[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 3663 Introduced in Senate (IS)]
<DOC>
118th CONGRESS
2d Session
S. 3663
To provide funding for programs and activities under the SUPPORT for
Patients and Communities Act.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
January 25, 2024
Mrs. Shaheen (for herself and Ms. Hassan) introduced the following
bill; which was read twice and referred to the Committee on Health,
Education, Labor, and Pensions
_______________________________________________________________________
A BILL
To provide funding for programs and activities under the SUPPORT for
Patients and Communities Act.
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 ``Turn the Tide Act''.
SEC. 2. CONTROLLED SUBSTANCE PROVISIONS OF THE SUPPORT FOR PATIENTS AND
COMMUNITIES ACT.
(a) Grants To Enhance Access to Substance Use Disorder Treatment.--
Section 3203(b) of the Substance Use-Disorder Prevention that Promotes
Opioid Recovery and Treatment for Patients and Communities Act (Public
Law 115-271) is amended to read as follows:
``(b) Appropriations.--For grants under subsection (a), there is
authorized to be appropriated, and there is appropriated, out of any
monies in the Treasury not otherwise appropriated, $4,000,000 for each
of fiscal years 2024 through 2027.''.
(b) Access to Increased Drug Disposal.--Section 3260 of the
Substance Use-Disorder Prevention that Promotes Opioid Recovery and
Treatment for Patients and Communities Act (Public Law 115-271) is
amended to read as follows:
``SEC. 3260. APPROPRIATIONS.
``To carry out this chapter, there is authorized to be
appropriated, and there is appropriated, out of any monies in the
Treasury not otherwise appropriated, $10,000,000 for each of fiscal
years 2024 through 2027.''.
SEC. 3. PUBLIC HEALTH PROVISIONS OF THE SUPPORT FOR PATIENTS AND
COMMUNITIES ACT.
(a) First Responder Training.--Section 546(h) of the Public Health
Service Act (42 U.S.C. 290ee-1(h)) is amended to read as follows:
``(h) Appropriations.--To carry out this section, there is
authorized to be appropriated, and there is appropriated, out of any
monies in the Treasury not otherwise appropriated, $56,000,000 for each
of fiscal years 2024 through 2027.''.
(b) Public Health Laboratories Pilot Program.--Section 7011(d) of
the Substance Use-Disorder Prevention that Promotes Opioid Recovery and
Treatment for Patients and Communities Act (Public Law 115-271) is
amended to read as follows:
``(d) Appropriations.--To carry out this section, there is
authorized to be appropriated, and there is appropriated, out of any
monies in the Treasury not otherwise appropriated, $15,000,000 for each
of fiscal years 2024 through 2027.''.
(c) Model Training Programs for Substance Use Disorder Patient
Records.--Section 7053(e) of the Substance Use-Disorder Prevention that
Promotes Opioid Recovery and Treatment for Patients and Communities Act
(Public Law 115-271) is amended to read as follows:
``(e) Appropriations.--To carry out this section, there is
authorized to be appropriated, and there is appropriated, out of any
monies in the Treasury not otherwise appropriated--
``(1) $4,000,000 for fiscal year 2024;
``(2) $2,000,000 for fiscal year 2025; and
``(3) $1,000,000 for each of fiscal years 2026 and 2027.''.
(d) 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 the first sentence and inserting the
following: ``To carry out this section, there is authorized to be
appropriated, and there is appropriated, out of any monies in the
Treasury not otherwise appropriated, $40,000,000 for each of fiscal
years 2024 through 2027.''.
(e) 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 to read as follows:
``(f) Appropriations.--To carry out this section, there is
authorized to be appropriated, and there is appropriated, out of any
monies in the Treasury not otherwise appropriated, $75,000,000 for each
of fiscal years 2024 through 2027.''.
(f) Coordination and Continuation of Care for Drug Overdose
Patients.--Section 7081(f) of the Substance Use-Disorder Prevention
that Promotes Opioid Recovery and Treatment for Patients and
Communities Act (Public Law 115-271) is amended to read as follows:
``(f) Appropriations.--To carry out this section, there is
authorized to be appropriated, and there is appropriated, out of any
monies in the Treasury not otherwise appropriated, $10,000,000 for each
of fiscal years 2024 through 2027.''.
(g) Emergency Department Alternatives to Opioids Demonstration
Program.--Section 7091(g) of the Substance Use-Disorder Prevention that
Promotes Opioid Recovery and Treatment for Patients and Communities Act
(Public Law 115-271) is amended to read as follows:
``(g) Appropriations.--To carry out this section, there is
authorized to be appropriated, and there is appropriated, out of any
monies in the Treasury not otherwise appropriated, $10,000,000 for each
of fiscal years 2024 through 2027.''.
(h) Regional Centers of Excellence in Substance Use Disorder
Education.--Section 551(f) of the Public Health Service Act (42 U.S.C.
290ee-6(f)) is amended to read as follows:
``(f) Appropriations.--To carry out this section, there is
authorized to be appropriated, and there is appropriated, out of any
monies in the Treasury not otherwise appropriated, $4,000,000 for each
of fiscal years 2024 through 2027.''.
(i) Youth Prevention and Recovery.--Section 7102(c)(9) of the
Substance Use-Disorder Prevention that Promotes Opioid Recovery and
Treatment for Patients and Communities Act (Public Law 115-271) is
amended to read as follows:
``(9) Appropriations.--To carry out this subsection, there
is authorized to be appropriated, and there is appropriated,
out of any monies in the Treasury not otherwise appropriated,
$18,000,000 for each of fiscal years 2024 through 2027.''.
(j) Comprehensive Opioid Recovery Centers.--Section 552(j) of the
Public Health Service Act (42 U.S.C. 290ee-7(j)) is amended to read as
follows:
``(j) Appropriations.--To carry out this section, there is
authorized to be appropriated, and there is appropriated, out of any
monies in the Treasury not otherwise appropriated, $10,000,000 for each
of fiscal years 2024 through 2027.''.
