[Congressional Record Volume 164, Number 97 (Tuesday, June 12, 2018)]
[House]
[Pages H5060-H5061]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




    SPECIAL REGISTRATION FOR TELEMEDICINE CLARIFICATION ACT OF 2018

  Mr. WALDEN. Mr. Speaker, I move to suspend the rules and pass the 
bill (H.R. 5483) to impose a deadline for the promulgation of interim 
final regulations in accordance with section 311(h) of the Controlled 
Substances Act (21 U.S.C. 831(h)) specifying the circumstances in which 
a special registration may be issued to a practitioner to engage in the 
practice of telemedicine, and for other purposes, as amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 5483

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Special Registration for 
     Telemedicine Clarification Act of 2018''.

     SEC. 2. DEADLINE FOR INTERIM FINAL REGULATIONS FOR A SPECIAL 
                   REGISTRATION TO ENGAGE IN THE PRACTICE OF 
                   TELEMEDICINE.

       Section 311(h)(2) of the Controlled Substances Act (21 
     U.S.C. 831(h)(2)) is amended by striking ``The Attorney 
     General shall, with the concurrence of the Secretary, 
     promulgate regulations'' and inserting ``Not later than 1 
     year after the date of enactment of the Special Registration 
     for Telemedicine Clarification Act of 2018, the Attorney 
     General shall, with the concurrence of the Secretary, 
     promulgate interim final regulations''.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Oregon (Mr. Walden) and the gentleman from New Jersey (Mr. Pallone) 
each will control 20 minutes.
  The Chair recognizes the gentleman from Oregon.


                             General Leave

  Mr. WALDEN. Mr. Speaker, I ask unanimous consent that all Members may 
have 5 legislative days in which to revise and extend their remarks and 
insert extraneous materials in the Record on the bill.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Oregon?
  There was no objection.
  Mr. WALDEN. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, many patients have limited access to mental health and 
substance use disorder services, particularly Americans who live 
outside of metropolitan areas. To increase access to specialized care, 
this legislation requires the Attorney General to issue waivers to 
healthcare providers to prescribe medication-assisted treatment, or 
MAT, for emergency situations, like the lack of access to an in-person 
specialist.
  Under a previous version of the bill, the DEA would have had up to 90 
days to complete this task. At their request, this committee favorably 
reported an amendment extending this window to 1 year.
  Finalizing the rules for the special waiver process is on the unified 
agenda of the Justice Department at DEA. That is a signal that they 
understand the need to implement this provision of law.
  We have the opportunity to consider this bill today because of the 
faithful dedication and thoughtful legislating of Representatives Buddy 
Carter of Georgia and Cheri Bustos of Illinois.
  Mr. Speaker, I yield such time as he may consume to the gentleman 
from Georgia (Mr. Carter) to speak on this legislation, our resident 
pharmacist, the only one, I believe, in the entire U.S. House of 
Representatives, who has

[[Page H5061]]

