Legislative Update, June 13, 2018: Special Opiate Edition

Share:

In this special edition of Legislative Update, Marilyn Singleton, MD, JD breaks down the surge of opiate-related legislation under consideration on Capitol Hill.

In response to the opiate abuse epidemic, Congress has put forth almost 60 bills, many of which are receiving votes by the full House this week (the week of June 11th). In addition, the Senate Finance Committee, on June 12, “unanimously approved its big bill to address the opioid crisis,” reports Politico.

Here is a peek inside the provisions under consideration:

Privacy

H.R. 3331, a bill to amend title XI of the Social Security Act to promote testing of incentive payments for behavioral health providers for adoption and use of certified electronic health record technology. This bill amends title XI (General Provisions) of the Social Security Act to specify that the Center for Medicare and Medicaid Innovation may test models to provide incentive payments to behavioral health providers for: (1) adopting electronic health records technology, and (2) using that technology to improve the quality and coordination of care. Rep. Lynn Jenkins (R-KS); https://www.govtrack.us/congress/bills/115/hr3331/text.

While not specifically an opioid bill, urging mental health professionals to use EMR is one more assault on privacy.

H.R. 5009, Jessie’s Law, would require HHS with outside experts to develop best practices for displaying information about opioid use disorder in a patient’s medical record. HHS would be required to develop and disseminate written materials annually to health care providers about what disclosure could be made while still complying with federal laws governing health care privacy. Rep. Tim Wahlberg (R-WI); https://www.govtrack.us/congress/bills/115/hr5009/text.

H.R. 5795, the Overdose Prevention and Patient Safety Act, would amend the Public Health Service Act so that requirements pertaining to the confidentiality and disclosure of medical records relating to substance abuse disorders align with the provisions of HIPAA. The bill would require HHS to issue regulations prohibiting discrimination based on data disclosed from such medical records, to issue regulations requiring covered entities to provide written notice of privacy practices. Rep. Earl Blumenauer (D-CT); https://www.govtrack.us/congress/bills/115/hr5795/text.

Legislation Affecting Medicaid, CHIP

H.R. 3192, CHIP Mental Health Parity Act, would require all Children’s Health Insurance Program plans to cover mental health and substance abuse treatment. States would not be allowed to impose financial or utilization limits on mental health treatment that are lower than limits placed on physical health treatment. Rep. Joseph Kennedy III (D-MA); https://www.govtrack.us/congress/bills/115/hr3192/text.

H.R. 4005, Medicaid Reentry Act, would amend Title XIX (Medicaid) of the Social Security Act to allow Medicaid payment for medical services furnished to an incarcerated individual during the 30-day period preceding the individual’s release. Rep. Paul Tonko (D-NY); https://www.govtrack.us/congress/bills/115/hr4005/text.

H.R. 5477, the Rural Development of Opioid Capacity Services Act (DOCS Act), would require the Centers for Medicare & Medicaid Services (CMS) to to conduct a 5-year demonstration project to increase the number of providers participating in Medicaid to provide treatment for substance abuse disorders. The CMS must select 10 states for inclusion under the demonstration project, giving preference to states that have a prevalence of substance-use disorders (in particular, opioid-use disorders) comparable to or higher than the national average. Rep. Tom Halloran (D-AZ); https://www.govtrack.us/congress/bills/115/hr5477/text.

H.R. 5789, a bill to amend title XIX of the Social Security Act to provide for Medicaid coverage protections for pregnant and post-partum women while receiving inpatient treatment for a substance use disorder, would direct HHS to issue guidance to states on best practices under Medicaid and CHIP for treating infants with neonatal abstinence syndrome. The bill would also direct the Government Accountability Office to study Medicaid coverage for pregnant and postpartum women with substance abuse disorders. Rep. Bill Foster (D-IL); https://www.govtrack.us/congress/bills/115/hr5789/text.

H.R. 5797, the IMD Care Act, would expand Medicaid coverage for people with opioid use disorder who are in institutions for mental disease (IMDs) for up to 30 days per year. Under a current polity called IMD exclusion, the federal government generally does not make matching payments to state Medicaid programs for most services provided to IMDs to adults between the ages of 21 to 64. Rep. Mimi Walters (R-CA); https://www.govtrack.us/congress/bills/115/hr5797/text.

