Bill Summary
The Respond NOW Act establishes the Opioid Epidemic Response Fund, allocating $5 billion annually for fiscal years 2020-2024 to various agencies and organizations for prevention, treatment, and research efforts. The Secretary of Health and Human Services is required to submit work plans and annual reports to Congress on the use of funds, with limitations on how the funds can be used. This section also amends the Social Security Act to provide Medicare coverage for methadone treatment and outlines the payment process. It will expire in fiscal year 2029 and must be implemented in a budget-neutral manner.
Possible Impacts
1. A person struggling with opioid addiction will have access to treatment and recovery support through the Opioid Epidemic Response Fund, which allocates $5 billion annually for programs and activities to address the epidemic.
2. Medicare beneficiaries with substance use disorders will now have coverage for methadone under Medicare Part B, allowing them to receive necessary treatment and detoxification services.
3. The legislation provides for oversight and limitations on the use of funds from the Opioid Epidemic Response Fund, ensuring that the allocated funds are used effectively and responsibly to combat the crisis.
[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2922 Introduced in House (IH)]
<DOC>
116th CONGRESS
1st Session
H. R. 2922
To address the opioid epidemic, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
May 22, 2019
Ms. Kuster of New Hampshire (for herself, Mr. Fitzpatrick, Ms. Scanlon,
Ms. Pingree, Ms. Stevens, Ms. Jackson Lee, Ms. Frankel, Mr. Trone, Mr.
Tonko, Mr. Raskin, Ms. Brownley of California, Mr. Doggett, Mr. Pappas,
Ms. Clark of Massachusetts, Mrs. Trahan, Mr. Welch, Mr. Castro of
Texas, Mrs. Dingell, Ms. Shalala, Ms. Moore, Mr. McNerney, Mr. Moulton,
Ms. Blunt Rochester, Mr. McGovern, Mr. Larson of Connecticut, Mr. Crow,
Ms. Matsui, Ms. Kelly of Illinois, Ms. Barragan, Ms. Schakowsky, Mr.
Veasey, and Ms. Bass) introduced the following bill; which was referred
to the Committee on Energy and Commerce, and in addition to the
Committees on the Judiciary, Ways and Means, the Budget, and Education
and Labor, for a period to be subsequently determined by the Speaker,
in each case for consideration of such provisions as fall within the
jurisdiction of the committee concerned
_______________________________________________________________________
A BILL
To address the opioid epidemic, and for other purposes.
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 ``Respond to the Needs in the Opioid
War Act'' or the ``Respond NOW Act''.
SEC. 2. TABLE OF CONTENTS.
The table of contents of this Act is as follows:
Sec. 1. Short title.
Sec. 2. Table of contents.
TITLE I--OPIOID EPIDEMIC RESPONSE FUND
Sec. 101. Opioid Epidemic Response Fund.
Sec. 102. Substance Abuse and Mental Health Services Administration.
Sec. 103. Centers for Disease Control and Prevention.
Sec. 104. Food and Drug Administration.
Sec. 105. National Institutes of Health.
Sec. 106. Health Resources and Services Administration.
Sec. 107. Administration for Children and Families.
TITLE II--ADDITIONAL INVESTMENTS IN EXISTING PROGRAMS TO RESPOND TO THE
OPIOID EPIDEMIC
Sec. 201. Increase in funding for regional partnership grants.
Sec. 202. Account for the State and Tribal Response to the Opioid Abuse
Crisis.
TITLE III--EXPANDING ACCESS TO TREATMENT SERVICES
Sec. 301. Eliminating time limitation for nurse practitioners, clinical
nurse specialists, certified registered
nurse anesthetists, certified nurse
midwives, and physician assistants To be
qualifying practitioners.
Sec. 302. Coverage of methadone under Medicare part B.
TITLE I--OPIOID EPIDEMIC RESPONSE FUND
SEC. 101. OPIOID EPIDEMIC RESPONSE FUND.
(a) In General.--The Secretary of Health and Human Services
(referred to in this section as the ``Secretary'') shall use any funds
appropriated pursuant to the authorization of appropriations under
subsection (c) to carry out the programs and activities described in
subsection (d) to address the opioid and substance use epidemic. Such
funds shall be in addition to any funds which are otherwise available
to carry out such programs and activities.
(b) Opioid Epidemic Response Fund.--
(1) Establishment of account.--There is established in the
Treasury an account, to be known as the Opioid Epidemic
Response Fund (referred to in this section as the ``Fund''),
for purposes of funding the programs and activities described
in subsection (d).
