House Bills and the Opioid Crisis

H.R. 6, SUBSTANCE USE-DISORDER PREVENTION THAT PROMOTES OPIOID RECOVERY AND TREATMENT FOR PATIENTS AND COMMUNITIES ACT

H.R. 6, SUBSTANCE USE-DISORDER PREVENTION THAT PROMOTES OPIOID RECOVERY AND TREATMENT FOR PATIENTS AND COMMUNITIES ACT. The House of Representatives passed a bipartisan, comprehensive bill on 6/22/2017, which aims at curbing the country’s growing opioid epidemic.  A vote of 396-14, the House passed H.R. 6, the SUPPORT for Patients Communities Act.  H.R. 6 targets Medicaid, Medicare, and public health reforms by advancing treatment and recovery initiatives.  Improving prevention, protecting communities, and bolstering efforts to combat illicit synthetic drugs like fentanyl.

 

Summary

Medicaid

  • Require state Medicaid programs to not terminate a juvenile’s medical assistance eligibility because the juvenile is incarcerated. A state may suspend coverage while the juvenile is an inmate, but must restore coverage upon release without requiring a new application unless the individual no longer meets the eligibility requirements for medical assistance (H.R. 1925)
  • Enable former foster youth who are in care by their 18th birthday and previously enrolled in Medicaid to receive health care until the age of 26 if they move out of state (H.R. 4998)
    Require the Centers for Medicare and Medicaid Services (CMS) to carry out a demonstration project to provide Can enhanced federal matching rate for state Medicaid expenditures related to the expansion of substance-use treatment and recovery services targeting provider capacity (H.R. 5477)
  • Require all state Medicaid programs to have a beneficiary assignment program that identifies Medicaid beneficiaries at-risk for substance use disorder (SUD) and assigns them to a pharmaceutical home program, which must set reasonable limits on the number of prescribers and dispensers that beneficiaries may utilize (H.R. 5808)
    • Require state Medicaid programs to have safety edits in place for opioid refills, monitor concurrent prescribing of opioids and certain other drugs, and monitor antipsychotic prescribing for children (H.R. 5799)
  • Require CMS to issue guidance on Neonatal Abstinence Syndrome (NAS) treatment options under Medicaid and require a study by the nonpartisan Government Accountability Office (GAO) on coverage gaps for pregnant women with SUD (H.R. 5789)
  • Provide additional incentives for Medicaid health homes for patients with substance use disorder (H.R. 5810

Medicare

  • Instruct CMS to evaluate the utilization of telehealth services in treating SUD (H.R. 5603)
  • Creates a pass-through payment extension under Medicare to encourage the development of clinically superior non-opioid drugs (H.R. 5809)
  • Add a review of current opioid prescriptions and, as appropriate, a screening for opioid use disorder (OUD) as part of the Welcome to Medicare initial examination (H.R. 5798)
  • Incentivize post-surgical injections as a pain treatment alternative to opioids by reversing a reimbursement cut for these treatments in the Ambulatory Service Center setting, as well as collect data on a subset of codes related to these treatments (H.R. 5804)
  • Require e-prescribing, with exceptions, for coverage of prescription drugs that are controlled substances under the Medicare Part D program (H.R. 3528)
  • Require prescription drug plan sponsors under the Medicare program establish drug management programs for at-risk beneficiaries (H.R. 5675)
  • Provide access to Medication-Assisted Treatment (MAT) in Medicare through bundled payments made to Opioid Treatment Programs for holistic service (Section 2 of H.R. 5776)

Public Health

  • Direct the Food and Drug Administration (FDA) to issue or update guidance on ways existing pathways can be used to bring novel non-addictive treatments for pain and addiction to patients. Several approaches have proven successful in speeding the availability of treatments for severe conditions through the FDA (H.R. 5806)
  • Authorize grants to state and local agencies for the establishment or operation of public health laboratories to detect fentanyl, its analogs, and other synthetic opioids (H.R. 5580)
  • Enable clinical nurse specialists, certified nurse midwives, and certified registered nurse anesthetists to prescribe buprenorphine; and make the buprenorphine prescribing authority for physician assistants and nurse practitioners permanent. Also, H.R. 6 will permit a waivered-practitioner to immediately start treating 100 patients at a time with buprenorphine (skipping the initial 30 patient cap) if the practitioner has board certification in addiction medicine or addiction psychiatry; or if practitioner provides MAT in a qualified practice setting. Medications, such as buprenorphine, in combination with counseling and behavioral therapies, provide a whole-patient approach to the treatment of opioid use disorder (H.R. 3692)

