[House Report 117-381]
[From the U.S. Government Publishing Office]
117th Congress } { Report
HOUSE OF REPRESENTATIVES
2d Session } { 117-381
======================================================================
PROVIDING FOR CONSIDERATION OF THE BILL (H.R. 4176) TO IMPROVE FEDERAL
POPULATION SURVEYS BY REQUIRING THE COLLECTION OF VOLUNTARY, SELF-
DISCLOSED INFORMATION ON SEXUAL ORIENTATION AND GENDER IDENTITY IN
CERTAIN SURVEYS, AND FOR OTHER PURPOSES; PROVIDING FOR CONSIDERATION OF
THE BILL (H.R. 5585) TO ESTABLISH THE ADVANCED RESEARCH PROJECTS
AGENCY-HEALTH, AND FOR OTHER PURPOSES; PROVIDING FOR CONSIDERATION OF
THE BILL (H.R. 7666) TO AMEND THE PUBLIC HEALTH SERVICE ACT TO
REAUTHORIZE CERTAIN PROGRAMS RELATING TO MENTAL HEALTH AND SUBSTANCE
USE DISORDERS, AND FOR OTHER PURPOSES; AND FOR OTHER PURPOSES
_______
June 21, 2022.--Referred to the House Calendar and ordered to be
printed
_______
Ms. Ross, from the Committee on Rules,
submitted the following
R E P O R T
[To accompany H. Res. 1191]
The Committee on Rules, having had under consideration
House Resolution 1191, by a record vote of 9 to 4, report the
same to the House with the recommendation that the resolution
be adopted.
SUMMARY OF PROVISIONS OF THE RESOLUTION
The resolution provides for consideration of H.R. 4176, the
LGBTQI+ Data Inclusion Act, under a structured rule. The
resolution provides one hour of general debate equally divided
and controlled by the chair and ranking minority member of the
Committee on Oversight and Reform or their designees. The
resolution waives all points of order against consideration of
the bill. The resolution provides that an amendment in the
nature of a substitute consisting of the text of Rules
Committee Print 117-52, modified by the amendment printed in
part A of this report, shall be considered as adopted and the
bill, as amended, shall be considered as read. The resolution
waives all points of order against provisions in the bill, as
amended.
The resolution makes in order only those further amendments
to H.R. 4176 printed in part B of this report. Each such
amendment may be offered only in the order printed in this
report, may be offered only by a Member designated in this
report, shall be considered as read, shall be debatable for the
time specified in the report equally divided and controlled by
the proponent and an opponent, shall not be subject to
amendment, and shall not be subject to a demand for division of
the question. The resolution waives all points of order against
the amendments printed in part B of the report. The resolution
provides for one motion to recommit. The resolution provides
for consideration of H.R. 5585, the Advanced Research Projects
Agency--Health Act, under a structured rule. The resolution
provides one hour of general debate on the bill equally divided
and controlled by the chair and ranking minority member of the
Committee on Energy and Commerce or their designees. The
resolution waives all points of order against consideration of
the bill. The resolution provides that the amendment in the
nature of a substitute recommended by the Committee on Energy
and Commerce now printed in the bill shall be considered as
adopted and the bill, as amended, shall be considered as read.
The resolution waives all points of order against provisions in
the bill, as amended. The resolution makes in order the further
amendment to H.R. 5585 printed in part C of this report, if
offered by the Member designated in this report, which shall be
considered as read, shall be debatable for the time specified
in the report equally divided and controlled by the proponent
and an opponent, and shall not be subject to a demand for
division of the question. The resolution waives all points of
order against the amendment printed in part C of this report.
The resolution provides one motion to recommit. The resolution
also provides for consideration of H.R. 7666, the Restoring
Hope for Mental Health and Well-Being Act of 2022, under a
structured rule. The resolution provides one hour of general
debate on the bill equally divided and controlled by the chair
and ranking minority member of the Committee on Energy and
Commerce or their designees. The resolution waives all points
of order against consideration of the bill. The resolution
provides that an amendment in the nature of a substitute
consisting of the text of Rules Committee Print 117-51,
modified by the amendment printed in part D of this report,
shall be considered as adopted and the bill, as amended, shall
be considered as read. The resolution waives all points of
order against provisions in the bill, as amended. The
resolution provides that following debate, each further
amendment printed in part E of this report not earlier
considered as part of amendments en bloc pursuant to section 6
shall be considered only in the order printed in this report,
may be offered only by a Member designated in this report,
shall be considered as read, shall be debatable for the time
specified in this report equally divided and controlled by the
proponent and an opponent, may be withdrawn by the proponent at
any time before the question is put thereon, shall not be
subject to amendment, and shall not be subject to a demand for
division of the question. Section 6 of the resolution provides
that at any time after debate the chair of the Committee on
Energy and Commerce or his designee may offer amendments en
bloc consisting of further amendments printed in part E this
report not earlier disposed of. Amendments en bloc shall be
considered as read, shall be debatable for 20 minutes equally
divided and controlled by the chair and ranking minority member
of the Committee on Energy and Commerce or their designees,
shall not be subject to amendment, and shall not be subject to
a demand for division of the question. The resolution waives
all points of order against the amendments printed in part E of
this report and amendments en bloc described in section 6 of
the resolution. The resolution provides one motion to recommit.
The resolution provides that House Resolution 188, agreed to
March 8, 2021 (as most recently amended by House Resolution
1170, agreed to June 14, 2022), is amended by striking ``June
22, 2022'' each place it appears and inserting (in each
instance) ``July 13, 2022''. The resolution provides that
proceedings may be postponed through July 15, 2022, on measures
that were the object of motions to suspend the rules on the
legislative days of June 21, 2022, June 22, 2022, June 23,
2022, or June 24, 2022, and on which the yeas and nays were
ordered.
EXPLANATION OF WAIVERS
The waiver of all points of order against consideration of
H.R. 4176 includes a waiver of clause 3(d)(1) of rule XIII of
the Congressional Budget Act, which requires the inclusion of
committee cost estimate in a committee report. A CBO cost
estimate on H.R. 4176 was not available at the time the
Committee on the Oversight and Reform filed its report.
Although the resolution waives all points of order against
provisions in H.R. 4176, as amended, the Committee is not aware
of any points of order. The waiver is prophylactic in nature.
Although the resolution waives all points of order against
the amendments to H.R. 4176 printed in part B of this report,
the Committee is not aware of any points of order. The waiver
is prophylactic in nature.
Although the resolution waives all points of order against
consideration of H.R. 5585, the Committee is not aware of any
points of order. The waiver is prophylactic in nature.
The waiver of all points of order against provisions in
H.R. 5585, as amended, includes a waiver of clause 4 of rule
XXI, which prohibits reporting a bill carrying an appropriation
from a committee not having jurisdiction to report an
appropriation.
Although the resolution waives all points of order against
the amendment to H.R. 5585 printed in part C of this report,
the Committee is not aware of any points of order. The waiver
is prophylactic in nature.
The waiver of all points of order against consideration of
H.R. 7666 includes waivers of the following:
--Clause 10 of rule XXI, which prohibits consideration of a
measure that has a net effect of increasing the deficit or
reducing the surplus over the five- or 10-year period; however,
the budgetary effects of the bill are fully offset over the 10-
year period.
--Section 302(f) of the Congressional Budget Act, which
prohibits consideration of a bill if it has the net effect of
increasing mandatory spending over the five- or ten-year
period.
The waiver of all points of order against provisions in
H.R. 7666, as amended, includes waivers of the following:
--Clause 4 of rule XXI, which prohibits reporting a bill
carrying an appropriation from a committee not having
jurisdiction to report an appropriation.
--Clause 5(a) of rule XXI, which prohibits a bill or joint
resolution carrying a tax or tariff measure from being reported
by a committee not having jurisdiction to report tax or tariff
measures.
Although the resolution waives all points of order against
the amendments to H.R. 7666 printed in part E of this report
and amendments en bloc described in section 6 of the
resolution, the Committee is not aware of any points of order.
The waiver is prophylactic in nature.
COMMITTEE VOTES
The results of each record vote on an amendment or motion
to report, together with the names of those voting for and
against, are printed below:
Rules Committee record vote No. 240
Motion by Mr. Cole to add language to the rule that would
eliminate the ability to vote remotely by proxy. Defeated: 4-9
----------------------------------------------------------------------------------------------------------------
Majority Members Vote Minority Members Vote
----------------------------------------------------------------------------------------------------------------
Mrs. Torres..................................... Nay Mr. Cole.......................... Yea
Mr. Perlmutter.................................. Nay Mr. Burgess....................... Yea
Mr. Raskin...................................... Nay Mr. Reschenthaler................. Yea
Ms. Scanlon..................................... Nay Mrs. Fischbach.................... Yea
Mr. Morelle..................................... Nay
Mr. DeSaulnier.................................. Nay
Ms. Ross........................................ Nay
Mr. Neguse...................................... Nay
Mr. McGovern, Chairman.......................... Nay
----------------------------------------------------------------------------------------------------------------
Rules Committee record vote No. 241
Motion by Mr. Burgess to amend the rule to H.R. 5585 to
make in order amendment #2, offered by Rep. Burgess (TX), which
would ensure that nothing in this Act or the amendments made by
this Act shall be construed to impede or interfere in any way
with the innovation, development, or distribution of
transformative health technologies, including diagnostic tests
for early disease detection and intervention. Defeated: 4-9
----------------------------------------------------------------------------------------------------------------
Majority Members Vote Minority Members Vote
----------------------------------------------------------------------------------------------------------------
Mrs. Torres..................................... Nay Mr. Cole.......................... Yea
Mr. Perlmutter.................................. Nay Mr. Burgess....................... Yea
Mr. Raskin...................................... Nay Mr. Reschenthaler................. Yea
Ms. Scanlon..................................... Nay Mrs. Fischbach.................... Yea
Mr. Morelle..................................... Nay
Mr. DeSaulnier.................................. Nay
Ms. Ross........................................ Nay
Mr. Neguse...................................... Nay
Mr. McGovern, Chairman.......................... Nay
----------------------------------------------------------------------------------------------------------------
Rules Committee record vote No. 242
Motion by Ms. Ross to report the rule. Adopted: 9-4
----------------------------------------------------------------------------------------------------------------
Majority Members Vote Minority Members Vote
----------------------------------------------------------------------------------------------------------------
Mrs. Torres..................................... Yea Mr. Cole.......................... Nay
Mr. Perlmutter.................................. Yea Mr. Burgess....................... Nay
Mr. Raskin...................................... Yea Mr. Reschenthaler................. Nay
Ms. Scanlon..................................... Yea Mrs. Fischbach.................... Nay
Mr. Morelle..................................... Yea
Mr. DeSaulnier.................................. Yea
Ms. Ross........................................ Yea
Mr. Neguse...................................... Yea
Mr. McGovern, Chairman.......................... Yea
----------------------------------------------------------------------------------------------------------------
SUMMARY OF THE AMENDMENT TO H.R. 4176 IN PART A CONSIDERED AS ADOPTED
1. Maloney, Carolyn (NY): Adds a finding and makes
technical and conforming changes to the bill.
SUMMARY OF THE AMENDMENTS TO H.R. 4176 IN PART B MADE IN ORDER
1. Jackson Lee (TX): Requires a report to Congress from the
Comptroller General about the impact of the implementation of
this Act on the provision of services to persons according to
their gender identity, sexual orientation, and variations in
sex characteristics. (10 minutes)
2. Maloney, Sean (NY): Clarifies that when applicable,
federal surveys should gather information from a knowledgeable
proxy of a deceased LGBTQI+ individual. (10 minutes)
3. Tlaib (MI): Requires agencies collecting information
through a covered survey to establish data standards and
protocols for anonymizing data collected and destroying
personally-identifiable information at the appropriate time,
which cannot be later than 3 years after the date that the
information was collected. (10 minutes)
SUMMARY OF THE AMENDMENT TO H.R. 5585 IN PART C MADE IN ORDER
1. Eshoo (CA), Guthrie (KY): Clarifies organizational
structure of offices within ARPA-H, limits the amount of
administrative funding that may be used to operate ARPA-H to
15%, removes the requirement of Senate confirmation of
Director, and clarifies ARPA-H's leasing authority. (10
minutes)
SUMMARY OF THE AMENDMENT TO H.R. 7666 IN PART D CONSIDERED AS ADOPTED
1. Pallone (NJ), McMorris Rodgers (WA): Makes technical
changes and adds provisions from H.R. 7233 as reported out of
the Committee on Energy and Commerce. Includes provisions to
increase transparency of pharmacy benefit managers for plan
sponsors related to prescription drug spending and requires NIH
to examine the effects of modern technology and multimedia on
youth.
SUMMARY OF THE AMENDMENTS TO H.R. 7666 IN PART E MADE IN ORDER
1. Bera (CA), Fitzpatrick (PA): Adds the House passed
Helping Emergency Responders Overcome (HERO) Act, which
establishes a series of programs relating to the behavioral
health of law enforcement officers, first responders, 9-1-1
operators, and other public safety officers and health care
providers. (10 minutes)
2. Davis, Rodney (IL), Bilirakis (FL), O'Halleran (AZ),
Wagner (MO), Kuster (NH): Adds the text of HR 2355, the Opioid
Prescription Verification Act of 2021, which encourages the
expanded use of electronic prescribing for opioids similar to
the mandate for Medicare Part D opioid prescriptions under
current law. Incentivize states to maintain and fully utilize
prescription drug monitoring programs (PDMP) and requires the
U.S. Department of Health and Human Services (HHS) to work with
the CDC, DEA, and FDA to offer materials and guidance to
pharmacists on how to verify the identity patients to help
facilitate safe and responsible opioid prescriptions. (10
minutes)
3. Dean (PA), Spartz (IN), Scanlon (PA), Fitzpatrick (PA):
Increases the time limit for health care providers to use and
hold long-acting injectable (LAI) buprenorphine, if received
through a specialty pharmacy, from 14 to 60 days. (10 minutes)
4. Demings (FL): Requires a report on the available mental
health and stress related resources or programs that are
available to law enforcement officers. The report shall include
additional legislative tools and authorities that may be
helpful or necessary to assist in assessing, monitoring, and
improving the mental health of law enforcement officers. (10
minutes)
5. Feenstra (IA): Requires the Behavioral Health Crisis
Coordinating Office to include the Veterans Crisis Line as an
entity to provide rapid post-crisis follow-up care. (10
minutes)
6. Ferguson (GA), Burgess (TX), Pappas (NH), Carter, Buddy
(GA), Costa (CA), Fitzpatrick (PA), McBath (GA): Requires the
Department of Health and Human Services (HHS) to develop best
practices for establishing behavioral intervention teams in
educational settings. (10 minutes)
7. Gottheimer (NJ): Includes veterans as an eligible group
for mental health and substance abuse care. (10 minutes)
8. Griffith (VA): Sets January 1, 2024 as date of
applicability for Sec. 262 to allow states time to review and
update state law, if desired. (10 minutes)
9. Joyce, David (OH): Requires the Department of Defense to
carry out a two-year pilot program aimed at preventing suicides
amongst active duty members of the Armed Forces by pre-
downloading resources onto smart devices issued to members of
the Armed Forces and to provide training on the use of these
resources. (10 minutes)
10. Katko (NY), Napolitano (CA), Beyer (VA), Raskin (MD),
Cardenas (CA), Fitzpatrick (PA): Adds the House-passed Suicide
Prevention Lifeline Improvement Act, which includes enhanced
funding for the National Suicide Prevention Lifeline,
authorization for HHS to develop and implement an enhanced
quality assurance plan for the suicide prevention hotline,
improved data sharing with the CDC, and a pilot program for
innovative technologies for suicide prevention. (10 minutes)
11. Kim (NJ), Davids (KS): Adds the text of the Synthetic
Opioid Danger Awareness Act, which requires HHS to conduct a
public education campaign about synthetic opioids (including
fentanyl and its analogues), disseminate information about
synthetic opioids to health care providers, and develop a
training guide and webinar for first responders and other
individuals at high risk of exposure to synthetic opioids that
details measures to prevent exposure. (10 minutes)
12. McKinley (WV), Dingell (MI): Amends the Controlled
Substances Act to clarify the process for registrants to
exercise due diligence upon discovering a suspicious order. (10
minutes)
13. Moore (WI): Add appropriate state, local, and tribal
public officials administering programs that serve low-income
pregnant and postpartum individuals to the list of entities
that the Secretary should consult with in operating and
maintaining the maternal mental health hotline. (10 minutes)
14. Napolitano (CA), Katko (NY): Revises Project AWARE,
which is administered by the Substance Abuse and Mental Health
Services Administration, to provide comprehensive school-based
mental health services, including screening, treatment, and
outreach programs. (10 minutes)
15. Pressley (MA): Requires HHS to administer a report to
study rates of suicidal behaviors among children and
adolescents with chronic illnesses, including substance use
disorders, autoimmune disorders and heritable blood disorders
and to submit a report to Congress on findings. (10 minutes)
16. Reschenthaler (PA), Morelle (NY), Wild (PA), Dean (PA):
Requires a study to determine the true costs of untreated
serious mental illness on families, health care systems, public
housing, and law enforcement in America. (10 minutes)
17. Trone (MD), Armstrong (ND), Sherrill (NJ): Authorizes
State Opioid Response (SOR) Grants and Tribal Opioid Response
(TOR) Grants for 5 years at $1.75 billion per year, with a 5%
set-aside for TOR. (10 minutes)
PART A--TEXT OF AMENDMENT TO H.R. 4176 CONSIDERED AS ADOPTED
Page 2, after line 2, insert the following:
(5) The integrity of the Federal statistical system
relies on the ability of agencies to determine the
content of their statistical surveys based on
considerations of relevance, timeliness, accuracy,
objectivity, and ability to maintain confidentiality.
