To provide for comprehensive provisions for the prevention and enforcement of opioid abuse and treatment of opioid addiction.

SA 3395. Mr. WYDEN (for himself, Mr. Schumer, and Mrs. Murray)
submitted an amendment intended to be proposed to amendment SA 3378
proposed by Mr. Grassley (for himself, Mr. Leahy, Mr. Whitehouse, Mr.
Portman, Ms. Klobuchar, Ms. Ayotte, Mr. Graham, Mr. Coons, Mr. Cornyn,
and Mr. Durbin) to the bill S. 524, to authorize the Attorney General
to award grants to address the national epidemics of prescription
opioid abuse and heroin use; as follows:

At the appropriate place, insert the following:

SEC. __. INCREASED ANTI-KICKBACKS PENALTIES.

Paragraphs (1) and (2) of section 1128B(b) of the Social
Security Act (42 U.S.C. 1320a-7b(b)) are each amended by
inserting ``(or, beginning January 1, 2017, $50,000)'' after
``$25,000''.

SEC. __. CENTER FOR MEDICARE AND MEDICAID INNOVATION TESTING
OF OPIOID ABUSE TREATMENT PROGRAM MODEL FOR
PART D PRESCRIPTION DRUG PLAN ENROLLEES.

Section 1115A of the Social Security Act (42 U.S.C. 1315a)
is amended--
(1) in subsection (b)(2)(A), by adding at the end the
following new sentence: ``The models selected under this
subparagraph shall include the model described in subsection
(h).''; and
(2) by adding at the end the following new subsection:
``(h) Opioid Abuse Treatment Program Model.--
``(1) In general.--The Secretary shall test a model
requiring prescription drug plans under part D of title XVIII
to have in place, directly or through appropriate
arrangements, an opioid abuse treatment program for
applicable enrollees in lieu of the medication therapy
management program under section 1860D-4(c)(2) with respect
to such applicable enrollees.
``(2) Start date.--The model under this subsection shall
start in plan year 2018.
``(3) Selection.--The Secretary shall select a limited
number of Medicare part D regions in which to the model,
giving priority to regions based on the number of total
opioid prescriptions in the region.
``(4) Requirements for program.--Under an opioid abuse
treatment program, the PDP sponsor offering the plan shall--
``(A) establish a care team that includes at least--
``(i) a pharmacist;
``(ii) a physician; and
``(iii) an individual licenced in a State with expertise in
behavioral health (as determined by the Secretary), which may
be the physician described in clause (ii); and
``(B) develop, in consultation with the applicable enrollee
and with input from the prescriber to the extent necessary
and practicable, a care plan for the applicable enrollee that
is intended to treat the applicable enrollee's pain and limit
any unnecessary opioid prescriptions when possible.
``(5) Payment.--
``(A) In general.--Under the model under this subsection,
the Secretary shall make a monthly payment to the PDP sponsor
offering the prescription drug plan for each applicable
enrollee who receives services under the opioid abuse
treatment program.
``(B) Shared savings.--Under the model under this
subsection, the Secretary shall (using a methodology
determined appropriate by the Secretary) make payments (in
addition to the payments under subparagraph (A)) to the PDP
sponsor offering the prescription drug plan if the Secretary
determines that total spending under parts A, B, and D of
title XVIII (and including the payments under subparagraph
(A)) for applicable enrollees who receive services under the
opioid abuse treatment program is less than a historical
benchmark of total spending under such parts A, B, and D for
such enrollees or similar enrollees. Such benchmark shall be
adjusted at the Secretary's discretion for changes in law or
regulation, unforeseen circumstances, or advances in medical
practice.
``(6) Quality.--Under the model under this subsection, the
Secretary shall measure the quality of care furnished by
opioid abuse treatment programs, including elements related
to access to care, the unnecessary use of opioids, pain
management, and the delivery of behavioral health services.
``(7) Applicable enrollee.--In this subsection, the term
`applicable enrollee' means an individual who is, with
respect to a prescription drug plan--
``(A) enrolled with the plan; and
``(B) an at-risk beneficiary for prescription drug abuse
(as defined in section 1860D-4(c)(5)(C)).
``(8) Model not applicable to ma-pd plans.--The model under
this subsection shall not apply to MA-PD plans or enrollees
of such plans.
``(9) Clarification of application.--For purposes of the
preceding provisions of this section (including paragraphs
(3) and (4) of subsection (b) and subsections (d) and (f)),
the model under this subsection shall be deemed to be a model
under subsection (b).''.
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