H.R. 5799, the Medicaid Drug Review, Utilization, Good Governance Improvement Act the (Medicaid DRUG Improvement Act), would require Medicaid programs to implement additional review of opioid prescriptions, monitor concurrent prescribing of opioids and certain other drugs, and monitor the use of antipsychotic drugs by children. Rep. Marsha Blackburn (R-TN); https://www.govtrack.us/congress/bills/115/hr5799/text.

H.R. 5800, the Medicaid Institutes for Mental Disease Are Decisive in Delivering Inpatient Treatment for Individuals but Opportunities for Needed Access are Limited without Information Needed about Facility Obligations Act (Medicaid IMD ADDITIONAL INFO Act), would direct the Medicaid and CHIP Payment and Access Commission to study institutions for mental diseases in a representative sample of states. Rep. Fred Upton (R-MI); https://www.govtrack.us/congress/bills/115/hr5800/text.

H.R. 5801, the Medicaid Providers Are Required To Note Experiences in Record Systems to Help In-Need Patients (PARTNERSHIP Act), would require providers who are permitted to prescribe controlled substances and who participate in Medicare to query prescription drug monitoring programs (PDMPs) before prescribing controlled substances to Medicaid patients. The bill would also require PDMPs to comply with certain data and system criteria, and PDMPs would receive additional federal funds to help cover administrative costs. Rep. Morgan Griffin (R-VA); https://www.govtrack.us/congress/bills/115/hr5801/text.

H.R. 5808, the Medicaid Pharmaceutical Home Act of 2018, would require Medicaid programs to operate pharmacy programs that would identify people at high risk of abusing controlled substances and require those patients to use a limited number of providers and pharmacies. Rep. Gus Bilirakis (R-FL); https://www.govtrack.us/congress/bills/115/hr5808/text.

H.R. 5810, the Medicaid Health Homes for Opioid-Use-Disorder Medicaid Enrollees Encouraged Act (the Medicaid Health HOME Act), would allow states to receive 6 months of enhanced federal Medicaid funding for programs that coordinate care for people with substance use disorders. The bill would require states to cover all FDA-approved drugs used in medication-assisted treatment for five years, but states could seek a waiver from the requirement. Currently a few states exclude methadone. Rep. Leonard Lance (R-NJ); https://www.govtrack.us/congress/bills/115/hr5810/text.

Legislation Affecting Medicare

H.R. 3331 amends title XI (General Provisions) of the Social Security Act to specify that the Center for Medicare and Medicaid Innovation may test models to provide incentive payments to behavioral health providers for: (1) adopting electronic health records technology, and (2) using that technology to improve the quality and coordination of care. Rep. Lynn Jenkins (R-KS); https://www.govtrack.us/congress/bills/115/hr3331.

H.R. 3528, the Every Prescription Conveyed Securely Act, would require prescriptions for controlled substances covered under Medicare Part D to be transmitted electronically starting January 1, 2021. Rep. Katherine Clark (D-MA); https://www.govtrack.us/congress/bills/115/hr3528/text.

H.R. 4284, the Indexing Narcotics, Fentanyl, and Opioids Act of 2017 (INFO Act), would require HHS to appoint a Federal Coordinator for the Department of Health and Human Services to coordinate programs within the Department of Health and Human Services that relate to opioid abuse reduction. Rep. Robert Latta (R-OH); https://www.govtrack.us/congress/bills/115/hr4284/text.

H.R. 4841, Standardizing Electronic Prior Authorization for Safe Prescribing Act of 2018, would require health care professionals to submit prior authorization requests electronically starting January 1, 2021, for drugs covered under Medicare Part D. Rep. David Schweikert (R-AZ); https://www.govtrack.us/congress/bills/115/hr4841/text.

H.R. 5582, the Abuse Deterrent Access Act of 2018, would require the Centers for Medicare & Medicaid Services to report to Congress on the adequacy of access to abuse-deterrent opioid formulations for individuals with chronic pain enrolled in a prescription drug plan under Medicare or Medicare Advantage (MA). The report must account for any barriers preventing enrollees from accessing such formulations under Medicare or MA. Rep. Buddy Carter (R-GA); https://www.govtrack.us/congress/bills/115/hr5582/text.