View Bills Here

H.R. 5590, Opioid Addiction Action Plan Act
H.R. 5603, Access to Telehealth Services for Opioid Use Disorder
H.R. 5605, Advancing High-Quality Treatment for Opioid Use Disorders in Medicare Act
H.R. 5798, Opioid Screening and Chronic Pain Management Alternatives for Seniors Act
H.R. 5804, Post-Surgical Injections as an Opioid Alternative Act
H.R. 3692, Addiction Treatment Access Improvement Act of 2017
H.R. 4684, Ensuring Access to Quality Sober Living Act of 2018
H.R. 5329, Poison Center Network Enhancement Act of 2018
H.R. 5580, STOP Fentanyl Deaths Act of 2018
H.R. 5587, Peer Support Communities of Recovery Act
H.R. 5797 IMD CARE Act
H.R. 5799, Medicaid DRUG Improvement Act
H.R. 5800, Medicaid IMD ADDITIONAL INFO Act
H.R. 5801, Medicaid PARTNERSHIP Act
H.R. 5715, Strengthening Partnerships to Prevent Opioid Abuse Act
H.R. 5716, Commit to Opioid Medical Prescriber Accountability and Safety for Seniors (COMPASS) Act
H.R. 5796, Responsible Education Achieves Care and Healthy Outcomes for Users’ Treatment (REACH OUT) Act of 2018
H.R. 5228, Stop Counterfeit Drugs by Regulating and Enhancing Enforcement Now Act
H.R. 5752, the Stop Illicit Drug Importation Act of 2018
H.R. 5806, 21st Century Tools for Pain and Addiction Treatments Act
H.R. 4998, Health Insurance for Former Foster Youth Act
H.R. 5477, Rural Development of Opioid Capacity Services Act
H.R. 1925, At-Risk Youth Medicaid Protection Act of 2017
H.R. 3192, CHIP Mental Health Parity Act
H.R. 4005, Medicaid Reentry Act
H.R. 5583, Requiring Medicaid Programs to Report on All Core Behavioral Health Measures
H.R. 5808, Medicaid Pharmaceutical Home Act
H.R. 5795, Overdose Prevention and Patient Safety Act
H.R. 5807, Substance Use Disorder Coordination, Access, Recovery Enhancement (SUD CARE) Act of 2018
H.R. 5811, to amend the Federal Food, Drug, and Cosmetic Act concerning post approval study requirements for certain controlled substances, and for other purposes
H.R. 5812, Creating Opportunities that Necessitate New and Enhanced Connections that Improve Opioid Navigating Strategies Act (CONNECTIONS) Act
H.R. 5809, Postoperative Opioid Prevention Act of 2018
H.R. 5810, Medicaid Health HOME Act
H.R. 5789, To amend title XIX of the Social Security Act to provide for Medicaid IMD coverage for pregnant and postpartum women

*It is important to note that some of these bills were passed by voice vote, which is a vote taken by indicating the relative strength and volume of calls of aye and no.

Why These Bill are Important

According to the Centers for Disease Control and Prevention (CDC):

1,000 people are treated for opioid misuse in emergency departments per day.

115 Americans die per day, and opioid-related overdoses have increased steadily since 1999.

Life expectancy dropped in 2015 and 2106 due to an increase in unintentional injuries (drug overdoses). The opioid crisis has affected the labor force by almost 1 million workers ($702 billion) in the years between 1999 and 2015.

In 2015, the total economic burden of the opioid epidemic was estimated to be $504 billion.
More than 2 million Americans will suffer from addiction to opioids in 2018.

What’s Next

It is now up to the Senate to craft its legislation. We know that the opioid legislation should be a priority, but there is not a specific timeline for the Senate to draft the bills.  We may have to wait up until November to see what proposals or policy ideas if any are coming out of the Senate.  For more detailed information about the House Opioid bills, here is a look at some of the most impactful bills. http://ow.ly/N1se30kI7pm