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House and Senate to Reconcile Opioid Legislation after Senate Passes Opioid Crisis Response Act The Senate this week passed the Opioid Crisis Response Act of 2018, a substantially different opioid  package from the SUPPORT Patients and Communities Act that the House passed in June. The Senate bill lacks several NABH-supported provisions, including one from the House-passed bill that would repeal the Institutions for Mental Diseases (IMD) exclusion for patients with opioid or cocaine use disorders for five years. In addition, the Senate bill does not include a provision that would allow Medicare part B to reimburse opioid treatment programs for using methadone in a medication assisted treatment program. The bill also does not include any reforms to 42 CFR part 2, which the House addressed separately (not as part of the SUPPORTAct). The next step is for the two chambers to reconcile these and other differences in their bills. NABH has learned from congressional staff that this will happen most likely through negotiations in the coming days, rather than the more formal conference committee process. If the House and Senate do not agree on a combined bill soon, the process will likely be delayed until November following this year’s mid-term elections. NABH continues to urge Senate staff to support the House bill. The NABH team has also been an active member within the Partnership to Reform 42 CFR Part 2 and signed onto a letter this week that encouraged House and Senate leaders to include reforms to 42 CFR part 2 in any opioid legislative agreement. To influence the process, Sens. Rob Portman (R-Ohio) and Dick Durbin (D-Ill.) introduced the Improving Coverage for Addiction Recovery Expansion Act, bipartisan legislation that would repeal the IMD exclusion for all patients with substance use disorders if state Medicaid programs offer at least six of nine criteria from the American Society of Addiction Medicine. The NABH team continues to work closely with Sen. Portman’s office and also continues to urge policymakers to include a provision that would ensure Medicare part B covers methadone treatment. HHS Awards More than $1 billion for Opioid Crisis HHS this week awarded more than $1 billion in grant funding to address America’s opioid crisis. An announcement from HHS said the grants support the department’s five-point opioid strategy, which was launched last year and focuses on better addiction prevention, treatment, and recovery services; better data, better pain management; better targeting of overdose-reversing drugs; and better research. “This week, HHS updated its strategic framework for tackling the opioid crisis, which uses science as a foundation for our comprehensive strategy,” Admiral Brett Giroir, M.D., assistant secretary for health and senior advisor for opioid policy, said in the announcement. “With these new funds, states, tribes, and communities across America will be able to advance our strategy and continue making progress against this crisis.” SAMHSA awarded more than $930 million in state opioid response grants, and about $90 million to other programming for states and communities to expand access to medication assisted treatment; increase distribution and use of overdose-reversal drugs; and increase workforce-development activities. U.S. Surgeon General Urges ‘Cultural Shift’ in How Americans Talk About Opioids No area of the country has been spared from the opioid crisis, yet only 53 percent of the public consider opioid addiction a major concern, according to a new Spotlight on Opioids from U.S. Surgeon General Jerome Adams, M.D., M.P.H. Consequently, the U.S. Surgeon General has asked the public to take specific actions that could ultimately help shift the dialogue on this public health emergency. These include: talking about opioid misuse; taking opioid medications only as prescribed; storing medication in a secure place; understanding pain and talking with a healthcare provider about non-opioid treatments to manage pain; understanding that addiction is a chronic disease; and learning how to use naloxone, an opioid overdose-reversing drug. Also this week, HHS announced it has developed materials to help clarify how clinicians can use telemedicine as a tool to expand buprenorphine-based medication assisted treatment for opioid use disorder treatment. Click here to learn more. CMS Seeks Comment on Special Conditions of Participation In a proposed rule this week, the Centers for Medicare and Medicaid Services (CMS) clarified a requirement that would allow for the use of non-physician practitioners or doctors of medicine or osteopathy to document progress notes of patients who receive services in psychiatric hospitals. The agency is seeking comment on the proposed rule for the next 60 days. NABH will submit comments during this process. SAMHSA Posts Disaster Distress Hotline for Hurricane Florence Survivors The Substance Abuse and Mental Health Services Administration (SAMHSA) posted information regarding immediate crisis counseling for those affected by Hurricane Florence in the Carolinas and Virginia. SAMHSA’s Helpline, 1-800-985-5990, is available 24 hours a day, seven days a week, for anyone who needs counseling after a natural or human-made tragedy. Click here for more information. NABH thanks its members in the region who have provided and will continue to provide care for those who need it. Save the Date for the NABH 2019 Annual Meeting! Behavioral Healthcare: Improving Coordination, Collaboration, Integration is the theme for the NABH 2019 Annual Meeting. Please save the date and plan to join us at the Mandarin Oriental Washington, D.C. from March 18-20, 2019. For questions or comments about CEO Update, please contact Jessica Zigmond.