SECTION 1. SHORT TITLE

This Act may be cited as the “Pain Patient Protection and Clinical Autonomy Act of 2025.”

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SECTION 2. CONGRESSIONAL FINDINGS AND PURPOSE

(a) Findings

Congress finds the following:

1. Millions of patients in the United States suffer from acute and chronic pain arising from medical conditions including cardiovascular disease, cancer, neurological injury, post-surgical recovery, and congenital disorders.
2. The practice of medicine requires individualized clinical judgment based on patient-specific risk–benefit analysis, informed consent, and evidence-based standards of care.
3. In response to concerns regarding misuse of prescription opioids, healthcare institutions and regulatory bodies implemented broad, categorical restrictions that, in many cases:
   • Supplanted individualized medical judgment;
   • Resulted in undertreatment or denial of pain care; and
   • Caused foreseeable harm to patients with legitimate medical need.
4. Certain policies denied or restricted pain treatment based solely on lawful conduct, including participation in state-authorized medical cannabis programs.
5. Cannabis has been recognized by the federal government as having accepted medical use and therapeutic value pursuant to its rescheduling under the Controlled Substances Act.
6. Public health objectives related to substance misuse must be pursued without infringing upon patient rights, medical ethics, or the integrity of clinical decision-making.
7. The conflation of law enforcement priorities with medical treatment decisions has undermined patient trust and physician autonomy.

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(b) Purpose

The purposes of this Act are:

1. To protect patients from categorical denial of pain treatment unrelated to individualized medical necessity;
2. To restore and safeguard clinical discretion in pain management;
3. To prohibit discrimination against patients based on lawful medical therapies;
4. To separate healthcare delivery from criminal-law enforcement functions; and
5. To establish enforceable patient protections consistent with federal law.

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SECTION 3. DEFINITIONS

For purposes of this Act:

1. “Pain patient” means an individual experiencing acute or chronic pain arising from a diagnosed medical condition.
2. “Covered healthcare entity” means any hospital, integrated delivery system, insurer, pharmacy benefit manager, or healthcare organization receiving federal funds or participating in Medicare, Medicaid, or federally regulated insurance markets.
3. “Clinician” means a physician or other licensed healthcare professional authorized to prescribe controlled substances under federal and state law.
4. “Individualized clinical determination” means a documented, patient-specific medical decision based on:
   • Medical history;
   • Contraindications;
   • Available treatment alternatives; and
   • A reasoned risk–benefit analysis.
5. “Lawful medical cannabis use” means the use of cannabis in compliance with applicable state or federal law.
6. “Categorical exclusion” means any policy or practice that denies or restricts pain treatment solely on the basis of a non-clinical factor without individualized assessment.

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SECTION 4. PROHIBITION ON CATEGORICAL DENIAL OF PAIN CARE

(a) General Rule

No covered healthcare entity may deny, restrict, or condition access to pain treatment through a categorical exclusion that is not based on an individualized clinical determination.

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(b) Prohibited Bases for Categorical Exclusion

A covered healthcare entity shall not deny or restrict pain treatment solely on the basis of:

1. A positive test for tetrahydrocannabinol (THC);
2. Participation in a lawful medical cannabis program;
3. The use of a lawful, non-impairing medical therapy unrelated to the prescribed treatment;
4. Institutional risk-avoidance policies that override clinician judgment without individualized review.

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SECTION 5. PRESERVATION OF CLINICAL DISCRETION

(a) Affirmation of Medical Judgment

Nothing in this Act shall be construed to require a clinician to prescribe any specific medication.

(b) Protection of Discretion

A clinician shall not be disciplined, penalized, or subject to adverse action solely for prescribing opioid analgesics or other pain treatments when:

1. The prescription is medically indicated;
2. An individualized clinical determination is documented; and
3. Applicable monitoring and safety standards are followed.

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SECTION 6. PAIN PATIENT BILL OF RIGHTS

Each pain patient receiving care from a covered healthcare entity shall have the right to:

1. An individualized pain assessment;
2. Access to evidence-based treatment options;
3. Informed consent regarding risks and alternatives;
4. A written explanation for any denial or limitation of pain treatment;
5. A timely internal review of adverse decisions;
6. Referral for an independent second opinion where clinically appropriate;
7. Continuity of care without abrupt or non-consensual discontinuation absent medical necessity.

