(6) of the Public 
     Health Service Act (42 U.S.C. 290bb-1).''.
       (2) Authorization of appropriations.--Section 1001(a) of 
     title I of the Omnibus Crime Control and Safe Streets Act of 
     1968 (42 U.S.C. 3793(a)) is amended by inserting after 
     paragraph (26) the following:
       ``(27) There are authorized to be appropriated to carry out 
     part LL $103,000,000 for each of fiscal years 2017 through 
     2021.''.
       (b) Emergency Federal Law Enforcement Assistance.--Section 
     609Y(a) of the Justice Assistance Act of 1984 (42 U.S.C. 
     10513(a)) is amended by striking ``September 30, 1984'' and 
     inserting ``September 30, 2021''.
       (c) Inclusion of Services for Pregnant Women Under Family-
     Based Substance Abuse Grants.--Part DD of title I of the 
     Omnibus Crime Control and Safe Streets Act (42 U.S.C. 3797s 
     et seq.) is amended--
       (1) in section 2921(2), by inserting before the period at 
     the end ``or pregnant women''; and
       (2) in section 2927--
       (A) in paragraph (1)(A), by inserting ``pregnant or'' 
     before ``a parent''; and
       (B) in paragraph (3), by inserting ``or pregnant women'' 
     after ``incarcerated parents''.
       (d) GAO Study and Report on Federal Agency Programs and 
     Research Relative to Substance Use and Substance Use 
     Disorders Among Adolescents and Young Adults.--
       (1) Study.--The Comptroller General of the United States 
     shall conduct a study on how Federal agencies, through grant 
     programs, are addressing prevention of, treatment for, and 
     recovery from, substance use by, and substance use disorders 
     among, adolescents and young adults. Such study shall include 
     an analysis of each of the following:
       (A) The research that has been, and is being, conducted or 
     supported pursuant to grant programs operated by Federal 
     agencies on prevention of, treatment for, and recovery from 
     substance use by and substance use disorders among 
     adolescents and young adults, including an assessment of--
       (i) such research relative to any unique circumstances 
     (including social and biological circumstances) of 
     adolescents and young adults that may make adolescent-
     specific and young adult-specific treatment protocols 
     necessary, including any effects that substance use and 
     substance use disorders may have on brain development and the 
     implications for treatment and recovery; and
       (ii) areas of such research in which greater investment or 
     focus is necessary relative to other areas of such research.
       (B) Federal agency nonresearch programs and activities that 
     address prevention of, treatment for, and recovery from 
     substance use by and substance use disorders among 
     adolescents and young adults, including an assessment of the 
     effectiveness of such programs and activities in

[[Page H4398]]

     preventing substance use by and substance use disorders among 
     adolescents and young adults, treating such adolescents and 
     young adults in a way that accounts for any unique 
     circumstances faced by adolescents and young adults, and 
     supports long-term recovery among adolescents and young 
     adults.
       (C) Gaps that have been identified by officials of Federal 
     agencies or experts in the efforts supported by grant 
     programs operated by Federal agencies relating to prevention 
     of, treatment for, and recovery from substance use by and 
     substance use disorders among adolescents and young adults, 
     including gaps in research, data collection, and measures to 
     evaluate the effectiveness of such efforts, and the reasons 
     for such gaps.
       (2) Report.--Not later than 2 years after the date of 
     enactment of this Act, the Comptroller General shall submit 
     to the appropriate committees of the Congress a report 
     containing the results of the study conducted under paragraph 
     (1), including--
       (A) a summary of the findings of the study; and
       (B) recommendations based on the results of the study, 
     including recommendations for such areas of research and 
     legislative and administrative action as the Comptroller 
     General determines appropriate.

     SEC. 202. FIRST RESPONDER TRAINING.

       Part D of title V of the Public Health Service Act (42 
     U.S.C. 290dd et seq.), as amended by section 110, is further 
     amended by adding at the end the following:

     ``SEC. 546. FIRST RESPONDER TRAINING.

       ``(a) Program Authorized.--The Secretary shall make grants 
     to States, local governmental entities, and Indian tribes and 
     tribal organizations (as defined in section 4 of the Indian 
     Self-Determination and Education Assistance Act) to allow 
     first responders and members of other key community sectors 
     to administer a drug or device approved or cleared under the 
     Federal Food, Drug, and Cosmetic Act for emergency treatment 
     of known or suspected opioid overdose.
       ``(b) Application.--
       ``(1) In general.--An entity seeking a grant under this 
     section shall submit an application to the Secretary--
       ``(A) that meets the criteria under paragraph (2); and
       ``(B) at such time, in such manner, and accompanied by such 
     information as the Secretary may require.
       ``(2) Criteria.--An entity, in submitting an application 
     under paragraph (1), shall--
       ``(A) describe the evidence-based methodology and outcome 
     measurements that will be used to evaluate the program funded 
     with a grant under this section, and specifically explain how 
     such measurements will provide valid measures of the impact 
     of the program;
       ``(B) describe how the program could be broadly replicated 
     if demonstrated to be effective;
       ``(C) identify the governmental and community agencies with 
     which the entity will coordinate to implement the program; 
     and
       ``(D) describe how the entity will ensure that law 
     enforcement agencies will coordinate with their corresponding 
     State substance abuse and mental health agencies to identify 
     protocols and resources that are available to overdose 
     victims and families, including information on treatment and 
     recovery resources.
       ``(c) Use of Funds.--An entity shall use a grant received 
     under this section to--
       ``(1) make a drug or device approved or cleared under the 
     Federal Food, Drug, and Cosmetic Act for emergency treatment 
     of known or suspected opioid overdose available to be carried 
     and administered by first responders and members of other key 
     community sectors;
       ``(2) train and provide resources for first responders and 
     members of other key community sectors on carrying and 
     administering a drug or device approved or cleared under the 
     Federal Food, Drug, and Cosmetic Act for emergency treatment 
     of known or suspected opioid overdose; and
       ``(3) establish processes, protocols, and mechanisms for 
     referral to appropriate treatment, which may include an 
     outreach coordinator or team to connect individuals receiving 
     opioid overdose reversal drugs to followup services.
       ``(d) Technical Assistance Grants.--The Secretary shall 
     make a grant for the purpose of providing technical 
     assistance and training on the use of a drug or device 
     approved or cleared under the Federal Food, Drug, and 
     Cosmetic Act for emergency treatment of known or suspected 
     opioid overdose, and mechanisms for referral to appropriate 
     treatment for an entity receiving a grant under this section.
       ``(e) Geographic Distribution.--In making grants under this 
     section, the Secretary shall ensure that not less than 20 
     percent of grant funds are awarded to eligible entities that 
     are not located in metropolitan statistical areas (as defined 
     by the Office of Management and Budget). The Secretary shall 
     take into account the unique needs of rural communities, 
     including communities with an incidence of individuals with 
     opioid use disorder that is above the national average and 
     communities with a shortage of prevention and treatment 
     services.
       ``(f) Evaluation.--The Secretary shall conduct an 
     evaluation of grants made under this section to determine--
       ``(1) the number of first responders and members of other 
     key community sectors equipped with a drug or device approved 
     or cleared under the Federal Food, Drug, and Cosmetic Act for 
     emergency treatment of known or suspected opioid overdose;
       ``(2) the number of opioid and heroin overdoses reversed by 
     first responders and members of other key community sectors 
     receiving training and supplies of a drug or device approved 
     or cleared under the Federal Food, Drug, and Cosmetic Act for 
     emergency treatment of known or suspected opioid overdose, 
     through a grant received under this section;
       ``(3) the number of responses to requests for services by 
     the entity or subgrantee, to opioid and heroin overdose; and
       ``(4) the extent to which overdose victims and families 
     receive information about treatment services and available 
     data describing treatment admissions.
       ``(g) Authorization of Appropriations.--To carry out this 
     section, there are authorized to be appropriated $12,000,000 
     for each of fiscal years 2017 through 2021.''.

     SEC. 203. PRESCRIPTION DRUG TAKE BACK EXPANSION.

       (a) Definition of Covered Entity.--In this section, the 
     term ``covered entity'' means--
       (1) a State, local, or tribal law enforcement agency;
       (2) a manufacturer, distributor, or reverse distributor of 
     prescription medications;
       (3) a retail pharmacy;
       (4) a registered narcotic treatment program;
       (5) a hospital or clinic with an onsite pharmacy;
       (6) an eligible long-term care facility; or
       (7) any other entity authorized by the Drug Enforcement 
     Administration to dispose of prescription medications.
       (b) Program Authorized.--The Attorney General, in 
     coordination with the Administrator of the Drug Enforcement 
     Administration, the Secretary of Health and Human Services, 
     and the Director of the Office of National Drug Control 
     Policy, shall coordinate with covered entities in expanding 
     or making available disposal sites for unwanted prescription 
     medications.

                   TITLE III--TREATMENT AND RECOVERY

     SEC. 301. EVIDENCE-BASED PRESCRIPTION OPIOID AND HEROIN 
                   TREATMENT AND INTERVENTIONS DEMONSTRATION.

       Subpart 1 of part B of title V of the Public Health Service 
     Act (42 U.S.C. 290bb et seq.) is amended by adding at the end 
     the following:

     ``SEC. 514B. EVIDENCE-BASED PRESCRIPTION OPIOID AND HEROIN 
                   TREATMENT AND INTERVENTIONS DEMONSTRATION.

       ``(a) Grants To Expand Access.--
       ``(1) Authority to award grants.--The Secretary shall award 
     grants, contracts, or cooperative agreements to State 
     substance abuse agencies, units of local government, 
     nonprofit organizations, and Indian tribes and tribal 
     organizations (as defined in section 4 of the Indian Self-
     Determination and Education Assistance Act) that have a high 
     rate, or have had a rapid increase, in the use of heroin or 
     other opioids, in order to permit such entities to expand 
     activities, including an expansion in the availability of 
     evidence-based medication-assisted treatment and other 
     clinically appropriate services, with respect to the 
     treatment of addiction in the specific geographical areas of 
     such entities where there is a high rate or rapid increase in 
     the use of heroin or other opioids, such as in rural areas.
       ``(2) Nature of activities.--Funds awarded under paragraph 
     (1) shall be used for activities that are based on reliable 
     scientific evidence of efficacy in the treatment of problems 
     related to heroin or other opioids.
       ``(b) Application.--To be eligible for a grant, contract, 
     or cooperative agreement under subsection (a), an entity 
     shall submit an application to the Secretary at such time, in 
     such manner, and accompanied by such information as the 
     Secretary may reasonably require.
       ``(c) Evaluation.--An entity that receives a grant, 
     contract, or cooperative agreement under subsection (a) shall 
     submit, in the application for such grant, contract, or 
     agreement a plan for the evaluation of any project undertaken 
     with funds provided under this section. Such entity shall 
     provide the Secretary with periodic evaluations of the 
     progress of such project and an evaluation at the completion 
     of such project as the Secretary determines to be 
     appropriate.
       ``(d) Geographic Distribution.--In awarding grants, 
     contracts, and cooperative agreements under this section, the 
     Secretary shall ensure that not less than 15 percent of funds 
     are awarded to eligible entities that are not located in 
     metropolitan statistical areas (as defined by the Office of 
     Management and Budget). The Secretary shall take into account 
     the unique needs of rural communities, including communities 
     with an incidence of individuals with opioid use disorder 
     that is above the national average and communities with a 
     shortage of prevention and treatment services.
       ``(e) Additional Activities.--In administering grants, 
     contracts, and cooperative agreements under subsection (a), 
     the Secretary shall--
       ``(1) evaluate the activities supported under such 
     subsection;
       ``(2) disseminate information, as appropriate, derived from 
     evaluations as the Secretary considers appropriate;
       ``(3) provide States, Indian tribes and tribal 
     organizations, and providers with technical assistance in 
     connection with the provision of treatment of problems 
     related to heroin and other opioids; and
       ``(4) fund only those applications that specifically 
     support recovery services as a critical component of the 
     program involved.
       ``(f) Authorization of Appropriations.--To carry out this 
     section, there are authorized to be appropriated $25,000,000 
     for each of fiscal years 2017 through 2021.''.

[[Page H4399]]

  


     SEC. 302. BUILDING COMMUNITIES OF RECOVERY.

       Part D of title V of the Public Health Service Act (42 
     U.S.C. 290dd et seq.), as amended by section 202, is further 
     amended by adding at the end the following:

     ``SEC. 547. BUILDING COMMUNITIES OF RECOVERY.

       ``(a) Definition.--In this section, the term `recovery 
     community organization' means an independent nonprofit 
     organization that--
       ``(1) mobilizes resources within and outside of the 
     recovery community to increase the prevalence and quality of 
     long-term recovery from substance use disorders; and
       ``(2) is wholly or principally governed by people in 
     recovery for substance use disorders who reflect the 
     community served.
       ``(b) Grants Authorized.--The Secretary shall award grants 
     to recovery community organizations to enable such 
     organizations to develop, expand, and enhance recovery 
     services.
       ``(c) Federal Share.--The Federal share of the costs of a 
     program funded by a grant under this section may not exceed 
     50 percent.
       ``(d) Use of Funds.--Grants awarded under subsection (b)--
       ``(1) shall be used to develop, expand, and enhance 
     community and statewide recovery support services; and
       ``(2) may be used to--
       ``(A) build connections between recovery networks, between 
     recovery community organizations, and with other recovery 
     support services, including--
       ``(i) behavioral health providers;
       ``(ii) primary care providers and physicians;
       ``(iii) the criminal justice system;
       ``(iv) employers;
       ``(v) housing services;
       ``(vi) child welfare agencies; and
       ``(vii) other recovery support services that facilitate 
     recovery from substance use disorders;
       ``(B) reduce the stigma associated with substance use 
     disorders; and
       ``(C) conduct outreach on issues relating to substance use 
     disorders and recovery, including--
       ``(i) identifying the signs of addiction;
       ``(ii) the resources available to individuals struggling 
     with addiction and to families with a family member 
     struggling with, or being treated for, addiction, including 
     programs that mentor and provide support services to 
     children;
       ``(iii) the resources available to help support individuals 
     in recovery; and
       ``(iv) related medical outcomes of substance use disorders, 
     the potential of acquiring an infectious disease from 
     intravenous drug use, and neonatal abstinence syndrome among 
     infants exposed to opioids during pregnancy.
       ``(e) Authorization of Appropriations.--There are 
     authorized to be appropriated to carry out this section 
     $1,000,000 for each of fiscal years 2017 through 2021.''.

     SEC. 303. MEDICATION-ASSISTED TREATMENT FOR RECOVERY FROM 
                   ADDICTION.

       (a) In General.--
       (1) In general.--Section 303(g)(2) of the Controlled 
     Substances Act (21 U.S.C. 823(g)(2)) is amended--
       (A) in subparagraph (B), by striking clauses (i), (ii), and 
     (iii) and inserting the following:
       ``(i) The practitioner is a qualifying practitioner (as 
     defined in subparagraph (G)).
       ``(ii) With respect to patients to whom the practitioner 
     will provide such drugs or combinations of drugs, the 
     practitioner has the capacity to provide directly, by 
     referral, or in such other manner as determined by the 
     Secretary--
       ``(I) all drugs approved by the Food and Drug 
     Administration for the treatment of opioid use disorder, 
     including for maintenance, detoxification, overdose reversal, 
     and relapse prevention; and
       ``(II) appropriate counseling and other appropriate 
     ancillary services.
       ``(iii)(I) The total number of such patients of the 
     practitioner at any one time will not exceed the applicable 
     number. Except as provided in subclause (II), the applicable 
     number is 30.
       ``(II) The applicable number is 100 if, not sooner than 1 
     year after the date on which the practitioner submitted the 
     initial notification, the practitioner submits a second 
     notification to the Secretary of the need and intent of the 
     practitioner to treat up to 100 patients.
       ``(III) The Secretary may by regulation change such 
     applicable number.
       ``(IV) The Secretary may exclude from the applicable number 
     patients to whom such drugs or combinations of drugs are 
     directly administered by the qualifying practitioner in the 
     office setting.'';
       (B) in subparagraph (D)--
       (i) in clause (ii), by striking ``Upon receiving a 
     notification under subparagraph (B)'' and inserting ``Upon 
     receiving a determination from the Secretary under clause 
     (iii) finding that a practitioner meets all requirements for 
     a waiver under subparagraph (B)''; and
       (ii) in clause (iii)--

       (I) by inserting ``and shall forward such determination to 
     the Attorney General'' before the period at the end of the 
     first sentence; and
       (II) by striking ``physician'' and inserting 
     ``practitioner'';

       (C) in subparagraph (G)--
       (i) by amending clause (ii)(I) to read as follows:

       ``(I) The physician holds a board certification in 
     addiction psychiatry or addiction medicine from the American 
     Board of Medical Specialties.'';

       (ii) by amending clause (ii)(II) to read as follows:

       ``(II) The physician holds an addiction certification or 
     board certification from the American Society of Addiction 
     Medicine or the American Board of Addiction Medicine.'';

       (iii) in clause (ii)(III), by striking ``subspecialty'';
       (iv) by amending clause (ii)(IV) to read as follows:
       ``(IV) The physician has, with respect to the treatment and 
     management of opiate-dependent patients, completed not less 
     than 8 hours of training (through classroom situations, 
     seminars at professional society meetings, electronic 
     communications, or otherwise) that is provided by the 
     American Society of Addiction Medicine, the American Academy 
     of Addiction Psychiatry, the American Medical Association, 
     the American Osteopathic Association, the American 
     Psychiatric Association, or any other organization that the 
     Secretary determines is appropriate for purposes of this 
     subclause. Such training shall include--
       ``(aa) opioid maintenance and detoxification;
       ``(bb) appropriate clinical use of all drugs approved by 
     the Food and Drug Administration for the treatment of opioid 
     use disorder;
       ``(cc) initial and periodic patient assessments (including 
     substance use monitoring);
       ``(dd) individualized treatment planning, overdose 
     reversal, and relapse prevention;
       ``(ee) counseling and recovery support services;
       ``(ff) staffing roles and considerations;
       ``(gg) diversion control; and
       ``(hh) other best practices, as identified by the 
     Secretary.''; and
       (v) by adding at the end the following:
       ``(iii) The term `qualifying practitioner' means--
       ``(I) a qualifying physician, as defined in clause (ii); or
       ``(II) during the period beginning on the date of enactment 
     of the Comprehensive Addiction and Recovery Act of 2016 and 
     ending on October 1, 2021, a qualifying other practitioner, 
     as defined in clause (iv).
       ``(iv) The term `qualifying other practitioner' means a 
     nurse practitioner or physician assistant who satisfies each 
     of the following:
       ``(I) The nurse practitioner or physician assistant is 
     licensed under State law to prescribe schedule III, IV, or V 
     medications for the treatment of pain.
       ``(II) The nurse practitioner or physician assistant has--
       ``(aa) completed not fewer than 24 hours of initial 
     training addressing each of the topics listed in clause 
     (ii)(IV) (through classroom situations, seminars at 
     professional society meetings, electronic communications, or 
     otherwise) provided by the American Society of Addiction 
     Medicine, the American Academy of Addiction Psychiatry, the 
     American Medical Association, the American Osteopathic 
     Association, the American Nurses Credentialing Center, the 
     American Psychiatric Association, the American Association of 
     Nurse Practitioners, the American Academy of Physician 
     Assistants, or any other organization that the Secretary 
     determines is appropriate for purposes of this subclause; or
       ``(bb) has such other training or experience as the 
     Secretary determines will demonstrate the ability of the 
     nurse practitioner or physician assistant to treat and manage 
     opiate-dependent patients.
       ``(III) The nurse practitioner or physician assistant is 
     supervised by, or works in collaboration with, a qualifying 
     physician, if the nurse practitioner or physician assistant 
     is required by State law to prescribe medications for the 
     treatment of opioid use disorder in collaboration with or 
     under the supervision of a physician.

     The Secretary may, by regulation, revise the requirements for 
     being a qualifying other practitioner under this clause.''; 
     and
       (D) in subparagraph (H)--
       (i) in clause (i), by inserting after subclause (II) the 
     following:
       ``(III) Such other elements of the requirements under this 
     paragraph as the Secretary determines necessary for purposes 
     of implementing such requirements.''; and
       (ii) by amending clause (ii) to read as follows:
       ``(ii) Not later than 18 months after the date of enactment 
     of the Opioid Use Disorder Treatment Expansion and 
     Modernization Act, the Secretary shall update the treatment 
     improvement protocol containing best practice guidelines for 
     the treatment of opioid-dependent patients in office-based 
     settings. The Secretary shall update such protocol in 
     consultation with experts in opioid use disorder research and 
     treatment.''.
       (2) Opioid defined.--Section 102(18) of the Controlled 
     Substances Act (21 U.S.C. 802(18)) is amended by inserting 
     ``or `opioid' '' after ``The term `opiate' ''.
       (3) Reports to congress.--
       (A) In general.--Not later than 3 years after the date of 
     enactment of this Act and not later than 3 years thereafter, 
     the Secretary of Health and Human Services, in consultation 
     with the Drug Enforcement Administration and experts in 
     opioid use disorder research and treatment, shall--
       (i) perform a thorough review of the provision of opioid 
     use disorder treatment services in the United States, 
     including services provided in opioid treatment programs and 
     other specialty and nonspecialty settings; and
       (ii) submit a report to the Congress on the findings and 
     conclusions of such review.
       (B) Contents.--Each report under subparagraph (A) shall 
     include an assessment of--
       (i) compliance with the requirements of section 303(g)(2) 
     of the Controlled Substances Act (21 U.S.C. 823(g)(2)), as 
     amended by this section;
       (ii) the measures taken by the Secretary of Health and 
     Human Services to ensure such compliance;
       (iii) whether there is further need to increase or decrease 
     the number of patients a practitioner, pursuant to a waiver 
     under section 303(g)(2) of the Controlled Substances Act (21 
     U.S.C. 823(g)(2)), is permitted to treat;
       (iv) the extent to which, and proportions with which, the 
     full range of Food and Drug Administration-approved 
     treatments for opioid use disorder are used in routine health 
     care settings

[[Page H4400]]

     and specialty substance use disorder treatment settings;
       (v) access to, and use of, counseling and recovery support 
     services, including the percentage of patients receiving such 
     services;
       (vi) changes in State or local policies and legislation 
     relating to opioid use disorder treatment;
       (vii) the use of prescription drug monitoring programs by 
     practitioners who are permitted to dispense narcotic drugs to 
     individuals pursuant to a waiver described in clause (iii);
       (viii) the findings resulting from inspections by the Drug 
     Enforcement Administration of practitioners described in 
     clause (vii); and
       (ix) the effectiveness of cross-agency collaboration 
     between Department of Health and Human Services and the Drug 
     Enforcement Administration for expanding effective opioid use 
     disorder treatment.
       (b) State Flexibility.--Section 303(g)(2) of the Controlled 
     Substances Act (21 U.S.C. 823(g)(2)) is amended by striking 
     subparagraphs (I) and (J), and inserting the following:
       ``(I) Notwithstanding section 708, nothing in this 
     paragraph shall be construed to preempt any State law that--
       ``(i) permits a qualifying practitioner to dispense 
     narcotic drugs in schedule III, IV, or V, or combinations of 
     such drugs, for maintenance or detoxification treatment in 
     accordance with this paragraph to a total number of patients 
     that is more than 30 or less than the total number applicable 
     to the qualifying practitioner under subparagraph 
     (B)(iii)(II) if a State enacts a law modifying such total 
     number and the Attorney General is notified by the State of 
     such modification; or
       ``(ii) requires a qualifying practitioner to comply with 
     additional requirements relating to the dispensing of 
     narcotic drugs in schedule III, IV, or V, or combinations of 
     such drugs, including requirements relating to the practice 
     setting in which the qualifying practitioner practices and 
     education, training, and reporting requirements.''.
       (c) Update Regulations.--Not later than 18 months after the 
     date of enactment of this Act, the Attorney General and the 
     Secretary of Health and Human Services, as appropriate, shall 
     update regulations regarding practitioners described in 
     subsection (a)(3)(B)(vii) (as amended by this section) to 
     include nurse practitioners and physician assistants to 
     ensure the quality of patient care and prevent diversion.

