Mainstreaming Addiction Treatment Act of 2021

II 117TH CONGRESS 1ST SESSION S. 445 To amend section 303(g) of the Controlled Substances Act (21 U.S.C. 823(g)) to eliminate the separate registration requirement for dispensing narcotic drugs in schedule III, IV, or V, such as buprenorphine, for maintenance or detoxification treatment, and for other purposes. IN THE SENATE OF THE UNITED STATES FEBRUARY 25, 2021 Ms. HASSAN (for herself and Ms. MURKOWSKI) introduced the following bill; which was read twice and referred to the Committee on Health, Edu- cation, Labor, and Pensions A BILL To amend section 303(g) of the Controlled Substances Act (21 U.S.C. 823(g)) to eliminate the separate registration requirement for dispensing narcotic drugs in schedule III, IV, or V, such as buprenorphine, for maintenance or detoxification treatment, and for other purposes. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Mainstreaming Addic- 4 tion Treatment Act of 2021’’. 5 VerDate Sep 11 2014 03:33 Mar 18, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S445.IS S445 kjohnson on DSK79L0C42PROD with BILLS 2 •S 445 IS SEC. 2. ELIMINATING SEPARATE REGISTRATION REQUIRE- 1 MENT FOR DISPENSING NARCOTIC DRUGS IN 2 SCHEDULES III, IV, AND V FOR MAINTENANCE 3 OR DETOXIFICATION TREATMENT. 4 (a) IN GENERAL.—Section 303(g) of the Controlled 5 Substances Act (21 U.S.C. 823(g)) is amended— 6 (1) by striking paragraph (2); 7 (2) by striking ‘‘(g)(1) Except as provided in 8 paragraph (2), practitioners who dispense narcotic 9 drugs to individuals for maintenance treatment or 10 detoxification treatment’’ and inserting ‘‘(g) Practi- 11 tioners who dispense narcotic drugs (other than nar- 12 cotic drugs in schedule III, IV, or V) to individuals 13 for maintenance treatment or detoxification treat- 14 ment’’; 15 (3) by redesignating subparagraphs (A), (B), 16 and (C) as paragraphs (1), (2), and (3), respectively; 17 and 18 (4) in paragraph (2), as so redesignated, by re- 19 designating clauses (i) and (ii) as subparagraphs (A) 20 and (B), respectively. 21 (b) TECHNICAL AND CONFORMING EDITS.— 22 (1) Section 304 of the Controlled Substances 23 Act (21 U.S.C. 824) is amended— 24 VerDate Sep 11 2014 03:33 Mar 18, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S445.IS S445 kjohnson on DSK79L0C42PROD with BILLS 3 •S 445 IS (A) in subsection (a), by striking 1 ‘‘303(g)(1)’’ each place it appears and inserting 2 ‘‘303(g)’’; and 3 (B) in subsection (d)(1), by striking 4 ‘‘303(g)(1)’’ and inserting ‘‘303(g)’’. 5 (2) Section 309A(a) of the Controlled Sub- 6 stances Act (21 U.S.C. 829a(a)) is amended by 7 striking paragraph (2) and inserting the following: 8 ‘‘(2) the controlled substance— 9 ‘‘(A) is a narcotic drug in schedule III, IV, 10 or V to be administered for the purpose of 11 maintenance or detoxification treatment; and 12 ‘‘(B) is to be administered by injection or 13 implantation;’’. 14 (3) Section 520E–4(c) of the Public Health 15 Service Act (42 U.S.C. 290bb–36d(c)) is amended, 16 in the matter preceding paragraph (1), by striking 17 ‘‘information on any qualified practitioner that is 18 certified to prescribe medication for opioid depend- 19 ency under section 303(g)(2)(B) of the Controlled 20 Substances Act’’ and inserting ‘‘information on any 21 practitioner who prescribes narcotic drugs in sched- 22 ule III, IV, or V of section 202(c) of the Controlled 23 Substances Act (21 U.S.C. 812(c)) for the purpose 24 of maintenance or detoxification treatment’’. 25 VerDate Sep 11 2014 03:33 Mar 18, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S445.IS S445 kjohnson on DSK79L0C42PROD with BILLS 4 •S 445 IS (4) Section 544(a)(3) of the Public Health 1 Service Act (42 U.S.C. 290dd–3(a)(3)) is amended 2 by striking ‘‘any practitioner dispensing narcotic 3 drugs pursuant to section 303(g) of the Controlled 4 Substances Act’’ and inserting ‘‘any practitioner dis- 5 pensing narcotic drugs for the purpose of mainte- 6 nance or detoxification treatment’’. 7 (5) Section 1833 of the Social Security Act (42 8 U.S.C. 1395l) is amended by striking subsection 9 (bb). 10 (6) Section 1834(o) of the Social Security Act 11 (42 U.S.C. 1395m(o)) is amended by striking para- 12 graph (3). 