(k) CDC Surveillance and Data Collection.--Section 7131(e) of the
Substance Use-Disorder Prevention that Promotes Opioid Recovery and
Treatment for Patients and Communities Act (Public Law 115-271) is
amended to read as follows:
``(e) Appropriations.--To carry out this section, there is
authorized to be appropriated, and there is appropriated, out of any
monies in the Treasury not otherwise appropriated, $2,000,000 for each
of fiscal years 2024 through 2027.''.
(l) National Child Traumatic Stress Initiative.--Section 582(j) of
the Public Health Service Act (42 U.S.C. 290hh-1(j)) is amended to read
as follows:
``(j) Appropriations.--To carry out this section, there is
authorized to be appropriated, and there is appropriated, out of any
monies in the Treasury not otherwise appropriated, $112,000,000 for
each of fiscal years 2024 through 2027.''.
(m) Trauma Support Services and Mental Health Care.--Section
7134(l) of the Substance Use-Disorder Prevention that Promotes Opioid
Recovery and Treatment for Patients and Communities Act (Public Law
115-271) is amended to read as follows:
``(l) Appropriations.--To carry out this section, there is
authorized to be appropriated, and there is appropriated, out of any
monies in the Treasury not otherwise appropriated, $50,000,000 for each
of fiscal years 2024 through 2027.''.
(n) Surveillance and Education Regarding Infections Associated With
Illicit Drug Use and Other Risk Factors.--Section 317N(d) of the Public
Health Service Act (42 U.S.C. 247b-15(d)) is amended to read as
follows:
``(d) Appropriations.--To carry out this section, there is
authorized to be appropriated, and there is appropriated, out of any
monies in the Treasury not otherwise appropriated, $40,000,000 for each
of fiscal years 2024 through 2027.''.
(o) Building Communities of Recovery.--Section 547(f) of the Public
Health Service Act (42 U.S.C. 290ee-2(f)) is amended to read as
follows:
``(f) Appropriations.--To carry out this section, there is
authorized to be appropriated, and there is appropriated, out of any
monies in the Treasury not otherwise appropriated, $16,000,000 for each
of fiscal years 2024 through 2027.''.
(p) Peer Support Technical Assistance Center.--Section 547A(e) of
the Public Health Service Act (42 U.S.C. 290ee-2a(e)) is amended to
read as follows:
``(e) Appropriations.--To carry out this section, there is
authorized to be appropriated, and there is appropriated, out of any
monies in the Treasury not otherwise appropriated, $2,000,000 for each
of fiscal years 2024 through 2027.''.
(q) Preventing Overdoses of Controlled Substances.--Section 392A(d)
of the Public Health Service Act (42 U.S.C. 280b-1(d)) is amended to
read as follows:
``(d) Appropriations.--To carry out this section, there is
authorized to be appropriated, and there is appropriated, out of any
monies in the Treasury not otherwise appropriated, $506,000,000 for
each of fiscal years 2024 through 2027.''.
(r) Career Act.--Section 7183(k) of the Substance Use-Disorder
Prevention that Promotes Opioid Recovery and Treatment for Patients and
Communities Act (Public Law 115-271) is amended to read as follows:
``(k) Appropriations.--To carry out this section, there is
authorized to be appropriated, and there is appropriated, out of any
monies in the Treasury not otherwise appropriated, $12,000,000 for each
of fiscal years 2024 through 2027.''.
SEC. 4. HOUSING AND DEPARTMENT OF JUSTICE PROVISIONS OF THE SUPPORT FOR
PATIENTS AND COMMUNITIES ACT.
(a) Reauthorization and Improvement of Recovery Housing Program.--
Section 8071 of the SUPPORT for Patients and Communities Act (42 U.S.C.
5301 note; Public Law 115-271) is amended--
(1) in subsection (a), by striking ``such sums as may be
necessary for each of fiscal years 2019 through 2023'' and
inserting ``$60,000,000 for each of fiscal years 2024 through
2029'';
(2) in subsection (b)--
(A) in paragraph (1), by striking ``date of
enactment of this Act'' and inserting ``date of
enactment of the Turn the Tide Act''; and
(B) by striking paragraph (2) and inserting the
following:
``(2) Priority.--
``(A) In general.--The funding formula required
under paragraph (1) shall ensure that priority for
amounts appropriated or otherwise made available under
this section is given to States with the greatest need,
as such need is determined by the Secretary based on
the following factors, and weighting such factors as
described in subparagraph (B):
``(i) The highest average rates of
unemployment based on data provided by the
Bureau of Labor Statistics for calendar years
2019 through 2023.
``(ii) The lowest average labor force
participation rates based on data provided by
the Bureau of Labor Statistics for calendar
years 2019 through 2023.
``(iii) The highest average age-adjusted
rates of drug overdose deaths based on data
from the Centers for Disease Control and
Prevention for the 3 most recent calendar
years.
``(B) Weighting.--The factors described in
subparagraph (A) shall be weighted as follows:
``(i) The rate described in subparagraph
(A)(i) shall be weighted at 15 percent.
``(ii) The rate described in subparagraph
(A)(ii) shall be weighted at 15 percent.
``(iii) The rate described in subparagraph
(A)(iii) shall be weighted at 70 percent.'';
and
(3) in subsection (c)(1), by striking ``at least 30 percent
of such funds within one year'' and inserting ``at least 50
percent of such funds within 2 years''.
(b) Building Capacity for Family-Focused Residential Treatment.--
Section 8083(c) of the Substance Use-Disorder Prevention that Promotes
Opioid Recovery and Treatment for Patients and Communities Act (Public
Law 115-271) is amended to read as follows:
``(c) Appropriations.--To carry out this section, there is
authorized to be appropriated, and there is appropriated, out of any
monies in the Treasury not otherwise appropriated, $20,000,000 for
fiscal years 2024, which shall remain available through fiscal year
2027.''.
(c) Comprehensive Opioid Abuse Grant Program.--Section 1001(a)(27)
of title I of the Omnibus Crime Control and Safe Streets Act of 1968
(34 U.S.C. 10261(a)(27)) is amended to read as follows:
``(27) To carry out part LL, there is authorized to be
appropriated, and there is appropriated, out of any monies in the
Treasury not otherwise appropriated, $500,000,000 for each of fiscal
years 2024 through 2027.''.