              TITLE IV--ADDRESSING COLLATERAL CONSEQUENCES

     SEC. 401. GAO REPORT ON RECOVERY AND COLLATERAL CONSEQUENCES.

       (a) Report Required.--Not later than 1 year after the date 
     of enactment of this Act, the Comptroller General of the 
     United States shall submit to the Committee on the Judiciary 
     of the Senate and the Committee on the Judiciary of the House 
     of Representatives a report that--
       (1) describes the collateral consequences for individuals 
     with convictions for nonviolent drug-related offenses;
       (2) describes the effect of the collateral consequences 
     described in paragraph (1) on individuals in resuming their 
     personal and professional activities, especially, to the 
     extent data are available, the effect on individuals who are 
     participating in or have completed a recovery program for a 
     substance use disorder;
       (3) discusses policy bases and justifications for imposing 
     collateral consequences on individuals convicted of 
     nonviolent drug-related offenses identified under paragraph 
     (1); and
       (4) provides perspectives on the potential for mitigating 
     the effect of the collateral consequences described in 
     paragraph (1) on individuals who are participating in or have 
     completed a recovery program, while also taking into account 
     the policy interests described in paragraph (3).
       (b) Definition.--In this section, the term ``collateral 
     consequence''--
       (1) means a penalty, disability, or disadvantage imposed 
     upon an individual as a result of a criminal conviction for a 
     drug-related offense--
       (A) automatically by operation of law; or
       (B) by authorized action of an administrative agency or 
     court on a case-by-case basis; and
       (2) does not include a direct consequence imposed as part 
     of the judgment of a court at sentencing, including a term of 
     imprisonment or community supervision, or a fine.

  TITLE V--ADDICTION AND TREATMENT SERVICES FOR WOMEN, FAMILIES, AND 
                                VETERANS

     SEC. 501. IMPROVING TREATMENT FOR PREGNANT AND POSTPARTUM 
                   WOMEN.

       (a) General Amendments to the Residential Treatment Program 
     for Pregnant and Postpartum Women.--Section 508 of the Public 
     Health Service Act (42 U.S.C. 290bb-1) is amended--
       (1) in subsection (a)--
       (A) in the matter preceding paragraph (1)--
       (i) by inserting ``(referred to in this section as the 
     `Director')'' after ``Substance Abuse Treatment'';
       (ii) by striking ``grants, cooperative agreement,'' and 
     inserting ``grants, including the grants under subsection 
     (r), cooperative agreements''; and
       (iii) by striking ``for substance abuse'' and inserting 
     ``for substance use disorders''; and
       (B) in paragraph (1), by inserting ``or receive outpatient 
     treatment services from'' after ``reside in'';
       (2) in subsection (b)(2), by inserting ``and her children'' 
     before the period at the end;
       (3) in subsection (c)--
       (A) in paragraph (1), by striking ``to the woman of the 
     services'' and inserting ``of services for the woman and her 
     children''; and
       (B) in paragraph (2)--
       (i) in subparagraph (A), by striking ``substance abuse'' 
     and inserting ``substance use disorders''; and
       (ii) in subparagraph (B), by striking ``such abuse'' and 
     inserting ``such a disorder'';
       (4) in subsection (d)--
       (A) in paragraph (3)(A), by striking ``maternal substance 
     abuse'' and inserting ``a maternal substance use disorder'';
       (B) by amending paragraph (4) to read as follows:
       ``(4) Providing therapeutic, comprehensive child care for 
     children during the periods in which the woman is engaged in 
     therapy or in other necessary health and rehabilitative 
     activities.'';
       (C) in paragraphs (9), (10), and (11), by striking 
     ``women'' each place such term appears and inserting 
     ``woman'';
       (D) in paragraph (9), by striking ``units'' and inserting 
     ``unit''; and
       (E) in paragraph (11)--
       (i) in subparagraph (A), by striking ``their children'' and 
     inserting ``any child of such woman'';
       (ii) in subparagraph (B), by striking ``; and'' and 
     inserting a semicolon;
       (iii) in subparagraph (C), by striking the period and 
     inserting ``; and''; and
       (iv) by adding at the end the following:
       ``(D) family reunification with children in kinship or 
     foster care arrangements, where safe and appropriate.'';
       (5) in subsection (e)--
       (A) in paragraph (1)--
       (i) in the matter preceding subparagraph (A), by striking 
     ``substance abuse'' and inserting ``substance use 
     disorders''; and
       (ii) in subparagraph (B), by striking ``substance abuse'' 
     and inserting ``substance use disorders''; and
       (B) in paragraph (2)--
       (i) by striking ``(A) Subject'' and inserting the 
     following:
       ``(A) In general.--Subject'';
       (ii) in subparagraph (B)--

       (I) by striking ``(B)(i) In the case'' and inserting the 
     following:

       ``(B) Waiver of participation agreements.--
       ``(i) In general.--In the case''; and

       (II) by striking ``(ii) A determination'' and inserting the 
     following:

       ``(ii) Donations.--A determination''; and
       (iii) by striking ``(C) With respect'' and inserting the 
     following:
       ``(C) Nonapplication of certain requirements.--With 
     respect'';
       (6) in subsection (g)--
       (A) by striking ``who are engaging in substance abuse'' and 
     inserting ``who have a substance use disorder''; and
       (B) by striking ``such abuse'' and inserting ``such 
     disorder'';
       (7) in subsection (j)--
       (A) in the matter preceding paragraph (1), by striking ``to 
     on'' and inserting ``to or on''; and
       (B) in paragraph (3), by striking ``Office for'' and 
     inserting ``Office of'';
       (8) by amending subsection (m) to read as follows:
       ``(m) Allocation of Awards.--In making awards under 
     subsection (a), the Director shall give priority to an 
     applicant that agrees to use the award for a program serving 
     an area that is a rural area, an area designated under 
     section 332 by the Secretary as a health professional 
     shortage area, or an area determined by the Director to have 
     a shortage of family-based substance use disorder treatment 
     options.''; and
       (9) in subsection (q)--
       (A) in paragraph (3), by striking ``funding agreement under 
     subsection (a)'' and inserting ``funding agreement''; and
       (B) in paragraph (4), by striking ``substance abuse'' and 
     inserting ``a substance use disorder''.
       (b) Reauthorization of Program.--Section 508 of the Public 
     Health Service Act (42 U.S.C. 290bb-1), as amended by 
     subsection (a), is further amended--
       (1) in subsection (p), in the first sentence, by inserting 
     ``(other than subsection (r))'' after ``section''; and
       (2) in subsection (r), by striking ``such sums'' and all 
     that follows through ``2003'' and inserting ``$16,900,000 for 
     each of fiscal years 2017 through 2021''.
       (c) Pilot Program Grants for State Substance Abuse 
     Agencies.--
       (1) In general.--Section 508 of the Public Health Service 
     Act (42 U.S.C. 290bb-1), as amended by subsections (a) and 
     (b), is further amended--
       (A) by redesignating subsection (r), as amended by 
     subsection (b), as subsection (s); and
       (B) by inserting after subsection (q) the following new 
     subsection:
       ``(r) Pilot Program for State Substance Abuse Agencies.--
       ``(1) In general.--From amounts made available under 
     subsection (s), the Director of the Center for Substance 
     Abuse Treatment shall carry out a pilot program under which 
     competitive grants are made by the Director to State 
     substance abuse agencies--
       ``(A) to enhance flexibility in the use of funds designed 
     to support family-based services for pregnant and postpartum 
     women with a primary diagnosis of a substance use disorder, 
     including opioid use disorders;
       ``(B) to help State substance abuse agencies address 
     identified gaps in services furnished to such women along the 
     continuum of care, including services provided to women in 
     nonresidential-based settings; and
       ``(C) to promote a coordinated, effective, and efficient 
     State system managed by State substance abuse agencies by 
     encouraging new approaches and models of service delivery.
       ``(2) Requirements.--In carrying out the pilot program 
     under this subsection, the Director shall--

[[Page H4401]]

       ``(A) require State substance abuse agencies to submit to 
     the Director applications, in such form and manner and 
     containing such information as specified by the Director, to 
     be eligible to receive a grant under the program;
       ``(B) identify, based on such submitted applications, State 
     substance abuse agencies that are eligible for such grants;
       ``(C) require services proposed to be furnished through 
     such a grant to support family-based treatment and other 
     services for pregnant and postpartum women with a primary 
     diagnosis of a substance use disorder, including opioid use 
     disorders;
       ``(D) not require that services furnished through such a 
     grant be provided solely to women that reside in facilities;
       ``(E) not require that grant recipients under the program 
     make available through use of the grant all the services 
     described in subsection (d); and
       ``(F) consider not applying the requirements described in 
     paragraphs (1) and (2) of subsection (f) to an applicant, 
     depending on the circumstances of the applicant.
       ``(3) Required services.--
       ``(A) In general.--The Director shall specify a minimum set 
     of services required to be made available to eligible women 
     through a grant awarded under the pilot program under this 
     subsection. Such minimum set of services--
       ``(i) shall include the services requirements described in 
     subsection (c) and be based on the recommendations submitted 
     under subparagraph (B); and
       ``(ii) may be selected from among the services described in 
     subsection (d) and include other services as appropriate.
       ``(B) Stakeholder input.--The Director shall convene and 
     solicit recommendations from stakeholders, including State 
     substance abuse agencies, health care providers, persons in 
     recovery from substance abuse, and other appropriate 
     individuals, for the minimum set of services described in 
     subparagraph (A).
       ``(4) Duration.--The pilot program under this subsection 
     shall not exceed 5 years.
       ``(5) Evaluation and report to congress.--
       ``(A) In general.--The Director of the Center for 
     Behavioral Health Statistics and Quality shall evaluate the 
     pilot program at the conclusion of the first grant cycle 
     funded by the pilot program.
       ``(B) Report.--The Director of the Center for Behavioral 
     Health Statistics and Quality, in coordination with the 
     Director of the Center for Substance Abuse Treatment shall 
     submit to the relevant committees of jurisdiction of the 
     House of Representatives and the Senate a report on the 
     evaluation under subparagraph (A). The report shall include, 
     at a minimum--
       ``(i) outcomes information from the pilot program, 
     including any resulting reductions in the use of alcohol and 
     other drugs;
       ``(ii) engagement in treatment services;
       ``(iii) retention in the appropriate level and duration of 
     services;
       ``(iv) increased access to the use of medications approved 
     by the Food and Drug Administration for the treatment of 
     substance use disorders in combination with counseling; and
       ``(v) other appropriate measures.
       ``(C) Recommendation.--The report under subparagraph (B) 
     shall include a recommendation by the Director of the Center 
     for Substance Abuse Treatment as to whether the pilot program 
     under this subsection should be extended.
       ``(6) State substance abuse agencies defined.--For purposes 
     of this subsection, the term `State substance abuse agency' 
     means, with respect to a State, the agency in such State that 
     manages the Substance Abuse Prevention and Treatment Block 
     Grant under part B of title XIX.''.
       (2) Funding.--Subsection (s) of section 508 of the Public 
     Health Service Act (42 U.S.C. 290bb-1), as amended by 
     subsection (a) and redesignated by paragraph (1), is further 
     amended by adding at the end the following new sentences: 
     ``Of the amounts made available for a year pursuant to the 
     previous sentence to carry out this section, not more than 25 
     percent of such amounts shall be made available for such year 
     to carry out subsection (r), other than paragraph (5) of such 
     subsection. Notwithstanding the preceding sentence, no funds 
     shall be made available to carry out subsection (r) for a 
     fiscal year unless the amount made available to carry out 
     this section for such fiscal year is more than the amount 
     made available to carry out this section for fiscal year 
     2016.''.

     SEC. 502. VETERANS TREATMENT COURTS.

       Section 2991 of the Omnibus Crime Control and Safe Streets 
     Act of 1968 (42 U.S.C. 3797aa) is amended--
       (1) by redesignating subsection (i) as subsection (j); and
       (2) by inserting after subsection (h) the following:
       ``(i) Assisting Veterans.--
       ``(1) Definitions.--In this subsection:
       ``(A) Peer-to-peer services or programs.--The term `peer-
     to-peer services or programs' means services or programs that 
     connect qualified veterans with other veterans for the 
     purpose of providing support and mentorship to assist 
     qualified veterans in obtaining treatment, recovery, 
     stabilization, or rehabilitation.
       ``(B) Qualified veteran.--The term `qualified veteran' 
     means a preliminarily qualified offender who--
       ``(i) served on active duty in any branch of the Armed 
     Forces, including the National Guard or Reserves; and
       ``(ii) was discharged or released from such service under 
     conditions other than dishonorable, unless the reason for the 
     dishonorable discharge was attributable to a substance abuse 
     disorder.
       ``(C) Veterans treatment court program.--The term `veterans 
     treatment court program' means a court program involving 
     collaboration among criminal justice, veterans, and mental 
     health and substance abuse agencies that provides qualified 
     veterans with--
       ``(i) intensive judicial supervision and case management, 
     which may include random and frequent drug testing where 
     appropriate;
       ``(ii) a full continuum of treatment services, including 
     mental health services, substance abuse services, medical 
     services, and services to address trauma;
       ``(iii) alternatives to incarceration; or
       ``(iv) other appropriate services, including housing, 
     transportation, mentoring, employment, job training, 
     education, or assistance in applying for and obtaining 
     available benefits.
       ``(2) Veterans assistance program.--
       ``(A) In general.--The Attorney General, in consultation 
     with the Secretary of Veterans Affairs, may award grants 
     under this subsection to applicants to establish or expand--
       ``(i) veterans treatment court programs;
       ``(ii) peer-to-peer services or programs for qualified 
     veterans;
       ``(iii) practices that identify and provide treatment, 
     rehabilitation, legal, transitional, and other appropriate 
     services to qualified veterans who have been incarcerated; or
       ``(iv) training programs to teach criminal justice, law 
     enforcement, corrections, mental health, and substance abuse 
     personnel how to identify and appropriately respond to 
     incidents involving qualified veterans.
       ``(B) Priority.--In awarding grants under this subsection, 
     the Attorney General shall give priority to applications 
     that--
       ``(i) demonstrate collaboration between and joint 
     investments by criminal justice, mental health, substance 
     abuse, and veterans service agencies;
       ``(ii) promote effective strategies to identify and reduce 
     the risk of harm to qualified veterans and public safety; and
       ``(iii) propose interventions with empirical support to 
     improve outcomes for qualified veterans.''.

     SEC. 503. INFANT PLAN OF SAFE CARE.

       (a) Best Practices for Development of Plans of Safe Care.--
     Section 103(b) of the Child Abuse Prevention and Treatment 
     Act (42 U.S.C. 5104(b)) is amended--
       (1) by redesignating paragraphs (5) through (8) as 
     paragraphs (6) through (9), respectively; and
       (2) by inserting after paragraph (4) the following:
       ``(5) maintain and disseminate information about the 
     requirements of section 106(b)(2)(B)(iii) and best practices 
     relating to the development of plans of safe care as 
     described in such section for infants born and identified as 
     being affected by substance abuse or withdrawal symptoms, or 
     a Fetal Alcohol Spectrum Disorder;''.
       (b) State Plans.--Section 106(b)(2)(B) of the Child Abuse 
     Prevention and Treatment Act (42 U.S.C. 5106a(b)(2)(B)) is 
     amended--
       (1) in clause (ii), by striking ``illegal substance abuse'' 
     and inserting ``substance abuse''; and
       (2) in clause (iii)--
       (A) by striking ``illegal substance abuse'' and inserting 
     ``substance abuse''; and
       (B) by inserting before the semicolon at the end the 
     following: ``to ensure the safety and well-being of such 
     infant following release from the care of health care 
     providers, including through--
       ``(I) addressing the health and substance use disorder 
     treatment needs of the infant and affected family or 
     caregiver; and
       ``(II) the development and implementation by the State of 
     monitoring systems regarding the implementation of such plans 
     to determine whether and in what manner local entities are 
     providing, in accordance with State requirements, referrals 
     to and delivery of appropriate services for the infant and 
     affected family or caregiver''.
       (c) Data Reports.--
       (1) In general.--Section 106(d) of the Child Abuse 
     Prevention and Treatment Act (42 U.S.C. 5106a(d)) is amended 
     by adding at the end of the following:
       ``(17) The number of infants--
       ``(A) identified under subsection (b)(2)(B)(ii);
       ``(B) for whom a plan of safe care was developed under 
     subsection (b)(2)(B)(iii); and
       ``(C) for whom a referral was made for appropriate 
     services, including services for the affected family or 
     caregiver, under subsection (b)(2)(B)(iii).''.
       (2) Redesignation.--Effective on May 29, 2017, section 
     106(d) of the Child Abuse Prevention and Treatment Act (42 
     U.S.C. 5106a(d)) is amended by redesignating paragraph (17) 
     (as added by paragraph (1)) as paragraph (18).
       (d) Monitoring and Oversight.--
       (1) Amendment.--Title I of the Child Abuse Prevention and 
     Treatment Act (42 U.S.C. 5101 et seq.) is amended by adding 
     at the end the following:

     ``SEC. 114. MONITORING AND OVERSIGHT.

       ``The Secretary shall conduct monitoring to ensure that 
     each State that receives a grant under section 106 is in 
     compliance with the requirements of section 106(b), which--
       ``(1) shall--
       ``(A) be in addition to the review of the State plan upon 
     its submission under section 106(b)(1)(A); and
       ``(B) include monitoring of State policies and procedures 
     required under clauses (ii) and (iii) of section 
     106(b)(2)(B); and
       ``(2) may include--
       ``(A) a comparison of activities carried out by the State 
     to comply with the requirements of section 106(b) with the 
     State plan most recently approved under section 432 of the 
     Social Security Act;
       ``(B) a review of information available on the website of 
     the State relating to its compliance with the requirements of 
     section 106(b);
       ``(C) site visits, as may be necessary to carry out such 
     monitoring; and

[[Page H4402]]

       ``(D) a review of information available in the State's 
     Annual Progress and Services Report most recently submitted 
     under section 1357.16 of title 45, Code of Federal 
     Regulations (or successor regulations).''.
       (2) Table of contents.--The table of contents in section 
     1(b) of the Child Abuse Prevention and Treatment Act (42 
     U.S.C. 5101 note) is amended by inserting after the item 
     relating to section 113, the following:

``Sec. 114. Monitoring and oversight.''.

       (e) Rule of Construction.--Nothing in this section, or the 
     amendments made by this section, shall be construed to 
     authorize the Secretary of Health and Human Services or any 
     other officer of the Federal Government to add new 
     requirements to section 106(b) of the Child Abuse Prevention 
     and Treatment Act (42 U.S.C. 5106a(b)), as amended by this 
     section.

     SEC. 504. GAO REPORT ON NEONATAL ABSTINENCE SYNDROME (NAS).

       (a) In General.--Not later than 1 year after the date of 
     the enactment of this Act, the Comptroller General of the 
     United States shall submit to the Committee on Energy and 
     Commerce of the House of Representatives and the Committee on 
     Finance and the Committee on Health, Education, Labor, and 
     Pensions of the Senate a report on neonatal abstinence 
     syndrome (in this section referred to as ``NAS'') in the 
     United States.
       (b) Information To Be Included in Report.--Such report 
     shall include information on the following:
       (1) The prevalence of NAS in the United States, including 
     the proportion of children born in the United States with NAS 
     who are eligible for medical assistance under State Medicaid 
     programs under title XIX of the Social Security Act (42 
     U.S.C. 1396 et seq.) at birth, and the costs associated with 
     coverage under such programs for treatment of infants with 
     NAS.
       (2) The services for which coverage is available under 
     State Medicaid programs for treatment of infants with NAS.
       (3) The settings (including inpatient, outpatient, 
     hospital-based, and other settings) for the treatment of 
     infants with NAS and the reimbursement methodologies and 
     costs associated with such treatment in such settings.
       (4) The prevalence of utilization of various care settings 
     under State Medicaid programs for treatment of infants with 
     NAS and any Federal barriers to treating such infants under 
     such programs, particularly in non-hospital-based settings.
       (5) What is known about best practices for treating infants 
     with NAS.
       (c) Recommendations.--Such report also shall include such 
     recommendations as the Comptroller General determines 
     appropriate for improvements that will ensure access to 
     treatment for infants with NAS under State Medicaid programs.

  TITLE VI--INCENTIVIZING STATE COMPREHENSIVE INITIATIVES TO ADDRESS 
                       PRESCRIPTION OPIOID ABUSE

     SEC. 601. STATE DEMONSTRATION GRANTS FOR COMPREHENSIVE OPIOID 
                   ABUSE RESPONSE.

       Part D of title V of the Public Health Service Act (42 
     U.S.C. 290dd et seq.), as amended by section 302, is further 
     amended by adding at the end the following:

     ``SEC. 548. STATE DEMONSTRATION GRANTS FOR COMPREHENSIVE 
                   OPIOID ABUSE RESPONSE.

