I 117TH CONGRESS 1ST SESSION H. R. 1384 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 HOUSE OF REPRESENTATIVES FEBRUARY 25, 2021 Mr. TONKO (for himself, Mr. TURNER, Mr. DELGADO, Mr. GONZALEZ of Ohio, Ms. BARRAGA´N, Ms. BASS, Ms. BLUNT ROCHESTER, Ms. BROWNLEY, Mr. CARBAJAL, Mr. CA´RDENAS, Mr. CASE, Ms. CLARKE of New York, Mr. RODNEY DAVIS of Illinois, Ms. DEAN, Mr. GALLEGO, Mr. HASTINGS, Mr. HIGGINS of New York, Mr. FITZPATRICK, Ms. JAYAPAL, Mr. JONES, Mr. KATKO, Mr. KIM of New Jersey, Ms. KUSTER, Mr. LAWSON of Flor- ida, Mr. LEVIN of California, Ms. MATSUI, Mr. MEEKS, Mr. NADLER, Mrs. NAPOLITANO, Ms. NORTON, Mr. O’HALLERAN, Mr. PASCRELL, Mr. PAYNE, Ms. PINGREE, Mr. RASKIN, Miss RICE of New York, Ms. SCAN- LON, Mr. SCHRADER, Mr. SMITH of Washington, Ms. STRICKLAND, Mr. SUOZZI, Mr. TAYLOR, Mr. TRONE, Ms. UNDERWOOD, Mrs. WATSON COLEMAN, Mr. WELCH, Ms. WILD, and Ms. ADAMS) introduced the fol- lowing bill; which was referred to the Committee on Energy and Com- merce, and in addition to the Committees on Ways and Means, and the Judiciary, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdic- tion of the committee concerned 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. VerDate Sep 11 2014 15:43 Mar 24, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6652 E:\BILLS\H1384.IH H1384 pamtmann on DSKBC07HB2PROD with BILLS 2 •HR 1384 IH 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 SEC. 2. ELIMINATING SEPARATE REGISTRATION REQUIRE- 6 MENT FOR DISPENSING NARCOTIC DRUGS IN 7 SCHEDULE III, IV, AND V FOR MAINTENANCE 8 OR DETOXIFICATION TREATMENT. 9 (a) IN GENERAL.—Section 303 of the Controlled 10 Substances Act (21 U.S.C. 823) is amended— 11 (1) by striking paragraph (2) of subsection (g); 12 and 13 (2) in subsection (g), as amended— 14 (A) by striking ‘‘(g)(1) Except as provided 15 in paragraph (2), practitioners who dispense 16 narcotic drugs to individuals for maintenance 17 treatment or detoxification treatment’’ and in- 18 serting ‘‘(g) Practitioners who dispense narcotic 19 drugs (other than narcotic drugs in schedule 20 III, IV, or V) to individuals for maintenance 21 treatment or detoxification treatment’’; 22 (B) by redesignating subparagraphs (A), 23 (B), and (C) as paragraphs (1), (2), and (3), 24 respectively; and 25 VerDate Sep 11 2014 15:43 Mar 24, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H1384.IH H1384 pamtmann on DSKBC07HB2PROD with BILLS 3 •HR 1384 IH (C) in paragraph (2), as redesignated, by 1 redesignating clauses (i) and (ii) as subpara- 2 graphs (A) and (B), respectively. 3 (b) CONFORMING CHANGES.— 4 (1) Subsections (a) and (d)(1) of section 304 of 5 the Controlled Substances Act (21 U.S.C. 824) are 6 amended by striking ‘‘303(g)(1)’’ each place it ap- 7 pears and inserting ‘‘303(g)’’. 8 (2) Section 309A(a)(2) of the Controlled Sub- 9 stances Act (21 U.S.C. 829a) is amended— 10 (A) in the matter preceding subparagraph 11 (A), by striking ‘‘the controlled substance is to 12 be administered for the purpose of maintenance 13 or detoxification treatment under section 14 303(g)(2)’’ and inserting ‘‘the controlled sub- 15 stance is a narcotic drug in schedule III, IV, or 16 V to be administered for the purpose of mainte- 17 nance or detoxification treatment’’; and 18 (B) by striking ‘‘and—’’ and all that fol- 19 lows through ‘‘is to be administered by injection 20 or implantation;’’ and inserting ‘‘and is to be 21 administered by injection or implantation;’’. 22 (3) Section 520E–4(c) of the Public Health 23 Service Act (42 U.S.C. 290bb–36d(c)) is amended 24 by striking ‘‘information on any qualified practi- 25 VerDate Sep 11 2014 15:43 Mar 24, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H1384.IH H1384 pamtmann on DSKBC07HB2PROD with BILLS 4 •HR 1384 IH tioner that is certified to prescribe medication for 1 opioid dependency under section 303(g)(2)(B) of the 2 Controlled Substances Act’’ and inserting ‘‘informa- 3 tion on any practitioner who prescribes narcotic 4 drugs in schedule III, IV, or V of section 202 of the 5 Controlled Substances Act for the purpose of main- 6 tenance or detoxification treatment’’. 7 (4) Section 544(a)(3) of the Public Health 8 Service Act (42 U.S.C. 290dd–3) is amended by 9 striking ‘‘any practitioner dispensing narcotic drugs 10 pursuant to section 303(g) of the Controlled Sub- 11 stances Act’’ and inserting ‘‘any practitioner dis- 12 pensing narcotic drugs for the purpose of mainte- 13 nance or detoxification treatment’’. 14 (5) Section 1833(bb)(3)(B) of the Social Secu- 15 rity Act (42 U.S.C. 1395l(bb)(3)(B)) is amended by 16 striking ‘‘first receives a waiver under section 303(g) 17 of the Controlled Substances Act on or after Janu- 18 ary 1, 2019’’ and inserting ‘‘first begins prescribing 19 narcotic drugs in schedule III, IV, or V of section 20 202 of the Controlled Substances Act for the pur- 21 pose of maintenance or detoxification treatment on 22 or after January 1, 2021’’. 