D.C. Update – May 16, 2016

In the News

  • House of Representatives approves Improving Treatment for Pregnant/Postpartum Women Act (H.R. 3691)
  • House of Representatives passes Improving Safe Care for the Prevention of Infant Abuse and Neglect Act (H.R. 4843)
  • White House issues statement calling for additional funding for opioid legislation
  • House Energy and Commerce Committee Chairman Fred Upton (R-MI) writes blog about committee’s determination to fight opioid epidemic
  • Altarum Institute releases addiction recovery timeline, highlighting milestones in the history of recovery services

News from the States

  • Vermont details plans for Next Generation Accountable Care Organization program
  • Delaware proposes stricter prescribing guidelines for prescription pain medications

Around the Agencies

  • HHS issues final rule on Section 1557 of the Affordable Care Act, clarifying nondiscrimination requirements

In the News

House of Representatives approves Improving Treatment for Pregnant/Postpartum Women Act (H.R. 3691)
The full House of Representatives considered and passed H.R. 3691, the Improving Treatment for Pregnant and Postpartum Women Act last week. The bill was authored by Rep. Luján (D-NM), with original co-sponsors including Reps. Tonko (D-NY), Matsui (D-CA), and Cardenas (D-CA). The bill contains the following provisions:

Reauthorization of the “PPW” Program: The Improving Treatment for Pregnant and Postpartum Women Act would reauthorize the residential services for pregnant and postpartum women program (PPW) grant program within the Substance Abuse and Mental Health Services Administration’s (SAMHSA) Center for Substance Abuse Treatment (CSAT).  This important program supports family-centered substance use disorder for women and young children in residential settings.

Creation of Pilot Program for State Substance Abuse Agencies: The bill would also create a pilot program for State substance abuse agencies to use up to 25 percent of these funds for services to pregnant and parenting women in non-residential settings. The purpose of the pilot program is to spur innovation and fill gaps in family-centered services across the continuum of care.  The legislation would require SAMHSA to lead a process where State substance abuse agencies, experts in addiction services and others would meet to discuss the development of the new application for the pilot program.

Funding: In FY 2016, the PPW received $15.9 million. The bill as introduced authorized $40 million for the PPW and pilot program.  During the markup held in the full House Energy and Commerce Committee, an amendment was offered to change the authorization of funds in the bill from $40 million to $16.9 million.

“Trigger Language” Added During Mark-Up:  Further, Rep. Ben Ray Luján (D-NM), the original sponsor of the bill, offered an amendment that would authorize the use of funds for the pilot program only if the amount for the overall PPW program exceeded FY 2016 funding levels.

Next Steps: The bill was inserted into a larger House package on the opioid crisis that was approved on May 13th.

Read NASADAD’s section-by-section summary of the bill here.

House of Representatives passes Improving Safe Care for the Prevention of Infant Abuse and Neglect Act (H.R. 4843)
The House of Representatives unanimously passed the Improving Safe Care for the Prevention of Infant Abuse and Neglect Act (H.R. 4843) with a vote of 421-0 last week. The legislation, originally introduced by Rep. Barletta, Lou (R-PA), amends the Child Abuse Prevention and Treatment Act (CAPTA) by requiring the Department of Health and Human Services (HHS) to provide information about best treatment practices for infants born affected by illicit drug exposure, withdrawal symptoms, or a Fetal Alcohol Spectrum Disorder. States will be required to submit data reports that “include the total number of such infants for whom a plan of safe care was developed, and for whom referrals are made for appropriate services, including services for the affected family or caregiver.” H.R. 4843 was inserted into a larger House package on the opioid crisis that was approved on May 13th.

Read more about this bill here.

White House issues statement calling for additional funding for opioid legislation
Last week the White House issued a statement calling for additional funding for opioid legislation. The statement acknowledges that while pieces of legislation such as H.R. 4641 (To provide for the establishment of an inter-agency task force to review, modify, and update best practices for pain management and prescribing pain medication) and H.R. 5046 (the Comprehensive Opioid Abuse Reduction Act of 2016) move treatment and recovery services in the right direction, they will require appropriate financial resources to be effective. The Obama Administration previously submitted a budget proposal in February 2016 to provide for $1.1 billion in new funding to address the opioid epidemic and expand access to treatment.

Read the full statement here.

