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Opioid Legislation Remains Top Focus in Washington; Legislation Advancing

June 14, 2018

Action this week in both the U.S. House and the U.S. Senate moves the legislative process forward in advancing a package of opioid policies that seek to address multi-faceted elements of the opioid crisis by expanding access to treatment and recovery, promoting prevention strategies, and enhancing law enforcement responses.

After weeks of work at the committee level, the House overwhelmingly approved more than two dozen bills aimed at addressing the opioid epidemic. The American Hospital Association highlighted the hospital community’s support for four specific bills:

  • H.R. 5176, the Preventing Overdoses While in Emergency Rooms (POWER) Act, introduced by Congressman Mike Doyle (D, PA-14), would provide resources for hospitals to develop protocols on discharging patients who have presented with an opioid overdose
  • H.R. 5197, the Alternatives to Opioids (ALTO) in the Emergency Department Act, would establish a demonstration program to test alternative pain management protocols to limit opioid use in hospital emergency departments 
  • H.R. 5582, the Abuse Deterrent Access Act, would direct the Centers for Medicare & Medicaid Services to evaluate coverage of abuse-deterrent opioids in Medicare plans
  • H.R. 5685, the Medicare Opioid Safety Education Act, would include opioid use and pain management resources in the "Medicare & You" handbook

The House is expected to consider additional bills next week with the goal of reconciling differences with whatever policy package the Senate approves this summer. Key policies to be considered next week would:

  • Improve information sharing among providers with regard to substance use disorder treatment by aligning 42 CFR Part 2 regulations with the Health Insurance Portability and Accountability Act
  • Allow states to receive federal matching funds for up to 30 days per year for services provided to adult Medicaid beneficiaries with an opioid use disorder in an Institution for Mental Disease

HAP also supports an effort by Congressman Ryan Costello (R, PA-06) to include the Opioid Workforce Act, H.R. 5818/S. 2843, in whatever package ultimately advances through Congress. Importantly, the bill incentivizes the training of physicians specialized in the treatment of substance use disorders and pain management by providing Medicare support for an additional 1,000 graduate medical education positions during the next five years. 

On the other side of the Capitol, the Senate Finance Committee unanimously approved a package of policies addressing the opioid crisis through Medicare, Medicaid, and human services programs. The Helping to End Addiction and Lessen (HEAL) Substance Use Disorders Act of 2018, which is estimated to cost $162 million over 10 years, would:

  • Promote opioid safety education and enhance access to non-opioid treatment options
  • Expand access to treatment services through payment changes that increase the availability of telehealth for addiction treatment and remove lifetime limits under Medicaid for medication-assisted treatment for substance use disorder
  • Enhance information sharing to support proper prescribing practices and protect at-risk beneficiaries
  • Require that health care professionals use electronic prescribing for Medicare-covered drugs for certain controlled substances

In addition to Finance Committee, the Senate Health, Education, Labor, and Pensions Committee and the Senate Judiciary Committee have already advanced their own legislation. The Senate is expected to move to consideration of a full package of policies later this summer.

This policy initiative is intended to build on significant work last Congress to confront the opioid crisis. During the summer of 2016, Congress passed the Comprehensive Addiction and Recovery Act (CARA) which authorized a wide array of grants to carry out a comprehensive opioid abuse response through education, treatment, and recovery efforts. Later that year, the 21st Century Cures Act dedicated $1 billion over 2 years for grants to states to supplement opioid abuse prevention and treatment activities. Pennsylvania has received two federal funding allocations from the 21st Century Cures Act to support opioid activities. Most recently, Congress provided $4 billion in resources to address the opioid epidemic in the March government funding bill.

A report released by the Pennsylvania Health Care Cost Containment Council (PHC4) yesterday details hospitalization trends related to the opioid overdoses, showing that Pennsylvania is making progress in addressing the opioid crisis, but highlighting the reality that the opioid use disorder touches every part of the state and all demographic and socioeconomic groups.

Many of the policy provisions under consideration in Congress will take steps to reverse this tragic epidemic. HAP will continue to work with federal lawmakers to advance positive policy solutions.

For information about HAP’s clinical work around the opioid crisis, contact Michael Consuelos, MD, 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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