IMPROVE Addiction Care Act

I 116TH CONGRESS 2D SESSION H. R. 8388 To amend title XIX of the Social Security Act to encourage appropriate prescribing under Medicaid for victims of opioid overdose. IN THE HOUSE OF REPRESENTATIVES SEPTEMBER 24, 2020 Mr. MULLIN (for himself and Mr. ROUDA) introduced the following bill; which was referred to the Committee on Energy and Commerce 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 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 ‘‘Improving Medicaid 4 Programs’ Response to Overdose Victims and Enhancing 5 Addiction Care Act’’ or the ‘‘IMPROVE Addiction Care 6 Act’’. 7 VerDate Sep 11 2014 23:55 Oct 16, 2020 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H8388.IH H8388 kjohnson on DSK79L0C42PROD with BILLS 2 •HR 8388 IH SEC. 2. ENCOURAGING APPROPRIATE PRESCRIBING 1 UNDER MEDICAID FOR VICTIMS OF OPIOID 2 OVERDOSE. 3 (a) IN GENERAL.—Section 1927(g)(2) of the Social 4 Security Act (42 U.S.C. 1396r–8(g)(2)) is amended by 5 adding at the end the following new subparagraph: 6 ‘‘(E) ADDITIONAL DRUG USE REVIEW RE- 7 QUIREMENTS.—As part of a State’s prospective 8 and retrospective drug use review under sub- 9 paragraphs (A) and (B), as applicable, the 10 State shall, not later than January 1, 2022, de- 11 velop and implement, or review and update, 12 protocols to, subject to any applicable privacy 13 or confidentiality protections— 14 ‘‘(i) identify individuals receiving ben- 15 efits under this title who have experienced 16 a nonfatal opioid-related overdose within 17 the last 5 years, to the extent that such 18 data is available, and make a good faith ef- 19 fort to connect these individuals to treat- 20 ment options that have been determined 21 appropriate by the Secretary; 22 ‘‘(ii) if an individual receiving benefits 23 under this title experiences a fatal overdose 24 that is opioid-related (or, if specified by 25 the Secretary, related to another covered 26 VerDate Sep 11 2014 23:55 Oct 16, 2020 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H8388.IH H8388 kjohnson on DSK79L0C42PROD with BILLS 3 •HR 8388 IH outpatient drug), not later than 6 months 1 after the date of such overdose— 2 ‘‘(I) notify each provider that, 3 during the period (to be established 4 by the Secretary) preceding such over- 5 dose, prescribed opioids (or such other 6 specified covered outpatient drug, if 7 applicable) to such individual of such 8 overdose; and 9 ‘‘(II) provide each such provider 10 with educational materials on pre- 11 scribing opioids (or such other speci- 12 fied covered outpatients drugs, if ap- 13 plicable); 14 ‘‘(iii) ensure that a provider who is 15 treating an individual receiving benefits 16 under this title has notice of the individ- 17 ual’s diagnosis or history of opioid use dis- 18 order, opioid poisoning diagnosis, or his- 19 tory of nonfatal opioid-related overdose; 20 and 21 ‘‘(iv) perform ongoing retrospective 22 drug utilization reviews and offer provider 23 education that is informed by such reviews 24 (which may include education provided 25 VerDate Sep 11 2014 23:55 Oct 16, 2020 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H8388.IH H8388 kjohnson on DSK79L0C42PROD with BILLS 4 •HR 8388 IH under an educational outreach program es- 1 tablished under subparagraph (D) or 2 through an intervention described in para- 3 graph (3)(C)(iii)) regarding appropriate 4 prescribing practices for individuals receiv- 5 ing benefits under this title with a diag- 6 nosis or history of opioid use disorder, a 7 history of nonfatal opioid-related overdose, 8 or an opioid poisoning diagnosis.’’. 9 (b) TECHNICAL AMENDMENTS.—Section 1932(i) of 10 the Social Security Act (42 U.S.C. 1396u–2(i)) is amend- 11 ed— 12 (1) by striking ‘‘section 483.3(s)(4)’’ and in- 13 serting ‘‘section 438.3(s)(4)’’; and 14 (2) by striking ‘‘483.3(s)(5)’’ and inserting 15 ‘‘438.3(s)(5)’’. 16 Æ VerDate Sep 11 2014 23:55 Oct 16, 2020 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6301 E:\BILLS\H8388.IH H8388 kjohnson on DSK79L0C42PROD with BILLS