(d) Office of National Drug Control Policy.--Section 714 of the
Office of National Drug Control Policy Reauthorization Act of 1998 (21
U.S.C. 1711) is amended to read as follows:
``SEC. 714. AUTHORIZATION OF APPROPRIATIONS; APPROPRIATIONS.
``To carry out this title, except activities otherwise specified,
there is authorized to be appropriated, and there is appropriated, out
of any monies in the Treasury not otherwise appropriated, $50,000,000
for each of fiscal years 2024 through 2027, to remain available until
expended.''.
(e) Drug-Free Communities Program.--Section 1024 of the Anti-Drug
Abuse Act of 1988 (21 U.S.C. 1524) is amended--
(1) in the heading, by inserting ``; appropriations'' after
``authorization of appropriations''; and
(2) by striking subsection (a) and inserting the following:
``(a) In General.--To carry out this chapter, there is authorized
to be appropriated to the Office of National Drug Control Policy, and
there is appropriated, out of any monies in the Treasury not otherwise
appropriated, $175,000,000 for each of fiscal years 2024 through
2027.''.
(f) High-Intensity Drug Trafficking Area Program.--Section 707(p)
of the Office of National Drug Control Policy Reauthorization Act of
1988 (21 U.S.C. 1706(p)) is amended--
(1) by redesignating paragraphs (1) through (6) as
subparagraphs (A) through (F), respectively, and adjusting the
margins accordingly;
(2) by striking ``There is authorized'' and inserting the
following:
``(1) In general.--There is authorized'';
(3) in paragraph (1), as so designated--
(A) in subparagraph (E), as so redesignated, by
striking ``each of''; and
(B) in subparagraph (F), as so redesignated, by
striking ``2018 through 2023'' and inserting ``2024
through 2027''; and
(4) by adding at the end the following:
``(2) Appropriations.--To carry out this section, there is
authorized to be appropriated to the Office of National Drug
Control Policy, and there is appropriated, out of any monies in
the Treasury not otherwise appropriated, $350,000,000 for each
of fiscal years 2024 through 2027.''.
(g) Drug Court Program.--Section 1001(a)(25)(A) of title I of the
Omnibus Crime Control and Safe Streets Act of 1968 (34 U.S.C.
10261(a)(25)(A)) is amended to read as follows:
``(25)(A) Except as provided in subparagraph (C), to carry out part
EE, there is authorized to be appropriated, and there is appropriated,
out of any monies in the Treasury not otherwise appropriated,
$125,000,000 for each of fiscal years 2024 through 2027.''.
(h) Drug Court Training and Technical Assistance.--Section
705(e)(2) of the Office of National Drug Control Policy Reauthorization
Act of 1988 (21 U.S.C. 1704(e)(2)) is amended to read as follows:
``(2) Authorization of appropriations; appropriations.--To
carry out this subsection, there is authorized to be
appropriated, and there is appropriated, out of any monies in
the Treasury not otherwise appropriated, $5,000,000 for each of
fiscal years 2024 through 2027.''.
(i) Administration of the Office of National Drug Control Policy.--
Section 704(i)(2) of the Office of National Drug Control Policy
Reauthorization Act of 1998 (21 U.S.C. 1703(i)(2)) is amended to read
as follows:
``(2) Authorization of appropriations; appropriations.--To
carry out this subsection, there is authorized to be
appropriated, and there is appropriated, out of any monies in
the Treasury not otherwise appropriated, $1,750,000 for each of
fiscal years 2024 through 2027.''.
(j) Emerging Threats Committee, Plan, and Media Campaign.--Section
709(g) of the Office of National Drug Control Policy Reauthorization
Act of 1998 (21 U.S.C. 1708(g)) is amended to read as follows:
``(g) Authorization of Appropriations; Appropriations.--To carry
out this section, there is authorized to be appropriated to the Office,
and there is appropriated, out of any monies in the Treasury not
otherwise appropriated, $35,000,000 for each of fiscal years 2024
through 2027.''.
SEC. 5. BOLSTERING COMMITMENTS TO STATE GRANTS FOR SUBSTANCE USE
DISORDER TREATMENT AND PREVENTION.
(a) State Opioid Response Grants.--
(1) In general.--To carry out activities under section 1003
of the 21st Century Cures Act (42 U.S.C. 290ee-3 note) relating
to opioids by the State agency responsible for administering
the substance abuse prevention and treatment block grant under
subpart II of part B of title XIX of the Public Health Service
Act (42 U.S.C. 300x-21 et seq.), there is authorized to be
appropriated, and there is appropriated, $5,500,000,000 for
each of fiscal years 2024 through 2028.
(2) Flexibility in 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:
``(3) Flexibility.--States and Indian tribes may use
amounts provided under grants under this subsection to support
substance use disorder treatment care and related services
regardless of whether the patient involved has a primary
diagnosis of opioid use disorder, so long as the individual has
a substance use disorder diagnosis.
``(4) Rule of construction.--Nothing in this subsection
shall be construed to prohibit States from using grant funds
under this subsection to allocate amounts to local governments
to establish subgrantee awards in such localities.''.
(3) Substance abuse prevention and treatment block
grants.--Section 1935(a) of the Public Health Service Act (42
U.S.C. 300x-35(a)) is amended to read as follows:
``(a) Appropriations.--To carry out this subpart, subpart III, and
section 505(d), there is authorized to be appropriated, and there is
appropriated, out of any monies in the Treasury not otherwise
appropriated, $3,000,000,000 for each of fiscal years 2024 through
2028, and $2,500,000,000 for each of fiscal years 2029 through 2033.''.
(b) Requirements.--For the purposes of carrying out activities with
amounts appropriated under this section (and the amendment made by this
section), the Secretary of Health and Human Services shall ensure that
the following requirements are complied with:
(1) Of the amount appropriated for each fiscal year under
subsection (a) (and the amendment made by such subsection),
$50,000,000 shall be made available to Indian Tribes or tribal
organizations.
