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Population health

Congress tackles the opioid crisis

June 28, 2018

Congress tackles the opioid crisis

Every day, more than 115 people in the United States die as a result of an opioid overdose. Beyond the human toll, the Centers for Disease Control and Prevention estimates that the total economic burden of prescription opioid misuse in the United States is $78.5 billion per year. Based on any metric, the misuse of and addiction to opioids- which include prescription pain medication, heroin, and fentanyl- is impacting the health, social, and economic well-being of our nation.

In response, last year the federal government declared opioids a public health emergency and announced it was focusing efforts to combat the crisis on five key priorities: (1) improving access to treatment and recovery services; (2) promoting use of overdose-reversing drugs; (3) strengthening our understanding of the epidemic through better public health surveillance; (4) providing support for new research on pain and addiction; and (5) advancing better practices for pain management.

As for Congress, following months of committee hearings and markups, last week the U.S. House of Representatives voted 396-14 to pass the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act. The 100-page bill (which is also known as the SUPPORT for Patients and Communities Act) combined the legislative language of 58 individual opioid-focused bills recently passed by bipartisan majorities in the House.

Included in the bill are provisions focused on opioid and substance use disorder prevention, treatment, and recovery services across the Medicaid and Medicare programs. Specific provisions include:

  • establishing a Medicaid demonstration project to increase provider treatment capacity for substance use disorders,
  • requiring the establishment of drug management programs for at-risk Medicaid beneficiaries,
  • exempting substance use disorder telehealth services from specified Medicare requirements,
  • aligning privacy regulations for substance use disorder patients (42 CFR Part 2) with existing Health Insurance Portability and Accountability Act (HIPAA) privacy regulations,
  • requiring the Medicare examination for new enrollees to include opioid use disorder screening,
  • requiring Medicare coverage for services provided by certified opioid treatment programs, and
  • mandating electronic prescribing for all controlled substances under Medicare beginning in 2020.

With the support of President Trump and the White House, the bipartisan bill now heads to the Senate where the committees of jurisdiction are already working to push companion legislation to the Senate floor for a vote. According to Senate leaders, if all goes according to plan, they should be able to send a final bill to the President’s desk to be signed into law by the end of the summer.

For healthcare providers, the ultimate impact of this potential legislation remains to be seen. But based on the content of the House bill, it is clear that members of Congress believe that ensuring providers have access to accurate health and prescription information through the use of health information technology tools- such as electronic health records, prescription drug monitoring programs, and electronic prescribing- will be a key part of combatting this crisis.


Chris Emper

Government Affairs Advisor, NextGen Healthcare

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