       ``(a) Definitions.--In this section:
       ``(1) Dispenser.--The term `dispenser' has the meaning 
     given the term in section 102 of the Controlled Substances 
     Act (21 U.S.C. 802).
       ``(2) Prescriber.--The term `prescriber' means a dispenser 
     who prescribes a controlled substance, or the agent of such a 
     dispenser.
       ``(3) Prescriber of a schedule ii, iii, or iv controlled 
     substance.--The term `prescriber of a schedule II, III, or IV 
     controlled substance' does not include a prescriber of a 
     schedule II, III, or IV controlled substance that dispenses 
     the substance--
       ``(A) for use on the premises on which the substance is 
     dispensed;
       ``(B) in a hospital emergency room, when the substance is 
     in short supply;
       ``(C) for a certified opioid treatment program; or
       ``(D) in other situations as the Secretary may reasonably 
     determine.
       ``(4) Schedule ii, iii, or iv controlled substance.--The 
     term `schedule II, III, or IV controlled substance' means a 
     controlled substance that is listed on schedule II, schedule 
     III, or schedule IV of section 202(c) of the Controlled 
     Substances Act.
       ``(b) Grants for Comprehensive Opioid Abuse Response.--
       ``(1) In general.--The Secretary shall award grants to 
     States, and combinations of States, to implement an 
     integrated opioid abuse response initiative.
       ``(2) Purposes.--A State receiving a grant under this 
     section shall establish a comprehensive response plan to 
     opioid abuse, which may include--
       ``(A) education efforts around opioid use, treatment, and 
     addiction recovery, including education of residents, medical 
     students, and physicians and other prescribers of schedule 
     II, III, or IV controlled substances on relevant prescribing 
     guidelines, the prescription drug monitoring program of the 
     State described in subparagraph (B), and overdose prevention 
     methods;
       ``(B) establishing, maintaining, or improving a 
     comprehensive prescription drug monitoring program to track 
     dispensing of schedule II, III, or IV controlled substances, 
     which may--
       ``(i) provide for data sharing with other States; and
       ``(ii) allow all individuals authorized by the State to 
     write prescriptions for schedule II, III, or IV controlled 
     substances to access the prescription drug monitoring program 
     of the State;
       ``(C) developing, implementing, or expanding prescription 
     drug and opioid addiction treatment programs by--
       ``(i) expanding the availability of treatment for 
     prescription drug and opioid addiction, including medication-
     assisted treatment and behavioral health therapy, as 
     appropriate;
       ``(ii) developing, implementing, or expanding screening for 
     individuals in treatment for prescription drug and opioid 
     addiction for hepatitis C and HIV, and treating or referring 
     those individuals if clinically appropriate; or
       ``(iii) developing, implementing, or expanding recovery 
     support services and programs at high schools or institutions 
     of higher education;
       ``(D) developing, implementing, and expanding efforts to 
     prevent overdose death from opioid abuse or addiction to 
     prescription medications and opioids; and
       ``(E) advancing the education and awareness of the public, 
     providers, patients, consumers, and other appropriate 
     entities regarding the dangers of opioid abuse, safe disposal 
     of prescription medications, and detection of early warning 
     signs of opioid use disorders.
       ``(3) Application.--A State seeking a grant under this 
     section shall submit to the Secretary an application in such 
     form, and containing such information, as the Secretary may 
     reasonably require.
       ``(4) Use of funds.--A State that receives a grant under 
     this section shall use the grant for the cost, including the 
     cost for technical assistance, training, and administration 
     expenses, of carrying out an integrated opioid abuse response 
     initiative as outlined by the State's comprehensive response 
     plan to opioid abuse established under paragraph (2).
       ``(5) Priority considerations.--In awarding grants under 
     this section, the Secretary shall, as appropriate, give 
     priority to a State that--
       ``(A)(i) provides civil liability protection for first 
     responders, health professionals, and family members who have 
     received appropriate training in administering a drug or 
     device approved or cleared under the Federal Food, Drug, and 
     Cosmetic Act for emergency treatment of known or suspected 
     opioid overdose; and
       ``(ii) submits to the Secretary a certification by the 
     attorney general of the State that the attorney general has--
       ``(I) reviewed any applicable civil liability protection 
     law to determine the applicability of the law with respect to 
     first responders, health care professionals, family members, 
     and other individuals who--

       ``(aa) have received appropriate training in administering 
     a drug or device approved or cleared under the Federal Food, 
     Drug, and Cosmetic Act for emergency treatment of known or 
     suspected opioid overdose; and
       ``(bb) may administer a drug or device approved or cleared 
     under the Federal Food, Drug, and Cosmetic Act for emergency 
     treatment of known or suspected opioid overdose; and

       ``(II) concluded that the law described in subclause (I) 
     provides adequate civil liability protection applicable to 
     such persons;
       ``(B) has a process for enrollment in services and benefits 
     necessary by criminal justice agencies to initiate or 
     continue treatment in the community, under which an 
     individual who is incarcerated may, while incarcerated, 
     enroll in services and benefits that are necessary for the 
     individual to continue treatment upon release from 
     incarceration;
       ``(C) ensures the capability of data sharing with other 
     States, where applicable, such as by making data available to 
     a prescription monitoring hub;
       ``(D) ensures that data recorded in the prescription drug 
     monitoring program database of the State are regularly 
     updated, to the extent possible;
       ``(E) ensures that the prescription drug monitoring program 
     of the State notifies prescribers and dispensers of schedule 
     II, III, or IV controlled substances when overuse or misuse 
     of such controlled substances by patients is suspected; and
       ``(F) has in effect one or more statutes or implements 
     policies that maximize use of prescription drug monitoring 
     programs by individuals authorized by the State to prescribe 
     schedule II, III, or IV controlled substances.
       ``(6) Evaluation.--In conducting an evaluation of the 
     program under this section pursuant to section 701 of the 
     Comprehensive Addiction and Recovery Act of 2016, with 
     respect to a State, the Secretary shall report on State 
     legislation or policies related to maximizing the use of 
     prescription drug monitoring programs and the incidence of 
     opioid use disorders and overdose deaths in such State.
       ``(7) States with local prescription drug monitoring 
     programs.--
       ``(A) In general.--In the case of a State that does not 
     have a prescription drug monitoring program, a county or 
     other unit of local government within the State that has a 
     prescription drug monitoring program shall be treated as a 
     State for purposes of this section, including for purposes of 
     eligibility for grants under paragraph (1).
       ``(B) Plan for interoperability.--In submitting an 
     application to the Secretary under paragraph (3), a county or 
     other unit of local government shall submit a plan outlining 
     the methods such county or unit of local government shall use 
     to ensure the capability of data sharing with other counties 
     and units of local government within the state and with other 
     States, as applicable.
       ``(c) Authorization of Funding.--For the purpose of 
     carrying out this section, there are authorized to be 
     appropriated $5,000,000 for each of fiscal years 2017 through 
     2021.''.

                        TITLE VII--MISCELLANEOUS

     SEC. 701. GRANT ACCOUNTABILITY AND EVALUATIONS.

       (a) Department of Justice Grant Accountability.--Part LL of 
     title I of the Omnibus

[[Page H4403]]

     Crime Control and Safe Streets Act of 1968 (42 U.S.C. 3711 et 
     seq.), as added by section 201, is amended by adding at the 
     end the following:

     ``SEC. 3026. GRANT ACCOUNTABILITY.

       ``(a) Definition of Applicable Committees.--In this 
     section, the term `applicable committees' means--
       ``(1) the Committee on the Judiciary of the Senate; and
       ``(2) the Committee on the Judiciary of the House of 
     Representatives.
       ``(b) Accountability.--All grants awarded by the Attorney 
     General under this part shall be subject to the following 
     accountability provisions:
       ``(1) Audit requirement.--
       ``(A) Definition.--In this paragraph, the term `unresolved 
     audit finding' means a finding in the final audit report of 
     the Inspector General of the Department of Justice that the 
     audited grantee has utilized grant funds for an unauthorized 
     expenditure or otherwise unallowable cost that is not closed 
     or resolved within 12 months after the date on which the 
     final audit report is issued.
       ``(B) Audit.--Beginning in the first fiscal year beginning 
     after the date of enactment of this section, and in each 
     fiscal year thereafter, the Inspector General of the 
     Department of Justice shall conduct audits of recipients of 
     grants awarded by the Attorney General under this part to 
     prevent waste, fraud, and abuse of funds by grantees. The 
     Inspector General shall determine the appropriate number of 
     grantees to be audited each year.
       ``(C) Mandatory exclusion.--A recipient of grant funds 
     under this part that is found to have an unresolved audit 
     finding shall not be eligible to receive grant funds under 
     this part during the first 2 fiscal years beginning after the 
     end of the 12-month period described in subparagraph (A).
       ``(D) Priority.--In awarding grants under this part, the 
     Attorney General shall give priority to eligible applicants 
     that did not have an unresolved audit finding during the 3 
     fiscal years before submitting an application for a grant 
     under this part.
       ``(E) Reimbursement.--If an entity is awarded grant funds 
     under this part during the 2-fiscal-year period during which 
     the entity is barred from receiving grants under subparagraph 
     (C), the Attorney General shall--
       ``(i) deposit an amount equal to the amount of the grant 
     funds that were improperly awarded to the grantee into the 
     General Fund of the Treasury; and
       ``(ii) seek to recoup the costs of the repayment to the 
     fund from the grant recipient that was erroneously awarded 
     grant funds.
       ``(2) Nonprofit organization requirements.--
       ``(A) Definition.--For purposes of this paragraph and the 
     grant programs under this part, the term `nonprofit 
     organization' means an organization that is described in 
     section 501(c)(3) of the Internal Revenue Code of 1986 and is 
     exempt from taxation under section 501(a) of such Code.
       ``(B) Prohibition.--A nonprofit organization that holds 
     money in offshore accounts for the purpose of avoiding paying 
     the tax described in section 511(a) of the Internal Revenue 
     Code of 1986 may not--
       ``(i) be party to a contract entered into under section 
     3021(b); or
       ``(ii) receive a subaward under section 3021(b).
       ``(C) Disclosure.--Each nonprofit organization that 
     receives a subaward or is party to a contract entered into 
     under section 3021(b) and uses the procedures prescribed in 
     regulations to create a rebuttable presumption of 
     reasonableness for the compensation of its officers, 
     directors, trustees, and key employees, shall disclose, in 
     the application for such contract or subaward, the process 
     for determining such compensation, including the independent 
     persons involved in reviewing and approving such 
     compensation, the comparability data used, and 
     contemporaneous substantiation of the deliberation and 
     decision. Upon request, the Attorney General shall make the 
     information disclosed under this subparagraph available for 
     public inspection.
       ``(3) Conference expenditures.--
       ``(A) Limitation.--No amounts made available to the 
     Attorney General under this part may be used by the Attorney 
     General, or by any State, unit of local government, or entity 
     awarded a grant, subaward, or contract under this part, to 
     host or support any expenditure for conferences that uses 
     more than $20,000 in funds made available by the Attorney 
     General, unless the head of the relevant agency, bureau, or 
     program office provides prior written authorization that the 
     funds may be expended to host or support the conference.
       ``(B) Written authorization.--Written authorization under 
     subparagraph (A) shall include a written estimate of all 
     costs associated with the conference, including the cost of 
     all food, beverages, audio-visual equipment, honoraria for 
     speakers, and entertainment.
       ``(C) Report.--The Deputy Attorney General shall submit to 
     the applicable committees an annual report on all conference 
     expenditures approved by the Attorney General under this 
     paragraph.
       ``(4) Annual certification.--Beginning in the first fiscal 
     year beginning after the date of enactment of this section, 
     the Attorney General shall submit to the applicable 
     committees an annual certification--
       ``(A) indicating whether--
       ``(i) all audits issued by the Inspector General of the 
     Department of Justice under paragraph (1) have been completed 
     and reviewed by the appropriate Assistant Attorney General or 
     Director;
       ``(ii) all mandatory exclusions required under paragraph 
     (1)(C) have been issued; and
       ``(iii) all reimbursements required under paragraph (1)(E) 
     have been made; and
       ``(B) that includes a list of any grant recipients excluded 
     under paragraph (1) from the previous year.
       ``(c) Preventing Duplicative Grants.--
       ``(1) In general.--Before the Attorney General awards a 
     grant to an applicant under this part, the Attorney General 
     shall compare potential grant awards with other grants 
     awarded under this part by the Attorney General to determine 
     if duplicate grant awards are awarded for the same purpose.
       ``(2) Report.--If the Attorney General awards duplicate 
     grants under this part to the same applicant for the same 
     purpose, the Attorney General shall submit to the applicable 
     committees a report that includes--
       ``(A) a list of all duplicate grants awarded under this 
     part, including the total dollar amount of any duplicate 
     grants awarded; and
       ``(B) the reason the Attorney General awarded the duplicate 
     grants.''.
       (b) Evaluation of Performance of Department of Justice 
     Programs.--
       (1) Evaluation of justice department comprehensive opioid 
     abuse grant program.--Not later than 5 years after the date 
     of enactment of this Act, the Attorney General shall complete 
     an evaluation of the effectiveness of the Comprehensive 
     Opioid Abuse Grant Program under part LL of title I of the 
     Omnibus Crime Control and Safe Streets Act of 1968, as added 
     by section 201, administered by the Department of Justice 
     based upon the information reported under paragraph (4).
       (2) Interim evaluation.--Not later than 3 years after the 
     date of enactment of this Act, the Attorney General shall 
     complete an interim evaluation assessing the nature and 
     extent of the incidence of opioid abuse and illegal opioid 
     distribution in the United States.
       (3) Metrics and outcomes for evaluation.--Not later than 
     180 days after the date of enactment of this Act, the 
     Attorney General shall identify outcomes that are to be 
     achieved by activities funded by the Comprehensive Opioid 
     Abuse Grant Program and the metrics by which the achievement 
     of such outcomes shall be determined.
       (4) Metrics data collection.--The Attorney General shall 
     require grantees under the Comprehensive Opioid Abuse Grant 
     Program (and those receiving subawards under section 3021(b) 
     of part LL of title I of the Omnibus Crime Control and Safe 
     Streets Act of 1968, as added by section 201) to collect and 
     annually report to the Department of Justice data based upon 
     the metrics identified under paragraph (3).
       (5) Publication of data and findings.--
       (A) Publication of outcomes and metrics.--The Attorney 
     General shall, not later than 30 days after completion of the 
     requirement under paragraph (3), publish the outcomes and 
     metrics identified under that paragraph.
       (B) Publication of evaluation.--In the case of the interim 
     evaluation under paragraph (2), and the final evaluation 
     under paragraph (1), the entity conducting the evaluation 
     shall, not later than 90 days after such an evaluation is 
     completed, publish the results of such evaluation and issue a 
     report on such evaluation to the Committee on the Judiciary 
     of the House of Representatives and the Committee on the 
     Judiciary of the Senate. Such report shall also be published 
     along with the data used to make such evaluation.
       (6) Independent evaluation.--For purposes of paragraphs 
     (1), (2), and (3), the Attorney General shall--
       (A) enter into an arrangement with the National Academy of 
     Sciences; or
       (B) enter into a contract or cooperative agreement with an 
     entity that is not an agency of the Federal Government, and 
     is qualified to conduct and evaluate research pertaining to 
     opioid use and abuse, and draw conclusions about overall 
     opioid use and abuse on the basis of that research.
       (c) Department of Health and Human Services Grant 
     Accountability.--
       (1) Definitions.--In this subsection:
       (A) Applicable committees.--The term ``applicable 
     committees'' means--
       (i) the Committee on Health, Education, Labor and Pensions 
     of the Senate; and
       (ii) the Committee on Energy and Commerce of the House of 
     Representatives.
       (B) Covered grant.--The term ``covered grant'' means a 
     grant awarded by the Secretary under a program established 
     under this Act (or an amendment made by this Act, other than 
     sections 703 through 707), including any grant administered 
     by the Administrator of the Substance Abuse and Mental Health 
     Services Administration under section 103.
       (C) Grantee.--The term ``grantee'' means the recipient of a 
     covered grant.
       (D) Secretary.--The term ``Secretary'' means the Secretary 
     of Health and Human Services.
       (2) Accountability measures.--Each covered grant shall be 
     subject to the following accountability requirements:
       (A) Effectiveness report.--The Secretary shall require 
     grantees to report on the effectiveness of the activities 
     carried out with amounts made available to carry out the 
     program under which the covered grant is awarded, including 
     the number of persons served by such grant, if applicable, 
     the number of persons seeking services who could not be 
     served by such grant, and such other information as the 
     Secretary may prescribe.
       (B) Report on prevention of fraud, waste, and abuse.--
       (i) In general.--Not later than 1 year after the date of 
     the enactment of this Act, the Secretary, in coordination 
     with the Inspector General of the Department of Health and 
     Human Services, shall submit to the applicable committees a 
     report on the policies and procedures the Department has in 
     place to prevent waste,

[[Page H4404]]

     fraud, and abuse in the administration of covered grants.
       (ii) Contents.--The policies and procedures referred to in 
     clause (i) shall include policies and procedures that are 
     designed to--

       (I) prevent grantees from utilizing funds awarded through a 
     covered grant for unauthorized expenditures or otherwise 
     unallowable costs; and
       (II) ensure grantees will not receive unwarranted duplicate 
     grants for the same purpose.

       (C) Conference expenditures.--
       (i) In general.--No amounts made available to the Secretary 
     under this Act (or in a provision of law amended by this Act, 
     other than sections 703 through 707) may be used by the 
     Secretary, or by any individual or entity awarded 
     discretionary funds through a cooperative agreement under a 
     program established under this Act (or in a provision of law 
     amended by this Act), to host or support any expenditure for 
     conferences that uses more than $20,000 in funds made 
     available by the Secretary, unless the head of the relevant 
     operating division or program office provides prior written 
     authorization that the funds may be expended to host or 
     support the conference. Such written authorization shall 
     include a written estimate of all costs associated with the 
     conference, including the cost of all food, beverages, audio-
     visual equipment, honoraria for speakers, and entertainment.
       (ii) Report.--The Secretary (or the Secretary's designee) 
     shall submit to the applicable committees an annual report on 
     all conference expenditures approved by the Secretary under 
     this subparagraph.
       (d) Evaluation of Performance of Department of Health and 
     Human Services Programs.--
       (1) Evaluations.--
       (A) In general.--Not later than 5 years after the date of 
     enactment of this Act, except as otherwise provided in this 
     section, the Secretary of Health and Human Services (in this 
     subsection referred to as the ``Secretary'') shall complete 
     an evaluation of any program administered by the Secretary 
     included in this Act (or an amendment made by this Act, 
     excluding sections 703 through 707), including any grant 
     administered by the Administrator of the Substance Abuse and 
     Mental Health Services Administration under section 103, that 
     provides grants for the primary purpose of providing 
     assistance in addressing problems pertaining to opioid abuse 
     based upon the outcomes and metrics identified under 
     paragraph (2).
       (B) Publication.--With respect to each evaluation completed 
     under subparagraph (A), the Secretary shall, not later than 
     90 days after the date on which such evaluation is completed, 
     publish the results of such evaluation and issue a report on 
     such evaluation to the appropriate committees. Such report 
     shall also be published along with the data used to make such 
     evaluation.
       (2) Metrics and outcomes.--
       (A) In general.--Not later than 180 days after the date of 
     enactment of this Act, the Secretary shall identify--
       (i) outcomes that are to be achieved by activities funded 
     by the programs described in paragraph (1)(A); and
       (ii) the metrics by which the achievement of such outcomes 
     shall be determined.
       (B) Publication.--The Secretary shall, not later than 30 
     days after completion of the requirement under subparagraph 
     (A), publish the outcomes and metrics identified under such 
     subparagraph.
       (3) Metrics data collection.--The Secretary shall require 
     grantees under the programs described in paragraph (1)(A) to 
     collect, and annually report to the Secretary, data based 
     upon the metrics identified under paragraph (2)(A).
       (4) Independent evaluation.--For purposes of paragraph (1), 
     the Secretary shall--
       (A) enter into an arrangement with the National Academy of 
     Sciences; or
       (B) enter into a contract or cooperative agreement with an 
     entity that--
       (i) is not an agency of the Federal Government; and
       (ii) is qualified to conduct and evaluate research 
     pertaining to opioid use and abuse and draw conclusions about 
     overall opioid use and abuse on the basis of that research.
       (5) Exception.--If a program described in paragraph (1)(A) 
     is subject to an evaluation similar to the evaluation 
     required under such paragraph pursuant to another provision 
     of Federal law, the Secretary may opt not to conduct an 
     evaluation under such paragraph with respect to such program.
       (e) Additional Report.--In the case of a report submitted 
     under subsection (c) to the applicable committees, if such 
     report pertains to a grant under section 103, that report 
     shall also be submitted, in the same manner and at the same 
     time, to the Committee on Oversight and Government Reform of 
     the House of Representatives and to the Committee on the 
     Judiciary of the Senate.
       (f) No Additional Funds Authorized.--No additional funds 
     are authorized to be appropriated to carry out this section.

     SEC. 702. PARTIAL FILLS OF SCHEDULE II CONTROLLED SUBSTANCES.

       (a) In General.--Section 309 of the Controlled Substances 
     Act (21 U.S.C. 829) is amended by adding at the end the 
     following:
       ``(f) Partial Fills of Schedule II Controlled Substances.--
       ``(1) Partial fills.--A prescription for a controlled 
     substance in schedule II may be partially filled if--
       ``(A) it is not prohibited by State law;
       ``(B) the prescription is written and filled in accordance 
     with this title, regulations prescribed by the Attorney 
     General, and State law;
       ``(C) the partial fill is requested by the patient or the 
     practitioner that wrote the prescription; and
       ``(D) the total quantity dispensed in all partial fillings 
     does not exceed the total quantity prescribed.
       ``(2) Remaining portions.--
       ``(A) In general.--Except as provided in subparagraph (B), 
     remaining portions of a partially filled prescription for a 
     controlled substance in schedule II--
       ``(i) may be filled; and
       ``(ii) shall be filled not later than 30 days after the 
     date on which the prescription is written.
       ``(B) Emergency situations.--In emergency situations, as 
     described in subsection (a), the remaining portions of a 
     partially filled prescription for a controlled substance in 
     schedule II--
       ``(i) may be filled; and
       ``(ii) shall be filled not later than 72 hours after the 
     prescription is issued.
       ``(3) Currently lawful partial fills.--Notwithstanding 
     paragraph (1) or (2), in any circumstance in which, as of the 
     day before the date of enactment of this subsection, a 
     prescription for a controlled substance in schedule II may be 
     lawfully partially filled, the Attorney General may allow 
     such a prescription to be partially filled.''.
       (b) Rule of Construction.--Nothing in this section shall be 
     construed to affect the authority of the Attorney General to 
     allow a prescription for a controlled substance in schedule 
     III, IV, or V of section 202(c) of the Controlled Substances 
     Act (21 U.S.C. 812(c)) to be partially filled.

     SEC. 703. GOOD SAMARITAN ASSESSMENT.

       (a) Finding.--The Congress finds that the executive branch, 
     including the Office of National Drug Control Policy, has a 
     policy focus on preventing and addressing prescription drug 
     misuse and heroin use, and has worked with States and 
     municipalities to enact Good Samaritan laws that would 
     protect caregivers, law enforcement personnel, and first 
     responders who administer opioid overdose reversal drugs or 
     devices.
       (b) GAO Study on Good Samaritan Laws Pertaining to 
     Treatment of Opioid Overdoses.--The Comptroller General of 
     the United States shall submit to the Committee on the 
     Judiciary of the House of Representatives, the Committee on 
     Oversight and Government Reform of the House of 
     Representatives, the Committee on the Judiciary of the 
     Senate, and the Committee on Homeland Security and 
     Governmental Affairs of the Senate a report on--
       (1) the extent to which the Director of National Drug 
     Control Policy has reviewed Good Samaritan laws, and any 
     findings from such a review, including findings related to 
     the potential effects of such laws, if available;
       (2) efforts by the Director to encourage the enactment of 
     Good Samaritan laws; and
       (3) a compilation of Good Samaritan laws in effect in the 
     States, the territories, and the District of Columbia.
       (c) Definitions.--In this section--
       (1) the term ``Good Samaritan law'' means a law of a State 
     or unit of local government that exempts from criminal or 
     civil liability any individual who administers an opioid 
     overdose reversal drug or device, or who contacts emergency 
     services providers in response to an overdose; and
       (2) the term ``opioid'' means any drug, including heroin, 
     having an addiction-forming or addiction-sustaining liability 
     similar to morphine or being capable of conversion into a 
     drug having such addiction-forming or addiction-sustaining 
     liability.

     SEC. 704. PROGRAMS TO PREVENT PRESCRIPTION DRUG ABUSE UNDER 
                   MEDICARE PARTS C AND D.

       (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-10(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 one or more 
     prescribers selected under subparagraph (D), and dispensed 
     for such beneficiary by one or more 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.

       ``(ii) Initial notice.--An initial 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 describing all State and Federal public 
     health resources that are designed to address prescription 
     drug abuse to which the beneficiary has access, including 
     mental health services and other counseling services;
       ``(III) notice of, and information about, the right of the 
     beneficiary to appeal such identification under subsection 
     (h) and the option of an automatic escalation to external 
     review;
       ``(IV) 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

[[Page H4405]]

     identified as an at-risk beneficiary for prescription drug 
     abuse as described in clause (iii)(I);
       ``(V) 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);
       ``(VI) 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; and
       ``(VII) contact information for other organizations that 
     can provide the beneficiary with assistance regarding such 
     drug management program (similar to the information provided 
     by the Secretary in other standardized notices provided to 
     part D eligible individuals enrolled in prescription drug 
     plans under this part).

       ``(iii) Second notice.--A second 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 is 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 (or prescribers) and pharmacy (or 
     pharmacies) selected for such individual under subparagraph 
     (D);
       ``(IV) of, and information about, the beneficiary's right 
     to appeal such identification under subsection (h) and the 
     option of an automatic escalation to external review;
       ``(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.