H.R. 5590, the Opioid Addiction Action Plan Act, would require the Centers for Medicare & Medicaid Services (CMS) to develop an action plan to provide recommendations on changes to the Medicare and Medicaid programs to enhance: (1) the treatment and prevention of opioid addiction, and (2) the coverage and reimbursement of medication-assisted treatment for opioid addiction. The CMS must convene a stakeholder meeting to solicit public comment on the action plan. Rep. Adam Kinzinger (R-IL); https://www.govtrack.us/congress/bills/115/hr5590/text.

H.R. 5603, Access to Telehealth Services for Opioid Use Disorders Act, would permit HHS to lift current geographic and other restrictions on coverage of telehealth services under Medicare for treatment of substance abuse disorders or co-occurring mental health disorders. HHS would be directed to encourage other payers to coordinate payments for opioid use disorder treatments and to evaluate the extent to which the demonstration project reduces hospitalizations, increases the use of medication-assisted treatments, and improves health outcomes. Rep. Doris Matsui (D-CA); https://www.govtrack.us/congress/bills/115/hr5603/text.

H.R. 5605, the Advancing High Quality Treatment for Opioid Use Disorders in Medicare Act, would require the Centers for Medicare & Medicaid Services (CMS) to carry out a demonstration program to: (1) increase access of opioid use disorder treatment services for Medicare beneficiaries, (2) improve physical and mental health outcomes for such beneficiaries, and (3) reduce Medicare expenditures. Opioid use disorder care teams of practitioners may apply for participation in the demonstration project. The CMS must establish a performance-based incentive payment for participating teams. The CMS must adopt or develop program quality standards and performance methods. Rep. Raul Ruiz (D-CA); https://www.govtrack.us/congress/bills/115/hr5605/text.

H.R. 5675. This bill would require Medicare prescription drug plan (PDP) sponsors, for plan years beginning on or after January 1, 2021, to establish drug management programs for at-risk beneficiaries. Current law authorizes, but does not require, PDP sponsors to establish such programs. Rep. Gus Bilirakis (R-FL); https://www.govtrack.us/congress/bills/115/hr5675/text.

H.R. 5684, Protecting Seniors From Opioid Abuse Act, would establish individuals who are identified as at-risk beneficiaries for prescription drug abuse as qualifying participants in medication therapy management programs under the Medicare prescription drug benefit. Rep. Mike Kelly (R-PA); https://www.govtrack.us/congress/bills/115/hr5684/text.

H.R. 5685, Medicare Opioid Safety Education Act of 2018, would require the Centers for Medicare & Medicaid Services to provide Medicare beneficiaries with educational resources regarding opioid use and pain management, as well as descriptions of covered alternative (non-opioid) pain-management treatments. Rep. John Faso (R-NY); https://www.govtrack.us/congress/bills/115/hr5685/text.

H.R. 5686, Medicare Clear Health Options in Care for Enrollees Act of 2018 or the Medicare CHOICE Act of 2018, would require Medicare and Medicare Advantage prescription drug plan (PDP) sponsors to annually disclose information to enrollees about: (1) the adverse effects of prolonged opioid use; and (2) the plan’s coverage of nonpharmacological therapies, devices, and non-opioid medications. PDP sponsors may limit disclosure to a subset of enrollees (such as those who were prescribed an opioid in the previous two-year period). Rep. Erik Paulsen (R-MN); https://www.govtrack.us/congress/bills/115/hr5686/text.

H.R. 5715, the Strengthening Partnerships to Prevent Opioid Abuse Act, would require the Centers for Medicare & Medicaid Services (CMS) to establish a secure online portal to allow: (1) data sharing among the CMS, Medicare prescription drug benefit plans, and Medicare Advantage (MA) plans; and (2) referrals by such plans of substantiated fraud, waste, or abuse in order to initiate or assist investigations by contracted entities under the Medicare Integrity Program. The CMS must disseminate and report certain collected information to such plans, including information regarding providers that were referred through the portal and trends in identifying suspicious activity. Additionally, for plan years beginning on or after January 1, 2021, MA organizations must submit information to the CMS regarding investigations or other actions taken by MA plans against providers that prescribe high volumes of opioids (as determined by the CMS). Rep. James Renacci (R-PH); https://www.govtrack.us/congress/bills/115/hr5715/text.

