[Congressional Record Volume 166, Number 128 (Tuesday, July 21, 2020)]
[Senate]
[Pages S4350-S4355]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS
By Ms. COLLINS (for herself and Ms. Smith):
S. 4233. A bill to establish a payment program for unexpected loss of
markets and revenues to timber harvesting and timber hauling businesses
due to the COVID-19 pandemic, and for other purposes; to the Committee
on Agriculture, Nutrition, and Forestry.
Ms. COLLINS. Mr. President, I rise to introduce a bill with my
colleague, Senator Smith that will help the hardworking loggers across
this Nation whose operations have suffered serious losses directly due
to the pandemic. In Maine alone, logging has a roughly $650 million
annual economic impact, and is the backbone of the forest products
economy. The industry is made up of countless multi-generational family
businesses, whose survival is being seriously threatened.
In Maine and in many places across the Country, the logging industry
first felt the effects of COVID-19 in January as exports to foreign
markets were significantly limited if not eliminated entirely. Declines
in demand for paper products and other wood fiber based products caused
by the COVID-19 pandemic have prompted shutdowns, slowdowns, and
closures across the globe. As a result, Maine has seen declining demand
for wood from mills across the board, and low prices and quotas driven
by that lack of demand. And while timber prices have remained
relatively stable, mills have drastically reduced their processing
capacity--resulting in a ripple effect that has hit loggers and timber
hauling companies hard.
The Professional Logging Contractors of Maine projects at least a 20
percent reduction in the annual harvest, which would threaten more than
600 jobs and represent the potential loss of $86 million in economic
activity in my State. The explosion of a pulp digester earlier this
year at a mill in Jay, coupled with the recent shutdown of a paper
machine at another mill in Westbrook, have compounded the harm imposed
by the pandemic.
Although the industry is certainly not alone in its struggles during
this time, it faces unique challenges, including high capital costs
relative to payroll and the fact that payroll costs do not reflect the
amounts paid to independent contractors. And unlike some of our farmers
who have been able to access direct payments from USDA and our
fishermen who were allocated relief funding in the CARES Act, our
forestry professionals have not been provided targeted assistance.
The legislation we are introducing today would direct the Secretary
of Agriculture to provide financial assistance to loggers and timber
hauling businesses that have experienced at least a 10 percent loss in
revenues from January 2020 through July 2020 as compared to the same
timeframe last year. The amount would be equal to 10 percent of 2019
gross revenues and could only be used for operating expenses, including
payroll. I am grateful for the American Logging Council's support of
our legislation, and urge my colleagues
[[Page S4351]]
to join in this effort to support one of our country's core economic
drivers.
Loggers and forestry industry professionals were rightfully deemed
essential workers during this public health crisis, and we must ensure
that they receive the support necessary to emerge from this downturn.
______
By Mr. REED (for himself, Ms. Murkowski, Mr. Jones, and Mr.
Tillis):
S. 4237. A bill to extend zero interest rate benefits and payment
suspension to all Federal student loan borrowers, and for other
purposes; to the Committee on Health, Education, Labor, and Pensions.
Mr. REED. Mr. President, today, along with Senator Murkowski, we are
introducing legislation to provide relief to all Federal student loan
borrowers during this public health and economic crisis. The bipartisan
Student Loan Fairness Act, which is also cosponsored by Senators
Murkowski, Jones, and Tillis, will correct an inequity in the CARES Act
that left out millions of Federal student loan borrowers from benefits
to ease the burden of repayment as we continue to fight COVID-19.
The CARES Act benefits are restricted to borrowers of student loans
that are held by the Federal government. This leaves out the borrowers
whose Federal Family Education Loans (FFEL) are still held by
commercial and State agency lenders, and those with Perkins Loans that
are administered by institutions of higher education. In fact, nearly 6
million borrowers were left out under the FFEL Program and another 1.9
million under the Perkins Loan Program. This disparate treatment by
loan type is as confusing as it is unfair.
In April, a broad group of more than two dozen organizations
representing educators, borrower advocates, veterans, lenders, guaranty
agencies, and student loan servicers implored Congress to remedy this
inequity. They wrote, ``A Federal loan borrower--regardless of the
origination of that loan, be it Part B, D, E, commercial, or
government-held--should receive equal, immediate, and critical support
in this unprecedented time . . . Already, borrowers are confused as to
why their Federal loans are treated differently than others.''