       ``(iv) Timing of notices.--

       ``(I) In general.--Subject to subclause (II), a second 
     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 (I), the PDP sponsor may provide such second notice 
     on such earlier date.

       ``(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 as such an at-risk beneficiary 
     through the use of clinical guidelines that indicate misuse 
     or abuse of prescription drugs described in subparagraph (G) 
     and that are developed by the Secretary in consultation with 
     PDP sponsors and other stakeholders, including individuals 
     entitled to benefits under part A or enrolled under part B, 
     advocacy groups representing such individuals, physicians, 
     pharmacists, and other clinicians, retail pharmacies, plan 
     sponsors, entities delegated by plan sponsors, and 
     biopharmaceutical manufacturers; 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 the 
     prescription drug plan in which such individual was most 
     recently 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) is a resident of a long-term care facility, of a 
     facility described in section 1905(d), or of another facility 
     for which frequently abused drugs are dispensed for residents 
     through a 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 guidelines 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 and pharmacies.--
       ``(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)(IV) and (iii)(V) of 
     subparagraph (B) (except as otherwise provided in this 
     subparagraph) 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.

     For purposes of subclause (II), in the case of a pharmacy 
     that has multiple locations that share real-time electronic 
     data, all such locations of the pharmacy shall collectively 
     be treated as one pharmacy.
       ``(ii) Reasonable access.--In making the selections under 
     this subparagraph--

       ``(I) a PDP sponsor shall ensure that the beneficiary 
     continues to have reasonable access to frequently abused 
     drugs (as defined in subparagraph (G)), taking into account 
     geographic location, beneficiary preference, impact on 
     costsharing, and reasonable travel time; and
       ``(II) a PDP sponsor shall ensure such access (including 
     access to prescribers and pharmacies with respect to 
     frequently abused drugs) in the case of individuals with 
     multiple residences, in the case of natural disasters and 
     similar situations, and in the case of the provision of 
     emergency services.

       ``(iii) Beneficiary preferences.--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--

       ``(I) review such preferences;
       ``(II) select or change the selection of prescribers and 
     pharmacies for the beneficiary based on such preferences; and
       ``(III) inform the beneficiary of such selection or change 
     of selection.

       ``(iv) Exception regarding beneficiary preferences.--In the 
     case that the PDP sponsor determines that a change to the 
     selection of prescriber or pharmacy under clause (iii)(II) 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 prescriber or 
     pharmacy for the beneficiary without regard to the 
     preferences of the beneficiary described in clause (iii). If 
     the PDP sponsor changes the selection pursuant to the 
     preceding sentence, the PDP sponsor shall provide the 
     beneficiary with--

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

       ``(v) 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) Terminations and 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, 
     the selection of prescriber or pharmacy under subparagraph 
     (D), and information to be shared under subparagraph (I), 
     with respect to such individual, shall be subject to 
     reconsideration and appeal under subsection (h) and the 
     option of an automatic escalation to external review to the 
     extent provided by the Secretary.
       ``(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); and
       ``(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 a controlled substance that the Secretary determines 
     to be frequently abused or diverted.
       ``(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 the 
     PDP sponsor to disclose data, including any necessary 
     individually identifiable health information, in a form and 
     manner specified by the Secretary, about the decision to 
     impose such limitations and the limitations imposed by the 
     sponsor under this part.
       ``(ii) Data to reduce fraud, abuse, and waste.--The 
     Secretary shall establish rules and

[[Page H4406]]

     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 by Medicare administrative contractors 
     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) Application under ma-pd plans.--Pursuant to section 
     1860D-21(c)(1), the provisions of this paragraph apply under 
     part D to MA organizations offering MA-PD plans to MA 
     eligible individuals in the same manner as such provisions 
     apply under this part to a PDP sponsor offering a 
     prescription drug plan to a part D eligible individual.
       ``(M) 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 further 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 (6)(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 (and an MA organization offering an MA-PD 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 (or organization) 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 compliance reviews and program audits 
     biennially include a certification that utilization 
     management tools under this paragraph are in compliance with 
     the requirements for such tools.''.
       (c) Expanding Activities of Medicare Drug Integrity 
     Contractors (MEDICs).--
       (1) In general.--Section 1893 of the Social Security Act 
     (42 U.S.C. 1395ddd) is amended by adding at the end the 
     following new subsection:
       ``(j) Expanding Activities of Medicare Drug Integrity 
     Contractors (MEDICs).--
       ``(1) Access to information.--Under contracts entered into 
     under this section with Medicare drug integrity contractors 
     (including any successor entity to a Medicare drug integrity 
     contractor), the Secretary shall authorize such contractors 
     to directly accept prescription and necessary medical records 
     from entities such as pharmacies, prescription drug plans, 
     MA-PD plans, and physicians with respect to an individual in 
     order for such contractors to provide information relevant to 
     the determination of whether such individual is an at-risk 
     beneficiary for prescription drug abuse, as defined in 
     section 1860D-4(c)(5)(C).
       ``(2) Requirement for acknowledgment of referrals.--If a 
     PDP sponsor or MA organization refers information to a 
     contractor described in paragraph (1) in order for such 
     contractor to assist in the determination described in such 
     paragraph, the contractor shall--
       ``(A) acknowledge to the sponsor or organization receipt of 
     the referral; and
       ``(B) in the case that any PDP sponsor or MA organization 
     contacts the contractor requesting to know the determination 
     by the contractor of whether or not an individual has been 
     determined to be an individual described in such paragraph, 
     shall inform such sponsor or organization of such 
     determination on a date that is not later than 15 days after 
     the date on which the sponsor or organization contacts the 
     contractor.
       ``(3) Making data available to other entities.--
       ``(A) In general.--For purposes of carrying out this 
     subsection, subject to subparagraph (B), the Secretary shall 
     authorize MEDICs to respond to requests for information from 
     PDP sponsors and MA organizations, State prescription drug 
     monitoring programs, and other entities delegated by such 
     sponsors or organizations using available programs and 
     systems in the effort to prevent fraud, waste, and abuse.
       ``(B) HIPAA compliant information only.--Information may 
     only be disclosed by a MEDIC under subparagraph (A) if the 
     disclosure of such information is permitted under the Federal 
     regulations (concerning the privacy of individually 
     identifiable health information) promulgated under section 
     264(c) of the Health Insurance Portability and Accountability 
     Act of 1996 (42 U.S.C. 1320d-2 note).''.
       (2) OIG study and report on effectiveness of medics.--
       (A) Study.--The Inspector General of the Department of 
     Health and Human Services shall conduct a study on the 
     effectiveness of Medicare drug integrity contractors with 
     which the Secretary of Health and Human Services has entered 
     into a contract under section 1893 of the Social Security Act 
     (42 U.S.C. 1395ddd) in identifying, combating, and preventing 
     fraud under the Medicare program, including under the 
     authority provided under section 1893(j) of the Social 
     Security Act, added by paragraph (1).
       (B) Report.--Not later than 24 months after the date of the 
     enactment of this Act, the Inspector General shall submit to 
     Congress a report on the study conducted under subparagraph 
     (A). Such report shall include such recommendations for 
     improvements in the effectiveness of such contractors as the 
     Inspector General determines appropriate.
       (d) 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.''.
       (e) 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.
       (f) Reports.--
       (1) Report by secretary on appeals process.--
       (A) 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.
       (B) Feedback.--In development of the report described in 
     subparagraph (A), 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.
       (2) GAO study and report.--
       (A) 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

[[Page H4407]]

     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--
       (i) 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;
       (ii) 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;
       (iii) the types of--

       (I) individuals who, in the implementation of such section, 
     are determined to be individuals described in such 
     subparagraph (C); and
       (II) prescribers and pharmacies that are selected under 
     subparagraph (D) of such section; and

       (iv) other areas determined appropriate by the Comptroller 
     General.
       (B) 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 subparagraph (A), together with 
     recommendations for such legislation and administrative 
     action as the Comptroller General determines to be 
     appropriate.
       (g) Effective Date; Rulemaking.--
       (1) In general.--The amendments made by this section shall 
     apply to prescription drug plans (and MA-PD plans) for plan 
     years beginning on or after January 1, 2019.
       (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, advocacy groups 
     representing such individuals, physicians, pharmacists, and 
     other clinicians, retail pharmacies, plan sponsors, 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 paragraph 
     (3).
       (B) Topics described.--The topics described in this 
     subparagraph are the topics of--
       (i) the anticipated impact of drug management programs for 
     at-risk beneficiaries under paragraph (5) of section 1860D-
     4(c) of the Social Security Act (42 U.S.C. 1395w-104(c)) on 
     cost-sharing and ensuring accessibility to prescription drugs 
     for enrollees in prescription drug plans of PDP sponsors, and 
     enrollees in MA-PD plans, who are at-risk beneficiaries for 
     prescription drug abuse (as defined in subparagraph (C) of 
     such paragraph);
       (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 that allow an 
     automatic escalation to external review of claims submitted 
     under such part);
       (iii) the types of enrollees that should be treated as 
     exempted individuals, as described in subparagraph (C)(ii) of 
     such paragraph;
       (iv) the manner in which terms and definitions in such 
     paragraph 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;
       (v) the information to be included in the notices described 
     in subparagraph (B) of such paragraph and the standardization 
     of such notices;
       (vi) with respect to a PDP sponsor (or Medicare Advantage 
     organization) that establishes a drug management program for 
     at-risk beneficiaries under such paragraph, the 
     responsibilities of such PDP sponsor (or organization) 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 of 
     title XVIII of the Social Security Act with PDP sponsors.
       (3) Rulemaking.--Not later than one year after the date of 
     the enactment of this Act, the Secretary of Health and Human 
     Services shall, taking into account the input gathered 
     pursuant to paragraph (2)(A) and after providing notice and 
     an opportunity to comment, promulgate regulations to carry 
     out the provisions of, and amendments made by this section.
       (h) Deposit of Savings Into Medicare Improvement Fund.--
     Section 1898(b)(1) of the Social Security Act (42 U.S.C. 
     1395iii(b)(1)) is amended by striking ``during and after 
     fiscal year 2020, $0'' and inserting ``during and after 
     fiscal year 2021, $140,000,000''.

     SEC. 705. EXCLUDING ABUSE-DETERRENT FORMULATIONS OF 
                   PRESCRIPTION DRUGS FROM THE MEDICAID ADDITIONAL 
                   REBATE REQUIREMENT FOR NEW FORMULATIONS OF 
                   PRESCRIPTION DRUGS.

       (a) In General.--The last sentence of section 1927(c)(2)(C) 
     of the Social Security Act (42 U.S.C. 1396r-8(c)(2)(C)) is 
     amended by inserting before the period at the end the 
     following: ``, but does not include an abuse-deterrent 
     formulation of the drug (as determined by the Secretary), 
     regardless of whether such abuse-deterrent formulation is an 
     extended release formulation''.
       (b) Effective Date.--The amendment made by subsection (a) 
     shall apply to drugs that are paid for by a State in calendar 
     quarters beginning on or after the date of the enactment of 
     this Act.

     SEC. 706. LIMITING DISCLOSURE OF PREDICTIVE MODELING AND 
                   OTHER ANALYTICS TECHNOLOGIES TO IDENTIFY AND 
                   PREVENT WASTE, FRAUD, AND ABUSE.

       (a) In General.--Title XI of the Social Security Act is 
     amended by inserting after section 1128J (42 U.S.C. 1320a-7k) 
     the following new section:

     ``SEC. 1128K. DISCLOSURE OF PREDICTIVE MODELING AND OTHER 
                   ANALYTICS TECHNOLOGIES TO IDENTIFY AND PREVENT 
                   WASTE, FRAUD, AND ABUSE.

       ``(a) Reference to Predictive Modeling Technologies 
     Requirements.--For provisions relating to the use of 
     predictive modeling and other analytics technologies to 
     identify and prevent waste, fraud, and abuse with respect to 
     the Medicare program under title XVIII, the Medicaid program 
     under title XIX, and the Children's Health Insurance Program 
     under title XXI, see section 4241 of the Small Business Jobs 
     Act of 2010 (42 U.S.C. 1320a-7m).
       ``(b) Limiting Disclosure of Predictive Modeling 
     Technologies.--In implementing such provisions under such 
     section 4241 with respect to covered algorithms (as defined 
     in subsection (c)), the following shall apply:
       ``(1) Nonapplication of foia.--The covered algorithms used 
     or developed for purposes of such section 4241 (including by 
     the Secretary or a State (or an entity operating under a 
     contract with a State)) shall be exempt from disclosure under 
     section 552(b)(3) of title 5, United States Code.
       ``(2) Limitation with respect to use and disclosure of 
     information by state agencies.--
       ``(A) In general.--A State agency may not use or disclose 
     covered algorithms used or developed for purposes of such 
     section 4241 except for purposes of administering the State 
     plan (or a waiver of the plan) under the Medicaid program 
     under title XIX or the State child health plan (or a waiver 
     of the plan) under the Children's Health Insurance Program 
     under title XXI, including by enabling an entity operating 
     under a contract with a State to assist the State to identify 
     or prevent waste, fraud, and abuse with respect to such 
     programs.
       ``(B) Information security.--A State agency shall have in 
     effect data security and control policies that the Secretary 
     finds adequate to ensure the security of covered algorithms 
     used or developed for purposes of such section 4241 and to 
     ensure that access to such information is restricted to 
     authorized persons for purposes of authorized uses and 
     disclosures described in subparagraph (A).
       ``(C) Procedural requirements.--State agencies to which 
     information is disclosed pursuant to such section 4241 shall 
     adhere to uniform procedures established by the Secretary.
       ``(c) Covered Algorithm Defined.--In this section, the term 
     `covered algorithm'--
       ``(1) means a predictive modeling or other analytics 
     technology, as used for purposes of section 4241(a) of the 
     Small Business Jobs Act of 2010 (42 U.S.C. 1320a-7m(a)) to 
     identify and prevent waste, fraud, and abuse with respect to 
     the Medicare program under title XVIII, the Medicaid program 
     under title XIX, and the Children's Health Insurance Program 
     under title XXI; and
       ``(2) includes the mathematical expressions utilized in the 
     application of such technology and the means by which such 
     technology is developed.''.
       (b) Conforming Amendments.--
       (1) Medicaid state plan requirement.--Section 1902(a) of 
     the Social Security Act (42 U.S.C. 1396a(a)) is amended--
       (A) in paragraph (80), by striking ``and'' at the end;
       (B) in paragraph (81), by striking the period at the end 
     and inserting ``; and''; and
       (C) by inserting after paragraph (81) the following new 
     paragraph:
       ``(82) provide that the State agency responsible for 
     administering the State plan under this title provides 
     assurances to the Secretary that the State agency is in 
     compliance with subparagraphs (A), (B), and (C) of section 
     1128K(b)(2).''.
       (2) State child health plan requirement.--Section 
     2102(a)(7) of the Social Security Act (42 U.S.C. 
     1397bb(a)(7)) is amended--
       (A) in subparagraph (A), by striking ``, and'' at the end 
     and inserting a semicolon;
       (B) in subparagraph (B), by striking the period at the end 
     and inserting ``; and''; and
       (C) by adding at the end the following new subparagraph:
       ``(C) to ensure that the State agency involved is in 
     compliance with subparagraphs (A), (B), and (C) of section 
     1128K(b)(2).''.

     SEC. 707. MEDICAID IMPROVEMENT FUND.

       Section 1941(b)(1) of the Social Security Act (42 U.S.C. 
     1396w-1(b)(1)) is amended to read as follows:
       ``(1) In general.--There shall be available to the Fund, 
     for expenditures from the Fund for fiscal year 2021 and 
     thereafter, $5,000,000.''.

     SEC. 708. SENSE OF THE CONGRESS REGARDING TREATMENT OF 
                   SUBSTANCE ABUSE EPIDEMICS.

       It is the sense of the Congress that decades of experience 
     and research have demonstrated that a fiscally responsible 
     approach to addressing the opioid abuse epidemic and other 
     substance abuse epidemics requires treating such epidemics as 
     a public health emergency emphasizing prevention, treatment, 
     and recovery.

[[Page H4408]]

  


              TITLE VIII--KINGPIN DESIGNATION IMPROVEMENT

     SEC. 801. PROTECTION OF CLASSIFIED INFORMATION IN FEDERAL 
                   COURT CHALLENGES RELATING TO DESIGNATIONS UNDER 
                   THE NARCOTICS KINGPIN DESIGNATION ACT.

       Section 804 of the Foreign Narcotics Kingpin Designation 
     Act (21 U.S.C. 1903) is amended by adding at the end the 
     following:
       ``(i) Protection of Classified Information in Federal Court 
     Challenges Relating to Designations.--In any judicial review 
     of a determination made under this section, if the 
     determination was based on classified information (as defined 
     in section 1(a) of the Classified Information Procedures Act) 
     such information may be submitted to the reviewing court ex 
     parte and in camera. This subsection does not confer or imply 
     any right to judicial review.''.

                TITLE IX--DEPARTMENT OF VETERANS AFFAIRS

     SEC. 901. SHORT TITLE.

       This title may be cited as the ``Jason Simcakoski Memorial 
     and Promise Act''.

     SEC. 902. DEFINITIONS.

       In this title:
       (1) The term ``controlled substance'' has the meaning given 
     that term in section 102 of the Controlled Substances Act (21 
     U.S.C. 802).
       (2) The term ``State'' means each of the several States, 
     territories, and possessions of the United States, the 
     District of Columbia, and the Commonwealth of Puerto Rico.
       (3) The term ``complementary and integrative health'' has 
     the meaning given that term, or any successor term, by the 
     National Institutes of Health.
       (4) The term ``opioid receptor antagonist'' means a drug or 
     device approved or cleared under the Federal Food, Drug, and 
     Cosmetic Act (21 U.S.C. 301 et seq.) for emergency treatment 
     of known or suspected opioid overdose.

             Subtitle A--Opioid Therapy and Pain Management

     SEC. 911. IMPROVEMENT OF OPIOID SAFETY MEASURES BY DEPARTMENT 
                   OF VETERANS AFFAIRS.

       (a) Expansion of Opioid Safety Initiative.--
       (1) Inclusion of all medical facilities.--Not later than 
     180 days after the date of the enactment of this Act, the 
     Secretary of Veterans Affairs shall expand the Opioid Safety 
     Initiative of the Department of Veterans Affairs to include 
     all medical facilities of the Department.
       (2) Guidance.--The Secretary shall establish guidance that 
     each health care provider of the Department of Veterans 
     Affairs, before initiating opioid therapy to treat a patient 
     as part of the comprehensive assessment conducted by the 
     health care provider, use the Opioid Therapy Risk Report tool 
     of the Department of Veterans Affairs (or any subsequent 
     tool), which shall include information from the prescription 
     drug monitoring program of each participating State as 
     applicable, that includes the most recent information to date 
     relating to the patient that accessed such program to assess 
     the risk for adverse outcomes of opioid therapy for the 
     patient, including the concurrent use of controlled 
     substances such as benzodiazepines, as part of the 
     comprehensive assessment conducted by the health care 
     provider.
       (3) Enhanced standards.--The Secretary shall establish 
     enhanced standards with respect to the use of routine and 
     random urine drug tests for all patients before and during 
     opioid therapy to help prevent substance abuse, dependence, 
     and diversion, including--
       (A) that such tests occur not less frequently than once 
     each year or as otherwise determined according to treatment 
     protocols; and
       (B) that health care providers appropriately order, 
     interpret and respond to the results from such tests to 
     tailor pain therapy, safeguards, and risk management 
     strategies to each patient.
       (b) Pain Management Education and Training.--
       (1) In general.--In carrying out the Opioid Safety 
     Initiative of the Department, the Secretary shall require all 
     employees of the Department responsible for prescribing 
     opioids to receive education and training described in 
     paragraph (2).
       (2) Education and training.--Education and training 
     described in this paragraph is education and training on pain 
     management and safe opioid prescribing practices for purposes 
     of safely and effectively managing patients with chronic 
     pain, including education and training on the following:
       (A) The implementation of and full compliance with the VA/
     DOD Clinical Practice Guideline for Management of Opioid 
     Therapy for Chronic Pain, including any update to such 
     guideline.
       (B) The use of evidence-based pain management therapies and 
     complementary and integrative health services, including 
     cognitive-behavioral therapy, non-opioid alternatives, and 
     non-drug methods and procedures to managing pain and related 
     health conditions including, to the extent practicable, 
     medical devices approved or cleared by the Food and Drug 
     Administration for the treatment of patients with chronic 
     pain and related health conditions.
       (C) Screening and identification of patients with substance 
     use disorder, including drug-seeking behavior, before 
     prescribing opioids, assessment of risk potential for 
     patients developing an addiction, and referral of patients to 
     appropriate addiction treatment professionals if addiction is 
     identified or strongly suspected.
       (D) Communication with patients on the potential harm 
     associated with the use of opioids and other controlled 
     substances, including the need to safely store and dispose of 
     supplies relating to the use of opioids and other controlled 
     substances.
       (E) Such other education and training as the Secretary 
     considers appropriate to ensure that veterans receive safe 
     and high-quality pain management care from the Department.
       (3) Use of existing program.--In providing education and 
     training described in paragraph (2), the Secretary shall use 
     the Interdisciplinary Chronic Pain Management Training Team 
     Program of the Department (or successor program).
       (c) Pain Management Teams.--
       (1) In general.--In carrying out the Opioid Safety 
     Initiative of the Department, the director of each medical 
     facility of the Department shall identify and designate a 
     pain management team of health care professionals, which may 
     include board certified pain medicine specialists, 
     responsible for coordinating and overseeing pain management 
     therapy at such facility for patients experiencing acute and 
     chronic pain that is non-cancer related.
       (2) Establishment of protocols.--
       (A) In general.--In consultation with the Directors of each 
     Veterans Integrated Service Network, the Secretary shall 
     establish standard protocols for the designation of pain 
     management teams at each medical facility within the 
     Department.
       (B) Consultation on prescription of opioids.--Each protocol 
     established under subparagraph (A) shall ensure that any 
     health care provider without expertise in prescribing 
     analgesics or who has not completed the education and 
     training under subsection (b), including a mental health care 
     provider, does not prescribe opioids to a patient unless that 
     health care provider--
       (i) consults with a health care provider with pain 
     management expertise or who is on the pain management team of 
     the medical facility; and
       (ii) refers the patient to the pain management team for any 
     subsequent prescriptions and related therapy.
       (3) Report.--
       (A) In general.--Not later than one year after the date of 
     enactment of this Act, the director of each medical facility 
     of the Department shall submit to the Under Secretary for 
     Health and the director of the Veterans Integrated Service 
     Network in which the medical facility is located a report 
     identifying the health care professionals that have been 
     designated as members of the pain management team at the 
     medical facility pursuant to paragraph (1).
       (B) Elements.--Each report submitted under subparagraph (A) 
     with respect to a medical facility of the Department shall 
     include--
       (i) a certification as to whether all members of the pain 
     management team at the medical facility have completed the 
     education and training required under subsection (b);
       (ii) a plan for the management and referral of patients to 
     such pain management team if health care providers without 
     expertise in prescribing analgesics prescribe opioid 
     medications to treat acute and chronic pain that is non-
     cancer related; and
       (iii) a certification as to whether the medical facility--

       (I) fully complies with the stepped-care model, or 
     successor models, of pain management and other pain 
     management policies of the Department; or
       (II) does not fully comply with such stepped-care model, or 
     successor models, of pain management and other pain 
     management policies but is carrying out a corrective plan of 
     action to ensure such full compliance.