(2) Transfer.--For each of fiscal years 2020 through 2024,
$5,000,000,000 shall be transferred to the Fund from the
general fund of the Treasury.
(3) Amounts deposited.--Any amounts transferred under
paragraph (2) shall remain unavailable in the Fund until such
amounts are appropriated pursuant to subsection (c).
(c) Appropriations.--
(1) Authorization of appropriations.--For the period of
fiscal years 2020 through 2024, there is authorized to be
appropriated from the Fund to the Department of Health and
Human Services, for the purpose of carrying out the programs
and activities described in subsection (d), an amount not to
exceed the total amount transferred to the Fund under
subsection (b)(2), to remain available until expended.
(2) Offsetting future appropriations.--For any of fiscal
years 2020 through 2024, for any discretionary appropriation to
the Department of Health and Human Services (or any agency
therein) pursuant to the authorization of appropriations under
paragraph (1) for the purpose of carrying out the programs and
activities described in subsection (d), the total amount of
such appropriations for the applicable fiscal year (not to
exceed the total amount remaining in the Account) shall be
subtracted from the estimate of discretionary budget authority
and the resulting outlays for any estimate under the
Congressional Budget and Impoundment Control Act of 1974 or the
Balanced Budget and Emergency Deficit Control Act of 1985, and
the amount transferred to the Fund shall be reduced by the same
amount.
(d) Programs and Activities.--Of the total amount authorized to be
appropriated from the Fund to the Department of Health and Human
Services by subsection (c)(1), such amount shall be allocated as
follows:
(1) SAMHSA.--For the Substance Abuse and Mental Health
Services Administration to carry out programs and activities
pursuant to section 102, $3,650,000,000 for each of fiscal
years 2020 through 2024.
(2) CDC.--For the Centers for Disease Control and
Prevention to carry out programs and activities pursuant to
section 103, $500,000,000 for each of fiscal years 2020 through
2024.
(3) FDA.--For the Food and Drug Administration to carry out
programs and activities pursuant to section 104, $65,000,000
for each of fiscal years 2020 through 2024.
(4) NIH.--For the National Institutes of Health to carry
out programs and activities pursuant to section 105,
$500,000,000 for each of fiscal years 2020 through 2024.
(5) HRSA.--For the Health Resources and Services
Administration to carry out programs and activities pursuant to
section 106, $235,000,000 for each of fiscal years 2020 through
2024.
(6) ACF.--For the Administration for Children and Families
to carry out programs and activities pursuant to section 107,
$50,000,000 for each of fiscal years 2020 through 2024.
(e) Accountability and Oversight.--
(1) Work plan.--
(A) In general.--Not later than 180 days after the
date of enactment of this Act, the Secretary of Health
and Human Services shall submit to the Committee on
Health, Education, Labor, and Pensions and the
Committee on Appropriations of the Senate and the
Committee on Energy and Commerce and the Committee on
Appropriations of the House of Representatives, a work
plan including the proposed allocation of funds
appropriated pursuant to the authorization of
appropriations under subsection (c) for each of fiscal
years 2020 through 2024 and the contents described in
subparagraph (B).
(B) Contents.--The work plan submitted under
subparagraph (A) shall include--
(i) the amount of money to be obligated or
expended out of the Fund in each fiscal year
for each program and activity described in
subsection (d); and
(ii) a description and justification of
each such program and activity.
(2) Reports.--
(A) Annual reports.--Not later than October 1 of
each of fiscal years 2020 through 2024, the Secretary
of Health and Human Services shall submit to the
Committee on Health, Education, Labor, and Pensions and
the Committee on Appropriations of the Senate and the
Committee on Energy and Commerce and the Committee on
Appropriations of the House of Representatives, a
report including--
(i) the amount of money obligated or
expended out of the Fund in the prior fiscal
year for each program and activity described in
subsection (d);
(ii) a description of all programs and
activities using funds provided pursuant to the
authorization of appropriations under
subsection (c); and
(iii) how the programs and activities are
responding to the opioid epidemic.
(B) Additional reports.--At the request of the
Committee on Health, Education, Labor, and Pensions or
the Committee on Appropriations of the Senate, or the
Committee on Energy and Commerce or the Committee on
Appropriations of the House of Representatives, the
Secretary of Health and Human Services shall provide an
update in the form of testimony and any additional
reports to the respective congressional committee
regarding the allocation of funding under this section
or the description of the programs and activities
undertaken with such funding.
(f) Limitations.--Notwithstanding any transfer authority authorized
by this Act or any appropriations Act, any funds made available
pursuant to the authorization of appropriations under subsection (c)
may not be used for any purpose other than the programs and activities
described in subsection (d) to address the opioid and substance use
epidemic.
