[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4974 Introduced in House (IH)]
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116th CONGRESS
1st Session
H. R. 4974
To amend the Controlled Substances Act to require physicians and other
prescribers of controlled substances to complete training on treating
and managing patients with opioid and other substance use disorders
(which shall also satisfy certain training required to receive a waiver
for dispensing narcotic drugs for maintenance or detoxification
treatment), and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
November 1, 2019
Mrs. Trahan (for herself, Mr. Bergman, Mr. Carter of Georgia, Mr.
Trone, Mr. Rogers of Kentucky, Ms. Kuster of New Hampshire, Mr. Tonko,
Mr. Crow, Mr. Rose of New York, and Mr. Pappas) introduced the
following bill; which was referred to the Committee on Energy and
Commerce, and in addition to the Committee on the Judiciary, 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 Controlled Substances Act to require physicians and other
prescribers of controlled substances to complete training on treating
and managing patients with opioid and other substance use disorders
(which shall also satisfy certain training required to receive a waiver
for dispensing narcotic drugs for maintenance or detoxification
treatment), 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 ``Medication Access and Training
Expansion Act of 2019'' or the ``MATE Act of 2019''.
SEC. 2. REQUIRING PRESCRIBERS OF CONTROLLED SUBSTANCES TO COMPLETE
TRAINING ON TREATING AND MANAGING PATIENTS WITH OPIOID
AND OTHER SUBSTANCE USE DISORDERS.
(a) In General.--Section 303 of the Controlled Substances Act (21
U.S.C. 823) is amended by adding at the end the following:
``(l) Required Training for Prescribers on Treating and Managing
Patients With Opioid and Other Substance Use Disorders.--
``(1) Applicability.--This subsection applies--
``(A) with respect to any practitioner who is
licensed under State law to prescribe controlled
substances; and
``(B) beginning with the first registration or
renewal of registration by the practitioner under this
section occurring 90 or more days after the date of
enactment of the Medication Access and Training
Expansion Act of 2019.
``(2) Training required.--As a condition on registration
under this section to dispense controlled substances in
schedule II, III, IV, or V, the Attorney General shall require
any practitioner described in paragraph (1)(A) to meet the
following:
``(A) If the practitioner is a physician, the
practitioner must meet one or more of the following
conditions:
``(i) The physician holds a board
certification in addiction psychiatry or
addiction medicine from the American Board of
Medical Specialties.
``(ii) The physician holds an addiction
certification or board certification from the
American Society of Addiction Medicine or the
American Board of Addiction Medicine.
``(iii) The physician holds a board
certification in addiction medicine from the
American Osteopathic Association.
``(iv) The physician has, with respect to
the treatment and management of patients with
opioid and other substance use disorders,
completed not less than 8 hours of training
(through classroom situations, seminars at
professional society meetings, electronic
communications, or otherwise) that is provided
by the American Society of Addiction Medicine,
the American Academy of Addiction Psychiatry,
the American Medical Association, the American
Osteopathic Association, the American
Psychiatric Association, or any other
organization that the Secretary determines is
appropriate for purposes of this clause. Such
training shall include--
``(I) opioid maintenance and
detoxification;
``(II) appropriate clinical use of
all drugs approved by the Food and Drug
Administration for the treatment of a
substance use disorder;
``(III) initial and periodic
patient assessments (including
substance use monitoring);
``(IV) individualized treatment
planning, overdose reversal, and
relapse prevention;
``(V) counseling and recovery
support services;
``(VI) staffing roles and
considerations;
``(VII) diversion control; and
``(VIII) other best practices, such
as prevention of addiction, as
identified by the Secretary, after
consultation with practitioners from a
variety of medical specialties and who
practice in different settings in which
controlled substances are prescribed.
``(v) The physician has participated as an
investigator in one or more clinical trials
leading to the approval of a narcotic drug in
schedule III, IV, or V for maintenance or
detoxification treatment, as demonstrated by a
statement submitted to the Secretary by the
sponsor of such approved drug.
``(vi) The physician has such other
training or experience as the State medical
licensing board of the State where the
physician will provide maintenance or
detoxification treatment considers to
demonstrate the ability of the physician to
treat and manage patients with opioid and other
substance use disorders.
``(vii) The physician has such other
training or experience as the Secretary
considers to demonstrate the ability of the
physician to treat and manage patients with
opioid and other substance use disorders. Any
criteria of the Secretary under this clause
shall be established by regulation. Any such
criteria are effective only for 3 years after
the date on which the criteria are promulgated,
but may be extended for such additional
discrete 3-year periods as the Secretary
considers appropriate for purposes of this
clause. Such an extension of criteria may only
be effectuated through a statement published in
the Federal Register by the Secretary during
the 30-day period preceding the end of the 3-
year period involved.
