SUPPORT FOR PATIENTS AND COMMUNITIES ACT (FEDERAL OPIOID LAW): PROVISIONS IMPACTING PROVIDERS

 

            On October 24, 2018, the President signed the SUPPORT (Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment) for Patients and Communities Act, a law that won overwhelming bipartisan support in Congress. The law is considered by most experts as a good step forward in addressing the nation’s opioid epidemic, but that more than the $6 billion allocated will be necessary to solve the crisis. The law is intended to expand access to treatment, increase education and awareness about opioid prescribing and opioid abuse, increase screening for opioid abuse, and prevent fraud in opioid prescribing.

            The sweeping law consists of 660 pages and makes changes to Medicare, Medicaid, and several other federal laws.  Listed below are some of the provisions that could impact providers.  Many of these provisions require studies and reports that won’t immediately impact providers, but could in the future, depending on the findings of these reports.  The law specifically requires consultation with providers as well as medical and specialty societies in preparing their preparation.
 

  • The law will expand access to medication-assisted treatment (MAT) by codifying the ability for qualified physicians to prescribe MAT for up to 275 patients, by allowing physicians who have recently graduated in good standing from an accredited school of allopathic or osteopathic medicine who meet the training requirements to obtain waivers to prescribe MAT, and by allowing certain other professionals, including clinical nurse specialists, certified nurse midwives, certified registered nurse anesthetists to prescribe MAT.

  • Medicare coverage will be expanded to cover Opioid Treatment Programs for the purposes of delivering MAT. 

  • Restrictions on using telehealth to treat substance abuse disorders will be loosened for Medicare and Medicaid beneficiaries.

  • By January 1, 2021, prescriptions for Schedule II, III, IV, or V Controlled Substances covered under a Part D prescription drug plan or a Medicare Advantage Prescription Drug Plan will be required to be transmitted in accordance with an electronic prescription drug program.

  • Within two years, the Secretary of HHS will be required to annually notify prescribers who have been identified as outlier prescribers of opioids compared to other prescribers in their specialty and geographic area, although the Secretary may exclude certain specified individuals and prescribers from the analysis, including individuals receiving hospice services or diagnosed with cancer.

  • The FDA will be required to develop evidence-based opioid analgesic prescribing guidelines for the indication-specific treatment of acute pain such no such guidelines currently exist.

  • The Secretary of HHS will be required to develop a toolkit by July 1, 2019 in consultation with medical professional organizations and providers (among others), which provides best practices to Medicare participating hospitals for reducing opioid use.

  • The Secretary of HHS will be required to convene a Technical Expert Panel within six months consisting of medical and surgical specialty societies and hospital organizations to provide recommendations on best practices for pain management in surgical settings and to issue a report within one year.

  • The Secretary of HHS will be required to review payments made through the Outpatient Prospective Payment System and payments made to Ambulatory Surgery Centers to ensure that there are no financial incentives to use opioids instead of evidence-based non-opioid substitutes.

  • HHS and the Attorney General will be required to submit a report to Congress on the impact of federal and state laws and regulations limiting the length, quantity, or dosage of opioid prescriptions.