S.Amdt. 2562

SA 2562. Mrs. CAPITO submitted an amendment intended to be proposed
to amendment SA 2499 proposed by Mr. McConnell to the bill S. 178, to
condemn gross human rights violations of ethnic Turkic Muslims in
Xinjiang, and calling for an end to arbitrary detention, torture, and
harassment of these communities inside and outside China; which was
ordered to lie on the table; as follows:

At the appropriate place, insert the following:

SEC. __. ACCESS TO NON-OPIOID TREATMENTS FOR PAIN.

(a) In General.--Section 1833(t) of the Social Security Act
(42 U.S.C. 1395l(t)) is amended--

[[Page S4873]]

(1) in paragraph (2)(E), by inserting ``and separate
payments for non-opioid treatments under paragraph (16)(G),''
after ``payments under paragraph (6)''; and
(2) in paragraph (16), by adding at the end the following
new subparagraph:
``(G) Access to non-opioid treatments for pain.--
``(i) In general.--Notwithstanding any other provision of
this subsection, with respect to a covered OPD service (or
group of services) furnished on or after January 1, 2020, and
before January 1, 2025, the Secretary shall not package, and
shall make a separate payment as specified in clause (ii)
for, a non-opioid treatment (as defined in clause (iii))
furnished as part of such service (or group of services).
``(ii) Amount of payment.--The amount of the payment
specified in this clause is, with respect to a non-opioid
treatment that is--

``(I) a drug or biological product, the amount of payment
for such drug or biological determined under section 1847A;
or
``(II) a medical device, the amount of the hospital's
charges for the device, adjusted to cost.

``(iii) Definition of non-opioid treatment.--A `non-opioid
treatment' means--

``(I) a drug or biological product that is indicated to
produce analgesia without acting upon the body's opioid
receptors; or
``(II) an implantable, reusable, or disposable medical
device cleared or approved by the Administrator for Food and
Drugs for the intended use of managing or treating pain;

that has demonstrated the ability to replace or reduce opioid
consumption in a clinical trial or through clinical data
published in a peer-reviewed journal.''.
(b) Ambulatory Surgical Center Payment System.--Section
1833(i)(2)(D) of the Social Security Act (42 U.S.C.
1395l(i)(2)(D)) is amended--
(1) by aligning the margins of clause (v) with the margins
of clause (iv);
(2) by redesignating clause (vi) as clause (vii); and
(3) by inserting after clause (v) the following new clause:
``(vi) In the case of surgical services furnished on or
after January 1, 2020, and before January 1, 2025, the
payment system described in clause (i) shall provide for a
separate payment for a non-opioid treatment (as defined in
clause (iii) of subsection (t)(16)(G)) furnished as part of
such services in the amount specified in clause (ii) of such
subsection.''.
(c) Evaluation of Therapeutic Services for Pain
Management.--
(1) Report to congress.--Not later than 1 year after the
date of the enactment of this Act, the Secretary of Health
and Human Services (in this subsection referred to as the
``Secretary''), acting through the Administrator of the
Centers for Medicare & Medicaid Services, shall submit to
Congress a report identifying--
(A) limitations, gaps, barriers to access, or deficits in
Medicare coverage or reimbursement for restorative therapies,
behavioral approaches, and complementary and integrative
health services that are identified in the Pain Management
Best Practices Inter-Agency Task Force Report and that have
demonstrated the ability to replace or reduce opioid
consumption; and
(B) recommendations to address the limitations, gaps,
barriers to access, or deficits identified under subparagraph
(A) to improve Medicare coverage and reimbursement for such
therapies, approaches, and services.
(2) Public consultation.--In developing the report
described in paragraph (1), the Secretary shall consult with
relevant stakeholders as determined appropriate by the
Secretary.
(3) Exclusive treatment.--Any drug, biological product, or
medical device that is a non-opioid treatment (as defined in
section 1833(t)(16)(G)(iii) of the Social Security Act, as
added by subsection (a)) shall not be considered a
therapeutic service for the purpose of the report described
in paragraph (1).
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