[House Report 109-116]
[From the U.S. Government Publishing Office]
109th Congress Rept. 109-116
HOUSE OF REPRESENTATIVES
1st Session Part 1
======================================================================
DRUG ADDICTION TREATMENT EXPANSION ACT
_______
June 9, 2005.--Ordered to be printed
_______
Mr. Barton of Texas, from the Committee on Energy and Commerce,
submitted the following
R E P O R T
[To accompany H.R. 869]
[Including cost estimate of the Congressional Budget Office]
The Committee on Energy and Commerce, to whom was referred
the bill (H.R. 869) to amend the Controlled Substances Act to
lift the patient limitation on prescribing drug addiction
treatments by medical practitioners in group practices, and for
other purposes, having considered the same, report favorably
thereon without amendment and recommend that the bill do pass.
CONTENTS
Page
Purpose and Summary.............................................. 1
Background and Need for Legislation.............................. 2
Hearings......................................................... 2
Committee Consideration.......................................... 2
Committee Votes.................................................. 2
Committee Oversight Findings..................................... 2
Statement of General Performance Goals and Objectives............ 3
New Budget Authority, Entitlement Authority, and Tax Expenditures 3
Committee Cost Estimate.......................................... 3
Congressional Budget Office Estimate............................. 3
Federal Mandates Statement....................................... 4
Advisory Committee Statement..................................... 4
Constitutional Authority Statement............................... 4
Applicability to Legislative Branch.............................. 4
Section-by-Section Analysis of the Legislation................... 4
Changes in Existing Law Made by the Bill, as Reported............ 4
Purpose and Summary
The purpose of H.R. 869, the Drug Addiction Treatment
Expansion Act, is to amend Section 303(g)(1)(B) of the
Controlled Substances Act thereby increasing access to drug
addiction therapy.
Background and Need for Legislation
In 2000, Congress passed the Drug Addiction Treatment Act,
Public Law 106-310. Section 2(a)(2) of the Act established a
new waiver mechanism for schedule IV or V treatment programs
and placed it in paragraph 303(g)(2) of the Controlled
Substances Act. The waiver is available to qualified physicians
for maintenance treatment and detoxification treatment using
approved schedule IV or V narcotic drugs, either alone or in
combination.
Physicians who wish to use the waiver must notify the
Secretary of their intentions, certifying (1) that they meet
one or more of the training and experience demands defined in
section 303(g)(2)(G); (2) that they have the capacity to refer
patients to counseling and other ancillary services as
appropriate; and, (3) that they will honor the limitations
placed on the number of patients they may treat at any one
time. Subject to regulatory adjustment by the Secretary,
neither sole practitioners nor any collection of physicians
practicing as a group may treat more than 30 patients at any
one time.
The 30 patient limitation on group practices has proven to
be an unnecessary barrier to addiction treatment medication.
H.R. 869 lifts the 30 patient limitation for group practices.
The individual physician limitation of 30 patients remains in
place. This small but substantive change in Section 303 of the
Controlled Substances Act will improve access to drug addiction
therapy.
Hearings
The Committee on Energy and Commerce has not held hearings
on the legislation.
Committee Consideration
On Wednesday, April 27, 2005, the Subcommittee on Health
met in open markup session and approved H.R. 869 for Full
Committee consideration, without amendment, by a voice vote, a
quorum being present. On Wednesday, May 4, 2005, the Full
Committee met in open markup session and ordered H.R. 869
favorably reported to the House, without amendment, by a voice
vote, a quorum being present.
Committee Votes
Clause 3(b) of rule XIII of the Rules of the House of
Representatives requires the Committee to list the record votes
on the motion to report legislation and amendments thereto.
There were no record votes taken in connection with ordering
H.R. 869 reported. A motion by Mr. Barton to order H.R. 869
reported to the House, without amendment, was agreed to by a
voice vote.
Committee Oversight Findings
Pursuant to clause 3(c)(1) of rule XIII of the Rules of the
House of Representatives, the Committee has not held oversight
or legislative hearings on this legislation.
Statement of General Performance Goals and Objectives
The objective of this legislation is to expand access to
addiction treatment therapy.
New Budget Authority, Entitlement Authority, and Tax Expenditures
In compliance with clause 3(c)(2) of rule XIII of the Rules
of the House of Representatives, the Committee finds that H.R.
869, the Drug Addiction Treatment Expansion Act, would result
in no new or increased budget authority, entitlement authority,
or tax expenditures or revenues.
Committee Cost Estimate
The Committee adopts as its own the cost estimate prepared
by the Director of the Congressional Budget Office pursuant to
section 402 of the Congressional Budget Act of 1974.
Congressional Budget Office Estimate
Pursuant to clause 3(c)(3) of rule XIII of the Rules of the
House of Representatives, the following is the cost estimate
provided by the Congressional Budget Office pursuant to section
402 of the Congressional Budget Act of 1974:
U.S. Congress,
Congressional Budget Office,
Washington, DC, May 12, 2005.