Page 2, line 9, insert ``for statistical purposes'' after
``survey''.
Page 2, beginning on line 11, strike ``existing data sets to
determine in which data sets'' and insert ``covered surveys to
determine in which surveys''.
Page 2, line 24 insert ``for any survey identified in
paragraph (1)'' after ``sex characteristics''.
Page 3, strike lines 13 through 16 and insert the following:
(2) Waiver.--The statistical official (as described
in section 314 of title 5, United States Code) of each
agency, or the head of the agency, for any agency that
does not have a statistical official, may waive the
requirement under paragraph (1), on a case-by-case
basis, if the standards and policies in subsection (c)
can not be met, or if adding such information to the
survey would impair the ability of the agency to
preserve the utility, accuracy, or objectivity of the
survey while also generating relevant evidence about
the LGBTQI+ community.
Page 3, beginning on line 22, strike ``(d) Applicability.--''
and all that follows through ``(1) Construction.--'' and insert
``(d) Construction.--''.
Page 4, strike lines 3 through 9.
Page 4, line 13, after ``any individual'' insert the
following: ``, or that is inconsistent with disclosure
limitations established in any other law''.
Page 5, line 16, strike ``observation or''.
PART B--TEXT OF AMENDMENTS TO H.R. 4176 MADE IN ORDER
1. An Amendment To Be Offered by Representative Jackson Lee of Texas or
Her Designee, Debatable for 10 Minutes
Page 4, after line 9, insert the following (and redesignate
the subsequent subsections accordingly):
(e) Report.-- Not later than 2 years after the date of the
enactment of this Act, the Comptroller General shall provide a
report to Congress on the implementation of the requirements of
this Act by agencies, including how the implementation of such
requirements by agencies affected the provision of services to
persons according to the gender identity, sexual orientation,
and variations in sex characteristics of the persons.
----------
2. An Amendment To Be Offered by Representative Maloney of New York or
His Designee, Debatable for 10 Minutes
Page 4, line 22, insert after ``proxy'' the following:
``(including a proxy of a deceased individual, if
applicable)''.
----------
3. An Amendment To Be Offered by Representative Tlaib of Michigan or
Her Designee, Debatable for 10 Minutes
Page 2, line 20, insert after ``confidentiality'' the
following: ``, including protocols for anonymizing data
collected and destroying personally-identifiable information at
the appropriate time and not later than three years after the
date on which the information is collected''.
PART C--TEXT OF AMENDMENT TO H.R. 5585 MADE IN ORDER
1. An Amendment To Be Offered by Representative Eshoo of California or
Her Designee, Debatable for 10 Minutes
Page 3, line 13, strike ``There is established'' and insert
the following:
(1) In general.--There is established
Page 3, after line 23, insert the following:
(2) Organization.--
(A) In general.--There shall be within ARPA-
H--
(i) an Office of the Director;
(ii) not more than 6 program offices;
and
(iii) such special project offices as
the Director may establish.
(B) Program offices dedicated to research and
development.--Not fewer than two-thirds of the
program offices of ARPA-H shall be exclusively
dedicated to research and development.
Page 6, line 16, strike ``with the advice and consent of the
Senate,''.
Page 14, strike line 19, and all that follows through page
16, line 6, and insert the following:
``(3) Utilization of lease funds.--The Director shall
deposit amounts of cash consideration received for a
lease entered into under this subsection in the
`Advanced Research Projects Agency for Health' account
as discretionary offsetting collections, and such
amounts shall be available only to the extent and in
the amounts provided in advance in appropriations
Acts--
``(A) to cover the full costs to ARPA-H in
connection with the lease;
``(B) for maintenance, capital
revitalization, and improvements of the real
property assets and related personal property
under the jurisdiction of the Director; and
``(C) for maintenance, capital
revitalization, and improvements of the real
property assets and related personal property
at the respective center or facility of ARPA-H
engaged in the lease, subject to the
concurrence of the Director.''.
Page 26, lines 15 through 19, amend paragraph (3) to read as
follows:
``(3) not award any grants, cooperative agreements,
contracts, prizes, and other transactions to
nondomestic recipients organized under the laws of a
covered foreign country (as defined in section 119C of
the National Security Act of 1947); and
Page 34, lines 23 and 24, strike ``There is authorized'' and
insert the following:
(1) In general.--To carry out this section, there is
authorized
Page 35, after line 2 (but before the close quotation mark
and second period) insert the following:
(2) Administrative expenses.--Not more than 15
percent of the amounts made available to carry out this
section for any fiscal year may be used for
administrative expenses to operate ARPA-H.
PART D--TEXT OF AMENDMENT TO H.R. 7666 CONSIDERED AS ADOPTED
Amend section 263 to read as follows:
SEC. 263. REQUIRING PRESCRIBERS OF CONTROLLED SUBSTANCES TO COMPLETE
TRAINING.
Section 303 of the Controlled Substances Act (21 U.S.C. 823)
is amended by adding at the end the following:
``(l) Required Training for Prescribers.--
``(1) Training required.--As a condition on
registration under this section to dispense controlled
substances in schedule II, III, IV, or V, the Attorney
General shall require any qualified practitioner,
beginning with the first applicable registration for
the practitioner, to meet the following:
``(A) If the practitioner is a physician (as
defined under section 1861(r) of the Social
Security Act), the practitioner meets one or
more of the following conditions:
``(i) The physician holds a board
certification in addiction psychiatry
or addiction medicine from the American
Board of Medical Specialties.
``(ii) The physician holds a board
certification from the American Board
of Addiction Medicine.
``(iii) The physician holds a board
certification in addiction medicine
from the American Osteopathic
Association.
``(iv) The physician has, with
respect to the treatment and management
of patients with opioid or other
substance use disorders, or the safe
pharmacological management of dental
pain and screening, brief intervention,
and referral for appropriate treatment
of patients with or at risk of
developing opioid or other substance
use disorders, completed not less than
8 hours of training (through classroom
situations, seminars at professional
society meetings, electronic
communications, or otherwise) that is
provided by--
``(I) the American Society of
Addiction Medicine, the
American Academy of Addiction
Psychiatry, the American
Medical Association, the
American Osteopathic
Association, the American
Dental Association, the
American Association of Oral
and Maxillofacial Surgeons, the
American Psychiatric
Association, or any other
organization accredited by the
Accreditation Council for
Continuing Medical Education
(commonly known as the `ACCME')
or the Commission on Dental
Accreditation;
``(II) any organization
accredited by a State medical
society accreditor that is
recognized by the ACCME or the
Commission on Dental
Accreditation;
``(III) any organization
accredited by the American
Osteopathic Association to
provide continuing medical
education; or
``(IV) any organization
approved by the Assistant
Secretary for Mental Health and
Substance Abuse, the ACCME, or
the Commission on Dental
Accreditation.
``(v) The physician graduated in good
standing from an accredited school of
allopathic medicine, osteopathic
medicine, dental surgery, or dental
medicine in the United States during
the 5-year period immediately preceding
the date on which the physician first
registers or renews under this section
and has successfully completed a
comprehensive allopathic or osteopathic
medicine curriculum or accredited
medical residency or dental surgery or
dental medicine curriculum that
included not less than 8 hours of
training on--
``(I) treating and managing
patients with opioid and other
substance use disorders,
including the appropriate
clinical use of all drugs
approved by the Food and Drug
Administration for the
treatment of a substance use
disorder; or
``(II) the safe
pharmacological management of
dental pain and screening,
brief intervention, and
referral for appropriate
treatment of patients with or
at risk of developing opioid
and other substance use
disorders.
``(B) If the practitioner is not a physician
(as defined under section 1861(r) of the Social
Security Act), the practitioner meets one or
more of the following conditions:
``(i) The practitioner has completed
not fewer than 8 hours of training with
respect to the treatment and management
of patients with opioid or other
substance use disorders (through
classroom situations, seminars at
professional society meetings,
electronic communications, or
otherwise) provided by the American
Society of Addiction Medicine, the
American Academy of Addiction
Psychiatry, the American Medical
Association, the American Osteopathic
Association, the American Nurses
Credentialing Center, the American
Psychiatric Association, the American
Association of Nurse Practitioners, the
American Academy of Physician
Associates, or any other organization
approved or accredited by the Assistant
Secretary for Mental Health and
Substance Abuse or the Accreditation
Council for Continuing Medical
Education.
``(ii) The practitioner has graduated
in good standing from an accredited
physician assistant school or
accredited school of advanced practice
nursing in the United States during the
5-year period immediately preceding the
date on which the practitioner first
registers or renews under this section
and has successfully completed a
comprehensive physician assistant or
advanced practice nursing curriculum
that included not fewer than 8 hours of
training on treating and managing
patients with opioid and other
substance use disorders, including the
appropriate clinical use of all drugs
approved by the Food and Drug
Administration for the treatment of a
substance use disorder.
``(2) One-time training.--
``(A) In general.--The Attorney General shall
not require any qualified practitioner to
complete the training described in clause (iv)
or (v) of paragraph (1)(A) or clause (i) or
(ii) of paragraph (1)(B) more than once.
``(B) Notification.--Not later than 90 days
after the date of the enactment of the
Restoring Hope for Mental Health and Well-Being
Act of 2022, the Attorney General shall provide
to qualified practitioners a single written,
electronic notification of the training
described in clauses (iv) and (v) of paragraph
(1)(A) or clauses (i) and (ii) of paragraph
(1)(B).
``(3) Rule of construction.--Nothing in this
subsection shall be construed to preclude the use, by a
qualified practitioner, of training received pursuant
to this subsection to satisfy registration requirements
of a State or for some other lawful purpose.
``(4) Definitions.--In this section:
``(A) First applicable registration.--The
term `first applicable registration' means the
first registration or renewal of registration
by a qualified practitioner under this section
that occurs on or after the date that is 180
days after the date of enactment of the
Restoring Hope for Mental Health and Well-Being
Act of 2022.
``(B) Qualified practitioner.--In this
subsection, the term `qualified practitioner'
means a practitioner who--
``(i) is licensed under State law to
prescribe controlled substances; and
``(ii) is not solely a
veterinarian.''.
Page 150, after line 5, insert the following:
SEC. 312. REAUTHORIZATION OF MINORITY FELLOWSHIP PROGRAM.
Section 597(c) of the Public Health Service Act (42 U.S.C.
290ll(c)) is amended by striking ``$12,669,000 for each of
fiscal years 2018 through 2022'' and inserting ``$25,000,000
for each of fiscal years 2023 through 2027''.
At the end of title IV, add the following new subtitle:
Subtitle D--Media and Mental Health
SEC. 431. STUDY ON THE EFFECTS OF SMARTPHONE AND SOCIAL MEDIA USE ON
ADOLESCENTS.
(a) In General.--Not later than 1 year after the date of
enactment of this Act, the Secretary of Health and Human
Services shall conduct or support research on--
(1) smartphone and social media use by adolescents;
and
(2) the effects of such use on--
(A) emotional, behavioral, and physical
health and development; and
(B) any disparities in the mental health
outcomes of rural, minority, and other
underserved populations.
(b) Report.--Not later than 5 years after the date of
enactment of this Act, the Secretary of Health and Human
Services shall submit to the Congress, and make publicly
available, a report on the findings of research under this
section.
SEC. 432. RESEARCH ON THE HEALTH AND DEVELOPMENT EFFECTS OF MEDIA ON
INFANTS, CHILDREN, AND ADOLESCENTS.
Subpart 7 of part C of title IV of the Public Health Service
Act (42 U.S.C. 285g et seq.) is amended by adding at the end
the following:
``SEC. 452H. RESEARCH ON THE HEALTH AND DEVELOPMENT EFFECTS OF MEDIA ON
INFANTS, CHILDREN, AND ADOLESCENTS.
``(a) In General.--The Director of the National Institutes of
Health, in coordination with or acting through the Director of
the Institute, shall conduct and support research and related
activities concerning the health and developmental effects of
media on infants, children, and adolescents, which may include
the positive and negative effects of exposure to and use of
media, such as social media, applications, websites,
television, motion pictures, artificial intelligence, mobile
devices, computers, video games, virtual and augmented reality,
and other media formats as they become available. Such research
shall attempt to better understand the relationships between
media and technology use and individual differences and
characteristics of children and shall include longitudinally
designed studies to assess the impact of media on youth over
time. Such research shall include consideration of core areas
of child and adolescent health and development including the
following:
``(1) Cognitive.--The role and impact of media use
and exposure in the development of children and
adolescents within such cognitive areas as language
development, executive functioning, attention, creative
problem solving skills, visual and spatial skills,
literacy, critical thinking, and other learning
abilities, and the impact of early technology use on
developmental trajectories.
``(2) Physical.--The role and impact of media use and
exposure on children's and adolescent's physical
development and health behaviors, including diet,
exercise, sleeping and eating routines, and other areas
of physical development.
``(3) Socio-emotional.--The role and impact of media
use and exposure on children's and adolescents' social-
emotional competencies, including self-awareness, self-
regulation, social awareness, relationship skills,
empathy, distress tolerance, perception of social cues,
awareness of one's relationship with the media, and
decision-making, as well as outcomes such as violations
of privacy, perpetration of or exposure to violence,
bullying or other forms of aggression, depression,
anxiety, substance use, misuse or disorder, and
suicidal ideation/behavior and self-harm.
``(b) Developing Research Agenda.--The Director of the
National Institutes of Health, in consultation with the
Director of the Institute, other appropriate national research
institutes, academies, and centers, the Trans-NIH Pediatric
Research Consortium, and non-Federal experts as needed, shall
develop a research agenda on the health and developmental
effects of media on infants, children, and adolescents to
inform research activities under subsection (a). In developing
such research agenda, the Director may use whatever means
necessary (such as scientific workshops and literature reviews)
to assess current knowledge and research gaps in this area.
``(c) Research Program.--In coordination with the Institute
and other national research institutes and centers, and
utilizing the National Institutes of Health's process of
scientific peer review, the Director of the National Institutes
of Health shall fund an expanded research program on the health
and developmental effects of media on infants, children, and
adolescents.
``(d) Report to Congress.--Not later than 1 year after the
date of enactment of this Act, the Director of the National
Institutes of Health shall submit a report to Congress on the
progress made in gathering data and expanding research on the
health and developmental effects of media on infants, children,
and adolescents in accordance with this section. Such report
shall summarize the grants and research funded, by year, under
this section.''.
At the end of the bill, add the following new titles:
TITLE V--MEDICAID AND CHIP
SEC. 501. MEDICAID AND CHIP REQUIREMENTS FOR HEALTH SCREENINGS AND
REFERRALS FOR ELIGIBLE JUVENILES IN PUBLIC
INSTITUTIONS.
(a) Medicaid State Plan Requirement.--Section 1902 of the
Social Security Act (42 U.S.C. 1396a) is amended--
(1) in subsection (a)(84)--
(A) in subparagraph (A), by inserting ``,
subject to subparagraph (D),'' after ``but'';
(B) in subparagraph (B), by striking ``and''
at the end;
(C) in subparagraph (C), by adding ``and'' at
the end; and
(D) by adding at the end the following new
subparagraph:
``(D) beginning on the first day of the first
calendar quarter that begins two years after
the date of enactment of this subparagraph, in
the case of individuals who are eligible
juveniles described in subsection (nn)(2), are
within 30 days of the date on which such
eligible juvenile is scheduled to be released
from a public institution following
adjudication, the State shall have in place a
plan to ensure, and in accordance with such
plan, provide--
``(i) for, in the 30 days prior to
the release of such an eligible
juvenile from such public institution
(or not later than one week after
release from the public institution),
and in coordination with such
institution--
``(I) any screening or
diagnostic service which meets
reasonable standards of medical
and dental practice, as
determined by the State, or as
indicated as medically
necessary, in accordance with
paragraphs (1)(A) and (5) of
section 1905(r); and
``(II) a mental health or
other behavioral health
screening that is a screening
service described under section
1905(r)(1), or a diagnostic
service described under
paragraph (5) of such section,
if such screening or diagnostic
service was not otherwise
conducted pursuant to this
clause;
``(ii) for, not later than one week
after release from the public
institution, referrals for such
eligible juvenile to the appropriate
care and services available under the
State plan (or waiver of such plan) in
the geographic region of the home or
residence of such eligible juvenile,
based on such screenings; and
``(iii) for, following the release of
such eligible juvenile from such
institution, not less than 30 days of
targeted case management services
furnished by a provider in the
geographic region of the home or
residence of such eligible juvenile.'';
and
(2) in subsection (nn)(3), by striking ``(30)'' and
inserting ``(31)''.