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SECTION 7. TRANSPARENCY AND REVIEW REQUIREMENTS

(a) Policy Disclosure

Covered healthcare entities shall publicly disclose pain-management policies that affect access to care.

(b) Documentation

Any denial or restriction of pain treatment shall be documented with specific clinical justification.

(c) Appeals Process

Covered entities shall establish an internal appeals process and provide access to external review mechanisms.

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SECTION 8. SEPARATION OF MEDICAL CARE AND LAW ENFORCEMENT

(a) Non-Delegation

Clinical decision-making shall not be delegated to, dictated by, or conditioned upon directives from law enforcement agencies.

(b) Limitation on Enforcement Influence

No federal agency may condition funding, enforcement discretion, or regulatory approval on the adoption of categorical pain-treatment exclusions.

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SECTION 9. SAFE HARBOR FOR CLINICIANS

A clinician who complies with this Act shall be deemed to be acting within the scope of professional practice for purposes of federal law, including enforcement under the Controlled Substances Act.

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SECTION 10. ENFORCEMENT

(a) Administrative Enforcement

The Secretary of Health and Human Services shall promulgate regulations to enforce this Act.

(b) Private Right of Action

Any person aggrieved by a violation of this Act may bring a civil action for:

• Declaratory relief;
• Injunctive relief; and
• Reasonable attorney’s fees.

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SECTION 11. PREEMPTION AND CONSTRUCTION

(a) Minimum Federal Standard

This Act establishes minimum federal protections and does not preempt state laws providing greater patient protections.

(b) Rule of Construction

Nothing in this Act shall be construed to expand criminal liability or mandate prescribing.

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SECTION 12. EFFECTIVE DATE

This Act shall take effect 30 days after enactment.

A BILL
To affirm the constitutional rights of faith-based organizations to establish internal safety policies and to protect such organizations from civil or criminal liability arising solely from lawful firearm possession by members on church premises.

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Section 1. Short Title

This Act may be cited as the “Faith-Based Self-Defense and Liability Protection Act of 2025.”

Section 2. Findings

Congress finds that—

1. The First Amendment guarantees the free exercise of religion, including the right of congregations to worship in safety.
2. The Second Amendment secures the individual right to keep and bear arms for lawful purposes, including self-defense.
3. Religious assemblies have been targets of violent attacks; reasonable safety measures are essential to preserving life.
4. Faith-based organizations should not face civil or criminal penalties when members lawfully possess firearms for personal protection on premises used for worship.
5. Nothing in this Act compels any faith-based organization to adopt or reject firearm policies inconsistent with its doctrine.

Section 3. Definitions

(a) Faith-based organization—any church, synagogue, mosque, temple, or other religious assembly recognized under section 501(c)(3) of the Internal Revenue Code.
(b) Lawful firearm possession—possession, carrying, or use of a firearm consistent with all applicable federal, state, and local laws.
(c) Premises—real property owned, leased, or controlled by a faith-based organization and used primarily for religious worship or fellowship.

Section 4. Civil Liability Limitation

(a) No faith-based organization or its officers shall be liable in any civil action for damages, injury, or death arising solely from the lawful possession or defensive use of a firearm by a member, attendee, or employee while on premises controlled by the organization.
(b) Liability shall attach only upon clear and convincing evidence of gross negligence or willful misconduct by the organization.
(c) Adoption of, or failure to adopt, a written firearm or safety policy shall not by itself create a duty or a basis for liability.

Section 5. Criminal Liability Limitation

(a) No pastor, minister, priest, rabbi, imam, elder, or governing officer of a faith-based organization shall be criminally liable under federal law solely because an individual lawfully possesses a firearm on premises controlled by the organization.
(b) This section shall not apply to unlawful possession, discharge, or use of a firearm.

Section 6. Rule of Construction

(a) Nothing in this Act shall be construed to—
 (1) preempt state or local laws providing greater protections;
 (2) compel any religious organization to permit firearms contrary to its beliefs; or
 (3) limit lawful prosecution of criminal conduct involving firearms.

Draft Bill

A BILL
To amend Title 49 of the United States Code to enhance safety, accountability, and professional standards among common carriers and holders of Commercial Driver’s Licenses (CDLs), and for other purposes.

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Section 1. Short Title

This Act may be cited as the “Commercial Carrier Safety and Accountability Enhancement Act of 2025.”

