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Federal Policymakers Continue to Pursue Solutions to Opioid Epidemic

April 12, 2018

On the heels of investing nearly $4 billion in new resources to tackle the opioid epidemic in the recently enacted fiscal year 2018 omnibus appropriations act, Congressional committees are vetting new policy avenues to improve the response to the opioid crisis. 

After months of hearings and calls for stakeholder input, Congressional committees are working to build bipartisan consensus on specific policy recommendations.

The U.S. Senate Health, Education, Labor and Pensions (HELP) Committee held a hearing to vet policy concepts included in a discussion draft of the Opioid Crisis Response Act of 2018, put forward by HELP Committee Chairman Lamar Alexander (R–TN) and Ranking Member Patty Murray (D–WA). A summary of the bill details the far-reaching proposal which seeks to:

  • Promote opioid research and the development of new pain therapies
  • Improve opioid prescribing practices
  • Enhance access to treatment options
  • Foster education, data collection, and prevention activities
  • Provide support for children, families and workers
  • Address drug enforcement policies
  • Encourage greater information and data sharing
  • Bolster the mental health, behavioral and substance use workforce

Participating in the hearing, U.S. Senator Bob Casey (D–PA) spoke to the importance of addressing the needs of substance-exposed infants. Senator Casey applauded policy included in the HELP Committee discussion draft which would authorize a new grant program to support states in implementing “plans of safe care” for substance-exposed infants. The policy builds on Senator Casey’s work in 2016 to strengthen the requirement in the Child Abuse Prevention and Treatment Act that requires the development of a “plan of safe care” for each infant affected by substance abuse or withdrawal.

The HELP Committee has scheduled a formal mark-up of the Opioid Crisis Response Act on April 24 and hopes to advance comprehensive opioid legislation through the full Senate in the coming months.

A two-day hearing—Combating the Opioid Crisis: Improving the Ability of Medicare and Medicaid to Provide Care for Patients—by the U.S. House Energy & Commerce Health Subcommittee provided a forum to discuss more than 30 bills that would amend Medicare and Medicaid policies. The committee reviewed legislation that would:

  • Improve access to substance use care through Institutions for Mental Disease, health homes and telehealth
  • Promote drug utilization review, medication therapy management, and programs to identify at-risk individuals and limit drug diversion
  • Test payment models and new incentives to support the treatment of substance use disorders
  • Promote the use of prescription drug monitoring programs
  • Enhance the reporting and transparency of Medicaid data
  • Increase substance use provider capacity and training

Speaking from the provider perspective at the hearing, by John Kravitz, CIO of Geisinger, offered testimony that highlighted the multi-faceted approach Geisinger is employing to curb the use of opioids through initiatives such as:

  • Utilizing information technology—including tracking documentation within the electronic health record, a dashboard that shows providers reviewed the prescription drug monitoring program, listing findings in patient medical records, and integrating data from a pain app
  • Electronic prescribing (e-prescribing)
  • Implementing best practices for pain management
  • Embedding pharmacists in primary care clinics
  • Establishing drug take-back programs

This is the third legislative hearing conducted by the Energy & Commerce Committee this spring in furtherance of the goal of advancing comprehensive opioid legislation on the House floor before Memorial Day.

Also this week, the U.S. Ways & Means Committee issued an opioid white paper that provides an analysis of feedback received from stakeholders on best practices and ideas to address the opioid epidemic. Similar to the issued addressed in legislation highlighted as priorities by the Senate HELP and House Energy & Commerce Committees, the white paper speaks to the need for action on common emergent themes:

  • Providing greater treatment options and reimbursement, and increasing access to medication-assisted treatment
  • Employing tools to prevent overprescribing and abuse
  • Promoting better screening and data tracking
  • Enhancing provider and patient education and communication

Additionally, the U.S. House Oversight & Government Reform Subcommittee on Healthcare, Benefits, and Administrative Rules held a hearing “Local Responses and Resources to Curtail the Opioid Epidemic” and the U.S. Senate Judiciary Subcommittee on Crime and Terrorism considered the topic “Defeating Fentanyl: Addressing the Deadliest Drugs Fueling the Opioid Crisis.”

HAP is assessing the various opioid policy proposals that are advancing through Congressional committees and providing Pennsylvania perspectives to federal elected officials from the commonwealth.

For information about HAP’s clinical work around the opioid crisis, contact Dr. Michael Consuelos, HAP’s senior vice president, clinical integration. For information about federal and state advocacy efforts, contact Laura Stevens Kent, HAP’s vice president, federal advocacy, and Stephanie Watkins, HAP’s vice president, state legislative advocacy.

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