The Support for Patients and Communities Act (a.k.a. HR6) was approved easily by the House on 9/28/18 and then the Senate on 10/3/18. The President is to sign the bill ASAP. The broad legislation covers everything from education, prevention, treatment, recovery, provider workforce expansion, prescription medication safety and disposal, and law enforcement. Here are 7 points of note that stood out for us.
- IMD Facilities’ Big Win
Partially repealing the Institutes for Mental Health (IMD) exclusion, the legislation now enables state Medicaid programs to be able to cover up to 30 days of services for substance use disorder treatment in an Institution for Mental Diseases for patients 21-64 years old, and, removes the 16-bed restriction.
- 42 CFR Lost Opportunity with Patient Confidentiality
Advocates such as the American Hospital Association and others were hoping that the Senate would go along with the House approval to lift the restrictions of 42 CFR Part 2, the Confidentiality of Substance Use Disorder Patient Records.
“We are disappointed that the final bill does not include a critical provision passed overwhelmingly by the House that would allow the responsible sharing of patients’ SUD treatment information in accordance with Health Insurance Portability and Accountability Act regulations. We remain committed to eliminating this statutory barrier to optimal care for our patients and will continue to seek a legislative solution.” Rick Pollack, CEO of AHA commented.
- Telehealth to Fight Substance Use Disorder
The legislation directs CMS to expand Medicaid and Medicare coverage and eliminate barriers to use telehealth to treat substance use disorders. Among other items, CMS is to issue a report to Congress to compare services delivered via telehealth to in-person for children.
- Non-opioid, Non-addictive Drug Usage Encouragement
Through several provisions, the legislation seeks to enhance patient access to non-opioid treatment options. This includes requesting CMS to issue guidance on using non-opioid pain treatment and management options for Medicaid beneficiaries. And, requiring the Medicare Payment Advisory Commission to submit a report to Congress on how Medicare currently pays for opioid and non-opioid pain management treatments and to understand and eliminate the financial incentives to prescribe opioid versus non-opioid medications in both the inpatient and outpatient settings.
- Stronger Border Security for Fentanyl and Other Illegal Shipments
The STOP Act (Synthetics Trafficking and Overdose Protection) within the legislative package has several provisions for federal agencies such as DEA, USPS, and the FDA to work with CBP (Customs and Border Patrol) to better screen incoming packages and impose stricter penalties.
- Increasing Medication Assisted Treatment Providers
By addressing workforce shortages through provision of student loans to health professionals and grants to states as well as by increasing the numbers and capacity of current MAT (medication assisted treatment) prescribers. The legislation authorizes clinical nurse specialists, certified nurse midwives, and certified registered nurse anesthetists to prescribe MAT for five years. Physician assistants and nurse practitioners now have permanent authority to continue prescribing MAT. Qualified physicians can increase their numbers of MAT patients up to 275 patients.
- Heightened Focus on Pregnant Women and Children
Through a number of Medicaid and other provisions including access through CHIP (Children’s Health Insurance Program), the legislation expands coverage, support, and treatment for pregnant women, babies born with neonatal abstinence syndrome, and children needing mental health services.