The Student Loan Fairness Act will extend the CARES Act relief to
these borrowers by covering the cost of interest and suspending monthly
payments for the period of March 13 through September 30, 2020, and
suspending all involuntary collection, such as administrative wage
garnishment or offsets from tax refunds, for this period.
This legislation is one component of what should be a comprehensive
package of student loan debt relief. As the crisis continues, we should
extend the repayment relief until health and economic conditions
improve sufficiently for borrowers to be able to begin repayment.
Additionally, we should forgive at least $10,000 of debt for each
student loan borrower to help speed the recovery and reduce the drag of
the roughly $1.6 trillion in outstanding student loan debt on economic
prospects for over 40 million Americans. Going forward, we must reduce
the need for student loan borrowing by expanding need-based grants,
such as the Pell Grant, and ensuring that states and institutions do
their part to lower the cost to students and families.
We should work together to build on the important steps Congress took
to provide relief to student loan borrowers in the CARES Act. However,
we need to ensure that all Federal student loan borrowers have access
to this relief. I hope that my colleagues will join us in cosponsoring
the Student Loan Fairness Act and pushing for its inclusion in the next
COVID-19 relief package.
______
By Mrs. LOEFFLER (for herself, Mrs. Blackburn, and Mr. Cotton):
S. 4238. A bill to amend title 18, United States Code, relating to
criminal street gangs, and for other purposes; to the Committee on the
Judiciary.
Mrs. LOEFFLER. Mr. President, this spring, 14-year-old Janina
Valenzuela was riding a bike with a friend in Marietta, GA, when she
was killed as part of an initiation into an MS-13 gang. In 2016,
Christopher Dean was brutally murdered by gang members in Atlanta. The
D.A. called it ``the most horrific death'' in recent history. His
murder left two children without a father. In 2010, 11-year-old
Nicholas Sheffey was shot and killed sleeping in his bed during a
drive-by shooting in Chamblee, GA. These are just three of the too many
lives that have been lost, tragically cut short due to senseless gang
violence.
In Georgia, there are over 71,000 known gang members representing a
variety of gangs, including the Ghostface Gangsters, an all-White gang
in Georgia; the Gangster Disciples, which formed in Chicago and quickly
spread to Georgia; and the Aryan Brotherhood, a White supremacy gang.
Nationwide, there are more than 1.4 million members and 33,000 gangs
across the U.S. According to the most recent National Gang Report, half
of law enforcement officials reported that gang-related violence has
increased in each of their jurisdictions. Thankfully, President Trump
and Georgia leaders have taken strong action to address the rising tide
of gang violence and to end the cycles of violence that they cause.
For the first time ever, the Department of Justice has brought
terrorism charges against a member of the MS-13 gang, taking action
against their leader and 21 other gang members.
Under the leadership of Georgia Governor Brian Kemp and Attorney
General Chris Carr, my home State of Georgia has led the way on
confronting gang violence, passing legislation that gives prosecutors
the tools they need to disrupt and dismantle these terrible gang
networks.
Today, I am introducing the Cracking Down on Gangs and Deporting
Criminals Act to apply Georgia's anti-gang, pro-community measures
across our country. This legislation, based on the Georgia law that
Attorney General Carr has called ``one of the strongest statutes in the
Nation,'' aims to deter and punish criminals who set out to destroy
lives and communities. This includes violent crimes like the murders of
Janina, Christopher, and Nicholas.
In addition to violence, gangs run elaborate drug operations. One
recent bust in Pickens County last month resulted in the arrest of
nearly 50 individuals. Law enforcement confiscated nearly $2 million
worth of methamphetamine from a drug ring run by three gangs.
They deal in the abhorrent world of human trafficking. A study in San
Diego County found that an astounding 85 percent of those involved in
human trafficking were actively involved in gangs.
Current Federal gang statute has three strict criteria that are
difficult for prosecutors to meet in order to hold someone accountable
for their participation in a street gang. The legislation I am
introducing today will make it easier for Federal prosecutors to seek
harsh sentences for gang activity. It will facilitate the removal of
criminal gang members who are in our country illegally, and it would
create a national gang database, making it easier to eradicate these
gang networks.
We need to take action now to take violent gang members off of our
streets. Across the country, violence is skyrocketing in our cities,
while radicals call to defund and abolish the police. The troubling
decline in support for law enforcement, coupled with the effects of the
pandemic and recent unrest, threatens the further spread of gang
violence across communities in America.