(2) Of such remaining amounts for each such fiscal year, 15
percent shall be made available to the States with the highest
mortality rate related to opioid use disorders. For purposes of
allocating such funds, the Secretary shall develop a formula
that avoids a significant cliff between States with similar
mortality rates to prevent unusually large changes in certain
States when compared to prior year allocations, including
consideration of new formula methodologies to avoid such
funding cliffs.
(3) Of the amount made available for each fiscal year under
subsections (a)(1) for State Opioid Response Grants, not more
than 2 percent of such amount shall be available for Federal
administrative expenses, training, technical assistance, and
evaluation.
(4) Of the amounts not reserved under paragraphs (1)
through (3), the Secretary shall make allocations to States,
territories, and the District of Columbia according to a
formula using national survey results that the Secretary
determines are the most objective and reliable measure of drug
use and drug-related deaths.
(5) The formula methodology under paragraph (4) shall be
submitted to the Committees on Appropriations of the House of
Representatives and the Committee on Appropriations of the
Senate not less than 15 days prior to publishing a Funding
Opportunity Announcement.
(6) The prevention and treatment activities funded through
grants under this section may include education, treatment
(including the provision of medication), behavioral health
services for individuals in treatment programs, referral to
treatment services, recovery support, and medical screening
associated with such treatment.
(7) Each State, including the District of Columbia, shall
receive not less than $4,000,000 under grants under this
section.
(8) In addition to amounts appropriated under this section
(and the amendment made by this section), the following amounts
shall be available under section 241 of the Public Health
Service Act (42 U.S.C. 238j):
(A) $79,200,000 to carry out subpart II of part B
of title XIX of the Public Health Service Act to fund
section 1935(b) (42 U.S.C. 300x-35) (relating to
technical assistance, national data, data collection
and evaluation activities) and the total available
under this Act for activities under such section
1935(b) shall not exceed 5 percent of the amounts
appropriated for such subpart II of part B of title
XIX.
(B) $2,000,000 to evaluate substance abuse
treatment programs.
(9) None of the funds provided for under section 1921 of
the Public Health Service Act (42 U.S.C. 300x-21) or State
Opioid Response Grants under section 1003 of the 21st Century
Cures Act (42 U.S.C. 290ee-3 note) shall be subject to section
241 of such Act (42 U.S.C. 238j).
SEC. 6. ELIMINATING INSURANCE BARRIERS TO MEDICATION-ASSISTED
TREATMENT.
(a) Prohibition.--Section 1903(i) of the Social Security Act (42
U.S.C. 1396b(i)) is amended--
(1) in paragraph (26), by striking ``; or'' and inserting a
semicolon;
(2) in paragraph (27), by striking the period at the end
and inserting ``; or''; and
(3) by inserting after paragraph (27) the following new
paragraph:
``(28) with respect to any amount expended for medical
assistance for medication-assisted treatment (as defined in
section 1905(ee)) if the State imposes any utilization control
policies or procedures (as defined by the Secretary), including
any prior authorization requirements, with respect to the
provision of such assistance; or''.
(b) Conforming Amendment.--Section 1905(a)(29) of the Social
Security Act (42 U.S.C. 1396d(a)(29)) is amended by inserting ``and
section 1903(i)(28)'' after ``subsection (ee)''.
(c) Effective Date.--The amendments made by this subsection take
effect on October 1, 2024.
SEC. 7. LIMITATIONS ON COST-SHARING FOR OPIOID OVERDOSE REVERSAL
MEDICATIONS.
(a) Limitations on Cost-Sharing.--
(1) Public health service act.--Part D of title XXVII of
the Public Health Service Act (42 U.S.C. 300gg-111 et seq.) is
amended by adding at the end the following:
``SEC. 2799A-11. LIMITATIONS ON COST-SHARING FOR OPIOID OVERDOSE
REVERSAL AGENTS.
``(a) In General.--A group health plan or a health insurance issuer
offering group or individual health insurance coverage shall provide
coverage for, and shall not impose any cost-sharing requirement under
the plan or coverage with respect to at least one formulation of an
opioid overdose reversal agent.
``(b) Utilization Control Policies; Medical Management.--A group
health plan or health insurance issuer offering group or individual
health insurance coverage shall not impose any utilization control
policies or procedures (as defined by the Secretary), including prior
authorization requirements, with respect to opioid overdose reversal
agents covered under the plan or coverage. Such a plan or issuer may
apply medical management practices in providing the benefits described
in subsection (a).
``(c) Definition.--In this section, the term `opioid overdose
reversal agent' means a drug or biological product approved by the Food
and Drug Administration for one of the following uses (or a similar
use):
``(1) Complete or partial reversal of opioid depression,
including respiratory depression, induced by opioids.
``(2) Emergency treatment of a known or suspected opioid
overdose, as manifested by respiratory or central nervous
system depression.''.
(2) Employee retirement income security act of 1974.--
(A) In general.--Subpart B of part 7 of subtitle B
of title I of the Employee Retirement Income Security
Act of 1974 (29 U.S.C. 1185 et seq.) is amend by adding
at the end the following:
``SEC. 726. LIMITATIONS ON COST-SHARING FOR OPIOID OVERDOSE REVERSAL
AGENTS.
``(a) In General.--A group health plan or a health insurance issuer
offering group health insurance coverage shall provide coverage for,
and shall not impose any cost-sharing requirement under the plan or
coverage with respect to at least one formulation of an opioid overdose
reversal agent.
``(b) Utilization Control Policies; Medical Management.--A group
health plan or health insurance issuer offering group health insurance
coverage shall not impose any utilization control policies or
procedures (as defined by the Secretary), including prior authorization
requirements, with respect to opioid overdose reversal agents covered
under the plan or coverage. Such a plan or issuer may apply medical
management practices in providing the benefits described in subsection
(a).
``(c) Definition.--In this section, the term `opioid overdose
reversal agent' means a drug or biological product approved by the Food
and Drug Administration for one of the following uses (or a similar
use):
``(1) Complete or partial reversal of opioid depression,
including respiratory depression, induced by opioids.
