[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4531 Introduced in House (IH)]
<DOC>
118th CONGRESS
1st Session
H. R. 4531
To reauthorize certain programs that provide for opioid use disorder
prevention, recovery, and treatment, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
July 11, 2023
Mr. Guthrie (for himself and Ms. Kuster) introduced the following bill;
which was referred to the Committee on Energy and Commerce, and in
addition to the Committees on the Judiciary, and Education and the
Workforce, 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 reauthorize certain programs that provide for opioid use disorder
prevention, recovery, and 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 ``Support for Patients and Communities
Reauthorization Act''.
SEC. 2. TABLE OF CONTENTS.
The table of contents for this Act is as follows:
Sec. 1. Short title.
Sec. 2. Table of contents.
TITLE I--PUBLIC HEALTH
Sec. 101. Monitoring and education regarding infections associated with
illicit drug use and other risk factors.
Sec. 102. Preventing overdoses of controlled substances.
Sec. 103. Residential treatment programs for pregnant and postpartum
women.
Sec. 104. First responder training.
Sec. 105. Building communities of recovery.
Sec. 106. National Peer-Run Training and Technical Assistance Center
for Addiction Recovery Support.
Sec. 107. Comprehensive opioid recovery centers.
Sec. 108. Grants to address the problems of persons who experience
violence related stress.
Sec. 109. Mental and behavioral health education and training grants.
Sec. 110. Loan repayment program for the substance use disorder
treatment workforce.
Sec. 111. Pilot program for public health laboratories to detect
fentanyl and other synthetic opioids.
Sec. 112. Monitoring and reporting of child, youth, and adult trauma.
Sec. 113. Task force to develop best practices for trauma-informed
identification, referral, and support.
Sec. 114. Treatment, recovery, and workforce support grants.
Sec. 115. Grant program for State and Tribal response to opioid use
disorders.
Sec. 116. References to opioid overdose reversal agents in HHS grant
programs.
Sec. 117. Addressing other concurrent substance use disorders through
grant program for State and Tribal response
to opioid use disorders.
Sec. 118. Providing for a study on the effects of remote monitoring on
individuals who are prescribed opioids.
TITLE II--CONTROLLED SUBSTANCES
Sec. 201. Delivery of certain substances by a pharmacy to an
administering practitioner.
Sec. 202. Reviewing the scheduling of approved products containing a
combination of buprenorphine and naloxone.
Sec. 203. Combating illicit xylazine.
Sec. 204. Technical corrections.
TITLE III--MEDICAID
Sec. 301. Extending requirement for State Medicaid plans to provide
coverage for medication-assisted treatment.
Sec. 302. Expanding required reports on T-MSIS substance use disorder
data to include mental health condition
data.
Sec. 303. Monitoring prescribing of antipsychotic medications.
TITLE I--PUBLIC HEALTH
SEC. 101. MONITORING AND EDUCATION REGARDING INFECTIONS ASSOCIATED WITH
ILLICIT DRUG USE AND OTHER RISK FACTORS.
Section 317N of the Public Health Service Act (42 U.S.C. 247b-15)
is amended--
(1) in the section heading, by striking ``surveillance
and'' and inserting ``monitoring and''; and
(2) in subsection (d), by striking ``fiscal years 2019
through 2023'' and inserting ``fiscal years 2024 through
2028''.
SEC. 102. PREVENTING OVERDOSES OF CONTROLLED SUBSTANCES.
(a) Evidence-Based Prevention Grants.--Section 392A(a)(2)(D) of the
Public Health Service Act (42 U.S.C. 280b-1(a)(2)(D)) is amended by
inserting after ``new and emerging public health crises'' the
following: ``, such as the fentanyl crisis,''.
(b) Authorization of Appropriations.--Section 392A(e) of the Public
Health Service Act (42 U.S.C. 280b-1(e)) is amended by striking
``$496,000,000 for each of fiscal years 2019 through 2023'' and
inserting ``$505,579,000 for each of fiscal years 2024 through 2028''.