(b) Authorization of Federal Financial Participation.--The
subdivision (A) of section 1905(a) of the Social Security Act
(42 U.S.C. 1396d(a)) following paragraph (31) of such section
is amended by inserting ``, or in the case of an eligible
juvenile described in section 1902(a)(84)(D) with respect to
the screenings, diagnostic services, referrals, and case
management required under such subparagraph (D)'' after
``(except as a patient in a medical institution''.
(c) CHIP Conforming Amendments.--
(1) Section 2103(c) of the Social Security Act (42
U.S.C. 1397cc(c)) is amended by adding at the end the
following new paragraph:
``(12) Required coverage of screenings, diagnostic
services, referrals, and case management for certain
inmates pre-release.--With respect to individuals
described in section 2110(b)(7), the State shall
provide screenings, diagnostic services, referrals, and
case management otherwise covered under the State child
health plan (or waiver of such plan) during the period
described in such section with respect to such
screenings, services, referrals, and case
management.''.
(2) Section 2110(b) of the Social Security Act (42
U.S.C. 1397jj(b)) is amended--
(A) in paragraph (2)(A), by inserting
``except as provided in paragraph (7),'' before
``a child who is an inmate of a public
institution''; and
(B) by adding at the end the following new
paragraph:
``(7) Exception to exclusion of children who are
inmates of a public institution.--A child shall not be
considered to be described in paragraph (2)(A) if such
child is an eligible juvenile (as described in section
1902(a)(84)(D)) with respect to the screenings,
diagnostic services, referrals, and case management
otherwise covered under the State child health plan (or
waiver of such plan) during the period with respect to
which such screenings, services, referrals, and case
management is respectively required under such
section.''.
SEC. 502. GUIDANCE ON REDUCING ADMINISTRATIVE BARRIERS TO PROVIDING
HEALTH CARE SERVICES IN SCHOOLS.
(a) In General.--Not later than 12 months after the date of
enactment of this Act, the Secretary of Health and Human
Services shall issue guidance to State Medicaid agencies,
elementary and secondary schools, and school-based health
centers on reducing administrative barriers to such schools and
centers furnishing medical assistance and obtaining payment for
such assistance under titles XIX and XXI of the Social Security
Act (42 U.S.C. 1396 et seq., 1397aa et seq.).
(b) Contents of Guidance.--The guidance issued pursuant to
subsection (a) shall--
(1) include revisions to the May 2003 Medicaid
School-Based Administrative Claiming Guide, the 1997
Medicaid and Schools Technical Assistance Guide, and
other relevant guidance in effect on the date of
enactment of this Act;
(2) provide information on payment under titles XIX
and XXI of the Social Security Act (42 U.S.C. 1396 et
seq., 1397aa et seq.) for the provision of medical
assistance, including such assistance provided in
accordance with an individualized education program or
under the policy described in the State Medicaid
Director letter on payment for services issued on
December 15, 2014 (#14-006);
(3) take into account reasons why small and rural
local education agencies may not provide medical
assistance and provide information on best practices to
encourage such agencies to provide such assistance; and
(4) include best practices and examples of methods
that State Medicaid agencies and local education
agencies have used to pay for, and increase the
availability of, medical assistance.
(c) Definitions.--In this Act:
(1) Individualized education program.--The term
``individualized education program'' has the meaning
given such term in section 602(14) of the Individuals
with Disabilities Education Act (20 U.S.C. 1401(14)).
(2) School-based health center.--The term ``school-
based health center'' has the meaning given such term
in section 2110(c)(9) of the Social Security Act (42
U.S.C. 1397jj(c)(9)), and includes an entity that
provides Medicaid-covered services in school-based
settings for which Federal financial participation is
permitted.
SEC. 503. GUIDANCE TO STATES ON SUPPORTING PEDIATRIC BEHAVIORAL HEALTH
SERVICES UNDER MEDICAID AND CHIP.
Not later than 18 months after the date of enactment of this
Act, the Secretary of Health and Human Services shall issue
guidance to States on how to expand the provision of, and
access to, behavioral health services, including mental health
services, for children covered under State plans (or waivers of
such plans) under title XIX of the Social Security Act (42
U.S.C. 1396 et seq.), or State child health plans (or waivers
of such plans) under title XXI of such Act (42 U.S.C. 1397aa et
seq.), including a description of best practices for--
(1) expanding access to such services;
(2) expanding access to such services in underserved
communities;
(3) flexibilities that States may offer for pediatric
hospitals and other pediatric behavioral health
providers to expand access to services; and
(4) recruitment and retention of providers of such
services.
SEC. 504. ENSURING CHILDREN RECEIVE TIMELY ACCESS TO CARE.
(a) Guidance to States on Flexibilities to Ensure Provider
Capacity to Provide Pediatric Behavioral Health, Including
Mental Health, Crisis Care.--Not later than 18 months after the
date of enactment of this Act, the Secretary of Health and
Human Services shall provide guidance to States on existing
flexibilities under State plans (or waivers of such plans)
under title XIX of the Social Security Act (42 U.S.C. 1396 et
seq.), or State child health plans under title XXI of such Act
(42 U.S.C. 1397aa et seq.), to support children experiencing a
behavioral health crisis or in need of intensive behavioral
health, including mental health, services.
(b) Ensuring Consistent Review and State Implementation of
Early and Periodic Screening, Diagnostic, and Treatment
Services.--Section 1905(r) of the Social Security Act (42
U.S.C. 1396d(r)) is amended by adding at the end the following:
``Not later than January 1, 2025, and every 5 years thereafter,
the Secretary shall review implementation of the requirements
of this subsection by States, including such requirements
relating to services provided by managed care organizations,
prepaid inpatient health plans, prepaid ambulatory health
plans, and primary care case managers, to identify and
disseminate best practices for ensuring comprehensive coverage
of services, to identify gaps and deficiencies in meeting
Federal requirements, and to provide guidance to States on
addressing identified gaps and disparities and meeting Federal
coverage requirements in order to ensure children have access
to health services.''.
SEC. 505. STRATEGIES TO INCREASE ACCESS TO TELEHEALTH UNDER MEDICAID
AND CHIP.
Not later than 1 year after the date of the enactment of this
Act, and in the event updates are available, once every five
years thereafter, the Secretary of Health and Human Services
shall update guidance issued by the Centers for Medicare &
Medicaid Services to States, the State Medicaid & CHIP
Telehealth Toolkit, or any successor guidance, to describe
strategies States may use to overcome existing barriers and
increase access to telehealth services under the Medicaid
program under title XIX of the Social Security Act (42 U.S.C.
1396 et seq.) and the Children's Health Insurance Program under
title XXI of such Act (42 U.S.C. 1397aa et seq.). Such updated
guidance shall include examples of and promising practices
regarding--
(1) telehealth delivery of covered services;
(2) recommended voluntary billing codes, modifiers,
and place-of-service designations for telehealth and
other virtual health care services;
(3) strategies States can use for the simplification
or alignment of provider credentialing and enrollment
protocols with respect to telehealth across States,
State Medicaid plans under title XIX, State child
health plans under title XXI, Medicaid managed care
organizations, prepaid inpatient health plans, prepaid
ambulatory health plans, and primary care case
managers, including during national public health
emergencies; and
(4) strategies States can use to integrate telehealth
and other virtual health care services into value-based
health care models.
SEC. 506. REMOVAL OF LIMITATIONS ON FEDERAL FINANCIAL PARTICIPATION FOR
INMATES WHO ARE ELIGIBLE JUVENILES PENDING
DISPOSITION OF CHARGES.
(a) Medicaid.--
(1) In general.--The subdivision (A) of section
1905(a) of the Social Security Act (42 U.S.C. 1396d(a))
following paragraph (31) of such section, as amended by
section 501(b), is further amended by inserting ``, or,
at the option of the State, for an individual who is an
eligible juvenile (as defined in section 1902(nn)(2)),
while such individual is an inmate of a public
institution (as defined in section 1902(nn)(3)) pending
disposition of charges'' after ``or in the case of an
eligible juvenile described in section 1902(a)(84)(D)
with respect to the screenings, diagnostic services,
referrals, and case management required under such
subparagraph (D)''.
(2) Conforming.--Section 1902(a)(84)(A) of the Social
Security Act (42 U.S.C. 1396a(a)(84)(A)) is amended by
inserting ``(or in the case of a State electing the
option described in the subdivision (A) following
paragraph (31) of section 1905(a), during such period
beginning after the disposition of charges with respect
to such individual)'' after ``is such an inmate''.
(b) CHIP.--Section 2110(b)(7) of the Social Security Act (42
U.S.C. 13977jj(b)(7)), as added by section 501(c)(2)(B), is
further amended by inserting ``or, at the option of the State,
for an individual who is a juvenile, while such individual is
an inmate of a public institution pending disposition of
charges'' after ``if such child is an eligible juvenile (as
described in section 1902(a)(84)(D)) with respect to
screenings, diagnostic services, referrals, and case management
otherwise covered under the State child health plan (or waiver
of such plan)''.
(c) Effective Date.--The amendments made by this section
shall take effect on the first day of the first calendar
quarter that begins after the date that is 18 months after the
date of enactment of this Act and shall apply to items and
services furnished for periods beginning on or after such date.
TITLE VI--MISCELLANEOUS PROVISIONS
SEC. 601. DETERMINATION OF BUDGETARY EFFECTS.
The budgetary effects of this Act, for the purpose of
complying with the Statutory Pay-As-You-Go Act of 2010, shall
be determined by reference to the latest statement titled
``Budgetary Effects of PAYGO Legislation'' for this Act,
submitted for printing in the Congressional Record by the
Chairman of the House Budget Committee, provided that such
statement has been submitted prior to the vote on passage.
SEC. 602. OVERSIGHT OF PHARMACY BENEFIT MANAGER SERVICES.
(a) PHSA.--Title XXVII of the Public Health Service Act (42
U.S.C. 300gg et seq.) is amended--
(1) in part D (42 U.S.C. 300gg-111 et seq.), by
adding at the end the following new section:
``SEC. 2799A-11. OVERSIGHT OF PHARMACY BENEFIT MANAGER SERVICES.
``(a) In General.--For plan years beginning on or after
January 1, 2024, a group health plan or health insurance issuer
offering group health insurance coverage or an entity or
subsidiary providing pharmacy benefits management services on
behalf of such a plan or issuer shall not enter into a contract
with a drug manufacturer, distributor, wholesaler,
subcontractor, rebate aggregator, or any associated third party
that limits the disclosure of information to plan sponsors in
such a manner that prevents the plan or issuer, or an entity or
subsidiary providing pharmacy benefits management services on
behalf of a plan or issuer, from making the reports described
in subsection (b).
``(b) Reports.--
``(1) In general.--For plan years beginning on or
after January 1, 2024, not less frequently than once
every 6 months, a health insurance issuer offering
group health insurance coverage or an entity providing
pharmacy benefits management services on behalf of a
group health plan or an issuer providing group health
insurance coverage shall submit to the plan sponsor (as
defined in section 3(16)(B) of the Employee Retirement
Income Security Act of 1974) of such group health plan
or health insurance coverage a report in accordance
with this subsection and make such report available to
the plan sponsor in a machine-readable format. Each
such report shall include, with respect to the
applicable group health plan or health insurance
coverage--
``(A) as applicable, information collected
from drug manufacturers by such issuer or
entity on the total amount of copayment
assistance dollars paid, or copayment cards
applied, that were funded by the drug
manufacturer with respect to the participants
and beneficiaries in such plan or coverage;
``(B) a list of each drug covered by such
plan, issuer, or entity providing pharmacy
benefit management services that was dispensed
during the reporting period, including, with
respect to each such drug during the reporting
period--
``(i) the brand name, chemical
entity, and National Drug Code;
``(ii) the number of participants and
beneficiaries for whom the drug was
filled during the plan year, the total
number of prescription fills for the
drug (including original prescriptions
and refills), and the total number of
dosage units of the drug dispensed
across the plan year, including whether
the dispensing channel was by retail,
mail order, or specialty pharmacy;
``(iii) the wholesale acquisition
cost, listed as cost per days supply
and cost per pill, or in the case of a
drug in another form, per dose;
``(iv) the total out-of-pocket
spending by participants and
beneficiaries on such drug, including
participant and beneficiary spending
through copayments, coinsurance, and
deductibles; and
``(v) for any drug for which gross
spending of the group health plan or
health insurance coverage exceeded
$10,000 during the reporting period--
``(I) a list of all other
drugs in the same therapeutic
category or class, including
brand name drugs and biological
products and generic drugs or
biosimilar biological products
that are in the same
therapeutic category or class
as such drug; and
``(II) the rationale for
preferred formulary placement
of such drug in that
therapeutic category or class,
if applicable;
``(C) a list of each therapeutic category or
class of drugs that were dispensed under the
health plan or health insurance coverage during
the reporting period, and, with respect to each
such therapeutic category or class of drugs,
during the reporting period--
``(i) total gross spending by the
plan, before manufacturer rebates,
fees, or other manufacturer
remuneration;
``(ii) the number of participants and
beneficiaries who filled a prescription
for a drug in that category or class;
``(iii) if applicable to that
category or class, a description of the
formulary tiers and utilization
mechanisms (such as prior authorization
or step therapy) employed for drugs in
that category or class;
``(iv) the total out-of-pocket
spending by participants and
beneficiaries, including participant
and beneficiary spending through
copayments, coinsurance, and
deductibles; and
``(v) for each therapeutic category
or class under which 3 or more drugs
are included on the formulary of such
plan or coverage--
``(I) the amount received, or
expected to be received, from
drug manufacturers in rebates,
fees, alternative discounts, or
other remuneration--
``(aa) that has been
paid, or is to be paid,
by drug manufacturers
for claims incurred
during the reporting
period; or
``(bb) that is
related to utilization
of drugs, in such
therapeutic category or
class;
``(II) the total net
spending, after deducting
rebates, price concessions,
alternative discounts or other
remuneration from drug
manufacturers, by the health
plan or health insurance
coverage on that category or
class of drugs; and
``(III) the net price per
course of treatment or single
fill, such as a 30-day supply
or 90-day supply, incurred by
the health plan or health
insurance coverage and its
participants and beneficiaries,
after manufacturer rebates,
fees, and other remuneration
for drugs dispensed within such
therapeutic category or class
during the reporting period;
``(D) total gross spending on prescription
drugs by the plan or coverage during the
reporting period, before rebates and other
manufacturer fees or remuneration;
``(E) total amount received, or expected to
be received, by the health plan or health
insurance coverage in drug manufacturer
rebates, fees, alternative discounts, and all
other remuneration received from the
manufacturer or any third party, other than the
plan sponsor, related to utilization of drug or
drug spending under that health plan or health
insurance coverage during the reporting period;
``(F) the total net spending on prescription
drugs by the health plan or health insurance
coverage during the reporting period; and
``(G) amounts paid directly or indirectly in
rebates, fees, or any other type of
remuneration to brokers, consultants, advisors,
or any other individual or firm who referred
the group health plan's or health insurance
issuer's business to the pharmacy benefit
manager.
``(2) Privacy requirements.--Health insurance issuers
offering group health insurance coverage and entities
providing pharmacy benefits management services on
behalf of a group health plan shall provide information
under paragraph (1) in a manner consistent with the
privacy, security, and breach notification regulations
promulgated under section 264(c) of the Health
Insurance Portability and Accountability Act of 1996,
and shall restrict the use and disclosure of such
information according to such privacy regulations.
``(3) Disclosure and redisclosure.--
``(A) Limitation to business associates.--A
group health plan receiving a report under
paragraph (1) may disclose such information
only to business associates of such plan as
defined in section 160.103 of title 45, Code of
Federal Regulations (or successor regulations).