Hon. Joe Barton,
Chairman, Committee on Energy and Commerce,
House of Representatives, Washington, DC.
Dear Mr. Chairman: The Congressional Budget Office has
prepared the enclosed cost estimate for H.R. 869, a bill to
amend the Controlled Substances Act to lift the patient
limitation on prescribing drug addiction treatments by medical
practitioners in group practices, and for other purposes.
If you wish further details on this estimate, we will be
pleased to provide them. The CBO staff contact is Eric Rollins.
Sincerely,
Elizabeth M. Robinson,
(For Douglas Holtz-Eakin, Director).
Enclosure.
H.R. 869--A bill to amend the Controlled Substances Act to lift the
patient limitation on prescribing drug addiction treatments by
medical practitioners in group practices, and for other
purposes
H.R. 869 would allow medical group practices to prescribe
and dispense narcotic drugs in schedules III, IV, or V (the
drugs rated the lowest risk for abuse) for drug addiction
treatment to more than 30 patients at a time without first
registering with the Drug Enforcement Administration (DEA). The
bill would prohibit individual practitioners within such groups
from treating more than 30 patients at a time. Individual
practitioners and group practices that treat fewer than 30
patients are already exempt from the requirement to register
with DEA.
CBO estimates that this bill would have no significant
budgetary effect. Enacting the bill could affect direct
spending, but any such effects would likely be negligible. H.R.
869 contains no intergovernmental or private-sector mandates as
defined in the Unfunded Mandates Reform Act and would impose no
costs on state, local, or tribal governments.
The CBO staff contact for this estimate is Eric Rollins.
This estimate was approved by Peter H. Fontaine, Deputy
Assistant Director for Budget Analysis.
Federal Mandates Statement
The Committee adopts as its own the estimate of Federal
mandates prepared by the Director of the Congressional Budget
Office pursuant to section 423 of the Unfunded Mandates Reform
Act.
Advisory Committee Statement
No advisory committees within the meaning of section 5(b)
of the Federal Advisory Committee Act were created by this
legislation.
Constitutional Authority Statement
Pursuant to clause 3(d)(1) of rule XIII of the Rules of the
House of Representatives, the Committee finds that the
Constitutional authority for this legislation is provided in
Article I, section 8, clause 3, which grants Congress the power
to regulate commerce with foreign nations, among the several
States, and with the Indian tribes.
Applicability to Legislative Branch
The Committee finds that the legislation does not relate to
the terms and conditions of employment or access to public
services or accommodations within the meaning of section
102(b)(3) of the Congressional Accountability Act.
Section-by-Section Analysis of the Legislation
Section 1. Maintenance of detoxification treatment with certain
narcotic drugs; elimination of 30-patient limit for group
practices.
Subsection (a) amends Section 303(g)(2)(B) of the
Controlled Substance Act (21 U.S.C. 823(g)(2)(B) by striking
clause (iv). Striking clause (iv) would lift the 30 patient
limitation for group practices that dispense narcotic drugs for
maintenance or detoxification treatment.
Subsection (b) is a conforming amendment to ensure that the
individual physician limit of 30 patients still applies to
physicians in group practices.
Subsection (c) states the section shall take affect on the
date of enactment of the Act.
Changes in Existing Law Made by the Bill, as Reported
In compliance with clause 3(e) of rule XIII of the Rules of
the House of Representatives, changes in existing law made by
the bill, as reported, are shown as follows (existing law
proposed to be omitted is enclosed in black brackets, new
matter is printed in italics, existing law in which no change
is proposed is shown in roman):
SECTION 303 OF THE CONTROLLED SUBSTANCE ACT
registration requirements
Sec. 303. (a) * * *
* * * * * * *
(g)(1) * * *
(2)(A) * * *
(B) For purposes of subparagraph (A), the conditions
specified in this subparagraph with respect to a practitioner
are that, before the initial dispensing of narcotic drugs in
schedule III, IV, or V or combinations of such drugs to
patients for maintenance or detoxification treatment, the
practitioner submit to the Secretary a notification of the
intent of the practitioner to begin dispensing the drugs or
combinations for such purpose, and that the notification
contain the following certifications by the practitioner:
(i) * * *
* * * * * * *
(iii) [In any case in which the practitioner is not
in a group practice, the total] The total number of
such patients of the practitioner at any one time will
not exceed the applicable number. For purposes of this
clause, the applicable number is 30, except that the
Secretary may by regulation change such total number.
[(iv) In any case in which the practitioner is in a
group practice, the total number of such patients of
the group practice at any one time will not exceed the
applicable number. For purposes of this clause, the
applicable number is 30, except that the Secretary may
by regulation change such total number, and the
Secretary for such purposes may by regulation establish
different categories on the basis of the number of
practitioners in a group practice and establish for the
various categories different numerical limitations on
the number of such patients that the group practice may
have.]
* * * * * * *