SEC. 103. RESIDENTIAL TREATMENT PROGRAMS FOR PREGNANT AND POSTPARTUM
WOMEN.
Section 508(s) of the Public Health Service Act (42 U.S.C. 290bb-
1(s)) is amended by striking ``$29,931,000 for each of fiscal years
2019 through 2023'' and inserting ``$38,931,000 for each of fiscal
years 2024 through 2028''.
SEC. 104. FIRST RESPONDER TRAINING.
Section 546(h) of the Public Health Service Act (42 U.S.C. 290ee-
1(h)) is amending by striking ``$36,000,000 for each of fiscal years
2019 through 2023'' and inserting ``$56,000,000 for each of fiscal
years 2024 through 2028''.
SEC. 105. BUILDING COMMUNITIES OF RECOVERY.
Section 547(f) of the Public Health Service Act (42 U.S.C. 290ee-
2(f)) is amended by striking ``$5,000,000 for each of fiscal years 2019
through 2023'' and inserting ``$16,000,000 for each of fiscal years
2024 through 2028''.
SEC. 106. NATIONAL PEER-RUN TRAINING AND TECHNICAL ASSISTANCE CENTER
FOR ADDICTION RECOVERY SUPPORT.
Section 547A(e) of the Public Health Service Act (42 U.S.C. 290ee-
2a(e)) is amended by striking ``$1,000,000 for each of fiscal years
2019 through 2023'' and inserting ``$2,000,000 for each of fiscal years
2024 through 2028''.
SEC. 107. COMPREHENSIVE OPIOID RECOVERY CENTERS.
(a) Reauthorization.--Section 552(j) of the Public Health Service
Act (42 U.S.C. 290ee-7(j)) is amended by striking ``2019 through 2023''
and inserting ``2024 through 2028''.
(b) Documentation for Evidence of Capacity To Carry Out Required
Activities.--Section 552(d) of the Public Health Service Act (42 U.S.C.
290ee-7(d)) is amended by adding at the end the following:
``(3) Documentation.--
``(A) In general.--Evidence required to be provided
under paragraph (1) may be provided through a letter of
intent from partner agencies or other relevant
documentation (as defined by the Secretary).
``(B) Partner agency defined.--In this paragraph,
the term `partner agency' means a non-governmental
organization or other public or private entity--
``(i) the primary purpose of which is the
delivery of mental health or substance use
disorder treatment services; and
``(ii) with which the applicant coordinates
to provide the full continuum of treatment
services (as specified in subsection (g)(1)(B))
that the applicant is unable to offer on
site.''.
(c) Center Activities Carried Out Through Third Parties.--Section
552(g) of the Public Health Service Act (42 U.S.C. 290ee-7(g)) is
amended in the matter preceding paragraph (1) by striking ``Each Center
shall'' and all that follows through ``subsection (f):'' and inserting
the following: ``Each Center shall, at a minimum, carry out the
activities specified in this subsection directly, through referral, or
through contractual arrangements. If a Center elects to carry out such
activities through contractual arrangements, the Secretary may issue
guidance on best practices to ensure that the Center is capable of
carrying out such activities, including carrying out such activities
through technology-enabled collaborative learning and capacity building
models described in subsection (f) and coordinating the full continuum
of treatment services specified in subparagraph (B). Such activities
include the following:''.
SEC. 108. GRANTS TO ADDRESS THE PROBLEMS OF PERSONS WHO EXPERIENCE
VIOLENCE RELATED STRESS.
Section 582(j) of the Public Health Service Act (42 U.S.C. 290hh-
1(j)) is amended by striking ``$63,887,000 for each of fiscal years
2019 through 2023'' and inserting ``$93,887,000 for each of fiscal
years 2024 through 2028''.
SEC. 109. MENTAL AND BEHAVIORAL HEALTH EDUCATION AND TRAINING GRANTS.
Section 756(f) of the Public Health Service Act (42 U.S.C. 294e-
1(f)) is amended by striking ``fiscal years 2023 through 2027'' and
inserting ``fiscal years 2024 through 2028''.
