Issue in Focus

Combating the Opioid Crisis: Legislation


Over the weeks of June 11 and June 18, the House will vote individually on dozens of bills to combat the opioid crisis. This effort follows the passage of the Comprehensive Addiction and Recovery Act and the 21st Century Cures Act last Congress, as well as the $4 billion appropriated in the omnibus earlier this year.

Energy and Commerce has been developing bipartisan solutions to combat the crisis for months. This latest effort kicked off in October 2017, when more than 50 bipartisan members from both on and off the committee testified to share personal and local stories, statistics, and potential solutions to combat the opioid crisis.  The committee then pursued an aggressive timeline to produce a legislative package prior to Memorial Day.  Following three legislative hearings, an additional legislative hearing focused solely on an outdated law that impedes patient care and safety, a subcommittee markup and two full committee markups, Energy and Commerce advanced a total of 57 bills to the House Floor. Taken together, these bills combat the opioid crisis through treatment and recovery, prevention, protecting communities, and fighting fentanyl.  This is the most significant congressional effort against a single drug crisis in history.

H.R. 6, the SUPPORT for Patients and Communities Act

H.R. 6, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act, introduced by Energy and Commerce Committee Chairman Greg Walden (R-OR), Ways and Means Committee Chairman Kevin Brady (R-TX), Energy and Commerce Committee Ranking Member Frank Pallone, Jr. (D-NJ), and Ways and Means Committee Ranking Member Richard Neal (D-MA), includes several Medicaid, Medicare, and public health reforms to help combat the opioid crisis.  The policies contained in H.R. 6 were advanced through regular order by the House Energy and Commerce and Ways and Means Committees.  This fully offset, bipartisan bill will help in our overall efforts to advance treatment and recovery initiatives, improve prevention, protect our communities, and bolster our efforts to fight deadly illicit synthetic drugs like fentanyl. In addition to the provisions within H.R. 6 as introduced, H.R. 6 will serve as the underlying vehicle for the majority of House-passed bills to combat the opioid crisis to move over to the Senate.

Legislation

Below is a complete list of bills to help combat the opioid crisis that were advanced to the House of Representatives by the Energy and Commerce Committee:

H.R. 449, Synthetic Drug Awareness Act of 2017, authored by Reps. Hakeem Jeffries (D-NY) and Chris Collins (R-NY), will require the U.S. Surgeon General to submit a comprehensive report to Congress on the public health effects of the rise in synthetic drug use among youth aged 12 to 18 in order to further educate parents and the medical community on the health effects of synthetics. H.R. 449 passed the committee by voice vote.  On June 12, 2018, H.R. 449 passed the House by voice vote.

H.R. 4284, Indexing Narcotics, Fentanyl, and Opioids (INFO) Act of 2017, authored by Rep. Bob Latta (R-OH), will direct HHS to create a public and easily accessible electronic dashboard linking to all of the nationwide efforts and strategies to combat the opioid crisis. H.R. 4284 passed the committee, as amended, by voice vote. On June 12, 2018, H.R. 4284 passed the House by voice vote.

H.R. 5002, ACE Research Act, authored by Rep. Debbie Dingell (D-MI) and Rep. Fred Upton (R-MI), will provide the National Institutes of Health (NIH) with new, flexible authorities to conduct innovative research and spur urgently needed research on new non-addictive pain medications. H.R. 5002 passed the committee by voice vote. On June 12, 2018, H.R. 5002 passed the House by voice vote.

H.R. 5102, Substance Use Disorder Workforce Loan Repayment Act of 2018, authored by Reps. Katherine Clark (D-MA) and Hal Rogers (R-KY), will create a loan repayment program for substance use disorder (SUD) treatment providers.  Specifically, the bill will offer student loan repayment of up to $250,000 for participants who agree to work as a SUD treatment professional in areas most in need of their services. The program will be available to a wide range of direct care providers, including physicians, registered nurses, social workers, and other behavioral health professionals. H.R. 5102 passed the committee by voice vote. On June 12, 2018, H.R. 5102 passed the House by voice vote.