       (d) Tracking and Monitoring of Opioid Use.--
       (1) Prescription drug monitoring programs of states.--In 
     carrying out the Opioid Safety Initiative and the Opioid 
     Therapy Risk Report tool of the Department, the Secretary 
     shall--
       (A) ensure access by health care providers of the 
     Department to information on controlled substances, including 
     opioids and benzodiazepines, prescribed to veterans who 
     receive care outside the Department through the prescription 
     drug monitoring program of each State with such a program, 
     including by seeking to enter into memoranda of understanding 
     with States to allow shared access of such information 
     between States and the Department;
       (B) include such information in the Opioid Therapy Risk 
     Report tool; and
       (C) require health care providers of the Department to 
     submit to the prescription drug monitoring program of each 
     State with such a program information on prescriptions of 
     controlled substances received by veterans in that State 
     under the laws administered by the Secretary.
       (2) Report on tracking of data on opioid use.--Not later 
     than 18 months after the date of the enactment of this Act, 
     the Secretary shall submit to the Committee on Veterans' 
     Affairs of the Senate and the Committee on Veterans' Affairs 
     of the House of Representatives a report on the feasibility 
     and advisability of improving the Opioid Therapy Risk Report 
     tool of the Department to allow for more advanced real-time 
     tracking of and access to data on--
       (A) the key clinical indicators with respect to the 
     totality of opioid use by veterans;
       (B) concurrent prescribing by health care providers of the 
     Department of opioids in different health care settings, 
     including data on concurrent prescribing of opioids to treat 
     mental health disorders other than opioid use disorder; and
       (C) mail-order prescriptions of opioids prescribed to 
     veterans under the laws administered by the Secretary.
       (e) Availability of Opioid Receptor Antagonists.--
       (1) Increased availability and use.--
       (A) In general.--The Secretary shall maximize the 
     availability of opioid receptor antagonists, including 
     naloxone, to veterans.
       (B) Availability, training, and distributing.--In carrying 
     out subparagraph (A), not later than 90 days after the date 
     of the enactment of this Act, the Secretary shall--
       (i) equip each pharmacy of the Department with opioid 
     receptor antagonists to be dispensed to outpatients as 
     needed; and

[[Page H4409]]

       (ii) expand the Overdose Education and Naloxone 
     Distribution program of the Department to ensure that all 
     veterans in receipt of health care under laws administered by 
     the Secretary who are at risk of opioid overdose may access 
     such opioid receptor antagonists and training on the proper 
     administration of such opioid receptor antagonists.
       (C) Veterans who are at risk.--For purposes of subparagraph 
     (B), veterans who are at risk of opioid overdose include--
       (i) veterans receiving long-term opioid therapy;
       (ii) veterans receiving opioid therapy who have a history 
     of substance use disorder or prior instances of overdose; and
       (iii) veterans who are at risk as determined by a health 
     care provider who is treating the veteran.
       (2) Report.--Not later than 120 days after the date of the 
     enactment of this Act, the Secretary shall submit to the 
     Committee on Veterans' Affairs of the Senate and the 
     Committee on Veterans' Affairs of the House of 
     Representatives a report on carrying out paragraph (1), 
     including an assessment of any remaining steps to be carried 
     out by the Secretary to carry out such paragraph.
       (f) Inclusion of Certain Information and Capabilities in 
     Opioid Therapy Risk Report Tool of the Department.--
       (1) Information.--The Secretary shall include in the Opioid 
     Therapy Risk Report tool of the Department--
       (A) information on the most recent time the tool was 
     accessed by a health care provider of the Department with 
     respect to each veteran; and
       (B) information on the results of the most recent urine 
     drug test for each veteran.
       (2) Capabilities.--The Secretary shall include in the 
     Opioid Therapy Risk Report tool the ability of the health 
     care providers of the Department to determine whether a 
     health care provider of the Department prescribed opioids to 
     a veteran without checking the information in the tool with 
     respect to the veteran.
       (g) Notifications of Risk in Computerized Health Record.--
     The Secretary shall modify the computerized patient record 
     system of the Department to ensure that any health care 
     provider that accesses the record of a veteran, regardless of 
     the reason the veteran seeks care from the health care 
     provider, will be immediately notified whether the veteran--
       (1) is receiving opioid therapy and has a history of 
     substance use disorder or prior instances of overdose;
       (2) has a history of opioid abuse; or
       (3) is at risk of developing an opioid use disorder, as 
     determined by a health care provider who is treating the 
     veteran.

     SEC. 912. STRENGTHENING OF JOINT WORKING GROUP ON PAIN 
                   MANAGEMENT OF THE DEPARTMENT OF VETERANS 
                   AFFAIRS AND THE DEPARTMENT OF DEFENSE.

       (a) In General.--Not later than 90 days after the date of 
     enactment of this Act, the Secretary of Veterans Affairs and 
     the Secretary of Defense shall ensure that the Pain 
     Management Working Group of the Health Executive Committee of 
     the Department of Veterans Affairs-Department of Defense 
     Joint Executive Committee (Pain Management Working Group) 
     established under section 320 of title 38, United States 
     Code, includes a focus on the following:
       (1) The opioid prescribing practices of health care 
     providers of each Department.
       (2) The ability of each Department to manage acute and 
     chronic pain among individuals receiving health care from the 
     Department, including training health care providers with 
     respect to pain management.
       (3) The use by each Department of complementary and 
     integrative health in treating such individuals.
       (4) The concurrent use and practice by health care 
     providers of each Department of opioids and prescription 
     drugs to treat mental health disorders, including 
     benzodiazepines.
       (5) The use of care transition plans by health care 
     providers of each Department to address case management 
     issues for patients receiving opioid therapy who transition 
     between inpatient and outpatient care.
       (6) The coordination in coverage of and consistent access 
     to medications prescribed for patients transitioning from 
     receiving health care from the Department of Defense to 
     receiving health care from the Department of Veterans 
     Affairs.
       (7) The ability of each Department to properly screen, 
     identify, refer, and treat patients with substance use 
     disorders who are seeking treatment for acute and chronic 
     pain management conditions.
       (b) Coordination and Consultation.--The Secretary of 
     Veterans Affairs and the Secretary of Defense shall ensure 
     that the working group described in subsection (a)--
       (1) coordinates the activities of the working group with 
     other relevant working groups established under section 320 
     of title 38, United States Code;
       (2) consults with other relevant Federal agencies, 
     including the Centers for Disease Control and Prevention, 
     with respect to the activities of the working group; and
       (3) consults with the Department of Veterans Affairs and 
     the Department of Defense with respect to the VA/DOD Clinical 
     Practice Guideline for Management of Opioid Therapy for 
     Chronic Pain, or any successor guideline, and reviews and 
     provides comments before any update to the guideline is 
     released.
       (c) Clinical Practice Guidelines.--
       (1) In general.--Not later than 180 days after the date of 
     the enactment of this Act, the Secretary of Veterans Affairs 
     and the Secretary of Defense shall issue an update to the VA/
     DOD Clinical Practice Guideline for Management of Opioid 
     Therapy for Chronic Pain.
       (2) Matters included.--In conducting the update under 
     paragraph (1), the Pain Management Working Group, in 
     coordination with the Clinical Practice Guideline VA/DoD 
     Management of Opioid Therapy for Chronic Pain Working Group, 
     shall work to ensure that the Clinical Practical Guideline 
     includes the following:
       (A) Enhanced guidance with respect to--
       (i) the co-administration of an opioid and other drugs, 
     including benzodiazepines, that may result in life-limiting 
     drug interactions;
       (ii) the treatment of patients with current acute 
     psychiatric instability or substance use disorder or patients 
     at risk of suicide; and
       (iii) the use of opioid therapy to treat mental health 
     disorders other than opioid use disorder.
       (B) Enhanced guidance with respect to the treatment of 
     patients with behaviors or comorbidities, such as post-
     traumatic stress disorder or other psychiatric disorders, or 
     a history of substance abuse or addiction, that requires a 
     consultation or co-management of opioid therapy with one or 
     more specialists in pain management, mental health, or 
     addictions.
       (C) Enhanced guidance with respect to health care 
     providers--
       (i) conducting an effective assessment for patients 
     beginning or continuing opioid therapy, including 
     understanding and setting realistic goals with respect to 
     achieving and maintaining an expected level of pain relief, 
     improved function, or a clinically appropriate combination of 
     both; and
       (ii) effectively assessing whether opioid therapy is 
     achieving or maintaining the established treatment goals of 
     the patient or whether the patient and health care provider 
     should discuss adjusting, augmenting, or discontinuing the 
     opioid therapy.
       (D) Guidelines to inform the methodologies used by health 
     care providers of the Department of Veterans Affairs and the 
     Department of Defense to safely taper opioid therapy when 
     adjusting or discontinuing the use of opioid therapy, 
     including--
       (i) prescription of the lowest effective dose based on 
     patient need;
       (ii) use of opioids only for a limited time; and
       (iii) augmentation of opioid therapy with other pain 
     management therapies and modalities.
       (E) Guidelines with respect to appropriate case management 
     for patients receiving opioid therapy who transition between 
     inpatient and outpatient health care settings, which may 
     include the use of care transition plans.
       (F) Guidelines with respect to appropriate case management 
     for patients receiving opioid therapy who transition from 
     receiving care during active duty to post-military health 
     care networks.
       (G) Guidelines with respect to providing options, before 
     initiating opioid therapy, for pain management therapies 
     without the use of opioids and options to augment opioid 
     therapy with other clinical and complementary and integrative 
     health services to minimize opioid dependence.
       (H) Guidelines with respect to the provision of evidence-
     based non-opioid treatments within the Department of Veterans 
     Affairs and the Department of Defense, including medical 
     devices and other therapies approved or cleared by the Food 
     and Drug Administration for the treatment of chronic pain as 
     an alternative to or to augment opioid therapy.
       (I) Guidelines developed by the Centers for Disease Control 
     and Prevention for safely prescribing opioids for the 
     treatment of chronic, non-cancer related pain in outpatient 
     settings.
       (3) Rule of construction.--Nothing in this subsection shall 
     be construed to prevent the Secretary of Veterans Affairs and 
     the Secretary of Defense from considering all relevant 
     evidence, as appropriate, in updating the VA/DOD Clinical 
     Practice Guideline for Management of Opioid Therapy for 
     Chronic Pain, as required under paragraph (1), or from 
     ensuring that the final clinical practice guideline updated 
     under such paragraph remains applicable to the patient 
     populations of the Department of Veterans Affairs and the 
     Department of Defense.

     SEC. 913. REVIEW, INVESTIGATION, AND REPORT ON USE OF OPIOIDS 
                   IN TREATMENT BY DEPARTMENT OF VETERANS AFFAIRS.

       (a) Comptroller General Report.--
       (1) In general.--Not later than two years after the date of 
     the enactment of this Act, the Comptroller General of the 
     United States shall submit to the Committee on Veterans' 
     Affairs of the Senate and the Committee on Veterans' Affairs 
     of the House of Representatives a report on the Opioid Safety 
     Initiative of the Department of Veterans Affairs and the 
     opioid prescribing practices of health care providers of the 
     Department.
       (2) Elements.--The report submitted under paragraph (1) 
     shall include the following:
       (A) An assessment of the implementation and monitoring by 
     the Veterans Health Administration of the Opioid Safety 
     Initiative of the Department, including examining, as 
     appropriate, the following:
       (i) How the Department monitors the key clinical outcomes 
     of such safety initiative (for example, the percentage of 
     unique veterans visiting each medical center of the 
     Department that are prescribed an opioid or an opioid and 
     benzodiazepine concurrently) and how the Department uses that 
     information--

       (I) to improve prescribing practices; and
       (II) to identify high prescribing or otherwise 
     inappropriate prescribing practices by health care providers.

       (ii) How the Department monitors the use of the Opioid 
     Therapy Risk Report tool of the Department (as developed 
     through such safety initiative) and compliance with such tool 
     by medical facilities and health care providers of the 
     Department, including any findings by the Department of 
     prescription rates or prescription practices by medical 
     facilities or health care providers that are inappropriate.

[[Page H4410]]

       (iii) The implementation of academic detailing programs 
     within the Veterans Integrated Service Networks of the 
     Department and how such programs are being used to improve 
     opioid prescribing practices.
       (iv) Recommendations on such improvements to the Opioid 
     Safety Initiative of the Department as the Comptroller 
     General considers appropriate.
       (B) Information made available under the Opioid Therapy 
     Risk Report tool with respect to--
       (i) deaths resulting from sentinel events involving 
     veterans prescribed opioids by a health care provider;
       (ii) overall prescription rates and, if applicable, 
     indications used by health care providers for prescribing 
     chronic opioid therapy to treat non-cancer, non-palliative, 
     and non-hospice care patients;
       (iii) the prescription rates and indications used by health 
     care providers for prescribing benzodiazepines and opioids 
     concomitantly;
       (iv) the practice by health care providers of prescribing 
     opioids to treat patients without any pain, including to 
     treat patients with mental health disorders other than opioid 
     use disorder; and
       (v) the effectiveness of opioid therapy for patients 
     receiving such therapy, including the effectiveness of long-
     term opioid therapy.
       (C) An evaluation of processes of the Department in place 
     to oversee opioid use among veterans, including procedures to 
     identify and remedy potential over-prescribing of opioids by 
     health care providers of the Department.
       (D) An assessment of the implementation by the Secretary of 
     Veterans Affairs of the VA/DOD Clinical Practice Guideline 
     for Management of Opioid Therapy for Chronic Pain, including 
     any figures or approaches used by the Department to assess 
     compliance with such guidelines by medical centers of the 
     Department and identify any medical centers of the Department 
     operating action plans to improve compliance with such 
     guidelines.
       (E) An assessment of the data that the Department has 
     developed to review the opioid prescribing practices of 
     health care providers of the Department, as required by this 
     subtitle, including a review of how the Department identifies 
     the practices of individual health care providers that 
     warrant further review based on prescribing levels, health 
     conditions for which the health care provider is prescribing 
     opioids or opioids and benzodiazepines concurrently, or other 
     practices of the health care provider.
       (b) Semi-annual Progress Report on Implementation of 
     Comptroller General Recommendations.--Not later than 180 days 
     after the date of the submittal of the report required under 
     subsection (a), and not less frequently than annually 
     thereafter until the Comptroller General of the United States 
     determines that all recommended actions are closed, the 
     Secretary of Veterans Affairs shall submit to the Committee 
     on Veterans' Affairs of the Senate and the Committee on 
     Veterans' Affairs of the House of Representatives a progress 
     report detailing the actions by the Secretary to address any 
     outstanding findings and recommendations by the Comptroller 
     General of the United States under subsection (a) with 
     respect to the Veterans Health Administration.
       (c) Annual Report on Opioid Therapy and Prescription 
     Rates.--Not later than one year after the date of the 
     enactment of this Act, and not less frequently than annually 
     for the following five years, the Secretary shall submit to 
     the Committee on Veterans' Affairs of the Senate and the 
     Committee on Veterans' Affairs of the House of 
     Representatives a report on opioid therapy and prescription 
     rates for the one-year period preceding the date of the 
     submission of the report. Each such report shall include each 
     of the following:
       (1) The number of patients and the percentage of the 
     patient population of the Department who were prescribed 
     benzodiazepines and opioids concurrently by a health care 
     provider of the Department.
       (2) The number of patients and the percentage of the 
     patient population of the Department without any pain who 
     were prescribed opioids by a health care provider of the 
     Department, including those who were prescribed 
     benzodiazepines and opioids concurrently.
       (3) The number of non-cancer, non-palliative, and non-
     hospice care patients and the percentage of such patients who 
     were treated with opioids by a health care provider of the 
     Department on an inpatient-basis and who also received 
     prescription opioids by mail from the Department while being 
     treated on an inpatient-basis.
       (4) The number of non-cancer, non-palliative, and non-
     hospice care patients and the percentage of such patients who 
     were prescribed opioids concurrently by a health care 
     provider of the Department and a health care provider that is 
     not a health care provider of the Department.
       (5) With respect to each medical facility of the 
     Department, the collected and reviewed information on opioids 
     prescribed by health care providers at the facility to treat 
     non-cancer, non-palliative, and non-hospice care patients, 
     including--
       (A) the prescription rate at which each health care 
     provider at the facility prescribed benzodiazepines and 
     opioids concurrently to such patients and the aggregate of 
     such prescription rate for all health care providers at the 
     facility;
       (B) the prescription rate at which each health care 
     provider at the facility prescribed benzodiazepines or 
     opioids to such patients to treat conditions for which 
     benzodiazepines or opioids are not approved treatment and the 
     aggregate of such prescription rate for all health care 
     providers at the facility;
       (C) the prescription rate at which each health care 
     provider at the facility prescribed or dispensed mail-order 
     prescriptions of opioids to such patients while such patients 
     were being treated with opioids on an inpatient-basis and the 
     aggregate of such prescription rate for all health care 
     providers at the facility; and
       (D) the prescription rate at which each health care 
     provider at the facility prescribed opioids to such patients 
     who were also concurrently prescribed opioids by a health 
     care provider that is not a health care provider of the 
     Department and the aggregate of such prescription rates for 
     all health care providers at the facility.
       (6) With respect to each medical facility of the 
     Department, the number of times a pharmacist at the facility 
     overrode a critical drug interaction warning with respect to 
     an interaction between opioids and another medication before 
     dispensing such medication to a veteran.
       (d) Investigation of Prescription Rates.--If the Secretary 
     determines that a prescription rate with respect to a health 
     care provider or medical facility of the Department conflicts 
     with or is otherwise inconsistent with the standards of 
     appropriate and safe care, the Secretary shall--
       (1) immediately notify the Committee on Veterans' Affairs 
     of the Senate and the Committee on Veterans' Affairs of the 
     House of Representatives of such determination, including 
     information relating to such determination, prescription 
     rate, and health care provider or medical facility, as the 
     case may be; and
       (2) through the Office of the Medical Inspector of the 
     Veterans Health Administration, conduct a full investigation 
     of the health care provider or medical facility, as the case 
     may be.
       (e) Prescription Rate Defined.--In this section, the term 
     ``prescription rate'' means, with respect to a health care 
     provider or medical facility of the Department, each of the 
     following:
       (1) The number of patients treated with opioids by the 
     health care provider or at the medical facility, as the case 
     may be, divided by the total number of pharmacy users of that 
     health care provider or medical facility.
       (2) The average number of morphine equivalents per day 
     prescribed by the health care provider or at the medical 
     facility, as the case may be, to patients being treated with 
     opioids.
       (3) Of the patients being treated with opioids by the 
     health care provider or at the medical facility, as the case 
     may be, the average number of prescriptions of opioids per 
     patient.

     SEC. 914. MANDATORY DISCLOSURE OF CERTAIN VETERAN INFORMATION 
                   TO STATE CONTROLLED SUBSTANCE MONITORING 
                   PROGRAMS.

       Section 5701(l) of title 38, United States Code, is amended 
     by striking ``may'' and inserting ``shall''.

     SEC. 915. ELIMINATION OF COPAYMENT REQUIREMENT FOR VETERANS 
                   RECEIVING OPIOID ANTAGONISTS OR EDUCATION ON 
                   USE OF OPIOID ANTAGONISTS.

       (a) Copayment for Opioid Antagonists.--Section 1722A(a) of 
     title 38, United States Code, is amended by adding at the end 
     the following new paragraph:
       ``(4) Paragraph (1) does not apply to opioid antagonists 
     furnished under this chapter to a veteran who is at high risk 
     for overdose of a specific medication or substance in order 
     to reverse the effect of such an overdose.''.
       (b) Copayment for Education on Use of Opioid Antagonists.--
     Section 1710(g)(3) of such title is amended--
       (1) by striking ``with respect to home health services'' 
     and inserting ``with respect to the following:''
       ``(A) Home health services''; and
       (2) by adding at the end the following subparagraph:
       ``(B) Education on the use of opioid antagonists to reverse 
     the effects of overdoses of specific medications or 
     substances.''.

                      Subtitle B--Patient Advocacy

     SEC. 921. COMMUNITY MEETINGS ON IMPROVING CARE FURNISHED BY 
                   DEPARTMENT OF VETERANS AFFAIRS.

       (a) Community Meetings.--
       (1) Medical centers.--Not later than 90 days after the date 
     of the enactment of this Act, and not less frequently than 
     once every 90 days thereafter, the Secretary shall ensure 
     that each medical facility of the Department of Veterans 
     Affairs hosts a community meeting open to the public on 
     improving health care furnished by the Secretary.
       (2) Community-based outpatient clinics.--Not later than one 
     year after the date of the enactment of this Act, and not 
     less frequently than annually thereafter, the Secretary shall 
     ensure that each community-based outpatient clinic of the 
     Department hosts a community meeting open to the public on 
     improving health care furnished by the Secretary.
       (b) Attendance by Director of Veterans Integrated Service 
     Network or Designee.--
       (1) In general.--Each community meeting hosted by a medical 
     facility or community-based outpatient clinic under 
     subsection (a) shall be attended by the Director of the 
     Veterans Integrated Service Network in which the medical 
     facility or community-based outpatient clinic, as the case 
     may be, is located. Subject to paragraph (2), the Director 
     may delegate such attendance only to an employee who works in 
     the Office of the Director.
       (2) Attendance by director.--Each Director of a Veterans 
     Integrated Service Network shall personally attend not less 
     than one community meeting under subsection (a) hosted by 
     each medical facility located in the Veterans Integrated 
     Service Network each year.
       (c) Notice.--The Secretary shall notify the Committee on 
     Veterans' Affairs of the Senate, the Committee on Veterans' 
     Affairs of the House of Representatives, and each Member of 
     Congress (as defined in section 902) who represents the area 
     in which the medical facility is located of a community 
     meeting under subsection (a) by not later than 10 days before 
     such community meeting occurs.

[[Page H4411]]

  


     SEC. 922. IMPROVEMENT OF AWARENESS OF PATIENT ADVOCACY 
                   PROGRAM AND PATIENT BILL OF RIGHTS OF 
                   DEPARTMENT OF VETERANS AFFAIRS.

       Not later than 90 days after the date of the enactment of 
     this Act, the Secretary of Veterans Affairs shall, in as many 
     prominent locations as the Secretary determines appropriate 
     to be seen by the largest percentage of patients and family 
     members of patients at each medical facility of the 
     Department of Veterans Affairs--
       (1) display the purposes of the Patient Advocacy Program of 
     the Department and the contact information for the patient 
     advocate at such medical facility; and
       (2) display the rights and responsibilities of--
       (A) patients and family members of patients at such medical 
     facility; and
       (B) with respect to community living centers and other 
     residential facilities of the Department, residents and 
     family members of residents at such medical facility.

     SEC. 923. COMPTROLLER GENERAL REPORT ON PATIENT ADVOCACY 
                   PROGRAM OF DEPARTMENT OF VETERANS AFFAIRS.

       (a) In General.--Not later than two years after the date of 
     the enactment of this Act, the Comptroller General of the 
     United States shall submit to the Committee on Veterans' 
     Affairs of the Senate and the Committee on Veterans' Affairs 
     of the House of Representatives a report on the Patient 
     Advocacy Program of the Department of Veterans Affairs (in 
     this section referred to as the ``Program'').
       (b) Elements.--The report required by subsection (a) shall 
     include the following:
       (1) A description of the Program, including--
       (A) the purpose of the Program;
       (B) the activities carried out under the Program; and
       (C) the sufficiency of the Program in achieving the purpose 
     of the Program.
       (2) An assessment of the sufficiency of staffing of 
     employees of the Department responsible for carrying out the 
     Program.
       (3) An assessment of the sufficiency of the training of 
     such employees.
       (4) An assessment of--
       (A) the awareness of the Program among veterans and family 
     members of veterans; and
       (B) the use of the Program by veterans and family members 
     of veterans.
       (5) Such recommendations and proposals for improving or 
     modifying the Program as the Comptroller General considers 
     appropriate.
       (6) Such other information with respect to the Program as 
     the Comptroller General considers appropriate.

