September 28, 2018

House-Passed Opioids Package Includes Multiple Pieces of Legislation Authored by Luján

Today, the House passed a bipartisan opioids package, H.R. 6, the Support for Patient and Communities Act, by a vote of 393-8. The package contains several of Congressman Ben Ray Luján’s (D-NM) priorities, including measures that increase substance use provider capacity in Medicaid, support drug management programs that help at-risk beneficiaries in Medicare, provide improved guidance for infants with neonatal abstinence syndrome and their moms, and utilize telehealth to expand access to treatment in rural and underserved areas.

“While this package will make a difference in people’s lives, it is not the end,” said Luján.“I’m pleased that this package includes several of my priorities, which will help people in New Mexico and across the country access the care that their families need. This package should be followed by comprehensive funding for prevention, treatment, and recovery services.”

Importantly, this package includes Congressman Luján’s provision expanding the types of providers who can treat patients with buprenorphine for Opioid Use Disorder (OUD).  Currently, only physicians, nurse practitioners, and physician’s assistants can prescribe buprenorphine to patients with OUD. This package would expand access to Medication Assistance Treatment (MAT) by authorizing clinical nurse specialists, certified nurse midwives, and certified registered nurse anesthetists to treat up to one hundred patients with OUD with buprenorphine for five years. The bill also makes permanent existing levels of expanded treatment capacity for nurse practitioners (NPs) and physician assistants (PAs).  It also codifies the ability for qualified physicians to prescribe MAT for up to 275 patients and allows waivered practitioners to immediately treat 100 patients at a time if the practitioner is board certified in addiction medicine or addiction psychiatry or if the practitioner provides MAT in a qualified practice setting.

“The New Mexico Nurses Association applauds the work and leadership of Congressman Ben Ray Lujan in securing an additional pool of nurse providers to treat those addicted to opioids,” said Deborah Walker MSN, RN Executive Director NM Nurses Association. "NMNA thanks the Congressman for listening to nurses across the district to find ways to improve access to medication assisted treatment throughout New Mexico. His efforts today will have an impact in his district to address treatment needs of those addicted to opioids and will provide a healthier treatment option for pregnant women here in the state and across the nation.”

“The Congressman’s efforts to add certified nurse midwives into the provider pool will allow a larger group of providers to take care of our addicted moms prenatally, providing quality care and improving outcomes for both mom and baby,” said Elaine  Brightwater DNP, certified nurse midwife with the NM Affiliate of the American College of Nurse Midwives.

“Continuity of care is incredibly important to recovery. The TREAT Act included in this package helps ensure moms and families who are struggling with addiction can rely on trusted health care providers within their communities, like midwives, to get treatment as quickly as possible,” said Luján.

Congressman Luján was instrumental in the passage of 10 bipartisan opioid bills that were a part of the opioids package. Specifically, the agreed upon legislative package includes the following priorities led by the Congressman:  

  • Medicaid substance use disorder treatment via telehealth: Directs CMS to issue guidance to states on options for providing services via telehealth that address substance use disorders under Medicaid. Requires guidance to cover state options for federal reimbursement for substance use disorder services and treatment using telehealth including, services addressing high-risk individuals, provider education through a hub-and-spoke model, and options for providing telehealth services to students in school-based health centers. (Sec. 1009)
  • Encouraging appropriate prescribing under Medicare for victims of opioid overdose: Requires that CMS identify beneficiaries enrolled in Medicare Part D with a history of opioid-related overdose and include them in its system for monitoring those potentially at-risk for prescription drug abuse, enabling prescription drug plans to take steps that inform prescribers and dispensing pharmacies and facilitate improved care (Sec. 2006)
  • Clarifying FDA Regulations for Non-Addictive and Non-Opioids Products: To help advance the development of products that can reduce, replace, or avoid patients’ use of opioids to control pain, this would direct FDA to clarify requirements for opioid sparing data to be used in the label. (Sec. 3001)
  • Expanding Buprenorphine Prescribing (TREAT Act): Authorizes clinical nurse specialists, certified nurse midwives, and certified registered nurse anesthetists to prescribe buprenorphine for five years. Permanently authorizes nurse practitioners and physicians assistants to prescribe buprenorphine. (Sec. 3201)
  • Standardizing electronic prior authorization for safe prescribing: Requires that prior authorizations related to Part D prescriptions that are processed electronically use a standard format, improving the efficiency with which prior authorizations are processed and enabling beneficiaries to more promptly receive needed drugs. (Sec. 6062)
  • Protecting moms and infants: Reauthorizes the Residential Treatment for Pregnant and Postpartum Women grant program. (Sec. 7062)
  • Early interventions for pregnant women and infants:  Requires the Center for Substance Abuse Prevention to develop, in cooperation with the Centers for Disease Control and Prevention (CDC), educational materials for clinicians to use with pregnant women for shared decision-making regarding pain management during pregnancy. Requires implementation and dissemination, as appropriate, of the recommendations in the report entitled “Protecting Our Infants Act: Final Strategy,” issued by HHS in 2017. (Sec. 7063)
  • Comprehensive Opioid Recovery Centers: Authorizes a grant program through the Substance Abuse and Mental Health Services Administration (SAMHSA) for entities to establish or operate comprehensive opioid recovery centers that serve as a resource for the community. These entities may utilize the ECHO model, which supports care coordination and services delivery through technology. (Sec. 7121)
  • Peer support technical assistance center: Requires HHS to establish or operate a National Peer-Run Training and Technical Assistance Center for Addiction Recovery Support, to provide technical assistance and support to recovery community organizations and peer support networks providing peer support services related to substance use disorder. (Sec. 7152)
  • State response to the opioid abuse crisis:Reauthorizes and improves the state targeted response grants from the 21st Century Cures Act to provide funding to Tribes and to improve flexibility for states in using the grants. (Sec. 7181)