[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4793 Introduced in House (IH)]
<DOC>
116th CONGRESS
1st Session
H. R. 4793
To amend the Internal Revenue Code of 1986 to establish a stewardship
fee on the production and importation of opioid pain relievers, and for
other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
October 22, 2019
Mr. Norcross (for himself and Mr. Larson of Connecticut) introduced the
following bill; which was referred to the Committee on Energy and
Commerce, and in addition to the Committee on Ways and Means, for a
period to be subsequently determined by the Speaker, in each case for
consideration of such provisions as fall within the jurisdiction of the
committee concerned
_______________________________________________________________________
A BILL
To amend the Internal Revenue Code of 1986 to establish a stewardship
fee on the production and importation of opioid pain relievers, and for
other purposes.
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 ``Budgeting for Opioid Addiction
Treatment Act''.
SEC. 2. 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 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. 3. 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 2(d) of the Budgeting for Opioid Addiction Treatment Act (as
described in section 1933(a)(1)(B)(i)) be used exclusively for
substance abuse (including opioid abuse) treatment efforts in the
State, including--
``(1) treatment programs--
``(A) establishing new addiction treatment
facilities, residential and outpatient, including
covering capital costs;
``(B) establishing sober living facilities;
``(C) recruiting and increasing reimbursement for
certified mental health providers providing substance
abuse treatment in medically underserved communities or
communities with high rates of prescription drug abuse;
``(D) expanding access to long-term, residential
treatment programs for opioid addicts (including 30-,
60-, and 90-day programs);
``(E) establishing or operating support programs
that offer employment services, housing, and other
support services to help recovering addicts transition
back into society;
``(F) establishing or operating housing for
children whose parents are participating in substance
abuse treatment programs, including capital costs;
``(G) establishing or operating facilities to
provide care for babies born with neonatal abstinence
syndrome, including capital costs; and
``(H) other treatment programs, as the Secretary
determines appropriate; and
``(2) recruitment and training of substance use disorder
professionals to work in rural and medically underserved
communities.''.
(d) Additional Funding.--Section 1933(a)(1)(B)(i) of the Public
Health Service Act (42 U.S.C. 300x-33(a)(1)(B)(i)) is amended by
inserting ``, plus 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 2(d) of the Budgeting for Opioid Addiction
Treatment Act'' before the period.
SEC. 4. REPORT.
Not later than 2 years after the date described in section 2(c),
the Secretary of Health and Human Services shall submit to Congress a
report on the impact of the amendments made by sections 2 and 3 on--
(1) the retail cost of active opioids (as defined in
section 4192 of the Internal Revenue Code of 1986, as added by
section 2);
(2) patient access to such opioids, particularly cancer and
hospice patients, including the effect of the discount or
rebate on such opioids for cancer and hospice patients under
section 2(d);
(3) how the increase in revenue to the Treasury resulting
from the enactment of section 4192 of the Internal Revenue Code
of 1986 is used to improve substance abuse treatment efforts in
accordance with section 1923A of the Public Health Service Act
(as added by section 3); and
(4) suggestions for improving--
(A) access to opioids for cancer and hospice
patients; and
(B) substance abuse treatment efforts under such
section 1923A.
<all>