H.R. 5716, the Commit to Opioid Medical Prescriber Accountability and Safety for Seniors Act (the COMPASS Act) would require the Centers for Medicare & Medicaid Services (CMS) to identify outlier prescribers of opioids under the Medicare prescription drug benefit and Medicare Advantage prescription drug plans. Specifically, the CMS must: (1) establish an opioid-prescription threshold for determining whether a prescriber is an outlier compared to other prescribers, based on specialty and geographic area; (2) use National Provider Identifiers (unique provider identification numbers currently included on claims for covered drugs) to identify outlier prescribers; and (3) annually notify identified outlier prescribers of their status and provide them with resources on proper prescribing methods. The CMS may also identify and notify outlier prescribers based on co-prescriptions of covered drugs that have adverse effects when used in combination with opioids. Rep. Peter Roskam (R-IL); https://www.govtrack.us/congress/bills/115/hr5716/text.

H.R. 5796, Responsible Education Achieves Care and Healthy Outcomes for Users’ Treatment Act of 2018 (REACH OUT Act of 2018), would allow HHS to award grants to certain organizations that provide technical assistance and education to high-volume prescribers of opioids. The bill would appropriate $100 million for fiscal year 2019. Rep. Brian Fitzpatrick (R-PA); https://www.govtrack.us/congress/bills/115/hr5796/text.

H.R. 5798, the Opioid Screening and Chronic Pain Management Alternatives for Seniors Act, would add an assessment of current opioid prescriptions and screening for opioid use disorder to the Welcome to Medical Initial Preventive Physical Examination. Rep. Larry Bucshon, MD (R-IN); https://www.govtrack.us/congress/bills/115/hr5798/text.

H.R. 5804, Post-Surgical Injections as an Opioid Alternative Act, would freeze Medicare payment rate for certain analgesic injections provided in ambulatory surgical centers. Rep. John Shimkus (R-IL); https://www.govtrack.us/congress/bills/115/hr5804/text.

H.R. 5809, the Postoperative Opioid Prevention Act of 2018, would create an additional payment under Medicare for nonopioid analgesics. Under current law, certain new drugs and devices may receive an additional payment – separate from the bundled payment for a surgical procedure – in outpatient hospital departments and ambulatory surgical centers The bill would allow nonopioid analgesics to qualify for a five-year period of additional payments. Rep. Scott Peters (D-CA); https://www.govtrack.us/congress/bills/115/hr5809/text.

Legislation affecting the FDA

H.R. 5333, the Over-the-Counter Monograph Safety, Innovation, and Reform Act of 2018, would change the Food and Drug Administration’s (FDA) procedures for regulatory activities for over-the-counter medications. The bill would require the Government Accountability Office to study exclusive market protections for certain qualifying OTC drugs. Rep. Robert Latta (R-OH); https://www.govtrack.us/congress/bills/115/hr5333/text.

H.R. 5473, Better Pain Management Through Better Data Act of 2018, would require the FDA to conduct a public meeting and issue guidance to the industry addressing data collection and labeling for medical products that reduce pain while enabling the reduction, replacement, or avoidance of oral opioids. Barbara Comstock (R-VA); https://www.govtrack.us/congress/bills/115/hr5473/text.

H.R.5752, Stop Illicit Drug Importation Act of 2018, would amend the federal Food, Drug, and Cosmetic Act (FDCA) to strengthen FDA’s seizure powers and enhance its authority to detain, refuse, seize, or destroy illegal products offered for import. The legislation would subject more people to debarment under the FDCA and thus increase the potential for violations, and subsequently, the assessment of civil penalties. Rep. Marsha Blackburn (R-TN); https://www.govtrack.us/congress/bills/115/hr5752/text.

H.R. 5687, the Securing Opioids and Unused Narcotics with Deliberate Disposal and Packaging Act of 2018 (the SOUND Disposal and Packaging Act) would permit the FDA to require certain packaging and disposal technologies, controls, or measures to mitigate the risk of abuse and misuse of drugs. This bill would also require that the Government Accountability Office study the effectiveness and use of packaging technologies for controlled substances. H.R. 5687 would permit the Secretary of Health and Human Services to require drug developers and manufacturers to implement new packaging and disposal technology for certain drugs. Rep. Richard Hudson (R-NC); https://www.govtrack.us/congress/bills/115/hr5687/text.

H.R. 5806, the 21st Century Tools for Pain and Addiction Treatment Act, would require the HHS acting through the Commissioner of Food and Drugs, to hold at least one public meeting to address the challenges and barriers of developing non-addictive medical products intended to treat pain or addiction and to issue one or more final guidance documents, or update existing guidance documents, to help address challenges to developing non-addictive medical products to treat pain or addiction. Rep. Michael Burgess, MD (R-TX); https://www.govtrack.us/congress/bills/115/hr5806/text.