SEC. 110. LOAN REPAYMENT PROGRAM FOR THE SUBSTANCE USE DISORDER
TREATMENT WORKFORCE.
Section 781(j) of the Public Health Service Act (42 U.S.C. 295h(j))
is amended by striking ``$25,000,000 for each of fiscal years 2019
through 2023'' and inserting ``$40,000,000 for each of fiscal years
2024 through 2028''.
SEC. 111. PILOT PROGRAM FOR PUBLIC HEALTH LABORATORIES TO DETECT
FENTANYL AND OTHER SYNTHETIC OPIOIDS.
Section 7011(d) of the SUPPORT for Patients and Communities Act (42
U.S.C. 247d-10(d)) is amended by striking ``fiscal years 2019 through
2023'' and inserting ``fiscal years 2024 through 2028''.
SEC. 112. MONITORING AND REPORTING OF CHILD, YOUTH, AND ADULT TRAUMA.
Section 7131(e) of the SUPPORT for Patients and Communities Act (42
U.S.C. 242t(e)) is amended by striking ``$2,000,000 for each of fiscal
years 2019 through 2023'' and inserting ``$9,000,000 for each of fiscal
years 2024 through 2028''.
SEC. 113. TASK FORCE TO DEVELOP BEST PRACTICES FOR TRAUMA-INFORMED
IDENTIFICATION, REFERRAL, AND SUPPORT.
Section 7132 of the SUPPORT for Patients and Communities Act
(Public Law 115-271) is amended--
(1) in subsection (g)--
(A) in paragraph (1), by striking ``and'' at the
end;
(B) in paragraph (2), by striking the period at the
end and inserting ``; and''; and
(C) by adding at the end the following:
``(3) additional reports and updates to existing reports,
as necessary.''; and
(2) by striking subsection (i).
SEC. 114. TREATMENT, RECOVERY, AND WORKFORCE SUPPORT GRANTS.
Section 7183 of the SUPPORT for Patients and Communities Act (42
U.S.C. 290ee-8) is amended--
(1) in subsection (b), by inserting ``each'' before ``for a
period'';
(2) by amending subsection (c)(2) to read as follows:
``(2) Rates.--The rates described in this paragraph are the
following:
``(A) The amount by which the average rate of drug
overdose deaths in the State, adjusted for age, for the
period of 5 calendar years for which there is available
data, including if necessary provisional data,
immediately preceding the grant cycle (which shall be
the period of calendar years 2018 through 2022 for the
first grant cycle following the enactment of the
Support for Patients and Communities Reauthorization
Act) is above the average national overdose mortality
rate, as determined by the Director of the Centers for
Disease Control and Prevention, for the same period.
``(B) The amount by which the average rate of
unemployment for the State, based on data provided by
the Bureau of Labor Statistics, for the period of 5
calendar years for which there is available data,
including if necessary provisional data, immediately
preceding the grant cycle (which shall be the period of
calendar years 2018 through 2022 for the first grant
cycle following the enactment of the Support for
Patients and Communities Reauthorization Act) is above
the national average for the same period.
