NASADAD has released an overview of buprenorphine patient limits. The overview includes a history of the issue, beginning with the Drug Addiction Treatment Act (DATA) of 2000, which permits physicians who meet certain qualifications to treat opioid use disorders with FDA-approved medications in treatment settings other than opioid treatment programs (OTPs). The document reviews the 2016 final rule on MAT for Opioid Use Disorders, which allows eligible physicians to request approval to treat up to 275 patients after prescribing at the 100-patient limit for one year. The overview also describes the impact of the Comprehensive Addiction and Recovery Act of 2016 and the SUPPORT Act of 2018, which both expanded the definition of a “qualifying other practitioner” who can prescribe buprenorphine to include nurse practitioners and physician assistants (CARA), as well as clinical nurse specialists, certified registered nurse anesthetists, and certified nurse midwives (SUPPORT).
The overview includes the current status of who can be considered a “qualifying practitioner”. If they meet certain criteria (e.g., 8 hours of training for physicians, 24 hours of training for NPs, Pas, CNSs, CRNAs, and CNMs), the following types of practitioners can apply for a DATA waiver in order to offer MAT:
- Physicians (including osteopathic and allopathic doctors)
- Nurse practitioners
- Physician assistants
- Clinical nurse specialists
- Certified registered nurse anesthetists
- Certified nurse midwives
Additionally, the overview summarizes the current maximum patient limit for physicians: Qualifying physicians can treat 100 patients in the first year if they meet the criteria outlined in the SUPPORT Act, and 275 after one year of prescribing at the 100-patient limit. If a physician does not meet the criteria to treat 100 patients in the first year, they would have to prescribe at the 30-patient limit for one year before requesting an increase to 100 patients, and then treat at the 100-patient limit for one year before requesting an increase to 275 patients.
Over the past several months, NASADAD has received an increasing number of questions about the State Targeted Response to the Opioid Crisis (STR) and State Opioid Response (SOR) grant programs, which are administered by the Substance Abuse and Mental Health Services Administration (SAMHSA). In response, we have created a timeline of STR and SOR that outlines key dates, such as: when grants were authorized; when Congress appropriated funds; when funding opportunity announcements (FOAs) were released; funding award periods for States for each of the grant programs; and more.
NASADAD has released a section-by-section summary of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act (P.L. 115-271). The SUPPORT Act was signed into law on October 24, 2018, and contains several provisions related to Medicaid, Medicare, FDA, CDC, SAMHSA, ONDCP, and more.
On September 28, 2018, President Trump signed into law H.R. 6157, the FY 2019 appropriations bill for the Department of Defense and the Departments of Labor, Health and Human Services (HHS), Education, and Related Agencies. The enrolled bill provides full-year funding (October 1, 2018-September 30, 2019) for programs within HHS, including the Substance Abuse and Mental Health Services Administration (SAMHSA) and other NASADAD priority programs. NASADAD created an overview of final FY 2019 funding levels for our priority programs within HHS, comparing them to FY 2018 levels.
On April 11, 2018, NASADAD’s Executive Director, Robert Morrison, testified before the Senate Health, Education, Labor, and Pensions (HELP) Committee during its seventh bipartisan hearing focused on the opioid crisis. The Committee, which is led by Chairman Lamar Alexander (R-TN) and Ranking Member Patty Murray (D-WA), released a discussion draft of the Opioid Crisis Response Act earlier in April, and during the hearing they sought input from witnesses on the bill, as well as other issues related to substance use disorders.
In addition to responding to certain provisions in the discussion draft, during his verbal testimony Mr. Morrison highlighted: the important role of the State alcohol and drug agencies; the critical role of the Substance Abuse Prevention and Treatment (SAPT) Block Grant as the cornerstone of the publicly funded system; and the use of State Targeted Response (STR) to the Opioid Crisis grant funds for comprehensive and innovative services.
Other witnesses who testified during the hearing were Jessica Hulsey Nickel, President and CEO of the Addiction Policy Forum (APF), and Jennifer Donahue, Child Abuse Investigation Coordinator for the Delaware Office of the Child Advocate.
Mr. Morrison’s written testimony, as well as the entire recording of the hearing, can be accessed here.
On February 12, 2018, the Administration released “Efficient, Effective, Accountable: An American Budget,” its budget proposal for fiscal year (FY) 2019 (October 1, 2018-September 30, 2019). NASADAD developed a summary of the Administration’s proposed funding levels for the Association’s priority programs within the Department of Health and Human Services (HHS), as well as select programs within the Department of Justice (DOJ) and the Office of National Drug Control Policy (ONDCP). The document compares the President’s FY 2019 proposal to the final FY 2018 funding levels that were included in the $1.3 trillion omnibus spending bill in March 2018.
Access NASADAD’s FY 2019 budget chart here.
On February 12, 2018, the Administration released “Efficient, Effective, Accountable: An American Budget,” its budget proposal for fiscal year (FY) 2019 (October 1, 2018-September 30, 2019). NASADAD has released a budget chart summarizing the Administration’s proposed funding levels for the Association’s priority programs within the Department of Health and Human Services (HHS), as well as select programs within the Department of Justice (DOJ). The chart compares the President’s FY 2019 proposal to the final FY 2018 funding levels that were included in the $1.3 trillion omnibus spending bill in March 2018.
Access the chart here.
On February 27, 2018, Senators Rob Portman (R-OH), Sheldon Whitehouse (D-RI), Shelley Moore Capito (R-WV), Amy Klobuchar (D-MN), Dan Sullivan (R-AK), Maggie Hassan (D-NH), Bill Cassidy (R-LA), and Maria Cantwell (D-WA) introduced “CARA 2.0,” a bill that aims to build upon the Comprehensive Addiction and Recovery Act (CARA) of 2016. CARA 2.0 increases the funding authorization levels of several CARA 2016 programs, and proposes policy changes to address the opioid crisis.
Access NASADAD’s summary of CARA 2.0 here.