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U.S. House Committees Advance Additional Opioid Bills

May 18, 2018

The U.S. House Ways & Means and Energy & Commerce Committees advanced a slate of bills with the goal of making progress in tackling the opioid crisis and protecting communities by:

  • Bolstering enforcement efforts
  • Strengthening prevention and public health efforts
  • Addressing coverage and payment issues in Medicare and Medicaid

The Ways & Means Committee marked-up seven bipartisan bills that were largely aimed at improving guidance and information available to health care providers and Medicare beneficiaries about:

  • Opioid use and pain management
  • Implementing additional strategies to prevent opioid abuse by Medicare beneficiaries
  • Making treatment options available

The Energy & Commerce Committee had approved 25 non-controversial bills last week, and advanced another 32 during a legislative mark-up yesterday, including a handful that stimulated robust debate. 

The Committee approved legislation to address access to treatment for vulnerable populations including:

  • H.R. 4005, the Medicaid Reentry Act, which would allow for Medicaid coverage for treatment of inmates during the 30-day period preceding release 
  • H.R. 4998, the Health Insurance for Former Foster Youth Act, which would provide coverage continuity for former foster care children by allowing them to stay on Medicaid coverage until they are 26 years old
  • H.R. 3192, the CHIP Mental Health Parity Act, which would ensure access to mental health care through the Children's Health Insurance Program (CHIP)

Controversy surrounded the review of legislation that would expand buprenorphine prescribing authority (H.R. 3692, Addiction Treatment Access Improvement Act of 2017). 

H.R. 5797, the IMD CARE Act, would take steps to provide for appropriate payment through Medicaid for substance abuse treatment at institutions for mental disease (IMD). These include hospitals, nursing facilities, or other institutions of more than 16 beds that are primarily engaged in providing diagnosis, treatment, or care of persons with mental diseases. 

Finally, the committee dedicated significant time to discussing 42 CFR Part 2, which:

  • Governs the sharing of a patient’s medical information
  • Requires explicit patient consent for the sharing of behavioral health information

After grappling with the need to both protect patients and allow information sharing to support coordinated care, the committee approved H.R. 5795, the Overdose Prevention and Patient Safety Act. This legislation would:

  • Ease current restrictions that limit the ability of health care providers to access a patient’s mental health and substance use records
  • Clarify that patients still have the right to request restrictions on information
  • Provide explicit protections with respect to the use of substance use records in criminal, civil, or administrative investigations, actions, or proceedings

Both the U.S. House and Senate are developing opioid packages and have set the goal of approving legislation before the end of the summer:

  • The Ways & Means and Energy & Commerce Committees bills are expected to be rolled into a comprehensive package for consideration by the full House
  • The U.S. Senate Health, Education, Labor and Pensions Committee advanced their own legislative package, S. 2680, the Opioid Crisis Response Act of 2018, in late April
  • Action is still awaited by the Senate Finance Committee, and the House and Senate Judiciary Committees 

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

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