``(C) The amount by which the average rate of labor
force participation in the State, based on data
provided by the Bureau of Labor Statistics, for the
period of 5 calendar years for which there is available
data, including if necessary provisional data,
immediately preceding the grant cycle (which shall be
the period of calendar years 2018 through 2022 for the
first grant cycle following the enactment of the
Support for Patients and Communities Reauthorization
Act) is below the national average for the same
period.'';
(3) in subsection (g)--
(A) in paragraphs (1) and (3), by redesignating
subparagraphs (A) and (B) as clauses (i) and (ii),
respectively, and adjusting the margins accordingly;
(B) by redesignating paragraphs (1) through (3) as
subparagraphs (A) through (C), respectively, and
adjusting the margins accordingly;
(C) by striking ``An entity'' and inserting the
following:
``(1) In general.--An entity''; and
(D) by adding at the end the following:
``(2) Transportation services.--An entity receiving a grant
under this section may use the funds for providing
transportation for individuals to participate in an activity
supported by a grant under this section, which transportation
shall be to or from a place of work or a place where the
individual is receiving vocational education or job training
services or receiving services directly linked to treatment of
or recovery from a substance use disorder.'';
(4) in subsection (j)--
(A) in paragraph (1), by inserting ``for each grant
cycle'' after ``grant period''; and
(B) in paragraph (2)--
(i) in the matter preceding subparagraph
(A)--
(I) by striking ``the preliminary
report'' and inserting ``each
preliminary report''; and
(II) by inserting ``for the grant
cycle'' after ``final report''; and
(ii) in subparagraph (A), by striking
``(g)(3)'' and inserting ``(g)(1)(C)''; and
(5) in subsection (k), by striking ``$5,000,000 for each of
fiscal years 2019 through 2023'' and inserting ``$12,000,000
for each of fiscal years 2024 through 2028''.
SEC. 115. GRANT PROGRAM FOR STATE AND TRIBAL RESPONSE TO OPIOID USE
DISORDERS.
Section 1003(b)(4)(A) of the 21st Century Cures Act (42 U.S.C.
290ee-3a(b)(4)(A)) is amended after ``which may include drugs or
devices approved, cleared, or otherwise legally marketed under the
Federal Food, Drug, and Cosmetic Act'' by inserting ``or fentanyl or
xylazine test strips''.
SEC. 116. REFERENCES TO OPIOID OVERDOSE REVERSAL AGENTS IN HHS GRANT
PROGRAMS.
(a) In General.--The Secretary of Health and Human Services shall
ensure that, whenever the Department of Health and Human Services
issues a regulation, guidance, or other document for any grant program
addressing opioid misuse and use disorders, any reference to an opioid
overdose reversal agent (such as a reference to naloxone) is inclusive
of any opioid overdose reversal agent that has been approved or
otherwise authorized for use by the Food and Drug Administration.
(b) Existing References.--
(1) Update.--Not later than the end of calendar year 2023,
the Secretary of Health and Human Services shall update all
references described in paragraph (2) to be inclusive of any
opioid overdose reversal agent that has been approved or
otherwise authorized for use by the Food and Drug
Administration.
(2) References.--A reference described in this paragraph is
any reference to an opioid overdose reversal agent (such as
naloxone) in any regulation, guidance, or other document of the
Department of Health and Human Services that--
(A) was issued before the date of enactment of this
Act; and
(B) is for--
(i) the grant program for State and Tribal
response to opioid use disorders under section
1003 of the 21st Century Cures Act (42 U.S.C.
290ee-3 note; commonly referred to as ``State
Opioid Response Grants'' and ``Tribal Opioid
Response Grants''); or
(ii) the grant program for priority
substance use disorder prevention needs of
regional and national significance under
section 516 of the Public Health Service Act
(42 U.S.C. 290bb-22).
SEC. 117. ADDRESSING OTHER CONCURRENT SUBSTANCE USE DISORDERS THROUGH
GRANT PROGRAM FOR STATE AND TRIBAL RESPONSE TO OPIOID USE
DISORDERS.
(a) Additional Use of Funds.--Section 1003(b) of the 21st Century
Cures Act (42 U.S.C. 290ee-3 note) is amended by adding at the end the
following:
``(5) Other concurrent substance use disorders.--The
Secretary may authorize the recipient of a grant under this
subsection, in addition to using the grant for activities
described in paragraph (4) with respect to opioid misuse and
use disorders and stimulant misuse and use disorders, to use
the grant to for similar activities with respect to other
concurrent substance use disorders.''.