``(2) Emergency treatment of a known or suspected opioid
overdose, as manifested by respiratory or central nervous
system depression.''.
(B) Clerical amendment.--The table of contents in
section 1 of the Employee Retirement Income Security
Act of 1974 (29 U.S.C. 1001 et seq.) is amended by
inserting after the item relating to section 725 the
following new item:
``Sec. 726. Limitations on cost-sharing for opioid overdose reversal
agents.''.
(3) Internal revenue code of 1986.--
(A) In general.--Subchapter B of chapter 100 of the
Internal Revenue Code of 1986 is amended by adding at
the end the following:
``SEC. 9826. LIMITATIONS ON COST-SHARING FOR OPIOID OVERDOSE REVERSAL
AGENTS.
``(a) In General.--A group health plan shall provide coverage for,
and shall not impose any cost-sharing requirement under the plan with
respect to at least one formulation of an opioid overdose reversal
agent.
``(b) Utilization Control Policies; Medical Management.--A group
health plan shall not impose any utilization control policies or
procedures (as defined by the Secretary), including prior authorization
requirements, with respect to opioid overdose reversal agents covered
under the plan. Such a plan may apply medical management practices in
providing the benefits described in subsection (a).
``(c) Definition.--In this section, the term `opioid overdose
reversal agent' means a drug or biological product approved by the Food
and Drug Administration for one of the following uses (or a similar
use):
``(1) Complete or partial reversal of opioid depression,
including respiratory depression, induced by opioids.
``(2) Emergency treatment of a known or suspected opioid
overdose, as manifested by respiratory or central nervous
system depression.''.
(B) Clerical amendment.--The table of sections for
subchapter B of chapter 100 of the Internal Revenue
Code of 1986 is amended by adding at the end the
following new item:
``Sec. 9826. Limitations on cost-sharing for opioid overdose reversal
agents.''.
(4) Effective date.--The amendments made by this subsection
shall apply to plan years beginning on or after January 1,
2025.
(b) Safe Harbor for Absence of Deductible for Opioid Overdose
Reversal Agents.--
(1) In general.--Paragraph (2) of section 223(c) of the
Internal Revenue Code of 1986 is amended by adding at the end
the following new subparagraph:
``(H) Safe harbor for absence of deductible for
opioid overdose reversal agents.--A plan shall not fail
to be treated as a high deductible health plan by
reason of failing to have a deductible for opioid
overdose reversal agents (as defined in section
9826(c)).''.
(2) Effective date.--The amendment made by this section
shall apply to plan years beginning on or after January 1,
2025.
(c) Limitations on Cost-Sharing Under Medicare Part D.--
(1) In general.--Section 1860D-2 of the Social Security Act
(42 U.S.C. 1395w-102) is amended--
(A) in subsection (b)--
(i) in paragraph (1)(A), in the matter
preceding clause (i), by striking ``and (9)''
and inserting ``, (9), and (10)'';
(ii) in paragraph (2)(A), in the matter
preceding clause (i), by striking ``and (9)''
and inserting ``, (9), and (10)''; and
(iii) by adding at the end the following
new paragraph:
``(10) Limitations on cost-sharing for opioid overdose
reversal agents.--
``(A) In general.--For plan year 2025 and each
subsequent plan year, each prescription drug plan and
MA-PD plan shall not impose any cost-sharing
requirement under the plan with respect to at least one
brand or generic version of an opioid overdose reversal
agent (as defined in section 2799A-11 of the Public
Health Service Act). The requirement under the
preceding sentence shall also apply to cost-sharing
applicable to subsidy eligible individuals under
section 1814D-14.
``(B) Cost-sharing.--For purposes of subparagraph
(A), the elimination of cost-sharing shall include the
following:
``(i) No application of deductible.--The
waiver of the deductible under paragraph (1).
``(ii) No application of coinsurance.--The
waiver of coinsurance under paragraph (2).'';
and
(B) in subsection (c), by adding at the end the
following new paragraph:
``(7) Treatment of cost-sharing for opioid overdose
reversal agents.--The coverage is provided in accordance with
subsection (b)(10).''.
(2) Conforming amendments to cost-sharing for low-income
individuals.--Section 1860D-14(a) of the Social Security Act
(42 U.S.C. 1395w-114(a)) is amended--
(A) in paragraph (1), in the matter preceding
subparagraph (A), by striking ``In the case'' and
inserting ``Subject to section 1860D-2(b)(10), in the
case''; and
(B) in paragraph (2), in the matter preceding
subparagraph (A), by striking ``In the case'' and
inserting ``Subject to section 1860D-2(b)(10), in the
case''.
SEC. 8. TARGETING HEALTH WORKFORCE LOAN REPAYMENT ASSISTANCE TO
HARDEST-HIT STATES.
(a) Loan Repayment Program for Substance Use Disorder Treatment
Workforce.--Section 781 of the Public Health Service Act (42 U.S.C.
295h) is amended--
(1) in subsection (b), by adding at the end the following:
``(3) Tax liability.--The amount of a payment made under
this section on behalf of an individual shall not be considered
income for any purpose under the Internal Revenue Code of
1986.''; and
(2) in subsection (j), by striking ``$25,000,000 for each
of fiscal years 2019 through 2023'' and inserting ``$50,000,000
for each of fiscal years 2024 through 2028''.
(b) Training Demonstration Program.--Section 760(g) of the Public
Health Service Act (42 U.S.C. 294k(g)) is amended to read as follows:
``(g) Appropriations.--
``(1) In general.--To carry out this section (other than
paragraph (2)), there is authorized to be appropriated, and
there is appropriated, out of any monies in the Treasury not
otherwise appropriated, $10,000,000 for each of fiscal years
2024 through 2027.
``(2) States with highest drug overdose death rates.--
``(A) In general.--To carry out the program under
this section with respect to grantees located in States
described in subparagraph (B), there is authorized to
be appropriated, and there is appropriated, out of any
monies in the Treasury not otherwise appropriated,
$20,000,000 for each of fiscal years 2024 through 2027.