The Cracking Down on Gangs and Deporting Criminals Act will help keep
our communities safe and support law enforcement in their work to root
out gang activity. No family should have to go through what Janina,
Christopher, and Nicholas did. Parents should be able to send their
children outdoors and off to school without worrying that they won't
make it home, and children shouldn't fear that their parents won't
return home. It is time that we hold gang members accountable for their
vile and evil actions and keep the American public safe
______
By Mr. DURBIN:
S. 4242. A bill to establish programs related to prevention of
prescription opioid misuse, and for other purposes; to the Committee on
Finance.
Mr. DURBIN. Mr. President, I ask unanimous consent that the text of
the bill be printed in the Record.
[[Page S4352]]
There being no objection, the text of the bill was ordered to be
printed in the Record, as follows:
S. 4242
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 ``Addiction Prevention and
Responsible Opioid Practices Act''.
SEC. 2. EXCISE TAX 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
manufacturer or producer of any taxable active opioid a tax
equal to the amount determined under subsection (b).
``(b) Amount Determined.--The amount determined under this
subsection with respect to a manufacturer or producer for a
calendar year is 1 cent per milligram of taxable active
opioid in the production or manufacturing quota determined
for such manufacturer or producer for the calendar year under
section 306 of the Controlled Substances Act (21 U.S.C. 826).
``(c) Taxable Active Opioid.--For purposes of this
section--
``(1) In general.--The term `taxable active opioid' means
any controlled substance (as defined in section 102 of the
Controlled Substances Act (21 U.S.C. 802), as in effect on
the date of the enactment of this section) manufactured in
the United States which is opium, an opiate, or any
derivative thereof.
``(2) Exclusions.--
``(A) Other ingredients.--In the case of a product that
includes a taxable active opioid and another ingredient,
subsection (a) shall apply only to the portion of such
product that is a taxable active opioid.
``(B) Drugs used in addiction treatment.--The term `taxable
active opioid' shall not include any controlled substance (as
so defined) which is used exclusively for the treatment of
opioid addiction as part of a medication-assisted
treatment.''.
(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 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 calendar years beginning after the date of the
enactment of this Act.
SEC. 3. OPIOID CONSUMER ABUSE REDUCTION PROGRAM.
(a) Opioid Take-back Program.--Section 302 of the
Controlled Substances Act (21 U.S.C. 822) is amended by
adding at the end the following:
``(h)(1) The Attorney General shall establish a national
take-back program for the safe and environmentally
responsible disposal of controlled substances.
``(2) In establishing the take-back program required under
paragraph (1), the Attorney General--
``(A) shall consult with the Secretary and the
Administrator of the Environmental Protection Agency; and
``(B) may coordinate with States, law enforcement agencies,
water resource management agencies, manufacturers,
practitioners, pharmacists, public health entities,
transportation and incineration service contractors, and
other entities and individuals, as appropriate.
``(3) The take-back program established under paragraph
(1)--
``(A) shall--
``(i) ensure appropriate geographic distribution so as to
provide--
``(I) reasonably convenient and equitable access to
permanent take-back locations, including not less than 1
disposal site for every 25,000 residents and not less than 1
physical disposal site per town, city, county, or other unit
of local government, where possible; and
``(II) periodic collection events and mail-back programs,
including public notice of such events and programs, as a
supplement to the permanent take-back locations described in
subclause (I), particularly in areas in which the provision
of access to such locations at the level described in that
subclause is not possible;
``(ii) establish a process for the accurate cataloguing and
reporting of the quantities of controlled substances
collected; and
``(iii) include a public awareness campaign and education
of practitioners and pharmacists; and
``(B) may work in coordination with State and locally
implemented public and private take-back programs.
``(4) From time to time, beginning in the second calendar
year that begins after the date of enactment of this
subsection, the Secretary of the Treasury shall transfer from
the general fund of the Treasury an amount equal to one-half
of the total amount of taxes collected under section 4192 of
the Internal Revenue Code of 1986 to the Attorney General to
carry out this subsection. Amounts transferred under this
subparagraph shall remain available until expended.''.
(b) Funding of Substance Abuse Programs.--From time to
time, beginning in the second calendar year that begins after
the date of enactment of this Act, the Secretary of the
Treasury shall transfer from the general fund of the Treasury
an amount equal to one-half of the total amount of taxes
collected under section 4192 of the Internal Revenue Code of
1986, as added by this Act, to the Director of the Center for
Substance Abuse Treatment of the Substance Abuse and Mental
Health Services Administration for programs of the Center,
including the Block Grants for Prevention and Treatment of
Substance Abuse program under subpart II of part B of title
XIX of the Public Health Service Act (42 U.S.C. 300x-21 et
seq.) and Programs of Regional and National Significance.
