Under current law, physicians must obtain a waiver from the Substance Abuse and Mental Health Services Administration (SAMHSA) to prescribe buprenorphine to patients with opioid dependency. Those waivers permit the physician to treat up to 30 patients initially; after one year, a physician may apply to increase that cap to 100 patients. S. 1455 would increase the caps to 100 in the first year and 500 in subsequent years. The bill also would permit nurse practitioners and physician assistants who meet certain criteria to apply for those waivers. However, the bill would not preempt state laws that place stricter controls on the provision of treatments for opioid dependency than would be established by S. 1455.
Over the 2017-2026 period, CBO estimates that enacting S. 1455 would increase net direct spending by $2.3 billion and reduce revenues by $0.7 billion, resulting in a $3.1 billion increase in federal deficits. (Of that increase, $2.9 billion would be on-budget.) Implementing S. 1455 also would have a discretionary cost of about $4 million over the 2017-2021 period; any such spending would be subject to the availability of appropriated funds. Pay-as-you-go procedures apply to the bill because enacting it would affect direct spending and revenues.
CBO estimates that enacting the legislation would not increase net direct spending or on-budget deficits by more than $5 billion in any of the four consecutive 10-year periods beginning in 2027.
S. 1455 contains no intergovernmental or private sector-mandates as defined in the Unfunded Mandates Reform Act.