House Energy and Commerce Committee Chairman Fred Upton (R-MI) writes blog about committee’s determination to fight opioid epidemic
Last week the House of Representatives’ Energy and Commerce Committee Chairman Fred Upton (R-MI) released a blog detailing the committee’s determination to fight the opioid crisis. The blog describes the impact opioid use has had in Rep. Upton’s district in Kalamazoo, MI, as opioid overdoses increased from 9 in the first quarter of 2012 to 13 in the first quarter of 2013. Rep. Upton emphasizes the need for policies that contain both public health and criminal justice approaches, stating that “we cannot simply arrest our way out of this epidemic.” The blog concludes by highlighting the passage of the Protecting Our Infants Act of 2015 (S. 799) and the Improving Regulatory Transparency for New Medical Therapies Act (H.R. 639) at the end of 2015 as indications of the Energy and Commerce Committee continued commitment to combating the opioid epidemic.

Read the full blog here.

Altarum Institute releases addiction recovery timeline, highlighting milestones in the history of recovery services
The Altarum Institute released its addition recovery timeline last week, highlighting a variety of milestones in the history of recovery support services. The timeline traces the history of recovery support services from the formation of Native American recovery circles beginning in 1750 to the UNITE to Face Addiction Rally held in Washington, DC in October 2015. The timeline was compiled with the support of William L. White and other recovery movement historians, and will be updated as new events occur.

Access the timeline here.

News from the States

Vermont details plans for Next Generation Accountable Care Organization program
Vermont‘s forthcoming Next Generation Accountable Care Organization (Vermont Next Gen ACO) program was detailed in a Center for Health Care Strategies, Inc. article last week. Vermont released a request for proposals for its Next Gen ACO program in April, stating that the program will enable Vermont’s Medicaid Shared Savings Program (VMSSP) to save money and deliver high-quality health care services to Medicaid enrollees throughout the State. The Vermont Next Gen ACO is similar to CMS’s Medicare Next Gen Model, yet differs in several ways – most notably by “requiring participating ACOs to accept full risk for their Medicaid patients in exchange for a capitated payment.”

The Vermont Next Gen ACO also contains differences from Vermont’s existing Medicaid ACO program by shifting to prospective payment and by reducing the number of quality metrics from 28 to 6, with each metric in the Next Gen ACO model related to payment. The Vermont Next Gen ACO is expected to launch sometime in 2017.

Read the full article here.

Delaware proposes stricter prescribing guidelines for prescription pain medications
Delaware has announced plans to more strictly regulate prescription pain medications, as the Wilmington News Journal reports. The new regulations limit the amount of pain medication doctors are able to prescribe by restricting initial maximums to a seven-day supply. The regulations further require that patients’ histories be examined in Delaware’s Prescription Drug Monitoring Program (PDMP) and that doctors provide information about addiction risks when providing medication to patients. Chronic pain patients would be required to sign a treatment agreement and take urine-based drug tests twice each year. Medications falling under the new regulations include morphine, codeine, fentanyl, meperidine, and methadone. While Delaware officials do not believe the regulations will interfere with treatment, pain management specialists are concerned that limiting initial supplies to seven days will hinder the ability of doctors to help patients.

Read the Wilmington News Journal article here.

Read more about Delaware’s efforts to combat the opioid epidemic here.

Around the Agencies

HHS issues final rule on Section 1557 of the Affordable Care Act, clarifying nondiscrimination requirements
The Department of Health and Human Services (HHS) issued its final rule on Section 1557 of the Affordable Care Act (ACA) last week. The rule clarifies and codifies nondiscrimination requirements and describes plans to implement Section 1557. Section 1557 prohibits discrimination on the basis of sex in any health program or activity that receives HHS funding, insurers in the marketplace that receive HHS funding, and any other program that HHS administers. The final rule prohibits discrimination on the basis of gender identity and sex stereotyping, and requires that individuals be provided access to facilities consistent with their gender identity. The rule also contains provisions providing guidance on requirements for language assistance services, including oral interpreters and written translations. The rule will be made effective on July 18, 2016.

Read the full final rule here.

Should you have any questions, or require additional information, please do not hesitate to contact Robert Morrison, Executive Director, (202) 293-0090 or Shalini Wickramatilake-Templeman, Public Policy Associate, at (202) 293-0090.