Amounts transferred under this subsection shall remain
available until expended.
SEC. 4. GAO STUDY.
Not later than 1 year after the date of enactment of this
Act, the Comptroller General of the United States shall--
(1) conduct a study examining the coverage offered under
commercial health insurance plans and reimbursement rates
under the Medicare program and State Medicaid plans with
respect to--
(A) substance use disorder treatment services, as compared
to other health services, and how any disparity identified
under this paragraph may contribute to differences in salary
and turnover among substance abuse disorder providers; and
(B) rates of coverage or reimbursement, as applicable, for
substance abuse disorder services provided via telehealth, as
compared to such services provided in-person; and
(2) provide recommendations with respect to addressing any
disparities identified under subparagraph (A) or (B) of
paragraph (1) in order to bolster retention of substance
abuse disorder providers and the provision of substance abuse
disorder services.
SEC. 5. EXPANDING ACCESS TO SUBSTANCE USE DISORDER AND MENTAL
HEALTH SERVICES FURNISHED THROUGH TELEHEALTH
UNDER THE MEDICARE PROGRAM.
Section 1834(m)(7) of the Social Security Act (42 U.S.C.
1395m(m)(7)) is amended--
(1) in the paragraph heading, by inserting ``and mental
health services'' after ``substance use disorder services'';
(2) by inserting ``or, on or after the first day after the
end of the public health emergency described in section
1135(g)(1)(B), to an eligible telehealth individual for
purposes of diagnosis of a substance use disorder or
diagnosis or treatment of a mental health disorder, as
determined by the Secretary,'' after ``as determined by the
Secretary,''.
SEC. 6. ENSURING PARITY FOR MENTAL HEALTH AND ADDICTION
TREATMENT SERVICES.
Title V of the Public Health Service Act (42 U.S.C. 290ll
et seq.) is amended--
(1) in part K, by redesignating section 550 (42 U.S.C.
290ee-10), relating to sobriety treatment and recovery teams,
as section 553 and transferring such section to appear after
section 552 in part D; and
(2) by adding at the end of such part D the following:
``SEC. 554. COMPLIANCE WITH MENTAL HEALTH AND ADDICTION
TREATMENT PARITY.
``(a) In General.--The Secretary, in coordination with the
Secretary of Labor, shall award grants to, or enter into
cooperative agreements with, States to ensure that health
insurance issuers in the State comply with section 2726.
``(b) Use of Grant.--A State shall use amounts received
under a grant or cooperative agreement under this section
to--
``(1) establish clear guidelines for parity compliance for
mental health and substance use disorder benefits;
``(2) ensure parity compliance during public health
emergencies with best practices for delivering evidence-based
mental health and substance use disorder treatment, including
to ensure virtual, video, internet, telephonic, and other
remote services are appropriately covered, including
alignment with authorities, flexibilities, and coverage
promulgated by the Centers for Medicare & Medicaid Services;
``(3) engage with health insurance issuers to ensure that
they comply with the guidelines promulgated and other
provisions of section 2726, including through audits, market
conduct examinations, secret shopper programs, or other
means;
``(4) share information with other States who receive
grants under this section;
``(5) submit a report to the Secretary and the Secretary of
Labor on information, actions, recommendations, and such
other information as such secretaries may require; and
``(6) publicly post a summary of the report submitted under
paragraph (6) on the websites of the Department of Health and
Human Services and the Department of Labor.
``(c) Authorization of Appropriations.--There are
authorized to be appropriated to carry out this section
$10,000,000 for each of fiscal years 2021 through 2025.''.
SEC. 7. FEDERAL LICENSURE OF PHARMACEUTICAL REPRESENTATIVES
WHO PROMOTE CERTAIN OPIOIDS.
Subchapter E of chapter V of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C.
[[Page S4353]]
360bbb et seq.) is amended by adding at the end the
following:
``SEC. 569E. FEDERAL LICENSURE OF PHARMACEUTICAL
REPRESENTATIVES WHO PROMOTE CERTAIN OPIOIDS.
``(a) In General.--The Secretary, in consultation with the
Attorney General, shall establish a licensure program for
pharmaceutical representatives described in subsection (b).