``(B) Clarification regarding public
disclosure of information.--Nothing in this
section prevents a health insurance issuer
offering group health insurance coverage or an
entity providing pharmacy benefits management
services on behalf of a group health plan from
placing reasonable restrictions on the public
disclosure of the information contained in a
report described in paragraph (1), except that
such issuer or entity may not restrict
disclosure of such report to the Department of
Health and Human Services, the Department of
Labor, the Department of the Treasury, or
applicable State agencies.
``(C) Limited form of report.--The Secretary
shall define through rulemaking a limited form
of the report under paragraph (1) required of
plan sponsors who are drug manufacturers, drug
wholesalers, or other direct participants in
the drug supply chain, in order to prevent
anti-competitive behavior.
``(4) Report to gao.--A health insurance issuer
offering group health insurance coverage or an entity
providing pharmacy benefits management services on
behalf of a group health plan shall submit to the
Comptroller General of the United States each of the
first 4 reports submitted to a plan sponsor under
paragraph (1) with respect to such coverage or plan,
and other such reports as requested, in accordance with
the privacy requirements under paragraph (2), the
disclosure and redisclosure standards under paragraph
(3), the standards specified pursuant to paragraph (5),
and such other information that the Comptroller General
determines necessary to carry out the study under
section 602(d) of the Restoring Hope for Mental Health
and Well-Being Act of 2022.
``(5) Standard format.--Not later than June 1, 2023,
the Secretary shall specify through rulemaking
standards for health insurance issuers and entities
required to submit reports under paragraph (4) to
submit such reports in a standard format.
``(c) Enforcement.--
``(1) In general.--The Secretary, in consultation
with the Secretary of Labor and the Secretary of the
Treasury, shall enforce this section.
``(2) Failure to provide timely information.--A
health insurance issuer or an entity providing pharmacy
benefit management services that violates subsection
(a) or fails to provide information required under
subsection (b), or a drug manufacturer that fails to
provide information under subsection (b)(1)(A) in a
timely manner, shall be subject to a civil monetary
penalty in the amount of $10,000 for each day during
which such violation continues or such information is
not disclosed or reported.
``(3) False information.--A health insurance issuer,
entity providing pharmacy benefit management services,
or drug manufacturer that knowingly provides false
information under this section shall be subject to a
civil money penalty in an amount not to exceed $100,000
for each item of false information. Such civil money
penalty shall be in addition to other penalties as may
be prescribed by law.
``(4) Procedure.--The provisions of section 1128A of
the Social Security Act, other than subsection (a) and
(b) and the first sentence of subsection (c)(1) of such
section shall apply to civil monetary penalties under
this subsection in the same manner as such provisions
apply to a penalty or proceeding under section 1128A of
the Social Security Act.
``(5) Waivers.--The Secretary may waive penalties
under paragraph (2), or extend the period of time for
compliance with a requirement of this section, for an
entity in violation of this section that has made a
good-faith effort to comply with this section.
``(d) Rule of Construction.--Nothing in this section shall be
construed to permit a health insurance issuer, group health
plan, or other entity to restrict disclosure to, or otherwise
limit the access of, the Department of Health and Human
Services to a report described in subsection (b)(1) or
information related to compliance with subsection (a) by such
issuer, plan, or entity.
``(e) Definition.--In this section, the term `wholesale
acquisition cost' has the meaning given such term in section
1847A(c)(6)(B) of the Social Security Act.''; and
(2) in section 2723 (42 U.S.C. 300gg-22)--
(A) in subsection (a)--
(i) in paragraph (1), by inserting
``(other than subsections (a) and (b)
of section 2799A-11)'' after ``part
D''; and
(ii) in paragraph (2), by inserting
``(other than subsections (a) and (b)
of section 2799A-11)'' after ``part
D''; and
(B) in subsection (b)--
(i) in paragraph (1), by inserting
``(other than subsections (a) and (b)
of section 2799A-11)'' after ``part
D'';
(ii) in paragraph (2)(A), by
inserting ``(other than subsections (a)
and (b) of section 2799A-11)'' after
``part D''; and
(iii) in paragraph (2)(C)(ii), by
inserting ``(other than subsections (a)
and (b) of section 2799A-11)'' after
``part D''.
(b) ERISA.--
(1) In general.--Subtitle B of title I of the
Employee Retirement Income Security Act of 1974 (29
U.S.C. 1021 et seq.) is amended--
(A) in subpart B of part 7 (29 U.S.C. 1185 et
seq.), by adding at the end the following:
``SEC. 726. OVERSIGHT OF PHARMACY BENEFIT MANAGER SERVICES.
``(a) In General.--For plan years beginning on or after
January 1, 2024, a group health plan (or health insurance
issuer offering group health insurance coverage in connection
with such a plan) or an entity or subsidiary providing pharmacy
benefits management services on behalf of such a plan or issuer
shall not enter into a contract with a drug manufacturer,
distributor, wholesaler, subcontractor, rebate aggregator, or
any associated third party that limits the disclosure of
information to plan sponsors in such a manner that prevents the
plan or issuer, or an entity or subsidiary providing pharmacy
benefits management services on behalf of a plan or issuer,
from making the reports described in subsection (b).
``(b) Reports.--
``(1) In general.--For plan years beginning on or
after January 1, 2024, not less frequently than once
every 6 months, a health insurance issuer offering
group health insurance coverage or an entity providing
pharmacy benefits management services on behalf of a
group health plan or an issuer providing group health
insurance coverage shall submit to the plan sponsor (as
defined in section 3(16)(B)) of such group health plan
or group health insurance coverage a report in
accordance with this subsection and make such report
available to the plan sponsor in a machine-readable
format. Each such report shall include, with respect to
the applicable group health plan or health insurance
coverage--
``(A) as applicable, information collected
from drug manufacturers by such issuer or
entity on the total amount of copayment
assistance dollars paid, or copayment cards
applied, that were funded by the drug
manufacturer with respect to the participants
and beneficiaries in such plan or coverage;
``(B) a list of each drug covered by such
plan, issuer, or entity providing pharmacy
benefit management services that was dispensed
during the reporting period, including, with
respect to each such drug during the reporting
period--
``(i) the brand name, chemical
entity, and National Drug Code;
``(ii) the number of participants and
beneficiaries for whom the drug was
filled during the plan year, the total
number of prescription fills for the
drug (including original prescriptions
and refills), and the total number of
dosage units of the drug dispensed
across the plan year, including whether
the dispensing channel was by retail,
mail order, or specialty pharmacy;
``(iii) the wholesale acquisition
cost, listed as cost per days supply
and cost per pill, or in the case of a
drug in another form, per dose;
``(iv) the total out-of-pocket
spending by participants and
beneficiaries on such drug, including
participant and beneficiary spending
through copayments, coinsurance, and
deductibles; and
``(v) for any drug for which gross
spending of the group health plan or
health insurance coverage exceeded
$10,000 during the reporting period--
``(I) a list of all other
drugs in the same therapeutic
category or class, including
brand name drugs and biological
products and generic drugs or
biosimilar biological products
that are in the same
therapeutic category or class
as such drug; and
``(II) the rationale for
preferred formulary placement
of such drug in that
therapeutic category or class,
if applicable;
``(C) a list of each therapeutic category or
class of drugs that were dispensed under the
health plan or health insurance coverage during
the reporting period, and, with respect to each
such therapeutic category or class of drugs,
during the reporting period--
``(i) total gross spending by the
plan, before manufacturer rebates,
fees, or other manufacturer
remuneration;
``(ii) the number of participants and
beneficiaries who filled a prescription
for a drug in that category or class;
``(iii) if applicable to that
category or class, a description of the
formulary tiers and utilization
mechanisms (such as prior authorization
or step therapy) employed for drugs in
that category or class;
``(iv) the total out-of-pocket
spending by participants and
beneficiaries, including participant
and beneficiary spending through
copayments, coinsurance, and
deductibles; and
``(v) for each therapeutic category
or class under which 3 or more drugs
are included on the formulary of such
plan or coverage--
``(I) the amount received, or
expected to be received, from
drug manufacturers in rebates,
fees, alternative discounts, or
other remuneration--
``(aa) that has been
paid, or is to be paid,
by drug manufacturers
for claims incurred
during the reporting
period; or
``(bb) that is
related to utilization
of drugs, in such
therapeutic category or
class;
``(II) the total net
spending, after deducting
rebates, price concessions,
alternative discounts or other
remuneration from drug
manufacturers, by the health
plan or health insurance
coverage on that category or
class of drugs; and
``(III) the net price per
course of treatment or single
fill, such as a 30-day supply
or 90-day supply, incurred by
the health plan or health
insurance coverage and its
participants and beneficiaries,
after manufacturer rebates,
fees, and other remuneration
for drugs dispensed within such
therapeutic category or class
during the reporting period;
``(D) total gross spending on prescription
drugs by the plan or coverage during the
reporting period, before rebates and other
manufacturer fees or remuneration;
``(E) total amount received, or expected to
be received, by the health plan or health
insurance coverage in drug manufacturer
rebates, fees, alternative discounts, and all
other remuneration received from the
manufacturer or any third party, other than the
plan sponsor, related to utilization of drug or
drug spending under that health plan or health
insurance coverage during the reporting period;
``(F) the total net spending on prescription
drugs by the health plan or health insurance
coverage during the reporting period; and
``(G) amounts paid directly or indirectly in
rebates, fees, or any other type of
remuneration to brokers, consultants, advisors,
or any other individual or firm who referred
the group health plan's or health insurance
issuer's business to the pharmacy benefit
manager.
``(2) Privacy requirements.--Health insurance issuers
offering group health insurance coverage and entities
providing pharmacy benefits management services on
behalf of a group health plan shall provide information
under paragraph (1) in a manner consistent with the
privacy, security, and breach notification regulations
promulgated under section 264(c) of the Health
Insurance Portability and Accountability Act of 1996,
and shall restrict the use and disclosure of such
information according to such privacy regulations.
``(3) Disclosure and redisclosure.--
``(A) Limitation to business associates.--A
group health plan receiving a report under
paragraph (1) may disclose such information
only to business associates of such plan as
defined in section 160.103 of title 45, Code of
Federal Regulations (or successor regulations).
``(B) Clarification regarding public
disclosure of information.--Nothing in this
section prevents a health insurance issuer
offering group health insurance coverage or an
entity providing pharmacy benefits management
services on behalf of a group health plan from
placing reasonable restrictions on the public
disclosure of the information contained in a
report described in paragraph (1), except that
such issuer or entity may not restrict
disclosure of such report to the Department of
Health and Human Services, the Department of
Labor, the Department of the Treasury, or
applicable State agencies.
``(C) Limited form of report.--The Secretary
shall define through rulemaking a limited form
of the report under paragraph (1) required of
plan sponsors who are drug manufacturers, drug
wholesalers, or other direct participants in
the drug supply chain, in order to prevent
anti-competitive behavior.
``(4) Report to gao.--A health insurance issuer
offering group health insurance coverage or an entity
providing pharmacy benefits management services on
behalf of a group health plan shall submit to the
Comptroller General of the United States each of the
first 4 reports submitted to a plan sponsor under
paragraph (1) with respect to such coverage or plan,
and other such reports as requested, in accordance with
the privacy requirements under paragraph (2), the
disclosure and redisclosure standards under paragraph
(3), the standards specified pursuant to paragraph (5),
and such other information that the Comptroller General
determines necessary to carry out the study under
section 602(d) of the Restoring Hope for Mental Health
and Well-Being Act of 2022.
``(5) Standard format.--Not later than June 1, 2023,
the Secretary shall specify through rulemaking
standards for health insurance issuers and entities
required to submit reports under paragraph (4) to
submit such reports in a standard format.
``(c) Enforcement.--
``(1) In general.--The Secretary, in consultation
with the Secretary of Health and Human Services and the
Secretary of the Treasury, shall enforce this section.
``(2) Failure to provide timely information.--A
health insurance issuer or an entity providing pharmacy
benefit management services that violates subsection
(a) or fails to provide information required under
subsection (b), or a drug manufacturer that fails to
provide information under subsection (b)(1)(A) in a
timely manner, shall be subject to a civil monetary
penalty in the amount of $10,000 for each day during
which such violation continues or such information is
not disclosed or reported.
``(3) False information.--A health insurance issuer,
entity providing pharmacy benefit management services,
or drug manufacturer that knowingly provides false
information under this section shall be subject to a
civil money penalty in an amount not to exceed $100,000
for each item of false information. Such civil money
penalty shall be in addition to other penalties as may
be prescribed by law.
``(4) Procedure.--The provisions of section 1128A of
the Social Security Act, other than subsection (a) and
(b) and the first sentence of subsection (c)(1) of such
section shall apply to civil monetary penalties under
this subsection in the same manner as such provisions
apply to a penalty or proceeding under section 1128A of
the Social Security Act.
``(5) Waivers.--The Secretary may waive penalties
under paragraph (2), or extend the period of time for
compliance with a requirement of this section, for an
entity in violation of this section that has made a
good-faith effort to comply with this section.
``(d) Rule of Construction.--Nothing in this section shall be
construed to permit a health insurance issuer, group health
plan, or other entity to restrict disclosure to, or otherwise
limit the access of, the Department of Labor to a report
described in subsection (b)(1) or information related to
compliance with subsection (a) by such issuer, plan, or entity.
``(e) Definition.--In this section, the term `wholesale
acquisition cost' has the meaning given such term in section
1847A(c)(6)(B) of the Social Security Act.''; and
(B) in section 502(b)(3) (29 U.S.C.
1132(b)(3)), by inserting ``(other than section
726)'' after ``part 7''.
(2) Clerical amendment.--The table of contents in
section 1 of the Employee Retirement Income Security
Act of 1974 (29 U.S.C. 1001 et seq.) is amended by
inserting after the item relating to section 725 the
following new item:
``Sec. 726. Oversight of pharmacy benefit manager services.''.
(c) IRC.--
(1) In general.--Subchapter B of chapter 100 of the
Internal Revenue Code of 1986 is amended by adding at
the end the following:
``SEC. 9826. OVERSIGHT OF PHARMACY BENEFIT MANAGER SERVICES.
``(a) In General.--For plan years beginning on or after
January 1, 2024, a group health plan or an entity or subsidiary
providing pharmacy benefits management services on behalf of
such a plan shall not enter into a contract with a drug
manufacturer, distributor, wholesaler, subcontractor, rebate
aggregator, or any associated third party that limits the
disclosure of information to plan sponsors in such a manner
that prevents the plan, or an entity or subsidiary providing
pharmacy benefits management services on behalf of a plan, from
making the reports described in subsection (b).
``(b) Reports.--
``(1) In general.--For plan years beginning on or
after January 1, 2024, not less frequently than once
every 6 months, an entity providing pharmacy benefits
management services on behalf of a group health plan
shall submit to the plan sponsor (as defined in section
3(16)(B) of the Employee Retirement Income Security Act
of 1974) of such group health plan a report in
accordance with this subsection and make such report
available to the plan sponsor in a machine-readable
format. Each such report shall include, with respect to
the applicable group health plan--
``(A) as applicable, information collected
from drug manufacturers by such entity on the
total amount of copayment assistance dollars
paid, or copayment cards applied, that were
funded by the drug manufacturer with respect to
the participants and beneficiaries in such
plan;
``(B) a list of each drug covered by such
plan or entity providing pharmacy benefit
management services that was dispensed during
the reporting period, including, with respect
to each such drug during the reporting period--
``(i) the brand name, chemical
entity, and National Drug Code;
``(ii) the number of participants and
beneficiaries for whom the drug was
filled during the plan year, the total
number of prescription fills for the
drug (including original prescriptions
and refills), and the total number of
dosage units of the drug dispensed
across the plan year, including whether
the dispensing channel was by retail,
mail order, or specialty pharmacy;
``(iii) the wholesale acquisition
cost, listed as cost per days supply
and cost per pill, or in the case of a
drug in another form, per dose;
``(iv) the total out-of-pocket
spending by participants and
beneficiaries on such drug, including
participant and beneficiary spending
through copayments, coinsurance, and
deductibles; and
``(v) for any drug for which gross
spending of the group health plan
exceeded $10,000 during the reporting
period--
``(I) a list of all other
drugs in the same therapeutic
category or class, including
brand name drugs and biological
products and generic drugs or
biosimilar biological products
that are in the same
therapeutic category or class
as such drug; and
``(II) the rationale for
preferred formulary placement
of such drug in that
therapeutic category or class,
if applicable;
``(C) a list of each therapeutic category or
class of drugs that were dispensed under the
health plan during the reporting period, and,
with respect to each such therapeutic category
or class of drugs, during the reporting
period--
``(i) total gross spending by the
plan, before manufacturer rebates,
fees, or other manufacturer
remuneration;
``(ii) the number of participants and
beneficiaries who filled a prescription
for a drug in that category or class;
``(iii) if applicable to that
category or class, a description of the
formulary tiers and utilization
mechanisms (such as prior authorization
or step therapy) employed for drugs in
that category or class;
``(iv) the total out-of-pocket
spending by participants and
beneficiaries, including participant
and beneficiary spending through
copayments, coinsurance, and
deductibles; and
``(v) for each therapeutic category
or class under which 3 or more drugs
are included on the formulary of such
plan--
``(I) the amount received, or
expected to be received, from
drug manufacturers in rebates,
fees, alternative discounts, or
other remuneration--
``(aa) that has been
paid, or is to be paid,
by drug manufacturers
for claims incurred
during the reporting
period; or
``(bb) that is
related to utilization
of drugs, in such
therapeutic category or
class;
``(II) the total net
spending, after deducting
rebates, price concessions,
alternative discounts or other
remuneration from drug
manufacturers, by the health
plan on that category or class
of drugs; and
``(III) the net price per
course of treatment or single
fill, such as a 30-day supply
or 90-day supply, incurred by
the health plan and its
participants and beneficiaries,
after manufacturer rebates,
fees, and other remuneration
for drugs dispensed within such
therapeutic category or class
during the reporting period;
``(D) total gross spending on prescription
drugs by the plan during the reporting period,
before rebates and other manufacturer fees or
remuneration;
``(E) total amount received, or expected to
be received, by the health plan in drug
manufacturer rebates, fees, alternative
discounts, and all other remuneration received
from the manufacturer or any third party, other
than the plan sponsor, related to utilization
of drug or drug spending under that health plan
during the reporting period;
``(F) the total net spending on prescription
drugs by the health plan during the reporting
period; and
``(G) amounts paid directly or indirectly in
rebates, fees, or any other type of
remuneration to brokers, consultants, advisors,
or any other individual or firm who referred
the group health plan's business to the
pharmacy benefit manager.