``(B) States described.--A State described in this
subparagraph is a State that is among the top 10 States
in terms of highest per capita drug poisoning deaths in
each of calendar years 2019, 2020, and 2021, based on
the most recent data available from the Centers for
Disease Control and Prevention.
``(C) Application of section.--Except as provided
in this paragraph, the requirements of this section
otherwise applicable to grantees under this section
shall apply to grantees receiving assistance under this
paragraph.''.
SEC. 9. MEDICAID PAYMENTS FOR BEHAVIORAL HEALTH AND MENTAL HEALTH
PROVIDERS.
(a) In General.--
(1) Fee-for-service.--Section 1902 of the Social Security
Act (42 U.S.C. 1396a) is amended--
(A) in subsection (a)(13)--
(i) by striking ``and'' at the end of
subparagraph (B);
(ii) by adding ``and'' at the end of
subparagraph (C); and
(iii) by adding at the end the following
new subparagraph:
``(D) payment for mental health and behavioral
health services (as defined in subsection (uu)(1))
furnished on or after October 1, 2024, and before
October 1, 2028, by a physician or applicable
professional (as defined in subsection (uu)(2)) at a
rate that is not less than 100 percent of the payment
rate that applies to such services and physician or
applicable professional under part B of title XVIII
(or, if greater, the payment rate that would be
applicable under such part if the conversion factor
under section 1848(d) for the year involved were the
conversion factor under such section for 2024, and, if
such services are not covered under such part, the
reasonable and customary rate the Secretary determines
would apply to such services and physician or
applicable professional);''; and
(B) by adding at the end the following new
subsection:
``(uu) Mental Health and Behavioral Health Services.--For purposes
of subsection (a)(13)(D):
``(1) Mental health and behavioral health services.--
``(A) In general.--The term `mental health and
behavioral health services' means the following
services, when provided to a patient with a diagnosis
of substance use disorder (as defined in subparagraph
(B)) as a part of the management or treatment of the
patient's substance use disorder (as determined in
accordance with regulations promulgated by the
Secretary under subparagraph (C)):
``(i) Evaluation and management services
that are procedure codes (for services covered
under title XVIII) for services in the category
designated Evaluation and Management in the
Healthcare Common Procedure Coding System
(established by the Secretary under section
1848(c)(5) as of December 31, 2020, and as
subsequently modified).
``(ii) Counseling services, as defined by
the Secretary.
``(iii) Payment codes established by the
Secretary for opioid use disorder treatment
services under section 1866F.
``(iv) Any other services the Secretary
determines are necessary for the management or
treatment of a patient with a diagnosis of
substance use disorder.
``(B) Patient with a diagnosis of substance use
disorder.--For purposes of subparagraph (A), the term
`patient with a diagnosis of substance use disorder'
means an individual who has been diagnosed with 1 or
more diagnosis codes within the code set entitled the
`Mental health and behavioral disorders due to
psychoactive substance use' under the 10th revision of
the International Statistical Classification of
Diseases and Related Health Problems.
``(C) Regulations.--Not later than 90 days after
the enactment of this subsection, the Secretary shall
promulgate regulations regarding when services are
sufficiently related to part of the management or
treatment of a patient's substance use disorder.
``(2) Applicable professional.--The term `applicable
professional' means--
``(A) a clinical psychologist (as defined for
purposes of section 1861(ii));
``(B) a clinical social worker (as defined in
section 1861(hh)(1));
``(C) a medical professional approved to furnish
medication-assisted treatment under section 303(g)(2)
of the Controlled Substances Act; or
``(D) a medical professional that is authorized
under the State plan or under a waiver of such plan to
furnish mental and behavioral health services (as
defined in paragraph (1)).''.
(2) Managed care.--Section 1932(f) of such Act (42 U.S.C.
1396u-2(f)) is amended--
(A) in the subsection heading, by inserting ``and
Mental Health and Behavioral Health Services'' after
``Care Services''; and
(B) by inserting before the period at the end the
following: ``, and, in the case of mental health and
behavioral health services described in section
1902(a)(13)(D), consistent with the minimum payment
rates specified in such section (regardless of the
manner in which such payments are made, including in
the form of capitation or partial capitation)''.
(b) Increased FMAP for Additional Costs.--Section 1905 of the
Social Security Act (42 U.S.C. 1396d) is amended--
(1) in subsection (b), by striking ``and (ii)'' and
inserting ``(ii), and (jj)''; and
(2) by adding at the end the following new subsection:
``(jj) Increased FMAP for Additional Expenditures for Mental Health
and Behavioral Health Services.--
``(1) In general.--Notwithstanding subsection (b), with
respect to the portion of the amounts expended for medical
assistance for services described in section 1902(a)(13)(D)
furnished on or after October 1, 2024, and before October 1,
2028, that is attributable to the amount by which the minimum
payment rate required under such section (or, by application,
section 1932(f)) exceeds the payment rate applicable to such
services under the State plan or a waiver of such plan as of
July 1, 2024, the Federal medical assistance percentage for a
State shall be equal to 100 percent. The preceding sentence
shall not be construed as prohibiting the payment of Federal
financial participation based on the Federal medical assistance
percentage for the portion of the amounts expended for medical
assistance for such services that is attributable to the amount
(if any) by which the payment rate applicable to such services
under the State plan or waiver exceeds such minimum payment
rate.
``(2) Disregard of enhanced payments for purposes of
territorial limits.--The amount of any payment made for
expenditures on medical assistance that is attributable to the
application of the Federal medical assistance percentage
described in paragraph (1) shall not be taken into account for
purposes of applying payment limits under subsections (f) and
(g) of section 1108.''.
SEC. 10. CMI DEMONSTRATION TO TEST THE PROVISION OF RECOVERY HOUSING
FOR INDIVIDUALS WITH OPIOID USE DISORDER UNDER MEDICAID.