     SEC. 924. ESTABLISHMENT OF OFFICE OF PATIENT ADVOCACY OF THE 
                   DEPARTMENT OF VETERANS AFFAIRS.

       (a) In General.--Subchapter I of chapter 73 of title 38, 
     United States Code, is amended by adding at the end the 
     following new section:

     ``Sec. 7309A. Office of Patient Advocacy

       ``(a) Establishment.--There is established in the 
     Department within the Office of the Under Secretary for 
     Health an office to be known as the `Office of Patient 
     Advocacy' (in this section referred to as the `Office').
       ``(b) Head.--(1) The Director of the Office of Patient 
     Advocacy shall be the head of the Office.
       ``(2) The Director of the Office of Patient Advocacy shall 
     be appointed by the Under Secretary for Health from among 
     individuals qualified to perform the duties of the position 
     and shall report directly to the Under Secretary for Health.
       ``(c) Function.--(1) The function of the Office is to carry 
     out the Patient Advocacy Program of the Department.
       ``(2) In carrying out the Patient Advocacy Program of the 
     Department, the Director shall ensure that patient advocates 
     of the Department--
       ``(A) advocate on behalf of veterans with respect to health 
     care received and sought by veterans under the laws 
     administered by the Secretary;
       ``(B) carry out the responsibilities specified in 
     subsection (d); and
       ``(C) receive training in patient advocacy.
       ``(d) Patient Advocacy Responsibilities.--The 
     responsibilities of each patient advocate at a medical 
     facility of the Department are the following:
       ``(1) To resolve complaints by veterans with respect to 
     health care furnished under the laws administered by the 
     Secretary that cannot be resolved at the point of service or 
     at a higher level easily accessible to the veteran.
       ``(2) To present at various meetings and to various 
     committees the issues experienced by veterans in receiving 
     such health care at such medical facility.
       ``(3) To express to veterans their rights and 
     responsibilities as patients in receiving such health care.
       ``(4) To manage the Patient Advocate Tracking System of the 
     Department at such medical facility.
       ``(5) To compile data at such medical facility of 
     complaints made by veterans with respect to the receipt of 
     such health care at such medical facility and the 
     satisfaction of veterans with such health care at such 
     medical facility to determine whether there are trends in 
     such data.
       ``(6) To ensure that a process is in place for the 
     distribution of the data compiled under paragraph (5) to 
     appropriate leaders, committees, services, and staff of the 
     Department.
       ``(7) To identify, not less frequently than quarterly, 
     opportunities for improvements in the furnishing of such 
     health care to veterans at such medical facility based on 
     complaints by veterans.
       ``(8) To ensure that any significant complaint by a veteran 
     with respect to such health care is brought to the attention 
     of appropriate staff of the Department to trigger an 
     assessment of whether there needs to be a further analysis of 
     the problem at the facility-wide level.
       ``(9) To support any patient advocacy programs carried out 
     by the Department.
       ``(10) To ensure that all appeals and final decisions with 
     respect to the receipt of such health care are entered into 
     the Patient Advocate Tracking System of the Department.
       ``(11) To understand all laws, directives, and other rules 
     with respect to the rights and responsibilities of veterans 
     in receiving such health care, including the appeals 
     processes available to veterans.
       ``(12) To ensure that veterans receiving mental health 
     care, or the surrogate decision-makers for such veterans, are 
     aware of the rights of veterans to seek representation from 
     systems established under section 103 of the Protection and 
     Advocacy for Mentally Ill Individuals Act of 1986 (42 U.S.C. 
     10803) to protect and advocate the rights of individuals with 
     mental illness and to investigate incidents of abuse and 
     neglect of such individuals.
       ``(13) To fulfill requirements established by the Secretary 
     with respect to the inspection of controlled substances.
       ``(14) To document potentially threatening behavior and 
     report such behavior to appropriate authorities.
       ``(e) Training.--In providing training to patient advocates 
     under subsection (c)(2)(C), the Director shall ensure that 
     such training is consistent throughout the Department.
       ``(f) Controlled Substance Defined.--In this section, the 
     term `controlled substance' has the meaning given that term 
     in section 102 of the Controlled Substances Act (21 U.S.C. 
     802).''.
       (b) Clerical Amendment.--The table of sections at the 
     beginning of chapter 73 of such title is amended by inserting 
     after the item relating to section 7309 the following new 
     item:

``7309A. Office of Patient Advocacy.''.

       (c) Date Fully Operational.--The Secretary of Veterans 
     Affairs shall ensure that the Office of Patient Advocacy 
     established under section 7309A of title 38, United States 
     Code, as added by subsection (a), is fully operational not 
     later than the date that is one year after the date of the 
     enactment of this Act.

            Subtitle C--Complementary and Integrative Health

     SEC. 931. EXPANSION OF RESEARCH AND EDUCATION ON AND DELIVERY 
                   OF COMPLEMENTARY AND INTEGRATIVE HEALTH TO 
                   VETERANS.

       (a) Establishment.--There is established a commission to be 
     known as the ``Creating Options for Veterans' Expedited 
     Recovery'' or the ``COVER Commission'' (in this section 
     referred to as the ``Commission''). The Commission shall 
     examine the evidence-based therapy treatment model used by 
     the Secretary of Veterans Affairs for treating mental health 
     conditions of veterans and the potential benefits of 
     incorporating complementary and integrative health treatments 
     available in non-Department facilities (as defined in section 
     1701 of title 38, United States Code).
       (b) Duties.--The Commission shall perform the following 
     duties:
       (1) Examine the efficacy of the evidence-based therapy 
     model used by the Secretary for treating mental health 
     illnesses of veterans and identify areas to improve wellness-
     based outcomes.
       (2) Conduct a patient-centered survey within each of the 
     Veterans Integrated Service Networks to examine--
       (A) the experience of veterans with the Department of 
     Veterans Affairs when seeking medical assistance for mental 
     health issues through the health care system of the 
     Department;
       (B) the experience of veterans with non-Department 
     facilities and health professionals for treating mental 
     health issues;
       (C) the preference of veterans regarding available 
     treatment for mental health issues and which methods the 
     veterans believe to be most effective;
       (D) the experience, if any, of veterans with respect to the 
     complementary and integrative health treatment therapies 
     described in paragraph (3);
       (E) the prevalence of prescribing prescription medication 
     among veterans seeking treatment through the health care 
     system of the Department as remedies for addressing mental 
     health issues; and
       (F) the outreach efforts of the Secretary regarding the 
     availability of benefits and treatments for veterans for 
     addressing mental health issues, including by identifying 
     ways to reduce barriers to gaps in such benefits and 
     treatments.
       (3) Examine available research on complementary and 
     integrative health treatment therapies for mental health 
     issues and identify what benefits could be made with the 
     inclusion of such treatments for veterans, including with 
     respect to--
       (A) music therapy;
       (B) equine therapy;
       (C) training and caring for service dogs;
       (D) yoga therapy;
       (E) acupuncture therapy;
       (F) meditation therapy;
       (G) outdoor sports therapy;
       (H) hyperbaric oxygen therapy;
       (I) accelerated resolution therapy;
       (J) art therapy;
       (K) magnetic resonance therapy; and
       (L) other therapies the Commission determines appropriate.
       (4) Study the sufficiency of the resources of the 
     Department to ensure the delivery of quality health care for 
     mental health issues among veterans seeking treatment within 
     the Department.
       (5) Study the current treatments and resources available 
     within the Department and assess--
       (A) the effectiveness of such treatments and resources in 
     decreasing the number of suicides per day by veterans;
       (B) the number of veterans who have been diagnosed with 
     mental health issues;

[[Page H4412]]

       (C) the percentage of veterans using the resources of the 
     Department who have been diagnosed with mental health issues;
       (D) the percentage of veterans who have completed 
     counseling sessions offered by the Department; and
       (E) the efforts of the Department to expand complementary 
     and integrative health treatments viable to the recovery of 
     veterans with mental health issues as determined by the 
     Secretary to improve the effectiveness of treatments offered 
     by the Department.
       (c) Membership.--
       (1) In general.--The Commission shall be composed of 10 
     members, appointed as follows:
       (A) Two members appointed by the Speaker of the House of 
     Representatives, at least one of whom shall be a veteran.
       (B) Two members appointed by the minority leader of the 
     House of Representatives, at least one of whom shall be a 
     veteran.
       (C) Two members appointed by the majority leader of the 
     Senate, at least one of whom shall be a veteran.
       (D) Two members appointed by the minority leader of the 
     Senate, at least one of whom shall be a veteran.
       (E) Two members appointed by the President, at least one of 
     whom shall be a veteran.
       (2) Qualifications.--Members of the Commission shall be 
     individuals who--
       (A) are of recognized standing and distinction within the 
     medical community with a background in treating mental 
     health;
       (B) have experience working with the military and veteran 
     population; and
       (C) do not have a financial interest in any of the 
     complementary and integrative health treatments reviewed by 
     the Commission.
       (3) Chairman.--The President shall designate a member of 
     the Commission to be the Chairman.
       (4) Period of appointment.--Members of the Commission shall 
     be appointed for the life of the Commission.
       (5) Vacancy.--A vacancy in the Commission shall be filled 
     in the manner in which the original appointment was made.
       (6) Appointment deadline.--The appointment of members of 
     the Commission in this section shall be made not later than 
     90 days after the date of the enactment of this Act.
       (d) Powers of Commission.--
       (1) Meetings.--
       (A) Initial meeting.--The Commission shall hold its first 
     meeting not later than 30 days after a majority of members 
     are appointed to the Commission.
       (B) Meeting.--The Commission shall regularly meet at the 
     call of the Chairman. Such meetings may be carried out 
     through the use of telephonic or other appropriate 
     telecommunication technology if the Commission determines 
     that such technology will allow the members to communicate 
     simultaneously.
       (2) Hearings.--The Commission may hold such hearings, sit 
     and act at such times and places, take such testimony, and 
     receive evidence as the Commission considers advisable to 
     carry out the responsibilities of the Commission.
       (3) Information from federal agencies.--The Commission may 
     secure directly from any department or agency of the Federal 
     Government such information as the Commission considers 
     necessary to carry out the duties of the Commission.
       (4) Information from nongovernmental organizations.--In 
     carrying out its duties, the Commission may seek guidance 
     through consultation with foundations, veteran service 
     organizations, nonprofit groups, faith-based organizations, 
     private and public institutions of higher education, and 
     other organizations as the Commission determines appropriate.
       (5) Commission records.--The Commission shall keep an 
     accurate and complete record of the actions and meetings of 
     the Commission. Such record shall be made available for 
     public inspection and the Comptroller General of the United 
     States may audit and examine such record.
       (6) Personnel records.--The Commission shall keep an 
     accurate and complete record of the actions and meetings of 
     the Commission. Such record shall be made available for 
     public inspection and the Comptroller General of the United 
     States may audit and examine such records.
       (7) Compensation of members; travel expenses.--Each member 
     shall serve without pay but shall receive travel expenses to 
     perform the duties of the Commission, including per diem in 
     lieu of substances, at rates authorized under subchapter I of 
     chapter 57 of title 5, United States Code.
       (8) Staff.--The Chairman, in accordance with rules agreed 
     upon the Commission, may appoint and fix the compensation of 
     a staff director and such other personnel as may be necessary 
     to enable the Commission to carry out its functions, without 
     regard to the provisions of title 5, United States Code, 
     governing appointments in the competitive service, without 
     regard to the provision of chapter 51 and subchapter III of 
     chapter 53 of such title relating to classification and 
     General Schedule pay rates, except that no rate of pay fixed 
     under this paragraph may exceed the equivalent of that 
     payable for a position at level IV of the Executive Schedule 
     under section 5315 of title 5, United States Code.
       (9) Personnel as federal employees.--
       (A) In general.--The executive director and any personnel 
     of the Commission are employees under section 2105 of title 
     5, United States Code, for purpose of chapters 63, 81, 83, 
     84, 85, 87, 89, and 90 of such title.
       (B) Members of the commission.--Subparagraph (A) shall not 
     be construed to apply to members of the Commission.
       (10) Contracting.--The Commission may, to such extent and 
     in such amounts as are provided in appropriations Acts, enter 
     into contracts to enable the Commission to discharge the 
     duties of the Commission under this Act.
       (11) Expert and consultant service.--The Commission may 
     procure the services of experts and consultants in accordance 
     with section 3109 of title 5, United States Code, at rates 
     not to exceed the daily rate paid to a person occupying a 
     position at level IV of the Executive Schedule under section 
     5315 of title 5, United States Code.
       (12) Postal service.--The Commission may use the United 
     States mails in the same manner and under the same conditions 
     as departments and agencies of the United States.
       (13) Physical facilities and equipment.--Upon the request 
     of the Commission, the Administrator of General Services 
     shall provide to the Commission, on a reimbursable basis, the 
     administrative support services necessary for the Commission 
     to carry out its responsibilities under this Act. These 
     administrative services may include human resource 
     management, budget, leasing accounting, and payroll services.
       (e) Report.--
       (1) Interim reports.--
       (A) In general.--Not later than 60 days after the date on 
     which the Commission first meets, and each 30-day period 
     thereafter ending on the date on which the Commission submits 
     the final report under paragraph (2), the Commission shall 
     submit to the Committees on Veterans' Affairs of the House of 
     Representatives and the Senate and the President a report 
     detailing the level of cooperation the Secretary of Veterans 
     Affairs (and the heads of other departments or agencies of 
     the Federal Government) has provided to the Commission.
       (B) Other reports.--In carrying out its duties, at times 
     that the Commission determines appropriate, the Commission 
     shall submit to the Committees on Veterans' Affairs of the 
     House of Representatives and the Senate and any other 
     appropriate entities an interim report with respect to the 
     findings identified by the Commission.
       (2) Final report.--Not later than 18 months after the first 
     meeting of the Commission, the Commission shall submit to the 
     Committee on Veterans' Affairs of the House of 
     Representatives and the Senate, the President, and the 
     Secretary of Veterans Affairs a final report on the findings 
     of the Commission. Such report shall include the following:
       (A) Recommendations to implement in a feasible, timely, and 
     cost-efficient manner the solutions and remedies identified 
     within the findings of the Commission pursuant to subsection 
     (b).
       (B) An analysis of the evidence-based therapy model used by 
     the Secretary of Veterans Affairs for treating veterans with 
     mental health care issues, and an examination of the 
     prevalence and efficacy of prescription drugs as a means for 
     treatment.
       (C) The findings of the patient-centered survey conducted 
     within each of the Veterans Integrated Service Networks 
     pursuant to subsection (b)(2).
       (D) An examination of complementary and integrative health 
     treatments described in subsection (b)(3) and the potential 
     benefits of incorporating such treatments in the therapy 
     models used by the Secretary for treating veterans with 
     mental health issues.
       (3) Plan.--Not later than 90 days after the date on which 
     the Commission submits the final report under paragraph (2), 
     the Secretary of Veterans Affairs shall submit to the 
     Committees on Veterans' Affairs of the House of 
     Representatives and the Senate a report on the following:
       (A) An action plan for implementing the recommendations 
     established by the Commission on such solutions and remedies 
     for improving wellness-based outcomes for veterans with 
     mental health care issues.
       (B) A feasible timeframe on when the complementary and 
     integrative health treatments described in subsection (b)(3) 
     can be implemented Department-wide.
       (C) With respect to each recommendation established by the 
     Commission, including any complementary and integrative 
     health treatment, that the Secretary determines is not 
     appropriate or feasible to implement, a justification for 
     such determination and an alternative solution to improve the 
     efficacy of the therapy models used by the Secretary for 
     treating veterans with mental health issues.
       (f) Termination of Commission.--The Commission shall 
     terminate 30 days after the Commission submits the final 
     report under subsection (e)(2).

     SEC. 932. EXPANSION OF RESEARCH AND EDUCATION ON AND DELIVERY 
                   OF COMPLEMENTARY AND INTEGRATIVE HEALTH TO 
                   VETERANS.

       (a) Development of Plan To Expand Research, Education, and 
     Delivery.--Not later than 180 days after the date of the 
     enactment of this Act, the Secretary of Veterans Affairs 
     shall develop a plan to expand materially and substantially 
     the scope of the effectiveness of research and education on, 
     and delivery and integration of, complementary and 
     integrative health services into the health care services 
     provided to veterans.
       (b) Elements.--The plan required by subsection (a) shall 
     provide for the following:
       (1) Research on the following:
       (A) The effectiveness of various complementary and 
     integrative health services, including the effectiveness of 
     such services integrated with clinical services.
       (B) Approaches to integrating complementary and integrative 
     health services into other health care services provided by 
     the Department of Veterans Affairs.
       (2) Education and training for health care professionals of 
     the Department on the following:
       (A) Complementary and integrative health services selected 
     by the Secretary for purposes of the plan.
       (B) Appropriate uses of such services.

[[Page H4413]]

       (C) Integration of such services into the delivery of 
     health care to veterans.
       (3) Research, education, and clinical activities on 
     complementary and integrative health at centers of innovation 
     at medical centers of the Department.
       (4) Identification or development of metrics and outcome 
     measures to evaluate the effectiveness of the provision and 
     integration of complementary and integrative health services 
     into the delivery of health care to veterans.
       (5) Integration and delivery of complementary and 
     integrative health services with other health care services 
     provided by the Department.
       (c) Consultation.--
       (1) In general.--In carrying out subsection (a), the 
     Secretary shall consult with the following:
       (A) The Director of the National Center for Complementary 
     and Integrative Health of the National Institutes of Health.
       (B) The Commissioner of Food and Drugs.
       (C) Institutions of higher education, private research 
     institutes, and individual researchers with extensive 
     experience in complementary and integrative health and the 
     integration of complementary and integrative health practices 
     into the delivery of health care.
       (D) Nationally recognized providers of complementary and 
     integrative health.
       (E) Such other officials, entities, and individuals with 
     expertise on complementary and integrative health as the 
     Secretary considers appropriate.
       (2) Scope of consultation.--The Secretary shall undertake 
     consultation under paragraph (1) in carrying out subsection 
     (a) with respect to the following:
       (A) To develop the plan.
       (B) To identify specific complementary and integrative 
     health practices that, on the basis of research findings or 
     promising clinical interventions, are appropriate to include 
     as services to veterans.
       (C) To identify barriers to the effective provision and 
     integration of complementary and integrative health services 
     into the delivery of health care to veterans, and to identify 
     mechanisms for overcoming such barriers.

     SEC. 933. PILOT PROGRAM ON INTEGRATION OF COMPLEMENTARY AND 
                   INTEGRATIVE HEALTH AND RELATED ISSUES FOR 
                   VETERANS AND FAMILY MEMBERS OF VETERANS.

       (a) Pilot Program.--
       (1) In general.--Not later than 180 days after the date on 
     which the Secretary of Veterans Affairs receives the final 
     report under section 931(e)(2), the Secretary shall commence 
     a pilot program to assess the feasibility and advisability of 
     using complementary and integrative health and wellness-based 
     programs (as defined by the Secretary) to complement the 
     provision of pain management and related health care 
     services, including mental health care services, to veterans.
       (2) Matters addressed.--In carrying out the pilot program, 
     the Secretary shall assess the following:
       (A) Means of improving coordination between Federal, State, 
     local, and community providers of health care in the 
     provision of pain management and related health care services 
     to veterans.
       (B) Means of enhancing outreach, and coordination of 
     outreach, by and among providers of health care referred to 
     in subparagraph (A) on the pain management and related health 
     care services available to veterans.
       (C) Means of using complementary and integrative health and 
     wellness-based programs of providers of health care referred 
     to in subparagraph (A) as complements to the provision by the 
     Department of Veterans Affairs of pain management and related 
     health care services to veterans.
       (D) Whether complementary and integrative health and 
     wellness-based programs described in subparagraph (C)--
       (i) are effective in enhancing the quality of life and 
     well-being of veterans;
       (ii) are effective in increasing the adherence of veterans 
     to the primary pain management and related health care 
     services provided such veterans by the Department;
       (iii) have an effect on the sense of well-being of veterans 
     who receive primary pain management and related health care 
     services from the Department; and
       (iv) are effective in encouraging veterans receiving health 
     care from the Department to adopt a more healthy lifestyle.
       (b) Duration.--The Secretary shall carry out the pilot 
     program under subsection (a)(1) for a period of three years.
       (c) Locations.--
       (1) Facilities.--The Secretary shall carry out the pilot 
     program under subsection (a)(1) at facilities of the 
     Department providing pain management and related health care 
     services, including mental health care services, to veterans. 
     In selecting such facilities to carry out the pilot program, 
     the Secretary shall select not fewer than 15 geographically 
     diverse medical centers of the Department, of which not fewer 
     than two shall be polytrauma rehabilitation centers of the 
     Department.
       (2) Medical centers with prescription rates of opioids that 
     conflict with care standards.--In selecting the medical 
     centers under paragraph (1), the Secretary shall give 
     priority to medical centers of the Department at which there 
     is a prescription rate of opioids that conflicts with or is 
     otherwise inconsistent with the standards of appropriate and 
     safe care.
       (d) Provision of Services.--Under the pilot program under 
     subsection (a)(1), the Secretary shall provide covered 
     services to covered veterans by integrating complementary and 
     integrative health services with other services provided by 
     the Department at the medical centers selected under 
     subsection (c).
       (e) Covered Veterans.--For purposes of the pilot program 
     under subsection (a)(1), a covered veteran is any veteran 
     who--
       (1) has a mental health condition diagnosed by a clinician 
     of the Department;
       (2) experiences chronic pain;
       (3) has a chronic condition being treated by a clinician of 
     the Department; or
       (4) is not described in paragraph (1), (2), or (3) and 
     requests to participate in the pilot program or is referred 
     by a clinician of the Department who is treating the veteran.
       (f) Covered Services.--
       (1) In general.--For purposes of the pilot program, covered 
     services are services consisting of complementary and 
     integrative health services as selected by the Secretary.
       (2) Administration of services.--Covered services shall be 
     administered under the pilot program as follows:
       (A) Covered services shall be administered by professionals 
     or other instructors with appropriate training and expertise 
     in complementary and integrative health services who are 
     employees of the Department or with whom the Department 
     enters into an agreement to provide such services.
       (B) Covered services shall be included as part of the 
     Patient Aligned Care Teams initiative of the Office of 
     Patient Care Services, Primary Care Program Office, in 
     coordination with the Office of Patient Centered Care and 
     Cultural Transformation.
       (C) Covered services shall be made available to--
       (i) covered veterans who have received conventional 
     treatments from the Department for the conditions for which 
     the covered veteran seeks complementary and integrative 
     health services under the pilot program; and
       (ii) covered veterans who have not received conventional 
     treatments from the Department for such conditions.
       (g) Reports.--
       (1) In general.--Not later than 30 months after the date on 
     which the Secretary commences the pilot program under 
     subsection (a)(1), the Secretary shall submit to the 
     Committee on Veterans' Affairs of the Senate and the 
     Committee on Veterans' Affairs of the House of 
     Representatives a report on the pilot program.
       (2) Elements.--The report under paragraph (1) shall include 
     the following:
       (A) The findings and conclusions of the Secretary with 
     respect to the pilot program under subsection (a)(1), 
     including with respect to--
       (i) the use and efficacy of the complementary and 
     integrative health services established under the pilot 
     program;
       (ii) the outreach conducted by the Secretary to inform 
     veterans and community organizations about the pilot program; 
     and
       (iii) an assessment of the benefit of the pilot program to 
     covered veterans in mental health diagnoses, pain management, 
     and treatment of chronic illness.
       (B) Identification of any unresolved barriers that impede 
     the ability of the Secretary to incorporate complementary and 
     integrative health services with other health care services 
     provided by the Department.
       (C) Such recommendations for the continuation or expansion 
     of the pilot program as the Secretary considers appropriate.

