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Opioid Efforts Advance in Washington: U.S. Senate Passes Comprehensive Policy Package and Opioid Investments

September 18, 2018

The U.S. Senate passed a bipartisan policy package aimed at stemming the opioid epidemic, and separately, a funding bill that includes nearly $4 billion in related resources. Policies included in the package are intended to improve access to treatment, bolster the behavioral and mental health workforce, and take tangible actions to prevent opioid misuse.

Opioids Crisis Response Act of 2018

The Senate’s bipartisan policy package—the Opioids Crisis Response Act of 2018—was crafted by five committees, incorporating legislative proposals from 72 Senators. A section-by-section summary outlines the details of the package.

Of particular importance, the Senate opioid bill seeks to expand the use of telehealth services for the treatment of opioid use disorder and other substance use disorders. The bill makes targeted changes to Medicare policy in order to: 

  • Expand instances where telehealth services may be provided to Medicare beneficiaries for the treatment of substance use disorders
  • Provide payment for substance use treatment services furnished via telehealth 

Additionally, the bill will:

  • Offer guidance to states about options for providing services via telehealth that address substance use disorders under Medicaid and state options for federal reimbursement for substance use disorder services and treatment using telehealth including services addressing high-risk individuals, provider education through a hub-and-spoke model, and options for providing telehealth services to students in school-based health centers 
  • Clarify the ability of the Drug Enforcement Administration to develop a regulation to allow qualified providers to prescribe controlled substances in limited circumstances via telemedicine
  • Evaluate children’s access to Medicaid services to treat substance use disorders, including options to improve access through telehealth 
  • Develop best practices and identify potential solutions to barriers to furnishing services to children via telehealth

In a Statement of Administration Policy, the White House indicated it “strongly” supports passage of the Opioids Crisis Response Act and “looks forward to working with the Congress to address the opioid crisis as the legislative process continues.”

The U.S. House passed opioid legislation—H.R. 6, the SUPPORT for Patients and Communities Act—during June. Federal lawmakers have pledged to work quickly to reach a final agreement that can be enacted into law before the mid-term elections. Action on a final agreement could come as early as next week.

Funding for Resources to Fight the Epidemic

Congress has also been working during the last few months to pass federal appropriations bills to fund the federal government into fiscal year 2019 and avoid a government shutdown. Last week, the House and Senate reached a bipartisan agreement to fund the Departments of Health & Human Services (HHS), Education, and Labor and Defense—which represents 87 percent of all discretionary funding. That HHS package, which the Senate passed by a vote of 93 to 7, prioritizes resources to fight the opioid epidemic. 

The agreement includes $3.8 billion, an increase of $206 million over fiscal year 2018, for opioid-related activities including $1.5 billion for State Opioid Response grants, of which 15 percent is set-aside for the most impacted states, such as Pennsylvania. 

The House is expected to vote on that funding package next week.

Building on Work from Last Congress

This policy initiative builds 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 during two years for grants to states to supplement opioid abuse prevention and treatment activities. Pennsylvania has received federal funding allocations from the 21st Century Cures Act to support opioid activities. Most recently, Congress provided more than $4 billion in resources to address the opioid epidemic in the March government funding bill

Many of the policy provisions poised for enactment through the current policy work on the Opioid Crisis Response Act will take steps to reverse this tragic epidemic and new funding will help support ongoing work by diverse stakeholders. HAP will continue to work with federal lawmakers to advance positive policy solutions that provide sustained resources to address addiction and build capacity for treatment.

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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