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Section 2. Findings and Purpose

Congress finds that:

1. Commercial motor vehicle operators perform a critical role in interstate commerce and public safety.
2. Enhanced standards of mental, technical, and behavioral fitness are necessary to reduce highway fatalities and improve public trust in the transport sector.
3. Accountability of carriers and companies must be strengthened to ensure civil and criminal liability attaches to negligent acts and omissions.
4. Compensation of carriers must reflect the increased regulatory and safety burdens placed upon them.

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Section 3. Amendments to Title 49, United States Code

(a) English Proficiency

49 U.S.C. § 31310 is amended by adding:

(f) Immediate English Proficiency Testing. — The Secretary of Transportation shall require all applicants for a commercial driver’s license (CDL), regardless of immigration status, to demonstrate English language proficiency sufficient to communicate with enforcement officials, understand traffic signs, and comply with federal regulations.

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(b) Mental and Psychological Screening

49 U.S.C. § 31310 is amended by inserting after subsection (f):

(g) Mental Health Screening. —
(1) Each CDL applicant shall undergo a comprehensive psychological and mental health evaluation at the time of application.
(2) Any diagnosis of disorders likely to manifest in violence, sociopathy, or impaired judgment shall disqualify the applicant.
(3) CDL holders shall undergo periodic psychological re-evaluations not less than twice annually.
(4) A CDL holder disqualified due to subsequent mental health deterioration after five or more consecutive years of active service shall be afforded presumptive eligibility for Social Security Disability Insurance (SSDI).

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(c) Safety and Technical Proficiency

49 U.S.C. § 31305 is amended by adding:

(c) Technical Proficiency Examinations. — The Secretary shall establish immediate and comprehensive safety and technical skill proficiency testing as a prerequisite for CDL issuance.

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(d) Drug and Criminal Background Screening

49 U.S.C. § 31306 is amended to read:

(1) Randomized Quarterly Drug Testing. — All CDL holders shall be subject to a minimum of four randomized drug tests per twelve-month period, with no less than two months between tests.
(2) Zero Tolerance. — A first positive drug test, verified instance of road rage, or violent conduct while operating a commercial vehicle shall result in permanent disqualification from CDL eligibility.
(3) Criminal Background Checks. — Prior felony convictions for crimes evidencing disregard for human life, including but not limited to vehicular manslaughter, aggravated assault, arson, armed robbery, and major narcotics trafficking, shall disqualify applicants from CDL eligibility.

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(e) Company Accountability

49 U.S.C. § 31132 is amended by inserting:

(j) Carrier Liability. — Each trucking company engaged in interstate commerce shall be subject to both civil and criminal liability for negligent acts or omissions of its employed carriers when such acts occur within the scope of employment.

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(f) Point System for Infractions

A new section, 49 U.S.C. § 31311a, is added:

§ 31311a. Carrier Infraction Point System.
(a) The Secretary shall establish a uniform, nationwide CDL point system to assess accountability for infractions not rising to immediate CDL disqualification.
(b) Points shall be weighted based on severity, number of persons affected, extent of injuries, amount of property damage, and repetition of similar infractions.
(c) Accumulation of points above thresholds established by regulation shall result in CDL suspension or permanent disqualification.

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(g) Compensation Standards

A new section, 49 U.S.C. § 31508a, is added:

§ 31508a. Minimum Wage for Carriers.
(a) Each State shall establish a minimum compensation standard for carriers domiciled within that State, based on cost-of-living indexes and the State Consumer Price Index (CPI).
(b) Such rates shall be reviewed by the Secretary for adequacy and equity.
(c) Compensation shall proportionally reflect the heightened safety, accountability, and professional requirements imposed under this Act.

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(h) Restrictions on Foreign Nationals and Foreign Companies

[Note: Likely unconstitutional / in conflict with trade treaties. Retained here in legislative style for completeness.]

(1) No foreign national shall be issued a CDL unless naturalized as a United States citizen and at least five years have elapsed since naturalization.
(2) No foreign-owned trucking company may be authorized to operate within the United States.

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(i) Enforcement and Funding Conditions

49 U.S.C. § 31314 is amended by adding:

(e) Withholding of Funds. — The Secretary shall withhold federal highway and transportation funds from any State that fails to implement the requirements of this Act.

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Section 4. Effective Date

This Act shall take effect one year after the date of enactment.