(g) Sunset.--This section shall expire at the end of fiscal year
2029.
SEC. 102. SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION.
The entirety of the funds made available pursuant to section
101(d)(1) shall be for carrying out subsections (b) and (c) of section
1003 of the 21st Century Cures Act (42 U.S.C. 290ee-3 note).
SEC. 103. CENTERS FOR DISEASE CONTROL AND PREVENTION.
(a) Addressing Opioid Use Disorder.--The entirety of the funds made
available pursuant to section 101(d)(2) shall be for the Director of
the Centers for Disease Control and Prevention, pursuant to applicable
authorities in the Public Health Service Act (42 U.S.C. 201 et seq.),
to continue and expand programs of the Centers for Disease Control and
Prevention to address opioid use disorder, including by--
(1) improving the timeliness and quality of data on the
opioid epidemic, including improvement of--
(A) data on fatal and nonfatal overdoses;
(B) syndromic surveillance;
(C) data on long-term sequelae (including neonatal
abstinence syndrome); and
(D) cause of death reporting related to substance
abuse or opioid overdose;
(2) expanding and strengthening evidence-based prevention
and education strategies;
(3) supporting responsible prescribing practices, including
through development and dissemination of prescriber guidelines;
(4) improving access to and use of effective prevention,
treatment, and recovery support, including through grants and
the provision of technical assistance to States and localities;
(5) strengthening partnerships with first responders,
including to protect their safety;
(6) considering the needs of vulnerable populations;
(7) addressing infectious diseases linked to the opioid
crisis;
(8) strengthening prescription drug monitoring programs;
and
(9) providing financial and technical assistance to State
and local health department efforts to treat and prevent
substance use disorder.
(b) Limitation.--Of the funds made available pursuant to section
101(d)(2) for carrying out this section, not more than 20 percent may
be used for intramural purposes.
SEC. 104. FOOD AND DRUG ADMINISTRATION.
The entirety of the funds made available pursuant to section
101(d)(3) shall be for the Commissioner of Food and Drugs, pursuant to
applicable authorities in the Public Health Service Act (42 U.S.C. 201
et seq.) or the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 301 et
seq.) and other applicable law, to support widespread innovation in
non-opioid and non-addictive medical products for pain treatment,
access to opioid addiction treatments, appropriate use of approved
opioids, and efforts to reduce illicit importation of opioids. Such
support may include the following:
(1) Facilitating the development of non-opioid and non-
addictive pain treatments.
(2) Advancing guidance documents for sponsors of non-opioid
pain products.
(3) Developing evidence to inform the potential for
nonprescription overdose therapies.
(4) Examining expanded labeling indications for medication-
assisted treatment.
(5) Conducting public education and outreach, including
public workshops or public meetings, regarding the benefits of
medication-assisted treatment, and approved non-opioid drug and
device treatment options.
(6) Exploring the expansion and possible mandatory nature
of prescriber education regarding pain management and
appropriate opioid prescribing through authorities under
section 505-1 of the Federal Food, Drug, and Cosmetic Act (21
U.S.C. 355-1).
(7) Examining options to limit the duration of opioid
prescriptions for acute pain, including through packaging
options.
(8) Increasing staff and infrastructure capacity to inspect
and analyze packages at international mail facilities and
pursue criminal investigations.
SEC. 105. NATIONAL INSTITUTES OF HEALTH.
The entirety of the funds made available pursuant to section
101(d)(4) shall be for the Director of the National Institutes of
Health, pursuant to applicable authorities in the Public Health Service
Act (42 U.S.C. 201 et seq.), to carry out activities related to--
(1) accelerating research for addressing the opioid
epidemic, including developing non-opioid medications and
interventions, including non-addictive medications, to manage
pain, as well as to treat and to prevent substance use
disorders;
(2) conducting and supporting research on which treatments
(in terms of pain management as well as treating and preventing
substance use disorders) are optimal for which patients; and
(3) conducting and supporting research on creating longer-
lasting or faster-acting antidotes for opioid overdose,
particularly in response to the prevalence of fentanyl and
carfentanyl overdoses.
SEC. 106. HEALTH RESOURCES AND SERVICES ADMINISTRATION.
The entirety of the funds made available pursuant to section
101(d)(5) shall be for the Administrator of the Health Resources and
Services Administration, pursuant to applicable authorities in titles
III, VII, and VIII of the Public Health Service Act (42 U.S.C. 241 et
seq.), to carry out activities that increase the availability and
capacity of the behavioral health workforce. Such activities may
include providing loan repayment assistance for substance abuse
treatment providers.
