HHS to Expand Access to MAT by Eliminating ‘X-Waiver’ for DEA-Registered Physicians
The U.S. Health and Human Services Department (HHS) on Thursday
said it will publish new
guidelines that will exempt office-based physicians from having to receive a DATA 2000 waiver, known as the X-waiver, in order to prescribe buprenorphine for opioid use disorder treatment for up to 30 patients. The guidance is effective immediately.
Specifically, the new guidance permits physicians to prescribe buprenorphine for up to 30 patients without completing eight hours of training prior to prescribing buprenorphine. The training requirement has been cited as a barrier to more physicians prescribing the drug. The new guidance does not change the existing regulations for physician assistants, nurse practitioners, or other mid-level practitioners.
This move is intended to address the surge in opioid deaths in the past year. After declining between 2017 and 2018 by 4.1%, the number of overdose deaths increased 18.2% from June 2019 to May 2020. During this period, overdose deaths increased more than 20% in 25 states and the District of Columbia, 10% to 19% in 11 states and New York City, and up to 9% in 10 states.
The new guidance has been issued under regulatory flexibility that permits the administration to make exemptions from the regulatory requirements, as deemed necessary, in consultation with the Drug Enforcement Administration, the National Institute on Drug Abuse, and the U.S. Food and Drug Administration.
A new issue brief from the HHS Office of the Assistant Secretary for Planning and Evaluation (ASPE) found that increasing buprenorphine prescribing capacity of one patient per 100 residents increases prescribing by 3.8% and decreases the use of other opioid prescribing by 2.3%. The relationship holds true only for metropolitan areas.
Meena Vythilingam, M.D. Named Acting Assistant Secretary for Mental Health and Substance Use
Capt. Meena Vythilingam, M.D. of the United States Public Health Service is serving as the acting assistant secretary for mental health and substance use, succeeding Elinore McCance-Katz, M.D., Ph.D., who resigned last week.
Vythilingam, a board-certified psychiatrist, is also the first director of the HHS Center for Health Innovation, and the senior advisor for mental health and opioids in HHS’ office of the assistant secretary for health.
Before she completed her psychiatry residency and post-doctoral fellowship at the Yale University School of Medicine, Vythilingam completed a residency in psychological medicine at the National Institute of Mental Health and Neurosciences in Bangalore, India.
The Substance Abuse and Mental Health Services Administration (SAMHSA)
announcement did not indicate how long Vythilingam will serve in the position.
NABH Highlights Priorities in Letter to the Biden-Harris Transition Team
NABH this week sent a
letter to the Biden-Harris transition team that outlines the biggest challenges for behavioral healthcare and recommendations on how to address those problems.
The 12-page letter describes the heightened need for mental health and substance use disorder services in the United States, which the Covid-19 pandemic has exacerbated.
“Elevated levels of mental health and substance use disorders are expected to linger long after the Covid-19 pandemic ends,” NABH President and CEO Shawn Coughlin wrote. “Large-scale disasters such as the current pandemic are known to have widespread and long-lasting detrimental effects on mental health and substance use. Moreover, studies of past disasters have shown the mental health distress and suicidality often do not peak until years after the disaster has ended.”
The letter includes recommendations related to vaccines for behavioral healthcare providers, continued telehealth coverage for mental health and addiction treatment, flexibilities regarding Special Conditions of Participation, increased availability of behavioral healthcare for children and youth, and the 988 hotline.
NABH Issue Brief Provides Details on Expanded Telehealth Coverage
NABH this week sent an Issue Brief to members that highlights details of the extended Medicare coverage that the Centers for Medicare & Medicaid Services (CMS) authorized in its final 2021 Medicare Physician Fee Schedule rule that was published in the
Federal Register last month. Click
here to learn more.
RAND Corp. Releases Report on Transforming U.S. Mental Health System
RAND Corp. has released a report with analysis and recommendations in 15 areas where there is potential to help improve the lives of more than 60 million Americans living with mental illness.
How to Transform the U.S. Mental Health System addresses the following three questions: 1) How can policy changes at all levels of government effect transformational change to improve the lives of Americans with mental illness? 2) What are the best practices and recent innovations in the mental health sector? and 3) What opportunities for change in the mental healthcare system are supported by the research literature?
The report is divided into five chapters, and it focuses on topics areas such as integrating behavioral health expertise in general health settings, strengthening mental health parity regulation and enforcement, establishing evidence-based behavioral health treatments at their true cost, linking homeless individuals with mental illness to supportive housing, and more.
NABH Director of Policy and Regulatory Affairs Kirsten Beronio served on the advisory panel for this report.
NIH-Supported Study Finds Team-Based Approach May Improve Buprenorphine Care
A recent pilot study concluded that a collaborative approach to treating opioid use disorder that relies heavily on community pharmacists “is feasible and may increase adherence and participant satisfaction,” according to research published in the journal
Addiction.
The study—which the National Institute on Drug Abuse, part of the National Institutes of Health, supported—studied the transfer of care of 71 participants using buprenorphine maintenance therapy for opioid use disorder from waivered physicians to trained community pharmacists. According to the study, about 90% of people in the United States live within five miles of a community pharmacy.
Researchers from Duke University and their collaborators found that nearly 89% of participants remained in the study and 95.3% adhered to the daily medication regimen. “Participants, physicians, and pharmacists alike reported high rates of satisfaction with the program,” the journal article noted.
The study’s authors concluded that the pilot shows “strong support” for advancing physician-pharmacist team-based approaches to leveraging community resources when it comes to expanding access to opioid use disorder treatment with buprenorphine.
SAMHSA Accepting Applications for Grants to Prevent Prescription Drug/Opioid Overdose-Related Deaths
SAMHSA’s Center for Substance Abuse Treatment is accepting applications for fiscal year 2021 grants to prevent prescription drug and opioid overdose-related deaths through Monday, March 1.
The program is meant to reduce the number of prescription drug and opioid overdose-related deaths and adverse events among individuals aged 18 and older by training first responders and community members on preventing these deaths and on how to implement secondary prevention strategies, such as buying and distributing naloxone.
SAMHSA said it has a total amount of about $11.4 million for this project and expects to grant 13 awards of up to $850,000 per year for up to five years. Click
here to learn more.
Center for Connected Health Policy to Host Telehealth Policy Webinar on Feb. 5
The Center for Connected Health Policy will host Telehealth & Medicaid: What’s Next? A Roadmap for Telehealth Beyond the Pandemic on Friday, Feb. 5, 2021 at 2 p.m. ET.
The webinar will feature experts in a panel discussion about what the future looks like for telehealth policy in Medicaid. Attendees will hear from high-level administrators and policy staff from the Medicaid and CHIP Payment Advisory Commission (MACPAC), the Arizona Health Care Cost Containment System, the Colorado Department of Health Care Policy and Financing, and the Oregon Health Authority.
Click
here to learn more and to register.
Save the Date: NABH 2021 Annual Meeting
NABH will host its 2021 Annual Meeting from Wednesday, Oct. 6 – Friday, Oct. 8, 2021 at the Mandarin Oriental Washington, DC.
The association re-scheduled for this later date in 2021 due to the ongoing Covid-19 pandemic. We hope you can join us!
After 2021, NABH will host its subsequent Annual Meetings in June. Please save the date for these future NABH Annual Meetings:
We look forward to seeing you in Washington!
Fact of the Week
A Mental Health America
survey between June-September 2020 found that 76% of healthcare workers reported exhaustion and burnout.
For questions or comments about this CEO Update, please contact Jessica Zigmond.