``(b) Licensure Program.--
``(1) Requirement.--Beginning on July 1, 2021, no
individual described in paragraph (2) may engage in the
marketing or promoting of opioid drugs unless such individual
is licensed under this section.
``(2) Individuals required to obtain licensure.--An
individual required to obtain a license under this section is
any individual who, on behalf of a drug manufacturer,
engaged, on more than 15 days in a calendar year, in the
marketing or promotion to health care professionals,
including educational or sales communications, meetings or
paid events, and the provision of goods, gifts, and samples,
of any opioid drug (other than methadone) that is listed in
schedule II of section 202(c) of the Controlled Substances
Act.
``(3) Licensure period.--Each license issued under this
section shall be valid for 3 years, and may be renewed for
additional 3-year periods.
``(c) Requirements.--An individual required to obtain a
license under this section shall--
``(1) submit to the Secretary, at such time and in such
manner as the Secretary may require--
``(A) such information as the Secretary may require; and
``(B) a registration fee in the amount of $3,000;
``(2) certify that such individual has completed training
on ethics, pharmaceutical marketing regulations, the `CDC
Guidelines for Prescribing Opioids for Chronic Pain',
published by the Centers for Disease Control and Prevention
in 2016 (or any successor document) or the `FDA Blueprint for
Prescriber Education for Extended-Release and Long-Acting
Opioid Analgesics', and applicable Federal laws pertaining to
drug marketing, labeling, and clinical trials, as the
Secretary may require;
``(3) certify that such individual will not engage in any
illegal, fraudulent, misleading, or other deceptive marketing
of schedule II opioid drugs; and
``(4) file with the Secretary annual reports disclosing the
names of providers visited and any drug samples or gifts such
individual gives any such provider.
``(d) Manufacturer Reporting Requirements.--The
manufacturer who employs or contracts with any individual
required to obtain a license under this section shall include
in reports required under section 1128G of the Social
Security Act the name of each such licensed individual that
provides payments or other transfers of value required to be
reported under such section 1128G that relates to an opioid
drug that is listed in schedule II of the Controlled
Substances Act.''.
SEC. 8. WITHDRAWAL OF APPROVAL OF CERTAIN OPIOIDS.
(a) In General.--Notwithstanding any other provision of
law, any ultra-high-dose opioid shall be considered a drug
that presents an imminent hazard to the public health within
the meaning of section 505(e) of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 355(e)), and the Secretary of Health
and Human Services shall suspend the approval of such drug,
in accordance with such section 505(e).
(b) Definition.--In this section, the term ``ultra-high-
dose opioid'' means an opioid drug for which the daily dosage
provided for in the approved label exceeds the morphine
milligram equivalents per day outlined in the report entitled
``CDC Guidelines for Prescribing Opioids for Chronic Pain'',
published by the Centers for Disease Control and Prevention
in 2016 (or any successor document).
SEC. 9. CONTINUING MEDICAL EDUCATION AND PRESCRIPTION DRUG
MONITORING PROGRAM REGISTRATION FOR
PRESCRIBERS.
Section 303 of the Controlled Substances Act (21 U.S.C.
823) is amended--
(1) by redesignating subsection (k) as subsection (l); and
(2) by inserting after subsection (j) the following:
``(k)(1) The Attorney General shall not register, or renew
the registration of, a practitioner under subsection (f) who
is licensed under State law to prescribe controlled
substances in schedule II, III, or IV, unless the
practitioner submits to the Attorney General, for each such
registration or renewal request, a written certification
that--
``(A)(i) the practitioner has, during the 1-year period
preceding the registration or renewal request, completed a
training program described in paragraph (2); or
``(ii) the practitioner, during the applicable registration
period, will not prescribe such controlled substances in
amounts in excess of a 72-hour supply (for which no refill is
available); and
``(B) the practitioner has registered with the prescription
drug monitoring program of the State in which the
practitioner practices, if the State has such program.