SEC. 107. ADMINISTRATION FOR CHILDREN AND FAMILIES.
Of the funds made available pursuant to section 101(d)(6) for each
of fiscal years 2020 through 2024--
(1) $25,000,000 for each such fiscal year shall be for the
Secretary of Health and Human Services to carry out title I of
the Child Abuse Prevention and Treatment Act (42 U.S.C. 5101 et
seq.); and
(2) $25,000,000 for each such fiscal year shall be for the
Secretary of Health and Human Services to carry out title II of
such Act (42 U.S.C. 5116 et seq.).
TITLE II--ADDITIONAL INVESTMENTS IN EXISTING PROGRAMS TO RESPOND TO THE
OPIOID EPIDEMIC
SEC. 201. INCREASE IN FUNDING FOR REGIONAL PARTNERSHIP GRANTS.
Section 436 of the Social Security Act (42 U.S.C. 629f) is
amended--
(1) in subsection (a), by striking ``$345,000,000 for each
of fiscal years 2017 through 2021'' and inserting
``$385,000,000 for each of fiscal years 2018 through 2024'';
and
(2) in subsection (b)--
(A) in paragraph (4)(A), by striking ``2017 through
2021'' and inserting ``2018 through 2024''; and
(B) in paragraph (5), by striking ``$20,000,000 for
each of fiscal years 2017 through 2021'' and inserting
``$60,000,000 for each of fiscal years 2018 through
2024''.
SEC. 202. ACCOUNT FOR THE STATE AND TRIBAL RESPONSE TO THE OPIOID ABUSE
CRISIS.
Section 1003(h) of the 21st Century Cures Act (42 U.S.C. 290ee-3
note) is amended by striking ``$500,000,000 for each of fiscal years
2019 through 2021'' and inserting ``$500,000,000 for fiscal years 2019
and $3,750,000,000 for each of fiscal years 2020 through 2023''.
TITLE III--EXPANDING ACCESS TO TREATMENT SERVICES
SEC. 301. ELIMINATING TIME LIMITATION FOR NURSE PRACTITIONERS, CLINICAL
NURSE SPECIALISTS, CERTIFIED REGISTERED NURSE
ANESTHETISTS, CERTIFIED NURSE MIDWIVES, AND PHYSICIAN
ASSISTANTS TO BE QUALIFYING PRACTITIONERS.
Section 303(g)(2)(G)(iii)(III) of the Controlled Substances Act (21
U.S.C. 823(g)(2)(G)(iii)(III)) is amended by striking ``for the period
beginning on October 1, 2018, and ending on October 1, 2023,''.
SEC. 302. COVERAGE OF METHADONE UNDER MEDICARE PART B.
(a) Coverage.--Section 1861(s)(2) of the Social Security Act (42
U.S.C. 1395x(s)(2)) is amended--
(1) by striking ``and'' at the end of subparagraph (GG);
(2) by adding ``and'' at the end of subparagraph (HH); and
(3) by inserting after subparagraph (HH) the following new
subparagraph:
``(II) methadone, if furnished or dispensed
(including by prescription) in an oral form on or after
January 1, 2019, to an individual for the purpose of
maintenance or detoxification treatment by a physician
or other practitioner who has in effect a registration
or waiver under section 303(g) of such Act (21 U.S.C.
823(g)) to dispense methadone for such purpose;''.
(b) Payment.--
(1) In connection with physician and supplier service.--
Section 1842(o)(1) of the Social Security Act (42 U.S.C.
1395u(o)(1)) is amended by adding at the end the following new
subparagraph:
``(H) In the case of methadone (as described in
section 1861(s)(2)(II)), the amount provided under
section 1847A for such drug.''.
(2) Covered opd service.--Section 1833(t)(1)(B)(iii) of the
Social Security Act (42 U.S.C. 1395l(t)(1)(B)(iii)) is amended
by inserting ``and methadone described in paragraph (2)(II) of
such section'' after ``section 1861(s)''.
(c) Budget Neutrality.--The Secretary of Health and Human Services
shall implement the amendments made by this section in a manner such
that--
(1) estimated expenditures under the physician fee schedule
under section 1848 of the Social Security Act (42 U.S.C. 1395w-
4) with application of such amendments are equal to estimated
expenditures under such schedule without application of such
amendments; and
(2) estimated expenditures under the prospective payment
system under section 1833(t) of the Social Security Act (42
U.S.C. 1395l(t)) with application of such amendments made by
this section are equal to estimated expenditures under such
system without application of such amendments.
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