H.R. 5009, Jessie’s Law, authored by Reps. Tim Walberg (R-MI) and Debbie Dingell (D-MI), will ensure medical professionals have access to a consenting patient’s complete health history when making treatment decisions by requiring the Department of Health and Human Services (HHS) to develop and disseminate best practices regarding the prominent display of substance use disorder (SUD) history in patient records of patients who have previously provided this information to a health care provider. H.R. 5009 passed the committee, as amended, by voice vote.  On June 12, 2018, H.R. 5009passed the House by voice vote.

H.R. 5176, Preventing Overdoses While in Emergency Rooms (POWER) Act of 2018, authored by Reps. David McKinley (R-WV) and Michael Doyle (D-PA), will provide resources for hospitals to develop protocols on discharging patients who have presented with an opioid overdose. These protocols would address the provision of naloxone upon discharge, connection with peer-support specialists, and the referral to treatment and other services that best fit the patient’s needs. H.R. 5176 passed the committee by voice vote. On June 12, 2018, H.R. 5176 passed the House by voice vote.

H.R. 5197, Alternatives to Opioids (ALTO) in the Emergency Department Act, authored by Reps. Bill Pascrell, Jr. (D-NJ) and David McKinley (R-WV), will establish a demonstration program to test alternative pain management protocols to limit the use of opioids in hospital emergency departments. H.R. 5197 passed the committee, as amended, by voice vote. On June 12, 2018, H.R. 5197 passed the House by voice vote.

H.R. 5261, TEACH to Combat Addiction Act of 2018, authored by Rep. Bill Johnson (R-OH), will support Centers of Excellence, or institutions of learning that have championed substance use disorder (SUD) treatment education to improve how health professionals are taught about both SUD and pain. H.R. 5261 passed the committee by voice vote. On June 12, 2018, H.R. 5261 passed the House by voice vote.

H.R. 5272, Reinforcing Evidence-based Standards Under Law in Treating Substance abuse (RESULTS) Act of 2018, authored by Reps. Steve Stivers (R-OH) and Eliot Engel (D-NY), will direct the Substance Abuse and Mental Health Services Administration (SAMHSA) to provide guidance for entities applying for substance use disorder (SUD) and mental illness grants, including guidance to grantees on how best to articulate the rationale for a given program or activity. Additionally, it will also encourage the funding of evidence-based interventions and the replication of promising or effective practices. H.R. 5272 passed the committee by voice vote. On June 12, 2018, H.R. 5272 passed the House by voice vote.

H.R. 5327, Comprehensive Opioid Recovery Centers Act 2018, authored by Reps. Brett Guthrie (R-KY) and Green (D-TX), will establish Comprehensive Opioid Recovery Centers (CORCs) that will serve as models for comprehensive treatment and recovery. CORCs would utilize the full range of FDA-approved medications and evidence-based treatments, have strong linkages with the community, generate meaningful outcomes data, and dramatically improve the opportunities for individuals to establish and maintain long-term recovery as productive members of society. H.R. 5327 passed the committee, as amended by Rep. Guthrie and Rep. Ben Ray Lujan (D-NM), by voice vote. On June 12, 2018, the House passed H.R. 5041 by a vote of 383-13.

H.R. 5353, Eliminating Opioid-Related Infectious Diseases Act of 2018, authored by Reps. Leonard Lance (R-NJ) and Rep. Joe Kennedy III (D-MA), will authorize the CDC to undertake an injection drug use-associated infection elimination initiative and work with states to improve education, surveillance and treatment of injection drug-use associated infections, like human immunodeficiency virus (HIV) and hepatitis. H.R. 5353 passed the committee by voice vote. On June 12, 2018, H.R. 5353 passed the House by voice vote.

H.R. 3331, To amend title XI of the Social Security Act to promote testing of incentive payments for behavioral health providers for adoption and use of certified electronic health record technology, authored by Reps. Lynn Jenkins (R-KS) and Doris Matsui (D-CA), will promote the testing of incentive payments for behavioral health providers for adoption and use of certified electronic health record technology. H.R. 3331 passed the committee, as amended, by voice vote. On June 12, 2018, H.R. 3331 passed the House by voice vote.