``(2) Privacy requirements.--Entities providing
pharmacy benefits management services on behalf of a
group health plan shall provide information under
paragraph (1) in a manner consistent with the privacy,
security, and breach notification regulations
promulgated under section 264(c) of the Health
Insurance Portability and Accountability Act of 1996,
and shall restrict the use and disclosure of such
information according to such privacy regulations.
``(3) Disclosure and redisclosure.--
``(A) Limitation to business associates.--A
group health plan receiving a report under
paragraph (1) may disclose such information
only to business associates of such plan as
defined in section 160.103 of title 45, Code of
Federal Regulations (or successor regulations).
``(B) Clarification regarding public
disclosure of information.--Nothing in this
section prevents an entity providing pharmacy
benefits management services on behalf of a
group health plan from placing reasonable
restrictions on the public disclosure of the
information contained in a report described in
paragraph (1), except that such entity may not
restrict disclosure of such report to the
Department of Health and Human Services, the
Department of Labor, the Department of the
Treasury, or applicable State agencies.
``(C) Limited form of report.--The Secretary
shall define through rulemaking a limited form
of the report under paragraph (1) required of
plan sponsors who are drug manufacturers, drug
wholesalers, or other direct participants in
the drug supply chain, in order to prevent
anti-competitive behavior.
``(4) Report to gao.--An entity providing pharmacy
benefits management services on behalf of a group
health plan shall submit to the Comptroller General of
the United States each of the first 4 reports submitted
to a plan sponsor under paragraph (1) with respect to
such plan, and other such reports as requested, in
accordance with the privacy requirements under
paragraph (2), the disclosure and redisclosure
standards under paragraph (3), the standards specified
pursuant to paragraph (5), and such other information
that the Comptroller General determines necessary to
carry out the study under section 602(d) of the
Restoring Hope for Mental Health and Well-Being Act of
2022.
``(5) Standard format.--Not later than June 1, 2023,
the Secretary shall specify through rulemaking
standards for entities required to submit reports under
paragraph (4) to submit such reports in a standard
format.
``(c) Enforcement.--
``(1) In general.--The Secretary, in consultation
with the Secretary of Labor and the Secretary of Health
and Human Services, shall enforce this section.
``(2) Failure to provide timely information.--An
entity providing pharmacy benefit management services
that violates subsection (a) or fails to provide
information required under subsection (b), or a drug
manufacturer that fails to provide information under
subsection (b)(1)(A) in a timely manner, shall be
subject to a civil monetary penalty in the amount of
$10,000 for each day during which such violation
continues or such information is not disclosed or
reported.
``(3) False information.--An entity providing
pharmacy benefit management services, or drug
manufacturer that knowingly provides false information
under this section shall be subject to a civil money
penalty in an amount not to exceed $100,000 for each
item of false information. Such civil money penalty
shall be in addition to other penalties as may be
prescribed by law.
``(4) Procedure.--The provisions of section 1128A of
the Social Security Act, other than subsection (a) and
(b) and the first sentence of subsection (c)(1) of such
section shall apply to civil monetary penalties under
this subsection in the same manner as such provisions
apply to a penalty or proceeding under section 1128A of
the Social Security Act.
``(5) Waivers.--The Secretary may waive penalties
under paragraph (2), or extend the period of time for
compliance with a requirement of this section, for an
entity in violation of this section that has made a
good-faith effort to comply with this section.
``(d) Rule of Construction.--Nothing in this section shall be
construed to permit a group health plan or other entity to
restrict disclosure to, or otherwise limit the access of, the
Department of the Treasury to a report described in subsection
(b)(1) or information related to compliance with subsection (a)
by such plan or entity.
``(e) Definition.--In this section, the term `wholesale
acquisition cost' has the meaning given such term in section
1847A(c)(6)(B) of the Social Security Act.''.
(2) Clerical amendment.--The table of sections for
subchapter B of chapter 100 of the Internal Revenue
Code of 1986 is amended by adding at the end the
following new item:
``Sec. 9826. Oversight of pharmacy benefit manager services.''.
(d) GAO Study.--
(1) In general.--Not later than 3 years after the
date of enactment of this Act, the Comptroller General
of the United States shall submit to Congress a report
on--
(A) pharmacy networks of group health plans,
health insurance issuers, and entities
providing pharmacy benefit management services
under such group health plan or group or
individual health insurance coverage, including
networks that have pharmacies that are under
common ownership (in whole or part) with group
health plans, health insurance issuers, or
entities providing pharmacy benefit management
services or pharmacy benefit administrative
services under group health plan or group or
individual health insurance coverage;
(B) as it relates to pharmacy networks that
include pharmacies under common ownership
described in subparagraph (A)--
(i) whether such networks are
designed to encourage enrollees of a
plan or coverage to use such pharmacies
over other network pharmacies for
specific services or drugs, and if so,
the reasons the networks give for
encouraging use of such pharmacies; and
(ii) whether such pharmacies are used
by enrollees disproportionately more in
the aggregate or for specific services
or drugs compared to other network
pharmacies;
(C) whether group health plans and health
insurance issuers offering group or individual
health insurance coverage have options to elect
different network pricing arrangements in the
marketplace with entities that provide pharmacy
benefit management services, the prevalence of
electing such different network pricing
arrangements;
(D) pharmacy network design parameters that
encourage enrollees in the plan or coverage to
fill prescriptions at mail order, specialty, or
retail pharmacies that are wholly or partially-
owned by that issuer or entity; and
(E) the degree to which mail order,
specialty, or retail pharmacies that dispense
prescription drugs to an enrollee in a group
health plan or health insurance coverage that
are under common ownership (in whole or part)
with group health plans, health insurance
issuers, or entities providing pharmacy benefit
management services or pharmacy benefit
administrative services under group health plan
or group or individual health insurance
coverage receive reimbursement that is greater
than the median price charged to the group
health plan or health insurance issuer when the
same drug is dispensed to enrollees in the plan
or coverage by other pharmacies included in the
pharmacy network of that plan, issuer, or
entity that are not wholly or partially owned
by the health insurance issuer or entity
providing pharmacy benefit management services.
(2) Requirement.--The Comptroller General of the
United States shall ensure that the report under
paragraph (1) does not contain information that would
allow a reader to identify a specific plan or entity
providing pharmacy benefits management services or
otherwise contain commercial or financial information
that is privileged or confidential.
(3) Definitions.--In this subsection, the terms
``group health plan'', ``health insurance coverage'',
and ``health insurance issuer'' have the meanings given
such terms in section 2791 of the Public Health Service
Act (42 U.S.C. 300gg-91).
SEC. 603. MEDICARE IMPROVEMENT FUND.
Section 1898(b)(1) of the Social Security Act (42 U.S.C.
1395iii(b)(1)) is amended by striking ``$5,000,000'' and
inserting ``$1,029,000,000''.
SEC. 604. LIMITATIONS ON AUTHORITY.
In carrying out any program of the Substance Abuse and Mental
Health Services Administration whose statutory authorization is
enacted or amended by this Act, the Secretary of Health and
Human Services shall not allocate funding, or require award
recipients to prioritize, dedicate, or allocate funding,
without consideration of the incidence, prevalence, or
determinants of mental health or substance use issues, unless
such allocation or requirement is consistent with statute,
regulation, or other Federal law.
PART E--TEXT OF AMENDMENTS TO H.R. 7666 MADE IN ORDER
1. An Amendment To Be Offered by Representative Bera of California or
His Designee, Debatable for 10 Minutes
After section 331, insert the following new subtitle:
Subtitle E--Improving Emergency Department Mental Health Access,
Services, and Responders
SEC. 341. HELPING EMERGENCY RESPONDERS OVERCOME.
(a) Data System to Capture National Public Safety Officer
Suicide Incidence.--The Public Health Service Act is amended by
inserting before section 318 of such Act (42 U.S.C. 247c) the
following:
``SEC. 317V. DATA SYSTEM TO CAPTURE NATIONAL PUBLIC SAFETY OFFICER
SUICIDE INCIDENCE.
``(a) In General.--The Secretary, in coordination with the
Director of the Centers for Disease Control and Prevention and
other agencies as the Secretary determines appropriate, may--
``(1) develop and maintain a data system, to be known
as the Public Safety Officer Suicide Reporting System,
for the purposes of--
``(A) collecting data on the suicide
incidence among public safety officers; and
``(B) facilitating the study of successful
interventions to reduce suicide among public
safety officers; and
``(2) integrate such system into the National Violent
Death Reporting System, so long as the Secretary
determines such integration to be consistent with the
purposes described in paragraph (1).
``(b) Data Collection.--In collecting data for the Public
Safety Officer Suicide Reporting System, the Secretary shall,
at a minimum, collect the following information:
``(1) The total number of suicides in the United
States among all public safety officers in a given
calendar year.
``(2) Suicide rates for public safety officers in a
given calendar year, disaggregated by--
``(A) age and gender of the public safety
officer;
``(B) State;
``(C) occupation; including both the
individual's role in their public safety agency
and their primary occupation in the case of
volunteer public safety officers;
``(D) where available, the status of the
public safety officer as volunteer, paid-on-
call, or career; and
``(E) status of the public safety officer as
active or retired.
``(c) Consultation During Development.--In developing the
Public Safety Officer Suicide Reporting System, the Secretary
shall consult with non-Federal experts to determine the best
means to collect data regarding suicide incidence in a safe,
sensitive, anonymous, and effective manner. Such non-Federal
experts shall include, as appropriate, the following:
``(1) Public health experts with experience in
developing and maintaining suicide registries.
``(2) Organizations that track suicide among public
safety officers.
``(3) Mental health experts with experience in
studying suicide and other profession-related traumatic
stress.
``(4) Clinicians with experience in diagnosing and
treating mental health issues.
``(5) Active and retired volunteer, paid-on-call, and
career public safety officers.
``(6) Relevant national police, and fire and
emergency medical services, organizations.
``(d) Data Privacy and Security.--In developing and
maintaining the Public Safety Officer Suicide Reporting System,
the Secretary shall ensure that all applicable Federal privacy
and security protections are followed to ensure that--
``(1) the confidentiality and anonymity of suicide
victims and their families are protected, including so
as to ensure that data cannot be used to deny benefits;
and
``(2) data is sufficiently secure to prevent
unauthorized access.
``(e) Reporting.--
``(1) Annual report.--Not later than 2 years after
the date of enactment of the Restoring Hope for Mental
Health and Well-Being Act of 2022, and biannually
thereafter, the Secretary shall submit a report to the
Congress on the suicide incidence among public safety
officers. Each such report shall--
``(A) include the number and rate of such
suicide incidence, disaggregated by age,
gender, and State of employment;
``(B) identify characteristics and
contributing circumstances for suicide among
public safety officers;
``(C) disaggregate rates of suicide by--
``(i) occupation;
``(ii) status as volunteer, paid-on-
call, or career; and
``(iii) status as active or retired;
``(D) include recommendations for further
study regarding the suicide incidence among
public safety officers;
``(E) specify in detail, if found, any
obstacles in collecting suicide rates for
volunteers and include recommended improvements
to overcome such obstacles;
``(F) identify options for interventions to
reduce suicide among public safety officers;
and
``(G) describe procedures to ensure the
confidentiality and anonymity of suicide
victims and their families, as described in
subsection (d)(1).
``(2) Public availability.--Upon the submission of
each report to the Congress under paragraph (1), the
Secretary shall make the full report publicly available
on the website of the Centers for Disease Control and
Prevention.
``(f) Definition.--In this section, the term `public safety
officer' means--
``(1) a public safety officer as defined in section
1204 of the Omnibus Crime Control and Safe Streets Act
of 1968; or
``(2) a public safety telecommunicator as described
in detailed occupation 43-5031 in the Standard
Occupational Classification Manual of the Office of
Management and Budget (2018).
``(g) Prohibited Use of Information.--Notwithstanding any
other provision of law, if an individual is identified as
deceased based on information contained in the Public Safety
Officer Suicide Reporting System, such information may not be
used to deny or rescind life insurance payments or other
benefits to a survivor of the deceased individual.''.
(b) Peer-support Behavioral Health and Wellness Programs
Within Fire Departments and Emergency Medical Service
Agencies.--
(1) In general.--Part B of title III of the Public
Health Service Act (42 U.S.C. 243 et seq.) is amended
by adding at the end the following:
``SEC. 320C. PEER-SUPPORT BEHAVIORAL HEALTH AND WELLNESS PROGRAMS
WITHIN FIRE DEPARTMENTS AND EMERGENCY MEDICAL
SERVICE AGENCIES.
``(a) In General.--The Secretary may award grants to eligible
entities for the purpose of establishing or enhancing peer-
support behavioral health and wellness programs within fire
departments and emergency medical services agencies.
``(b) Program Description.--A peer-support behavioral health
and wellness program funded under this section shall--
``(1) use career and volunteer members of fire
departments or emergency medical services agencies to
serve as peer counselors;
``(2) provide training to members of career,
volunteer, and combination fire departments or
emergency medical service agencies to serve as such
peer counselors;
``(3) purchase materials to be used exclusively to
provide such training; and
``(4) disseminate such information and materials as
are necessary to conduct the program.
``(c) Definition.--In this section:
``(1) The term `eligible entity' means a nonprofit
organization with expertise and experience with respect
to the health and life safety of members of fire and
emergency medical services agencies.
``(2) The term `member'--
``(A) with respect to an emergency medical
services agency, means an employee, regardless
of rank or whether the employee receives
compensation (as defined in section 1204(7) of
the Omnibus Crime Control and Safe Streets Act
of 1968); and
``(B) with respect to a fire department,
means any employee, regardless of rank or
whether the employee receives compensation, of
a Federal, State, Tribal, or local fire
department who is responsible for responding to
calls for emergency service.''.
(2) Technical correction.--Effective as if included
in the enactment of the Children's Health Act of 2000
(Public Law 106-310), the amendment instruction in
section 1603 of such Act is amended by striking ``Part
B of the Public Health Service Act'' and inserting
``Part B of title III of the Public Health Service
Act''.
(c) Health Care Provider Behavioral Health and Wellness
Programs.--Part B of title III of the Public Health Service Act
(42 U.S.C. 243 et seq.), as amended by subsection (b)(1), is
further amended by adding at the end the following:
``SEC. 320D. HEALTH CARE PROVIDER BEHAVIORAL HEALTH AND WELLNESS
PROGRAMS.
``(a) In General.--The Secretary may award grants to eligible
entities for the purpose of establishing or enhancing
behavioral health and wellness programs for health care
providers.
``(b) Program Description.--A behavioral health and wellness
program funded under this section shall--
``(1) provide confidential support services for
health care providers to help handle stressful or
traumatic patient-related events, including counseling
services and wellness seminars;
``(2) provide training to health care providers to
serve as peer counselors to other health care
providers;
``(3) purchase materials to be used exclusively to
provide such training; and
``(4) disseminate such information and materials as
are necessary to conduct such training and provide such
peer counseling.