(b) Annual Report to Congress.--Section 1003(f) of the 21st Century
Cures Act (42 U.S.C. 290ee-3 note) is amended--
(1) in paragraph (2), strike ``and'' at the end;
(2) in paragraph (3), strike the period at the end and
insert a semicolon; and
(3) by adding at the end the following:
``(4) the amount of funds each State that receiving a grant
under subsection (b) received for the 12-month grant cycle
covered by the report;
``(5) the amount of grant funds each such State spent for
such grant cycle, disaggregated by the uses for which such
funds were spent, including each allowable use under paragraphs
(4) and (5) of subsection (b);
``(6) how many such States for such grant cycle did not
spend the all of the grant funds before such grant cycle
expired;
``(7) how many such States for such grant cycle requested
waivers to extend the grant cycle; and
``(8) challenges for such States to spend all of the funds
allocated and the reason for such challenges, including to what
extent reporting requirements or other requirements placed an
increased burden on the ability of such States to spend all of
the funds.''.
(c) Other Concurrent Substance Use Disorders Defined.--Section
1003(h) of the 21st Century Cures Act (42 U.S.C. 290ee-3 note) is
amended--
(1) by redesignating paragraphs (2) through (4) as
paragraphs (3) through (5); and
(2) by inserting before paragraph (3), as redesignated, the
following:
``(2) Other concurrent substance use disorders.--The term
`other substance use disorders' includes alcohol use disorders
co-occurring with opioid misuse and use disorders and alcohol
use disorders co-occurring with stimulant misuse and use
disorders, including polydrug use and alcohol use disorder.''.
(d) Rule of Construction.--Nothing in this Act or the amendments
made by this Act shall be construed to change the allocation of funds
among grantees pursuant to the minimum allocations and formula
methodology under section 1003 of the 21st Century Cures Act (42 U.S.C.
290ee-3 note).
SEC. 118. PROVIDING FOR A STUDY ON THE EFFECTS OF REMOTE MONITORING ON
INDIVIDUALS WHO ARE PRESCRIBED OPIOIDS.
(a) In General.--Not later than 18 months after the date of
enactment of this Act, the Comptroller General of the United States
shall conduct a study and submit to the Committee on Energy and
Commerce of the House of Representatives and the Committee on Health,
Education, Labor, and Pensions and the Committee on Finance of the
Senate a report on the use of remote monitoring with respect to
individuals who are prescribed opioids.
(b) Report.--The report described in subsection (a) shall include--
(1) an assessment of scientific evidence related to the
efficacy, individual outcomes, and potential cost savings
associated with remote monitoring for individuals who are
prescribed opioids compared to such individuals who are not so
monitored;
(2) an assessment of the current prevalence of remote
monitoring for individuals who are prescribed opioids,
including the use of such monitoring for such individuals in
other countries; and
(3) recommendations to improve availability, access, and
coverage for remote monitoring for individuals who are
prescribed opioids, including through changes to Federal health
care programs (as defined in section 1128B of the Social
Security Act (42 U.S.C. 1320a-7b)) and, if determined
appropriate by the Comptroller General, an identification of
cohorts of individuals who stand to benefit the most from
remote monitoring when prescribed opioids.
TITLE II--CONTROLLED SUBSTANCES
SEC. 201. DELIVERY OF CERTAIN SUBSTANCES BY A PHARMACY TO AN
ADMINISTERING PRACTITIONER.
Paragraph (2) of section 309A(a) of the Controlled Substances Act
(21 U.S.C. 829a(a)) is amended to read as follows:
``(2) the controlled substance is a drug in schedule III,
IV, or V that is, pursuant to the approval or licensure of such
drug under the Federal Food, Drug, and Cosmetic Act or section
351 of the Public Health Service Act, to be administered by, or
under the supervision of, the practitioner;''.
SEC. 202. REVIEWING THE SCHEDULING OF APPROVED PRODUCTS CONTAINING A
COMBINATION OF BUPRENORPHINE AND NALOXONE.
(a) Secretary of HHS.--The Secretary of Health and Human Services
shall, consistent with the requirements and procedures set forth in
sections 201 and 202 of the Controlled Substances Act (21 U.S.C. 811;
812)--
(1) review the relevant data pertaining to the scheduling
of products containing a combination of buprenorphine and
naloxone that have been approved under section 505 of the
Federal Food, Drug, and Cosmetic Act (21 U.S.C. 355); and
(2) if appropriate, request that the Attorney General
initiate rulemaking proceedings to revise the schedules
accordingly with respect to such products.