``(viii) The physician graduated in good
standing from an accredited school of
allopathic medicine or osteopathic medicine in
the United States during the 5-year period
immediately preceding the date on which the
physician first registers or renews under this
section and has successfully completed a
comprehensive allopathic or osteopathic
medicine curriculum or accredited medical
residency that--
``(I) included not less than 8
hours of training on treating and
managing patients with opioid and other
substance use disorders; and
``(II) included, at a minimum--
``(aa) the training
described in subclauses (I)
through (VIII) of clause (iv);
and
``(bb) training with
respect to any other best
practice the Secretary
determines should be included
in the curriculum, which may
include training on pain
management, including
assessment and appropriate use
of opioid and non-opioid
alternatives.
``(B) If the practitioner is not a physician, the
practitioner must meet one or more of the following
conditions:
``(i) Completed not fewer than 24 hours of
initial training addressing each of the topics
listed in subparagraph (A)(iv) (through
classroom situations, seminars at professional
society meetings, electronic communications, or
otherwise) provided by the American Society of
Addiction Medicine, the American Academy of
Addiction Psychiatry, the American Medical
Association, the American Osteopathic
Association, the American Nurses Credentialing
Center, the American Psychiatric Association,
the American Association of Nurse
Practitioners, the American Academy of
Physician Assistants, or any other organization
that the Secretary determines is appropriate
for purposes of this clause.
``(ii) Has such other training or
experience as the Secretary determines will
demonstrate the ability of the practitioner to
treat and manage patients with opioid and other
substance use disorders.
``(iii) Graduated in good standing from an
accredited physician assistant school or school
of advanced practice nursing in the United
States during the 5-year period immediately
preceding the date on which the practitioner
first registers or renews under this section
and has successfully completed a comprehensive
physician assistant or advanced practice
nursing curriculum that includes not less than
24 hours of training on treating and managing
patients with opioid and other substance use
disorders and, at a minimum--
``(I) the training described in
subclauses (I) through (VIII) of
subparagraph (A)(iv); and
``(II) training with respect to any
other best practice the Secretary
determines should be included in the
curriculum, which may include training
on pain management, including
assessment and appropriate use of
opioid and non-opioid alternatives.
``(3) Reciprocal treatment.--
``(A) Physicians.--A physician who meets one or
more of the conditions listed in paragraph (2)(A) is
deemed to meet one or more of the conditions listed in
subsection (g)(2)(G)(ii), and a physician who meets one
or more of the conditions listed in subsection
(g)(2)(G)(ii) is deemed to meet one or more of the
conditions listed in paragraph (2)(A).
``(B) Other practitioners.--A practitioner who is
not a physician, and who meets one or more of the
conditions listed in paragraph (2)(B), is deemed to
meet one or more of the conditions listed in subsection
(g)(2)(G)(iv)(II), and a practitioner who is not a
physician, and who meets one or more of the conditions
listed in subsection (g)(2)(G)(iv)(II), is deemed to
meet one or more of the conditions listed in paragraph
(2)(B).''.
(b) Training Required.--
(1) Physicians.--Section 303(g)(2)(G)(ii)(IV)(hh) of the
Controlled Substances Act (21 U.S.C. 823(g)(2)(G)(ii)(IV)) is
amended by inserting ``such as prevention of addiction,'' after
``other best practices,''.
(2) Other practitioners.--Section 303(g)(2)(G)(iv)(II) of
the Controlled Substances Act (21 U.S.C. 823(g)(2)(G)(iv)(II))
is amended--
(A) in item (aa), by striking ``or'' at the end;
(B) in item (bb), by striking the period at the end
and inserting ``; or''; and
(C) by adding at the end the following new item:
``(cc) graduated in good standing from an
accredited physician assistant school or school of
advanced practice nursing in the United States during
the 5-year period immediately preceding the date on
which the practitioner submits to the Secretary a
written notification under subparagraph (B) and has
successfully completed a comprehensive physician
assistant or advanced practice nursing curriculum that
includes not less than 24 hours of training on treating
and managing opioid-dependent patients and, at a
minimum--
``(AA) the training described in items (aa)
through (hh) of clause (ii)(IV); and
``(BB) training with respect to any other
best practice the Secretary determines should
be included in the curriculum, which may
include training on pain management, including
assessment and appropriate use of opioid and
non-opioid alternatives.''.
(3) Technical correction.--Section 303(g)(2)(G)(iv)(II)(bb)
of the Controlled Substances Act (21 U.S.C.
823(g)(2)(G)(iv)(II)(bb)) is amended by striking ``has'' before
``such other training''.
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