CEO Update | 12
U.S. House Passes Dozens of Opioid-Related Bills
House members this week approved nearly three dozen pieces of legislation to address America’s opioid crisis and will likely consider several other opioid-related bills in the coming days.
Next week the House is expected to focus on two NABH-supported bills. The first is the IMD CARE Act, which would partially repeal Medicaid’s Institutions for Mental Diseases (IMD) exclusion for patients with opioid use disorder or with co-occurring behavioral health conditions. And the second is the Overdose Prevention and Patient Safety Act, which would align 42 CFR (Part 2) with the Health Insurance Portability and Accountability Act of 1996. These individual bills will likely be included in a broader opioid package that the House will then send to the Senate for its consideration.
Meanwhile, the influential Senate Finance Committee this week passed the Helping to End Addiction and Lessen (HEAL) Substance Use Disorders Act of 2018. Several amendments related to NABH’s key issues were not included in this bill, but NABH staff has learned those measures could be offered as amendments when the full Senate considers the legislation. The NABH team will continue to engage legislators on the association’s legislative priorities and will keep members apprised of any developments.
FDA Approves Generic Versions of Suboxone
The Food and Drug Administration (FDA) this week approved the first generic versions of Suboxone (buprenorphine and naloxone) sublingual film—which is applied under the tongue—to treat opioid dependence.
“The FDA is taking steps to advance the development of improved treatments for opioid use disorder, and to make sure these medicines are accessible to the patients who need them,” FDA Commissioner Scott Gottlieb, M.D., said in the public announcement. “That includes promoting the development of better drugs, and also facilitating market entry of generic versions of approved drugs to help ensure broader access.”
SAMHSA Announces $930 Million in Grant Funding to Address Opioid Crisis
The Substance Abuse and Mental Health Services Administration (SAMHSA) is accepting applications $930 million in the agency’s State Opioid Response Grants program.
According to a SAMHSA announcement, the federal funding is meant to address the crisis by expanding access to evidence-based, medication-assisted treatment; reducing unmet treatment needs; and lowering opioid-related overdose deaths.
In a statement, Assistant Secretary for Mental Health and Substance Use Elinore McCance-Katz, M.D., Ph.D., said the grants were designed to meet the specific needs of communities.
“The grants will expand capacity to provide much-needed, evidence-based care to people who haven’t yet been reached,” McCance-Katz said.
MACPAC Highlights Substance Use Disorder in June 2018 Report
The Medicaid and CHIP Payment and Access Commission (MACPAC) included two chapters related to substance use disorder (SUD) treatment in the June 2018 Report to Congress on Medicaid and CHIP that the commission released on Friday, June 15.
In the report’s chapters Substance Use Disorder Confidentiality Regulations and Care Integration in Medicaid and CHIP and Access to Substance Use Disorder Treatment in Medicaid, MACPAC commissioners examine reforming 42 CFR Part 2 (Part 2) and the IMD exclusion, both NABH priorities.
Regarding Part 2, MACPAC recommended the HHS secretary issue sub-regulatory guidance to clarify key provisions and offer information about education and technical assistance for Part 2. The commission did not make any recommendations about the IMD exclusion. Commissioners acknowledged that “the IMD exclusion is not the only reason gaps in coverage exist.” They also noted that the “largest gaps in state clinical service coverage are for partial hospitalization and residential treatment” and added that “the institutions for mental diseases (IMD) exclusion is often cited as a barrier to paying for residential services.”
MACPAC commissioners noted that some states—such as the commonwealth of Virginia—are reimbursing IMDs for SUD treatment through 1115 waivers. The report also said Virginia has seen a significant increase in the number of providers participating in Medicaid, as the total jumped to 77 from 4.
CMS Releases Roadmap to Address Opioid Crisis
Prevention, treatment, and data are the Centers for Medicare and Medicaid Services’ three areas of focus to address the nation’s opioid crisis, according to a new roadmap the agency released this week.
Presented as an infographic with key data points, analytic tools, and recommendations, the four-page roadmap also highlights best practices and a summary of CMS activities to date. For instance, the agency noted that as of this month, it has approved a dozen Medicaid 1115 demonstrations to improve access to opioid use disorder treatment, “including new flexibility to cover inpatient and residential treatment while ensuring quality of care.”
Looking ahead, CMS noted in the roadmap it will focus its data efforts and provide tools for states, plans and providers to monitor success of prevention measures related to reducing overuse and misuse of prescription opioids; improve data transparency and interoperability, and expand tools such as the Medicare “heat map” of prescribing rates that help determine where to target safe prescribing efforts; analyze prescription opioid use patterns across CMS programs and in special populations; and support state Medicaid program capacity to track and report data.
Prepare Early for National Recovery Month in September
SAMHSA has announced that its toolkit to prepare for National Recovery Month in September is now available.
Now in its 29th year, National Recovery Month is meant to promote awareness and understanding about mental and substance use disorders and to celebrate individuals living in recovery.
This year’s theme is Join the Voices for Recovery: Invest in health, Home, Purpose and Community, and more information—including SAMHSA’s toolkit—is available here.
For questions or comments about CEO Update, please contact Jessica Zigmond.