(b) Attorney General.--The Attorney General shall review any
request made by the Secretary of Health and Human Services under
subsection (a)(2) and determine whether to initiate proceedings to
revise the schedules in accordance with the criteria set forth in
sections 201 and 202 of the Controlled Substances Act (21 U.S.C. 811;
812).
SEC. 203. COMBATING ILLICIT XYLAZINE.
(a) Definitions.--
(1) In general.--In this section, the term ``xylazine'' has
the meaning given the term in paragraph (60) of section 102 of
the Controlled Substances Act, as added by paragraph (2).
(2) Controlled substances act.--Section 102 of the
Controlled Substances Act (21 U.S.C. 802) is amended--
(A) by redesignating the second paragraph (57)
(relating to serious drug felony) and paragraph (58) as
paragraphs (58) and (59), respectively;
(B) by moving the margin of paragraph (57) 2 ems to
the left;
(C) by moving the margins of paragraphs (58) and
(59), as redesignated, 2 ems to the left; and
(D) by adding at the end the following:
``(60)(A) The term `xylazine' means the substance xylazine as well
as its salts, isomers, and salts of isomers whenever the existence of
such salts, isomers, and salts of isomers is possible.
``(B) Except as provided in subparagraph (E), such term does not
include a substance described in subparagraph (A) to the extent--
``(i) such substance is used or intended for use in animals
other than humans and is an animal drug that has been approved
by the Secretary of Health and Human Services under section 512
of the Federal Food, Drug, and Cosmetic Act, conditionally
approved under section 571 of such Act, index listed under
section 573 of such Act, or subject to an exemption for
investigational use under section 512(j) of such Act, and such
use or intended use conforms to the approved application or
index listing, including the manufacturing, importation,
holding, or distribution for such use;
``(ii) such substance is used or intended for use in
animals other than humans as permitted under section 512(a)(4)
of the Federal Food, Drug, and Cosmetic Act;
``(iii) such substance is manufactured, imported, held,
distributed, or used--
``(I) as an active pharmaceutical ingredient for
manufacturing an animal drug approved under section 512
of the Federal Food, Drug, and Cosmetic Act,
conditionally approved under section 571 of such Act,
index listed under section 573 of the such Act, or
subject to an exemption for investigational use under
section 512(j) of such Act; or
``(II) as a bulk chemical for pharmaceutical
compounding of a new animal drug (as defined in section
201 of the Federal Food, Drug, and Cosmetic Act) by or
under the direct supervision of a licensed pharmacist
or by or on the lawful written or oral order of a
licensed veterinarian within the context of a
veterinarian-client-patient relationship, as defined by
the Secretary of Health and Human Services;
``(iv) such substance is held or used as a compounded new
animal drug described in clause (iii)(II);
``(v) such substance is otherwise used or intended for use
in animals other than humans, and such use is approved or
otherwise authorized under the Federal Food, Drug, and Cosmetic
Act provided any such use conforms to such approval or
authorization;
``(vi) such substance is subject to an exemption for
investigational use under section 505(i) or 520(g) of the
Federal Food, Drug, and Cosmetic Act;
``(vii) such substance is imported, held, distributed, or
used for the development, manufacturing, or performance of
tests for detection of xylazine (including xylazine used as a
control or calibration standard) by persons who are
professionally, regularly, and lawfully engaged in such
activities; or
``(viii) such substance is held, distributed, or used in a
commercially manufactured test for the detection of xylazine,
provided such test does not contain xylazine in a form that can
be extracted.
``(C) Notwithstanding subparagraph (B), the Attorney General may
place any substance listed in such subparagraph on a schedule under
section 202 in accordance with subsections (a) through (c) of section
201.
``(D) Nothing in this paragraph shall be construed as a basis for
inferring that a compounded animal drug is not a new animal drug
subject to the requirements of section 512(a) of the Federal Food,
Drug, and Cosmetic Act.
