On Wednesday, the president signed a bipartisan bill to address the opioid epidemic. Called the SUPPORT for Patients and Communities Act, this legislation pieces together dozens of separate proposals and programs and ultimately works to increase access to addiction treatment, monitor opioid use, and prevent abuse.
Although this legislation has been lauded for many of its Medicaid and Medicare changes, support for education and research, and expansion of treatment options, organizations like the American Hospital Association and American Association of Medical Colleges argue that it doesn’t do enough to eliminate barriers to care. But no matter the criticism, the 250-page law is sure to affect providers from all care settings. To prepare you for its implementation, we’ve outlined some of the SUPPORT act’s key features:
Improved Access to Long-Term Treatment: This legislation temporarily abolishes a Medicaid rule that prohibited coverage for substance abuse treatment for patients in facilities with more than 16-beds. Until 2023, states can elect to cover 30 days of treatment within a 12-month period in any institution that is primarily focused on treating people with mental diseases, including addiction.
Focus on Opioid Overprescription: The SUPPORT act authorizes reductions in production quotas for opioid-related controlled substances (e.g., fentanyl, oxycodone) if appropriate, with the goal of decreasing instances of drug diversion and cutting overprescription. It also authorizes monetary support for states to establish prescription drug monitoring programs (if they do not already have one) and encourages them to implement mandates such as requiring that providers check the PDMP for the prescription history of patients covered by Medicaid before prescribing.
Tracking Synthetic Opioids: To stop synthetic opioids from entering the U.S., this legislation requires the U.S. Postal Service to screen packages coming in from other countries for fentanyl. Additionally, the legislation package funds a new grant program for public health laboratories and a pilot program for tracking fentanyl and other synthetic drugs. Legislators hope that this will prevent fatal overdoses.
Medication-Assisted Treatment Access Expansion: This new law gets rid of regulations that had prevented doctors from prescribing medication-assisted substance abuse treatment over telemedicine, allowing providers to more easily prescribe buprenorphine, methadone, and other life-saving drugs. It also allows more types of providers to prescribe these drugs, increases the maximum number of patients providers may treat with these medications, and temporarily allows Medicaid to cover them.
Community Support: The SUPPORT act goes beyond traditional payers and providers, focusing also on community-based interventions. For example, it expands an existing program that allows first responders to carry the overdose-reversing drug naloxone. Similarly, it supports funding to help those in prison with opioid dependency successfully reenter the outside world. It also provides community-based funding for behavioral health issues and requires Medicaid quality health measures to include behavioral health.
Resources for Research and Education: Along with installing many research grants, the new legislation provides monetary resources for patient education, requiring Medicaid to inform patients and health centers to educate the community about opioid use and pain management. It also funds provider education with the goal of preventing abuse and, for example, includes grants to improve the practices of providers who give out too many opioid prescriptions.
These are just highlights from the hundreds of changes introduced by the SUPPORT act; a section-by-section description can be found here for more information. HBI will keep a close eye on the implementation of this legislation in the coming months.
In the meantime, HBI recently released a best practice report on our members-only web portal about the opioid epidemic. This report includes information on inpatient interventions, infrastructure considerations, and community initiatives, many of which can help you prepare for the changes introduced by this new legislation.
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