13 (7) Section 1866F(c)(3) of the Social Security 14 Act (42 U.S.C. 1395cc–6(c)(3)) is amended— 15 (A) in subparagraph (A), by inserting 16 ‘‘and’’ at the end; 17 (B) in subparagraph (B), by striking ‘‘; 18 and’’ and inserting a period; and 19 (C) by striking subparagraph (C). 20 (8) Section 1903(aa)(2)(C) of the Social Secu- 21 rity Act (42 U.S.C. 1396b(aa)(2)(C)) is amended— 22 (A) in clause (i), by inserting ‘‘and’’ at the 23 end; 24 (B) by striking clause (ii); and 25 VerDate Sep 11 2014 03:33 Mar 18, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S445.IS S445 kjohnson on DSK79L0C42PROD with BILLS 5 •S 445 IS (C) by redesignating clause (iii) as clause 1 (ii). 2 SEC. 3. NATIONAL EDUCATION CAMPAIGN. 3 (a) IN GENERAL.—The Secretary of Health and 4 Human Services, acting through the Assistant Secretary 5 for Mental Health and Substance Use, shall conduct a na- 6 tional campaign to educate practitioners with respect to 7 the elimination of the separate registration requirement 8 under section 303(g) of the Controlled Substances Act (21 9 U.S.C. 823(g)), as in effect on the day before the date 10 of enactment of this Act, for dispensing narcotic drugs in 11 schedule III, IV, and V for maintenance or detoxification 12 treatment. 13 (b) REQUIRED COMPONENTS.—The national edu- 14 cation campaign under subsection (a) shall— 15 (1) encourage practitioners to integrate sub- 16 stance use treatment into their practices; and 17 (2) include education on publicly available edu- 18 cational resources and training modules that can as- 19 sist practitioners in treating patients with a sub- 20 stance use disorder. 21 VerDate Sep 11 2014 03:33 Mar 18, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S445.IS S445 kjohnson on DSK79L0C42PROD with BILLS 6 •S 445 IS SEC. 4. COMMUNITY HEALTH AIDES AND COMMUNITY 1 HEALTH PRACTITIONERS. 2 (a) PRACTICE OF TELEMEDICINE.—Section 102 of 3 the Controlled Substances Act (21 U.S.C. 802) is amend- 4 ed— 5 (1) in paragraph (54)(A), by striking clause (i) 6 and inserting the following: 7 ‘‘(i) while the patient is— 8 ‘‘(I) being treated by, and physically 9 located in, a hospital or clinic registered 10 under section 303(f); or 11 ‘‘(II) for purposes of section 302(h), 12 being treated by a community health aide 13 or community health practitioner; and’’; 14 (2) by redesignating paragraph (58) as para- 15 graph (59); 16 (3) by redesignating the second paragraph des- 17 ignated as paragraph (57) (relating to the definition 18 of ‘‘serious drug felony’’) as paragraph (58); 19 (4) by moving paragraphs (57), (58) (as so re- 20 designated), and (59) (as so redesignated) 2 ems to 21 the left; and 22 (5) by adding at the end the following: 23 ‘‘(60) The terms ‘community health aide’ and ‘com- 24 munity health practitioner’ have the meanings within the 25 VerDate Sep 11 2014 03:33 Mar 18, 2021 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S445.IS S445 kjohnson on DSK79L0C42PROD with BILLS 7 •S 445 IS meaning of section 119 of the Indian Health Care Im- 1 provement Act (25 U.S.C. 1616l).’’. 2 (b) DISPENSATION OF NARCOTIC DRUGS IN SCHED- 3 ULE III, IV, OR V.—Section 302 of the Controlled Sub- 4 stances Act (21 U.S.C. 822) is amended by adding at the 5 end the following: 6 ‘‘(h) DISPENSATION OF NARCOTIC DRUGS IN SCHED- 7 ULE III, IV, OR V BY CERTAIN PRACTITIONERS.— 8 ‘‘(1) IN GENERAL.—Notwithstanding subsection 9 (a)(2), a community health aide or community 10 health practitioner may dispense a narcotic drug in 11 schedule III, IV, or V, such as buprenorphine, or a 12 combination of such drugs, to an individual for 13 maintenance treatment or detoxification treatment 14 (or both) without being registered under this title if 15 the drug is prescribed by a practitioner through the 16 practice of telemedicine. 17 ‘‘(2) PREEMPTION.—Notwithstanding section 18 708, a State may not require a community health 19 aide or community health practitioner to be licensed 20 by the State in order to dispense narcotic drugs in 21 accordance with paragraph (1) of this subsection.’’. 22 Æ VerDate Sep 11 2014 03:33 Mar 18, 2021 Jkt 019200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6301 E:\BILLS\S445.IS S445 kjohnson on DSK79L0C42PROD with BILLS