H.R. 5685, the Medicare Opioid Safety Education Act, authored by Reps. John Faso (R-NY), Peter Welch (D-VT), and Jim Renacci (R-OH), will direct the Centers for Medicare and Medicaid Services (CMS) to compile education resources for beneficiaries regarding opioid use, pain management, and alternative pain management treatments, and include these resources in the “Medicare and You” Handbook. H.R. 5685 passed the committee by voice vote. On June 12, 2018, H.R. 5685 passed the House by voice vote.

H.R. 3528, Every Prescription Conveyed Securely Act, authored by Reps. Katherine Clark (D-MA) and Markwayne Mullin (R-OK), will require e-prescribing, with exceptions, for coverage of prescription drugs that are controlled substances under the Medicare Part D program. H.R. 3528 passed the committee, as amended, by voice vote.

H.R. 4841, Standardizing Electronic Prior Authorization for Safe Prescribing Act of 2018, authored by Reps. David Schweikert (R-AZ), Bill Johnson (R-OH), and Ben Ray Lujan (D-NM), seeks to standardize electronic prior authorization under Medicare Part D. H.R. 4841 passed the committee, as amended, by voice vote.

H.R. 5675, to amend title XVIII of the Social Security Act to require prescription drug plan sponsors under the Medicare program to establish drug management programs for at-risk beneficiaries. H.R. 5675, authored by Reps. Gus Bilirakis (R-FL), Ben Ray Lujan (D-NM), Peter Roskam (R-IL), and Sander Levin (D-MI), will build off of work done in the Comprehensive Addiction Recovery Act (CARA), and require prescription drug plan sponsors under the Medicare program establish drug management programs for at-risk beneficiaries. H.R. 5675 passed the committee by voice vote. 

H.R. 5686, the Medicare Clear Health Options in Care for Enrollees (CHOICE) Act, authored by Reps. Erik Paulsen (R-MN), Chris Collins (R-NY), Terri Sewell (D-AL), and Connor Lamb (D-PA), will require prescription drug plans under Medicare Part D to include information on the adverse effects of opioid overutilization and of coverage of non-pharmacological therapies and non-opioid medications or devices used to treat pain. H.R. 5686 passed the committee by voice vote.

H.R. 5582, the Abuse Deterrent Access Act of 2018, authored by Reps. Buddy Carter (R-GA), David Loebsack (D-IA), and Tom Reed (R-NY), will direct CMS to evaluate the use of abuse-deterrent opioids in Medicare plans. H.R. 5582 passed the committee, as amended, by voice vote. On June 12, 2018, H.R. 5582 passed the House by voice vote.

H.R. 5684, the Protecting Seniors from Opioid Abuse Act, authored by Rep. Mike Kelly (R-PA), House Republican Conference Chair Cathy McMorris Rodgers (R-WA), Rep. Mike Thompson (D-CA), and Michael Doyle (D-PA), will add beneficiaries at-risk for prescription drug abuse to the list of targeted beneficiaries to be eligible for Medication Therapy Management (MTM) under Part D. H.R. 5684 passed the committee by voice vote.

H.R. 5473, the Better Pain Management Through Better Data Act of 2018, authored by Reps. Barbara Comstock (R-VA) and Ben Ray Lujan (D-NM), will direct the Food and Drug Administration (FDA) to articulate clear data collection methods that could be used to inform opioid-sparing labeling claims for products that may replace, delay, or reduce or the use of opioid analgesics. H.R. 5473 passed the committee by voice vote.  On June 12, 2018, H.R. 5473 passed the House by voice vote.

H.R. 5687, the Securing Opioids and Unused Narcotics with Deliberate Disposal and Packaging Act of 2018, authored by Reps. Richard Hudson (R-NC), Rep. G.K. Butterfield (D-NC), and Ted Budd (R-NC) will direct the FDA to work with manufacturers to establish programs for efficient return or destruction of unused Schedule II drugs, with an emphasis on opioids. These methods could include mail-back pouches to secure facilities for incineration, or methods to immediately inactivate/render unattractive unused drugs. In addition, this bill will facilitate utilization of packaging that may reduce overprescribing of opioids. Finally, this bill will require the Government Accountability Office (GAO) to study new and innovative technologies that claim to be able to safely dispose of opioids and other unused medications. GAO would review and detail the effectiveness of these disposal methods. H.R. 5687 passed the committee by voice vote. On June 19, 2018, H.R. 5687 passed the House by a vote of 342-13.

