[Congressional Record Volume 163, Number 126 (Wednesday, July 26, 2017)]
[Senate]
[Pages S4330-S4331]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

  SA 384. Mr. MANCHIN (for himself, Mr. Murphy, Mr. Whitehouse, Mr. 
King, Ms. Klobuchar, Mr. Nelson, Ms. Heitkamp, Mrs. Shaheen, Ms. 
Baldwin, Mr. Blumenthal, and Ms. Warren) submitted an amendment 
intended to be proposed to amendment SA 267 proposed by Mr. McConnell 
to the bill H.R. 1628, to provide for reconciliation pursuant to title 
II of the concurrent resolution on the budget for fiscal year 2017; 
which was ordered to lie on the table; as follows:

       At the appropriate place, insert the following:

     SEC. __01. STEWARDSHIP FEE ON OPIOID PAIN RELIEVERS.

       (a) In General.--Subchapter E of chapter 32 of the Internal 
     Revenue Code of 1986 is amended by adding at the end the 
     following new section:

     ``SEC. 4192. OPIOID PAIN RELIEVERS.

       ``(a) In General.--There is hereby imposed on the sale of 
     any active opioid by the manufacturer, producer, or importer 
     a fee equal to 1 cent per milligram so sold.
       ``(b) Active Opioid.--For purposes of this section--
       ``(1) In general.--The term `active opioid' means any 
     controlled substance (as defined in section 102 of the 
     Controlled Substances Act, as in effect on the date of the 
     enactment of this section) which is opium, an opiate, or any 
     derivative thereof.
       ``(2) Exclusion for certain prescription medications.--Such 
     term shall not include any prescribed drug which is used 
     exclusively for the treatment of opioid addiction as part of 
     a medically assisted treatment effort.
       ``(3) Exclusion of other ingredients.--In the case of a 
     product that includes an active opioid and another 
     ingredient, subsection (a) shall apply only to the portion of 
     such product that is an active opioid.''.
       (b) Clerical Amendments.--
       (1) The heading of subchapter E of chapter 32 of the 
     Internal Revenue Code of 1986 is amended by striking 
     ``Medical Devices'' and inserting ``Other Medical Products''.
       (2) The table of subchapters for chapter 32 of such Code is 
     amended by striking the item

[[Page S4331]]

     relating to subchapter E and inserting the following new 
     item:

               ``subchapter e. other medical products''.

       (3) The table of sections for subchapter E of chapter 32 of 
     such Code is amended by adding at the end the following new 
     item:

``Sec. 4192. Opioid pain relievers.''.
       (c) Effective Date.--The amendments made by this section 
     shall apply to sales on or after the date that is 1 year 
     after the date of the enactment of this Act.
       (d) Rebate or Discount Program for Certain Cancer and 
     Hospice Patients.--
       (1) In general.--The Secretary of Health and Human 
     Services, in consultation with patient advocacy groups and 
     other relevant stakeholders as determined by such Secretary, 
     shall establish a mechanism by which--
       (A) any amount paid by an eligible patient in connection 
     with the stewardship fee under section 4192 of the Internal 
     Revenue Code of 1986 (as added by this section) shall be 
     rebated to such patient in as timely a manner as possible, or
       (B) amounts paid by an eligible patient for active opioids 
     (as defined in section 4192(b) of such Code) are discounted 
     at time of payment or purchase to ensure that such patient 
     does not pay any amount attributable to such fee,
     with as little burden on the patient as possible. The 
     Secretary shall choose whichever of the options described in 
     subparagraph (A) or (B) is, in the Secretary's determination, 
     most effective and efficient in ensuring eligible patients 
     face no economic burden from such fee.
       (2) Eligible patient.--For purposes of this section, the 
     term ``eligible patient'' means--
       (A) a patient for whom any active opioid (as so defined) is 
     prescribed to treat pain relating to cancer or cancer 
     treatment;
       (B) a patient participating in hospice care; and
       (C) in the case of the death or incapacity of a patient 
     described in subparagraph (A) or (B) or any similar situation 
     as determined by the Secretary of Health and Human Services, 
     the appropriate family member, medical proxy, or similar 
     representative or the estate of such patient.

     SEC. __02. BLOCK GRANTS FOR PREVENTION AND TREATMENT OF 
                   SUBSTANCE ABUSE.

       (a) Grants to States.--Section 1921(b) of the Public Health 
     Service Act (42 U.S.C. 300x-21(b)) is amended by inserting 
     ``, and, as applicable, for carrying out section 1923A'' 
     before the period.
       (b) Nonapplicability of Prevention Program Provision.--
     Section 1922(a)(1) of the Public Health Service Act (42 
     U.S.C. 300x-22(a)(1)) is amended by inserting ``except with 
     respect to amounts made available as described in section 
     1923A,'' before ``will expend''.
       (c) Opioid Treatment Programs.--Subpart II of part B of 
     title XIX of the Public Health Service Act (42 U.S.C. 300x-21 
     et seq.) is amended by inserting after section 1923 the 
     following:

     ``SEC. 1923A. ADDITIONAL SUBSTANCE ABUSE TREATMENT PROGRAMS.

       ``A funding agreement for a grant under section 1921 is 
     that the State involved shall provide that any amounts made 
     available by any increase in revenues to the Treasury in the 
     previous fiscal year resulting from the enactment of section 
     4192 of the Internal Revenue Code of 1986, reduced by any 
     amounts rebated or discounted under section _01(d) of the 
     _______