``(c) Definitions.--In this section, the term `eligible
entity' means a hospital, including a critical access hospital
(as defined in section 1861(mm)(1) of the Social Security Act)
or a disproportionate share hospital (as defined under section
1923(a)(1)(A) of such Act), a Federally-qualified health center
(as defined in section 1905(1)(2)(B) of such Act), or any other
health care facility.''.
(d) Development of Resources for Educating Mental Health
Professionals About Treating Fire Fighters and Emergency
Medical Services Personnel.--
(1) In general.--The Secretary of Health and Human
Services shall develop and make publicly available
resources that may be used by the Federal Government
and other entities to educate mental health
professionals about--
(A) the culture of Federal, State, Tribal,
and local career, volunteer, and combination
fire departments and emergency medical services
agencies;
(B) the different stressors experienced by
firefighters and emergency medical services
personnel, supervisory firefighters and
emergency medical services personnel, and chief
officers of fire departments and emergency
medical services agencies;
(C) challenges encountered by retired
firefighters and emergency medical services
personnel; and
(D) evidence-based therapies for mental
health issues common to firefighters and
emergency medical services personnel within
such departments and agencies.
(2) Consultation.--In developing resources under
paragraph (1), the Secretary of Health and Human
Services shall consult with national fire and emergency
medical services organizations.
(3) Definitions.--In this subsection:
(A) The term ``firefighter'' means any
employee, regardless of rank or whether the
employee receives compensation, of a Federal,
State, Tribal, or local fire department who is
responsible for responding to calls for
emergency service.
(B) The term ``emergency medical services
personnel'' means any employee, regardless of
rank or whether the employee receives
compensation, as defined in section 1204(7) of
the Omnibus Crime Control and Safe Streets Act
of 1968 (34 U.S.C. 10284(7)).
(C) The term ``chief officer'' means any
individual who is responsible for the overall
operation of a fire department or an emergency
medical services agency, irrespective of
whether such individual also serves as a
firefighter or emergency medical services
personnel.
(e) Best Practices and Other Resources for Addressing
Posttraumatic Stress Disorder in Public Safety Officers.--
(1) Development; updates.--The Secretary of Health
and Human Services shall--
(A) develop and assemble evidence-based best
practices and other resources to identify,
prevent, and treat posttraumatic stress
disorder and co-occurring disorders in public
safety officers; and
(B) reassess and update, as the Secretary
determines necessary, such best practices and
resources, including based upon the options for
interventions to reduce suicide among public
safety officers identified in the annual
reports required by section 317V(e)(1)(F) of
the Public Health Service Act, as added by
subsection (a).
(2) Consultation.--In developing, assembling, and
updating the best practices and resources under
paragraph (1), the Secretary of Health and Human
Services shall consult with, at a minimum, the
following:
(A) Public health experts.
(B) Mental health experts with experience in
studying suicide and other profession-related
traumatic stress.
(C) Clinicians with experience in diagnosing
and treating mental health issues.
(D) Relevant national police, fire, and
emergency medical services organizations.
(3) Availability.--The Secretary of Health and Human
Services shall make the best practices and resources
under paragraph (1) available to Federal, State, and
local fire, law enforcement, and emergency medical
services agencies.
(4) Federal training and development programs.--The
Secretary of Health and Human Services shall work with
Federal departments and agencies, including the United
States Fire Administration, to incorporate education
and training on the best practices and resources under
paragraph (1) into Federal training and development
programs for public safety officers.
(5) Definition.--In this subsection, the term
``public safety officer'' means--
(A) a public safety officer as defined in
section 1204 of the Omnibus Crime Control and
Safe Streets Act of 1968 (34 U.S.C. 10284); or
(B) a public safety telecommunicator as
described in detailed occupation 43-5031 in the
Standard Occupational Classification Manual of
the Office of Management and Budget (2018).
----------
2. An Amendment To Be Offered by Representative Davis of Illinois or
His Designee, Debatable for 10 Minutes
At the end of title II, add the following new subtitle:
Subtitle G--Opioid Epidemic Response
SEC. 271. OPIOID PRESCRIPTION VERIFICATION.
(a) Materials for Training Pharmacists on Certain
Circumstances Under Which a Pharmacist May Decline to Fill a
Prescription.--
(1) Updates to materials.--Section 3212(a) of the
SUPPORT for Patients and Communities Act (21 U.S.C. 829
note) is amended by striking ``Not later than 1 year
after the date of enactment of this Act, the Secretary
of Health and Human Services, in consultation with the
Administrator of the Drug Enforcement Administration,
Commissioner of Food and Drugs, Director of the Centers
for Disease Control and Prevention, and Assistant
Secretary for Mental Health and Substance Use, shall
develop and disseminate'' and inserting ``The Secretary
of Health and Human Services, in consultation with the
Administrator of the Drug Enforcement Administration,
Commissioner of Food and Drugs, Director of the Centers
for Disease Control and Prevention, and Assistant
Secretary for Mental Health and Substance Use, shall
develop and disseminate not later than 1 year after the
date of enactment of this Act, and update periodically
thereafter''.
(2) Materials included.--Section 3212(b) of the
SUPPORT for Patients and Communities Act (21 U.S.C. 829
note) is amended--
(A) by redesignating paragraphs (1) and (2)
as paragraphs (2) and (3), respectively; and
(B) by inserting before paragraph (2), as so
redesignated, the following new paragraph:
``(1) pharmacists on how to verify the identity of
the patient;''.
(3) Materials for training on patient verification
.--Section 3212 of the SUPPORT for Patients and
Communities Act (21 U.S.C. 829 note) is amended by
adding at the end the following new subsection:
``(d) Materials for Training on Verification of Identity.--
Not later than 1 year after the date of enactment of this
subsection, the Secretary of Health and Human Services, after
seeking stakeholder input in accordance with subsection (c),
shall--
``(1) update the materials developed under subsection
(a) to include information for pharmacists on how to
verify the identity the patient; and
``(2) disseminate, as appropriate, the updated
materials.''.
(b) Incentivizing States To Facilitate Responsible, Informed
Dispensing of Controlled Substances.--
(1) In general.--Section 392A of the Public Health
Service Act (42 U.S.C. 280b-1) is amended--
(A) by redesignating subsections (c) and (d)
as subsections (d) and (e), respectively; and
(B) by inserting after subsection (b) the
following new subsection:
``(c) Preference.--In determining the amounts of grants
awarded to States under subsections (a) and (b), the Director
of the Centers for Disease Control and Prevention may give
preference to States in accordance with such criteria as the
Director may specify and may choose to give preference to
States that--
``(1) maintain a prescription drug monitoring
program;
``(2) require prescribers of controlled substances in
schedule II, III, or IV to issue such prescriptions
electronically, and make such requirement subject to
exceptions in the cases listed in section 1860D-
4(e)(7)(B) of the Social Security Act; and
``(3) require dispensers of such controlled
substances to enter certain information about the
purchase of such controlled substances into the
respective State's prescription drug monitoring
program, including--
``(A) the National Drug Code or, in the case
of compounded medications, compound identifier;
``(B) the quantity dispensed;
``(C) the patient identifier; and
``(D) the date filled.''.
(2) Definitions.--
(A) In general.--Subsection (d) of section
392A of the Public Health Service Act (42
U.S.C. 280b-1), as redesignated by paragraph
(1)(A), is amended to read as follows:
``(d) Definitions.--In this section:
``(1) Controlled substance.--The term `controlled
substance' has the meaning given that term in section
102 of the Controlled Substances Act.
``(2) Dispenser.--The term `dispenser' means a
physician, pharmacist, or other person that dispenses a
controlled substance to an ultimate user.
``(3) Indian tribe.--The term `Indian Tribe' has the
meaning given that term in section 4 of the Indian
Self-Determination and Education Assistance Act.''.
(B) Conforming change.--Section 392A of the
Public Health Service Act (42 U.S.C. 280b-1) is
amended by striking ``Indian tribes'' each
place it appears and inserting ``Indian
Tribes''.
----------
3. An Amendment To Be Offered by Representative Dean of Pennsylvania or
Her Designee, Debatable for 10 Minutes
After section 263, insert the following new section:
SEC. 264. INCREASE IN NUMBER OF DAYS BEFORE WHICH CERTAIN CONTROLLED
SUBSTANCES MUST BE ADMINISTERED.
Section 309A(a)(5) of the Controlled Substances Act (21
U.S.C. 829a(a)(5)) is amended by striking ``14 days'' and
inserting ``60 days''.
----------
4. An Amendment To Be Offered by Representative Demings of Florida or
Her Designee, Debatable for 10 Minutes
At the end of title III, add the following new subtitle:
Subtitle E--Other Provisions
SEC. 341. REPORT ON LAW ENFORCEMENT MENTAL HEALTH AND WELLNESS.
(a) In General.--Not later than 270 days after the date of
enactment of this Act, the Attorney General, in consultation
with the Director of the Federal Bureau of Investigation, the
Director of the National Institute for Justice, and the
Assistant Secretary for Mental Health and Substance Abuse,
shall submit to the Committee on Health, Education, Labor, and
Pensions and the Committee on the Judiciary of the Senate and
the Committee on Energy and Commerce and the Committee on the
Judiciary of the House of Representatives a report on--
(1) the types, frequency, and severity of mental
health and stress-related responses of law enforcement
officers to aggressive actions or other trauma-inducing
incidents against law enforcement officers;
(2) mental health and stress-related resources or
programs that are available to law enforcement officers
at the Federal, State, and local level, including peer-
to-peer programs;
(3) the extent to which law enforcement officers use
the resources or programs described in paragraph (2);
(4) the availability of, or need for, mental health
screening within Federal, State, and local law
enforcement agencies; and
(5) recommendations for Federal, State, and local law
enforcement agencies to improve the mental health and
wellness of their officers.
(b) Development.--In developing the report required under
subsection (a), the Attorney General, the Director of the
Federal Bureau of Investigation, the Director of the National
Institute of Justice, and the Assistant Secretary for Mental
Health and Substance Abuse shall consult relevant stakeholders,
including--
(1) Federal, State, Tribal and local law enforcement
agencies; and
(2) nongovernmental organizations, international
organizations, academies, or other entities.
----------
5. An Amendment To Be Offered by Representative Feenstra of Iowa or His
Designee, Debatable for 10 Minutes
Page 5, after line 21, insert the following new subparagraph
(and redesignate the subsequent subparagraphs accordingly):
``(B) the Veterans Crisis Line;
----------
6. An Amendment To Be Offered by Representative Ferguson of Georgia or
His Designee, Debatable for 10 Minutes
At the end of subtitle A of title IV, add the following new
section:
SEC. 403. BEST PRACTICES FOR BEHAVIORAL INTERVENTION TEAMS.
The Public Health Service Act is amended by inserting after
section 520H of such Act, as added by section 151, the
following new section:
``SEC. 520I. BEST PRACTICES FOR BEHAVIORAL INTERVENTION TEAMS.
``(a) In General.--The Secretary shall identify and
facilitate the development of best practices to assist
elementary schools, secondary schools, and institutions of
higher education in establishing and using behavioral
intervention teams.
``(b) Elements.--The best practices under subsection (a)(1)
shall include guidance on the following:
``(1) How behavioral intervention teams can operate
effectively from an evidence-based, objective
perspective while protecting the constitutional and
civil rights of individuals.
``(2) The use of behavioral intervention teams to
identify concerning behaviors, implement interventions,
and manage risk through the framework of the school's
or institution's rules or code of conduct, as
applicable.
``(3) How behavioral intervention teams can, when
assessing an individual--
``(A) access training on evidence-based,
threat-assessment rubrics;
``(B) ensure that such teams--
``(i) have trained, diverse
stakeholders with varied expertise; and
``(ii) use cross validation by a
wide-range of individual perspectives
on the team; and
``(C) use violence risk assessment.
``(4) How behavioral intervention teams can help
mitigate--
``(A) inappropriate use of a mental health
assessment;
``(B) inappropriate limitations or
restrictions on law enforcement's jurisdiction
over criminal matters;
``(C) attempts to substitute the behavioral
intervention process in place of a criminal
process, or impede a criminal process, when an
individual's behavior has potential criminal
implications;
``(D) endangerment of an individual's privacy
by failing to ensure that all applicable
Federal and State privacy laws are fully
complied with; or
``(E) inappropriate referrals to, or
involvement of, law enforcement when an
individual's behavior does not warrant a
criminal response.
``(c) Consultation.--In carrying out subsection (a)(1), the
Secretary shall consult with--
``(1) the Secretary of Education;
``(2) the Director of the National Threat Assessment
Center of the United States Secretary Service;
``(3) the Attorney General and the Director of the
Bureau of Justice Assistance;
``(4) teachers and other educators, principals,
school administrators, school board members, school
psychologists, mental health professionals, and parents
of students;
``(5) local law enforcement agencies and campus law
enforcement administrators;
``(6) privacy experts; and
``(7) other education and mental health professionals
as the Secretary deems appropriate.
``(d) Publication.--Not later than 2 years after the date of
enactment of this section, the Secretary shall publish the best
practices under subsection (a)(1) on the internet website of
the Department of Health and Human Services.
``(e) Technical Assistance.--The Secretary shall provide
technical assistance to institutions of higher education,
elementary schools, and secondary schools to assist such
institutions and schools in implementing the best practices
under subsection (a).
``(f) Definitions.--In this section:
``(1) The term `behavioral intervention team' means a
team of qualified individuals who--
``(A) are responsible for identifying and
assessing individuals exhibiting concerning
behaviors, experiencing distress, or who are at
risk of harm to self or others;
``(B) develop and facilitate implementation
of evidence-based interventions to mitigate the
threat of harm to self or others posed by an
individual and address the mental and
behavioral health needs of individuals to
reduce risk; and
``(C) provide information to students,
parents, and school employees on recognizing
behavior described in this subsection.
``(2) The terms `elementary school', `parent', and
`secondary school' have the meanings given to such
terms in section 8101 of the Elementary and Secondary
Education Act of 1965.
``(3) The term `institution of higher education' has
the meaning given to such term in section 102 of the
Higher Education Act of 1965.
``(4) The term `mental health assessment' means an
evaluation, primarily focused on diagnosis, determining
the need for involuntary commitment, medication
management, and on-going treatment recommendations.
``(5) The term `violence risk assessment' means a
broad determination of the potential risk of violence
based on evidence-based literature.''.
----------
7. An Amendment To Be Offered by Representative Gottheimer of New
Jersey or His Designee, Debatable for 10 Minutes
Page 9, line 22, insert ``veterans,'' after ``minorities,''.
----------
8. An Amendment To Be Offered by Representative Griffith of Virginia or
His Designee, Debatable for 10 Minutes
Page 130, after line 3, insert the following:
(c) Applicability.--The amendments made by this section shall
not apply until January 1, 2024.
----------
9. An Amendment To Be Offered by Representative Joyce of Ohio or His
Designee, Debatable for 10 Minutes
At the end of title I, add the following new subtitle:
Subtitle G--Military Suicide Prevention in the 21st Century
SEC. 155. PILOT PROGRAM ON PRE-PROGRAMMING OF SUICIDE PREVENTION
RESOURCES INTO SMART DEVICES ISSUED TO MEMBERS OF
THE ARMED FORCES.
(a) In General.--Commencing not later than 120 days after the
date of the enactment of this Act, the Secretary of Defense
shall carry out a pilot program under which the Secretary--
(1) pre-downloads the Virtual Hope Box application of
the Defense Health Agency, or such successor
application, on smart devices individually issued to
members of the Armed Forces;
(2) pre-programs the National Suicide Hotline number
and Veterans Crisis Line number into the contacts for
such devices; and
(3) provides training, as part of training on suicide
awareness and prevention conducted throughout the
Department of Defense, on the preventative resources
described in paragraphs (1) and (2).
(b) Duration.--The Secretary shall carry out the pilot
program under this section for a two-year period.
(c) Scope.--The Secretary shall determine the appropriate
scope of individuals participating in the pilot program under
this section to best represent each Armed Force and to ensure a
relevant sample size.
(d) Identification of Other Resources.--In carrying out the
pilot program under this section, the Secretary shall
coordinate with the Director of the Defense Health Agency and
the Secretary of Veterans Affairs to identify other useful
technology-related resources for use in the pilot program.
(e) Report.--Not later than 30 days after completing the
pilot program under this section, the Secretary shall submit to
the Committee on Armed Services of the Senate and the Committee
on Armed Services of the House of Representatives a report on
the pilot program.
(f) Veterans Crisis Line Defined.--In this section, the term
``Veterans Crisis Line'' means the toll-free hotline for
veterans established under section 1720F(h) of title 38, United
States Code.
----------
10. An Amendment To Be Offered by Representative Katko of New York or
His Designee, Debatable for 10 Minutes
After section 102, insert the following new section:
SEC. 103. SUICIDE PREVENTION LIFELINE IMPROVEMENT.