been a terrific asset as we have dealt with these issues of drugs and 
drug abuse and addiction, or addiction treatment, and trying to find 
the best paths forward.
  Mr. CARTER of Georgia. Mr. Speaker, I thank the gentleman for 
yielding.
  Mr. Speaker, in 2008 Congress strengthened prohibitions against 
inappropriately distributing and dispensing controlled substances 
online by passing the Ryan Haight Online Pharmacy Consumer Protection 
Act.
  The Ryan Haight Act made it illegal for a practitioner to dispense 
controlled substances through the Internet without at least one in-
person patient evaluation. The law included the ability for the 
Attorney General to issue a special registration to healthcare 
providers detailing in what circumstances they could prescribe 
controlled substances via telemedicine in legitimate emergency 
situations, such as a lack of access to an in-person specialist.
  However, the waiver process has never been implemented through 
regulation. Thus, some patients still do not have access to care that 
they need.
  The Special Registration for Telemedicine Clarification Act directs 
the Attorney General to promulgate interim final regulations within 1 
year after passage of the law. The 62 million Americans living in rural 
communities are more likely to be older, poorer, and suffer higher 
rates of chronic disease than their urban counterparts.
  Furthermore, a disproportionate number of Americans living in rural 
communities are struggling with prescription opioid abuse. We must 
ensure that these individuals are able to access the care that they 
need.
  Mr. Speaker, I urge Members to support this bipartisan legislation 
co-led by my colleague across the aisle, Representative Bustos, to 
connect patients with the substance use disorder treatment they need 
without jeopardizing important safeguards to prevent misuse or 
diversion.
  Mr. PALLONE. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I rise in support of H.R. 5483, legislation that will 
direct the Drug Enforcement Agency to take action to allow registered 
healthcare practitioners to practice telemedicine. I want to thank our 
Democratic sponsor, Mrs. Bustos from Illinois.
  If we are to end the cycle of opioid abuse and addiction, more must 
be done to help provide those suffering with access to treatment. 
However, I am optimistic that the legislation before us now authored by 
Representatives Bustos and Carter will offer one way forward to 
providing more individuals suffering from addiction with access to 
treatment by enabling the use of telemedicine.
  Telemedicine offers one opportunity to potentially reach more 
patients who could not otherwise access treatment, whether due to 
geographic reasons, provider access issues, financial concerns about 
in-person treatment, or the stigma of seeking treatment.
  While DEA has the authority to establish a special registration 
pathway for purposes of treating a patient via telemedicine, DEA has 
not acted to do so to date. The Special Registration for Telemedicine 
Clarification Act of 2018 would direct the Attorney General to issue 
regulations establishing a special registration process for engaging in 
the practice of telemedicine within a year of enactment.
  This approach will enable telemedicine to finally be deployed in 
treating patients with addiction, while still allowing DEA to ensure 
that there are appropriate safeguards in place to mitigate against the 
use of telemedicine in any manner that could further exacerbate the 
opioid crisis.
  This is practical legislation that I believe will help open access to 
treatment, and I urge my colleagues to vote in support of the bill.
  Mr. Speaker, I yield such time as she may consume to the gentlewoman 
from Illinois (Mrs. Bustos), the sponsor of the bill.
  Mrs. BUSTOS. Mr. Speaker, the opioid epidemic has claimed the lives 
of too many across our Nation. Although no corner of our country has 
remained unscathed, the crisis is worse in rural America, where drug-
related deaths are 45 percent higher.

  When I travel around my district, a vast district--7,000 square 
miles, 14 counties--I am told time and time again that access to 
treatment remains one of the largest barriers to recovery in many of 
the small towns and rural communities that I serve. We don't have 
enough doctors. We don't have enough treatment centers. If we don't 
have those things, too many people don't have a chance.
  That is why I worked with my colleague from Georgia, Congressman 
Buddy Carter, who also happens to be a pharmacist, to introduce the 
Special Registration for Telemedicine Clarification Act, with Democrats 
and Republicans working together in this endeavor.
  This bill is a commonsense measure that cuts through the red tape to 
provide more treatment options to underserved communities through the 
use of telemedicine. Saving our sons, our daughters, our brothers, our 
sisters, our nieces, and our nephews from this epidemic is a priority 
for Democrats and for Republicans.
  Mr. Speaker, I urge my colleagues from both sides of the aisle to 
support this legislation.
  Mr. WALDEN. Mr. Speaker, Members should support this very important 
legislation.
  Mr. Speaker, I have no further speakers, and I yield back the balance 
of my time.
  Mr. PALLONE. Mr. Speaker, I also urge my colleagues to support the 
bill, and I yield back the balance of my time.
  The SPEAKER pro tempore (Mr. Faso). The question is on the motion 
offered by the gentleman from Oregon (Mr. Walden) that the House 
suspend the rules and pass the bill, H.R. 5483, as amended.
  The question was taken; and (two-thirds being in the affirmative) the 
rules were suspended and the bill, as amended, was passed.
  A motion to reconsider was laid on the table.

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