``(2) A training program described in this paragraph is a
training program that--
``(A) follows the best practices for pain management, as
described in the `Guideline for Prescribing Opioids for
Chronic Pain' as published by the Centers for Disease Control
and Prevention in 2016, or any successor thereto, or the `FDA
Blueprint for Prescriber Education for Extended-Release and
Long-Acting Opioid Analgesics' as published by the Food and
Drug Administration in 2017, or any successor thereto;
``(B) includes information on--
``(i) recommending non-opioid and non-pharmacological
therapy;
``(ii) establishing treatment goals and evaluating patient
risks;
``(iii) prescribing the lowest dose and fewest number of
pills considered effective;
``(iv) addictive and overdose risks of opioids;
``(v) diagnosing and managing substance use disorders,
including linking patients to evidence-based treatment;
``(vi) identifying narcotics-seeking behaviors; and
``(vii) using prescription drug monitoring programs; and
``(C) is approved by the Secretary.''.
SEC. 10. REPORT ON PRESCRIBER EDUCATION COURSES FOR MEDICAL
AND DENTAL STUDENTS.
Each school of medicine, school of osteopathic medicine,
and school of dentistry participating in a program under
title IV of the Higher Education Act of 1965 (20 U.S.C. 1070a
et seq.), as a condition for such participation, shall submit
an annual report to the Secretary of Education and the
Secretary of Health and Human Services on any prescriber
education courses focused specifically on pain management and
responsible opioid prescribing practices that such school
requires students to take, and whether such courses are
consistent with the most recently published version of the
``Guideline for Prescribing Opioids for Chronic Pain'' of the
Centers for Disease Control and Prevention or the ``FDA
Blueprint for Prescriber Education for Extended-Release and
Long-Acting Opioid Analgesics'', as published by the Food and
Drug Administration in 2017. The Secretary of Education and
the Secretary of Health and Human Services shall compile the
reports submitted by such schools and submit an annual
summary of such reports to Congress.
SEC. 11. REQUIREMENTS UNDER PRESCRIPTION DRUG MONITORING
PROGRAMS.
(a) In General.--Beginning 1 year after the date of
enactment of this Act, each State that receives funding under
any of the programs described in subsection (c) shall--
(1) require practitioners, or their designees, in the State
to consult the database of the prescription drug monitoring
program before writing prescriptions for controlled
substances (as such term is defined in section 102 of the
Controlled Substances Act (21 U.S.C. 802)) in schedule II,
III, or IV under section 202 of such Act (21 U.S.C. 812);
(2) require dispensers of controlled substances in schedule
II, III, or IV, or their designees, to input data into the
database of the prescription drug monitoring program within
24 hours of filling a qualifying prescription, as required by
the Attorney General and the Secretary of Health and Human
Services, including patient identifier information, the
national drug code of the dispensed drug, date of dispensing
the drug, quantity and dosage of the drug dispensed, form of
payment, Drug Enforcement Administration registration number
of the practitioner, Drug Enforcement Administration
registration number of the dispenser;
(3) allow practitioners and dispensers to designate other
appropriate individuals to act as agents of such
practitioners and dispensers for purposes of obtaining and
inputing data from the database for purposes of complying
with paragraphs (1) and (2), as applicable;
(4) provide informational materials for practitioners and
dispensers to identify and refer patients with possible
substance use disorders to professional treatment
specialists;
(5) establish formal data sharing agreements to foster
electronic connectivity with the prescription drug monitoring
programs of each State (if such State has such a program)
with which the State shares a border, to facilitate the
exchange of information through an established technology
architecture that ensures common data standards, privacy
protection, and secure and streamlined information sharing;
(6) authorize direct access to the State's database of the
prescription drug monitoring program to all State law
enforcement agencies, State boards responsible for the
licensure, regulation, or discipline of practitioners,
pharmacists, or other persons authorized to prescribe,
administer, or dispense controlled substances; and
(7) in order to enhance accountability in prescribing and
dispensing patterns, not fewer than 4 times per year,
proactively provide informational reports on aggregate trends
and individual outliers, based on information available
through the State prescription drug monitoring program to--
(A) the State entities and persons described in paragraph
(6); and
(B) the Medicaid agency and the department of public health
of the State.
(b) Transparency in Prescribing Practices and Intervention
for High Prescribers.--
(1) State reporting requirement.--Each State that receives
funding under any of the programs described in subsection (c)
shall, twice per year, submit to the Secretary of Health and
Human Services and the Administrator of the Drug Enforcement
Administration--
[[Page S4354]]
(A) a list of all practitioners and dispensers who, in the
applicable reporting period, have prescribed or dispensed
schedule II, III, or IV opioids in the State;
(B) the amount of schedule II, III, or IV opioids that were
prescribed and dispensed by each individual practitioner and
dispenser described in subparagraph (A); and
(C) any additional information that the Secretary and
Administrator may require to support surveillance and
evaluation of trends in prescribing or dispensing of schedule
II, III, or IV opioids, or to identify possible non-medical
use and diversion of such substances.