(a) Suicide Prevention Lifeline.--
(1) Plan.--Section 520E-3 of the Public Health
Service Act (42 U.S.C. 290bb-36c) is amended--
(A) by redesignating subsection (c) as
subsection (e); and
(B) by inserting after subsection (b) the
following:
``(c) Plan.--
``(1) In general.--For purposes of maintaining the
suicide prevention hotline under subsection (b)(2), the
Secretary shall develop and implement a plan to ensure
the provision of high-quality service.
``(2) Contents.--The plan required by paragraph (1)
shall include the following:
``(A) Quality assurance provisions,
including--
``(i) clearly defined and measurable
performance indicators and objectives
to improve the responsiveness and
performance of the hotline, including
at backup call centers; and
``(ii) quantifiable timeframes to
track the progress of the hotline in
meeting such performance indicators and
objectives.
``(B) Standards that crisis centers and
backup centers must meet--
``(i) to participate in the network
under subsection (b)(1); and
``(ii) to ensure that each telephone
call, online chat message, and other
communication received by the hotline,
including at backup call centers, is
answered in a timely manner by a
person, consistent with the guidance
established by the American Association
of Suicidology or other guidance
determined by the Secretary to be
appropriate.
``(C) Guidelines for crisis centers and
backup centers to implement evidence-based
practices including with respect to followup
and referral to other health and social
services resources.
``(D) Guidelines to ensure that resources are
available and distributed to individuals using
the hotline who are not personally in a time of
crisis but know of someone who is.
``(E) Guidelines to carry out periodic
testing of the hotline, including at crisis
centers and backup centers, during each fiscal
year to identify and correct any problems in a
timely manner.
``(F) Guidelines to operate in consultation
with the State department of health, local
governments, Indian tribes, and tribal
organizations.
``(3) Initial plan; updates.--The Secretary shall--
``(A) not later than 6 months after the date
of enactment of the Restoring Hope for Mental
Health and Well-Being Act of 2022, complete
development of the initial version of the plan
required by paragraph (1), begin implementation
of such plan, and make such plan publicly
available; and
``(B) periodically thereafter, update such
plan and make the updated plan publicly
available.''.
(2) Transmission of data to cdc.--Section 520E-3 of
the Public Health Service Act (42 U.S.C. 290bb-36c) is
amended by inserting after subsection (c) of such
section, as added by paragraph (1), the following:
``(d) Transmission of Data to CDC.--The Secretary shall
formalize and strengthen agreements between the National
Suicide Prevention Lifeline program and the Centers for Disease
Control and Prevention to transmit any necessary
epidemiological data from the program to the Centers, including
local call center data, to assist the Centers in suicide
prevention efforts.''.
(3) Authorization of appropriations.--Subsection (e)
of section 520E-3 of the Public Health Service Act (42
U.S.C. 290bb-36c) is amended to read as follows:
``(e) Authorization of Appropriations.--
``(1) In general.--To carry out this section, there
are authorized to be appropriated $101,621,000 for each
of fiscal years 2023 through 2027.
``(2) Allocation.--Of the amount authorized to be
appropriated by paragraph (1) for each of fiscal years
2023 through 2027--
``(A) at least 80 percent shall be made
available to crisis centers; and
``(B) not more than 10 percent may be used
for carrying out the pilot program in section
103(b)(1) of the Restoring Hope for Mental
Health and Well-Being Act of 2022.''.
(b) Pilot Program on Innovative Technologies.--
(1) In general.--The Secretary of Health and Human
Services, acting through the Assistant Secretary for
Mental Health and Substance Use, shall carry out a
pilot program to research, analyze, and employ various
technologies and platforms of communication (including
social media platforms, texting platforms, and email
platforms) for suicide prevention in addition to the
telephone and online chat service provided by the
Suicide Prevention Lifeline.
(2) Report.--Not later than 24 months after the date
on which the pilot program under paragraph (1)
commences, the Secretary of Health and Human Services,
acting through the Assistant Secretary for Mental
Health and Substance Use, shall submit to the Congress
a report on the pilot program. With respect to each
platform of communication employed pursuant to the
pilot program, the report shall include--
(A) a full description of the program;
(B) the number of individuals served by the
program;
(C) the average wait time for each individual
to receive a response;
(D) the cost of the program, including the
cost per individual served; and
(E) any other information the Secretary
determines appropriate.
(c) HHS Study and Report.--Not later than 24 months after the
Secretary of Health and Human Services begins implementation of
the plan required by section 520E-3(c) of the Public Health
Service Act, as added by subsection (a)(1)(B), the Secretary
shall--
(1) complete a study on--
(A) the implementation of such plan,
including the progress towards meeting the
objectives identified pursuant to paragraph
(2)(A)(i) of such section 520E-3(c) by the
timeframes identified pursuant to paragraph
(2)(A)(ii) of such section 520E-3(c); and
(B) in consultation with the Director of the
Centers for Disease Control and Prevention,
options to expand data gathering from calls to
the Suicide Prevention Lifeline in order to
better track aspects of usage such as repeat
calls, consistent with applicable Federal and
State privacy laws; and
(2) submit a report to the Congress on the results of
such study, including recommendations on whether
additional legislation or appropriations are needed.
(d) GAO Study and Report.--
(1) In general.--Not later than 24 months after the
Secretary of Health and Human Services begins
implementation of the plan required by section 520E-
3(c) of the Public Health Service Act, as added by
subsection (a)(1)(B), the Comptroller General of the
United States shall--
(A) complete a study on the Suicide
Prevention Lifeline; and
(B) submit a report to the Congress on the
results of such study.
(2) Issues to be studied.--The study required by
paragraph (1) shall address--
(A) the feasibility of geolocating callers to
direct calls to the nearest crisis center;
(B) operation shortcomings of the Suicide
Prevention Lifeline;
(C) geographic coverage of each crisis call
center;
(D) the call answer rate of each crisis call
center;
(E) the call wait time of each crisis call
center;
(F) the hours of operation of each crisis
call center;
(G) funding avenues of each crisis call
center;
(H) the implementation of the plan under
section 520E-3(c) of the Public Health Service
Act, as added by subsection (a)(1)(B),
including the progress towards meeting the
objectives identified pursuant to paragraph
(2)(A)(i) of such section 520E-3(c) by the
timeframes identified pursuant to paragraph
(2)(A)(ii) of such section 520E-3(c); and
(I) service to individuals requesting a
foreign language speaker, including--
(i) the number of calls or chats the
Lifeline receives from individuals
speaking a foreign language;
(ii) the capacity of the Lifeline to
handle these calls or chats; and
(iii) the number of crisis centers
with the capacity to serve foreign
language speakers, in house.
(3) Recommendations.--The report required by
paragraph (1) shall include recommendations for
improving the Suicide Prevention Lifeline, including
recommendations for legislative and administrative
actions.
(e) Definition.--In this section, the term ``Suicide
Prevention Lifeline'' means the suicide prevention hotline
maintained pursuant to section 520E-3 of the Public Health
Service Act (42 U.S.C. 290bb-36c).
----------
11. An Amendment To Be Offered by Representative Kim of New Jersey or
His Designee, Debatable for 10 Minutes
At the end of title II, add the following new subtitle:
Subtitle G--Opioid Epidemic Response
SEC. 271. SYNTHETIC OPIOID DANGER AWARENESS.
(a) Synthetic Opioids Public Awareness Campaign.--Part B of
title III of the Public Health Service Act is amended by
inserting after section 317U (42 U.S.C. 247b-23) the following
new section:
``SEC. 317V. SYNTHETIC OPIOIDS PUBLIC AWARENESS CAMPAIGN.
``(a) In General.--Not later than one year after the date of
the enactment of this section, the Secretary shall provide for
the planning and implementation of a public education campaign
to raise public awareness of synthetic opioids (including
fentanyl and its analogues). Such campaign shall include the
dissemination of information that--
``(1) promotes awareness about the potency and
dangers of fentanyl and its analogues and other
synthetic opioids;
``(2) explains services provided by the Substance
Abuse and Mental Health Services Administration and the
Centers for Disease Control and Prevention (and any
entity providing such services under a contract entered
into with such agencies) with respect to the misuse of
opioids, particularly as such services relate to the
provision of alternative, non-opioid pain management
treatments; and
``(3) relates generally to opioid use and pain
management.
``(b) Use of Media.--The campaign under subsection (a) may be
implemented through the use of television, radio, internet, in-
person public communications, and other commercial marketing
venues and may be targeted to specific age groups.
``(c) Consideration of Report Findings.--In planning and
implementing the public education campaign under subsection
(a), the Secretary shall take into consideration the findings
of the report required under section 7001 of the SUPPORT for
Patients and Communities Act (Public Law 115-271).
``(d) Consultation.--In coordinating the campaign under
subsection (a), the Secretary shall consult with the Assistant
Secretary for Mental Health and Substance Use to provide
ongoing advice on the effectiveness of information disseminated
through the campaign.
``(e) Requirement of Campaign.--The campaign implemented
under subsection (a) shall not be duplicative of any other
Federal efforts relating to eliminating the misuse of opioids.
``(f) Evaluation.--
``(1) In general.--The Secretary shall ensure that
the campaign implemented under subsection (a) is
subject to an independent evaluation, beginning 2 years
after the date of the enactment of this section, and
every 2 years thereafter.
``(2) Measures and benchmarks.--For purposes of an
evaluation conducted pursuant to paragraph (1), the
Secretary shall--
``(A) establish baseline measures and
benchmarks to quantitatively evaluate the
impact of the campaign under this section; and
``(B) conduct qualitative assessments
regarding the effectiveness of strategies
employed under this section.
``(g) Report.--The Secretary shall, beginning 2 years after
the date of the enactment of this section, and every 2 years
thereafter, submit to Congress a report on the effectiveness of
the campaign implemented under subsection (a) towards meeting
the measures and benchmarks established under subsection
(e)(2).
``(h) Dissemination of Information Through Providers.--The
Secretary shall develop and implement a plan for the
dissemination of information related to synthetic opioids, to
health care providers who participate in Federal programs,
including programs administered by the Department of Health and
Human Services, the Indian Health Service, the Department of
Veterans Affairs, the Department of Defense, and the Health
Resources and Services Administration, the Medicare program
under title XVIII of the Social Security Act, and the Medicaid
program under title XIX of such Act.''.
(b) Training Guide and Outreach on Synthetic Opioid Exposure
Prevention.--
(1) Training guide.--Not later than 18 months after
the date of the enactment of this Act, the Secretary of
Health and Human Services shall design, publish, and
make publicly available on the internet website of the
Department of Health and Human Services, a training
guide and webinar for first responders and other
individuals who also may be at high risk of exposure to
synthetic opioids that details measures to prevent that
exposure.
(2) Outreach.--Not later than 18 months after the
date of the enactment of this Act, the Secretary of
Health and Human Services shall also conduct outreach
about the availability of the training guide and
webinar published under paragraph (1) to--
(A) police and fire managements;
(B) sheriff deputies in city and county
jails;
(C) ambulance transport and hospital
emergency room personnel;
(D) clinicians; and
(E) other high-risk occupations, as
identified by the Assistant Secretary for
Mental Health and Substance Use.
----------
12. An Amendment To Be Offered by Representative McKinley of West
Virginia or His Designee, Debatable for 10 Minutes
After section 263, insert the following new section:
SEC. 264. BLOCK, REPORT, AND SUSPEND SUSPICIOUS SHIPMENTS.
(a) Clarification of Process for Registrants to Exercise Due
Diligence Upon Discovering a Suspicious Order.--Paragraph (3)
of section 312(a) of the Controlled Substances Act (21 U.S.C.
832(a)) is amended to read as follows:
``(3) upon discovering a suspicious order or series
of orders, and in a manner consistent with the other
requirements of this section--
``(A) exercise due diligence as appropriate;
``(B) establish and maintain (for not less
than a period to be determined by the
Administrator of the Drug Enforcement
Administration) a record of the due diligence
that was performed;
``(C) decline to fill the order or series of
orders if the due diligence fails to dispel all
of the indicators that give rise to the
suspicion that, if the order or series of
orders is filled, the drugs that are the
subject of the order or series of orders are
likely to be diverted; and
``(D) notify the Administrator of the Drug
Enforcement Administration and the Special
Agent in Charge of the Division Office of the
Drug Enforcement Administration for the area in
which the registrant is located or conducts
business of--
``(i) each suspicious order or series
of orders discovered by the registrant;
and
``(ii) the indicators giving rise to
the suspicion that, if the order or
series of orders is filled, the drugs
that are the subject of the order or
series of orders are likely to be
diverted.''.
(b) Resolution of Suspicious Indicators.--Section 312 of the
Controlled Substances Act (21 U.S.C. 832) is amended--
(1) by redesignating subsection (b) and (c) as
subsections (c) and (d), respectively; and
(2) by inserting after subsection (a) the following:
``(b) Resolution of Suspicious Indicators.--If a registrant
resolves all of the indicators giving rise to suspicion about
an order or series of orders under subsection (a)(3)--
``(1) notwithstanding subsection (a)(3)(C), the
registrant may choose to fill the order or series of
orders; and
``(2) notwithstanding subsection (a)(3)(D), the
registrant may choose not to make the notification
otherwise required by such subsection.''.
(c) Regulations.--Not later than 1 year after the date of
enactment of this Act, for purposes of subsections (a)(3) and
(b) of section 312 of the Controlled Substances Act, as amended
or inserted by subsection (a), the Attorney General of the
United States shall promulgate a final regulation specifying
the indicators that give rise to a suspicion that, if an order
or series of orders is filled, the drugs that are the subject
of the order or series of orders are likely to be diverted.
(d) Applicability.--Subsections (a)(3) and (b) of section 312
of the Controlled Substances Act, as amended or inserted by
subsection (a), shall apply beginning on the day that is 1 year
after the date of enactment of this Act. Until such day,
section 312(a)(3) of the Controlled Substances Act shall apply
as such section 312(a)(3) was in effect on the day before the
date of enactment of this Act.
----------
13. An Amendment To Be Offered by Representative Moore of Wisconsin or
Her Designee, Debatable for 10 Minutes
Page 20, line 4, strike ``and''.
Page 20, line 9, strike the period at the end and insert ``;
and''.
Page 20, after line 9, add the following:
``(4) consult with appropriate State, local, and
Tribal public health officials, including officials
that administer programs that serve low-income pregnant
and postpartum individuals.''.
----------
14. An Amendment To Be Offered by Representative Napolitano of
California or Her Designee, Debatable for 10 Minutes
After section 402, insert the following new section:
SEC. 403. SCHOOL-BASED MENTAL HEALTH; CHILDREN AND ADOLESCENTS.
(a) Technical Amendments.--The second part G (relating to
services provided through religious organizations) of title V
of the Public Health Service Act (42 U.S.C. 290kk et seq.) is
amended--
(1) by redesignating such part as part J; and
(2) by redesignating sections 581 through 584 as
sections 596 through 596C, respectively.
(b) School-Based Mental Health and Children.--Section 581 of
the Public Health Service Act (42 U.S.C. 290hh) (relating to
children and violence) is amended to read as follows:
``SEC. 581. SCHOOL-BASED MENTAL HEALTH; CHILDREN AND ADOLESCENTS.
``(a) In General.--The Secretary, in consultation with the
Secretary of Education, shall, through grants, contracts, or
cooperative agreements awarded to eligible entities described
in subsection (c), provide comprehensive school-based mental
health services and supports to assist children in local
communities and schools (including schools funded by the Bureau
of Indian Education) dealing with traumatic experiences, grief,
bereavement, risk of suicide, and violence. Such services and
supports shall be--
``(1) developmentally, linguistically, and culturally
appropriate;
``(2) trauma-informed; and
``(3) incorporate positive behavioral interventions
and supports.
``(b) Activities.--Grants, contracts, or cooperative
agreements awarded under subsection (a), shall, as appropriate,
be used for--
``(1) implementation of school and community-based
mental health programs that--
``(A) build awareness of individual trauma
and the intergenerational, continuum of impacts
of trauma on populations;
``(B) train appropriate staff to identify,
and screen for, signs of trauma exposure,
mental health disorders, or risk of suicide;
and
``(C) incorporate positive behavioral
interventions, family engagement, student
treatment, and multigenerational supports to
foster the health and development of children,
prevent mental health disorders, and ameliorate
the impact of trauma;
``(2) technical assistance to local communities with
respect to the development of programs described in
paragraph (1);
``(3) facilitating community partnerships among
families, students, law enforcement agencies, education
agencies, mental health and substance use disorder
service systems, family-based mental health service
systems, child welfare agencies, health care providers
(including primary care physicians, mental health
professionals, and other professionals who specialize
in children's mental health such as child and
adolescent psychiatrists), institutions of higher
education, faith-based programs, trauma networks, and
other community-based systems to address child and
adolescent trauma, mental health issues, and violence;
and
``(4) establishing mechanisms for children and
adolescents to report incidents of violence or plans by
other children, adolescents, or adults to commit
violence.