H.R. 4275, Empowering Pharmacists in the Fight Against Opioid Abuse Act, authored by Reps. Mark DeSaulnier (D-CA) and Buddy Carter (R-GA), will help pharmacists detect fraudulent prescriptions. H.R. 4275 will help develop and disseminate materials, giving pharmacists greater understanding and ability to decline to fill controlled substances when they suspect the prescriptions are fraudulent, forged, or appear to be for abuse or diversion. H.R. 4275 passed the committee by voice vote. On June 12, 2018, H.R. 4275 passed the House by voice vote.

H.R. 5041, Safe Disposal of Unused Medication Act, authored by Reps. Tim Walberg (R-MI) and Debbie Dingell (D-MI), will help reduce the number of unused controlled substances at risk of diversion or misuse by allowing hospice employees to safely dispose of these medications on site after the death of a patient. H.R. 5041 passed the committee, as amended, by voice vote. On June 12, 2018, the House passed H.R. 5041 by a vote of 398-0.

H.R. 5202, Ensuring Patient Access to Substance Use Disorder Treatments Act of 2018, authored by Reps. Ryan Costello (R-PA), Rick Nolan (D-MN), Karen Handel (R-GA), David Rouzer (R-NC), and Elise Stefanik (R-NY), will make long overdue updates federal law to improve dispensing of implantable and injectable therapies – developed to make abuse, misuse, and diversion more difficult. H.R. 5202 passed the committee by voice vote.

H.R. 5483, Special Registration for Telemedicine Clarification Act of 2018, authored by Reps. Buddy Carter (R-GA), Cheri Bustos (D-IL), Karen Handel (R-GA), Elise Stefanik (R-NY), and Bobby Rush (D-IL), will clarify telemedicine waivers. Federal law permits the Attorney General to issue a special registration to health care providers to prescribe controlled substances via telemedicine in legitimate emergency situations, such as a lack of access to an in-person specialist. Unfortunately, the waiver process has never been implemented through regulation, and some patients do not have the emergency access they need to treatment. This bipartisan bill directs the Attorney General, with the Secretary of Health and Human Services, to promulgate interim final regulations within one year of passage of the law. H.R. 5483 passed the committee by voice vote. On June 12, 2018, H.R. 5483 passed the House by voice vote.

H.R. 5228, the Stop Counterfeit Drugs by Regulating and Enhancing Enforcement Now (SCREEN) Act, authored by Energy and Commerce Committee Ranking Member Frank Pallone, Jr. (D-NJ), will provide the Food and Drug Administration (FDA) with stronger recall and seizure authority to disrupt the entry of counterfeit and illicit drugs through International Mail Facilities (IMFs). The committee adopted an amendment in the nature of a substitute (AINS) offered by Ranking Member Pallone, and an amendment to the AINS offered by Rep. Gene Green (D-TX). H.R. 5228 passed the committee, as amended, by voice vote. On June 12, 2018, H.R. 5228 passed the House by voice vote.

H.R. 5752, the Stop Illicit Drug Importation Act of 2018, authored by Rep. Marsha Blackburn (R-TN), will streamline and enhance FDA’s tools to intercept illegal products. Illicit or unapproved drugs enter the U.S. supply chain through IMFs and pose serious public health threats to individuals across the country. H.R. 5752 passed the committee, as amended, by voice vote.  On June 13, 2018, H.R. 5752 passed the House by voice vote.

H.R. 5806, the 21st Century Tools for Pain and Addiction Treatments, authored by Reps. Michael C. Burgess, M.D. (R-TX), Larry Bucshon (R-IN), and Morgan Griffith (R-VA), will direct the FDA to issue or update existing guidance on ways existing pathways can be used to bring novel non-addictive treatments for pain and addiction to patients. Several approaches have proven successful in speeding the availability of treatments for serious diseases through the FDA. The FDA’s accelerated approval program facilitates faster approval of medications using surrogate endpoints for serious conditions where there is an unmet medical need. The breakthrough therapy pathway is a process designed to expedite the development and review of drugs, which may demonstrate substantial improvement over available therapy. H.R. 5806 passed the committee by a vote of 31-23. 