              Subtitle D--Fitness of Health Care Providers

     SEC. 941. ADDITIONAL REQUIREMENTS FOR HIRING OF HEALTH CARE 
                   PROVIDERS BY DEPARTMENT OF VETERANS AFFAIRS.

       As part of the hiring process for each health care provider 
     considered for a position at the Department of Veterans 
     Affairs after the date of the enactment of the Act, the 
     Secretary of Veterans Affairs shall require from the medical 
     board of each State in which the health care provider has or 
     had a medical license--
       (1) information on any violation of the requirements of the 
     medical license of the health care provider during the 20-
     year period preceding the consideration of the health care 
     provider by the Department; and
       (2) information on whether the health care provider has 
     entered into any settlement agreement for a disciplinary 
     charge relating to the practice of medicine by the health 
     care provider.

     SEC. 942. PROVISION OF INFORMATION ON HEALTH CARE PROVIDERS 
                   OF DEPARTMENT OF VETERANS AFFAIRS TO STATE 
                   MEDICAL BOARDS.

       Notwithstanding section 552a of title 5, United States 
     Code, with respect to each health care provider of the 
     Department of Veterans Affairs who has violated a requirement 
     of the medical license of the health care provider, the 
     Secretary of Veterans Affairs shall provide to the medical 
     board of each State in which the health care provider is 
     licensed detailed information with respect to such violation, 
     regardless of whether such board has formally requested such 
     information.

     SEC. 943. REPORT ON COMPLIANCE BY DEPARTMENT OF VETERANS 
                   AFFAIRS WITH REVIEWS OF HEALTH CARE PROVIDERS 
                   LEAVING THE DEPARTMENT OR TRANSFERRING TO OTHER 
                   FACILITIES.

       Not later than 180 days after the date of the enactment of 
     this Act, the Secretary of Veterans Affairs shall submit to 
     the Committee on Veterans' Affairs of the Senate and the 
     Committee on Veterans' Affairs of the House of 
     Representatives a report on the compliance by the Department 
     of Veterans Affairs with the policy of the Department--
       (1) to conduct a review of each health care provider of the 
     Department who transfers to another medical facility of the 
     Department, resigns, retires, or is terminated to determine 
     whether there are any concerns, complaints, or allegations of 
     violations relating to the medical practice of the health 
     care provider; and
       (2) to take appropriate action with respect to any such 
     concern, complaint, or allegation.

[[Page H4414]]

  


                       Subtitle E--Other Matters

     SEC. 951. MODIFICATION TO LIMITATION ON AWARDS AND BONUSES.

       Section 705 of the Veterans Access, Choice, and 
     Accountability Act of 2014 (Public Law 113-146; 38 U.S.C. 703 
     note) is amended to read as follows:

     ``SEC. 705. LIMITATION ON AWARDS AND BONUSES PAID TO 
                   EMPLOYEES OF DEPARTMENT OF VETERANS AFFAIRS.

       ``(a) Limitation.--The Secretary of Veterans Affairs shall 
     ensure that the aggregate amount of awards and bonuses paid 
     by the Secretary in a fiscal year under chapter 45 or 53 of 
     title 5, United States Code, or any other awards or bonuses 
     authorized under such title or title 38, United States Code, 
     does not exceed the following amounts:
       ``(1) With respect to each of fiscal years 2017 through 
     2018, $230,000,000.
       ``(2) With respect to each of fiscal years 2019 through 
     2021, $225,000,000.
       ``(3) With respect to each of fiscal years 2022 through 
     2024, $360,000,000.
       ``(b) Sense of Congress.--It is the sense of Congress that 
     the limitation under subsection (a) should not 
     disproportionately impact lower-wage employees and that the 
     Department of Veterans Affairs is encouraged to use bonuses 
     to incentivize high-performing employees in areas in which 
     retention is challenging.''.
       And the House agree to the same.
       That the Senate recede from its disagreement to the 
     amendment of the House to the title of the bill and agree to 
     the same with an amendment as follows:
       In lieu of the matter proposed to be inserted by the House 
     amendment to the title of the bill, insert the following: 
     ``An Act to authorize the Attorney General and Secretary of 
     Health and Human Services to award grants to address the 
     prescription opioid abuse and heroin use crisis, and for 
     other purposes.''.
       And the House agree to the same.

     For consideration of the Senate bill and the House 
     amendments, and modifications committed to conference:
     Fred Upton,
     Joseph R. Pitts,
     Leonard Lance,
     Brett Guthrie,
     Adam Kinzinger,
     Larry Bucshon,
     Susan W. Brooks,
     Bob Goodlatte,
     F. James Sensenbrenner, Jr.,
     Lamar Smith,
     Tom Marino,
     Doug Collins,
     David A. Trott,
     Mike Bishop,
     Kevin McCarthy,
     From the Committee on Education and the Workforce, for 
     consideration of title VII of the House amendment, and 
     modifications committed to conference:
     Lou Barletta,
     Earl L. ``Buddy'' Carter,
     From the Committee on Veterans' Affairs, for consideration of 
     title III of the House amendment, and modifications committed 
     to conference:
     Gus M. Bilirakis,
     Jackie Walorski,
     From the Committee on Ways and Means, for consideration of 
     sec. 705 of the Senate bill, and sec. 804 of the House 
     amendment, and modifications committed to conference:
     Patrick Meehan,
     Robert J. Dold,
                                Managers on the Part of the House.

     Chuck Grassley,
     Lamar Alexander,
     Orrin G. Hatch,
     Jeff Sessions,
                               Managers on the Part of the Senate.

       JOINT EXPLANATORY STATEMENT OF THE COMMITTEE OF CONFERENCE

       The managers on the part of the House and the Senate at the 
     conference on the disagreeing votes of the two Houses on the 
     amendments of the House 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, submit 
     the following joint statement to the House and the Senate in 
     explanation of the effect of the action agreed upon by the 
     managers and recommended in the accompanying conference 
     report:
       The House amendment to the text of the bill struck all of 
     the Senate bill after the enacting clause and inserted a 
     substitute text.
       The Senate recedes from its disagreement to the amendment 
     of the House with an amendment that is a substitute for the 
     Senate bill and the House amendment. The difference between 
     the Senate bill, the House amendment, and the substitute 
     agreed to in conference are noted below, except for clerical 
     corrections, conforming changes made necessary by agreements 
     reached by the conferees, and minor drafting and clarifying 
     changes.
       S. 524, the Comprehensive Addiction and Recovery Act 
     (CARA), authorizes the Attorney General and the Secretary of 
     Health and Human Services to award grants to address the 
     national epidemics of addiction to heroin and prescription 
     opioids, and makes various other changes to Federal law to 
     combat opioid addiction and abuse.

                   TITLE I--PREVENTION AND EDUCATION

     Section 101--Task force on pain management
       S. 524 included a task force to review best practices for 
     chronic and acute pain management and prescribing pain 
     medication. It was unclear which best practices the task 
     force would review, modify, and update. The task force would 
     have been required to convene not later than December 14, 
     2018, and within 180 days, modify and update such best 
     practices, as appropriate, and amend them further, if 
     appropriate, after soliciting and taking into consideration 
     public comment. Not later than 90 days after that, the task 
     force would have been required to submit a report to 
     Congress, including a strategy for disseminating best 
     practices as reviewed, modified, or updated.
       The House amendment included the same timeframes and 
     underlying activities but added a number of participants to 
     the task force. The House amendment also added considerations 
     that the task force would have been required to take into 
     account while reviewing, modifying, and updating best 
     practices, several of which extended beyond the scope of 
     chronic and acute pain management.
       Section 101 of the conference report requires the Secretary 
     of Health and Human Services (HHS), within two years of 
     enactment, to convene a task force comprised of federal 
     agencies and non-governmental stakeholders to identify, 
     review, and as appropriate, determine whether there are gaps 
     or inconsistencies between best practices for chronic and 
     acute pain management that have been developed or adopted by 
     Federal agencies. The task force is required to consider a 
     number of factors, existing research, and related efforts, 
     and, within one year of convening, propose any updates to 
     such best practices and recommendations on addressing gaps or 
     inconsistencies after providing the public with at least 90 
     days to submit comments. The task force would also develop a 
     strategy for disseminating information about best practices 
     prior to disbanding three years after enactment.
     Section 102--Awareness campaigns
       Section 102 requires that the Secretary of HHS, as 
     appropriate, to advance education and awareness of issues 
     related to opioid abuse. The Secretary is directed to carry 
     out these activities through existing programs and 
     activities. The awareness campaigns should address 
     information on prevention and detection of opioid abuse. 
     Section 102 of S. 524 included a similar provision.
     Section 103--Community-based coalition enhancement grants to 
         address local drug crises
       Section 103 authorizes the Office of National Drug Control 
     Policy (ONDCP) to award grants to implement community-wide 
     prevention strategies for addressing the local drug crisis or 
     emerging drug abuse issue in areas with high rates of opioid 
     or methamphetamine abuse. The section authorizes the 
     appropriation of $5 million for each of fiscal years 2017 
     through 2021, and allows ONDCP to delegate authority for 
     carrying out the grant program. Section 103 of S. 524 
     included a similar provision.
     Section 104--Information materials and resources to prevent 
         addiction related to youth sports injuries
       Section 104 directs the Secretary of HHS to make publically 
     available a report determining the extent to which 
     informational materials and resources are available with 
     respect to youth sports injuries for which opioids are 
     potentially prescribed. The Secretary may then facilitate the 
     development of materials if gaps are found in resources that 
     are currently available. Teenage athletes who are prescribed 
     an opioid are uniquely susceptible to opioid addiction. The 
     House amendment included similar language.
     Section 105--Assisting veterans with military emergency 
         medical training to meet requirements for becoming 
         civilian health care professionals
       Section 105 would award demonstration grants to states to 
     streamline the licensure requirements for veterans who held 
     military occupational specialties related to medical care or 
     who completed certain military medical training to more 
     easily meet civilian health care licensure requirements. The 
     House amendment included similar language that applied only 
     to military emergency medical technicians.
     Section 106--FDA opioid action plan
       Section 106 requires that the Food and Drug Administration 
     (FDA) consult with advisory committees prior to approval or 
     labeling of certain new opioids in pediatric populations. FDA 
     must also issue final guidance for generic drugs that claim 
     abuse deterrence within 18 months of the date of enactment, 
     and develop recommendations regarding educational programs 
     for prescribers of opioids. The House amendment included 
     similar language.
     Section 107--Improving access to overdose treatment
       Currently, there are questions as to when co-prescribing or 
     prescribing of opioid reversal drugs approved by the Federal 
     Food, Drug and Cosmetic Act for emergency treatment of known 
     or suspected opioid overdose is appropriate. Section 107 
     would allow the Secretary of HHS, the Secretary of Veterans 
     Affairs (VA), and the Secretary of Defense, 180 days after 
     enactment, to provide information to prescribers on co-
     prescribing or prescribing a drug or device for emergency 
     treatment of known or suspected opioid overdose. It 
     explicitly states that the best practices in this section are 
     not to be construed as or to establish a medical standard 
     of care. This section also establishes a grant program to 
     increase access to opioid overdose treatment. The House 
     amendment included similar language.

[[Page H4415]]

  

     Section 108--NIH opioid research
       Section 108 allows the National Institutes of Health (NIH) 
     to intensify and coordinate fundamental, translational, and 
     clinical research with respect to the understanding of pain, 
     the discovery and development of therapies for chronic pain, 
     and the development of alternatives to opioids for effective 
     pain treatments in order to advance the discovery and 
     development of novel, safe, non-addictive, effective, and 
     affordable pharmaceuticals and other therapies for chronic 
     pain.
     Section 109--National All Schedules Prescription Electronic 
         Reporting reauthorization
       Section 109 reauthorizes the National All Schedules 
     Prescription Electronic Reporting (NASPER) Act within HHS to 
     provide grants to states to establish, implement, and improve 
     state-based prescription drug monitoring programs (PDMPs). 
     NASPER first became law in 2005 but expired in 2010. CARA 
     will extend funding for NASPER for five years at $10 million 
     a year for FY 2017 through FY 2021. The House amendment 
     included similar language.
     Section 110--Opioid overdose reversal medication access and 
         education grant programs
       Section 110 would allow the Secretary of HHS to make grants 
     available for states to implement standing orders for opioid 
     reversal drugs approved by the Federal Food, Drug and 
     Cosmetic Act for emergency treatment of known or suspected 
     opioid overdose. These grants may target states that have a 
     significantly higher per-capita rate of opioid overdoses than 
     the national average. Each state that is awarded a grant 
     under this program must submit a report to the Secretary of 
     HHS evaluating the grant and the services that were provided. 
     The House amendment included similar language.

                TITLE II--LAW ENFORCEMENT AND TREATMENT

     Section 201--Comprehensive opioid abuse grant program
       Section 201 includes the provisions of Title II of the 
     House amendment to S. 524. It creates a comprehensive grant 
     program at the Department of Justice (DOJ) to address the 
     problems of opioid addiction and abuse. Though there is no 
     corresponding provision in S. 524 as passed by the Senate, 
     the program created by this section includes several 
     ``allowable uses'' that are similar to provisions in that 
     bill. Minor changes have been made to the conference 
     provisions for clarity. The allowable uses of grant funds 
     include:
       (1) Alternatives to incarceration programs, which replaces 
     Section 201 of the Senate bill. The list of allowable 
     alternatives to incarceration programs is very similar to the 
     programs in the Senate bill, including pre- and post-booking 
     treatment programs such as drug courts and veterans treatment 
     courts, and criminal justice training programs.
       (2) Collaboration between criminal justice agencies and 
     substance abuse systems, which is nearly identical to Section 
     201 of the Senate bill;
       (3) Training for first responders in carrying and 
     administering opioid overdose reversal drugs and purchasing 
     such drugs for first responders who have received training;
       (4) Investigative purposes related to the unlawful 
     distribution of opioids;
       (5) Medication-assisted treatment by criminal justice 
     agencies, which is highlighted in Section 302 of the Senate 
     bill;
       (6) Prescription drug monitoring programs administered by 
     states;
       (7) Programs that address juvenile opioid abuse, which does 
     not have a Senate companion;
       (8) Initiatives to prevent pilfering of prescription 
     opioids, which does not have a Senate companion;
       (9) Prescription drug take-back programs; and
       (10) Development of a jurisdiction's own comprehensive 
     opioid abuse reduction program.
       $103,000,000 is authorized to be appropriated for each of 
     fiscal years 2017 through 2021 to carry out this grant 
     program. This discretionary authorization is fully offset in 
     accordance with the House's CUTGO protocol.
       This section also allows grantees to make subawards to 
     local or regional nonprofit organizations, including faith-
     based organizations, units of local government, and tribal 
     organizations. This section would permit organizations that 
     are private and nonprofit to receive subawards, including 
     organizations that provide alternative complementary mental 
     health services.
       This section requires that the Attorney General ensure 
     equitable distribution of funds, taking into consideration 
     the needs of underserved populations such as rural and tribal 
     communities, and the prevalence of opioid abuse in a 
     community. It also ensures that entities that provide 
     services to pregnant women are eligible for grants under the 
     Family-Based Substance Abuse Grant Program.
       Finally, this section directs the Government Accountability 
     Office (GAO) to study and report on how federal agencies, 
     including ONDCP, through grant programs, are addressing 
     prevention, treatment, and recovery from substance abuse 
     disorders on the part of adolescents and young adults.
     Section 202--First responder training
       Section 201 of the conference report codifies an existing 
     grant program at the Substance Abuse and Mental Health 
     Services Administration (SAMSHA) to expand access to life-
     saving opioid overdose reversal drugs by supporting the 
     purchase and distribution of opioid overdose reversal drugs 
     and training for first responders and other key community 
     sectors. S. 524 included similar language.
     Section 203--Prescription drug take-back expansion
       This section, identical to Section 203 of the Senate bill, 
     authorizes the Attorney General, in coordination with the 
     Administrator of the Drug Enforcement Administration (DEA), 
     the Secretary of HHS, and the Director of ONDCP, to 
     coordinate with certain entities in expanding or making 
     available disposal sites for unwanted prescription 
     medications. These entities include state and local law 
     enforcement agencies, manufacturers and distributors of 
     prescription medications, retail pharmacies, narcotic 
     treatment programs, hospitals with on-site pharmacies, and 
     long-term care facilities.

                   TITLE III--TREATMENT AND RECOVERY

     Section 301--Evidence-based prescription opioid and heroin 
         treatment and interventions demonstration
       Section 301 of the conference report codifies an existing 
     grant program at SAMHSA to support states in expanding access 
     to addiction treatment services for individuals with an 
     opioid use disorder, including evidence-based medication 
     assisted treatment. This program is targeted toward areas 
     where there is a high rate or a rapid increase in the use of 
     heroin or other opioids, including rural areas. S. 524 
     included this language.
     Section 302--Building communities of recovery
       Section 302 of the conference report allows HHS to provide 
     grants to community organizations to develop, expand, and 
     enhance recovery services and build connections between 
     recovery networks, including physicians, the criminal justice 
     system, employers, and other recovery support systems. 
     Recovery services help individuals with a substance use 
     disorder get and stay well and increase long-term recovery 
     from substance use disorders. S. 524 included this language.
     Section 303--Medication-assisted treatment for recovery from 
         addiction
       The House amendment included provisions amending the 
     Controlled Substances Act to permit nurse practitioners and 
     physician assistants (NPs and PAs) who meet certain criteria 
     to receive a waiver from SAMHSA to dispense certain drugs for 
     maintenance or detoxification treatment in an office-based 
     setting to up to 30 patients in the first year and up to 100 
     patients after the first year and going forward. In states 
     where NPs and PAs are required to practice in collaboration 
     with, or under the supervision of a physician, such physician 
     would also need to be a qualifying practitioner (i.e., have 
     their own waiver from SAMHSA). This new authority for NPs and 
     PAs would sunset three years after the date of enactment.
       Section 303 of the conference report includes similar 
     operative language to the House amendment, though it requires 
     the implementing regulations to be updated no later than 18 
     months after the date of enactment and the new authority for 
     NPs and PAs expires October 1, 2021. Further, this section 
     would not preempt any state law that establishes a lower 
     limit on the number of patients a qualifying practitioner can 
     treat at any given time or requires a qualifying practitioner 
     to comply with additional requirements relating to the 
     dispensing of such drugs.

              TITLE IV--ADDRESING COLLATORAL CONSEQUENCES

     Section 401--GAO report on recovery and collateral 
         consequences
       This section directs GAO to submit a report to the Senate 
     and House Judiciary Committees on recovery and the collateral 
     consequences of drug-related criminal convictions within one 
     year of the date of the Act's enactment. The report will 
     study the collateral consequences for individuals with 
     convictions for non-violent drug-related offenses and the 
     effects of these collateral consequences on individuals in 
     recovery on their ability to resume their personal and 
     professional activities. The report will also discuss the 
     policy bases and justifications for imposing these collateral 
     consequences and provide perspectives on the potential for 
     mitigating the effect of these collateral consequences on 
     individuals in recovery.

  TITLE V--ADDICTION AND TREATMENT SERVICES FOR WOMEN, FAMILIES, AND 
                                VETERANS

     Section 501--Improving treatment for pregnant and postpartum 
         women
       Section 501 reauthorizes a grant program for residential 
     treatment for pregnant and postpartum women who have an 
     opioid use disorder. This program also provides services for 
     the children of such women, including those who may be born 
     with neonatal abstinence syndrome. It creates a new pilot 
     program to enhance the flexibility of the funds so states can 
     more broadly support family-based services for pregnant and 
     postpartum women and their children. S. 524 included language 
     to reauthorize this program and create a pilot program but at 
     a lower authorized level than the language included in the 
     House amendment.
     Section 502--Veterans treatment courts
       The language in this section is drawn from the House 
     amendment to S. 524, and replaces the language from Section 
     503 of the Senate

[[Page H4416]]

     bill. However, consistent with the Senate bill, this section 
     defines ``qualified veterans'' for purposes of the DOJ grant 
     program as those who have served on active duty in any branch 
     of the Armed Services and have been discharged under 
     conditions other than dishonorable, unless the reason for the 
     dishonorable discharge was attributable to a substance abuse 
     disorder.
       Additionally, this section provides a definitional 
     framework for ``peer-to peer'' programs, ``veterans treatment 
     court'' programs, and ``veterans assistance'' programs that 
     are eligible under this section. This section is cross-
     referenced in the ``alternatives to incarceration'' piece of 
     section 201 of the conference report, and should provide 
     guidance on how grantees are to use grant funds received for 
     veterans courts.
     Section 503.--Infant plan of safe care
       Section 503 incorporates text originally passed as part of 
     the House amendment to S. 524 and responds to concerns about 
     the increased number of infants born suffering from opioid 
     withdrawal symptoms and ensures states are in compliance with 
     the Child Abuse Prevention and Treatment Act (CAPTA). No 
     corresponding provision was included in S. 524. This section 
     requires the Department of HHS to review and confirm states 
     have CAPTA policies in place as required under the law, 
     strengthens protections for infants born with substance 
     exposure by clarifying the intent of safe care plans, and 
     requires the HHS Secretary to share best practices for 
     developing plans to keep infants and their caregivers safe 
     and healthy. It also improves accountability related to the 
     care of infants and their families by requiring additional 
     information be shared on incidents of infants exposed and 
     their subsequent care. Additionally, it encourages the use of 
     information made available through other child welfare laws 
     in verifying CAPTA compliance. Finally, section 503 prevents 
     HHS from adding new requirements to state assurances and 
     plans.
     Section 504--GAO report on Neonatal Abstinence Syndrome (NAS)
       Section 504 requires the Comptroller General of the United 
     States to, one year after enactment, issue a report on 
     neonatal abstinence syndrome (NAS), including information on 
     the treatment for infants with NAS under Medicaid. 
     Specifically, the report will examine what is known about the 
     prevalence of NAS in the country; the Medicaid-reimbursable 
     services available to treat NAS; the types of, and 
     reimbursement for care settings in which infants with NAS 
     receive care; and any federal policy barriers for treating 
     infants with NAS and what is known about best practices for 
     caring for infants with NAS. Similar language was included in 
     the House amendment.

  TITLE VI--INCENTIVIZING STATE COMPREHENSIVE INITIATIVES TO ADDRESS 
                       PRESCRIPTION OPIOID ABUSE

     Section 601--State demonstration grants for comprehensive 
         opioid abuse response
       Section 601 of the conference report supports State efforts 
     to combat opioid abuse by authorizing HHS to award grants to 
     States and combinations of States to carry out a 
     comprehensive opioid abuse response, including education, 
     treatment, and recovery efforts, maintaining prescription 
     drug monitoring programs, and efforts to prevent overdose 
     deaths. S. 524 included this language; there was no 
     corresponding legislation in the House amendment.