H.R. 5811, the Long-Term Opioid Efficacy Act of 2018, would allow the FDA to require that pharmaceutical manufacturers study certain drugs after they are approved to assess any potential reduction in those drugs’ effectiveness for the conditions of use prescribed, recommended, or suggested in labeling.

H.R. 5811 would expand an existing mandate that requires drug developers to conduct post-approval studies or clinical trials for certain drugs. Under current law, in certain instances, the FDA can require studies or clinical trials after a drug has been approved. H.R. 5811 would permit the FDA to use that authority if the reduction in a drug’s effectiveness meant that its benefits no longer outweighed its costs. Rep. Jerry McNerney (D-CA); https://www.govtrack.us/congress/bills/115/hr5811/text.

Miscellaneous

H.R. 449, Synthetic Drug Awareness Act of 2017, would require the Surgeon General to report to Congress on the public health effects of the increased use since January 2010 by individuals who are 12 to 18 years old of drugs developed and manufactured to avoid control under the Controlled Substances Act (e.g., synthetic marijuana, also known as “spice,” and synthetic amphetamines, also known as “bath salts”). Rep. Hakeem Jeffries (D-NY); https://www.govtrack.us/congress/bills/115/hr449/text.

H.R. 4275, Empowering Pharmacists in the Fight Against Opioid Abuse Act, would require the Drug Enforcement Administration (DEA) to develop and disseminate training programs and materials on: (1) the circumstances under which a pharmacist may refuse to fill a controlled substance prescription suspected to be fraudulent, forged, or indicative of abuse or diversion; and (2) federal requirements related to such refusal.

The DEA must seek input from relevant stakeholders. Rep. Mark DeSaulnier (D-CA); https://www.govtrack.us/congress/bills/115/hr4275/text.

H.R. 4684, Ensuring Access to Quality Sober Living Act of 2017, would require the Substance Abuse and Mental Health Services Administration to publish best practices for operating recovery housing, to distribute such publication to the states, and to provide technical assistance to states seeking to adopt such practices. “Recovery housing” means a shared living environment free from alcohol and illegal drug use and centered on peer support and connection to services to promote recovery from substance use disorders. Rep. Judy Chu (D-CA); https://www.govtrack.us/congress/bills/115/hr4684/text.

H.R. 5041, Safe Disposal of Unused Medication Act, would require hospice programs to have written policies and procedures for the disposal of controlled substances after a patient’s death. Rep. Tim Wahlberg (R-WI); https://www.govtrack.us/congress/bills/115/hr5041/text.

H.R. 5102, the Substance Use Disorder Workforce Loan Repayment Act of 2018, would amend the Public Health Service Act to create a loan repayment program for individuals who complete a period of service in a substance use disorder treatment job in a mental health professional shortage area or a county where the drug overdose death rate is higher than the national average.

The substance use disorder treatment job must be a full-time position where the primary intent and function is the direct care of patients with or in recovery from a substance use disorder.

Individuals must enter into an agreement of service of up to six years with the Health Resources and Services Administration. The repayment program would pay one-sixth of the principal and interest on any eligible loan for each year of service; the maximum total amount of repayment by the program is $250,000 per individual. Rep. Katherine Clark (D-MA); https://www.govtrack.us/congress/bills/115/hr5102/text.

H.R. 5176, the Preventing Overdoses While in Emergency Rooms Act of 2018, would authorize $50 million in 2019 and require HHS to develop protocols and grant a program for health care providers to address the needs of people who survive a drug overdose. Rep. David McKinley (R-WV); https://www.govtrack.us/congress/bills/115/hr5176/text.

H.R. 5197, Alternatives to Opioids (ALTO) in the Emergency Department Act, would direct HHS to carry out a demonstration program for hospitals and emergency departments to develop alternative protocols in pain management that limit the use of opioids. Rep. Bill Pascrell, Jr. (D-NJ); https://www.govtrack.us/congress/bills/115/hr5197/text.