H.R. 5811, to amend the Federal Food, Drug, and Cosmetic Act with respect to postapproval study requirements for certain controlled substances, and for other purposes. H.R. 5811, authored by Reps. Jerry McNerney (D-CA) and Morgan Griffith (R-VA) will enhance FDA’s authorities and enforcement tools to ensure timely post-marketing studies for chronically administered opioids. Currently, there is limited data on the long-term efficacy of opioids, and their overall place in the treatment of pain. The committee adopted an amendment to the bill, offered by Rep. Griffith, by a vote of 31-22. H.R. 5811 passed the committee, as amended, by voice vote. On June 19, 2018, H.R. 5811 passed the House by voice vote.

H.R. 1925, the At-Risk Youth Medicaid Protection Act of 2017, authored by Rep. Tony Cardenas (D-CA) and Rep. Morgan Griffith (R-VA), will require state Medicaid programs not terminate a juvenile’s medical assistance eligibility because he/she is incarcerated. A state may suspend coverage while the juvenile is an inmate, but must restore coverage upon release without requiring a new application unless the individual no longer meets the eligibility requirements for medical assistance. H.R. 1925 passed the committee by voice vote.

H.R. 3192, the CHIP Mental Health Parity Act, authored by Rep. Joseph Kennedy, III (D-MA), will require state Children’s Health Insurance Programs (CHIP) to cover mental health benefits. All state CHIP programs currently cover such benefits. H.R. 3192 passed the committee, as amended, by voice vote.  On June 19, 2018, H.R. 3192 passed the House by voice vote.

H.R. 4005, the Medicaid Reentry Act, authored by Rep. Paul Tonko (D-NY), as amended, will require the Secretary of HHS to convene a stakeholder group that will produce a report of best practices for states to consider in health care related transitions for inmates of public institutions. H.R. 4005 passed the committee, as amended, by voice vote. On June 19, 2018, H.R. 4005 passed the House by voice vote.

H.R. 4998, the Health Insurance for Former Foster Youth Act, authored by Rep. Karen Bass (D-CA). The Patient Protection and Affordable Care Act (PPACA) enabled former foster youth who are in care by their 18th birthday and previously enrolled in Medicaid to receive healthcare until the age of 26. However, PPACA did not extend Medicaid coverage to former foster youth if they move out of state. H.R. 4998 would enable such youth to receive Medicaid coverage if they moved to a different state. The committee adopted an AINS, offered by Rep. G. K. Butterfield (D-NC), which revises the underlying policy and directs the Centers for Medicare and Medicaid Services (CMS) to publish guidance on how states can remove barriers, track coverage status, and conduct outreach to this population. The AINS passed by voice vote. H.R. 4998 passed the committee, as amended, by voice vote. 

H.R. 5477, the Rural Development of Opioid Capacity Services Act, authored by Rep. Tom O’Halleran (D-AZ), will require CMS to carry out a demonstration project to provide an enhanced federal matching rate for state Medicaid expenditures related to the expansion of substance-use treatment and recovery services targeting provider capacity. H.R. 5477 passed the committee, as amended, by voice vote.

H.R. 5583, to amend title XI of the Social Security Act to require states to annually report on certain adult health quality measures, and for other purposes, authored by Rep. Yvette Clarke (D-NY), will require state Medicaid programs to report on the 11 behavioral health measures that are included in CMS’ 2018 Core Set of Adult Health Care Quality Measures for Medicaid. H.R. 5583 passed the committee by voice vote. On June 12, 2018, H.R. 5583 passed the House by voice vote.

H.R. 5789, to amend title XIX of the Social Security Act to provide for Medicaid coverage protections for pregnant and postpartum women while receiving inpatient treatment for substance use disorder, authored by Rep. Bill Foster (D-IL) and Rep. Brett Guthrie (R-KY), will improve access to inpatient treatment services for women with substance use disorder who are pregnant or who are suffering from postpartum depression. H.R. 5789 passed the committee, as amended, by voice vote.

H.R. 5797, the IMD CARE Act, authored by Rep. Mimi Walters (R-CA), will allow state Medicaid programs from FY2019 through FY2023 to remove the Institutions for Mental Diseases (IMD) exclusion for Medicaid beneficiaries aged 21-64 with an opioid use disorder. This bill improves the continuum of care by removing a barrier to care under current law, so Medicaid would pay for up to 30 total days of care in an IMD during a 12-month period and eligible individuals can get the care they need. H.R. 5797 passed the committee, as amended, by voice vote.