(2) Annual report.--Not later than 1 year after the date of
enactment of this Act, and annually thereafter, the Secretary
of Health and Human Services, in consultation with the
Administrator of the Drug Enforcement Administration, the
Secretary of Defense, the Secretary of Veterans Affairs, and
the Director of the Indian Health Service, shall submit to
Congress, and make public, a report identifying outliers
among the medical specialties and geographic areas with the
highest rates of opioid prescribing in the Nation, by zip
code.
(3) Development of action plan.--
(A) Initial plan.--Not later than 1 year after the date of
enactment of this Act, the Secretary of Health and Human
Services, in consultation with the Administrator of the Drug
Enforcement Administration, the Secretary of Defense, the
Secretary of Veterans Affairs, and the Director of the Indian
Health Service, shall submit to Congress a plan of action,
including warning letters and enforcement mechanisms, for
addressing outliers in opioid prescribing practices and
ensuring an adequate Federal response to protect the public
health.
(B) Updated plan.--The Secretary of Health and Human
Services shall submit to Congress updates to the plan of
action described in subparagraph (A), as such Secretary, in
consultation with the heads of agencies described in such
subparagraph, determines appropriate.
(c) Programs Described.--The programs described in this
subsection are--
(1) the Harold Rogers Prescription Drug Monitoring Program
established under the Departments of Commerce, Justice, and
State, the Judiciary, and Related Agencies Appropriations
Act, 2002 (Public Law 107-77; 115 Stat. 748);
(2) the controlled substance monitoring program under
section 399O of the Public Health Service Act (42 U.S.C.
280g-3);
(3) the Prescription Drug Overdose: Prevention for States
program of the Centers for Disease Control and Prevention;
(4) the Prescription Drug Overdose: Data-Driven Prevention
Initiative of Centers for Disease Control and Prevention;
(5) the Enhanced State Opioid Overdose Surveillance program
of the Centers for Disease Control and Prevention;
(6) the opioid grant program under section 1003 of the 21st
Century Cures Act (Public Law 114-255); and
(7) the State Opioid Response Grant program described under
the heading ``substance abuse treatment'' under the heading
``Substance Abuse and Mental Health Services Administration''
of title II of division A of the Further Consolidated
Appropriations Act, 2020 (Public Law 116-94).
(d) Definitions.--In this section, the terms ``dispenser''
and ``practitioner'' have the meanings given such terms in
section 102 of the Controlled Substances Act (21 U.S.C. 802).
SEC. 12. INTEROPERABILITY OF CERTIFIED HEALTH INFORMATION
TECHNOLOGY.
Section 3001(c)(5) of the Public Health Service Act (42
U.S.C. 300jj-11(c)(5)) is amended by adding at the end the
following:
``(F) Interoperability.--Beginning on January 1, 2021, the
National Coordinator shall not certify electronic health
records as health information technology that is in
compliance with applicable certification criteria under this
paragraph unless such technology is interoperable with the
prescription drug monitoring programs of each State that, at
the time of the request for such certification, has such a
program.''.
SEC. 13. STUDIES RELATED TO OVERDOSE DISCHARGE AND FOLLOW-UP
POLICIES.
(a) Study.--Not later than January 1, 2021, the Secretary
of Health and Human Services shall--
(1) conduct a study on the scope and circumstances of non-
fatal opioid overdoses, the policies and procedures that
States, health care systems, and first responders have
implemented; and
(2) in partnership with stakeholder organizations with
subject matter expertise, establish guidelines for hospital
procedures following non-fatal opioid overdose and the
administration of overdose reversal medication.
(b) Study and Development of Quality Measures Under
Medicare Related to Opioid Abuse and Substance Use
Disorder.--Section 1890A(e) of the Social Security Act (42
U.S.C. 1395aaa-1(e)) is amended--
(1) by striking ``Measures.--The Administrator'' and
inserting ``Measures.--
``(1) In general.--The Administrator''; and
(2) by adding at the end the following new paragraph:
``(2) Study and development of quality measures related to
opioid abuse and substance use disorder.--Beginning not later
than 1 year after the date of enactment of this paragraph,
the Administrator of the Center for Medicare & Medicaid
Services shall study, and through contracts develop, in
coordination with appropriate subject matter organizations
(such as the entity with a contract under section 1890), for
use under this Act, quality measures related to standards of
care for treating individuals with non-fatal opioid overdose,
discharge procedures, and linkages to appropriate substance
use disorder treatment and community support services.''.