Section 1115A of the Social Security Act (42 U.S.C. 1315a) is
amended--
(1) in subsection (b)(2)(A), by adding at the end the
following new sentence: ``The models selected under this
subparagraph shall include the demonstration described in
subsection (h) (which shall be implemented not later than 18
months after the date of enactment of such subsection).''; and
(2) by adding at the end the following new subsection:
``(h) Demonstration To Test the Provision of Recovery Housing for
Individuals With Opioid Use Disorder Under Medicaid.--
``(1) In general.--The CMI, in consultation with the
Secretary of Housing and Urban Development and other agencies,
as the Secretary determines appropriate, shall conduct a
demonstration project (referred to in this subsection as the
`demonstration') to test whether providing Medicaid managed
care entities with an elevated global capitated budget for
eligible Medicaid beneficiaries, paired with flexibilities to
allow States to provide medical assistance for recovery housing
for such beneficiaries, would result in reduced emergency
department visits, hospitalizations, and program expenditures
under per beneficiary, or improve quality of care for the such
beneficiaries without increasing expenditures under the
Medicaid program under title XIX.
``(2) Demonstration requirements.--
``(A) In general.--Under the demonstration, each
eligible State that is selected by the CMI to
participate in the demonstration shall enter into an
agreement with a Medicaid managed care entity under
which the entity agrees to provide services (including
recovery housing) to eligible Medicaid beneficiaries
under a payment model that meets the requirements of
subparagraph (B).
``(B) Capitated payments.--
``(i) In general.--The CMI shall establish
a capitated payments system for Medicaid
managed care entities under the demonstration
that is based on the demonstration budget
determined under clause (ii).
``(ii) Demonstration budget.--
``(I) In general.--For purposes of
clause (i), the demonstration budget of
a Medicaid managed care entity for each
year of a demonstration period shall be
determined by the CMI based on the
number of eligible Medicaid
beneficiaries enrolled with the entity
and the average annual spending under
title XIX in the State involved on
individuals who are enrolled in the
State plan under such title (or a
waiver of such plan) and who--
``(aa) have a diagnosis of
opioid use disorder;
``(bb) are in the top
quartile of per beneficiary
spending for such plan or
waiver for the most recent
year; and
``(cc) have attained age 21
but have not attained age 65.
``(II) Risk adjustment.--The CMI
may adjust the demonstration budget
determined for a Medicaid managed care
entity and a year under this clause
using a risk adjustment model selected
by the CMI to account for differences
in age and clinical conditions of the
eligible Medicaid beneficiaries
enrolled with the entity compared to
the overall population upon which the
demonstration budget is based.
``(C) Selection of eligible states.--Not later than
1 year after the date of enactment of this subsection,
the CMI shall select not less than 2 eligible States to
participate in the demonstration.
``(3) Additional waiver authority.--In addition to the
authority described in subsection (d)(1), the Secretary may
waive such requirements of title XIX as necessary to carry out
the demonstration.
``(4) Definitions.--In this subsection:
``(A) Eligible medicaid beneficiary.--The term
`eligible Medicaid beneficiary' means an individual
who--
``(i) is eligible for medical assistance
under a State plan under title XIX or a waiver
of such a plan;
``(ii) has a diagnosis of opioid use
disorder;
``(iii) does not have a permanent residence
(as certified by the individual);
``(iv) is currently receiving medication-
assisted treatment or completed a course of
medication-assisted treatment during the 3-
month period preceding the individual's
participation in the demonstration; and
``(v) has attained age 21 but has not
attained age 65.
``(B) Eligible state.--
``(i) In general.--The term `eligible
State' means a State that--
``(I) makes medical assistance
available to all individuals described
in section 1902(a)(10)(A)(i)(VIII); and
``(II) agrees to participate in the
demonstration.
``(ii) Selection of eligible states.--In
selecting eligible States to participate in the
demonstration, the CMI shall give priority to
States that are--
``(I) among the top 10 States in
terms of highest per capita drug
poisoning deaths in each of calendar
years 2019, 2020, and 2021, based on
the most recent data available from the
Centers for Disease Control and
Prevention; and
``(II) among the 10 States with the
lowest physician reimbursement rates
for services furnished under title XIX
(as determined by the Secretary) in
each of calendar years 2019, 2020, and
2021.
``(C) Managed care entity.--The term `managed care
entity' means a medicaid managed care organization
described in section 1932(a)(1)(B)(i).
``(D) Recovery housing.--The term `recovery
housing' means a shared living environment free from
alcohol and illicit drug use and centered on peer
support and connection to services that promote
sustained recovery from substance use disorders.
``(E) State.--The term `State' includes the 50
States and the District of Columbia.''.
SEC. 11. EXTENSION OF MEDICAID DELIVERY SYSTEM REFORM AND INCENTIVE
PAYMENT WAIVERS.
(a) Extension of Waivers.--In the case of a Medicaid section 1115
waiver described in subsection (b), not later than 60 days after the
date of enactment of this Act, the Secretary of Health and Human
Services shall--
(1) extend the termination date for the waiver to December
31, 2026 (or such earlier date as the State conducting the
waiver may elect);
(2) apply the same annual dollar allotment for the period
for which the waiver is extended under paragraph (1) as the
annual dollar allotment that applied to the waiver period in
effect on the date of enactment of this Act; and
(3) allow any State with such a waiver to use funds
provided during the period for which the waiver is extended
under paragraph (1) to support the training of direct service
workers that provide home and community-based services.
(b) Medicaid Section 1115 Waiver Described.--The Medicaid section
1115 waiver described in this subsection is a waiver approved under
section 1115 of the Social Security Act (42 U.S.C. 1315) relating to
delivery system reform incentive payments that--
(1) as of the date of enactment of this Act, is to
terminate on or before December 31, 2024;
(2) was in effect as of January 1, 2022; and
(3) was approved for any State that is among the top 10
States in terms of highest per capita drug poisoning deaths in
each of calendar years 2019, 2020, and 2021, based on the most
recent data available from the Centers for Disease Control and
Prevention.
SEC. 12. EXPANDING DRUG-FREE COMMUNITIES SUPPORT GRANTS.
