President Donald Trump signed a comprehensive opioid package dubbed “The Support for Patients and Communities Act” on October 24. The legislation encompassed months of work by the U.S. House and Senate and passed with nearly universal support in a rare bipartisan effort. While the legislation primarily focused on federal agency reforms, such as ordering new studies, recommendations, and guidelines for the various federal agencies that oversee substance use treatment, it included two positive reforms that WHA targeted its advocacy efforts on in Washington, D.C. during its May fly-in and subsequent visits, as covered by a previous Valued Voice article
In a June letter
to Wisconsin Congressional members, WHA President/CEO Eric Borgerding asked lawmakers to support three important opioid treatment reform bills that would “remove barriers in Medicare and Medicaid and improve outcomes in Wisconsin and across the nation.” The first, which was included in the final package, will lift regulations that currently bar Medicaid from funding most substance use treatment at Institutions of Mental Disease (IMDs)—facilities that have more than 16 beds. Wisconsin currently has 10 licensed short-term inpatient IMDs and an estimated 20-plus facilities that provide longer-term treatment and meet IMD criteria. Opening these locations to Medicaid treatment will help get more patients care where and when they need it, and will hopefully reduce reliance on hospital emergency rooms.
A second provision supported by WHA and included in the final package will ease Medicare’s “geographic originating site restrictions” for telehealth. These restrictions currently only allow Medicare to pay for telehealth services in certain rural areas and require patients to physically travel to a health care facility. Beginning in July 2019, the rural geographic restrictions are eliminated for substance use or co-occurring mental health treatment. Direct treatment in a patient’s home will also be allowed.
A third provision supported by WHA made it past the House, but, unfortunately, stalled in the Senate and was not included in the final package signed by President Trump. For years, WHA has advocated for aligning 42 CFR part II with the Health Insurance Portability and Accountability Act of 1996, better known as HIPAA. This would allow providers to share substance use and behavioral health records in the same manner they can share other patient health care records, while still providing the HIPAA protections patients expect and trust. WHA will continue to advocate for changing this outdated law in order to improve patient care.
For a full summary of the provisions included in the final opioid package, see the committee summary
or contact WHA’s Director of Federal and State Relations Jon Hoelter
for more information.