23 (6) Section 1834(o)(3)(C)(ii) of the Social Se- 24 curity Act (42 U.S.C. 1395m(o)(3)(C)(ii)) is amend- 25 VerDate Sep 11 2014 15:43 Mar 24, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H1384.IH H1384 pamtmann on DSKBC07HB2PROD with BILLS 5 •HR 1384 IH ed by striking ‘‘first receives a waiver under section 1 303(g) of the Controlled Substances Act on or after 2 January 1, 2019’’ and inserting ‘‘first begins pre- 3 scribing narcotic drugs in schedule III, IV, or V of 4 section 202 of the Controlled Substances Act for the 5 purpose of maintenance or detoxification treatment 6 on or after January 1, 2021’’. 7 (7) Section 1866F(c)(3) of the Social Security 8 Act (42 U.S.C. 1395cc–6(c)(3)) is amended— 9 (A) in subparagraph (A), by inserting 10 ‘‘and’’ at the end; 11 (B) in subparagraph (B), by striking ‘‘; 12 and’’ and inserting a period; and 13 (C) by striking subparagraph (C). 14 (8) Section 1903(aa)(2)(C) of the Social Secu- 15 rity Act (42 U.S.C. 1396b(aa)(2)(C)) is amended— 16 (A) in clause (i), by inserting ‘‘and’’ at the 17 end; and 18 (B) by striking clause (ii). 19 SEC. 3. NATIONAL EDUCATION CAMPAIGN. 20 (a) IN GENERAL.—The Secretary of Health and 21 Human Services, acting through the Assistant Secretary 22 for Mental Health and Substance Use, shall conduct a na- 23 tional campaign to educate practitioners with respect to 24 the elimination of the separate registration requirement 25 VerDate Sep 11 2014 15:43 Mar 24, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H1384.IH H1384 pamtmann on DSKBC07HB2PROD with BILLS 6 •HR 1384 IH under section 303(g) of the Controlled Substances Act (21 1 U.S.C. 823(g)), as in effect on the day before the date 2 of enactment of this Act, for dispensing narcotic drugs in 3 schedule III, IV, and V for maintenance or detoxification 4 treatment. 5 (b) REQUIRED COMPONENTS.—The national edu- 6 cation campaign under subsection (a) shall— 7 (1) encourage practitioners to integrate sub- 8 stance use treatment into their practices; and 9 (2) include education on publicly available edu- 10 cational resources and training modules that can as- 11 sist practitioners in treating patients with a sub- 12 stance use disorder. 13 SEC. 4. COMMUNITY HEALTH AIDES AND COMMUNITY 14 HEALTH PRACTITIONERS. 15 (a) PRACTICE OF TELEMEDICINE.—Section 102 of 16 the Controlled Substances Act (21 U.S.C. 802) is amend- 17 ed— 18 (1) in paragraph (54)(A), by striking clause (i) 19 and inserting the following: 20 ‘‘(i) while the patient is— 21 ‘‘(I) being treated by, and physically 22 located in, a hospital or clinic registered 23 under section 303(f); or 24 VerDate Sep 11 2014 15:43 Mar 24, 2021 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H1384.IH H1384 pamtmann on DSKBC07HB2PROD with BILLS 7 •HR 1384 IH ‘‘(II) for purposes of section 302(h), 1 being treated by a community health aide 2 or community health practitioner; and’’; 3 (2) by redesignating paragraph (58) as para- 4 graph (59); 5 (3) by redesignating the second paragraph des- 6 ignated as paragraph (57) as paragraph (58); 7 (4) by moving paragraphs (57), (58) (as so re- 8 designated), and (59) (as so redesignated) 2 ems to 9 the left; and 10 (5) by adding at the end the following: 11 ‘‘(60) The terms ‘community health aide’ and ‘com- 12 munity health practitioner’ have the meanings given to 13 such terms for purposes of section 119 of the Indian 14 Health Care Improvement Act (25 U.S.C. 1616l).’’. 15 (b) DISPENSATION OF NARCOTIC DRUGS IN SCHED- 16 ULE III, IV, OR V.—Section 302 of the Controlled Sub- 17 stances Act (21 U.S.C. 822) is amended by adding at the 18 end the following: 19 ‘‘(h) DISPENSATION OF NARCOTIC DRUGS IN SCHED- 20 ULE III, IV, OR V BY CERTAIN PRACTITIONERS.— 21 ‘‘(1) IN GENERAL.—Notwithstanding subsection 22 (a)(2), a community health aide or community 23 health practitioner may dispense a narcotic drug in 24 schedule III, IV, or V, such as buprenorphine, or a 25 VerDate Sep 11 2014 15:43 Mar 24, 2021 Jkt 019200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H1384.IH H1384 pamtmann on DSKBC07HB2PROD with BILLS 8 •HR 1384 IH combination of such drugs, to an individual for 1 maintenance treatment or detoxification treatment 2 (or both) without being registered under this title if 3 the drug is prescribed by a practitioner through the 4 practice of telemedicine. 5 ‘‘(2) PREEMPTION.—Notwithstanding section 6 708, a State may not require a community health 7 aide or community health practitioner to be licensed 8 by the State in order to dispense narcotic drugs in 9 accordance with paragraph (1) of this subsection.’’. 10 Æ VerDate Sep 11 2014 15:43 Mar 24, 2021 Jkt 019200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6301 E:\BILLS\H1384.IH H1384 pamtmann on DSKBC07HB2PROD with BILLS