S 921 United States Senate · 119th Congress

Tyler’s Law

S 921, titled "Tyler’s Law," requires the U.S. Department of Health and Human Services to study how often hospital emergency departments test for fentanyl during overdose cases, along with the costs, benefits, privacy impacts, and effects on patient-clinician relationships. The study must examine current testing frequency, associated costs, and how fentanyl testing might influence patient privacy and care. Within six months of completing the study, the Secretary must issue guidance on whether hospitals should routinely test for fentanyl, how to inform clinicians about testing protocols, and how such testing might affect future overdose risks and health outcomes. This bill directly affects hospitals with emergency departments and patients experiencing overdoses, but it does not mandate testing - it only mandates a study and subsequent guidance.

Issues: ✓ Healthcare

Bill status passed 3 of 5 stages cleared

Introduction

Mar 2025

Committee Review

Jan 2026

Senate Passage

Mar 2026

House Passage

President

Introduced Mar 10, 2025 Last action Mar 24, 2026

Maddy AI version diff · 1 comparison

What changed between versions

Introduced in Senate → Engrossed in Senate · 9 edits · Mar 23, 2026

MAJOR

The Senate engrossed version of S 921 significantly expands the scope and timeline of a federal study on fentanyl testing in emergency departments. The study deadline is extended from 1 year to 3 years, the definition of covered facilities is broadened to include freestanding emergency departments, and the study now covers fentanyl-related substances rather than only fentanyl itself. New elements address staff training needs, implementation barriers, and available federal resources.

TIMELINE

Study completion deadline extended from 1 year to 3 years after enactment; guidance issuance deadline extended from 6 months to 9 months after study completion.

SCOPE

Definition of 'hospital emergency department' expanded to include independent freestanding emergency departments, citing section 2799A-1(a)(3) of the Public Health Service Act instead of section 1867(a) of the Social Security Act.

All references to testing for 'fentanyl' broadened to 'fentanyl or fentanyl-related substances,' and the study now also considers other controlled substances related to an overdose.

REQUIREMENT

New study element requiring analysis of scenarios in which emergency departments do NOT administer fentanyl or related substance tests during an overdose.

New study element on potential staff training needs to support fentanyl and fentanyl-related substance testing.

New study element on barriers emergency departments may encounter when implementing testing, with recommendations on how to address those barriers.

FISCAL

New guidance item requiring the Secretary to identify available Federal resources that can assist emergency departments in implementing fentanyl and fentanyl-related substance testing.

TECHNICAL

Privacy language updated from general 'confidentiality and privacy of personal health information' to specific HIPAA citations (45 CFR part 160, subparts C and E of part 164); 'patient-physician relationship' changed to 'patient-health care professional relationship.'

Both the study and guidance provisions now specify that the Secretary acts through the Assistant Secretary for Mental Health and Substance Use and in coordination with other Federal departments, agencies, or stakeholders.

Floor votes

How they voted

This bill passed the Senate by voice vote (no roll call recorded).

Full legislative history

Actions timeline

Total actions

Key actions

Committee

Mar 23, 2026

Upper · Passed

Passed Senate with an amendment by Unanimous Consent. (consideration: CR S1559-1560; text: CR S1559-1560)

upper

Mar 23, 2026

Upper · Passed

Passed/agreed to in Senate: Passed Senate with an amendment by Unanimous Consent.

upper

Jan 28, 2026

Upper · Passed

Committee on Health, Education, Labor, and Pensions. Reported by Senator Cassidy with an amendment in the nature of a substitute. Without written report.

upper

Jan 15, 2026

Upper · Passed

Committee on Health, Education, Labor, and Pensions. Ordered to be reported with an amendment in the nature of a substitute favorably.

upper

Mar 10, 2025

Committee

Read twice and referred to the Committee on Health, Education, Labor, and Pensions.

upper

Mar 10, 2025

Introduced

Introduced in Senate

upper

1 primary · 13 co-sponsors