                        TITLE VII--MISCELLANEOUS

     Section 701--Grant accountability and evaluations
       This section combines language that originated in both the 
     House and Senate on grant oversight. It requires the DOJ 
     Inspector General, at his or her discretion, to conduct 
     audits of covered grantees to prevent waste, fraud, and abuse 
     of funds. This section prohibits grantees with unresolved 
     audit findings from receiving grants in the following fiscal 
     year, and prioritizes grantees that do not have unresolved 
     audit findings. If a grantee nevertheless receives funds 
     inappropriately, this section also compels DOJ to reimburse 
     the Department of the Treasury for the amount awarded, and to 
     seek to recoup the funds from the grantee.
       With respect to nonprofit organizations, this section 
     prohibits nonprofits that hold money in offshore accounts for 
     the purpose of avoiding certain federal taxes from receiving 
     subawards from grant recipients. It also requires nonprofit 
     organizations to disclose, in a grant application, the 
     compensation of its board of directors. Finally, this section 
     limits the use of grant funds for conference expenditures, 
     and prevents the awarding of duplicative grants.
       This section also contains the provisions applicable to DOJ 
     from Title VI of the House amendment to S. 524, the Opioid 
     Program Evaluation (OPEN) Act, which did not have a Senate 
     companion. It requires the Attorney General to complete an 
     evaluation of the effectiveness of the Comprehensive Opioid 
     Abuse Grant Program based upon the information reported by 
     grantees not later than 5 years after the enactment of the 
     Act. It requires the Attorney General to identify outcomes to 
     be achieved under the Comprehensive Opioid Grant Abuse 
     Program, and the metrics by which the achievement of such 
     outcomes shall be determined, not later than 180 days after 
     the enactment of the Act.
       This section provides that the Attorney General must 
     require grantees and those receiving subawards to collect and 
     annually report data on the activities conducted using their 
     grant funding. It requires that the Attorney General publish 
     the outcomes and metrics to be used to evaluate the program 
     not later than 30 days after identifying such outcomes and 
     metrics, and that the entity conducting the evaluation 
     publish the results and issue a report to the House and 
     Senate Judiciary Committees not later than 90 days after 
     completion of the evaluation. It further requires the data 
     collected from grantees to be published along with the 
     report.
       Finally, this section requires that the Attorney General 
     enter into an arrangement with the National Academy of 
     Sciences--or another non-government entity with expertise in 
     conducting and evaluating research pertaining to opioid use 
     and abuse and drawing conclusions about overall opioid use 
     and abuse on the basis of that research--to identify the 
     outcomes to be achieved, the metrics by which performance 
     will be evaluated, and the evaluation of the Comprehensive 
     Opioid Abuse Grant Program.
       Section 701 also authorizes HHS to evaluate grants 
     authorized within the Comprehensive Addiction Recovery Act 
     and identify outcomes to be achieved by the programs, and 
     metrics by which to measure those outcomes.
       This section also places restrictions on conference 
     expenditures using funding under a grant program in this Act.
     Section 702--Partial fill of Schedule II controlled 
         substances
       Section 702 clarifies that if a doctor or patient requests 
     a prescription for a Schedule II substance (such as an 
     opioid) not be filled in its entirety, in accordance with 
     state law; pharmacists are permitted to dispense only part of 
     the prescription. This change could lead to fewer opioids 
     being dispensed. The House amendment to CARA permitted more 
     flexibility in filling Schedule II prescriptions such as 
     opioids.
     Section 703--Good Samaritan Assessment
       This section includes the provisions of Title V of the 
     House amendment to S. 524, the Good Samaritan Assessment Act, 
     which did not have a Senate companion. It directs the GAO to 
     issue a report to the House and Senate Judiciary Committees, 
     the House Oversight and Government Reform Committee, and the 
     Senate Homeland Security and Governmental Affairs Committee, 
     on the extent to which ONDCP has reviewed Good Samaritan laws 
     and the findings from such a review; efforts by the ONDCP 
     Director to encourage the enactment of Good Samaritan laws; 
     and a compilation of Good Samaritan laws in effect in the 
     States, the territories, and the District of Columbia.
       Currently, more than half the states and the District of 
     Columbia have some form of Good Samaritan law on the books, 
     to protect citizens who render help to someone in need--or, 
     in the context of opioids, to exempt from criminal or civil 
     liability someone who administers an opioid overdose reversal 
     drug or device, such as naloxone, or who calls 911 to report 
     an overdose.
       Given the widespread activity in state legislatures on this 
     issue, and the differences between individual state statutes, 
     this section directs GAO to study and report to Congress on 
     the effects of the various Good Samaritan laws at the state 
     level, and efforts by ONDCP to address the issue.
     Section 704--Programs to prevent prescription drug abuse 
         under Medicare Parts C and D
       Section 704 would allow prescription drug plans in 
     Medicare, including Medicare Part D plans as well as 
     standalone Medicare Advantage Prescription Drug Plans, to 
     develop a safe prescribing and dispensing program for 
     beneficiaries that are at risk of abuse or diversion of drugs 
     that are frequently abused or diverted. The provision allows 
     the Secretary of HHS to work with private drug plan sponsors 
     to facilitate the creation and management of ``lock-in'' 
     programs to curb identified fraud, abuse, and misuse of 
     prescribed medications while at the same time ensuring that 
     legitimate beneficiary access to needed medications is not 
     impeded.
       Such controls would prevent doctor/pharmacy shopping as 
     well as duplicative and inappropriate drug therapies that can 
     lead to prescription drug abuse. The conference report gives 
     the Secretary responsibility to define an at-risk beneficiary 
     using clinical guidelines developed in consultation with 
     stakeholders. Plans would be able to identify enrolled 
     Medicare beneficiaries deemed at high risk of abusing 
     prescription drugs, and to limit such beneficiaries' choice 
     of prescribers or pharmacies in order to better monitor their 
     use of these medications. For example, restrictions might be 
     placed on beneficiaries suspected of abusing or reselling 
     certain controlled substances, but not placed on 
     beneficiaries with cancer or other conditions for which those 
     drugs are considered appropriate. Plan sponsors, under the 
     conference report, would have to take into consideration 
     where an at-risk beneficiary lives and works, as well as 
     other relevant factors when assigning providers and 
     pharmacies and would also consider the beneficiary's 
     preferences unless it is deemed the cause of potential abuse. 
     Plan sponsors also will have to comply with a number of 
     beneficiary protections including ensuring access, 
     notifications and disclosure requirements, as well as appeal 
     rights. S. 524 included similar language.

[[Page H4417]]

  

     Sections 705-707--Exempting abuse-deterrent formulations of 
         prescription drugs from the Medicaid additional rebate 
         requirement for new formulations of prescription drugs; 
         limiting disclosure of predictive modeling and other 
         analytics technologies to identify and prevent fraud, 
         waste, and abuse; and Medicaid improvement fund
       Sections 705-707 would exempt abuse deterrent formulations 
     of opioid drugs (ADFs) from the definition of ``line 
     extension'' for the purpose of calculating Medicaid rebates. 
     In its Opioids Action Plan, FDA said its goal is to ``expand 
     access to abuse deterrent formulations to discourage abuse.'' 
     And in its ADF guidance to manufacturers, the agency has said 
     it ``considers the development of these products a high 
     public health priority.'' This policy was also included in 
     the President's FY 2017 Budget, which noted that this 
     statutory change would ``incentivize continued development of 
     abuse deterrent formulations.''
       The budgetary impact of the ADF policy is being offset by a 
     policy from the President's budget that prevents the public 
     disclosure of program integrity algorithms used to identify 
     and predict waste, fraud, and abuse in Medicare, Medicaid, 
     and the Children's Health Insurance Program (CHIP) and places 
     the remaining savings in a Medicaid Improvement Fund. The 
     mathematical algorithms and predictive technologies the 
     Centers for Medicare and Medicaid Services (CMS) uses in 
     Medicare, Medicaid, and CHIP are vital to uncovering fraud, 
     waste, and abuse. However, if various aspects of these 
     algorithms were to become publicly known, fraudsters could 
     utilize the information to re-direct their schemes to other 
     areas of the Medicare, Medicaid, and CHIP programs or adjust 
     their schemes to avoid detection. This policy would simply 
     prevent the disclosure of these anti-fraud tools through 
     FOIA-related laws while still allowing CMS and state Medicaid 
     and CHIP programs to freely share algorithms and other 
     predictive analytical tools.
       The conference provision is the same as the provision 
     included in the House amendment.
     Section 708--Sense of Congress regarding treatment of 
         substance abuse epidemics
       This section includes a Sense of Congress that decades of 
     experience and research have demonstrated that a fiscally 
     responsible approach to addressing the opioid abuse epidemic 
     and other substance abuse epidemics requires treating such 
     epidemics as a public health emergency emphasizing 
     prevention, treatment, and recovery.

              TITLE VIII--KINGPIN DESIGNATION IMPROVEMENT

     Section 801--Protection of classified information
       This section incorporates the provisions of Title IV of the 
     House amendment to S. 524, which passed the House on May 10, 
     2016, and its Senate companion, S. 2914, the ``Kingpin 
     Designation Improvement Act.'' The section amends Section 804 
     of the Foreign Narcotics Kingpin Designation Act to include 
     language to protect classified information from disclosure 
     during a federal court challenge by a designee.
       Under current law, the Treasury Department's Office of 
     Foreign Assets Control (OFAC) uses the International 
     Emergency Economic Powers Act (IEEPA) and the Foreign 
     Narcotics Kingpin Designation Act (the ``Kingpin Act'') to 
     target and apply sanctions to international narcotics 
     traffickers and their organizations. The Kingpin Act is the 
     principal mechanism by which OFAC sanctions foreign persons 
     tied to global narcotics trafficking.
       OFAC's designations are often based upon classified 
     information. Unlike in a related federal statute, the Kingpin 
     Act does not contain such a mechanism to protect classified 
     information from release during a ``de-listing'' process. 
     That means OFAC may lose the opportunity to designate a high-
     level drug kingpin because it cannot risk the disclosure of 
     classified information.
       This section clarifies that OFAC can submit classified 
     information to defend its designations ex parte and in camera 
     in the relevant U.S. district court, thereby ensuring 
     classified information can be protected from disclosure.

                TITLE IX--DEPARTMENT OF VETERANS AFFAIRS

     Section 901--Short title
       Includes the title ``Jason Simcakoski Memorial and Promise 
     Act.''
     Section 902--Definitions
       This section includes various definitions of terms used 
     throughout Title IX.
     Section 911--Improvement of opioid safety measures by the 
         Department of Veterans Affairs
       This provision requires the Secretary to expand the Opioid 
     Safety Initiative to include all VA medical facilities within 
     180 days of enactment of this act, and would require that all 
     VA employees who prescribe opioids receive education and 
     training on pain management and safe opioid prescribing 
     practices. The Secretary would also be required to establish 
     enhanced standards with respect to the use of routine and 
     random drug tests for all patients before and during opioid 
     therapy. Directors of each medical facility will be required 
     to designate a pain management team of health care 
     professionals responsible for coordinating and overseeing 
     pain management therapy and will provide an annual report 
     identifying the members of the facility's pain management 
     team, certification as to education and training, and 
     compliance with the stepped-care model or other pain 
     management policies. This provision also requires 
     participation in state prescription drug monitoring programs; 
     a report on the feasibility and advisability of advanced 
     real-time tracking of opioid use data in the Opioid Therapy 
     Risk Report tool; an increase in the availability of opioid 
     receptor antagonists such as naloxone and a report on 
     compliance; inclusion in the Opioid Therapy Risk Report tool 
     of information identifying when health care providers access 
     the tool and the most recent urine drug test for each 
     veteran; and notification of opioid abuse risk in the 
     computerized patient record system.
       Both H.R. 4063 and S. 2921, as reported, included similar 
     language.
     Section 912--Strengthening of joint working group on pain 
         management of the Department of Veterans Affairs and the 
         Department of Defense
       H.R. 4063 and S. 2921, as reported, require that VA and the 
     Department of Defense (DOD) ensure that the Health Executive 
     Committee's Pain Management Working Group (PMWG) includes a 
     focus on the opioid prescribing practices of health care 
     providers of each Department; the ability of each Department 
     to manage acute and chronic pain, including training health 
     care providers with respect to pain management; the use by 
     each Department of complementary and integrative health; the 
     concurrent use by health care providers of each Department of 
     opioids and prescription drugs to treat mental health 
     disorders, including benzodiazepines; the use of care 
     transition plans by health care providers of each Department 
     to address case management issues for patients receiving 
     opioid therapy who transition between inpatient and 
     outpatient settings; coordination in coverage of and 
     consistent access to medications prescribed for patients 
     transitioning from receiving health care from DOD to VA; and 
     the ability of each Department to screen, identify, and treat 
     patients with substance use disorders who are seeking 
     treatment for acute and chronic pain.
       This provision also ensures the PMWG coordinates its 
     activities with other relevant working groups; consults with 
     other relevant federal agencies, including the Centers for 
     Disease Control and Prevention; consults with the VA and DOD 
     with respect to the VA/DOD Clinical Practice Guideline for 
     Management of Opioid Therapy for Chronic Pain; and reviews 
     and comments on the guideline before any update to such 
     guideline is released.
       This provision requires VA and DOD to jointly update the 
     VA/DOD Clinical Practice Guideline for Management of Opioid 
     Therapy for Chronic Pain within 180 days of enactment. This 
     provision requires that the PMWG, in coordination with the 
     Clinical Practice Guideline VA/DOD Management of Opioid 
     Therapy for Chronic Pain Working Group, examine whether the 
     guidelines should include numerous elements. The elements to 
     be considered include, but are not limited to, enhanced 
     guidance with respect to: opioid and other drug prescription 
     practices; treatment of patients with behaviors or 
     comorbidities that require co-management of opioid therapy; 
     patient status assessments conducted by providers; governance 
     of the methodologies used by VA and DOD providers to taper 
     opioid therapy; appropriate case management for opioid 
     patients transitioning from an inpatient setting to an 
     outpatient setting; appropriate case management for opioid 
     patients transitioning from active duty to post-military 
     health care networks; how providers should discuss with 
     patients options for pain management therapies before 
     initiating opioid therapy; provision of evidence-based non-
     opioid treatments within VA and DOD; and consideration of 
     guidelines developed by CDC for safely prescribing opioids.
     Section 913--Review, investigation, and report on use of 
         opioids in treatment by Department of Veterans Affairs
       This provision requires GAO, not later than 2 years after 
     enactment, to submit a report on the Opioid Safety Initiative 
     and the opioid prescribing practices of VA health care 
     providers. This provision also requires semi-annual progress 
     reports on the implementation of any GAO recommendations 
     generated by this report. The Secretary must also review and 
     report annually on the patient population receiving opioid 
     therapy and the prescription rates of each medical facility 
     and conduct investigations, through the Office of the Medical 
     Inspector, on prescription rates that conflict with or are 
     otherwise inconsistent with the standards of appropriate and 
     safe care.
       Both H.R. 4063 and S. 2921, as reported, included similar 
     language.
     Section 914--Mandatory disclosure of certain veteran 
         information to state controlled substance monitoring 
         programs
       This provision includes the H.R. 4063, as reported, 
     language requiring that VA providers shall disclose certain 
     veteran information to state controlled substance monitoring 
     programs.
     Section 915--Elimination of copayment requirement for 
         veterans receiving opioid antagonists or education on use 
         of opioid antagonists
       This provision includes the S. 2921, as reported, language 
     that would eliminate the copayment requirement for veterans 
     receiving opioid antagonists or education on the use of 
     opioid antagonists.

[[Page H4418]]

  

     Section 921--Community meetings on improving care furnished 
         by Department of Veterans Affairs
       This provision requires that, within 90 days of the 
     enactment of this act, and quarterly thereafter, each VA 
     medical facility hosts a public community meeting on 
     improving VA health care; and within one year of the 
     enactment of this act, and at least annually thereafter, that 
     each community-based outpatient clinic (CBOC) hosts such a 
     community meeting. These meetings will require regular senior 
     leadership attendance and notice will be given to the 
     Committees on Veterans' Affairs of the House and of the 
     Senate and the Members of Congress who represent the area in 
     which the facility is located at least ten days in advance.
       Both H.R. 4063 and S. 2921, as reported, included similar 
     language.
     Section 922--Improvement of awareness of Patient Advocacy 
         Program and Patient Bill of Rights of Department of 
         Veterans Affairs
       This provision would require, within 90 days of the 
     enactment of this act, the display of, in as many prominent 
     locations as the Secretary determines appropriate to be seen 
     by the largest percentage of patients at each VA medical 
     facility: (1) the purposes of the VA Patient Advocacy Program 
     and the contact information for the patient advocate at each 
     medical facility; and (2) the rights and responsibilities of 
     patients and family members and, with respect to community 
     living centers and other VA residential facilities.
       Both H.R. 4063 and S. 2921, as reported, included similar 
     language.
     Section 923--Comptroller General report on Patient Advocacy 
         Programs of Department of Veterans Affairs
       Both H.R. 4063 and S. 2921 require that, within two years 
     of the enactment of this act, GAO submit a report on the VA 
     Patient Advocacy Program to the Committees on Veterans' 
     Affairs of the House and of the Senate. The report will 
     include: (1) a description of the Program, including the 
     Program's purpose, activities, and sufficiency in achieving 
     its purpose; (2) an assessment of the sufficiency of the 
     Program's staffing; (3) an assessment of the Program's 
     employee training; (4) an assessment of veterans' and family 
     members' awareness of and utilization of the Program; (5) 
     recommendations for improving the Program; and (6) any other 
     information the GAO considers appropriate.
       Both H.R. 4063 and S. 2921, as reported, included similar 
     language.
     Section 924--Establishment of office of patient advocacy of 
         the Department of Veterans Affairs
       This section establishes an office of patient advocacy 
     within the Office of the Undersecretary for Health of the 
     Department of Veterans Affairs. This office will ensure 
     patient advocates appropriately advocate for veteran patients 
     and are trained in their responsibilities.
     Section 931--Expansion of research and education on and 
         delivery of complementary and integrative health to 
         veterans
       H.R. 4063, as reported, establishes a Commission to examine 
     the evidence-based therapy treatment model used by VA for 
     treating mental health conditions of veterans and the 
     potential benefits of incorporating complementary and 
     integrative health as standard practice throughout the 
     Department. The Commission would: (1) examine the efficacy of 
     the evidence-based therapy model used by VA to treat mental 
     health illnesses and identify areas of improvement; (2) 
     conduct a patient-centered survey within each VISN to 
     examine: the experiences of veterans with VA facilities 
     regarding mental health care, the experiences of veterans 
     with non-VA facilities regarding mental health care, the 
     preferences of veterans regarding available treatment for 
     mental health issues and which methods the veterans believe 
     to be most effective, the experience, if any, of veterans 
     with respect to the complementary and integrative health 
     treatment therapies, the prevalence of prescribing medication 
     to veterans seeking treatment for mental health disorders 
     through VA, and the outreach efforts of VA regarding the 
     availability of benefits and treatments for veterans for 
     addressing mental health issues; (3) examine available 
     research on complementary and integrative health for mental 
     health disorders in areas of therapy including: music 
     therapy, equine therapy, training and caring for service 
     dogs, yoga therapy, acupuncture therapy, meditation therapy, 
     outdoor sports therapy, hyperbaric oxygen therapy, 
     accelerated resolution therapy, art therapy, magnetic 
     resonance therapy, and others; (4) study the sufficiency of 
     VA resources to deliver quality mental health care; and (5) 
     study the current treatments and resources available within 
     VA and assess: the effectiveness of such treatments and 
     resources in decreasing the number of suicides per day by 
     veterans, the number of veterans who have been diagnosed with 
     mental health issues, the percentage of veterans who 
     have completed VA counseling sessions, and the efforts of 
     VA to expand complementary and integrative health 
     treatments viable to the recovery of veterans with mental 
     health issues as determined by the Secretary to improve 
     the effectiveness of treatments offered by VA.
     Section 932--Pilot program on integration of complementary 
         and integrative health and related issues for veterans 
         and family members of veterans
       The provision requires that the Secretary, informed by the 
     Commission's findings, commence a pilot program to assess the 
     feasibility and advisability of using wellness-based programs 
     to complement pain management and related health care 
     services. The pilot program would last for three years and be 
     carried out at no fewer than 15 VA facilities providing pain 
     management, two of which must be polytrauma centers. The 
     Secretary should prioritize medical centers at which there is 
     a prescription rate that is inconsistent with the standards 
     of appropriate care when selecting medical centers for the 
     pilot. The Secretary will report on findings and conclusions 
     regarding the use and efficacy of complementary and 
     integrative health services established under the pilot 
     program, the outreach conducted by VA about the pilot, and an 
     assessment of the benefit of the pilot program to covered 
     veterans, as well as identify any unresolved barriers to VA's 
     use of complementary and integrative medicine, and make 
     recommendations for the continuation or expansion of the 
     pilot program.
       Both H.R. 4063 and S. 2921, as reported, included similar 
     language.
     Section 941--Additional requirements for hiring of health 
         care providers by Department of Veterans Affairs
       This provision would require that, as part of the hiring 
     process for all heath care providers considered for a 
     position after the date of the enactment of this act, that 
     the Secretary require from the medical board of the State in 
     which the applicant is licensed: (1) information on any 
     violations of the requirements of medical license over the 
     previous 20 years; and (2) information on whether the 
     provider has entered into any settlement agreements for 
     disciplinary charges related to the practice of medicine.
       Both H.R. 4063 and S. 2921, as reported, included similar 
     language.
     Section 942--Provision of information on health care 
         providers of Department of Veterans Affairs to state 
         medical boards
       This provision would require that VA provide to the medical 
     board of each State in which the provider is licensed 
     information regarding violations, regardless of whether the 
     board has requested such information.
       Both H.R. 4063 and S. 2921, as reported, included similar 
     language.
     Section 943--Report on compliance by Department of Veterans 
         Affairs with reviews of health care providers leaving the 
         department or transferring to other facilities
       This provision would require that, within 180 days of the 
     enactment of this act, that the Secretary submit to the 
     Committees on Veterans' Affairs of the House and of the 
     Senate a report on VA's compliance with VA policy to conduct 
     a review of each provider who transfers from another VA 
     medical facility, retires, or is terminated, and to take 
     appropriate actions with respect to any concerns, complaints, 
     or allegations against the provider.
       Both H.R. 4063 and S. 2921, as reported, included similar 
     language.
     Section 951--Modification to limitation on bonus and awards
       This provision limits the amounts of funds available for 
     payment as bonuses and awards and directs those amounts now 
     available within the budget toward the payment for the 
     programs and services directed in this title.
       This section also includes a Sense of Congress that states 
     the limitation under this subsection should not 
     disproportionately impact lower-wage employees within the VA.

       Earmark, Limited Tax Benefits, and Limited Tariff Benefits

       In compliance with clause 9(e), 9(f), and 9(g) of Rule XXI 
     of the Rules of the House of Representatives, the conference 
     report and joint explanatory statement contain no earmarks, 
     limited tax benefits, or limited tariff benefits.

                 Constitutional Statement of Authority

       Congress has the power to enact this legislation pursuant 
     to the following: Article I, Section 8, Clause 3 of the 
     United States Constitution.

     For consideration of the Senate bill and the House 
     amendments, and modifications committed to conference:
     Fred Upton,
     Joseph R. Pitts,
     Leonard Lance,
     Brett Guthrie,
     Adam Kinzinger,
     Larry Bucshon,
     Susan W. Brooks,
     Bob Goodlatte,
     F. James Sensenbrenner, Jr.,
     Lamar Smith,
     Tom Marino,
     Doug Collins,
     David A. Trott,
     Mike Bishop,
     Kevin McCarthy,
     From the Committee on Education and the Workforce, for 
     consideration of title VII of the House amendment, and 
     modifications committed to conference:
     Lou Barletta,
     Earl L. ``Buddy'' Carter,
     From the Committee on Veterans' Affairs, for consideration of 
     title III of the House amendment, and modifications committed 
     to conference:
     Gus M. Bilirakis,
     Jackie Walorski,

[[Page H4419]]

     From the Committee on Ways and Means, for consideration of 
     sec. 705 of the Senate bill, and sec. 804 of the House 
     amendment, and modifications committed to conference:
     Patrick Meehan,
     Robert J. Dold,
                                Managers on the Part of the House.

     Chuck Grassley,
     Lamar Alexander,
     Orrin G. Hatch,
     Jeff Sessions,
     Managers on the Part of the Senate.

                          ____________________