``(E) If any person prescribes, dispenses, distributes,
manufactures, or imports xylazine for human use, such person shall be
considered to have prescribed, dispensed, distributed, manufactured, or
imported xylazine not subject to an exclusion under subparagraph
(B).''.
(b) Placement of Xylazine on Schedule III.--Schedule III in section
202(c) of the Controlled Substances Act (21 U.S.C. 812(c)) is amended
by adding at the end the following:
``(f) Xylazine.''.
(c) Report to Congress on Xylazine.--
(1) Initial report.--Not later than 1 year after the date
of enactment of this Act, the Attorney General, acting through
the Administrator of the Drug Enforcement Administration and in
coordination with the Commissioner of Food and Drugs, shall
submit to Congress a report on the prevalence of illicit use of
xylazine in the United States and the impacts of such use,
including--
(A) where the drug is being diverted;
(B) where the drug is originating;
(C) whether any analogues to such drug present a
substantial risk of abuse;
(D) whether and to what extent the illicit supply
of xylazine derives from the licit supply chain; and
(E) recommendations for Congress with respect to
whether xylazine should be transferred to another
schedule under section 202 of the Controlled Substances
Act (21 U.S.C. 812).
(2) Additional report.--Not later than 4 years after the
date of enactment of this Act, the Attorney General, acting
through the Administrator of the Drug Enforcement
Administration and in coordination with the Commissioner of
Food and Drugs, shall submit to Congress a report updating
Congress on the prevalence of xylazine trafficking, misuse, and
proliferation in the United States, including recommendations
for Congress with respect to whether xylazine should be
transferred to another schedule under section 202 of the
Controlled Substances Act (21 U.S.C. 812) or removed from
schedule III of such part.
SEC. 204. TECHNICAL CORRECTIONS.
Effective as if included in the enactment of Public Law 117-328--
(1) section 1252(a) of division FF of Public Law 117-328 is
amended, in the matter being inserted into section 302(e) of
the Controlled Substances Act, by striking ``303(g)'' and
inserting ``303(h)'';
(2) section 1262 of division FF of Public Law 117-328 is
amended--
(A) in subsection (a)--
(i) in the matter preceding paragraph (1),
by striking ``303(g)'' and inserting
``303(h)'';
(ii) in the matter being stricken by
subsection (a)(2), by striking ``(g)(1)'' and
inserting ``(h)(1)''; and
(iii) in the matter being inserted by
subsection (a)(2), by striking ``(g)
Practitioners'' and inserting ``(h)
Practitioners''; and
(B) in subsection (b)--
(i) in the matter being stricken by
paragraph (1), by striking ``303(g)(1)'' and
inserting ``303(h)(1)'';
(ii) in the matter being inserted by
paragraph (1), by striking ``303(g)'' and
inserting ``303(h)'';
(iii) in the matter being stricken by
paragraph (2)(A), by striking ``303(g)(2)'' and
inserting ``303(h)(2)'';
(iv) in the matter being stricken by
paragraph (3), by striking ``303(g)(2)(B)'' and
inserting ``303(h)(2)(B)'';
(v) in the matter being stricken by
paragraph (5), by striking ``303(g)'' and
inserting ``303(h)''; and
(vi) in the matter being stricken by
paragraph (6), by striking ``303(g)'' and
inserting ``303(h)''; and
(3) section 1263(b) of division FF of Public Law 117-328 is
amended--
(A) by striking ``303(g)(2)'' and inserting
``303(h)(2)''; and
(B) by striking ``(21 U.S.C. 823(g)(2))'' and
inserting ``(21 U.S.C. 823(h)(2))''.
TITLE III--MEDICAID
SEC. 301. EXTENDING REQUIREMENT FOR STATE MEDICAID PLANS TO PROVIDE
COVERAGE FOR MEDICATION-ASSISTED TREATMENT.
(a) In General.--Section 1905 of the Social Security Act (42 U.S.C.