H.R. 5799, the Medicaid DRUG Improvement Act, authored by Rep. Marsha Blackburn (R-TN), will build on current state Medicaid drug utilization review activities to help combat the opioid crisis. Under H.R. 5799, state Medicaid programs will be required to have safety edits in place for opioid refills, monitor concurrent prescribing of opioids and certain other drugs, and monitor antipsychotic prescribing for children. H.R. 5799 passed the committee, as amended, by voice vote.

H.R. 5800, the Medicaid IMD ADDITIONAL INFO Act, authored by Rep. Fred Upton (R-MI), will direct the Medicaid and CHIP Payment and Access Commission (MACPAC) to conduct a study on institutions for mental disease (IMD) that receive Medicaid reimbursement. The study will report on the requirements and standards that state Medicaid programs have for IMDs. MACPAC, considering input from stakeholders, will summarize the findings and make recommendations on improvements and best practices and data collection. The report would be due no later than January 2020. H.R. 5800 passed the committee by voice vote. On June 12, 2018, H.R. 5800 passed the House by voice vote.

H.R. 5801, the Medicaid PARTNERSHIP Act, authored by Rep. Morgan Griffith (R-VA), will require the Medicaid program in each state to integrate prescription drug monitoring program (PDMP) usage into Medicaid provider’s clinical workflow and require such providers to check the PDMP before prescribing a Schedule II controlled substance. H.R. 5801 will also establish a standard criteria that a PDMP must meet to be counted as a qualified PDMP, and requires state Medicaid programs to report to CMS on several PDMP issues. H.R. 5801 passed the committee, as amended, by voice vote. On June 19, 2018, H.R. 5801 passed the House by voice vote.

H.R. 5808, the Medicaid Pharmaceutical Home Act of 2018, authored by Rep. Gus Bilirakis (R-FL), will require all state Medicaid programs to have a beneficiary assignment program that identifies Medicaid beneficiaries at-risk for substance use disorder and assigns them to a pharmaceutical home program, which must set reasonable limits on the number of prescribers and dispensers that beneficiaries may utilize. H.R. 5808 passed the committee by voice vote.

H.R. 5810, the Medicaid Health HOME Act, authored by Rep. Leonard Lance (R-NJ) and Rep. Peter Welch (D-VT), will improve the state option for Medicaid health homes under current law that improve the coordination of, and access to care for Medicaid beneficiaries with substance use disorder. The bill extends the enhanced matching rate for qualified activities from eight quarters to 10 quarters. H.R. 5810 passed the committee, as amended, by voice vote.

H.R. 5715, the Strengthening Partnerships to Prevent Opioid Abuse Act, authored by Reps. James Renacci (R-OH), Terri Sewell (D-AL), Brett Guthrie (R-KY), and Scott Peters (D-CA), will help facilitate communication among Medicare Advantage and Part D plan sponsors, and CMS relating to sharing information on substantiated fraud, waste, and abuse investigations. H.R. 5715 passed the committee, as amended, by voice vote. 

H.R. 5716, the Commit to Opioid Medical Prescriber Accountability and Safety for Seniors (COMPASS) Act, authored by Reps. Peter Roskam (R-IL), John Larson (D-CT), Susan Brooks (R-IN), and Peter Welch (D-VT), will require CMS to establish a prescriber threshold based on specialty and geographic area, which could designate a prescriber as an outlier opioid prescriber. CMS would then be responsible for notifying prescribers identified as outliers of their status. H.R. 5716 passed the committee by voice vote.

H.R. 5796, the Responsible Education Achieves Care and Healthy Outcomes for Users’ Treatment (REACH OUT) Act of 2018, authored by Reps. Brian Fitzpatrick (R-PA), Carlos Curbelo (R-FL), and Mike Thompson (D-CA), will direct CMS to work with eligible entities, including Quality Improvement Organizations, to engage in outreach with prescribers identified as clinical outliers to share best practices to evaluate their prescribing behavior. H.R. 5796 passed the committee by voice vote. On June 19, 2018, H.R. 5796 passed the House by voice vote.

