[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4950 Introduced in House (IH)]
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118th CONGRESS
1st Session
H. R. 4950
To amend title XIX of the Social Security Act to encourage appropriate
prescribing under Medicaid for victims of opioid overdose.
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IN THE HOUSE OF REPRESENTATIVES
July 26, 2023
Mr. Trone (for himself, Mr. Fitzpatrick, and Ms. Kuster) introduced the
following bill; which was referred to the Committee on Energy and
Commerce
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A BILL
To amend title XIX of the Social Security Act to encourage appropriate
prescribing under Medicaid for victims of opioid overdose.
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 ``Improving Medicaid Programs'
Response to Overdose Victims and Enhancing Addiction Care Act'' or the
``IMPROVE Addiction Care Act''.
SEC. 2. ENCOURAGING APPROPRIATE PRESCRIBING UNDER MEDICAID FOR VICTIMS
OF OPIOID OVERDOSE.
(a) In General.--Section 1927(g)(2) of the Social Security Act (42
U.S.C. 1396r-8(g)(2)) is amended by adding at the end the following new
subparagraph:
``(E) Additional drug use review requirements.--As
part of a State's prospective and retrospective drug
use review under subparagraphs (A) and (B), as
applicable, the State shall, not later than 24 months
after the date of enactment of this subparagraph,
develop and implement, or review and update, protocols
to, subject to any applicable State or Federal privacy
or confidentiality protections that could preclude such
protocols--
``(i) identify individuals receiving
benefits under this title who have experienced
a nonfatal opioid-related overdose within a
look-back period (to be determined by the
Secretary except that such period shall not be
less than 1 year and shall not exceed 5 years),
to the extent that such data is available, and
make a good faith effort to connect these
individuals to treatment options and recovery
support services that have been determined
appropriate by the Secretary;
``(ii) if an individual receiving benefits
under this title experiences a fatal overdose
that is opioid-related (without regard to
whether such overdose was related to a covered
outpatient drug), or, if specified by the
Secretary, related to any other drug (including
a drug that is not a covered outpatient drug),
not later than 6 months after the date of such
overdose--
``(I) provide notice of such
overdose to each provider that, during
the period (to be established by the
Secretary) preceding such overdose,
prescribed opioids (or such other
specified drug, if applicable) to such
individual, to the extent that such
data is available; and
``(II) provide each such provider
with educational materials on
prescribing opioids (or such other
specified drugs, if applicable);
``(iii) ensure that a provider who is
treating an individual receiving benefits under
this title has notice of the individual's
diagnosis or history of opioid use disorder,
opioid poisoning diagnosis, history of nonfatal
opioid-related overdose, or a diagnosis or
history of a substance use disorder or overdose
for such other specified drug, if applicable,
to the extent such data is available; and
``(iv) perform ongoing retrospective drug
utilization reviews and offer provider
education that is informed by such reviews
(which may include education provided under an
educational outreach program established under
subparagraph (D) or through an intervention
described in paragraph (3)(C)(iii)) regarding
appropriate prescribing practices for
individuals receiving benefits under this title
with a diagnosis or history of opioid use
disorder, a history of nonfatal opioid-related
overdose, an opioid poisoning diagnosis, or a
diagnosis or history of a substance use
disorder or overdose for such other specified
drug, if applicable.
Nothing in this subparagraph shall be construed as
requiring a State to develop and implement additional
protocols if the State establishes to the satisfaction
of the Secretary that the State has in place existing
protocols meeting or exceeding the standards set forth
in this subparagraph.''.
(b) Technical Amendments.--Section 1932(i) of the Social Security
Act (42 U.S.C. 1396u-2(i)) is amended--
(1) by striking ``section 483.3(s)(4)'' and inserting
``section 438.3(s)(4)''; and
(2) by striking ``483.3(s)(5)'' and inserting
``438.3(s)(5)''.
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