1396d) is amended--
(1) in subsection (a)(29), by striking ``for the period
beginning October 1, 2020, and ending September 30, 2025,'' and
inserting ``beginning on October 1, 2020,''; and
(2) in subsection (ee)(2), by striking ``for the period
specified in such paragraph, if before the beginning of such
period the State certifies to the satisfaction of the
Secretary'' and inserting ``if such State certifies, not less
than every 5 years and to the satisfaction of the Secretary,''.
(b) Conforming Amendment.--Section 1006(b)(4)(A) of the Substance
Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for
Patients and Communities Act (42 U.S.C. 1396a note) is amended by
striking ``, and before October 1, 2025''.
SEC. 302. EXPANDING REQUIRED REPORTS ON T-MSIS SUBSTANCE USE DISORDER
DATA TO INCLUDE MENTAL HEALTH CONDITION DATA.
(a) In General.--Section 1015(a) of the SUPPORT for Patients and
Communities Act (42 U.S.C. 1320d-2 note) is amended--
(1) in the heading, by striking ``Substance Use Disorder
Data Book'' and inserting ``Behavioral Health Data Book'';
(2) in paragraph (2)--
(A) in the matter preceding subparagraph (A), by
inserting ``, including as updated in accordance with
paragraph (3),'' after ``paragraph (1)'';
(B) in subparagraph (A), by inserting ``, mental
health condition, or a mental health condition co-
occurring with substance use disorder'' after
``substance use disorder'';
(C) in subparagraph (B), by inserting ``and mental
health treatment services'' after ``substance use
disorder treatment services'';
(D) in subparagraph (C)--
(i) by inserting ``, mental health
condition, or a mental health condition co-
occurring with a substance use disorder
diagnosis'' after ``substance use disorder
diagnosis''; and
(ii) by inserting ``or mental health
treatment services, respectively,'' after
``substance use disorder treatment services'';
(E) in subparagraph (D), by inserting ``, mental
health condition, or a mental health condition co-
occurring with substance use disorder'' after
``substance use disorder diagnosis'';
(F) in subparagraph (E), by inserting ``or mental
health treatment'' after ``substance use disorder
treatment''; and
(G) in subparagraph (F), by inserting ``,
individuals with a mental health condition who receive
mental health treatment services, and individuals with
a co-occurring mental health condition and substance
use disorder who receive substance use disorder
treatment services and mental health treatment
services,'' after ``substance use disorder treatment
services''; and
(3) in paragraph (3), by striking ``through 2024''.
(b) Application.--The amendments made by subsection (a)(1) shall
apply beginning with respect to the first update made pursuant to
section 1015(a)(3) of the SUPPORT for Patients and Communities Act (42
U.S.C. 1320d-2 note) after the date that is 12 months after the date of
enactment of this Act.
SEC. 303. MONITORING PRESCRIBING OF ANTIPSYCHOTIC MEDICATIONS.
Section 1902(oo) of the Social Security Act (42 U.S.C. 1396a(oo))
is amended--
(1) in paragraph (1)(B)--
(A) in the subparagraph heading, by striking ``by
children''; and
(B) by inserting ``, and beginning on the date that
is 24 months after the date of enactment of the Support
for Patients and Communities Reauthorization Act,
individuals over the age of 18, individuals receiving
home and community-based services (as defined in
section 9817(a)(2)(B) of Public Law 117-2), and
individuals residing in institutional care settings
(including nursing facilities and intermediate care
facilities for individuals with intellectual
disabilities) enrolled,'' after ``children enrolled'';
and
(2) in paragraph (3)--
(A) in subparagraph (A)(ii), by striking ``is a
resident'' and inserting ``subject to subparagraph (C),
is a resident''; and
(B) by adding at the end the following new
subparagraph:
``(C) Application in case of program to monitor
antipsychotic medications.--Subparagraph (A)(ii) shall
not apply to the drug review and utilization
requirement described in paragraph (1)(B) with respect
to an individual to whom such subparagraph applies by
reason of the amendments made by section 303(1) of the
Support for Patients and Communities Reauthorization
Act.''.
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