H.R. 5590, the Opioid Addiction Action Plan Act, authored by Reps. Adam Kinzinger (R-IL),  Yvette Clarke (R-IL), Darin LaHood (R-IL), and Danny Davis (D-IL), will establish an action plan, including studies, reports to Congress authored by the Department of Health and Human Services (HHS), as well as meetings with stakeholders, for the purpose of addressing the opioid crisis. H.R. 5590 passed the committee, as amended, by voice vote. On June 19, 2018, H.R. 5590 passed the House by voice vote.

H.R. 5603, the Access to Telehealth Services for Opioid Use Disorder, authored by Reps. Doris Matsui (D-CA), Tony Cardenas (D-CA), and Bill Johnson (R-OH), will instruct CMS to evaluate the utilization of telehealth services in treating substance use disorder. H.R. 5603 passed the committee, as amended, by voice vote.

H.R. 5605, the Advancing High Quality Treatment for Opioid Use Disorders in Medicare Act, authored by Rep. Raul Ruiz (D-CA), will create a demonstration project for treating substance use disorder. This model includes the development of measures to evaluate the quality and outcomes of treatment. H.R. 5605 passed the committee, as amended, by voice vote. On June 19, 2018, H.R. 5605 passed the House by voice vote.

H.R. 5798, the Opioid Screening and Chronic Pain Management Alternatives for Seniors Act, authored by Reps. Larry Bucshon (R-IN), Debbie Dingell (D-MI), and Erik Paulsen (R-MN), will add a review of current opioid prescriptions and, as appropriate, a screening for opioid use disorder as part of the Welcome to Medicare initial examination. H.R. 5798 passed the committee by voice vote.

H.R. 4684, the Ensuring Access to Quality Sober Living Act of 2017, authored by Reps. Judy Chu (D-CA), Mimi Walters (R-CA), Gus Bilirakis (R-FL), and Raul Ruiz (D-CA), will authorize the Substance Abuse and Mental Health Services Administration (SAMHSA) to develop, publish, and disseminate best practices for operating recovery housing that promotes a safe environment for sustained recovery from substance use disorder (SUD). H.R. 4684 passed the committee by voice vote. On June 12, 2018, H.R. 4684 passed the House by voice vote.

H.R. 5329, the Poison Center Network Enhancement Act of 2018, authored by Reps. Susan Brooks R-IN), Eliot Engel (D-NY), and Joe Barton (R-TX), will reauthorize the national network of Poison Control Centers, which offer free, confidential, and expert medical advice 24 hours a day, seven days a week. Often times these programs serve as the primary resource for poisoning information and help reduce Emergency Room visits through in-home treatment. H.R. 5329 passed the committee, as amended, by voice vote. On June 12, 2018, H.R. 5329 passed the House by voice vote.

H.R. 5580, the STOP Fentanyl Deaths Act of 2018, authored by Rep. Anne Kuster (D-NH), will authorize grants to federal, state, and local agencies for the establishment or operation of public health laboratories to detect fentanyl, its analogues, and other synthetic opioids. H.R. 5580 passed the committee by voice vote.

H.R. 5587, the Peer Support Communities of Recovery Act, authored by Reps. Ben Ray Lujan (D-NM) and Bill Johnson (R-OH), will enhance CARA’s Building Communities of Recovery Program and authorize the Department of Health and Human Services to award grants to peer support specialist organizations for the development and expansion of recovery services. Peer support specialists/peer recovery coaches are health workers who are in recovery from substance use disorder (SUD). New programs are emerging across the country to use peers in a range of settings, including hospitals, to provide immediate and ongoing support and treatment linkages to individuals who have overdosed from opioids, or support individuals newly in recovery. H.R. 5587 passed the committee, as amended, by voice vote. On June 12, 2018, H.R. 5587 passed the House by voice vote.

