Senate Passes Package to Fight Opioid Crisis.
Measure now heads to conference with the House
WASHINGTON — The Senate approved a package of opioid bills by a vote of 99-1 on Monday that would provide more money for opioid use disorder treatment and clarify FDA regulation of non-opioid pain products.
“This bipartisan package of proposals is an important step forward to help our families and communities who are on the front lines of the opioid crisis,” said Sen. Patty Murray (D-Wash.) after the bill was approved. “I look forward to continuing to work with my colleagues to see it signed into law.”
The Senate voted to approve S. 2680, the Opioid Crisis Response Act, which is the Senate version of H.R. 6, the “Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment [SUPPORT] for Patients and Communities Act.” The measure includes legislation proposed by 70 senators and five Senate committees.
That House bill, passed June 22, includes a provision to relax confidentiality standards around substance use disorders; a provision to incentivize post-surgical injections as a pain treatment alternative to opioids by reversing a Medicare reimbursement cut for these treatments; and a provision to let certain non-physicians, such as nurse midwives and clinical nurse specialists, prescribe medication-assisted treatment.
The House version would also repeal the Institutions for Mental Diseases (IMD) exclusion for 5 years. The IMD exclusion bars Medicaid from reimbursing care in facilities with more than 16 beds; the bill would allow for opioid use disorder treatment for up to 30 days in an IMD.
The IMD provision, however, is not included in the Senate version of the bill, which must be reconciled with the House version; the compromise bill then must be passed by both chambers.
In a statement, the American Hospital Association said it was “extremely disappointed” that the IMD provision wasn’t in the Senate bill. “As Congressional leaders work to resolve the differences between the House and Senate versions, America’s hospitals and healthy [sic] systems strongly urge them to ensure that the final product includes … the IMD exclusion,” said Tom Nickels, the association’s executive vice president.
Other key provisions of the Senate bill include:
- * Preventing “doctor-shopping” by improving state prescription drug monitoring programs
- * Increasing availability of behavioral and mental health providers
- * Supporting comprehensive opioid recovery centers
- * Adding resources for neonatal abstinence syndrome treatment
- * Providing help for mothers with opioid use disorders
FDA Regulation of pain products.
The National Association of County and City Health Officials (NACCHO) praised certain provisions of the Senate legislation, including an expanded grant program to purchase naloxone, the drug used to treat opioid overdoses; allowing physicians to prescribe medication-assisted treatment to up to 275 patients (the current limit is 100); and giving FDA the authority to require drugmakers to package opioids in 3- or 7-day doses.
“The epidemic will be stopped community by community, and tailored approaches will be needed,” said Lori Tremmel Freeman, CEO of NACCHO, in a statement. “NACCHO calls on Congress to ensure that appropriate funding for prevention and response to the opioid epidemic reaches local communities.”
The Bipartisan Policy Center praised the Senate bill’s inclusion of a measure to improve detection and seizure of illegal drugs such as fentanyl by strengthening coordination activities between FDA and the federal Customs and Border Protection agency. The Senate bill also reauthorizes the Office of National Drug Control Policy through 2022, the center noted.
“We are pleased to see the diligent efforts of the Senate to advance legislation that builds on consensus proposals from numerous hearings this year to tackle the nation’s opioid crisis,” said Anand Parekh, MD, the center’s chief medical advisor. “We encourage the House and Senate to reach an agreement and send a bill to the president this fall.”
Another provision in both the House and Senate bills would require electronic prescribing for Schedule II through V controlled substances prescriptions covered under Medicare Part D to help prevent fraud, abuse, and waste; that provision was applauded by the National Association of Chain Drug Stores (NACDS).
“NACDS recommends greater reliance on electronic prescribing for this purpose, based on pharmacists’ first-hand experiences on the front lines of healthcare delivery,” Steven Anderson, the group’s president and CEO, said in a statement. “This is an important part of the comprehensive effort to keep opioids out of the wrong hands.”
The Trump administration also applauded the legislation’s passage. “This critical bipartisan legislation is a major step forward in the whole-of-government approach to combating drug demand and the opioid crisis,” the White House press secretary’s office said in a statement. “The President and his Administration continue to work toward and implement effective policies to address the opioid crisis and save lives. The Administration looks forward to working with both chambers as the legislative process continues to get a bill to the President’s desk to mitigate this crisis next door.”