HR 5202, Ensuring Patient Access to Substance Use Disorder Treatments Act of 2018, would clarify permission for pharmacists to deliver controlled substances to providers under certain circumstances, i.e., delivered to the location listed on the practitioner’s certificate of DEA registration, for substance abuse treatment, or for intrathecal injection, and not for general dispensing by the practitioner. Rep. Ryan Costello (R-PA); https://www.govtrack.us/congress/bills/115/hr5202/text.

H.R. 5228, the Stop Counterfeit Drugs by Regulating and Enhancing Enforcement Now Act (the SCREEN Act), would require drug distributors to cease distributing any drug that HHS determines might present an imminent or substantial hazard to public health. CBO cannot determine what drugs could be subject to such an order nor can it determine how private entities would respond. Consequently, CBO cannot determine whether the aggregate cost of the mandate would exceed the annual threshold for private-sector mandates. Rep. Frank Pallone, Jr. (D-NJ); https://www.govtrack.us/congress/bills/115/hr5228/text.

H.R. 5261, Treatment, Education, and Community Help to Combat Addiction Act of 2018 (the TEACH to Combat Addiction Act of 2018), would direct HHS to designate regional centers of excellence to improve the training of health professionals who treat substance abuse disorders. Rep. Bill Johnson (R-OH); https://www.govtrack.us/congress/bills/115/hr5261/text.

H.R. 5272, Reinforcing Evidence-Based Standards Under Law in Treating Substance Abuse Act of 2018 (the RESULTS Act of 2018), would require the National Mental Health and Substance Use Laboratory to issue guidance to applicants for SAMHSA grants that support evidence-based practices. Steve Stivers (R-OH); https://www.govtrack.us/congress/bills/115/hr5272/text.

H.R. 5327, Comprehensive Opioid Recovery Centers Act of 2018, would direct HHS to award grants to at least 10 providers that offer treatment for people with opioid use disorder, and would authorize $10 million a year from 2019 – 2023. Rep. Brett Guthrie (R-KY); https://www.govtrack.us/congress/bills/115/hr5327/text.

H.R. 5353, the Eliminating Opioid Related Infectious Diseases Act of 2018, would amend the Public Health Service Act by broadening the surveillance and education about Hepatitis C prevention and treatment of infections associated with injected drug use. Rep. Leonard Lance (R-NJ); https://www.govtrack.us/congress/bills/115/hr5353/text.

H.R. 5483, Special Registration for Telemedicine Clarification Act of 2018, would amend the Controlled Substances Act to establish a deadline for the Drug Enforcement Administration to promulgate regulations for the special registration of practitioners to practice to telemedicine. Rep. Buddy Carter (R-GA); https://www.govtrack.us/congress/bills/115/hr5483/text.

H.R. 5580, the Surveillance and Testing of Opioids to Prevent Fentanyl Deaths Act of 2018 (STOP Fentanyl Deaths Act of 2018), would establish a grant program for public health laboratories that conduct testing for fentanyl and other synthetic opioids. It would direct the CDC to expand its drug surveillance program with a focus on collecting data for fentanyl. Rep. Ann Huster (D-NH); https://www.govtrack.us/congress/bills/115/hr5580/text.

H.R. 5587, Peer Support Communities of Recovery Act, would direct HHS to award grants to nonprofit organizations that support community-based, peer-delivered support, including technical support for the establishment of recovery community organizations, independent, nonprofit groups led by people in recovery and their families. The bill would authorize $15 million per year for the 2019-2023 period. Based on historical spending patterns for similar activities, CBO estimates that implementing H.R. 5587 would cost $62 million over the 2019-2023 period; the remaining amounts would be spent in years after 2023.

Rep. Ben Lujan (D-NM); https://www.govtrack.us/congress/bills/115/hr5587/text.

H.R. 5788, the Securing the International Mail Against Opioids Act of 2018, would provide for the processing by U.S. Customs and Border Protection of certain international mail shipments and to require the provision of advance electronic information on international mail shipments of mail.

Rep. Mike Bishop (R-MI); https://www.govtrack.us/congress/bills/115/hr5788/text.

H.R. 5812, the Creating Opportunities that Necessitate New and Enhanced Connections That Improve Opioid Navigation Strategies Act of 2018 (the CONNECTIONS Act), gives the Director of the Centers for Disease Control and Prevention authorization to carry out any evidence-based prevention activity and provide training and technical assistance to States, localities, and Indian tribes. Rep. Morgan Griffith (R-VA); https://www.govtrack.us/congress/bills/115/hr5812/text.

Scroll Up