H.R. 5804, the Post-Surgical Injections as an Opioid Alternative Act, authored by Reps. John Shimkus (R-IL), Raja Krishnamoorthi (D-IL), and Peter Roskam (R-IL), seeks to incentivize post-surgical injections as a pain treatment alternative to opioids by reversing a reimbursement cut for these treatments in the Ambulatory Service Center setting, as well as collect data on a subset of codes related to these treatments. An amendment offered by Rep. Welch failed by a vote of 23-27. H.R. 5804 passed the committee by a vote of 36-14

H.R. 5809, Postoperative Opioid Prevention Act of 2018, authored by Reps. Scott Peters (D-CA) and Larry Bucshon (R-IN), will create a pass-through payment extension to encourage the development of non-opioid drugs for post-surgical pain management in Medicare. An amendment offered by Rep. Dingell failed by a vote of 22-29. H.R. 5809 passed the committee by a vote of 34-17.

H.R. 5795, the Overdose Prevention and Patient Safety Act, authored by Reps. Earl Blumenauer (D-OR) and Markwayne Mullin (R-OK), will align the use of substance use disorder (SUD) treatment records with the Health Insurance Portability and Accountability Act (HIPAA) for the purposes of treatment, payment, and healthcare operations between covered entities. H.R. 5795 will also enhance the penalties in the event of a disclosure of SUD treatment records, add breach notification requirements, and provide strong discrimination prohibitions to protect people seeking and receiving SUD treatment. An amendment offered by Rep. Joe Barton (R-TX), which was amended by a secondary amendment by Chairman Walden, passed the committee by voice vote. An amendment offered by Ranking Member Frank Pallone, Jr. (D-NJ) failed by a vote of 23-29. H.R. 5795 passed the committee, as amended, by 35-17.

H.R. 5812, the Creating Opportunities that Necessitate New and Enhanced Connections That Improve Opioid Navigation Strategies (CONNECTIONS) Act, authored by Rep. Morgan Griffith (R-VA) and Ranking Member Frank Pallone (D-NJ), will improve current federal support for state-run PDMPs. H.R. 5812 will authorize the Centers for Disease Control and Prevention to carry out certain controlled substances overdose prevention and surveillance activities in order to improve data collection and integration into physician clinical workflow so that timely, complete, and accurate information will get into the hands of providers and dispensers so that they can make the best clinical decisions for their patients. H.R. 5812 passed the committee by voice vote. On June 12, 2018, H.R. 5812 passed the House by voice vote.

Legislative Hearings

February 28, 2018:Combating the Opioid Crisis: Helping Communities Balance Enforcement and Patient Safety.”

March 21 & 22, 2018: Combating the Opioid Crisis: Prevention and Public Health Solutions.”

April 11 & 12, 2018: Combating the Opioid Crisis: Improving the Ability of Medicare and Medicaid to Provide Care for Patients.”

Legislative Markups

April 25, 2018: #SubHealth Markup of Opioids Legislation

May 9, 2018: Energy and Commerce Committee Vote on Opioids Legislation and H.R. 4606, H.R. 5174, H.R. 5175, H.R. 5239, and H.R. 5240

May 17, 2018: Energy and Commerce Committee Vote on Opioids Legislation

Energy and Commerce’s Full Committee Markups By the Numbers:

  • 57 bills advanced to the House of Representatives
  • 56 advanced with bipartisan votes out of committee
  • 53 passed by voice votes out of committee
  • 4 passed by roll call votes out of committee

Previous Legislation

Last Congress, E&C led two major initiatives being signed into law that provide critical resources for combating the crisis: The Comprehensive Addiction and Recovery Act (CARA) and the 21st Century Cures Act

October 2017 Full Committee Hearing Reviewing Previous Legislation and Federal Response to the Opioid Crisis

“The primary purpose of this hearing is to hear from the federal agencies charged with implementing the provisions of the Comprehensive Addiction and Recovery Act (CARA) and the 21st Century Cures Act,” said Chairman Walden during his opening remarks. “But it also allows this committee to have an important conversation with the Drug Enforcement Administration (DEA).”

During the full committee hearing on federal efforts to combat the opioid crisis, Chairman Walden grilled the DEA on their lack of cooperation or responsiveness to the committee’s ongoing investigation.

Chairman Walden detailed the committee’s ongoing bipartisan investigation into alleged pill dumping in the state of West Virginia, adding, “It is time for DEA to get this committee the information we need, and to do it quickly. No more dodges. No more delays.”

Read more.

Visit energycommerce.house.gov/opioids for more information on our overall efforts to Combat the Opioid Crisis