SEC. 14. MEDICAID OPIOID DRUG MAPPING TOOL.
(a) In General.--The Secretary of Health and Human Services
shall create an interactive opioid drug mapping tool, which
shall be made publicly available on the internet website of
the Centers for Medicare & Medicaid Services, showing
prescribing practices of providers that participate in State
Medicaid programs and geographic comparisons, at the State,
county, and ZIP code levels, of de-identified opioid
prescription claims made under State Medicaid programs under
title XIX of the Social Security Act (42 U.S.C. 1396 et
seq.).
(b) Collection of Data From States.--The Secretary of
Health and Human Services may request from States such data
as the Secretary determines necessary to create the opioid
mapping tool described in subsection (a).
SEC. 15. NATIONAL ACADEMIES STUDY.
(a) Study.--The Secretary of Health and Human Services
shall enter into a contract with the National Academies of
Science, Engineering, and Medicine (referred to in this
section as the ``National Academies'') to carry out a study
on the addition of coverage under the Medicare program under
title XVIII of the Social Security Act of alternative
treatment modalities (such as integrative medicine, including
acupuncture and exercise therapy, neural stimulation,
biofeedback, radiofrequency ablation, and trigger point
injections) furnished to Medicare beneficiaries who suffer
from acute or chronic lower back pain. Such study shall,
pursuant to the contract under this paragraph, include an
analysis of--
(1) scientific research on the short-term and long-term
impact of the addition of such coverage on clinical efficacy
for pain management of such beneficiaries;
(2) whether the lack of Medicare coverage for alternative
treatment modalities impacts the volume of opioids prescribed
for beneficiaries; and
(3) the cost to the Medicare program of the addition of
such coverage to treat pain and mitigate the progression of
chronic pain, as weighed against the cost of opioid use
disorder, overdose, readmission, subsequent surgeries, and
utilization and expenditures under parts B and D of such
title.
(b) Report.--Not later than 1 year after the date of
enactment of this Act, pursuant to the contract under
subsection (a), the National Academies shall submit to
Congress a report on the study under subsection (a).
(c) Authorization of Appropriations.--To carry out this
section, there are authorized to be appropriated such sums as
may be necessary.
______
By Mr. DURBIN:
S. 4243. A bill to protect children of certain immigrant workers from
detention and removal and aging out of lawful status, and for other
purposes; to the Committee on the Judiciary.
S. 4243
Mr. DURBIN. Mr. President, I ask unanimous consent that the text of
the bill be printed in the Record. There being no objection, the text
of the bill was ordered to be printed in the Record, as follows:
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 ``Protect Children of
Immigrant Workers Act''.
SEC. 2. PROTECTING CHILDREN OF CERTAIN IMMIGRANT WORKERS FROM
DETENTION AND REMOVAL AND AGING OUT OF LAWFUL
STATUS.
(a) In General.--Notwithstanding any other provision of
law, subject to subsection (b), with respect to an individual
whose parent is the principal beneficiary of an approved
employment-based immigrant worker petition filed on a date on
which the individual was a child (as defined in section
101(b) of the Immigration and Nationality Act (8 U.S.C.
1101(b))--
(1) the Secretary of Homeland Security shall not detain,
refer for removal, initiate removal proceedings against, or
remove the individual; and
(2) the individual shall--
(A) without regard to immigrant intent and on application
by the individual, be eligible--
(i) to extend nonimmigrant dependent status connected to
the nonimmigrant status of such parent until the date on
which an application for lawful permanent resident status
filed by the individual pursuant to subparagraph (B) is
adjudicated; or
(ii) to extend or change status to an alternative
nonimmigrant status independent of such parent's visa status
until the date on which an application for lawful permanent
resident status filed by the individual pursuant to that
subparagraph is adjudicated; and
[[Page S4355]]
(B) qualify as a derivative beneficiary child for immigrant
visa purposes beginning on the date on which such parent's
employment-based immigrant worker petition is approved and
ending on the date on which the individual's application for
lawful permanent resident status is adjudicated, regardless
of whether such parent is living or deceased.
(b) Applicability.--Subsection (a) shall not apply to any
individual who the Secretary determines, on an individualized
basis, poses a threat to public safety or national security.
____________________