Section 1032 of the Anti-Drug Abuse Act of 1988 (21 U.S.C. 1532) is
amended--
(1) in subsection (b)--
(A) in paragraph (3)--
(i) in subparagraph (A), by striking
``subparagraph (F)'' and inserting
``subparagraph (H)'';
(ii) by redesignating subparagraphs (D),
(E), and (F) as subparagraphs (F), (G), and
(H), respectively;
(iii) by inserting after subparagraph (C)
the following:
``(D) Subsequent additional grants.--Subject to
subparagraph (H), the Administrator may award a
subsequent additional grant to a grant recipient under
subparagraph (A), for each fiscal year during the 4-
fiscal-year period following the fiscal year for which
the initial additional grant under subparagraph (A) is
awarded, in an amount not to exceed the amount of non-
Federal funds, including in-kind contributions, raised
by the grant recipient for the fiscal year for which
the subsequent additional grant is awarded.
``(E) Renewal grants.--Subject to subparagraph (H),
the Administrator may award a renewal grant to a grant
recipient under subparagraph (D), for the first fiscal
year following the 4-fiscal-year period for which the
subsequent additional grant under subparagraph (D) is
awarded, in an amount not to exceed the amount of non-
Federal funds, including in-kind contributions, raised
by the grant recipient for the fiscal year for which
the renewal grant is awarded.''; and
(iv) in subparagraph (F), as so
redesignated--
(I) in the subparagraph heading, by
striking ``renewal'' and inserting
``subsequent renewal''; and
(II) in the matter preceding clause
(i)--
(aa) by striking ``clause
(iv)'' and inserting
``subparagraph (H)'';
(bb) by striking ``renewal
grant to a grant recipient
under this subparagraph'' and
inserting ``subsequent renewal
grant to a grant recipient
under subparagraph (E)''; and
(cc) by striking ``initial
additional grant'' and
inserting ``renewal grant under
subparagraph (E)''; and
(B) in paragraph (4), by striking ``(3)(E)'' and
inserting ``(3)(G)'';
(2) in subsection (d)--
(A) by striking ``In awarding'' and inserting the
following:
``(1) Priority for economically disadvantaged areas.--In
awarding''; and
(B) by adding at the end the following:
``(2) Priority for states demonstrating high mortality
rates relating to opioid use disorder.--
``(A) Grants to more than 1 eligible coalition
representing a community.--In awarding grants under
subsection (b)(1)(B)(ii), the Administrator shall give
priority to eligible coalitions that serve 1 or more
communities in a State that has a high mortality rate
relating to opioid use disorder.
``(B) Subsequent additional grants.--In awarding
subsequent additional grants under subsection
(b)(3)(D), the Administrator shall give priority to an
eligible coalition that serves 1 or more communities in
a State that has a high mortality rate relating to
opioid use disorder.''; and
(3) by adding at the end the following:
``(e) Limitation on Subsequent Renewal Grants.--A recipient of a
subsequent renewal grant awarded under subsection (b)(3)(F) may not be
awarded any further grant under this section.''.
SEC. 13. SUPPORT FOR LAW ENFORCEMENT MENTAL HEALTH AND WELLNESS.
There is authorized to be appropriated, and there is appropriated,
out of any monies in the Treasury not otherwise appropriated,
$15,000,000 for each of fiscal years 2024 through 2027 for grants under
section 1701(b)(23) of title I of the Omnibus Crime Control and Safe
Streets Act of 1968 (34 U.S.C. 10381(b)(23)) to establish peer
mentoring mental health and wellness pilot programs within State,
Tribal, and local law enforcement agencies.
SEC. 14. ADVERSE CHILDHOOD EXPERIENCES RESPONSE TEAM GRANT PROGRAM.
(a) In General.--Title I of the Omnibus Crime Control and Safe
Streets Act of 1968 (34 U.S.C. 10101 et seq.) is amended by adding at
the end the following:
``PART PP--ADVERSE CHILDHOOD EXPERIENCES RESPONSE TEAM GRANT PROGRAM
``SEC. 3061. GRANTS FOR ADVERSE CHILDHOOD EXPERIENCES RESPONSE TEAMS.
``(a) Grants Authorized.--From amounts made available to carry out
this section, the Attorney General, in coordination with the Secretary
of Health and Human Services, shall make grants to States, units of
local government, Indian Tribes, and neighborhood or community-based
organizations to address adverse childhood experiences associated with
exposure to trauma.
``(b) Use of Funds.--Amounts received under a grant under this
section may be used to establish an adverse childhood experiences
response team, including by--
``(1) establishing protocols to follow when encountering a
child or youth exposed to trauma to facilitate access to
services;
``(2) developing referral partnership agreements with
behavioral health providers, substance treatment facilities,
and recovery services for family members of children exposed to
trauma;
``(3) integrating law enforcement, mental health, and
crisis services to respond to situations where children have
been exposed to trauma;
``(4) implementing comprehensive programs and practices to
support children exposed to trauma;
``(5) identifying barriers for children to access trauma-
informed care in their communities;
``(6) providing training in trauma-informed care to
emergency response providers, victim service providers, child
protective service professionals, educational institutions, and
other community partners;
``(7) supporting cross-system planning and collaboration
among officers and employees who work in law enforcement, court
systems, child welfare services, correctional reentry programs,
emergency medical services, health care services, public
health, and substance abuse treatment and recovery support; and
``(8) providing technical assistance to communities,
organizations, and public agencies on how to prevent and
mitigate the impact of exposure to trauma and violence.
``(c) Application.--A State, unit of local government, Indian
Tribe, or neighborhood or community-based organization desiring a grant
under this section shall submit to the Attorney General an application
in such form, and containing such information, as the Attorney General
may reasonably require.''.
(b) Authorization of Appropriations.--Section 1001(a) of title I of
the Omnibus Crime Control and Safe Streets Act of 1968 (34 U.S.C.
10261(a)) is amended by adding at the end the following:
``(29) There are authorized to be appropriated to carry out part PP
$10,000,000 for each of fiscal years 2024 through 2027.''.
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