``(c) Requirements.--
``(1) In general.--To be eligible for a grant,
contract, or cooperative agreement under subsection
(a), an entity shall be a partnership that includes--
``(A) a State educational agency, as defined
in section 8101 of the Elementary and Secondary
Education Act of 1965, in coordination with one
or more local educational agencies, as defined
in section 8101 of the Elementary and Secondary
Education Act of 1965, or a consortium of any
entities described in subparagraph (B), (C),
(D), or (E) of section 8101(30) of such Act;
and
``(B) at least 1 community-based mental
health provider, including a public or private
mental health entity, health care entity,
family-based mental health entity, trauma
network, or other community-based entity, as
determined by the Secretary (and which may
include additional entities such as a human
services agency, law enforcement or juvenile
justice entity, child welfare agency, agency,
an institution of higher education, or another
entity, as determined by the Secretary).
``(2) Compliance with hipaa.--Any patient records
developed by covered entities through activities under
the grant shall meet the regulations promulgated under
section 264(c) of the Health Insurance Portability and
Accountability Act of 1996.
``(3) Compliance with ferpa.--Section 444 of the
General Education Provisions Act (commonly known as the
`Family Educational Rights and Privacy Act of 1974')
shall apply to any entity that is a member of the
partnership in the same manner that such section
applies to an educational agency or institution (as
that term is defined in such section).
``(d) Geographical Distribution.--The Secretary shall ensure
that grants, contracts, or cooperative agreements under
subsection (a) will be distributed equitably among the regions
of the country and among urban and rural areas.
``(e) Duration of Awards.--With respect to a grant, contract,
or cooperative agreement under subsection (a), the period
during which payments under such an award will be made to the
recipient shall be 5 years, with options for renewal.
``(f) Evaluation and Measures of Outcomes.--
``(1) Development of process.--The Assistant
Secretary shall develop a fiscally appropriate process
for evaluating activities carried out under this
section. Such process shall include--
``(A) the development of guidelines for the
submission of program data by grant, contract,
or cooperative agreement recipients;
``(B) the development of measures of outcomes
(in accordance with paragraph (2)) to be
applied by such recipients in evaluating
programs carried out under this section; and
``(C) the submission of annual reports by
such recipients concerning the effectiveness of
programs carried out under this section.
``(2) Measures of outcomes.--The Assistant Secretary
shall develop measures of outcomes to be applied by
recipients of assistance under this section to evaluate
the effectiveness of programs carried out under this
section, including outcomes related to the student,
family, and local educational systems supported by this
Act.
``(3) Submission of annual data.--An eligible entity
described in subsection (c) that receives a grant,
contract, or cooperative agreement under this section
shall annually submit to the Assistant Secretary a
report that includes data to evaluate the success of
the program carried out by the entity based on whether
such program is achieving the purposes of the program.
Such reports shall utilize the measures of outcomes
under paragraph (2) in a reasonable manner to
demonstrate the progress of the program in achieving
such purposes.
``(4) Evaluation by assistant secretary.--Based on
the data submitted under paragraph (3), the Assistant
Secretary shall annually submit to Congress a report
concerning the results and effectiveness of the
programs carried out with assistance received under
this section.
``(5) Limitation.--An eligible entity shall use not
more than 20 percent of amounts received under a grant
under this section to carry out evaluation activities
under this subsection.
``(g) Information and Education.--The Secretary shall
disseminate best practices based on the findings of the
knowledge development and application under this section.
``(h) Amount of Grants and Authorization of Appropriations.--
``(1) Amount of grants.--A grant under this section
shall be in an amount that is not more than $2,000,000
for each of the first 5 fiscal years following the date
of enactment of the Restoring Hope for Mental Health
and Well-Being Act of 2022. The Secretary shall
determine the amount of each such grant based on the
population of children up to age 21 of the area to be
served under the grant.
``(2) Authorization of appropriations.--There is
authorized to be appropriated to carry out this
section, $130,000,000 for each of fiscal years 2023
through 2027.''.
(c) Conforming Amendment.--Part G of title V of the Public
Health Service Act (42 U.S.C. 290hh et seq.), as amended by
subsection (b), is further amended by striking the part
designation and heading and inserting the following:
``PART G--SCHOOL-BASED MENTAL HEALTH''.
----------
15. An Amendment To Be Offered by Representative Pressley of
Massachusetts or Her Designee, Debatable for 10 Minutes
After section 402, insert the following new section:
SEC. 403. CO-OCCURRING CHRONIC CONDITIONS AND MENTAL HEALTH IN YOUTH
STUDY.
Not later than 12 months after the date of enactment of this
Act, the Secretary of Health and Human Services shall--
(1) complete a study on the rates of suicidal
behaviors among children and adolescents with chronic
illnesses, including substance use disorders,
autoimmune disorders, and heritable blood disorders;
and
(2) submit a report to the Congress on the results of
such study, including recommendations for early
intervention services for such children and adolescents
at risk of suicide, the dissemination of best practices
to support the emotional and mental health needs of
youth, and strategies to lower the rates of suicidal
behaviors in children and adolescents described in
paragraph (1) to reduce any demographic disparities in
such rates.
----------
16. An Amendment To Be Offered by Representative Reschenthaler of
Pennsylvania or His Designee, Debatable for 10 Minutes
At the end of subtitle C of title I, add the following new
section:
SEC. 124. STUDY ON THE COSTS OF SERIOUS MENTAL ILLNESS.
(a) In General.--The Secretary of Health and Human Services,
in consultation with the Assistant Secretary for Mental Health
and Substance Use, the Assistant Secretary for Planning and
Evaluation, the Attorney General of the United States, the
Secretary of Labor, and the Secretary of Housing and Urban
Development, shall conduct a study on the direct and indirect
costs of serious mental illness with respect to--
(1) nongovernmental entities; and
(2) the Federal Government and State, local, and
Tribal governments.
(b) Content.--The study under subsection (a) shall consider
each of the following:
(1) The costs to the health care system for health
services, including with respect to--
(A) office-based physician visits;
(B) residential and inpatient treatment
programs;
(C) outpatient treatment programs;
(D) emergency room visits;
(E) crisis stabilization programs;
(F) home health care;
(G) skilled nursing and long-term care
facilities;
(H) prescription drugs and digital
therapeutics; and
(I) any other relevant health services.
(2) The costs of homelessness, including with respect
to--
(A) homeless shelters;
(B) street outreach activities;
(C) crisis response center visits; and
(D) other supportive services.
(3) The costs of structured residential facilities
and other supportive housing for residential and
custodial care services.
(4) The costs of law enforcement encounters and
encounters with the criminal justice system, including
with respect to--
(A) encounters that do and do not result in
an arrest;
(B) criminal and judicial proceedings;
(C) services provided by law enforcement and
judicial staff (including public defenders,
prosecutors, and private attorneys); and
(D) incarceration.
(5) The costs of serious mental illness on
employment.
(6) With respect to family members and caregivers,
the costs of caring for an individual with a serious
mental illness.
(7) Any other relevant costs for programs and
services administered by the Federal Government or
State, Tribal, or local governments.
(c) Data Disaggregation.--In conducting the study under
subsection (a), the Secretary of Health and Human Services
shall (to the extent feasible)--
(1) disaggregate data by--
(A) costs to nongovernmental entities, the
Federal Government, and State, local, and
Tribal governments;
(B) types of serious mental illnesses and
medical chronic diseases common in patients
with a serious mental illness; and
(C) demographic characteristics, including
race, ethnicity, sex, age (including pediatric
subgroups), and other characteristics
determined by the Secretary; and
(2) include an estimate of--
(A) the total number of individuals with a
serious mental illness in the United States,
including in traditional and nontraditional
housing; and
(B) the percentage of such individuals in--
(i) homeless shelters;
(ii) penal facilities, including
Federal prisons, State prisons, and
county and municipal jails; and
(iii) nursing facilities.
(d) Report.--Not later than 2 years after the date of the
enactment of this Act, the Secretary of Health and Human
Services shall--
(1) submit to the Congress a report containing the
results of the study conducted under this section; and
(2) make such report publicly available.
----------
17. An Amendment To Be Offered by Representative Trone of Maryland or
His Designee, Debatable for 10 Minutes
At the end of title II, add the following new subtitle:
Subtitle I--Opioid Epidemic Response
SEC. 271. GRANT PROGRAM FOR STATE AND TRIBAL RESPONSE TO OPIOID AND
STIMULANT USE AND MISUSE.
Section 1003 of the 21st Century Cures Act (42 U.S.C. 290ee-3
note) is amended to read as follows:
``SEC. 1003. GRANT PROGRAM FOR STATE AND TRIBAL RESPONSE TO OPIOID AND
STIMULANT USE AND MISUSE.
``(a) In General.--The Secretary of Health and Human Services
(referred to in this section as the `Secretary') shall carry
out the grant program described in subsection (b) for purposes
of addressing opioid and stimulant use and misuse, within
States, Indian Tribes, and populations served by Tribal
organizations and Urban Indian organizations.
``(b) Grants Program.--
``(1) In general.--Subject to the availability of
appropriations, the Secretary shall award grants to
States, Indian Tribes, Tribal organizations, and Urban
Indian organizations for the purpose of addressing
opioid and stimulant use and misuse, within such
States, such Indian Tribes, and populations served by
such Tribal organizations and Urban Indian
organizations, in accordance with paragraph (2).
``(2) Minimum allocations; preference.--In
determining grant amounts for each recipient of a grant
under paragraph (1), the Secretary shall--
``(A) ensure that each State receives not
less than $4,000,000; and
``(B) give preference to States, Indian
Tribes, Tribal organizations, and Urban Indian
organizations whose populations have an
incidence or prevalence of opioid use disorders
or stimulant use or misuse that is
substantially higher relative to the
populations of other States, other Indian
Tribes, Tribal organizations, or Urban Indian
organizations, as applicable.
``(3) Formula methodology.--
``(A) In general.--Before publishing a
funding opportunity announcement with respect
to grants under this section, the Secretary
shall--
``(i) develop a formula methodology
to be followed in allocating grant
funds awarded under this section among
grantees, which includes performance
assessments for continuation awards;
and
``(ii) not later than 30 days after
developing the formula methodology
under clause (i), submit the formula
methodology to--
``(I) the Committee on Energy
and Commerce and the Committee
on Appropriations of the House
of Representatives; and
``(II) the Committee on
Health, Education, Labor, and
Pensions and the Committee on
Appropriations of the Senate.
``(B) Report.--Not later than two years after
the date of the enactment of the Restoring Hope
for Mental Health and Well-Being Act of 2022,
the Comptroller General of the United States
shall submit to the Committee on Health,
Education, Labor, and Pensions of the Senate
and the Committee on Energy and Commerce of the
House of Representatives a report that--
``(i) assesses how grant funding is
allocated to States under this section
and how such allocations have changed
over time;
``(ii) assesses how any changes in
funding under this section have
affected the efforts of States to
address opioid or stimulant use or
misuse; and
``(iii) assesses the use of funding
provided through the grant program
under this section and other similar
grant programs administered by the
Substance Abuse and Mental Health
Services Administration.
``(4) Use of funds.--Grants awarded under this
subsection shall be used for carrying out activities
that supplement activities pertaining to opioid and
stimulant use and misuse, undertaken by the State
agency responsible for administering the substance
abuse prevention and treatment block grant under
subpart II of part B of title XIX of the Public Health
Service Act (42 U.S.C. 300x-21 et seq.), which may
include public health-related activities such as the
following:
``(A) Implementing prevention activities, and
evaluating such activities to identify
effective strategies to prevent substance use
disorders.
``(B) Establishing or improving prescription
drug monitoring programs.
``(C) Training for health care practitioners,
such as best practices for prescribing opioids,
pain management, recognizing potential cases of
substance use disorders, referral of patients
to treatment programs, preventing diversion of
controlled substances, and overdose prevention.
``(D) Supporting access to health care
services, including--
``(i) services provided by federally
certified opioid treatment programs;
``(ii) outpatient and residential
substance use disorder treatment
services that utilize medication-
assisted treatment, as appropriate; or
``(iii) other appropriate health care
providers to treat substance use
disorders.
``(E) Recovery support services, including--
``(i) community-based services that
include peer supports;
``(ii) mutual aid recovery programs
that support medication-assisted
treatment; or
``(iii) services to address housing
needs and family issues.
``(F) Other public health-related activities,
as the State, Indian Tribe, Tribal
organization, or Urban Indian organization
determines appropriate, related to addressing
substance use disorders within the State,
Indian Tribe, Tribal organization, or Urban
Indian organization, including directing
resources in accordance with local needs
related to substance use disorders.
``(c) Accountability and Oversight.--A State receiving a
grant under subsection (b) shall include in reporting related
to substance use disorders submitted to the Secretary pursuant
to section 1942 of the Public Health Service Act (42 U.S.C.
300x-52), a description of--
``(1) the purposes for which the grant funds received
by the State under such subsection for the preceding
fiscal year were expended and a description of the
activities of the State under the grant;
``(2) the ultimate recipients of amounts provided to
the State; and
``(3) the number of individuals served through the
grant.
``(d) Limitations.--Any funds made available pursuant to
subsection (i)--
``(1) shall not be used for any purpose other than
the grant program under subsection (b); and
``(2) shall be subject to the same requirements as
substance use disorders prevention and treatment
programs under titles V and XIX of the Public Health
Service Act (42 U.S.C. 290aa et seq., 300w et seq.).
``(e) Indian Tribes, Tribal Organizations, and Urban Indian
Organizations.--The Secretary, in consultation with Indian
Tribes, Tribal organizations, and Urban Indian organizations,
shall identify and establish appropriate mechanisms for Indian
Tribes, Tribal organizations, and Urban Indian organizations to
demonstrate or report the information as required under
subsections (b), (c), and (d).
``(f) Report to Congress.--Not later than September 30, 2024,
and biennially thereafter, the Secretary shall submit to the
Committee on Health, Education, Labor, and Pensions of the
Senate and the Committee on Energy and Commerce of the House of
Representatives, and the Committees on Appropriations of the
House of Representatives and the Senate, a report that includes
a summary of the information provided to the Secretary in
reports made pursuant to subsections (c) and (e), including--
``(1) the purposes for which grant funds are awarded
under this section;
``(2) the activities of the grant recipients; and
``(3) for each State, Indian Tribe, Tribal
organization, and Urban Indian organization that
receives a grant under this section, the funding level
provided to such recipient.
``(g) Technical Assistance.--The Secretary, including through
the Tribal Training and Technical Assistance Center of the
Substance Abuse and Mental Health Services Administration,
shall provide States, Indian Tribes, Tribal organizations, and
Urban Indian organizations, as applicable, with technical
assistance concerning grant application and submission
procedures under this section, award management activities, and
enhancing outreach and direct support to rural and underserved
communities and providers in addressing substance use
disorders.
``(h) Definitions.--In this section:
``(1) Indian tribe.--The term `Indian Tribe' has the
meaning given the term `Indian tribe' in section 4 of
the Indian Self-Determination and Education Assistance
Act (25 U.S.C. 5304).
``(2) Tribal organization.--The term `Tribal
organization' has the meaning given the term `tribal
organization' in such section 4.
``(3) State.--The term `State' has the meaning given
such term in section 1954(b) of the Public Health
Service Act (42 U.S.C. 300x-64(b)).
``(4) Urban indian organization.--The term `Urban
Indian organization' has the meaning given such term in
section 4 of the Indian Health Care Improvement Act.
``(i) Authorization of Appropriations.--
``(1) In general.--For purposes of carrying out the
grant program under subsection (b), there is authorized
to be appropriated $1,750,000,000 for each of fiscal
years 2023 through 2027, to remain available until
expended.
``(2) Federal administrative expenses.--Of the
amounts made available for each fiscal year to award
grants under subsection (b), the Secretary shall not
use more than 20 percent for Federal administrative
expenses, training, technical assistance, and
evaluation.
``(3) Set aside.--Of the amounts made available for
each fiscal year to award grants under subsection (b)
for a fiscal year, the Secretary shall--
``(A) award 5 percent to Indian Tribes,
Tribal organizations, and Urban Indian
organizations; and
``(B) of the amount remaining after
application of subparagraph (A), set aside up
to 15 percent for awards to States with the
highest age-adjusted rate of drug overdose
death based on the ordinal ranking of States
according to the Director of the Centers for
Disease Control and Prevention.''.
[all]